Project Summary

Joseph Biederman, M.D. (Distinguished Investigator 2002) of Massachusetts General Hospital, will seek to understand the heterogeneity of mania through assessments of neuropsychological dysfunction and structural brain abnormalities by completing a magnetic resonance imaging study of typical and atypical manic adults.  The study is motivated by three converging bodies of empirical literature:  studies validating a distinction between a typical mania characterized by late onset, euthymia with demarcated episodes and an atypical form characterized by early onset, comorbid attention deficit hyperactivity disorder (ADHD), irritability with chronic symptoms; studies showing bipolar disorder is associated with neuropsychological dysfunction and structural brain abnormalities; and studies showing that ADHD is associated with neuropsychological dysfunction and structural brain abnormalities.  This data raises the research question:  Are the neuropsychological dysfunctions and structural brain abnormalities observed in mania limited to the atypical form?  And, given the very high prevalence of ADHD among typical cases, are those anomalies due to ADHD?  Answers to these questions will help elucidate the etiology and pathophysiology of mania, as may clarify which types of anomalies can be attributed to bipolar disorder and which to ADHD.  Separating typical and atypical forms of mania would be valuable to clinicians as it could point to anti-ADHD medications as a means of ameliorating the cognitive deficits associated with mania.  This will become especially relevant in the future as cognitive enhancers are now being tested in ADHD.

Program Area: MOOD DISORDERS\Bipolar

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