Novel pathways and markers for diagnosis and treatment of bipolar disorder

Looking into the brain is yielding vital clues to understanding, diagnosing and treating bipolar disorder, according to findings being presented at the Seventh International Conference on Bipolar Disorder.

Two studies have helped to identify novel pathways and markers for diagnosis and treatment of the disease.

The first study, presented by Husseini K. Manji, M.D., chief of the Laboratory of Molecular Pathophysiology at the National Institute of Mental Health (NIMH), suggests that bipolar disorder arises from abnormalities in neuronal plasticity cascades , the complex machinery inside of nerve cells that regulates numerous processes inside the body. Using animal and cellular models, Dr. Manji and colleagues at NIMH showed that disruptions in these pathways resulted in many of the core symptoms of bipolar disorder and explained many other observations about the disease. The findings suggest a new avenue for treating the underlying cause of bipolar, rather than treating flare-ups of depression or mania, and also provide new targets, for improved medications many of which are being tested in clinical trials.

Mary Phillips, M.D., professor of psychiatry at the University of Pittsburgh School of Medicine and director of functional neuroimaging in emotional disorders at Western Psychiatric Institute and Clinic of UPMC, will discuss the emerging role of brain imaging techniques in psychiatry in general as well as in bipolar disorder. Using neuroimaging, Dr. Phillips has identified patterns of abnormalities in the neural systems that underlie emotional processing and cognitive control unique to the bipolar brain. Such abnormalities are valuable biomarkers for the illness and have the potential to help clinicians diagnose bipolar disorder earlier and more efficiently. Dr. Phillips also will present data illustrating how imaging can be used to identify biomarkers and how these markers can help clinicians determine which patients will respond best to certain treatments. Neuroimaging also can help predict which patients of those who are genetically predisposed to bipolar disorder will develop symptoms of the disease.