Treatable Condition Could be Mistaken for Bipolar Disorder


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Researchers at Houston Methodist will pioneered a new study that will hopefully show that a significant number of people may have a treatable immune system condition often mistaken for either bipolar disorder or schizophrenia. This study could impact millions of people.

“We suspect that a significant number of people believed to have schizophrenia or bipolar disorder actually have an immune system disorder that affects the brain’s receptors,” said Joseph Masdeu, M.D., Ph.D., the study’s principal investigator and a neurologist with the Houston Methodist Neurological Institute. “If true, those people have diseases that are completely reversible – they just need a proper diagnosis and treatment to help them return to normal lives.”

In 2007, scientists discovered anti-NMDA receptor encephalitis, a disease which can be treated with immunotherapy medications that causes symptoms similar to bipolar disorder or schizophrenia. The encephalitis forces the immune system to attack N-methyl-D-aspartate (NMDA) receptors in the brain instead of invading agents.

The NMDA receptors control decision-making, thoughts, and perceptions, which is why this illness is often mistaken for bipolar disorder or schizophrenia. The encephalitis can also cause sufferers to hear voices or become paranoid.

The study will collect cerebral spinal fluid from 150 patients diagnosed with bipolar disorder or schizophrenia and 50 healthy controls between the ages of 18 to 35. The fluid will be examined for antibodies attacking NMDA and other brain receptors. If abnormal antibodies are found, the researchers will notify the patient so he or she may consider treatment.

Masdeu plans to use the findings for development of further studies about antibodies.

Materials provided by Houston Methodist.

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People with a Family History of Bipolar Disorder Have Reduced Planning Ability


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According to a new study published in Scientific Reports, people with a family history of bipolar disorder have reduced prefrontal cortex activity. One of the primary functions of the prefrontal cortex is to plan a person’s response to complex and difficult problems.

Examining a total of a 144 Japanese people–93 with psychiatric illnesses such as schizophrenia, bipolar disorder, and major depressive disorder, and 51 healthy controls–the researchers found significant prefrontal cortex dysfunction in those with family histories of mental health issues, compared to healthy controls and people with illnesses without family histories of them.

The scientists used near-infrared spectroscopy (NIRS), a functional neuroimaging technology, to measure prefrontal cortex activation during a verbal fluency test. During the test, the study subjects were instructed to come up with as many nouns as possible that start with a Japanese hiragana letter (‘a’, ‘ki’, and ‘ha’, each for 20 seconds). In the pre- and post-task intervals, patients were instructed to pronounce English vowels repeatedly.

This is the first study to focus on family histories of mental illnesses when measuring prefrontal cortex activity. The scientists hope that more studies investigating genetic factors underlying major psychiatric disorders and prefrontal activation will be conducted.


Ohi, K. et al. Impact of Familial Loading on Prefrontal Activation in Major Psychiatric Disorders: A Near-Infrared Spectroscopy (NIRS) Study. Sci. Rep. 7, 44268; doi: 10.1038/srep44268 (2017).

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People At-Risk for Bipolar Disorder May Age Faster


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People at-risk for bipolar disorder may age faster, according to a study by Timothy R Powell, Danai Dima, Sophia Frangou, and Gerome Breen. The findings were published in Neuropsychopharmacology, a scientific journal.


Telomeres are DNA repeat structures (TTAGGG) at the end of chromosomes. When telomeres are critically shortened, cell death occurs, which makes these structures a biomarker for aging. Lifestyle changes, cellular stressors, and social adversity all contribute to telomere shortening.

Shorter telomere length is associated with cardiovascular disease, type-2 diabetes, and age-related memory dysfunction. Telomere length is associated with the hippocampus, a sea-horse-shaped brain region which controls inhibition and emotion, and helps contribute to episodic memory.

Previous studies have shown reduced telomere length in schizophrenia, dementia, and major depressive disorder. But with regards to bipolar disorder, however, studies have demonstrated both reduced and increased telomere length in patients compared to healthy controls.

According to the Powell study, patients with bipolar disorder taking lithium have longer telomeres. The researchers used DNA sampling as well as magnetic resonance imaging (MRIs) of close relatives to bipolar disorder sufferers to determine whether people with the illness age faster.

The scientists found that lithium has a protective effect on telomere length, whereas other medications, such as antidepressants, don’t. Also, the relatives of patients with bipolar disorder had significantly shorter telomeres than healthy volunteers.

This is the first study to demonstrate a link between shorter telomere length and relatives with bipolar disorder. Understanding telomere biology may lead to therapies to maintain telomere length or reverse the shortening process, which means slower aging. Studying the effect of lithium on telomeres may also contribute to further psychological medications which can help patients who suffer from bipolar disorder.

