Summary: A recent study dentified a neurobehavioral signature that can predict the risk of future mania or hypomania in bipolar spectrum disorders (BSD).
Researchers identified three profiles: healthy, moderate risk, and high risk, based on factors such as reward sensitivity, impulsivity, and sleep-circadian characteristics. Over a 12-month period, individuals in the high-risk and moderate-risk groups showed more symptoms of mania than those in the healthy group.
The findings may help detect mania risk earlier and inform intervention strategies.
The research identified three neurobehavioral profiles linked to the risk of mania in bipolar spectrum disorders: healthy, moderate risk, and high risk.
Individuals identified as high risk showed elevated mania symptoms compared to the other two groups.
The study highlights the potential of combining neurobiological and clinical measures for early identification and intervention in severe mental health problems such as mania.
Mania, in which mood and energy level are extremely elevated for at least a week, and hypomania, which is less severe and lasts at least four days, are the defining features of bipolar spectrum disorders (BSD) and can be the most disruptive symptoms.
A new study in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging now identifies a signature of risk for developing future mania or hypomania.
BSD are psychiatric conditions that typically emerge in young adulthood, often severely disrupting lives and requiring intensive treatments.
Mania risk has remained challenging for clinicians to predict; the ability to do so would aid in directing treatments to at-risk patients sooner.
The researchers, led by Adriane M. Soehner, PhD, at the University of Pittsburgh, built on previous research showing that heightened reward motivation and sleep-circadian rhythm disruption are associated with mania/hypomania onset.
Brain imaging studies have also shown that BSD is associated with elevated reward expectancy activation in the left ventrolateral prefrontal cortex, a key reward- and salience-processing hub.
For the current study, Dr. Soehner and colleagues clustered these markers together; they hypothesized that a signature of increased mania risk would be marked by elevated reward sensitivity, impulsivity, and sleep-circadian characteristics.
Young adult participants, who did not have a diagnosis of BSD, completed assessments and underwent functional magnetic resonance imaging. About half the participants also underwent follow-up assessments at six and 12 months.
Three “profiles” emerged from the sample: one healthy, one at moderate risk, and one at high risk. Individuals at high risk had elevated mania symptoms at baseline compared to the other two groups.
Over the 12-month follow-up interval, mania symptoms in both the high-risk and moderate-risk groups exceeded the healthy group.
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.”
Cameron Carter, MD, 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.”
About this bipolar disorder research news
Author: Eileen Leahy Source: Elsevier Contact: Eileen Leahy – Elsevier Image: The image is credited to Neuroscience News
Neurobehavioral Reward and Sleep-Circadian Profiles Predict Present and Next-Year Mania/Hypomania Symptoms
Heightened reward sensitivity/impulsivity, related neural activity, and sleep-circadian disruption are important risk factors for bipolar spectrum disorders, the defining feature of which is mania/hypomania. Our goal was to identify neurobehavioral profiles based on reward and sleep-circadian features and examine their specificity to mania/hypomania versus depression vulnerability.
At baseline, a transdiagnostic sample of 324 adults (18–25 years) completed trait measures of reward sensitivity (Behavioral Activation Scale), impulsivity (UPPS-P-Negative Urgency), and a functional magnetic resonance imaging card-guessing reward task (left ventrolateral prefrontal activity to reward expectancy, a neural correlate of reward motivation and impulsivity, was extracted).
At baseline, 6-month follow-up, and 12-month follow-up, the Mood Spectrum Self-Report Measure – Lifetime Version assessed lifetime predisposition to subthreshold-syndromal mania/hypomania, depression, and sleep-circadian disturbances (insomnia, sleepiness, reduced sleep need, rhythm disruption). Mixture models derived profiles from baseline reward, impulsivity, and sleep-circadian variables.
Three profiles were identified: 1) healthy (no reward or sleep-circadian disruption; n = 162); 2) moderate-risk (moderate reward and sleep-circadian disruption; n = 109); and 3) high-risk (high impulsivity and sleep-circadian disruption; n = 53). At baseline, the high-risk group had significantly higher mania/hypomania scores than the other groups but did not differ from the moderate-risk group in depression scores. Over the follow-up period, the high-risk and moderate-risk groups exhibited elevated mania/hypomania scores, whereas depression scores increased at a faster rate in the healthy group than in the other groups.
Cross-sectional and next-year predisposition to mania/hypomania is associated with a combination of heightened reward sensitivity and impulsivity, related reward circuitry activity, and sleep-circadian disturbances. These measures can be used to detect mania/hypomania risk and provide targets to guide and monitor interventions.