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Monday, January 23, 2006

Finding Bipolar Disorder with MRI

Continued from page 1

By Paul Raeburn

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Several technical advances have contributed to MRI's improvement. Topping the list is the development of more-powerful MRI magnets, which enable more-detailed, higher-resolution scans. What megapixels are for a digital camera, teslas, a measure of magnetic-field strength, are for MRIs: the more you have, the better the quality of the image. The newest MRIs generate magnetic fields of about seven teslas, many thousands of times stronger than Earth's magnetic field and at least twice as strong as those typically used in hospitals. (Some research centers, including the McGovern Institute, have 9.4-tesla MRI scanners for animal studies.)

Another key development is a succession of ever more complex methods of computer analysis. These allow researchers to extract more and better information from scanner data and have improved not just fMRI but also MRI spectroscopy and DTI.

The ultimate aim of brain imaging research is to help explain how the billions of neurons and connections in the brain give rise to thought. But researchers are also applying the new MRI techniques to a more practical, immediate goal: improving the diagnosis and treatment of mental illnesses and learning disorders. The hope is that MRI imaging will provide far more accurate diagnosis of psychiatric diseases whose symptoms can resemble each other, preventing years of suffering for patients put on the wrong medications.

As part of this effort, researchers are using MRI to investigate the causes not only of psychiatric ailments but of all kinds of brain abnormalities and learning disorders, including those often found in children born prematurely. And while attempts to use brain imaging to improve psychiatric health care have met with little success over the last decade, the new MRI technologies -- in essence, far stronger telescopes on the mind -- are providing fresh hope of finding better ways to intervene.

Bipolar Fingerprint

One of the leaders in the effort to enlist MRI in the diagnosis and treatment of psychiatric ailments is John Port at the Mayo Clinic in Rochester, MN. Port is a neuroradiologist who began his career by studying electrical engineering and computer science at MIT and later earned a PhD in cell biology and an MD from the University of Illinois. So he's in a good position to research both basic MRI technology and its applications to medicine.

Port's work on MRI could have broad application in psychiatry, but for now he is concentrating on his particular interest: bipolar disorder. Also called manic-depression, bipolar disorder is characterized by mood swings from wild exuberance to profound depression, with periods of stability in between. X-rays or conventional MRIs show no difference between the brains of people with bipolar disorder and those without it; medical journals are littered with failed attempts to use imaging to find distinctive signs of the disease.

Port thinks a lot of those attempts were scientifically flawed. "I have a list of pet peeves a mile long," he says. "There are a million studies, but the patients might be on six different medications. So when you see something different, is it the meds? Or is something going on?" Another problem with many earlier studies, he says, is that they included too few patients. "You can't tell anything from 10 patients. A lot of the research hasn't been as rigorous as it should be."

Comments

  • Finding Bipolar Disorder with MRI
    Guest (O Viera) on 01/27/2006 at 12:00 AM
    Posts:
    1
    This is an excellent article. It helps me to increase my understanding of the role of the brain in mental illness. It is enlightening and is a hope for a more acurate diagnosis of mental illness.

      
    Rate this comment: 12345
  • Diagnosing Bi-polar Disorder with MRI
    Guest (Julie Thomas) on 01/27/2006 at 12:00 AM
    Posts:
    1
    I was diagnosed with Bi-polar Disorder three years ago when my life was completely in turmoil. I went through 1.5 years of prescription trials to find the "right" medication for me. I have been completely off all of my medications for a year. My psychiatrist told me he does not feel I have Bi-polar. (I was actually diagnosed by another psychiatrist)I would love the mystery to be solved. I do have depressive episodes and know that I deffinently did have wild mood swings at that time but at this point I really do not know if I have Bi-polar or not. If you want a Guinea Pig I will volunteer. Please, give me any input you can.
    Rate this comment: 12345
  • Thank you Doctor Port
    Guest (Jennifer) on 01/27/2006 at 12:00 AM
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    1
    I was diagnosed with manic depresion 15 years ago. Now called bipolar I have suffered so much over the last few years. Just comming out of a 3 year depresion I have been hospitalized 4 times in the past few years. All the groups i have attended all the people tht i have met, one of the biggest toppics has always been how horrible it is for us who suffer with this disease to waste so many years switching from this drug to that drug and switching diagnoses. How wonderful it would be for us to know what was wrong right away and be treated for it. My prayers are with you Dr. Port.
    Rate this comment: 12345
    • Willing test subject
      Guest (Barbara) on 01/28/2006 at 12:00 AM
      Posts:
      1
      I was diagnosed with bipolar in September 2002.  Since then I've been on a wide variety of drugs.  This past September (2005), after nearly of year of deep depression, we finally found a "cocktail" that worked with a little tweaking of what I was already on (removing one thing, adding another).  Then in December one of the meds I'd been on for a year decided that it wanted to mess with my system and started causing side effects.  I've been fully off that med for a week now and am feeling the effects of it terribly.  I am hoping that it passes without having to add something else, but only time will tell that.  In the meantime it is watch and listen and pay attention.  I would love if there were a way to determine exactly what is going on in the brain and what medication is the right one to treat it with.

