This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. OBJECTIVE: Bipolar disorder is a major psychiatric illness, and is a significant cause of human suffering and burden for society. It commonly manifests with comorbid alcoholism or other substance abuse in up to 30-40% of the cases. Comorbid alcoholism generally makes the illness course substantially worse and much less responsive to conventional treatments. There is a very limited understanding of potential brain mechanisms involved in bipolar disorder comorbid with alcoholism. In preliminary studies, we have started to characterize the brain morphometric and neurochemical abnormalities that may be present in bipolar patients who do not have other psychiatric comorbid conditions. Specific brain regions involved in mood regulation, in particular prefrontal cortex and medial temporal lobe have been suggested to be anatomically abnormal in this disorder. Because alcoholism is related to specific brain abnormalities, we hypothesize that bipolar patients with comorbid alcoholism have differential brain mechanisms potentially involved, and that these comorbid conditions are related to a larger degree of anatomical and neurochemical brain involvement than bipolar patients without such comorbidity. RESEARCH PLAN: The proposed study will investigate a group of 30 bipolar patients with comorbid alcoholism, 30 bipolar patients without any comorbid psychiatric conditions, and 60 healthy controls. METHODS: Patients will be diagnosed as bipolar type I, according to the DSM-IV criteria, as determined in a SCID-IV interview. A magnetic resonance imaging (MRI)/magnetic resonance spectroscopy (MRS) session will be conducted at a 1.5T Phillips MR scanner. Morphometric measurements of specific brain regions involved in mood regulation, as well as neurochemical measures of the levels of N-Acetyl Aspartatet (NAA) will be obtained. CLINICAL
This study could contribute to unravel the potential brain mechanisms involved in bipolar disorder comorbid with alcoholism. Considering the high prevalence of comorbid bipolar disorder and alcoholism, and the fact that this patient population is especially refractory to therapeutic interventions, this study could potentially be of high relevance for mental health and the care of patients suffering from these severe mental illnesses.
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