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New insights into bipolar disorder using novel imaging technologies
Abstracts / Journal of Affective Disorders 107 (2008) S21–S52
Sachs, G.S., et al., 2007. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N. Engl. J. Med. 356 (17), p. 1711–22. Peet, M., 1994. Induction of mania with selective serotonin re-uptake inhibitors and tricyclic antidepressants. Br. J. Psychiatry 164 (4), p. 549–50. Calabrese, J.R., et al., 2002. Long-term treatment of bipolar disorder with lamotrigine. J. Clin. Psychiatry 63 (Suppl 10), p. 18–22.
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References: Malhi, G.S., Ivanovski, B., Hadzi-Pavlovic, D., et al., 2007. Neuropsychological deficits and functional impairment in bipolar depression, hypomania and euthymia. Bipolar Disorders 9 (1–2), 114–125. Torres, I.J., Boudreau, V.G., Yatham, L.N., 2007. Neuropsychological functioning in euthymic bipolar disorder: a meta-analysis. Acta Psychiatrica Scandinavica 116, (S434), 17–26. doi:10.1016/j.jad.2007.12.216
doi:10.1016/j.jad.2007.12.215
Symposium 14 13.3 Clinical and research tools for measuring cognition in bipolar disorder G. Malhia,⁎, I. Torresb, L. Yathamc a University of Sydney, Sydney, Australia b Simon Fraser University, Canada c International Society for Bipolar Disorders & University of British Columbia, Canada In recent years, it has become apparent that in addition to the discernible cognitive compromise patients with bipolar disorder experience when depressed or manic, their neurocognition is also impaired when euthymic (Malhi et al., 2007). Deficits of cognition in remitted and seemingly well patients are important for two main reasons. Firstly they may serve as potential trait markers of the disorder and reflect core pathology of the illness (Torres et al., 2007). Secondly, the deficits correlate with functional impairment and therefore it is important to develop effective therapeutic strategies that target this neurocognitive compromise. For this, we need to develop a “standardised” neurocognitive battery. An ISBD task force has been convened to create a standard set of tests. Tests have been included in the proposed battery on the basis of their sensitivity to identifying bipolar disorder, their ability to assess neuropsychological deficits that accurately appraise neurocognition and those that may potentially identify trait markers of the illness. Tests have also been included that capture social and emotional processing and regulation, and together ensure that a range of cognitive domains are assessed. The reason for developing such a battery is to encourage different research groups to utilise common methodologies and assessment tools worldwide so that data sets can be combined or compared. In so doing a reliable profile of the neurocognitive deficits associated with bipolar disorder should eventually emerge and this should also allow correlation of cognitive measures with neural system substrates, genetic markers and psychosocial function.
New insights into bipolar disorder using novel imaging technologies Symposium Leader: D.L. Dunner University of Washington, USA 14 (overview) Recent developments in magnetic resonance technology have provided new insights into the neurobiological alterations that are present in persons with bipolar disorder. Dr. In Kyoon Lyoo will review the application of cortical thickness measurement, shape analysis, and voxel-based morphometry to studies of bipolar disorder. These studies document the differential effects of both illness and treatment on brain anatomy. Dr. Deborah Yurgelun-Todd will highlight the use of functional magnetic resonance imaging (fMRI) to characterize alterations in cerebral activity that are associated with bipolar disorder in different mood states. Central to this work is the emerging evidence for a failure of appropriate regulation of limbic structures by the prefrontal cortex. Dr. Perry Renshaw will summarize a range of magnetic resonance spectroscopy (MRS) findings that suggest bipolar disorder is characterized by mitochondrial dysfunction. These studies have led to the evaluation of pyrimidines as potential, novel treatments for bipolar disorder. Dr. Stephen Dager will provide an assessment of the extent to which some of these brain changes are present in both bipolar and panic disorder. This overlap suggests that both disorders are associated with significant metabolic dysfunction. Finally, Dr. David Dunner will present a discussion on the clinical significance of these observations for more objective diagnosis and treatment of bipolar disorder. doi:10.1016/j.jad.2007.12.217
Sachs, G.S., et al., 2007. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N. Engl. J. Med. 356 (17), p. 1711–22. Peet, M., 1994. Induction of mania with selective serotonin re-uptake inhibitors and tricyclic antidepressants. Br. J. Psychiatry 164 (4), p. 549–50. Calabrese, J.R., et al., 2002. Long-term treatment of bipolar disorder with lamotrigine. J. Clin. Psychiatry 63 (Suppl 10), p. 18–22.
