The patterns of brain activation during the expected reward can help identify individuals who are at highest risk of developing bipolar disorder spectrum (BPSD), according to research in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, published by Elsevier. Mania in BPSD people is often accompanied by impulsiveness, including impulsive responses to potential rewards. In the study, patterns of neural activation during the reward task predicted the severity of the symptoms of mania in young adults who had not yet developed the disorder.
Bearing in mind that manic symptoms predispose bipolar disorders, these findings can provide neuronal biomarkers for early detection of the risk of bipolar disorder in young adults.
First author of Leticia de Oliveira, PhD, Federal Fluminense University, Brazil
Having a family member with BPSD places the person at risk of that disorder, but this relationship does not provide enough information to make decisions about possible interventions to delay or prevent a disorder. The new study for the first time showed that brain activation patterns can be used to predict BPSD risks at the individual level. "These findings could potentially be used to guide the development and selection of early therapeutic interventions, to reduce significant social costs and harmful outcome-related disorders in these endangered individuals," says Dr. Oliveira.
To make sure that the approach will apply to anyone in danger, dr. Oliveira and colleagues performed brain imaging in a transgagnostic group of young adults – participants had different psychiatric complications, but none of them had yet developed BPSD.
From the whole brain, activation in the brain region used in decision-making in the context of rewarding, called the ventrolateral prefrontal cortex (vlPFC), has contributed most to predicting the severity of symptoms. This suggests that vlPFC activity is particularly useful for predicting the severity of maniac symptoms associated with BPSD risk in young adults.
This study shows that a powerful combination of computer imaging tools and a functionally targeted task of fMRI (in this case remedy treatment) can provide insights into neuronal systems that are the underlying symptoms that may indicate responsibility for mania, in a young, non-bipolar transdiggency group psychiatric patients. "
Cameron Carter, MD, Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
The researchers replicated the results and role of vlPFC in another independent sample of young adults in the same study, further confirming the potential usefulness of neural activation in this brain area as biomarkers for BPSD risk.
Reference of the journal:
Phillips, M.L. et al. (2019) Prediction of risk factors for bipolar disorder in impaired young adults from brain activation model to reward: machine learning approach. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. doi.org/10.1016/j.bpsc.2019.04.005.