title: [Mixed states and neuroimaging].
abstract: Despite the growing number of neuroimaging studies in bipolar disorder over the past years, the brain regions involved in mood dysregulation in this disease are still poorly understood. If some neurofunctional abnormalities seem to be independent of mood state, others were preferentially associated with mania or depression, involving the amygdala and other limbic regions as well as ventral frontal regions, with a likely hemispheric lateralization of these abnormalities according to the thymic state that was examined. Very few imaging studies became interested in bipolar patients in a mixed state, making it harder to connect brain malfunction to a given mood state. However, data obtained so far support the hypothesis of a lateralization of brain abnormalities in relation to bipolar symptomatology, suggesting that neurofonctional abnormalities preferentially located in the right ventral frontal and limbic areas may underlie the depressive component, associated with abnormalities of the left similar regions for the manic component. Identification of brain dysfunctions that may explain the emergence of mixed symptoms will likely provide useful information to better understand the respective roles of each hemisphere in the pathophysiology of bipolar disorder.
authors.affiliation: Pôle de psychiatrie des adultes, CHU Robert-Debré, Avenue du Général-Koenig, 51092 Reims cedex, France. Electronic address: akaladjian@chu-reims.fr.
authors.forename: A
authors.initials: A
authors.lastname: Kaladjian
authors.affiliation: Pôle universitaire de psychiatrie, Hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13274 Marseille cedex 09, France.
authors.forename: R
authors.initials: R
authors.lastname: Belzeaux
authors.affiliation: Pôle universitaire de psychiatrie, Hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13274 Marseille cedex 09, France.
authors.forename: J A
authors.initials: JA
authors.lastname: Micoulaud-Franchi
authors.affiliation: Pôle universitaire de psychiatrie, Hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13274 Marseille cedex 09, France.
authors.forename: M
authors.initials: M
authors.lastname: Cermolacce
authors.affiliation: Pôle universitaire de psychiatrie, Hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13274 Marseille cedex 09, France.
authors.forename: E
authors.initials: E
authors.lastname: Fakra
authors.affiliation: Pôle universitaire de psychiatrie, Hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13274 Marseille cedex 09, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Azorin
mesh_terms: D000339:Affect / Q000502:physiology*; D000679:Amygdala / Q000503:physiopathology; D001143:Arousal / Q000502:physiology*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D001921:Brain / Q000503:physiopathology*; D003952:Diagnostic Imaging; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004292:Dominance, Cerebral / Q000502:physiology; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008032:Limbic System / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D009415:Nerve Net / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000503:physiopathology
keywords: Bipolaire; Bipolar; Mixed state; Neuroimagerie; Neuroimaging; État mixte