Skip to main content

fMRI comparison between bipolar I and bipolar II disorders

Author/s
Melissa Ng
Citation
Issue 3 Summer 2013
CEPiP.2013;1:131-135
Abstract

Bipolar disorders are mood disorders characterised by manic (bipolar I disorder,) or hypomanic episodes and major depressive episodes (bipolar II disorder). These have been reworked into the model of bipolar spectrum disorder, where manic symptom load increases from unipolar depression to bipolar II to bipolar I. In this article we consider the fMRI findings for bipolar I, bipolar II and major depressive disorder (MDD) and conclude that bipolar disorder and MDD do not share the same pattern of neural disturbance. The distinction between bipolar I and bipolar II is less clear, as the data is still preliminary in nature, but the two disorders appear to share a similar pattern of brain activity. This fMRI data suggests that the bipolar spectrum model still requires refining, but provides a useful framework upon which to base future research into affective disorders.

Keywords: bipolar disorder, mood disorders, bipolar spectrum, fMRI, neuroimaging

Cite as: Cutting Edge Psychiatry in Practice 2013, 3(1):131-135; https://doi.org/10.65031/vuoc5712

References

  1. Phelps J, Angst J, Katzow J, Sadler J. Validity and utility of bipolar spectrum models. Bipolar Disord. 2008;10 (1 Pt 2):179-193. https://doi.org/10.1111/j.1399-5618.2007.00562.x
  2. Kuiper S, McLean L, Malhi GS. To BD or not to BD: functional neuroimaging and the boundaries of bip larity. Expert Rev. Neurother. 2013;13 (1):75-87. https://doi.org/10.1586/ern.12.126
  3. Savitz J, Drevets WC. Bipolar and major depressive disorder: neuroimaging the developmental- degenerative divide. Neurosci. Biobehav. Rev. 2009;33 (5):699-771. https://doi.org/10.1016/j.neubiorev.2009.01.004
  4. Chen CH, Suckling J, Lennox BR, Ooi C, Bullmore ET. A quantitative meta-analysis of fMRI studies in bipolar disorder. Bipolar Disord. 2011;13 (1):1-15. https://doi.org/10.1111/j.1399-5618.2011.00893.x
  5. Houenou J, Frommberger J, Carde S, et al. Neuroimaging-based markers of bipolar disorder: evidence from two meta-analyses. J. Affect. Disord. 2011;132 (3):344-355. https://doi.org/10.1016/j.jad.2011.03.016
  6. Delvecchio G, Fossati P, Boyer P, et al. Common and distinct neural correlates of emotional processing in Bipolar Disorder and Major Depressive Disorder: a voxel-based meta-analysis of functional magnetic resonance imaging studies. Eur. Neuropsychopharmacol. 2012;22 (2):100-113. https://doi.org/10.1016/j.euroneuro.2011.07.003
  7. Kupferschmidt DA, Zakzanis KK. Toward a functional neuroanatomical signature of bipolar disorder: quantitative evidence from the neuroimaging literature. Psychiatry Res. 2011;193 (2):71-79. https://doi.org/10.1016/j.pscychresns.2011.02.011
  8. Malhi GS, Lagopoulos J, Sachdev PS, Ivanovski B, Shnier R. An emotional Stroop functional MRI study of euthymic bipolar disorder. Bipolar Disord. 2005;7 (Suppl. 5):58-69. https://doi.org/10.1111/j.1399-5618.2005.00255.x
  9. Altshuler L, Bookheimer S, Townsend J, et al. Regional brain changes in bipolar I depression: a functional magnetic resonance imaging study. Bipolar Disord. 2008;10 (6):708-717. https://doi.org/10.1111/j.1399-5618.2008.00617.x
  10. Hassel S, Almeida JR, Frank E, et al. Prefrontal cortical and striatal activity to happy and fear faces in bipolar disorder is associated with comorbid substance abuse and eating disorder. J. Affect. Disord. 2009;118 (1-3):19-27. https://doi.org/10.1016/j.jad.2009.01.021
  11. Robinson JL, Monkul ES, Tordesillas-Gutiérrez D, et al. Fronto-limbic circuitry in euthymic bipolar disorder: evidence for prefrontal hyperactivation. Psychiatry Res. 2008;164 (2):106-113. https://doi.org/10.1016/j.pscychresns.2007.12.004
  12. Lennox BR, Jacob R, Calder AJ, Lupson V, Bullmore ET. Behavioural and neurocognitive responses to sad facial affect are attenuated in patients with mania. Psychol. Med. 2004;34 (5):795-802. https://doi.org/10.1017/s0033291704002557
