Health & Medicine - Posted by Tracy James-Indiana on Tuesday, May 31, 2011 16:53 - 4 Comments 
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(No Ratings Yet) Loading ...Balance, bipolar link point to therapy
Questions about whether therapies that improve balance may also help mood disorders are complicated by the fact that many medications for psychiatric disorders have severe side effects, including ones that affect motor control. (Credit: iStockphoto)
INDIANA U. (US) — Problems with balance may be a core component of bipolar disorder, signaling an increased risk of developing the condition.
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The text of this article by Futurity is licensed under a Creative Commons Attribution-No Derivatives License.
Knowing that postural control is not just a random symptom could provide insight into both areas of the brain affected by psychiatric disorders like schizophrenia and neurological disorders like Huntington’s and Parkinson’s disease and point to new potential targets for treatment, according to a new study.
“For a number of psychological disorders, many different psychiatric treatments and therapies have been tried, with marginal effects over the long term. Researchers are really starting to look at new targets,” says Amanda Bolbecker, research scientist at Indiana University.
“Our study suggests that brain areas traditionally believed to be responsible for motor behavior might represent therapeutic targets for bipolar disorder.”
The study is published in the journal PLoS One.
Try as we might, humans cannot stand perfectly still, says S. Lee Hong, assistant professor of kinesiology and the study’s co-author. “Instead, we make small adjustments at our hips and ankles based on what our eyes, muscles, ligaments, tendons, and semi-circular canals tells us. The better these sensory sources are integrated, the less someone sways.”
Certain areas of the brain critical for motor control, mainly the cerebellum, basal ganglia, and brain stem, also aid in mood regulation and are areas where abnormalities often are found in people with bipolar disorder.
Postural sway—a measure of the degree of endless adjustments people make in an attempt to stand still—is considered a sensitive gauge of motor control that likely is affected by these abnormalities.
In the study, participants who had bipolar disorder displayed more postural sway, particularly when their eyes were closed, than study participants who had no psychological disorders. The troubles, which involved the participants’ ability to process non-visual sensory information related to balance, were not affected by their mood or the severity of their disorder.
“It appears that people with bipolar disorder process sensory information differently and this is seen in their inability to adapt their movement patterns to different conditions, such as eyes open versus eyes closed or feet together versus feet apart,” saysd Hong, whose research focuses on how humans control motion.
“The different conditions will cause people to use the information their senses provide differently, in order to allow them to maintain their balance.”
Bipolar disorder, formerly known as manic-depressive illness, is a severe psychiatric disorder characterized by extreme, debilitating mood swings and unusual shifts in a person’s energy and ability to function.
The study involved 16 people (seven women) with bipolar disorder and 16 age-matched people (nine women) who had no psychiatric disorders. They each stood barefoot and as still as possible on a piece of equipment called a force platform, which measured various aspects of postural sway as they stood with their eyes open and feet close together, eyes open and feet shoulder-width apart, eyes closed and feet together, and eyes closed and feet apart.
The measurements during each 2-minute pose included such factors as the area covered by a person’s circular sway, how quickly they revolved and the degrees by which the sway moved more front to back or side to side.
More findings include:
- The study does not suggest a “global motor deficit,” where people with bipolar disorder have movement problems all around. Instead, it suggests a specific problem adapting to changing sensory input—when people close their eyes, they rely on a different sources of sensory information, such as proprioception and the vestibular system.
- Participants with bipolar disorder displayed a large decline in postural control when their eyes were closed, regardless of the position of their feet.
- A significant difference between the study groups involved side-to-side postural control, which is largely a factor of the hips. The participants with bipolar disorder had less control. This difference was not seen in the front-to-back control, which relies on ankle adjustments. Participants with bipolar disorder might not have fully developed the control of posture using their hips, which is consistent with developmental factors contributing to bipolar disorder.
Research involving motor control, mood and psychiatric disorders is complicated because the primary treatment for them is medication, which can have severe side effects including motor control problems. A limitation of Hong and Bolbecker’s study is that they could not factor out the effects of the various kinds and combinations of medications taken by their study participants with bipolar disorder.
The study was supported by NARSAD: the Brain and Behavior Research Fund, formally called the National Alliance for Research on Schizophrenia and Depression.
More news from Indiana University: http://www.indiana.edu/news/
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4 Comments
Pabel
TPM
Very interesting study…thank you. I saw this on Spotlight on Health on Facebook.
Very interesting article.
I was diagnosed when I was 17. The diagnosis came as a relief really because I had something to work on.
The “problem” with statistics and research no person is the same. The condition has defferent effects on each person.
I find that most of the research tends to try a find a common ground for understanding.
in my bipolar blog http://www.lithiumandchips.com , I raise these concerns. In the UK things may be different to the USA.
Thanks for posting the article
Monty H.
What are the developmental factors that contribute to bipolar disorder?
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Interesting! As a person who has been diagnosed with BP and does take medication, more anti-depressant than mood control for me, I began to think part way through the article, “really? what factor is due to medication, in particular, mood control medication” I was glad to see that you mentioned the medication issue at the bottom of the article.
However, having raised it, there are more questions. (This is why I always found courses in statistics frustrating. Any question beginning “But how do I know…” would never be answered by the teacher) Even if you knew the meds and dosage a patient took, you would be missing some essential information – information that you will never know. One question, is whether the prescribed medicine is either the most appropriate or the best dose for a particular patient. If you are going to include medication as a variable, then there is an inference of the efficacy of the medication. Not all psychiatrists are at the same competency or take the same amount of time with patients, etc.
There is a “therapeutic minimal level” that has a base for any med. After four years, I now take what is considered below that level. So, does this mean, and I think it does, that many patients received too much medication because of protocol? Can you assume that the right medication at the right dosage fit for each patient, and does that affect swaying?
Another factor, and this one is really wide open, is the patient pursuing effective psychological therapy? Is the patient ready and working at it? Is the therapist competent? It’s the outcome of this that allowed me to get my medication changed after years of frustration from the side effects of a med at its level. I recently took a small dose of Red Rice Yeast for cholesterol for 3 months. My doctor told me I was wasting my time at that dosage of lovastatin but I could try it. Well, my cholesterol level was cut in half. It turns out I am hyper sensitive to lovastatin. So, what happens in a similar situation with a BP patient? Do they have the ability to know or say their med level is too high? As for this research, I have to admit, I want to know if I sway and how much. Unfortunately, you can’t tell me if I sway less after having reduced my medication level,
Having worked on a psych unit, I know the routine. Patient comes in during an episode, medication gets adjusted until the patient is stable, patient is discharged, patient comes back to the unit……….. I would find this research useful if it were turned around and an application study was done to see if improving balance improved other behaviors associated with BP. Highly involved I know, but you would have controlled subjects with lots of information. It would need a system that works for the patient population but any success involving patients might have esteem benefits if nothing else – no small matter for psych patients.