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Longitudinal brain functional changes between mania and euthymia in bipolar disorder.

Silvia Alonso-Lana1,2, Noemí Moro3,4, Peter J McKenna1,2

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Summary

Bipolar disorder recovery shows normalized brain activation in key areas like the dorsolateral prefrontal cortex (DLPFC) and parietal cortex. However, ventromedial prefrontal cortex (vmPFC) abnormalities persist, suggesting a trait marker.

Keywords:
bipolar disorderdefault-mode networkfMRIfollow-upworking memory

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Brain Imaging

Background:

  • Bipolar disorder is characterized by widespread brain functional abnormalities.
  • Longitudinal studies examining brain changes during different illness phases, particularly mania and recovery, are limited.

Purpose of the Study:

  • To investigate longitudinal changes in brain function during mania and recovery in bipolar disorder patients.
  • To compare task-related brain activation and deactivation patterns between manic patients, recovered patients, and healthy controls.

Main Methods:

  • Functional magnetic resonance imaging (fMRI) was used to scan 26 bipolar patients during a working memory task (n-back) in manic and recovered states.
  • Twenty-six matched healthy controls were scanned twice for comparison.
  • Task-related brain activations and deactivations were analyzed.

Main Results:

  • Manic patients exhibited reduced activation in the left dorsolateral prefrontal cortex (DLPFC)/precentral cortex and bilateral parietal cortex/superior precuneus.
  • Failure of deactivation was observed in the ventromedial prefrontal cortex (vmPFC) during mania.
  • Following recovery, DLPFC and parietal activation normalized, but vmPFC deactivation failure persisted.

Conclusions:

  • Recovery from mania is linked to the normalization of hypoactivation in the DLPFC and parietal cortex.
  • Persistent failure of deactivation in the vmPFC suggests it may represent a trait abnormality in bipolar disorder.