  13. al-Mousawi AH, Evans N, Ebmeier KP, Roeda D, Chaloner F, Ashcroft GW. Limbic dysfunction in schizophrenia and mania. A study using 18F-labelled flurodeoxyglucose and positron emission tomography. Br. J. Psychiatry. 1996;169 (4):509-516. https://doi.org/10.1192/bjp.169.4.509
  14. Hulvershorn LA, Karne H, Gunn AD, et al. Neural activation during facial emotion processing in unmedicated bipolar depression, euthymia, and mania. Biol. Psychiatry. 2012;71 (7):603-610. https://doi.org/10.1016/j.biopsych.2011.10.038
  15. Wessa M, Houenou J, Paillère-Martinot ML, et al. Fronto-striatal overactivation in euthymic bipolar patients during an emotional go/nogo task. Am. J. Psychiatry. 2007;164 (4):638-646. https://doi.org/10.1176/ajp.2007.164.4.638
  16. Mah L, Zarate CAJr, Singh J, et al. Regional cerebral glucose metabolic abnormalities in bipolar II depression. Biol. Psychiatry. 2007;61 (6):765-775. https://doi.org/10.1016/j.biopsych.2006.06.009
  17. Ladouceur CD, Farchione T, Diwadkar V, et al. Differential patterns of abnormal activity and connectivity in the amygdala-prefrontal circuitry in bipolar-I and bipolar-NOS youth. J. Am. Acad. Child Adolesc. Psychiatry. 2011;50 (12):1275-1289.e2. https://doi.org/10.1016/j.jaac.2011.09.023
  18. Rigucci S, Serafini G, Pompili M, Kotzalidis GD, Tatarelli R. Anatomical and functional correlates in major depressive disorder: the contribution of neuroimaging studies. World J. Biol. Psychiatry. 2010;11 (2 Pt 2):165-180. https://doi.org/10.1080/15622970903131571
  19. Lawrence NS, Williams AM, Surguladze S, et al. Subcortical and ventral prefrontal cortical neural responses to facial expressions distinguish patients with bipolar disorder and major depression. Biol. Psychiatry. 2004;55 (6):578-587. https://doi.org/10.1016/j.biopsych.2003.11.017
  20. Marchand WR, Yurgelun-Todd D. Striatal structure and function in mood disorders: a comprehensive review. Bipolar Disord. 2010;12 (8):764-785. https://doi.org/10.1111/j.1399-5618.2010.00874.x
  21. Caligiuri MP, Brown GG, Meloy MJ, Eberson S, Niculescu AB, Lohr JB. Straitopallidal regulation of affect in bipolar disorder. J. Affect. Disord. 2006;91 (2-3):235-242. https://doi.org/10.1016/j.jad.2006.01.014
  22. Malhi GS, Lagopoulos J, Sachdev P, Mitchell PB, Ivanovski B, Parker GB. Cognitive generation of affect in hypomania: an fMRI study. Bipolar Disord. 2004;6 (4):271-285. https://doi.org/10.1111/j.1399-5618.2004.00123.x
  23. Ketter TA, Kimbrell TA, George MS, et al. Effects of mood and subtype on cerebral glucose metabolism in treatment-resistant bipolar disorder. Biol. Psychiatry. 2001;49 (2):97-109. https://doi.org/10.1016/s0006-3223(00)00975-6
  24. Chang KD, Wager C, Garrett A, Howe M, Reiss A. A preliminary functional magnetic resonance imaging study of prefrontal-amygdalar activation changes in adolescents with bipolar depression treated with lamotrigine. Bipolar Disord. 2008;10 (3):426-431. https://doi.org/10.1111/j.1399-5618.2007.00576.x
  25. Marchand WR, Lee JN, Garn C, et al. Striatal and cortical midline activation and connectivity associated with suicidal ideation and depression in bipolar II disorder. J. Affect. Disord. 2011;133 (3):638-645. https://doi.org/10.1016/j.jad.2011.04.039
  26. Dichter GS, Kozink RV, McClernon FJ, Smoski MJ. Remitted major depression is characterized by reward network hyperactivation during reward anticipation and hypoactivation during reward outcomes. J. Affect. Disord. 2012;136 (3):1126-1134. https://doi.org/10.1016/j.jad.2011.09.048
  27. Drevets WC, Price JL, Simpson JRJr, et al. Subgenual prefrontal cortex abnormalities in mood disorders. Nature. 1997;386 (6627):824-827. https://doi.org/10.1038/386824a0
  28. Dunn RT, Kimbrell TA, Ketter TA, et al. Principal components of the Beck Depression Inventory and regional cerebral metabolism in unipolar and bipolar depression. Biol. Psychiatry. 2002;51 (5): 387-399. https://doi.org/10.1016/s0006-3223(01)01244-6
  29. Blumberg HP, Stern E, Martinez D, et al. Increased anterior cingulate and caudate activity in bipolar mania. Biol. Psychiatry. 2000;48 (11):1045-1052. https://doi.org/10.1016/s0006-3223(00)00962-8
