The effects of carbamazepine on prefrontal activation in manic youth with bipolar disorder

Schneider, Marguerite; Klein, Christina; Weber, Wade; Bitter, Samantha M.; Elliott, Kimberly B.; Strakowski, Stephen M.; Adler, Caleb M.; DelBello, Melissa P.

doi:10.1016/j.pscychresns.2014.04.011

Cited by 20 publications

(21 citation statements)

References 6 publications

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“…We could not determine whether the results that we observed were due to the effects of psychotropic drugs, although NIRS signals were not correlated with drug dosage. For example, a very recent study reported that carbamazepine extended-release treatment normalized frontopolar activation in manic youths with BD [55], and that postmortem brain tissue from medicated patients with BD exhibited impaired myelination in the frontopolar cortex [56]. Thus, there remains a possibility that the association found in this study was due to the treatment and the long-term course of the disorder.…”

Section: Discussionmentioning

confidence: 85%

Social Function and Frontopolar Activation during a Cognitive Task in Patients with Bipolar Disorder

Nishimura¹,

Takahashi²,

Ohtani³

et al. 2015

Neuropsychobiology

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Background: It is important to understand the neural basis of functional impairments in patients with bipolar disorder (BD) in order to be able to address the recovery. Recently, neurocognitive impairment emerged as a predictor of psychosocial function. A number of functional brain imaging studies have shown that social function is associated with activation of the prefrontal cortex during a cognitive task in healthy adults, and in patients with major depressive disorder and schizophrenia. However, few studies have been conducted in patients with BD. Methods: We performed multichannel near-infrared spectroscopy (NIRS) imaging to investigate the activation of the prefrontal cortex during a verbal fluency task (VFT). We also used the Social Adaptation Self-Evaluation Scale (SASS) to assess social functioning in patients with BD. Thirty-three depressed patients with BD and 65 age-, gender- and task performance-matched healthy controls (HCs) participated in this study. Results: Depressed patients with BD showed reduced activation in the broader bilateral prefrontal cortex during the VFT compared to HCs. Moreover, a significant positive correlation was observed between the total SASS scores and right prefrontal activation in patients with BD. In the SASS subscores, the interest and motivation factor was also positively correlated with frontopolar activation. Conclusions: These results suggest an association between social function and prefrontal activation in depressed patients with BD. The present study provides evidence that NIRS imaging could be helpful in understanding the neural basis of social function.

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Section: Discussionmentioning

confidence: 85%

Social Function and Frontopolar Activation during a Cognitive Task in Patients with Bipolar Disorder

Nishimura¹,

Takahashi²,

Ohtani³

et al. 2015

Neuropsychobiology

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“…227 Treatment of mania with ziprasidone was associated with an increase in activation in the right ventrolateral prefrontal cortex in response to a sustained attention task, which suggests that the ziprasidone antimanic effect is associated with improved prefrontal modulation of emotional regulation. 228 Carbamazepine treatment of mania was also associated with increased activation in Brodmann area 10 of the right prefrontal cortex in a small sample of 11 adolescents, 229 further suggesting that mood stabilizers might exert their beneficial effects by improving the top-down prefrontal modulation of limbic areas. Treatment response to risperidone and divalproex sodium for mania may lead to increased functional connectivity of the amygdala within the ECN.…”

