New brain technologies including neuroimaging studies are powerful means for providing new insights into clinical and cognitive neuroscience. Bipolar disorder is a severe chronic phasic mental disease characterized by various cognitive dysfunctions. Working memory is one prominent domain of cognitive impairment in bipolar disorder. Disruptions in working memory are observed even in euthymic bipolar patients which makes it a potential endophenotypic marker for the disorder. Finding such markers may help in providing firm neurobiological basis for psychiatric nosologies and symptomatic presentations. This review aims to summarize some of the important aspects of findings from functional magnetic resonance imaging studies on the activation of brain structures in relation to working memory paradigms.

Functional imaging techniques, fMRI in particular, has given the possibility to investigate non-invasively the cognitive processes in healthy populations and different disorders concerning neuro-psychiatry, thus unfolding the concepts guiding diagnosis and patient management. Different brain structures seem to support different types of cognitive functions in particular learning and memory thus the neurobiological explanation of the retrieval of information is associated with knowledge of brain plasticity, memory circuits, synaptic neurotransmission and the modulation of glial cells. Consistent with fMRI investigations of memory systems we tested the dependability of a memory paradigm using heterogeneous memory stimuli in order to find the neurobiological basis that correlates with memory task performance. Our study resulted with statistical significant differences in brain activations across the block design contrasts in both occipital and temporal regions in 29 mentally healthy students during a memory paradigm performance after intensive learning. As functional magnetic resonance imaging has become an important and reliable tool for investigation of brain anatomy and its function in health and disease, it becomes clear that further research of neurobiological basis of cognitive and memory domains can clarify different diagnostic prototypes and thus explain the human brain impairments in neuropsychological patients, since these are characterized by various cognitive dysfunctions.

This case report presents the story of a young woman of Romani descent with a mixed dissociative (conversion) disorder within the contextual evidence-based and value-based medical framework. By painting the picture illustrating the course of her illness and the circumstances leading to the last clinical episode, compelling her most recent hospitalization, we delineate the contrast between common clinical phenomenology and the additional layers of the patient’s beliefs and values. Thus, we emphasize the importance of expanding the one-dimensional mainstream evidence-based approach, not only in cases of cross-cultural doctor-patient interactions but also in general medical practice, since the health attitudes and illness behaviors of every individual are influenced by their values and beliefs. In addition, the contemporary notion of medicine as a factual science requires a paradigm shift toward integrative multifaceted approaches if we as doctors are to treat human beings and not merely diseases.