Research Spotlight:

More evidence to implicate inflammation in bipolar disorder

While the cause of bipolar disorder remains unknown, there is an increasing focus on the roles of energy metabolism and inflammation in the brain. Brain cells (neurons) use a large amount of energy and this results in waste chemicals that need to be removed. The white cells in the brain are closely linked with the neurons and help to regulate and remove these waste products. It’s possible that this relationship — between brain cells and the immune cells that support them — is disrupted in bipolar disorder.

This recently published open-access article reports a laboratory experiment in which white blood cells — called macrophages — were exposed to blood serum (i.e., blood with the cells taken out) from people with bipolar disorder. The authors of the study were interested in whether the white blood cells would become ‘activated’ — responding to signs of inflammation in each subject’s serum.

Macrophages are a specific type of white blood cell in the immune system and are present in large numbers in the brain. They have an important role in controlling other cells by releasing chemical messages that tell the immune system to activate or deactivate.

For this study the authors took blood from subjects who attended a local clinic for treatment, and divided these samples into those from subjects with current manic symptoms, depressive symptoms, or without active symptoms (euthymic). They also had a control group.

When the cells were exposed to the blood, they found significant differences in inflammation depending on the source of the blood. That is, blood serum from subjects who were experiencing a manic or depressive episode caused a greater inflammatory response in the macrophages. The blood from subjects with bipolar disorder who were well at the time did not cause the same level of response, suggesting that inflammation is only relevant in people with bipolar disorder during times of mood instability (i.e., during mood episodes).

The study was quite small, with only 18 patients and 5 controls. With further replication in larger samples, it’s possible that this research will help to develop ways to manage inflammation before an episode starts. This could help to reduce episode severity and perhaps even help to predict or prevent future episodes.

Citation: Ferrari P, Parisi MM, Colombo R, Becker M, Fries G, Ascoli BM, Géa LP, Kauer-Sant’anna M, Kapczinski F, Klamt F, Guma FTCR, Rosa AR, Barbé-Tuana FM (2018). Depression and mania induce pro-inflammatory activation of macrophages following application of serum from individuals with bipolar disorderClinical Psychopharmacology & Neuroscience 16 (1): 103–108.

EMCR Committee Members

Dr Katie Douglas — Chair  |  NZ representative

Dr Katie Douglas is a Research Fellow at the Department of Psychological Medicine, University of Otago, in Christchurch, New Zealand. Her research interests relate to the cognitive, psychological and neurobiological aspects of mood and anxiety disorders, factors influencing response to psychotherapy and pharmacotherapy, and treatments aimed at improving cognitive and functional outcomes in mood disorders. She supervises PhD students in the areas of cognitive functioning in mood disorders, elderly depression and polycystic ovarian syndrome. Katie is a registered Clinical Psychologist and her clinical practice currently involves providing psychological therapy in clinical trials at the Department of Psychological Medicine for patients with mood disorders. She has previously worked clinically in the areas of health psychology and forensic psychology.

Katie has been awarded two major research grants as Principal Investigator from the Canterbury Medical Research Foundation. The first (2012) was a neuroimaging project of earthquake-related PTSD, which was successfully completed in 2016. The second grant (2016), which is currently underway, funded a project examining the effectiveness of a clinical trial of cognitively enhanced psychological therapy for recurrent mood disorders. She is a named investigator on two clinical trials of cognitive remediation interventions in inpatient and outpatient samples, and has published and presented extensively in this area. She is also a named investigator on a study of the subjective experience of cognitive impairment in mood disorders. Katie has received substantial travel grant funding to present at many international conferences, and prestigious awards that have recognised her achievements in clinical psychology.

Tamsyn Van RheenenDr Tamsyn Van Rheenen

Dr Tamsyn Van Rheenen is a post-doctoral research fellow working in the area of cognitive neuropsychiatry. Her research aims to use an understanding of neurobehavioral function and neurobiology to discover and validate biomarkers, improve diagnostic accuracy/risk identification and inform the development of novel treatment interventions for bipolar disorder.