Section: | Neuroimaging and Neurocognitionmentioning

confidence: 99%

The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

et al. 2017

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Objectives Over the past two decades, there has been tremendous growth in research regarding bipolar disorder (BD) among children and adolescents (ie, pediatric BD [PBD]). The primary purpose of this article is to distill the extant literature, dispel myths or exaggerated assertions in the field, and disseminate clinically relevant findings. Methods An international group of experts completed a selective review of the literature, emphasizing areas of consensus, identifying limitations and gaps in the literature, and highlighting future directions to mitigate these gaps. Results Substantial, and increasingly international, research has accumulated regarding the phenomenology, differential diagnosis, course, treatment, and neurobiology of PBD. Prior division around the role of irritability and of screening tools in diagnosis has largely abated. Gold-standard pharmacologic trials inform treatment of manic/mixed episodes, whereas fewer data address bipolar depression and maintenance/continuation treatment. Adjunctive psychosocial treatment provides a forum for psychoeducation and targets primarily depressive symptoms. Numerous neurocognitive and neuroimaging studies, and increasing peripheral biomarker studies, largely converge with prior findings from adults with BD. Conclusions As data have accumulated and controversy has dissipated, the field has moved past existential questions about PBD toward defining and pursuing pressing clinical and scientific priorities that remain. The overall body of evidence supports the position that perceptions about marked international (US vs elsewhere) and developmental (pediatric vs adult) differences have been overstated, although additional research on these topics is warranted. Traction toward improved outcomes will be supported by continued emphasis on pathophysiology and novel therapeutics.

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“…One approach toward extending these cross‐sectional studies is to identify how treatments have an impact on brain function in bipolar I disorder during the course of recovery from acute mood episodes . However, these types of studies, particularly of mania, are relatively rare and have often comprised small samples . In the context of an imaging study, mood stabilizers serve as useful neurobiological probes in order to identify brain activation changes during the process of recovery from acute affective episodes (i.e., treatment response) that might further clarify the functional neuroanatomy of bipolar illness.…”

mentioning

confidence: 99%

“…1 However, these types of studies, particularly of mania, are relatively rare and have often comprised small samples. [3][4][5][6][7][8] In the context of an imaging study, mood stabilizers serve as useful neurobiological probes in order to identify brain activation changes during the process of recovery from acute affective episodes (i.e., treatment response) that might further clarify the functional neuroanatomy of bipolar illness.…”

mentioning

confidence: 99%

“…Moreover, from previous work, we predicted increases in ventral prefrontal cortex (PFC) activation as bipolar individuals recovered, with corresponding decreases in overactivation of other limbic brain regions (e.g., the amygdale and striatum). [1][2][3][4][5] We used the Continuous Performance Task with Emotional and Neutral Distracters (CPT-END) during fMRI acquisitions because it was designed to evaluate interactions between emotional and attentional brain networks, and because it has been shown in our previous work to distinguish acutely manic and healthy participants in these key prefrontal and subcortical regions of interest. 3,11 1 | MATERIALS/PARTICIPANTS AND METHODS…”

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confidence: 99%

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fMRI brain activation changes following treatment of a first bipolar manic episode

et al. 2016

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Objectives In this study, we tested the hypothesis that, with treatment, functional magnetic resonance imaging (fMRI) regional brain activation in first-episode mania would normalize, i.e., differences from health subjects would diminish over time, and would be associated with clinical remission status, potentially identifying neuroanatomic treatment response markers. Methods Forty-two participants with bipolar I disorder were recruited during their first manic episode, pseudo-randomized to open-label lithium or quetiapine, and followed for eight weeks. fMRI scans were obtained at baseline and then after one and eight weeks of treatment, while participants performed a continuous performance task with emotional distracters. Healthy participants received fMRI scans at these same intervals. Specific region-of-interest (ROI) activations within prefrontal emotional networks were assessed as potential measures of treatment response. Results ROI data were reduced using exploratory factor analysis, which identified five factors that were organizationally consistent with functional anatomic models of human emotion modulation, replicating previous factor analyses in this population. One-half of the participants with bipolar disorder achieved remission by Week 8 and were contrasted with the other one-half that did not. Analyses demonstrated that, in the bipolar disorder group in general, treatment led to decreases in activation across brain regions toward healthy subject values. However, differences in activation changes were observed between subjects with bipolar disorder who did or did not achieve remission in subcortical and amygdala factors. Conclusions These findings provide evidence for potential neuroanatomic treatment response markers in first-episode bipolar disorder.

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The effects of carbamazepine on prefrontal activation in manic youth with bipolar disorder

Cited by 20 publications

References 6 publications

Social Function and Frontopolar Activation during a Cognitive Task in Patients with Bipolar Disorder

Social Function and Frontopolar Activation during a Cognitive Task in Patients with Bipolar Disorder

The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

fMRI brain activation changes following treatment of a first bipolar manic episode

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