Causal Lesion Network Guided Treatment of Bipolar Mania With Transcranial Electrical Stimulation
Mania is a core symptom of bipolar disorder involving periods of euphoria. Decreased inhibitory control, increased risk-taking behaviors, and aberrant reward processing are some of the more recognized symptoms of bipolar disorder and are included in the diagnostic criteria for mania. Current drug therapies for mania are frequently intolerable, ineffective, and carry significant risk for side effects. Presently there are no neurobiologically informed therapies that treat or prevent mania. However, using a newly validated technique termed lesion network mapping, researchers demonstrated that focal brain lesions having a causal role in the development of mania in people without a psychiatric history can occur in different brain locations, such as the right orbitofrontal cortex (OFC), right dorsolateral prefrontal cortex (DLPFC), and right inferior temporal gyrus (ITG). This lesion network evidence converges with existing cross-sectional and longitudinal observations in bipolar mania that have identified specific disruptions in network communication between the amygdala and ventro-lateral prefrontal cortex. The OFC is associated with inhibitory control, risk-taking behavior, and reward learning which are major components of bipolar mania. Thus, the association between OFC with mania symptoms, inhibitory control, risk-taking behavior, and reward processing suggests that this region could be targeted using non-invasive brain stimulation.
Conditions:
🦠 Bipolar Disorder
🦠 Schizo Affective Disorder
🗓️ Study Start (Actual)
16 December 2022
🗓️ Primary Completion (Estimated)
1 July 2024
✅ Study Completion (Estimated)
1 August 2024
👥 Enrollment (Estimated)
24
🔬 Study Type
INTERVENTIONAL
📊 Phase
NA
Locations:
📍
Boston, Massachusetts, United States
Description
Inclusion Criteria:
- 1. Aged 18-65 years of age
- 2. Proficient in English
- 3. Able to give informed consent
- 4. Meet diagnostic criteria for bipolar disorder or schizoaffective disorder, bipolar type as verified by the SCID
- 5. History of mania ( \>1 lifetime episode)
- 6. Experiencing mild to moderate symptoms of mania
- 7. No changes to mood stabilizing medications for a period of 2 weeks prior to participation
- 8. Has not recently participated in tES/TMS treatments
Exclusion Criteria:
- 1. Substance abuse or dependence (w/in past 6 months)
- 2. Those who are pregnant/breastfeeding
- 3. History of head injury with \> 15 minutes of loss of consciousness/mal sequelae
- 4. DSM-V intellectual disability
- 5. Having a non-removable ferromagnetic metal within the body (particularly in the head)
- 6. History of seizures
Ages Eligible for Study:
18 Years to 65 Years (ADULT, OLDER_ADULT)
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
No
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported
results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before
being posted on the public website.
Study Registration Dates
- First Submitted
17 June 2022
- First Submitted that Met QC Criteria
30 June 2022
- First Posted
6 July 2022
Study Record Updates
- Last Update Submitted that Met QC Criteria
4 February 2024
- Last Update Posted
6 February 2024
- Last Verified
February 2024