Tamsyn graduated from Swinburne University in 2009 with a Bachelor of Social Science succeeded by an honours degree in Psychology. She commenced her PhD at Swinburne University in April 2010, after receiving an Australian Postgraduate Award to complete her research into cognition and emotion processing in bipolar disorder. Her thesis was passed in March 2014.

Tamsyn has recently been awarded a Peter Doherty Biomedical early career research fellowship from the NHMRC. She has also been the recipient of substantial travel funding to support her to present her work at several national and international conferences.  The research she has been involved with has been featured in the in various news outlets (e.g., Medwire News, ABC Science, Nature World News, Psychiatry Weekly) and she has been recognized with several prestigious awards including an Australian Schizophrenia Conference Young Investigator Award for Research Excellence and a 2014 Australian Psychological Society Award for Excellent PhD thesis in Psychology.

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Frank1Dr Frank Giorlando — Committee Member & our Go-to-Techie!

Dr Frank Giorlando is a medical doctor and researcher investigating the perception of time. His research focuses upon integrating basic neuroscience with the psychiatry of dissociation. He is studying at the University of Melbourne and has also been a visiting scholar at the University of Cambridge. His current research includes studies of patients with Bipolar Disorder using the methodologies of psychophysics, computer modelling, MRI and EEG. Frank is a recepient of a Melbourne Research Scholarship and has received grants from the RANZCP, The University of Sydney, ASBDD/Astra Zeneca and Pfizer. He is also working on a theory integrating theoretical physics with non-dualist theory of consciousness.

Lana WilliamsDr Lana Williams — Committee Member

Dr Lana Williams is a NHMRC Career Development Fellow and Psychologist with significant experience in psychiatric epidemiology and a special interest in the co-occurrence of physical and mental disorders. She currently is the Head of the Division of Psychiatric Epidemiology within the IMPACT Strategic Research Centre, Deakin University, and also leads GOS Mental Health, a large epidemiological study involving an age-stratified, random, population-based sample of ~3000 men and women. Over the past years, Dr Williams has been developing an innovative program of research examining medical, lifestyle and social correlates of mood, anxiety and personality disorders within the community. Cornerstone is her work investigating the interplay between psychiatric disorders, the medications used to treat these disorders and bone health, which has attracted extensive project funding and personal awards. Her research program is an invaluable resource for collaborative studies, both nationally and internationally and student projects.

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Miss Emmanuelle Bostock — Committee Member | TAS representative | Newsletter Co-Editor

Miss Emmanuelle Bostock is a current University of Tasmania PhD candidate, funded by an Australian Postgraduate Award. She holds a Bachelor of Psychology (Hons) and a Graduate Certificate in Evidence-Based Complementary Medicine. Her research aims to better understand bipolar disorder in relation to a reference condition, temporal lobe epilepsy. To date, she has compared bipolar disorder and temporal lobe epilepsy on precipitating factors and neuropsychology, both of which were published in peer-reviewed journals. In addition, Emmanuelle also has a keen interest in the use of the ketogenic diet (i.e., a high-fat, low-carbohydrate diet) in the treatment of psychiatric disorders.

In 2015, she was awarded a Goddard Sapin-Jaloustre Scholarship to travel to Montpellier (France) where she undertook a course “Research Methods in Psychiatry”. The intensive programme of this summer school was developed by the French National Institute of Health and Medical Research (INSERM) in collaboration with the Institute of Psychiatry, King’s College London. She has also presented posters at various international and national conferences (partly funded by the University of Tasmania).

Melanie Ashton — Committee Member  |  VIC representative  |  Scribe

Melanie Ashton is a PhD student in the IMPACT SRC at Deakin University. Melanie has a particular interest in bipolar disorder and the need for a wider range of medications for the depressive phase of the illness. Therefore, for her PhD, she aims to trial a new natural fruit supplement to be taken in addition to current treatments. Melanie has received the ASDBDD / Lundbeck Neuroscience Scholarship to fund the first year of her PhD. She has also received the Australian Rotary Health — Ian Parker Bipolar Research Fund PhD Scholarship for Bipolar
Depressive Disorder Research.

