[Frontiers in Bioscience E4, 593-606, January 1, 2012]

Neuroimaging biomarkers in bipolar disorder

Josselin Houenou1,2,3,4, Marc-Antoine d'Albis1,2,3, Francois-Eric Vederine1,2, Chantal Henry1,2,3, Marion Leboyer1,2,3, Michele Wessa5

1AP-HP, University Paris-East, Department of Psychiatry, Henri Mondor-Albert Chenevier Hospitals, Creteil, F-94010, France, 2INSERM, U955 Unit, IMRB, Department of Medical Genetics, Psychiatry Genetics, Creteil, F-94010, France, 3FondaMental Foundation, Creteil, F-94010, France, 4Neurospin, CEA Saclay, LNAO, Gif-Sur-Yvette, France, 5Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Mannheim, Germany

TABLE OF CONTENTS

1.Abstract
2.Introduction
3.Structural and functional biomarkers of bipolar disorder
3.1. Structural imaging biomarkers
3.2. Functional imaging biomarkers
3.3. Heterogeneity of results
4.Neurobiological models of bipolar disorder
4.1. Models of normal emotional processing
4.2. Models of emotional dysregulation in BD
5.Connectivity in bipolar disorder
5.1. Anatomical connectivity (DTI)
5.2. Functional connectivity (fMRI)
5.3. Linking structural and functional connectivity: bipolar disorder as a connectivity disorder?
6.Perspective
6.1. Individual biomarkers in bipolar disorder
6.2. Imaging genetics of bipolar disorder
7. Acknowledgments
8. References

1. ABSTRACT

There is an urgent need to identify objective biomarkers for the assessment of bipolar disorder, to improve diagnosis and prognostic evaluation. Neuroimaging is a particularly promising approach. We review here the structural and functional neuroimaging studies carried out on bipolar disorder. These studies have led to the development of neurobiological models of bipolar disorder assuming cortical-limbic dysregulation. Dorsal brain structures are thought to decrease in volume and activity in bipolar disorder, reducing inhibition of the ventral-limbic network and enhancing emotional responses. These models also assume abnormal prefrontal-subcortical limbic connectivity. This abnormal connectivity has been identified by both diffusion tensor imaging studies (anatomical connectivity) and functional MRI (functional connectivity). However, studies are currently limited by the heterogeneity of the patients included. Future research should include studies to validate biomarkers for the assessment of bipolar disorder and studies of large and well characterized samples of patients with bipolar disorder.