Bipolar brain scan vs normal 

In this article, we will read about the brain scanning of people who are diagnosed with bi-polar, understand the differences between a normal scan and a scan of a person with bi-polar disorder, what is bi-polar disorder,how it is diagnosed and treated. 

In the United States, the illness affects about 2.8 percent of the adult population.

A doctor may use the following methods to diagnose bipolar disorder:

  • Conduct an interview with the person or ask questions about their symptoms
  • Conduct a physical examination
  • Advice a brain scan 

Currently, doctors utilise brain scans and blood tests to rule out other illnesses that could be generating symptoms that are similar to bipolar disorder.

Doctors may be able to utilise brain scans to assist diagnose this ailment in the future, according to new data.

Do doctors recommend brain scans for Bi-polar?

In general, brain scans are not recommended for the diagnosis of bipolar illness.

According to the Depression and Bipolar Support Alliance, a doctor may recommend a brain scan for a person with bipolar disease for two reasons.

The first reason is to see if symptoms are caused by something other than bipolar disorder, such as a stroke or a tumour. This is, however, a rare occurrence.

The second reason is that you  want to participate in research. Researchers are investigating whether there are identifiers in the brain that can aid in the diagnosis of bipolar disorder. The findings could aid a clinician in determining the difference between bipolar disorder and major depressive disorder.

According to researchers in a recent study published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, functional MRI (fMRI) may be the key to identifying specific neurons in the brain that are crucial to distinguishing bipolar disorder from depression.

In a press release, main author Mayuresh S. Korgaonkar, MD, noted, “Mental illness, particularly bipolar disorder and depression, can be difficult to identify because many illnesses have similar symptoms.” “Misdiagnosis can be harmful, resulting in poor social and economic results for patients who are being treated for a completely unrelated condition.”

What the research says 

The mechanism of bipolar disorder (BD) remains a mystery despite decades of investigation. Although structural changes in the brain have been linked to BD, the results of neuroimaging research have been mixed.

Researchers from the University of Sydney’s Westmead Institute for Medical Research used functional magnetic resonance imaging (fMRI) to see how the amygdala reacted when 81 patients processed anger, fear, sadness, disgust, and happiness

Thirty-one patients had remitted Bipolar I disorder, 25 had remitted Major Depressive Disorder, and another twenty-five were healthy controls.

In comparison to the 25 unipolar major depressive disorder patients, bipolar individuals had a less active and less linked left amygdala. The approach was able to distinguish the two with an accuracy of 80%.

These findings show that variations in amygdala activation and connectivity during facial emotion processing continue beyond depressive and manic phases, and could be a trait marker for distinguishing these diseases, according to Korgaonkar et al.

Read more about this study here 

Researchers examined MRI scans and visualisations to see whether there were any changes between patients with bipolar disorder and people in control groups in a 2018 study.

They discovered that when a person with bipolar disorder was neither in mania or depression, their brains responded in the same way as persons in the control group’s brains.

However, among those suffering from mania or depression, the researchers discovered brain alterations. Their visual cortices, in particular, altered appearance, demonstrating less activity than those in the control group.

Changes in sensory parts of the brain may potentially indicate bipolar disease, according to the study. Read more about the study here 

People with bipolar disorder have brain anomalies, according to a recent study.

A multinational team published new findings demonstrating that persons with bipolar illness had variations in the brain regions that control inhibition and emotion in the largest MRI study to date on patients with the disorder. 

The researchers analysed the MRI scans of 6,503 people, including 2,447 bipolar adults and 4,056 healthy controls. They also looked at the impact of common prescription drugs on cortical regions, as well as the age of illness beginning, history of psychosis, emotional state, and age and sex disparities.

When bipolar illness patients were compared to healthy controls, the researchers discovered grey matter loss in their brains. The frontal and temporal regions of the brain, which control inhibition and motivation, showed the most deficits.

Patients with bipolar disorder who had previously experienced psychosis had more grey matter impairments. Patients who were given lithium, antipsychotics, or anti-epileptic drugs had different brain signatures, according to the research. Treatment with lithium was linked to decreased grey matter thinning, implying that the drug has a brain-protective effect.

Cortical grey matter was found to be thinner in the frontal, temporal, and parietal regions of both cerebral hemispheres in another investigation. The left pars opercularis, left fusiform gyrus, and left rostral middle frontal cortex were the most affected by the disorder. 

Longer sickness duration was linked to lower cortical thickness in the frontal, medial parietal, and occipital regions (after accounting for age at the time of scanning). Even after accounting for patients who received numerous prescriptions, we discovered that several routinely prescribed medications, such as lithium, antiepileptic, and antipsychotic treatment, had substantial relationships with cortical thickness and surface area.

There was evidence of lower cortical surface area linked to a history of psychosis, but no link to mood at the time of scanning. Our research uncovered previously unknown relationships and provides a thorough examination of potential confounding variables in bi-polar disorder neuroimaging investigations. 

