Inspiration Nation

29 01 2011

Hello peoples who may be reading this. I know it’s not like me to end up posting another blog so soon after one, I think I’m posting one every other day on average. However, having slept on things I’ve been inspired to do a little research through the wonders of Google on what reports there are featuring Voxel-Based Morphography, the technique discussed in the previous post (click here if you missed it). The results have surprised me a little.

Voxel-Based Morphography is a technique used in neuroimaging which cuts out a lot of the guesswork about brain structure and enables the ability to differentiate between volumes in specific areas. Why is this significant? Well, going back to the previous post, there were four questions asked;

1. Are the same things observed in those with other forms of Bipolar Disorder?
2. Is there potential to use this as a way to confirm a diagnosis?
3. Could it be used to differentiate between seperate psychiatric conditions?
4. Is it possible to see what comes first, the first proper known episode of Bipolar Disorder or the brain structure difference?

I’ll answer these slightly out of order but bear with me.

The second question gets a YES! Ok, things are never as straightforward as they seem but the data seen so far does point to there being a very visible difference between those with a psychiatric condition and those without. With a little work, and I do mean a little, it should be possible to use neuroimaging to turn those guesses made by psychiatrists into hard fact. The positive about this is that it would be possible to achieve a concise diagnosis before any treatment is commenced which means better treatment from the beginning.

Connected to the second question is the need to differentiate between different psychiatric conditions, as asked in question three. Another yes here too as whilst there are a lot of similarities between schizophrenia and bipolar disorder in terms of grey matter structural deficits, there are locations of deficit which are exclusive to bipolar. So there is a definite opportunity to give an accurate diagnosis here, instead of just saying ‘confirmed psychiatric condition’.

Ok, the easy ones are out of the way, the more difficult ones are next.

There’s not much out there which defines between the different types of bipolar disorder so question one gets a resounding ‘I dunno’. Extrapolating the data and theorising an answer comes up with the deficit being more prolific for those with more severe cases of bipolar. I must admit that, whilst this is feasible, it doesn’t sit comfortably with me, I honestly can’t think why, perhaps because it doesn’t necessarily resolve other questions that arise from it. Biggest question would be ‘Can you go from being Bipolar II to Bipolar I or vice versa?’. What I do know is that it’s possible to influence the speed of cycling, having had the joy myself, although to be honest this is possibly a topic for another time.

Finally, what comes first in all of this? There have been pediatric studies using VBM which appear to confirm the information known about adult cases of bipolar disorder. What I don’t know yet is whether there were other variables involved as you have to wonder how these children were diagnosed in the first place and how they have been subsequently been treated. ‘Not enough information’ seems like a cop out but it’s the case.

So, been a big post this one so what have we learned? That there needs to be more research, as ever, in order to discover possible solutions to the key problems within the diagnosis and treatment of all psychiatric conditions. I still stick with my previous comment about there being much to be found n the next five years, it’s going to take some interesting work but at least the data is there in order to begin drafting the possible solutions.

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