J Korean Geriatr Psychiatry.  2013 Oct;17(2):56-60.

Secondary Mania and Frontal-Subcortical Circuit

  • 1Department of Psychiatry, Pusan National University Hospital, Busan, Korea. psyleekr@naver.com
  • 2Medical Research Institute, Pusan National University Hospital, Busan, Korea.


Secondary mania is closely linked to neurocircuitry defects. Frontal-subcortical circuits, in particular, play a major role in the affective, motor and cognitive symptoms of secondary mania. In this paper, we present the three main frontal-subcortical circuits : the dorsolateral prefrontal circuit, which mediates executive functions (i.e., the organization of information to facilitate a response) ; the anterior cingulate circuit, which is involved in motivated behavior ; the orbitofrontal circuit, which has medial (i.e., integration of visceral-amygdalar functions with the internal state of the organism) and lateral divisions (i.e., integration of limbic and emotional information into contextually appropriate behavioral responses). Impaired executive functions, apathy, disinhibition and impulsivity are hallmarks of frontal-subcortical circuit dysfunction. The various neuropsychiatric manifestations of secondary mania may result from disturbances that have a direct or indirect impact on the integrity or functioning of these loops.


Bipolar disorder; Late onset; Frontal-subcortical circuits
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