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Diverse pathophysiological processes converge on network disruption in mania.

Ivy Lee1, Kathryn Nielsen2, Uzma Nawaz1

  • 1Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.

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Brain lesions causing mania disrupt specific brain networks. These disruptions are also seen in bipolar disorder mania, suggesting shared circuit dysfunction in mood disorders.

Keywords:
BipolarDisorderLesionManiaNetworkfMRI

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Neuroimaging

Background:

  • Establishing causality in psychiatric neuroimaging is challenging.
  • Lesions causing mania offer a unique model to study brain network disruption in mania and bipolar disorder.

Purpose of the Study:

  • To identify specific brain networks disrupted by mania-inducing lesions.
  • To investigate if these network disruptions are present in bipolar disorder.

Main Methods:

  • Literature review of 23 case reports with mania-causing lesions.
  • Resting-state functional Magnetic Resonance Imaging (rsfMRI) to analyze connectivity to lesions.
  • Examination of rsfMRI connectivity in bipolar disorder patients across manic and euthymic states and healthy controls.

Main Results:

  • Mania-inducing lesions showed overlapping network connectivity.
  • These lesions selectively disrupted networks involving the orbitofrontal cortex, dorsolateral prefrontal cortex, and temporal lobes.
  • Bipolar mania exhibited significant disruption in network communication between these regions and the amygdala and ventro-lateral prefrontal cortex.

Conclusions:

  • Lesions causing mania reveal shared and specific network disruptions.
  • These disruptions are also evident in bipolar mania, indicating convergent circuit dysfunction across disorders.
  • Findings suggest a common pathophysiology for mania involving disrupted brain networks.