Table 12.
Functional Studies of the Basal Ganglia in BD.
| Study | Sample | Age | Method | Age of Onset |
Illness Duration/# Episodes |
Family History of Illness |
Clinical Status at Testing |
Medication Status | Comorbidity | Findings | Brodmann Map/Stereotaxic Coordinates |
|---|---|---|---|---|---|---|---|---|---|---|---|
| (Buchsbaum et al 1986) | 20 (16 BD + 4 MDD) 24 HC |
39±12.2 31±10.4 |
18 F-FDG | 24.8±10 | 16.8±11.5 | NR | NR | Unmedicated for 2+ weeks | NR | Decreased metabolism of the BG | NR |
| (Schwartz et al 1987) | 9 MDD 13 HC |
NR | 18 F-FDG | NR | NR | NR | Depressed | Drug free for 1+ week prior to scanning | NR | No difference in metabolic rate of caudate (normalized to whole hemisphere volume) in BD | NR |
| (Martinot et al 1990) | 7 BD 10 HC |
49±15 38±11 |
18 F-FDG | NR | NR | NR | Severely depressed | At baseline medicated with AP + BZ. Incomplete drug washout for other medications. | Substance abusers excluded. | No significant metabolic differences in striatal regions | NR |
| (Blumberg et al 2000) | 11 BD | 33.4±11.6 | 15O-H2O | NR | 14.2±14.9 (manic) 12.0±5.6 (euthymic) |
NR | 5 manic BD; 6 euthymic | MS, AP, AD, BZ | No comorbid axis I or II conditions. Substance abuse taking place > 5 years previously was allowed. | Increased L caudate activity in manic patients. | −16; 20; 0 |
| (Ketter et al 2001) | 43 BD I + II (treatment resistant) 43 HC |
37.5±10.6 38.1±10.4 |
18 F-FDG | 18.8±9.9 | 18.3±10.4 | NR | Depressed, mildly depressed + euthymic | Unmedicated for 2+ weeks | NR | Increased metabolism of ventral striatum in BD. | NR |
| (Dunn et al 2002) | 27 BD | 36.7±11.3 | 18 F-FDG | 18.0±9.9 | 16.7±14.6 | NR | Mildly to severely depressed | Unmedicated for 2+ weeks | No active substance abuse, eating disorder, OCD, dementia, medical illness | Anhedonia associated with decreased activity of the R striatum increased activity of L nucleus accumbens + caudate | 12; 18; 0 −4; 6; −4 |
| (Blumberg et al 2003c) | 10 BD 10 HC |
13.6±2.8 14.6±2.8 |
fMRI | NR | NR | Yes | Depressed | 4 lithium, 3 MS, 3 AD, 2 AP, 1 stimulant | No substance use within 24 hours of scan. 2 ADHD, 2 ODD, 2 substance abuse, 1 OCD, 1 anxiety, 1 phobia. | Elevated activity of L putamen during stroop. Greater depression associated with signal increase in ventral striatum. | NR |
| (Caligiuri et al 2003) | 24 BD 13 HC |
45.7±11.8 35.6±15.7 |
1.5T ROI Motor Probe |
NR | NR | NR | Manic + depressed | AP, MS, AD | No co-morbidity. Family-history of illness not exclusion criterion for HC. | Manic but not depressed patients showed elevated BOLD response in L GP + lower activity of R GP. Depressed subjects showed increases in caudate relative to manic patients. | NR |
| (Chang et al 2004) | 12 BD (I+II) 10 HC |
14.7±3.0 14.4±3.2 |
fMRI 3T Voxel-wise |
NR | 3.1 | Yes -56% | Euthymic | MS + AD. Stimulants discontinued 24 hours before screening. | 11/12 with ADHD. No substance abuse, pervasive developmental disorders. | Increased activation of L caudate in BD after working memory task. | −4; 14; 0 |
| (Bauer et al 2005) | 10 BD I 10 HC |
39.3±7.8 35.0±9.3 |
18 F-FDG voxelwise |
NR | 20.4±7.0 | NR | Depressed | AD, MS, AP | NR | Higher activity of the R vental striatum at baseline in BD | 18; 8; −8 |
| (Caligiuri et al 2006) | 10 BD | 49.5±11.9 | 1.5T ROI Motor Probe |
NR | NR | NR | 10 depressed, 2 manic, 1 mixed | 7 AD, 6 MS, 3 AP | NR | Greater caudate + L GP activity in euthymic + hypomanic subjects compared to normative sample. Negative correlation between severity of depression + activity of R GP | NR |
| (Mah et al 2007) | 13 BD II 18 HC |
43.0±8.4 39.0±8.0 |
18 F-FDG | 20±10.5 | 22.9±12 | NR | Depressed | Lithium | No substance abuse within 90 days, substance dependence within 5 years. No current psychotic features. 1 OCD, 1 eating disorder | Increased activity in the ventral striatum in BD | −14; 11; −7 16; 11; −6 −10; 10; 1 14; 10; 5 −22; 8; −2 26; 8; −2 30; 4; 0 18; 8; 5 |