scholarly journals Bipolar oscillations between positive and negative mood states in a computational model of Basal Ganglia

2017 ◽  
Author(s):  
Pragathi Priyadharsini Balasubramani ◽  
V. Srinivasa Chakravarthy
Keyword(s):  
Dynamical System ◽  
Bipolar Disorder ◽  
Basal Ganglia ◽  
Computational Model ◽  
Negative Mood ◽  
Positive Outcome ◽  
Mood States ◽  
Cycle Period ◽  
Levels Of Abstraction ◽  
Depressive Episodes

AbstractBipolar disorder is characterized by mood swings - oscillations between manic and depressive states. The swings (oscillations) mark the length of an episode in a patient’s mood cycle (period), and can vary from hours to years. The proposed modeling study uses decision making framework to investigate the role of basal ganglia network in generating bipolar oscillations. In this model, the basal ganglia system performs a two-arm bandit task in which one of the arms leads to a positive outcome, while the other leads to a negative outcome. In healthy conditions, the model chooses positive action and avoids negative one, whereas under bipolar conditions, the model exhibits slow oscillations in its choice of positive or negative outcomes, reminiscent of bipolar oscillations. The model is cast at three levels of abstraction: 1) a two-dimensional dynamical system model, 2) a phenomenological basal ganglia model, 3) a detailed network model of basal ganglia. Phase-plane analyses on the simple reduced dynamical system with two variables reveal the essential parameters that generate pathological ‘bipolar-like’ oscillations. Phenomenological and network models of the basal ganglia extend that logic, and interpret bipolar oscillations in terms of the activity of dopaminergic and serotonergic projections on the cortico-basal ganglia network dynamics. The network’s dysfunction, specifically in terms of reward and risk sensitivity, is shown to be responsible for the pathological bipolar oscillations. The study proposes a computational model that explores the effects of impaired serotonergic neuromodulation on the dynamics of the cortico basal ganglia network, and relates this impairment to abstract mood states (manic and depressive episodes) and oscillations of bipolar disorder.

scholarly journals Bipolar oscillations between positive and negative mood states in a computational model of Basal Ganglia

2019 ◽  
Vol 14 (2) ◽  
pp. 181-202 ◽  
Author(s):  
Pragathi Priyadharsini Balasubramani ◽  
V. Srinivasa Chakravarthy
Keyword(s):  
Basal Ganglia ◽  
Computational Model ◽  
Negative Mood ◽  
Mood States ◽  
Negative Mood States

A cognitive behavioural group therapy for bipolar disorder using daily mood monitoring

2020 ◽  
Vol 48 (5) ◽  
pp. 515-529
Author(s):  
H.T. Henken ◽  
R.W. Kupka ◽  
S. Draisma ◽  
J. Lobbestael ◽  
K. van den Berg ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Sequence Analysis ◽  
Psychological Health ◽  
Psychosocial Functioning ◽  
Small Sample ◽  
Mood States ◽  
Series Data ◽  
Cognitive Behavioural ◽  
Depressive Episodes

AbstractBackground and aim:This study investigated the effects of group cognitive behavioural therapy (CBT) for patients with bipolar disorder. The development of CBT for this disorder is relatively under-explored.Method:Participants with bipolar I or II disorder were treated with group CBT in addition to treatment as usual. The effectiveness of the protocol was explored through sequence analysis of daily mood monitoring prior to, during and after the intervention. Also, a repeated measures design was used assessing symptomatology, dysfunctional attitudes, sense of mastery, psychosocial functioning, and quality of life at start and end of intervention, and at follow-up 2 and 12 months later.Results:The results indicate that variation in mood states diminished over the course of the intervention. Also, there was a change from depressive states to more euthymic states. Greater number of reported lifetime depressive episodes was associated with greater diversity of mood states. There was an increase in overall psychosocial functioning and self-reported psychological health following the intervention. Improvement continued after treatment ended until follow-up at 2 months, and measured 1 year later, for outcomes representing depression, general psychosocial functioning and self-reported psychological health. Due to small sample size and the lack of a control group the results are preliminary.Conclusions:The results of this pilot study suggest that both offering CBT in group interventions and sequence analysis of time series data are helpful routes to further explore when improving standard CBT interventions for patients suffering from bipolar disorder.

scholarly journals Alterations of the cerebellum and basal ganglia in bipolar disorder mood states detected by quantitative T1ρ mapping

2018 ◽  
Vol 20 (4) ◽  
pp. 381-390 ◽  
Author(s):  
Casey P Johnson ◽  
Gary E Christensen ◽  
Jess G Fiedorowicz ◽  
Merry Mani ◽  
Joseph J Shaffer ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Basal Ganglia ◽  
Mood States ◽  
T1ρ Mapping

scholarly journals Deficits in explicit emotion regulation in bipolar disorder: a systematic review