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Men and Women Differ When it Comes to Bipolar Biomarkers


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According to a new study by an international team of researchers, men and women have different reactions to compounds associated with immune system response to bipolar disorder. This is exciting news! The findings mean that bipolar disorder can one day be diagnosed by biological measurements in the body, and that approaches to treatment can be tailored differently for the sexes.


Researchers have long known that bipolar disorder manifests differently in men and women. This suggests that different biological processes underlie the condition in the two sexes. Additionally, the immune system activates during periods of mania or depression, and previous studies have demonstrated that immune system activation starts low-level inflammatory process in the brain, which is harmful. This inflammation may contribute to poor function among bipolar sufferers.

The immune system works differently in men and women as well. Researchers decided to measure immune system factors in men and women with bipolar disorder to see if reliable markers for the diseases could be found.

Scientists measured concentrations of zinc and neopterin–both associated with inflammatory processes–in blood samples of both men and women experiencing manic or depressive episodes, as well as from healthy controls. Zinc is a mineral needed by a healthy immune system to function properly, while neopterin is an immune marker secreted by white blood cells when the immune system is activated.

The 27 people with bipolar disorder recruited for the study had lower levels of zinc in their blood than the 31 healthy controls. There was no difference in neopterin levels. However, when women had more zinc in their blood, their depression was worse, whereas men’s mania was worse if they had higher concentrations of neopterin.

Zinc deficiencies have been associated with depression in the past, so the findings were surprising. Scientists are now measuring zinc levels in the brains of mice with inflammatory depression to see if higher levels of zinc in the blood means less in the brain.

The findings do not suggest that people suffering depression should take zinc, however.

What the international team that contributed to this study is ultimately hoping for is to discover a blood marker that can help predict bipolar episodes, and whether treatment is working. Exciting news!

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Researchers Create Global Map of How Bipolar Disorder Affects the Brain

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In the largest magnetic resonance imaging (MRI) study to date, researchers have created a roadmap of bipolar disorder and how the illness affects the brain. Scientists found that people who suffer from bipolar disorder possessed differences in the brain regions that control inhibition and emotion.


Using MRI scans of 6,503 individuals, including 2,447 adults with bipolar disorder and 4,056 healthy controls, the researchers created a map of bipolar disorder. Also measured was the age of onset for the disorder, history of psychosis, mood state, age, sex, and commonly used prescription medications.

According to the study, patients with bipolar disorder showed thinning of grey matter in the frontal and temporal regions of the brain, which control motivation and inhibitions. The research also demonstrated that lithium has a protective effect on the brain, associated with less thinning of gray matter.

The international report includes research from 76 centers and 26 different groups around the world. Published in Molecular Psychiatry, the findings demonstrate the underlying mechanisms of bipolar disorder.

Researchers hope to use the study in early detection efforts, as well as to determine which medications will protect the brain.

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AI Used for Blowing Pilots Out of the Sky Helps Bipolar Patients

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The artificial intelligence that shot down human pilots in simulation after simulation at Wright-Patterson Air Force Base can also help treat bipolar disorder. The model originally used in air-to-air combat predicted who will respond to lithium 100 percent of the time, using “genetic fuzzy trees,” which mimic the natural evolution of genetics.


The LITHium Intelligent Agent (LITHIA) model, run by University of Cincinnati researchers, is the first to manage such accuracy, as even the best of eight common models used in treating bipolar disorder predict who will respond to lithium treatment with only 75 percent accuracy.

Lithium is a salt which treats both mania and depression in a lucky thirty percent of people with bipolar disorder. But prior to the discovery of a new method to predict who will respond to lithium, people were playing roulette. Scientists at the Salk Institute are able to predict with 92 percent accuracy who will respond to lithium with a blood test. But these results were blown out of the water by the UC model.

Fuzzy logic, the system the artificial intelligence is based on, relies on generalizations to make correct choices. The logic is labeled “genetic fuzzy” because the AI continually refines its answer, choosing the best inputs in a process similar to Darwinian natural selection. And unlike other types of AI, systems based on fuzzy logic can explain why it made its choices.

Teaching the AI is similar to getting a child to recognize an apple. Green apples and red apples may look different, but there’s a correct way to identify them each as the specific fruit after being given a few examples. In this way, the UC model was able to compensate for “noise” in the data, and narrow down its options to predict the correct route.

The UC findings were published in June 2017 in the Bipolar Disorders scientific journal. The researchers are also using the model to study concussions, a topic which has often confused scientists.

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Bipolar? Your Brain is Wired to Make Poor Decisions


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Struggling to plan and make decisions while depressed or manic are common problems. But have you ever had trouble doing the same while relatively stable? New research may show why.


