Is There a Neurological Marker for Individuals at Risk for Bipolar?

A large number of people who develop mood disorders such as bipolar (BD) and major depression (MDD) also have at least one family member with BD. There is a strong genetic link with these issues, and immediate relatives of individuals with BD are ten times more likely to develop BD and three times more likely to develop MDD than individuals with no family history of mood issues. Understanding the earliest signs and additional risks for MDD and BD could help identify those most at risk and enable clinicians to initiate treatment at an earlier time in order to improve the overall outcome. The prodromal symptoms of MDD and BD have been explored at length, but clinical markers for BD have not. Therefore, Heather C. Whalley of the Division of Psychiatry at the University of Edinburgh in the U.K. recently conducted study comparing neurological images of 98 high risk individuals from families with BD histories (HR) to those of 58 control participants with no family history of BD.

Whalley found that even though none of the participants had any symptoms of BD or MDD, 20 of the HR participants had increased insula cortex activation compared to the control participants and the remaining HR participants. Upon follow-up two years later, these same 20 participants met the clinical criteria for MDD. The insula is a region of the brain associated with emotional regulation, reaction inhibition, and subjective emotional response. In the 20 HR participants who later developed MDD, the insula did not disengage as the participants completed tasks during the experiment. But the HR participants who did not develop MDD and the control subjects all had increasing levels of disengagement as the experiment tasks increased in difficulty. These results show that even if symptoms are not present, neurological markers exist that can potentially identify high-risk individuals vulnerable to MDD. Whalley notes that although none of the participants developed BD during her study period, some people experience depressive symptoms years before the onset of BD. She hopes that this research will increase early diagnoses in those most vulnerable to future mood issues. She added, “These findings advance our understanding of the biological processes involved in the development of mood disorders and provide a potential biomarker that could be tested for clinical utility in future studies.”

Whalley, H.C., Sussmann, J.E., Romaniuk, L., Stewart, T., Papmeyer, M., et al. (2013). Prediction of depression in individuals at high familial risk of mood disorders using functional magnetic resonance imaging. PLoS ONE 8(3): e57357. doi:10.1371/journal.pone.0057357

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  • jake


    April 19th, 2013 at 11:42 PM

    although I’m tempted to say this sounds like a sure-shot way of recognizing people at risk I would like to see more research on this.And only then should they make any conclusion.Because in medicine there is always more than what meets the eye.

  • Bonnie


    April 20th, 2013 at 5:29 AM

    The one thing that I think is so important with any mental illness is to keep in mind that these things are often genetic, so if there is any kind of family history of this and you are questioning whether or not you should be looked at and evaluated, err on the side of caution. Close family members who have also suffered could be a strong indication that it could happen to you as well, so family history is definitely not something that you would want to ignore.

  • Sean.W


    April 20th, 2013 at 11:19 PM

    Not sure how many people will get the neurological tests but seems like it should be something family members of those already affected do.whats also important is that they look for symptoms in those who have a family link already.they could exhibit symptoms on a more subtly level but if present that is a fairly good indicator too.

  • beth


    April 22nd, 2013 at 3:48 AM

    Just how reasonable is it to assume that this kind of testing would be so widely available that everyone who needs it would be able to have it? I mean, this has to be pretty expensive, right?

  • Liz


    April 22nd, 2013 at 12:53 PM

    Genetic? Okay. But what if I’m the first in my family to get it? I would not be careful then would I? Solution is to remain forever cautious and routine health checkups are one way of achieving this.

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