  30. Haldane M, Jogia J, Cobb A, Kozuch E, Kumari V, Frangou S. Changes in brain activation during working memory and facial recognition tasks in patients with bipolar disorder with lamotrigine monotherapy. Eur. Neuropsychopharmacol. 2008;18 (1):48-54. https://doi.org/10.1016/j.euroneuro.2007.05.009
  31. Drevets WC, Savitz J, Trimble M. The subgenual anterior cingulate cortex in mood disorders. CNS Spectr. 2008;13 (8):663-681. https://doi.org/10.1017/s1092852900013754
  32. Bertocci MA, Bebko GM, Mullin BC, et al. Abnormal anterior cingulate cortical activity during emotional n-back task performance distinguishes bipolar from unipolar depressed females. Psychol. Med. 2012;42 (7):1417-1428. https://doi.org/10.1017/s003329171100242x
  33. Altshuler L, Bookheimer S, Proenza MA, et al. Increased amygdala activation during mania: a functional magnetic resonance imaging study. Am. J. Psychiatry. 2005;162 (6):1211-1213. https://doi.org/10.1176/appi.ajp.162.6.1211
  34. Lagopoulos J, Malhi GS. A functional magnetic resonance imaging study of emotional Stroop in euthymic bipolar disorder. Neuroreport. 2007;18 (15):1583-1587. https://doi.org/10.1097/wnr.0b013e3282efa07a
  35. Marchand WR, Lee JN, Garn C, et al. Aberrant emotional processing in posterior cortical midline structures in bipolar II depression. Prog. Neuropsychopharmacol. Biol. Psychiatry. 2011;35 (7): 1729-1737. https://doi.org/10.1016/j.pnpbp.2011.05.017
  36. Light SN, Heller AS, Johnstone T, et al. Reduced right ventrolateral prefrontal cortex activity while inhibiting positive affect is associated with improvement in hedonic capacity after 8 weeks of antidepressant treatment in major depressive disorder. Biol. Psychiatry. 2011;70 (10):962-968. https://doi.org/10.1016/j.biopsych.2011.06.031
  37. Lemogne C, Niedhammer I, Khlat M et al.; Lorhandicap group. Gender differences in the association between depressive mood and mortality: a 12-year follow-up population-based study. J. Affect. Disord. 2012;136 (3):267-275. https://doi.org/10.1016/j.jad.2011.11.041
  38. Kaladjian A, Jeannigros R, Azorin JM, et al. Remission from mania is associated with a decrease in amygdala activation during motor response inhibition. Bipolar Disord. 2009;11 (5):530-538. https://doi.org/10.1111/j.1399-5618.2009.00722.x
  39. Fusar-Poli P, Howes O, Bechdolf A, Borgwardt S. Mapping vulnerability to bipolar disorder: a systematic review and meta-analysis of neuroimaging studies. J. Psychiatry Neurosci. 2012;37 (3):170-184. https://doi.org/10.1503/jpn.110061
  40. Delaveau P, Jabourian M, Lemogne C, Guionnet S, Bergouignan L, FossatiBrain effects of antidepressants in major depression: a meta-analysis of emotional processing studies. J. Affect. Disord. 2011;130 (1-2):66-74. https://doi.org/10.1016/j.jad.2010.09.032
  41. Ramel W, Goldin PR, Eyler LT, Brown GG, Gotlib IH, McQuaid JR. Amygdala reactivity and mood- congruent memory in individuals at risk for depressive relapse. Biol. Psychiatry. 2007;61 (2): 231-239. https://doi.org/10.1016/j.biopsych.2006.05.004
  42. Anderson IM, Juhasz G, Thomas E, et al. The effect of acute citalopram on face emotion processing in remitted depression: a pharmacoMRI study. Eur. Neuropsychopharmacol. 2011;21 (1):140-148. https://doi.org/10.1016/j.euroneuro.2010.06.008
  43. Arnold JF, Fitzgeral DA, Fernández G, et al. Rose or black-coloured glasses? Altered neural processing of positive events during memory formation is a trait marker of depression. J. Affect. Disord. 2011;131 (1-3):214-223.                 
  44. Chen CH, Suckling J, Ooi C, et al. A longitudinal fMRI study of the manic and euthymic states of bipolar disorder. Bipolar Disord. 2010;12 (3):344-347. https://doi.org/10.1111/j.1399-5618.2010.00801.x
  45. Van der Schot A, Kahn R, Ramsey N, Nolen W, Vink M. Trait and state dependent functional impairments in bipolar disorder. Psychiatry Res. 2010;184 (3):135-142. https://doi.org/10.1016/j.pscychresns.2010.07.009