A new UK report suggests clinicians are a step closer to personalizing treatment and prevention for manic-depressive illness – also known as bipolar disorder.
Their research has shown why some people are more at risk and why others are more resilient to genetic and environmental factors underlying bipolar disorder.
Bipolar disorder occurs when the brain cannot regulate mood effectively, leading to mood swings.
Around 300,000 people in the UK have the disorder. Coping with bipolar disorder can be very trying for patients and their families and may lead to difficulties and setbacks in relationships, work and education. Relatives of people with bipolar disorder are at higher risk for a range of mood disorders but about 60 percent of them remain well.
Speaking at a meeting of the Biochemical Society in London, Dr. Sophia Frangou said, “We know a lot about what makes people vulnerable to bipolar disorder, but most people who are at risk remain well,” she said. “We wanted to find out what keeps them well.”
Dr. Frangou and her team from the Institute of Psychiatry in London examined how genetic risk factors translate into changes in the brain’s networks using a series of brain imaging studies involving 227 relatives from 53 families where one member had bipolar illness.
The participants were in the scanner for one hour and they also took part in cognitive tests designed to engage brain networks involved in emotional processing, decision-making, working memory and attention.
“We found that genetic risk to bipolar disorder was associated with overactivity within brain regions that process emotion, such as the amygdala. However, we also found that it was the function of another brain region, called the prefrontal cortex that seemed to differentiate those who became unwell compared to those who did not.
“In people who remained well, despite their genetic risk for bipolar disorder, the function of the prefrontal cortex also remained intact while this was compromised in those who developed the illness.”
Further analysis of the complexities of what makes a person at risk or resilient to bipolar disorder is required but this research suggest that it may soon be possible to advise people with a family history of bipolar disorder about their individual risk or resilience.
“Being a risk of bipolar disorder does not mean that developing the illness is inescapable,” said Dr. Frangou. “We are closer now to identifying risk so that people can be better informed about life choices. Our research will help us personalise prevention and treatment strategies.”
Source: The Biochemical Society