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Discovering a Risk Characteristic for Future Mania in Bipolar Disorders

The University of Pittsburgh researchers, led by Adriane M. Soehner, Ph.D., built on earlier research revealing that heightened reward motivation and sleep-circadian rhythm disruption are connected with the beginning of mania/hypomania. BSD has also been linked to increased reward expectation activation in the left ventrolateral prefrontal cortex, a critical reward- and salience-processing circuit.

Dr. Soehner and colleagues grouped these markers for the current investigation; they expected that a signature of heightened mania risk would be characterised by elevated reward sensitivity, impulsivity, and sleep-circadian features. Young adult volunteers who had not been diagnosed with BSD conducted evaluations and functional magnetic resonance imaging. Half of the subjects were also assessed at six and twelve months.

The sample yielded three “profiles”: one healthy, one at intermediate risk, and one at high risk. Individuals at high risk had more mania symptoms at the start than the other two groups. Mania symptoms outnumbered those in the healthy group across 12 months in both the high-risk and moderate-risk groups.

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Dr. Soehner said of the findings, “Here, we identified neurobehavioral profiles based on reward sensitivity, impulsivity, and sleep-circadian characteristics that help distinguish those with elevated mania vulnerability. These characteristics, in combination, may help detect mania risk and provide targets to guide and monitor early interventions.”

Early Identification and Intervention for Mania Risk

Cameron Carter, M.D., Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, said of the work, “New findings such as these highlight our emerging ability to combine neurobiological and clinical measures to identify groups of patients at highest risk for serious mental health problems such as mania, allowing for early identification and intervention for those at highest risk. Future research is needed to show that this can lead to reduced suffering and better outcomes in individuals identified in this way.”

References:

  1. Soehner, A. M., et al. (2023) Neurobehavioral Reward and Sleep-Circadian Profiles Predict Present and Next-Year Mania/Hypomania Symptoms. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. doi.org/10.1016/j.bpsc.2023.04.012.

Source: Medindia

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