Researchers examined ninety patients’–forty-five with bipolar disorder in stable moods, and forty-five controls without bipolar disorder–brains, and discovered that, in the bipolar sufferers, there are certain areas of the brain that have reduced activation regardless of mood due to structural damage.

This is the first study to look at the relationship between functional magnetic resonance imaging (MRIs) and structural MRIs in bipolar disorder. The scientists found that the patients with bipolar suffered from reduced cortical thickness and thus had less activity in areas of the brain that controlled impulses, or contributed to making decisions.

The study was published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, and conducted by scientists at the University of California, Los Angeles.

As this is the first study to find a link between structure and function, the results are exciting. The research proves that bipolar disorder damages your brain. You’re not stupid; your brain is just wired to make impulsive decisions and be poor at planning.

The scientists who conducted the study hope that their research will be used in future intervention studies. Good news!

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Six-Year Delay Between Onset of Bipolar Disorder and Diagnosis, Study Finds

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A new international study conducted by researchers in both Australia and Italy has found that there’s an average of six years between the onset of bipolar disorder and diagnosis of the disease. An analysis of 9,415 patients from 27 studies, the largest of its kind, the study notes that crucial opportunities to catch bipolar disorder at its onset, when mood episodes aren’t as severe, are being missed.


While patients with concurring disorders such as psychosis do generally receive timely treatment, most people suffer for years before being able to address their mental illness with proper medications and therapies.

Professor Large, a psychiatrist at Prince of Wales hospital, claims that the delay is most severe for young people, whose symptoms may be attributed to teenaged moodiness. Diagnosing a bipolar depressive episode is also difficult, as that is often mistaken for unipolar depression.

Doctors have to look to detailed medical histories of their patients, as well as symptoms triggered by external events, such as manic or hypomanic phases triggered by antidepressants.

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Molecular Mechanism Behind Lithium’s Effectiveness Identified


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Scientists have identified the molecular mechanism behind lithium’s effectiveness in treating bipolar disorder in an international study published in Proceedings of the National Academy of Sciences (PNAS). Researchers at Sanford Burnham Prebys Medical Discovery Institute (SBP), Yokohama School of Medicine, Harvard Medical School, and UC San Diego collaborated on the study, which used human induced pluripotent stem cells (hiPS cells) to map lithium’s response pathway.

Lithium is a salt which has long been considered the gold-standard for bipolar treatment. The side effects–such as nausea, weight gain, and birth defects–are a trial for many people who take the drug. Only about one-third of people who suffer from bipolar disorder respond to lithium treatment. Before researchers at the Salk institute developed a test to predict who will respond to lithium with 92 percent accuracy, there was no test, and the drug’s effect was only found through a trial-and-error process which could take months or years.

In the study, scientists used hiPs cells created from lithium-responsive and non-responsive patience to observe a physiological difference in a protein called CRMP2: the protein was in a much more inactive state in responsive patients. However, when the researchers applied lithium, CRMP2 worked properly. So the study shows that bipolar disorder has a physiological–not necessarily genetic–cause.

This study is the first to explain the molecular basis of bipolar disorder. Scientists hope to use the results to develop a blood test for the disease, as well as further tests that can predict whether people who suffer from bipolar disorder will respond to lithium. Research leading from this study may also discover safer and more effective drugs to treat the disorder.

Edited to Add: Here is the link to the study, as requested.

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Children at High Risk for Bipolar Disorder Genetically Vulnerable to Stress


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Genetic alterations that regulate stress have been found in children at high risk for bipolar disorder, according to research done by scientists at The University of Texas Health Science Center at Houston (UTHealth). The study was published in Translational Psychiatry, a Nature Publishing Group journal.


Researchers have long known that children who experience stressors in their lives are more likely to develop bipolar disorder. Parents with bipolar may struggle with their disorders, thus placing stress on their children. But this study shows that children at a high risk for developing bipolar–due to having family members with a history of psychiatric illness–are genetically vulnerable to stress.

The scientists at UTHealth took blood samples from eighteen children, consisting of a set of bipolar patients, a set of apparently neurotypical patients with bipolar parents, and a set of neurotypical controls with parents that have no history of mental illness. The blood samples revealed that, compared with the control group, bipolar children and unaffected kids with bipolar parents have genetic alterations that regulate the response to stress.

So, children with bipolar parents are more vulnerable to stress, and when stressed, tend to develop the disorder. This may sound like bad news all around, but there is a positive approach to this study. Future research may reveal the effects of reducing stress, as well as whether medication might be able to reverse the genetic alterations in children before bipolar disorder matures.

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