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Marcel Kurtz ◽  
Pia Mohring ◽  
Katharina Förster ◽  
Michael Bauer ◽  
Philipp Kanske
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
Emotion Regulation ◽  
Mood State ◽  
Bipolar Disorders ◽  
Protective Measure ◽  
Behavioral Measures ◽  
Increased Risk ◽  
Regulation Strategies ◽  
Depressive Episodes

Abstract Background This study aimed to compile and synthesize studies investigating explicit emotion regulation in patients with bipolar disorder and individuals at risk of developing bipolar disorder. The importance of explicit emotion regulation arises from its potential role as a marker for bipolar disorders in individuals at risk and its potent role in therapy for bipolar disorder patients. Methods To obtain an exhaustive compilation of studies dealing specifically with explicit emotion regulation in bipolar disorder, we conducted a systematic literature search in four databases. In the 15 studies we included in our review, the emotion-regulation strategies maintenance, distraction, and reappraisal (self-focused and situation-focused) were investigated partly on a purely behavioral level and partly in conjunction with neural measures. The samples used in the identified studies included individuals at increased risk of bipolar disorder, patients with current affective episodes, and patients with euthymic mood state. Results In summary, the reviewed studies' results indicate impairments in explicit emotion regulation in individuals at risk for bipolar disorder, patients with manic and depressive episodes, and euthymic patients. These deficits manifest in subjective behavioral measures as well as in neural aberrations. Further, our review reveals a discrepancy between behavioral and neural findings regarding explicit emotion regulation in individuals at risk for bipolar disorders and euthymic patients. While these groups often do not differ significantly in behavioral measures from healthy and low-risk individuals, neural differences are mainly found in frontostriatal networks. Conclusion We conclude that these neural aberrations are a potentially sensitive measure of the probability of occurrence and recurrence of symptoms of bipolar disorders and that strengthening this frontostriatal route is a potentially protective measure for individuals at risk and patients who have bipolar disorders.

scholarly journals The Challenges of Children with Bipolar Disorder

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 601
Author(s):  
Robert M. Post ◽  
Heinz Grunze
Keyword(s):  
Bipolar Disorder ◽  
Early Recognition ◽  
Childhood Onset ◽  
Traditional Treatment ◽  
Treatment As Usual ◽  
Treatment Regimens ◽  
Oppositional Defiant ◽  
Treatment Of Depression ◽  
The Common ◽  
Depressive Episodes

Childhood onset bipolar disorder (CO-BD) presents a panoply of difficulties associated with early recognition and treatment. CO-BD is associated with a variety of precursors and comorbidities that have been inadequately studied, so treatment remains obscure. The earlier the onset, the longer is the delay to first treatment, and both early onset and treatment delay are associated with more depressive episodes and a poor prognosis in adulthood. Ultra-rapid and ultradian cycling, consistent with a diagnosis of BP-NOS, are highly prevalent in the youngest children and take long periods of time and complex treatment regimens to achieve euthymia. Lithium and atypical antipsychotics are effective in mania, but treatment of depression remains obscure, with the exception of lurasidone, for children ages 10-17. Treatment of the common comorbid anxiety disorders, oppositional defiant disorders, pathological habits, and substance abuse are all poorly studied and are off-label. Cognitive dysfunction after a first manic hospitalization improves over the next year only on the condition that no further episodes occur. Yet comprehensive expert treatment after an initial manic hospitalization results in many fewer relapses than traditional treatment as usual, emphasizing the need for combined pharmacological, psychosocial, and psycho-educational approaches to this difficult and highly recurrent illness.

scholarly journals Treatment of bipolar depression with supraphysiologic doses of levothyroxine: a randomized, placebo-controlled study of comorbid anxiety symptoms

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Maximilian Pilhatsch ◽  
Thomas J Stamm ◽  
Petra Stahl ◽  
Ute Lewitzka ◽  
Anne Berghöfer ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Phenotypic Expression ◽  
Anxiety Symptoms ◽  
Controlled Study ◽  
Double Blind ◽  
Comorbid Anxiety ◽  
Depressed Patients ◽  
Depressive Episodes