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Miss Jennifer Nicholas — Committee Member  |  NSW representative  | Twitter-in-Charge:

Jennifer is a PhD candidate at the Black Dog Institute in the final stages of her project. Broadly, Jennifer is interested in improving access to evidence-based care and mental health tools and resources through technology. Her PhD research has investigated how smartphone apps can support young adults with bipolar disorder actively manage their mental health. This research has taken a strong consumer focus, with an exploration of consumer needs and perspectives on smartphone apps for disorder management central to the work. She has also investigated the scientific quality of existing resources available to consumers. Jennifer hopes the results will led to the development of acceptable, useful apps for bipolar disorder that meet the needs of young adults with the disorder. By intervening early in young people with bipolar disorder and supporting active disorder management with easy-to-use digital resources, Jennifer hopes to increase the quality of life of individuals living with the condition. She recently won the Black Puppy Award for best research paper on youth mental health. The prize will fund her attendance at the International Society for Research in Internet Interventions conference held this October in Berlin.

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Dr Aswin Ratheesh — Committee Member  |  VIC representative  | Newsletter Editor-in-Chief

Aswin is an NHMRC Early Career Fellow and consultant psychiatrist with Orygen — the National Centre of Excellence in Youth Mental Health and the Centre for Youth Mental Health at the University of Melbourne. He recently completed his PhD examining the clinical precursors for bipolar disorder (BD) among young people. His interests include: (i) understanding the barriers to care for young people with bipolar disorders; (ii) improving psychological and pharmacological interventions for these young people; (iii) understanding the co-evolution of bipolar disorder, substance use, depression and psychosis; and (iv) understanding the common and unique risk factors for serious mental disorders among young people. At the affiliated youth mental health service (Orygen Youth Health), he is developing new models of care for young people with bipolar disorders. Aswin also consults at a headspace setting where he works with young people with high-prevalence disorders such as depression and anxiety, where he is interested in the prediction and prevention of BD.

Aswin is an investigator on several ongoing clinical trials at Orygen and an Associate Editor for BMC Psychiatry. He has received research grant support from NHMRC and the Society for Mental Health Research (SMHR), as well as prizes and awards from ASBDD, International Early Psychosis Association (IEPA), International Society for Bipolar Disorders (ISBD) and the Japanese Society of Psychiatry and Neurology.

Dr Trung Ngo — Committee Member & Web-Ninja

Trung is currently an Honorary Fellow at UQ Diamantina Institute within the UQ Faculty of Medicine and Translational Research Institute (TRI). He completed a PhD in Neuroscience with Jack Pettigrew, employing caloric vestibular stimulation (CVS) — a simple, non-invasive (unihemispheric) brain stimulation technique — to demonstrate evidence for a novel neural mechanism of visual rivalry: the interhemispheric switch model. At Monash Alfred Psychiatry Research Centre, his NHMRC postdoctoral clinical research fellowship focused on investigating rivalry mechanisms and abnormalities in psychiatric groups. Trung’s fellowship studies also examined CVS as a potential therapeutic intervention in persistent (chronic) pain disorders.

He is continuing this body of work with research projects into: (i) novel visual task measures for identifying individuals at increased risk of developing mental illness (e.g., at-risk young people & early psychosis cohorts); (ii) the effectiveness of non-invasive repeated vestibulocortical stimulation (rVCS) protocols as a treatment for depression and related conditions; and (iii) the genetics and neuroimaging of therapeutic response to rVCS, with the aim of elucidating novel electroceutical pathways, response biomarkers and personalised treatment protocols across a spectrum psychiatric and neurological disorders (‘electroceutomics’).

His other broad research interest entails the thesis that bistable (anti-phase) interhemispheric oscillations are a fundamental neurobiological mechanism — given they’re widely observed in several species (e.g., rodents, birds, cetaceans, humans, Drosophila) and across diverse phenotypes such as biological rhythms (e.g., sleep/wake and menstrual cycles), autonomic functions, oculomotor activity, perception/attention and mood/behaviour changes. Studies in this area will aim to determine whether the underlying genes, neural network dynamics (e.g., vestibulocortical circuitry) and molecular mechanisms are conserved in nature, with significant implications for translational outcomes across psychiatry, neurology, cardiovascular & sleep medicine  |  #PrecisionSwitchMedicine

Connect with Trung on Twitter  —

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