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Neuroimaging Studies of Bipolar and Unipolar Depression 

Neuroimaging Studies of Bipolar and Unipolar Depression
Chapter:
Neuroimaging Studies of Bipolar and Unipolar Depression
Author(s):

Amelia Versace

, Jorge R. C. Almeida

, and Mary L. Phillips

DOI:
10.1093/med/9780199797608.003.0057
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date: 20 August 2019

Bipolar disorder is defined by the occurrence of mania, but affected individuals spend most of their time when ill struggling with depression. Consequently, understanding the neurobiology of depression might clarify the neural substrates of bipolar disorder. Moreover, contrasting the neurobiology of unipolar and bipolar depression might identify specific features of bipolar illness that result in mood cycling and might aid in diagnosis. Despite the significant promise in these considerations, relatively few neuroimaging studies have directly compared bipolar and unipolar depression. Nonetheless, white matter neuroimaging (e.g., diffusion tensor imaging, DTI) findings suggest that depression in bipolar and unipolar disorder may be distinguished by different abnormalities in right uncinate fasciculus. Moreover, these findings support a hypothesis that unipolar depression demonstrates left- but not right-sided abnormalities in amygdala-orbitomedial prefrontal cortical structural connectivity. Functional connectivity studies report corresponding differences between bipolar and unipolar depressed subjects in right-sided bottom-up amygdala-medial prefrontal effective connectivity. More studies comparing these depressive disorders are clearly needed to extend this model of bipolar depression.

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