      I would be a very willing guinea pig in your research.  Feel free to contact me at your discretion.  mrs_jaros@comcast.net
      Rate this comment: 12345
      • [no subject]
        Guest (Veronica Narutowicz) on 05/01/2006 at 12:00 AM
        Posts:
        1
        I am also in search of the right medication, and would like to be included in research that would bring us closer to successfully managing my illness.  I was wondering if you received a response about being a part of their research.
        Rate this comment: 12345
    • Another test subject
      Guest (Cathi) on 01/28/2006 at 12:00 AM
      Posts:
      1
      Dear Dr. Port,
      I live in an area where research of this type should be available.  I am close to Cleveland Clinic and University Hospitals but have no idea who to contact. It has been my contention that I should be treated by a neurologist, not a psychiatrist, for my BP. This is brain chemistry.  Thank God you are researching from that perspective.  If you or anyone is aware of somewhere in Northeastern Ohio where I can be a test subject, please e-mail me at cagreen2u@neo.rr.com.  Thank you.
      Rate this comment: 12345
  • Bi-polar
    Guest (Traci ~ Michigan) on 01/28/2006 at 12:00 AM
    Posts:
    1
    I have a 19 year old son who suffers from BP. It would be awesome to pinpoint his brain chemistry imbalance with MRI.He is heavily medicate and when he goes off he medshe ends up in a Psych unit. (THis Happens often~ he doesn't like the way the meds make him feel). Will medicaid pay for an MRI? Where would I go to see a good Psychiastrist that works with the neurologist in Michigan?
    Rate this comment: 12345
  • MRI and bipolar
    Guest (R) on 01/30/2006 at 12:00 AM
    Posts:
    1
    I was diagnosed with bipolar at the McLean Hospital a few years ago.  While I was there I had an MRI scan. After the scan I noticed that I felt remarkably better and that most of my symptoms had temporarily disappeared.  Now doctors are learning that the MRI scan itself can ease symptoms -- much like electroshock therapy!  An amazing development.  (By the way, I started a monotherapy of Lamictal a few years ago and it has put me in complete remission for two years now. Lamictal has saved my life.)
    Rate this comment: 12345
    • Scans and bp
      Guest (Betty) on 04/21/2006 at 12:00 AM
      Posts:
      1
      My son is diagnosed pediatric bipolar. We had a "spec scan" done a couple of years ago at the Aman Clinic. It mapped blood flow in his brain. We actually did this to help figure out the onset of learning disabilities--this was prior to his diagnosis as pediatric bipolar. It showed his brain as more or less "neurotypical" when he was engaged, but his brain at rest had increased blood flow all over the place. We are trying to get the meds right, which is hard since his is pubescent. He just got off of Depakote--he gained 50 pounds, and trying to cut back on lithium (his hands shake so badly he cant hold a pencil). Now we're on to lamictal, and I hope to god it will help chill him out. Thanks for your comments.
      Rate this comment: 12345
  • thanking dr port
    Guest (jes) on 05/01/2006 at 12:00 AM
    Posts:
    1
    my brother had been suffering from manic depression right now and he is not yet been fully diagonised as one with bipolar .they doubt it as bipolar with schizoprenic features .i just hope people like us will soon find a cloud with silver lining as ur research finds an answer. 
    Rate this comment: 12345
  • If they ever find a way then the majority of the pop will be diagnosed with wome mental illness
    les70808 on 10/12/2007 at 9:25 AM
    Posts:
    1
    everybody is crazy.
    Rate this comment: 12345
  • treatment options
    bpmrimdb on 09/10/2008 at 9:15 AM
    Posts:
    1
    I have been on testoterone therapy all my life and have had alot of problems.I went into psychosis twice and have been treated for bi polar since the first time. would the mri scan help me in chosing the right meds.And to what degree I have the disorder.realize that testosterone therapy creates mood problems.I would also like to participate in any study on this matter.I can be contacted at mrb1@cableone.net
    Rate this comment: 12345
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