S49
References: Malhi, G.S., Ivanovski, B., Hadzi-Pavlovic, D., et al., 2007. Neuropsychological deficits and functional impairment in bipolar depression, hypomania and euthymia. Bipolar Disorders 9 (1–2), 114–125. Torres, I.J., Boudreau, V.G., Yatham, L.N., 2007. Neuropsychological functioning in euthymic bipolar disorder: a meta-analysis. Acta Psychiatrica Scandinavica 116, (S434), 17–26. doi:10.1016/j.jad.2007.12.216
doi:10.1016/j.jad.2007.12.215
Symposium 14 13.3 Clinical and research tools for measuring cognition in bipolar disorder G. Malhia,⁎, I. Torresb, L. Yathamc a University of Sydney, Sydney, Australia b Simon Fraser University, Canada c International Society for Bipolar Disorders & University of British Columbia, Canada In recent years, it has become apparent that in addition to the discernible cognitive compromise patients with bipolar disorder experience when depressed or manic, their neurocognition is also impaired when euthymic (Malhi et al., 2007). Deficits of cognition in remitted and seemingly well patients are important for two main reasons. Firstly they may serve as potential trait markers of the disorder and reflect core pathology of the illness (Torres et al., 2007). Secondly, the deficits correlate with functional impairment and therefore it is important to develop effective therapeutic strategies that target this neurocognitive compromise. For this, we need to develop a “standardised” neurocognitive battery. An ISBD task force has been convened to create a standard set of tests. Tests have been included in the proposed battery on the basis of their sensitivity to identifying bipolar disorder, their ability to assess neuropsychological deficits that accurately appraise neurocognition and those that may potentially identify trait markers of the illness. Tests have also been included that capture social and emotional processing and regulation, and together ensure that a range of cognitive domains are assessed. The reason for developing such a battery is to encourage different research groups to utilise common methodologies and assessment tools worldwide so that data sets can be combined or compared. In so doing a reliable profile of the neurocognitive deficits associated with bipolar disorder should eventually emerge and this should also allow correlation of cognitive measures with neural system substrates, genetic markers and psychosocial function.
New insights into bipolar disorder using novel imaging technologies Symposium Leader: D.L. Dunner University of Washington, USA 14 (overview) Recent developments in magnetic resonance technology have provided new insights into the neurobiological alterations that are present in persons with bipolar disorder. Dr. In Kyoon Lyoo will review the application of cortical thickness measurement, shape analysis, and voxel-based morphometry to studies of bipolar disorder. These studies document the differential effects of both illness and treatment on brain anatomy. Dr. Deborah Yurgelun-Todd will highlight the use of functional magnetic resonance imaging (fMRI) to characterize alterations in cerebral activity that are associated with bipolar disorder in different mood states. Central to this work is the emerging evidence for a failure of appropriate regulation of limbic structures by the prefrontal cortex. Dr. Perry Renshaw will summarize a range of magnetic resonance spectroscopy (MRS) findings that suggest bipolar disorder is characterized by mitochondrial dysfunction. These studies have led to the evaluation of pyrimidines as potential, novel treatments for bipolar disorder. Dr. Stephen Dager will provide an assessment of the extent to which some of these brain changes are present in both bipolar and panic disorder. This overlap suggests that both disorders are associated with significant metabolic dysfunction. Finally, Dr. David Dunner will present a discussion on the clinical significance of these observations for more objective diagnosis and treatment of bipolar disorder. doi:10.1016/j.jad.2007.12.217