Recognizing Bipolar Disorder Sooner

Researchers affiliated with the Mulva Clinic for the Neurosciences hope to identify changes in brain development that predict condition onset

Reviewed by Jorge Almeida, MD, PhD, and Steve Strakowski, MD

Written by Lauren Schneider

A young woman wearing a light pink turtleneck sweater is sitting on a dark brown leather couch with her hands clasped together, smiling at a therapist.

A new collaboration between researchers at UT Austin and the University of Cincinnati seeks to understand the earliest stages of bipolar disorder.

The project focuses on individuals with a family history of bipolar disorder as that is “the highest risk factor” for developing the condition, says Jorge Almeida, MD, PhD, the director of the Bipolar Disorder Center within the Mulva Clinic for the Neurosciences. Dr. Almeida is one of the principal investigators of the study.

“Not everyone who has a parent with bipolar disorder will get bipolar disorder. We’re trying to identify those who show differences in development that result in disease onset,” says Steve Strakowski, MD, the other principal investigator who serves as a psychiatrist at Dell Medical School and Associate Vice President for Regional Mental Health in Central Texas.

Analyzing reward pathways over time

The longitudinal study utilizes functional magnetic resonance imaging (fMRI) to visualize early changes in the brain that accompany the onset of bipolar disorder. Participants between the ages of 14 and 21 are imaged over the course of five years.

“That’s the age when the hallmark symptoms of the disorder, mania and hypomania, may develop in individuals that are at risk for bipolar disorder,” explains Dr. Almeida.

Participants are asked to perform tasks that activate the brain’s reward networks, as people with bipolar disorder are believed to process reward differently from people without the disorder.

“We’re looking at the development of those networks in these people who are at risk for bipolar disorder with the idea that if you inherit the illness, you may have different development of those networks than if you don’t,” says Dr. Strakowski.

In particular, the researchers are characterizing activity in a region of the brain called the prefrontal cortex that governs some of the highest-level brain activity in humans.

“Animals don’t have a prefrontal cortical system,” Dr. Strakowski notes. “Bipolar disorder seems to have originated in that very human part of the brain.”

The researchers plan to employ machine learning techniques to analyze brain activity in the prefrontal cortex and other regions to understand how these networks develop differently in people at risk to develop bipolar disorder.

Leading the charge in bipolar research

Understanding the development of bipolar disorder at its earlies stages will enable healthcare providers to diagnose patients sooner, improving clinical outcomes associated with the condition.

“We have a twofold goal,” says Dr. Almeida. “One goal is start treatment before bipolar disorder truly develops to prevent the illness from being fully formed in the brain. The second goal is to identify the early markers to prevent misclassification of bipolar disorder as other conditions such as major depressive disorder.”

Dr. Strakowski says that this project builds on both his and Dr. Almeida’s previous work by trying to understand an even earlier stage of bipolar development.

“We’ve worked my whole career at the onset of the illness, and we keep pushing back to get ahead of the onset,” says Dr. Strakowski.

Both researchers agree this pioneering study demonstrates the strength of bipolar research conducted at Dell Medical School.

“Despite being a new institution, Dell Med has established a footprint as one of the country’s stronger bipolar disorder research programs,” says Dr. Strakowski.

More information about this particular study is available here. Information about other research studies at the Bipolar Disorder Research Center can be found here.

To learn more about other research at the Mulva Clinic for the Neurosciences, visit the center’s research page.

About UT Health Austin

UT Health Austin is the clinical practice of the Dell Medical School at The University of Texas at Austin. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to provide patients with an unparalleled quality of care. Our experienced healthcare professionals deliver personalized, whole-person care of uncompromising quality and treat each patient as an individual with unique circumstances, priorities, and beliefs. Working directly with you, your care team creates an individualized care plan to help you reach the goals that matter most to you — in the care room and beyond. For more information, call us at 1-833-UT-CARES or request an appointment here.