Abstract
Bipolar disorder is characterized by (hypo)manic episodes and depressive episodes which alternate with euthymic periods. It causes serious disability with poor outcome, increased suicidality risk, and significant societal costs. This chapter describes the findings of the PET/SPECT research efforts and the current ideas on the pathophysiology of bipolar disorder.
First, the cerebral blood flow and cerebral metabolism findings in the prefrontal cortex, limbic system, subcortical structures, and other brain regions are discussed, followed by an overview of the corticolimbic theory of mood disorders that explains these observations.
Second, the neurotransmitter studies are discussed. The serotonin transporter alterations are described, and the variation in study results is explained, followed by an overview of the results of the various dopamine receptor and transporter molecules studies, taking into account also the relation to psychosis.
Third, a concise overview is given of dominant bipolar disorder pathophysiological models, proposing starting points for future molecular imaging studies.
Finally, the most important conclusions are summarized, followed by remarks about the observed molecular imaging study designs specific for bipolar disorder.
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Abbreviations
- ACC:
-
Anterior cingulate cortex
- BA:
-
Brodmann areas
- BD:
-
Bipolar disorder
- BD-I:
-
Bipolar I disorder
- BD-II:
-
Bipolar II disorder
- CBF:
-
Cerebral blood flow
- CFT:
-
[O-methyl-11C]-carbomethoxy-3β-(4-fluorophenyl)tropane
- CMR:
-
Cerebral metabolic rate
- DASB:
-
3-11C-amino-4-(2-dimethylaminomethylphenylsulfanyl)benzonitrile
- DAT:
-
Dopamine transporter
- DTBZ:
-
(+)-α-11C-dihydrotetrabenazine
- DTI:
-
Diffusion tensor imaging
- FA:
-
Fractional anisotropy
- FDG:
-
18F-labeled fluorodeoxyglucose
- fMRI:
-
Functional magnetic resonance imaging
- HMPAO:
-
Hexamethylpropylene amine oxime
- IDO:
-
Indoleamine 2,3 dioxygenase
- IMP:
-
Iodoamphetamine
- LCSPT:
-
Limbic-cortical-striatal-pallidal-thalamic
- McNeil 5652:
-
Trans-1,2,3,5,6,10-hexahydro-6-[4-(methylthio)phenyl] pyrrolo-[2,1-a] isoquinoline
- MD:
-
Mean diffusivity
- MDD:
-
Major depressive disorder
- MRS:
-
Magnetic resonance spectroscopy
- NAA:
-
N-acetylaspartate
- PBR:
-
Peripheral benzodiazepine receptor
- PET:
-
Positron-emission tomography
- PFC:
-
Prefrontal cortex
- SPECT:
-
Single-photon emission computed tomography
- TZTP:
-
3-(3-(3-[18F]Flouropropyl)thio)-1,2, 5-thiadiazol-4-yl)-1,2,5,6-tetrahydro-1-methylpyridine
- VMAT2:
-
Vesicular monoamine transporter 2
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Haarman, B.(.C.M., Riemersma-Van der Lek, R.F., Ruhé, H.(.G., de Groot, J.C., Nolen, W.A., Doorduin, J. (2021). Bipolar Disorders. In: Dierckx, R.A., Otte, A., de Vries, E.F.J., van Waarde, A., Sommer, I.E. (eds) PET and SPECT in Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-57231-0_7
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