Self Focus in Bipolar Disorder: A Functional Magnetic Resonance Imaging (fMRI) Study

Study Overview
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Brief Summary
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The investigators propose to examine both resting state activity and functional activity during rumination and during self-processing to study the relationship between neural correlates of rumination/self-focus and self-processing in major depression and bipolar disorder.

Detailed Description
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Negative rumination, a specific form of self-focus, characterized by repetitively focusing on one's symptoms of distress, and the possible causes and consequences of these symptoms, is a hallmark of depression. Nearly a decade of research has culminated in evidence that the tendency to engage in negative rumination is highly correlated with depressive symptoms. Rumination also plays a critical role in the etiology and maintenance of depressed states and predicts risk for mania in bipolar disorder. Despite the central role of rumination in major depression and bipolar disorder, there have been few studies to date investigating the functional neuroanatomy of negative rumination, and no studies of positive rumination. The few neuroimaging studies that have utilized measures of the tendency to engage in negative rumination have focused on brain functioning when performing tasks that involve processing emotional or self-referential stimuli, but they have not studied resting state activity or functional activity during negative and positive rumination. We are examining both resting state activity and functional activity during negative and positive rumination and during self-processing to study the relationship between the neural correlates of rumination/self-focus and self-processing in major depression and bipolar disorder.

Official Title
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An fMRI Study of Self Processing and Self Focus in Major Depression and Bipolar Disorder

Conditions
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Bipolar Disorder, Major Depression, Rumination

Intervention / Treatment
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* Other: Functional Magnetic Resonance Imaging (fMRI)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria Healthy Controls: Right-handed (as determined by the Handedness Inventory; Oldfield, 1971) Normal or corrected-to normal vision and hearing Exclusion Criteria for Healthy Controls: Any current or past psychiatric history Significant medical, psychiatric or neurological illness Currently taking antidepressants, mood stabilizers, or benzodiazepines Positive MR screen (e.g., metal implant, claustrophobia, etc) Inclusion Criteria for Patients with Major Depression: Current diagnosis of MDD Right-handed (as determined by the Handedness Inventory; Oldfield, 1971) Normal or corrected-to normal vision and hearing Exclusion Criteria for MDD Patients: If a history of substance abuse, at least 6 months in remission Current suicidal ideation or history of suicide attempts Positive MR screen (e.g., metal implant, claustrophobia, etc) Inclusion Criteria for patients with BPAD: Current diagnosis of BPAD Right-handed (as determined by the Handedness Inventory; Oldfield, 1971) Normal or corrected-to normal vision and hearing Exclusion Criteria for BPAD Patients: If a history of substance abuse, at least 6 months in remission Current suicidal ideation or history of suicide attempts Positive MR screen (e.g., metal implant, claustrophobia, etc)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 64 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Bipolar Disorder<br>Clinical status will be determined using the Mini International Neuropsychiatric Interview (M.I.N.I) for 20 patients with bipolar disorder (BPAD). | Other: Functional Magnetic Resonance Imaging (fMRI)<br>* Imaging will be performed on a 3T Siemens Trio scanner. Each MRI scanning session will last no more than 90 minutes.<br>|
| Major Depressive Disorder<br>Clinical status will be determined using the Mini International Neuropsychiatric Interview (M.I.N.I) for 20 patients with major depression (MDD). | Other: Functional Magnetic Resonance Imaging (fMRI)<br>* Imaging will be performed on a 3T Siemens Trio scanner. Each MRI scanning session will last no more than 90 minutes.<br>|
| Healthy Control<br>Clinical status will be determined using the Mini International Neuropsychiatric Interview (M.I.N.I) for 20 normal, healthy volunteers. | Other: Functional Magnetic Resonance Imaging (fMRI)<br>* Imaging will be performed on a 3T Siemens Trio scanner. Each MRI scanning session will last no more than 90 minutes.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional Magnetic Resonance Imaging (fMRI) to examine self processing and self focus | Functional Magnetic Resonance Imaging (fMRI) will be used to look at the neuroanatomy of self processing and self focus. | Participants will be analyzed as quickly as possible after a screening visit, an expected average of 2 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Bipolar Disorder, Major Depression, Rumination, Self Processing