Evaluation of Cerebral Cortex Function in Clients with Bipolar Mood Disorder I (BMD I) Compared with BMD II Using QEEG Analysis

By Khaleghi, Ali; Sheikhani, Ali et al. | Iranian Journal of Psychiatry, April 2015 | Go to article overview

Evaluation of Cerebral Cortex Function in Clients with Bipolar Mood Disorder I (BMD I) Compared with BMD II Using QEEG Analysis


Khaleghi, Ali, Sheikhani, Ali, Mohammadi, Mohammad Reza, Nasrabadi, Ali Moti, Iranian Journal of Psychiatry


(ProQuest: ... denotes formulae omitted.)

Bipolar disorder is one of the severe and chronic disorders, involving mood changes, which may appear as elevated mood episodes (mania or hypomania) to low mood episodes (depression) (1). This disorder is often considered to have two ends one leading to bipolar I mood or classic disorder and the other end being sub-threshold mania or depression (2, 3). Bipolar II disorder is generally milder than bipolar I disorder, and according to DSM IV criteria, the number of criteria described for the both disorders is the same (1, 4, 5). The diagnostic criteria for these disorders are only based on the severity of symptoms; in the BMD II, performance will be slightly affected but in the BMD I the patients will have psychosis or less functions in various fields of life (4). However, both disorders have significant morbidity and mortality (6). Bipolar II disorder has more lifetime prevalence than bipolar I disorder (1, 4). Although the first accession in this disorder appears in late adolescence and early adulthood, this disorder is frequently seen in children and adolescents (7, 8). Despite the fact that the disorder appears in late adolescence and early adulthood with clear symptoms as episodic form, adolescents with bipolar disorder often have atypical and chronic symptoms without the episodes characterized by mania, hypomania and depression (7, 8). Therefore child or adolescent patients may experience elevated or low mood frequently during a day; and it is likely that they live with these symptoms without treatment for a few years and that the disorder may severely impact their educational and interpersonal performance and interfere with their personal and social development (8).

Accordingly, this disorder has a difficult diagnostic in childhood and adolescence. Therefore, under diagnosis and misdiagnosis is significant in this disorder (6, 9).

The QEEG as a common and reliable biomarker can be helpful in identification of neurophysiological differences in brain activity which are considered as main factors in occurrence of psychiatric disorders (10, 11, 12, 13, 14). The QEEG method is defined as "The mathematical processing of digitally recorded EEG in order to highlight specific waveform components, transform the EEG into a format or domain that elucidates relevant information, or associate numerical results" (15). Although many studies have examined the QEEG and brain function for several psychiatric disorders, there are a few studies on QEEG evaluation in patients with bipolar mood disorder (BMD), particularly in type I and type II, independently.

Oluboka and et al. evaluated absolute power and coherence differences with EEG signals features between patients with bipolar I disorder and schizophrenia (16). The results showed that right anterior hemisphere disorganization in BMD I patients is more than patients with schizophrenia. They also observed significant relationships between brain waves and presence of family history in the patients with BMD I. Bahrami et al. compared the fractal dimension of EEG signal in patients with BMD I through manic episode and normal subjects (17). They reported increases in brain complexity in BMD patients. Harmon-Jones et al. compared bipolar patients and normal individuals in relatively severe mental processes (18). They found higher left frontal activation in BMD patients.

In other studies, using EEG analysis and feature extraction from the signals, BMD diagnosis was done from other disorders such as schizophrenia and ADHD (19, 20, 21, 22). However, these studies were conducted without considering the type of bipolar disorder.

To the best of our knowledge, no studies have been conducted on patients with BMD I and BMD II and on their brain function, using QEEG analysis. While in some cases, the diagnosis of BMD I from BMD II is a serious challenge for psychiatrists, the aim of this study was to assess the differences in cortical function in these patients, using their EEG signal analysis. …

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