How is Bi-polar diagnosed?

To be diagnosed with bipolar disorder, a person must have undergone at least one manic episode, according to the National Alliance on Mental Illness.

A physical exam and a mental health interview are used to make a diagnosis. Currently, blood testing and imaging can be used to rule out other brain-damaging disorders.

A doctor will usually recommend a patient to a mental health specialist, such as a psychiatrist or psychologist, after an initial diagnosis. They can tell you what form of bipolar disorder you have.

The evaluation may include:

  • Examination of the body. A physical check and lab tests may be performed by your doctor to rule out any medical issues that could be causing your symptoms.
  • Psychiatric evaluation. Your doctor may send you to a psychiatrist, who will discuss your thoughts, feelings, and patterns of behaviour with you. A psychological self-assessment or questionnaire can also be completed. Family members or close friends may be asked to submit information on your symptoms with your approval.
  • Charting one’s mood. You may be requested to keep a daily journal of your moods, sleep habits, or other aspects that can aid in diagnosis and therapy selection.
  • Bipolar disorder criteria. Your psychiatrist may compare your symptoms to the criteria for bipolar and associated disorders in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Types of Bi-polar 

 Bi-polar I :When a person has bipolar I disorder, he or she has at least one manic episode and alternates between manic and depressed phases.

Bipolar II disorder is defined as a condition in which a person alternates between depression and hypomanic episodes but never has a full manic episode.

Cyclothymic disorder develops when a person has mild depression as well as hypomanic episodes for at least two years.

When a person exhibits mood elevations but does not meet the requirements for other bipolar types, they are classified as “other specified” or “unspecified.”

The Brain differences between Bi-poalr I and Bi-polar II 

The brains of persons with Bipolar 1 and Bipolar 2 disorders were compared in a study published in the Journal of Affective Disorders in December 2014. It was hypothesised that bipolar 1 patients’ brain structure and function differed significantly from bipolar 2 patients’.

The study looked at 31 people who had never been diagnosed with a mood disorder, 15 people who had bipolar one disorder, and 16 people who had bipolar two disease.

There was a considerable reduction in the size of the prefrontal cortex on the right side of the brain, in an area known as the medial orbitofrontal region, in bipolar one individuals. This area of the brain appears to play a key role in determining the benefits and hazards of behaviour. 

Other studies have discovered lower brain activity in this area, which has been linked to manic episodes. Of course, one of the characteristics of mania is a loss of awareness of the dangers of one’s actions. As a result, this conclusion is consistent with prior bipolar research.

In bipolar 2 patients, however, there were no variations in brain volume as compared to controls. However, utilising DTI imaging, there were substantial changes that indicated possible white matter impairment in the brains of persons with bipolar 2. The ramifications of this finding in terms of function and whether it is a cause or a result of the disorder are unclear, however it was most prevalent in patients with bipolar 2.

In conclusion, variations in brain structure were discovered in bipolar 1 patients but not in bipolar 2 patients in this investigation. 

In bipolar 2 patients, however, there were more abnormalities in white matter function, which had a diffuse effect on brain connections. 

The alterations in brain structure identified in bipolar one associated with the severity of the condition, but the abnormalities in white matter seen in bipolar 2 did not, therefore the relevance of these findings is less evident.

The bottom line 

Bipolar disorder patients’ brain scans may show various abnormalities or anomalies. Physical differences may exist, as well as decreased or increased cerebral activity.

Doctors do not currently use brain imaging to diagnose bipolar illness. More evidence may help clinicians utilise MRI scans or other imaging equipment to accurately identify bipolar disorder as research progresses.

Conclusion 

In this article, we read about different studies that were conducted on people with bi-polar disorder, the different results that were found, how is bi-polar diagnosed, the types of bi-polar and the differences between bi-polar I and bi-polar II patient’s brain structure. 

FAQs

 Can bi-polar be seen on a brain scan? 

Bipolar disorder patients’ brain scans may show various abnormalities or anomalies. Physical differences may exist, as well as decreased or increased cerebral activity. Doctors do not currently use brain scans to diagnose bipolar disorder.

Does a bi-polar brain look different?

Gray matter deficits in frontal brain regions involved in self-control (orange colours) are common in bipolar patients, while sensory and visual regions are normal (gray colors)

Does bi-polar damage the brain? 

Bipolar episodes cause a reduction in brain growth and, potentially, intelligence. Each manic or depressive episode destroys grey matter in the brains of patients with bipolar disorder.

Which part of the brain is responsible for bi-polar?

In a new study, a decrease in volume in specific areas of the brain’s hippocampus, which has long been thought to be a centre of mood and memory processing, was associated to bipolar disorder.

References 

https://www.technologynetworks.com/neuroscience/news/mri-study-of-bipolar-sufferers-reveals-structural-differences-288248
https://www.nature.com/articles/mp201773

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