Overview

The purpose of this NIH (National Institute of Health) funded study is to examine chemical imbalances that may be present in people with Bipolar Disorder (manic-depression) using magnetic resonance imaging and spectroscopy (MRI/MRS). The MRI takes pictures of the brain and the MRS simultaneously measures a specific brain chemical called N-Acetyl-Asparate (NAA). We want to compare the size of key brain regions of persons with bipolar disorder to those who do not have the condition to see if there is a relationship between these levels and the clinical symptoms of bipolar disorder. We also want to see if 2 medications, lithium and lamotrigene, have any noticeable effects on the brain's anatomy or chemistry.

If you meet initial eligibility criteria a screening visit is scheduled. The screening visit lasts up to 3 hours and involves a structured clinical interview that asks you questions about you and your family's medical and psychiatric history. This will be conducted by a member of our research team for the purpose of confirming a psychiatric diagnosis (or a lack thereof for healthy controls). A urine sample will also be taken to rule out pregnancy and illicit drug use. If you are a bipolar participant you will undergo a physical examination to rule out any current major medical conditions. If you continue to qualify for the study an MRI/MRS is scheduled at UNC's Biomedical Research Imaging Center. This visit will take approximately 2 hours. The next component of the study can be completed the same day as the MRI/MRS or at the next visit. You will be given several neuropsychological tests to assess your mental functioning. These tests consist of questions and particular exercises (including computer tasks) that will test your ability to concentrate, and to learn and deal with new information. This visit can take up to 4 hours.

Bipolar Participants: will be required to come back to our clinic during the treatment phase for 10 follow-up visits. The treatment phase beings after your initial assessment, first MRI/MRS, and first series of neuropsychological tests. This is when you will begin lithium treatment. Clinical assessment scales will be used to measure your symptoms and blood draws will be used to determine your medication levels. These will be scheduled for weeks 1 ,2, 3, 4, 6, 8, 10, 12, 14, and 16. You will be asked to repeat the MRI/MRS at the end of week 4 and at the end of week 16. You will also repeat the neuropsychological testing at the end of week 16.

Healthy Controls: if you are one of the 20 selected for return visits you will be asked to repeat the MRI/MRS at the end of week 4 and at the end of week 16. You will also repeat the neuropsychological testing at the end of week 16.

Eligibility

• For Bipolar Participants a diagnosis of Bipolar Disorder or you believe you may be suffering from Bipolar Disorder
• For Healthy Controls no previous psychiatric diagnosis for you or first degree relatives (parents, siblings, children)
• At least 18 years of age
• Not currently pregnant
• No current major medical problems (i.e. cancer, diabetes, hypertension, heart problems)
• No illegal substances for 6 months
• Not currently on psychiatric medications
• No metal plates/parts in body (pacemakers, aneurysm clips, screws, etc.)
• No history of epilepsy or loss of consciousness for more than 30 minutes

Study Payment