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

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

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.

Study Overview

• Status: Completed
• Conditions: Bipolar Disorder; Major Depression; Rumination
• Intervention / Treatment: Other: Functional Magnetic Resonance Imaging (fMRI)

Detailed Description

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.

• Study Type: Observational
• Enrollment (Actual): 32

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02114
      • Massachusetts General Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 60 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Healthy controls will be recruited through email announcements at MGH, internet website at Harvard, and flyers posted at the Massachusetts General Hospital and in the community (e.g., community centers, public libraries, coffee shops, restaurants, and laundromats). Subjects with major depression will be recruited through the Depression Clinic and Research Program at MGH and flyers posted at MGH. Subjects with bipolar disorder will be recruited through the Bipolar Clinic and Research Program at MGH and flyers posted at MGH.

Description

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)

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Cross-Sectional

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Bipolar Disorder; 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); Imaging will be performed on a 3T Siemens Trio scanner. Each MRI scanning session will last no more than 90 minutes.
Major Depressive Disorder; 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); Imaging will be performed on a 3T Siemens Trio scanner. Each MRI scanning session will last no more than 90 minutes.
Healthy Control; 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); Imaging will be performed on a 3T Siemens Trio scanner. Each MRI scanning session will last no more than 90 minutes.

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: Massachusetts General Hospital
• Collaborators: Brain & Behavior Research Foundation
• Investigators: Principal Investigator: Sharmin Ghaznavi, M.D., Ph.D., Massachusetts General Hospital

Study record dates

Study Major Dates

• Study Start: January 1, 2013
• Primary Completion (Actual): January 1, 2020
• Study Completion (Actual): January 1, 2020

Study Registration Dates

• First Submitted: September 24, 2014
• First Submitted That Met QC Criteria: September 26, 2014
• First Posted (Estimate): October 1, 2014

Study Record Updates

• Last Update Posted (Actual): September 1, 2021
• Last Update Submitted That Met QC Criteria: August 31, 2021
• Last Verified: August 1, 2021

More Information

Terms related to this study

• Keywords: Bipolar Disorder; Major Depression; Rumination; Self Processing
• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Digestive System Diseases; Pathologic Processes; Mood Disorders; Feeding and Eating Disorders; Gastrointestinal Diseases; Bipolar and Related Disorders; Depression; Depressive Disorder; Disease; Rumination Syndrome; Bipolar Disorder; Depressive Disorder, Major
• Other Study ID Numbers: 2012P000714; 19531 (Other Grant/Funding Number: Brain and Behavior Research Foundation)