New research from the Yale School of Medicine demonstrates a relationship between abnormalities in the white matter of the brain and bipolar patients who attempt suicide. The findings were released on December 9, 2014, at the annual meeting of the American College of Neuropsychopharmacology in Phoenix, Arizona.
Researcher Hilary Blumberg, M.D., and colleagues conducted brain scans on 68 participants, aged 14 to 25, with diagnosed bipolar disorder. Of those patients, 26 had attempted suicide. The study included a control group of 45 teens and young adults who did not have bipolar disorder.
There was a distinct difference between the brains of individuals in the bipolar group versus the control group. Specifically, those who had attempted suicide were found to have abnormalities in the prefrontal cortex and related areas of the brain. Their scans showed less “integrity” in the white matter in key frontal brain systems. This includes the system that connects the frontal lobe with areas that control emotion, motivation and memory, the researchers pointed out.
“These white matter abnormalities may disrupt the ability of these areas to work together,” Blumberg stated.
Additionally, the research team found a link between white matter deficits in these connections and the number and seriousness of the suicide attempts. This data suggests that white matter abnormalities in the brain’s frontal systems might be associated with increased suicide risk in patients with bipolar disorder or depression.
Bipolar disorder afflicts approximately 6.1 million Americans and, of those, 25 to 50 percent attempt suicide. Patients with bipolar disorder have one of the highest suicide rates among individuals with any mental health disorder. Bipolar disorder is a mental illness that causes extreme emotional mood swings characterized as manic (high) or depressive (low). Bipolar disorder typically occurs in late adolescence or early adulthood and, in some people, might also cause psychotic episodes, including hallucinations or delusions.
A manic episode is an exaggerated elevated mood that persists for long time periods, in which three or more of the following symptoms are present:
Feelings of euphoria
An abundance of energy
Becoming extremely active
Inability to concentrate
Ideas rushing through the mind
Abusing drugs or alcohol
Talking very fast and switching topics quickly
Using poor judgment
Increased sex drive
A depressive episode includes several of the following symptoms that last more than two weeks:
Sleeping too much
Losing interest in activities you once enjoyed
Unable to think clearly or concentrate
Feelings of guilt
Neglecting personal appearance
Eating too much or too little
Feeling intense sadness
Several prior studies have also pointed to brain abnormalities in patients with bipolar disorder. A 2011 study at the Central Institute of Mental Health in Germany identified objective biomarkers, such as functional and structural brain abnormalities, in patients with bipolar disorder. The study involved 156 patients with bipolar disorder and 164 mentally healthy subjects as the control group. Compared with those in the control group, patients with bipolar disorder showed decreased activity and/or reduction in gray matter volume in the right inferior frontal gyrus, the right superior frontal gyrus, the anterior cingulate and the precuneus. These areas of the brain control the regulation of emotions, the researchers noted.
In addition, this study showed that bipolar patients exhibited increased activity in the ventral-limbic brain structures. These brain areas mediate the experience of emotions and generation of emotional responses. “These results support and refine previously proposed neurobiological models of the disorder and suggest that an imbalance between cortical-cognitive and limbic brain networks may serve as a neurobiological marker of bipolar disorder, “ research member, Michele Wessa, Ph.D., stated.
In all, the research into brain abnormalities present in patients with bipolar disorder promises advances in identifying biological markers for the disorder, predicting suicidal behavior and providing suicide prevention measures.