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Bipolar Disorders

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PET and SPECT in Psychiatry

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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Authors and Affiliations

  1. Program for Mood and Anxiety Disorders, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 30.001, 9700 RB, Groningen, The Netherlands

    Bartholomeus (Benno) C. M. Haarman MD, Rixt F. Riemersma Van der Lek, Henricus G. Ruhé & Willem A. Nolen

  2. Department of Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands

    Bartholomeus (Benno) C. M. Haarman MD, Rixt F. Riemersma Van der Lek, Henricus G. Ruhé & Willem A. Nolen

  3. Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Henricus G. Ruhé

  4. Program for Mood and Anxiety Disorders, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Room 5.33., Hanzeplein 1, 9700 RB, Groningen, The Netherlands

    Henricus G. Ruhé

  5. Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands

    Jan Cees de Groot

  6. Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands

    Janine Doorduin

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  1. Bartholomeus (Benno) C. M. Haarman MD
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  2. Rixt F. Riemersma Van der Lek
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  3. Henricus G. Ruhé
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  4. Jan Cees de Groot
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  5. Willem A. Nolen
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  6. Janine Doorduin
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Correspondence to Bartholomeus (Benno) C. M. Haarman MD .

Editor information

Editors and Affiliations

  1. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Rudi A.J.O. Dierckx

  2. Faculty of Electrical Engineering and Information Technology, University of Applied Sciences Offenburg, Offenburg, Germany

    Andreas Otte

  3. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Erik F. J. de Vries

  4. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Aren van Waarde

  5. Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen (UMCG), Groningen, The Netherlands

    Johan A. den Boer

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Haarman, B.(.C.M., Van der Lek, R.F.R., Ruhé, H.G., de Groot, J.C., Nolen, W.A., Doorduin, J. (2014). Bipolar Disorders. In: Dierckx, R., Otte, A., de Vries, E., van Waarde, A., den Boer, J. (eds) PET and SPECT in Psychiatry. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40384-2_9

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