Brain Area that Regulates Emotions is Smaller in Persons with Bipolar Disorder

A brain scanning study of adolescents and adults with bipolar disorder shows significant decrease in size in the amygdala, a brain structure that governs emotions, a Yale School of Medicine researcher has found.

These findings suggest that amygdala volume deficit is an early feature of bipolar disorder that is present by adolescence and persists into adulthood, said principal investigator Hilary Blumberg, M.D., assistant professor of psychiatry. Bipolar disorder is also known as manic-depressive illness.

The researchers measured the almond-shaped amygdala using magnetic resonance imaging. In addition to the reduced size of the amygdala in adults, they found that it was also smaller in affected adolescents, indicating that this brain change is an early feature of the disorder.

“Research to understand bipolar disorder in youths is especially important because of their high risk for suicide,” Blumberg said of the study published in the current issue of the Archives of General Psychiatry.

Bipolar disorder is characterized by episodes that range from emotional highs, or manias, to emotional lows, or depressions. Extreme manic highs can be associated with over-spending, impulsiveness on the job or at school, and risky behaviors, including sexual indiscretions that can lead to loss of important relationships. In depressive episodes individuals may “take to bed,” and there is a high risk of suicide, Blumberg said.

“We now have places in the brain to look to try to detect and intervene in the disorder earlier so hopefully in the future we can reduce the suffering with this disorder,” Blumberg said.

This work was performed at Yale in collaboration with co-authors Joan Kaufman, AndrŽs Martin, M.D., Ronald Whiteman, Jane Hongyuan Zhang, John Gore, Dennis Charney, M.D., John Krystal, M.D., and Bradley Peterson, M.D.

The study was supported by the U.S. Department of Veterans Affairs Research Enhancement Award Program, the Donaghue Foundation Women’s Health Investigator Program at Yale, the National Alliance for Research in Schizophrenia and Affective Disorders, the Stanley Medical Research Institute, the Charles A. Dana Foundation, the National Institute of Mental Health and the National Institute on Alcohol Abuse and Alcoholism. The study was conducted at the West Haven Campus of the VA Connecticut Healthcare System and at the Yale Magnetic Resonance Center.

Citation: Archives of General Psychiatry: Vol. 60: 1201-1208 (December 2003)

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