Bipolar Disorder Research | Diagnosing Mental Disorders

Bipolar Disorder Research

Information from adoption, twin, and family, reports unequivocally prove the involvement of genetic factors powering bipolar disorder. Studies to date trigger the conclusion that within many families, bipolar disorder etiology is complicated, with vulnerability being caused by the interaction of several non-genetic and genetic factors. Researchers predict that identification of genes that confer vulnerability to bipolar disorder, as well as the brain proteins the genes code for make it probable to create improved diagnostic treatments, procedures, and preventive interventions aimed at the underlying sickness process.

The NIMH (National Institute of Mental Health) Bipolar Disorder Genetics Initiative, founded in 1989, continuously gathers genetic material, as well as state-of-the-art clinical and diagnostic information from families with more than two members affected with this disorder. The main objective of the initiative includes establishing a national resource which makes DNA and medical data broadly obtainable to eligible investigators within the scientific realm. The genetic and medical data is distributed within a way which keeps the researcher volunteers unknown. Ten research circles around the world are presently studying DNA and medical information from more than 650 people who have this disorder and associated illnesses within an effort to discover genes which confer vulnerability to this disorder.

Successful genetic research of complicated disorders such as bipolar disorder require extremely large samples that are drawn from multiple populations, and/or samples that are drawn from genetically isolated regions. To facilitate this type of research, recently NIMH funded 3 collaborative projects to gather information which significantly will augment the data already obtainable within the National Institute of Mental Health Bipolar Genetics Initiative.

Within one report, researchers at 9 research institutions around the U.S. will collect genetic and clinical information from a minimum of 500 families in which more than two siblings suffer with this disorder. In addition, Israeli and American scientists will utilize shared ways of information collection, clinical assessment, and diagnosis to study 300 other families. A 3rd project will study more than 300 families gathered from the realm of the Azores, a 9-island archipelago off of the coast of Portugal. National Institute of Mental Health additionally recently issued one Program Announcement that encouraged collaborations amongst genetic science groups around the world, by which several samples of bipolar pedigrees could be gathered into a single massive data set for combined assessment. New genetic assessments technologies and methods such as gene chips provide excellent potential for identifying certain gene sites that are responsible for vulnerability to this disorder in such massive family samples.

Brain Images

Technologies of brain imaging are assisting scientists in learning what hgoes wrong inside the brain to cause mental illness. National Institute of Mental Health researchers are utilizing enhanced imaging methods to assess brain structure and function in those who have this disorder.

One vital area of imaging science concentrates on characterizing and identifying enural circuits – networks of connected nerve cells inside the brain, interactions amongst which will form the basis for abnormal and normal behaviors. Scientists hypothesize that irregularities within the function and/or structure of specific brain circuits might underlie bipolar and additional mood disorders. Improved comprehension of the neural circuits included in regulating mood phases influence the creation of newer and better treatments, and ultimately will assist in diagnosis.

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Structural Images

NIMH supported considerable studies with the newer technology of MRI (magnetic resonance imaging) to assess the structure of brain tissue within different mental disorders, involving this disorder. The initial such reports appeared just within the last decade, with the pace of progress steadily increasing since this time. The objective of this research includes discovering the methods in which certain regions of the brain within those who have this disorder might vary from healthy people.

Amongst the most consistent discoveries to date was the appearance of certain irregularities, or lesions, within the white matter of a person’s brain in those who have this disorder. White matter comprises of clumps of nerve cell fibers that are surrounded by fatty sheaths which appear white in shade. The sheaths assist the transmission of electrical signals inside the brain. As the white matter irregularities appear within most portions of the brain within people who have this disorder, they’re usually concentrated in regions responsible for emotional processing.

The brain alterations rise in consistency with age in people who have bipolar disorder and people who have no mental illness, yet they appear more often than predicted in younger people who have this disorder. This discovery implies that the white matter irregularities witnessed with MRI are associated with the existence of bipolar disorder. But, a few patients who have this disorder don’t exhibit the white matter alterations, and conversely, a few entirely healthy people possess the lesions. Additionally, it isn’t clear yet whether these alterations contribute to the onset of bipolar disorder, or are within some way a consequence of becoming sick. As these MRI irregularities likely indicate a kind of malfunction within the brain circuits included in this disorder, more studies are clearly required to comprehend their significance and utility for early treatment and diagnosis.

Functional Images

Functional neuroimaging includes a vital tool for National Institute of Mental Health-supported scientists studying this disorder and additional mood disorders. Research utilizing PET (positron emission tomography), a method which measures brain functionality in terms of glucose metabolism or blood flow, have discovered irregular activity within certain brain areas involving the basal ganglia, prefrontal cortex, and temporal lobes within depressive and manic episodes. It isn’t known whether those functional irregularities are a consequence or cause of mood disorders.

As neurons become more active, the neurons demand for oxygen that is delivered through the blood supply, rises. Utilizing a unique measurement method referred to as an fMRI (functional magnetic resonance imaging), researchers could measure these alterations within blood oxygen levels inside various brain regions in healthy individuals and the ones who have certain brain disorders, involving bipolar and unipolar disorder and schizophrenia.

The method offers a great tool for comprehending how the brains of people who have mental disorders process data differently from healthy people, and for comprehending and also predicting how individuals who have these diseases may respond to various kinds of medication therapy.

Treatment Studies

The National Institute of Mental Health is committed to improving the treatments for this disorder, as well as is investing a considerable amount of researching effort in pursuit of this objective. Even though most individuals who have this disorder may be assisted by presently obtainable treatments, substantial challenges are still in effect. Rapid cycling includes a form of the sickness which is challenging to manage. Medicine side effects often are troublesome and may cause decreased treatment adherence. A few regimens operate well for years; then slowly lose their effectiveness. The National Institute of Mental Health scientists are operating at several levels – from neuroimaging to molecular genetics, to behavioral science, to medical trials – to study what underlies these, as well as additional treatment-associated issues and to apply this know-how towards the creation of improved treatments and advanced treatment plans.

 

Related links:

Bipolar Back Fact Sheet

National Quality Measures Clearinghouse

Sources:

Goodwin FK and Jamison KR, 1990. Bipolar illness. NY: Oxford University Press.

APA (American Psychiatric Association), 1994. Diagnostic & Statistical Mental Disorders Manual, Fourth Edition. Wash., DC: Am. Psychiatric Press.

Goodwin FK and Ghaemi SN, 1998. Understanding bipolar illness. General Psychiatry Archives, 55(1): 23-25.