Bipolar UK trustee and research psychologist Clare Dolman gives us an overview of recent bipolar research.

Understanding brain fog

Since you were diagnosed, have you ever felt that your brain was rather 'fuzzy'?

Well, now researchers have investigated this phenomenon and discovered it's not our imagination: people with bipolar do indeed suffer from what some call a 'cognitive dulling' effect and they've demonstrated that this effect is rooted in differences in brain activity.

In a paper in the journal BRAIN, researchers from the University of Michigan report the results of tests they gave to 612 women, more than two thirds of whom had experienced either major depression or bipolar, together with data from detailed brain scans of 52 of the women while they took the tests. Only women were involved to prevent gender differences influencing the findings.

Pooling data from several different studies, they found that the women with mood disorders didn't do as well as the control group on a 'sustained attention' test. When this was examined with the brain scan, it was found that women with bipolar or depression had different levels of activity from healthy women in the brain area called the right parietal cortex, which helps to control executive function, including working memory and problem-solving. Women with bipolar had the lowest amount of activity in this area. It's hoped that using scanning techniques like this might lead to new treatments to sharpen up our thinking!

Mood monitoring with smartphone technology

Bipolar UK has frequently showcased the latest technological interventions in bipolar research, including the True Colours mobile phone self-monitoring system developed by researchers at Oxford, which was introduced in our National Conference in 2010. Bipolar UK was also instrumental in the development of Beating Bipolar, on online psychoeducation programme.

Now Spanish researcher Francesc Colom and his team are proposing to combine both approaches in one integrated intervention called SIMPLe.

The idea is that someone with bipolar will be able to record changes in their mood and other signs of an approaching episode and then receive - via their smartphone - personally tailored psycho-educational content to help with their self-management.

It's hoped that this programme might help to prevent relapse and improve patients' overall prognosis.

Following a feasibility study and piloting with focus groups, the usefulness of SIMPLe will be tested in a 6 month randomised controlled trial in Spain. Sometimes the simplest ideas are the smartest...

Lithium resistance study

Lithium is among the most effective therapies for bipolar and remains the first-line treatment. But about half of patients don't respond to it. A new study may help to change that.

Researchers at Tel Aviv University have found that the insulin-like growth factor hormone IGF-1, essential for tissue growth, also increases lithium sensitivity in the blood cells of patients with bipolar for whom lithium was originally ineffective.

"Our study suggests that the lack of sufficient IGF-1 activity may underlie lithium resistance in the treatment of bipolar disorder, and this hormone, or drugs mimicking or promoting its action, should be considered for improved treatment of this disorder", says Dr Elena Milanesi, who led the study.

As IGF-1 is already approved for use in people who are deficient in this hormone, they're hoping to put it to the test by conducting a clinical trial of IGF-1 in lithium-resistant people with bipolar.