Neuroimaging Studies of Bipolar Depression: Therapeutic Implications

  • Jonathan SavitzEmail author
  • Harvey M. Morris
  • Wayne C. Drevets
Part of the Milestones in Drug Therapy book series (MDT)


Bipolar disorder (BD) is characterized by pathophysiological changes to the visceromotor network, disrupting the regulation of endocrine and autonomic responses to stress and, hence, emotion and behavior. Specifically, reductions in gray matter volume and/or cortical thickness and a concomitant increase in glutamatergic neurotransmission are observed in the pregenual (pgACC) and subgenual anterior cingulate cortex (sgACC); the orbitofrontal, frontal polar, and ventrolateral prefrontal cortex (PFC); and the posterior cingulate, ventral striatum, and hippocampus. Neuroreceptor imaging data provide preliminary evidence for serotonin, serotonin transporter (5-HTT), dopamine receptor, and cholinergic system dysfunction in BD. Recent PET imaging data also suggest microglial cell activation in mood disorders. Oft-reported abnormalities of the deep frontal and basal ganglia white matter, and enlargement of the third and lateral ventricles are likely associated with cerebrovascular disease. Mood stabilizers and antidepressant drugs may attenuate pathological limbic activity, increase neurotrophic processes, and decrease inflammation, restoring balance to the system.


Bipolar disorder (BD) Neuroimaging Amygdala Hippocampus Prefrontal cortex Glutamate 


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Copyright information

© Springer International Publishing Switzerland (outside the USA)  2016

Authors and Affiliations

  • Jonathan Savitz
    • 1
    • 2
    Email author
  • Harvey M. Morris
    • 1
  • Wayne C. Drevets
    • 3
  1. 1.Laureate Institute for Brain ResearchTulsaUSA
  2. 2.Faculty of Community MedicineThe University of TulsaTulsaUSA
  3. 3.Janssen Pharmaceuticals of J&J, Inc.TitusvilleUSA

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