Bipolar Disorder Ravages the Brain's Self-Control Regions

Bipolar disorder affects about 60 million people worldwide, according to the World Health Organization. And despite decades of study, scientists remain unsure about its underlying neurological mechanisms. However, a new study reveals brain abnormalities in people with the condition. Knowing that bipolar brains are physically different could lead to new methods of treatment, and even early detection and prevention.

The study, published in Molecular Psychiatry, involved a global consortium of researchers examining MRI scans of more than 6,500 brains; about 2,500 were taken of people with bipolar. Researchers discovered that those brains showed differences in the regions that control inhibition and emotion.

That makes sense, as the disorder is characterized by episodes of mania (elevated or irritable mood and inflated self-esteem, among other symptoms) and depression, separated by periods of normal mood. (A similar project recently discovered physical abnormalities in ADHD brains.)

Specifically, the study found that patients with bipolar disorder showed thinning of gray matter in their brains compared to the healthy subjects. The deficit was most pronounced in the frontal and temporal regions—areas associated with self-control. Meanwhile, the areas of the brain responsible for visual and sensory information were largely similar.

The researchers also looked at how brains were affected by common prescription medicines. Patients who'd taken lithium, anti-psychotics, and anti-epileptic treatments showed different brain signatures—those who'd taken lithium had less thinning of gray matter, suggesting the drug may offer some protective benefit for the brain. The study also collected information about participants' age of illness onset, history of psychosis, mood state, age, and sex differences. That data could prove useful in the future.

"We created the first global map of bipolar disorder and how it affects the brain, resolving years of uncertainty on how people's brains differ when they have this severe illness," Ole A. Andreassen, senior author of the study and a professor at the Norwegian Centre for Mental Disorders Research at the University of Oslo, said in a statement.

Scientists now have a roadmap that can help guide treatment; future research will test how different approaches might affect these brain measurements, and how that relates to symptoms and clinical effects. Thanks to a worldwide, collective effort, medical science now has an important new understanding of bipolar disorder, and a plan for moving forward.

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