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Impaired sensory processing measured by functional MRI in Bipolar disorder manic and depressed mood states

Abstract

Bipolar disorder is characterized by recurring episodes of depression and mania. Defining differences in brain function during these states is an important goal of bipolar disorder research. However, few imaging studies have directly compared brain activity between bipolar mood states. Herein, we compare functional magnetic resonance imaging (fMRI) responses during a flashing checkerboard stimulus between bipolar participants across mood states (euthymia, depression, and mania) in order to identify functional differences between these states. 40 participants with bipolar I disorder and 33 healthy controls underwent fMRI during the presentation of the stimulus. A total of 23 euthymic-state, 16 manic-state, 15 depressed-state, and 32 healthy control imaging sessions were analyzed in order to compare functional activation during the stimulus between mood states and with healthy controls. A reduced response was identified in the visual cortex in both the depressed and manic groups compared to euthymic and healthy participants. Functional differences between bipolar mood states were also observed in the cerebellum, thalamus, striatum, and hippocampus. Functional differences between mood states occurred in several brain regions involved in visual and other sensory processing. These differences suggest that altered visual processing may be a feature of mood states in bipolar disorder. The key limitations of this study are modest mood-state group size and the limited temporal resolution of fMRI which prevents the segregation of primary visual activity from regulatory feedback mechanisms.

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Acknowledgements

The authors would like to thank Janie Myers, Ashley Schumacher, Robin Follmer, Lois Warren, Autumn Craig, and Marla Kleingartner for their help in recruiting and assessing study participants.

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Joseph J. Shaffer completed statistical analysis and was primary author of the manuscript.

Casey Johnson contributed to experimental design, data collection, data analysis, manuscript preparation and review.

Jess Fiedorowicz responsible for clinical assessments and managed participant recruitment, data collection, and data management. Contributed to experimental design, interpretation, and manuscript revision.

Gary Christensen contributed to study design, interpretation, and manuscript revision.

John Wemmie contributed to conception, experimental design, interpretation, writing and editing of manuscript.

Vincent Magnotta contributed to conception, experimental design, interpretation, writing and editing of manuscript.

Corresponding author

Correspondence to Joseph J. Shaffer Jr.

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Funding

This study was supported by the generous donation provided by a Roger Koch. Archive and storage of imaging data was supported by the University of Iowa Institute for Clinical and Translational Science (U54TR001013).

J.A.W. was supported by the Department of Veterans Affairs (Merit Award), the NIMH (5R01MH085724), NHLBI (R01HL113863) and a NARSAD Independent Investigator Award.

JGF was supported by the NIMH (K23MH083695) and NHLBI (P01HL014388).

C.P.J. was supported in part by a NARSAD Young Investigator Award.

V.A.M. was supported in part by a NARSAD Independent Investigator Award.

Conflicts of interest

The authors do not have any conflicts of interest to report.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Iowa Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All participants provided informed written consent.

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Shaffer, J.J., Johnson, C.P., Fiedorowicz, J.G. et al. Impaired sensory processing measured by functional MRI in Bipolar disorder manic and depressed mood states. Brain Imaging and Behavior 12, 837–847 (2018). https://doi.org/10.1007/s11682-017-9741-8

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Keywords

  • Bipolar disorder
  • fMRI
  • Mood state
  • Mania
  • Depression
  • Visual cortex