Abstract Background Symptoms of anxiety co-occur in a variety of disorders including in depressive episodes of bipolar disorder and in patients with thyrotoxicosis. Treatment of refractory bipolar disorder with supraphysiologic doses of levothyroxine (L-T4) has been shown to improve the phenotypic expression of the disorder and is associated with an increase of circulating thyroid hormones. However, it might be associated with somatic and mental adverse effects. Here we report the investigation of the influence of treatment with supraphysiologic doses of L-T4 on symptoms of anxiety in patients with refractory bipolar depression. Methods Post-hoc analysis from a 6-week, multi-center, randomized, double-blind, placebo-controlled study of the effects of supraphysiologic L-T4 treatment on anxiety symptoms in bipolar depression. Anxiety symptoms were measured weekly with the Hamilton anxiety/somatization factor (HASF) score of the Hamilton Depression Rating Scale (HAMD) and the State- and Trait Anxiety Inventory (STAI). Results Treatment of both groups was associated with a significant reduction in anxiety symptoms (p < 0.001) with no statistical difference between groups (LT-4: from 5.9 (SD = 2.0) at baseline to 3.7 (SD = 2.4) at study end; placebo: from 6.1 (SD = 2.4) at baseline to 4.4 (SD = 2.8) at study end; p = 0.717). Severity of anxiety at baseline did not show a statistically significant correlation to the antidepressive effect of treatment with supraphysiologic doses of L-T4 (p = 0.811). Gender did not show an influence on the reduction of anxiety symptoms (females: from 5.6 (SD = 1.7) at baseline to 3.5 (SD = 2.4) at study end; males: from 6.1 (SD = 2.3) at baseline to 4.0 (SD = 2.4) at study end; p = 0.877). Conclusions This study failed to detect a difference in change of anxiety between bipolar depressed patients treated with supraphysiologic doses of L-T4 or placebo. Comorbid anxiety symptoms should not be considered a limitation for the administration of supraphysiologic doses of L-T4 refractory bipolar depressed patients. Trial registration ClinicalTrials, ClinicalTrials.gov identifier: NCT01528839. Registered 2 June 2012—Retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT01528839

Treatment of Bipolar Disorder During the Postpartum Period

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S5) ◽  
pp. 13-14
Author(s):  
Adele C. Viguera
Keyword(s):  
Bipolar Disorder ◽  
Postpartum Period ◽  
Clinical Information ◽  
Mood Stabilizer ◽  
Mood Stabilizers ◽  
Antipsychotic Treatment ◽  
Close Monitoring ◽  
Major Congenital Malformations ◽  
Major Depressive Episodes ◽  
Depressive Episodes

AbstractThe presentations and clinical courses of patients with bipolar disorder differ greatly by gender. In addition, medical therapy must be tailored differently for men and women because of emerging safety concerns unique to the female reproductive system. In November 2005, these topics were explored by a panel of experts in psychiatry, neurology, and reproductive health at a closed roundtable meeting in Dallas, Texas. This clinical information monograph summarizes the highlights of that meeting.Compared to men with bipolar disorder, women have more pervasive depressive symptoms and experience more major depressive episodes. They are also at higher risk for obesity and certain other medical and psychiatric comorbidities. Mood changes across the menstrual cycle are common, although the severity, timing, and type of changes are variable. Bipolar disorder is frequently associated with menstrual abnormalities and ovarian dysfunction, including polycystic ovarian syndrome. Although some cases of menstrual disturbance precede the treatment of bipolar disorder, it is possible that valproate and/or antipsychotic treatment may play a contributory role in young women.Pregnancy does not protect against mood episodes in untreated women. Maintenance of euthymia during pregnancy is critical because relapse during this period strongly predicts a difficult postpartum course. Suspending therapy in the first months of pregnancy may be an option for some women with mild-to-moderate illness, or those with a long history of euthymia during pre-pregnancy treatment. However, a mood stabilizer should be reintroduced either in the later stages of pregnancy or in the immediate postpartum period. Preliminary data suggest that fetal exposure to some mood stabilizers may raise the risk of major congenital malformations and neurodevelopmental delays. For women planning to become pregnant, clinicians may consider switching to other drugs before conception. The value and drawbacks of breastfeeding during treatment must be considered in partnership with the patient, with close monitoring of nursing infants thereafter. The risks and benefits of medical treatment for women with bipolar disorder should be carefully reconsidered at each stage of their reproductive lives, with a flexible approach that is responsive to the changing needs of patients and their families.

Profile of Mood States: Australian Normative Data

1990 ◽  
Vol 66 (2) ◽  
pp. 509-510 ◽  
Author(s):  
Kathleen Moore ◽  
Robb Stanley ◽  
Graham Burrows
Keyword(s):  
Normative Data ◽  
Negative Mood ◽  
Mood States ◽  
Profile Of Mood States ◽  
Negative Mood States

The Profile of Mood States was administered to 90 Australian women, 30 depressed, 30 anxious, and 30 nonpsychiatric controls. Both clinical groups scored higher than the McNair, Lorr, and Droppleman (1971) normative samples on the negative mood states and scored lower on Vigor. The means for these groups are presented and compared with the 1971 normative data of McNair, Lorr, and Droppleman.

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