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Brain activation patterns in anticipation of rewards can help identify those most at risk for developing bipolar spectrum disorder (BPSD), according to a study conducted in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, published by Elsevier. Mania in people with BPSD often accompanies impulsivity, including impulsive reactions to potential rewards. In the study, patterns of neuronal activation during a reward task predicted the severity of the manic symptom in young adults who had not yet developed the disorder.
"Since emerging manic symptoms predispose to bipolar disorder, these findings may provide neural biomarkers that facilitate early identification of the risk of bipolar disorder in young adults," said Leticia de Oliveira, PhD, University's first author Federal Fluminense, Brazil.
Having a family member with BPSD puts a person at risk of developing the disorder, but the relationship does not provide enough information to make decisions about potential interventions that may delay or prevent the disorder. The new study shows for the first time that brain activation patterns could be used to predict the risk of BPSD at the individual level. "These findings could potentially be used to guide the development and choice of early therapeutic interventions, thereby reducing the significant social costs and deleterious consequences badociated with the disorder in these vulnerable people," said Dr. Oliveira.
To ensure that the approach would apply to anyone at risk, Dr. Oliveira and his colleagues performed brain imaging in a group of transdiagnostic young adults – participants had various psychiatric complications, but none had further developed from BPSD.
Across the brain, activation in a region of the brain used in decision-making in reward settings, called ventrolateral prefrontal cortex (vLPFC), has contributed most to the prediction of symptom severity. This suggests that the activity of the vLPFC in particular may be useful for predicting the severity of mania symptoms badociated with the risk of DSPB in young adults.
"This study shows how the powerful combination of functionally focused computer-based image badysis and fMRI tools (in this case, reward processing) can provide valuable insights." information on neural systems underlying symptoms that may indicate manic responsibility in a young non-bipolar transdiagnostic group of psychiatric patients, "said Cameron Carter, MD, editor-in-chief of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.
The researchers replicated the results and role of the vlPFC in a second independent sample of young adults from the same study, thus confirming the potential utility of neuronal activation in this brain region as a biomarker of risk of DSPB.
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