51
|
Oliva V, Lippi M, Paci R, Del Fabro L, Delvecchio G, Brambilla P, De Ronchi D, Fanelli G, Serretti A. Gastrointestinal side effects associated with antidepressant treatments in patients with major depressive disorder: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2021; 109:110266. [PMID: 33549697 DOI: 10.1016/j.pnpbp.2021.110266] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/28/2021] [Accepted: 01/31/2021] [Indexed: 12/25/2022]
Abstract
Gastrointestinal side effects (SEs) are frequently observed in patients with major depressive disorder (MDD) while taking antidepressants and may lead to treatment discontinuation. The aim of this meta-analysis is to provide quantitative measures on short-term rates of gastrointestinal SEs in MDD patients treated with second-generation antidepressants. An electronic search of the literature was conducted by using MEDLINE, ISI Web of Science - Web of Science Core Collection, and Cochrane Library databases. Eligible studies had to focus on the use of at least one of 15 antidepressants commonly used in MDD (i.e., agomelatine, bupropion, citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, levomilnacipran, mirtazapine, paroxetine, reboxetine, sertraline, venlafaxine, and vortioxetine) and report data on treatment-emergent gastrointestinal SEs (i.e. nausea/vomiting, diarrhoea, constipation, abdominal pain, dyspepsia, anorexia, increased appetite and dry mouth) within 12 weeks of treatment. Overall, 304 studies were included in the meta-analyses. All the considered antidepressants showed higher rates of gastrointestinal SEs than placebo. Escitalopram and sertraline were shown to be the least tolerated antidepressants on the gastrointestinal tract, being associated with all the considered SEs with the exception of constipation and increased appetite, while mirtazapine was shown to be the antidepressant with fewer side effects on the gut, being only associated with increased appetite. In conclusion, commonly used antidepressants showed different profiles of gastrointestinal SEs, possibly related to their mechanisms of action. The specific tolerability profile of each compound should be considered by clinicians when prescribing antidepressants in order to improve adherence to treatment and increase positive outcomes in patients with MDD.
Collapse
Affiliation(s)
- Vincenzo Oliva
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Matteo Lippi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Riccardo Paci
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Lorenzo Del Fabro
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| |
Collapse
|
52
|
Enrico P, Delvecchio G, Turtulici N, Pigoni A, Villa FM, Perlini C, Rossetti MG, Bellani M, Lasalvia A, Bonetto C, Scocco P, D’Agostino A, Torresani S, Imbesi M, Bellini F, Veronese A, Bocchio-Chiavetto L, Gennarelli M, Balestrieri M, Colombo GI, Finardi A, Ruggeri M, Furlan R, Brambilla P. Classification of Psychoses Based on Immunological Features: A Machine Learning Study in a Large Cohort of First-Episode and Chronic Patients. Schizophr Bull 2021; 47:1141-1155. [PMID: 33561292 PMCID: PMC8266656 DOI: 10.1093/schbul/sbaa190] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
For several years, the role of immune system in the pathophysiology of psychosis has been well-recognized, showing differences from the onset to chronic phases. Our study aims to implement a biomarker-based classification model suitable for the clinical management of psychotic patients. A machine learning algorithm was used to classify a cohort of 362 subjects, including 160 first-episode psychosis patients (FEP), 70 patients affected by chronic psychiatric disorders (schizophrenia, bipolar disorder, and major depressive disorder) with psychosis (CRO) and 132 health controls (HC), based on mRNA transcript levels of 56 immune genes. Models distinguished between FEP, CRO, and HC and between the subgroup of drug-free FEP and HC with a mean accuracy of 80.8% and 90.4%, respectively. Interestingly, by using the feature importance method, we identified some immune gene transcripts that contribute most to the classification accuracy, possibly giving new insights on the immunopathogenesis of psychosis. Therefore, our results suggest that our classification model has a high translational potential, which may pave the way for a personalized management of psychosis.
Collapse
Affiliation(s)
- Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Nunzio Turtulici
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandro Pigoni
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy
| | | | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Maria Gloria Rossetti
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- AOUI – Verona Hospital Trust, Verona, Italy
| | - Antonio Lasalvia
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- AOUI – Verona Hospital Trust, Verona, Italy
| | - Chiara Bonetto
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Paolo Scocco
- Department of Mental Health, AULSS 6 Euganea, Padua, Italy
| | - Armando D’Agostino
- Department of Health Sciences, San Paolo University Hospital, University of Milan, Milan, Italy
| | - Stefano Torresani
- Department of Psychiatry, ULSS, Bolzano Suedtiroler Sanitaetbetrieb- Azienda Sanitaria dell’Alto Adige, Bolzano, Italy
| | | | | | | | - Luisella Bocchio-Chiavetto
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Faculty of Psychology, eCampus University, Novedrate, Como, Italy
| | - Massimo Gennarelli
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Gualtiero I Colombo
- Centro Cardiologico Monzino IRCCS, Immunology and Functional Genomics Unit, Milan, Italy
| | - Annamaria Finardi
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Mirella Ruggeri
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- AOUI – Verona Hospital Trust, Verona, Italy
| | - Roberto Furlan
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
53
|
Cattarinussi G, Delvecchio G, Maggioni E, Bressi C, Brambilla P. Ultra-high field imaging in Major Depressive Disorder: a review of structural and functional studies. J Affect Disord 2021; 290:65-73. [PMID: 33993082 DOI: 10.1016/j.jad.2021.04.056] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/25/2021] [Accepted: 04/23/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a severe and pervasive psychiatric condition with a lifetime prevalence of 15-25%. Numerous Magnetic Resonance Imaging (MRI) studies employing scans at field strengths of 1.5T or 3T have been carried out in the last decades, providing an unprecedented insight into the neural correlates of MDD. However, in recent years, MRI technology has largely progressed and the use of scans at ultra-high field (≥ 7T) has improved the sensitivity and the resolution of MR images. In this context, with this review we aim to summarize evidence of structural and functional brain mechanisms underlying MDD obtained with ultra-high field MRI. METHODS We conducted a search on PubMed, Scopus and Web of Science of neuroimaging studies on MDD patients, which employed ultra-high field MRI. We detected six structural MRI studies, two Diffusion Tensor Imaging (DTI) studies and five functional MRI (fMRI) studies. RESULTS Overall, the MRI and DTI studies showed volumetric and structural connectivity alterations in the hippocampus and, to a lesser extent, in the amygdala. In contrast, more heterogeneous results were reported by fMRI studies, which, though, described functional abnormalities in the cingulate cortex, thalamus and several other brain areas. LIMITATIONS The small sample size and the heterogeneity in patients' samples, processing and study design limit the conclusion of the present review. CONCLUSIONS Studies employing scans at ultra-high magnetic field may provide a useful contribution to the mixed body of literature on MDD. This preliminary but promising evidence confirms the importance of performing ultra-high field MRI investigations in order to detect and better characterize subtle brain abnormalities in MDD.
Collapse
Affiliation(s)
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, 20122 Milan, Italy.
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cinzia Bressi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, 20122 Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
54
|
Pigoni A, Dwyer D, Squarcina L, Borgwardt S, Crespo-Facorro B, Dazzan P, Smesny S, Spaniel F, Spalletta G, Sanfelici R, Antonucci LA, Reuf A, Oeztuerk OF, Schmidt A, Ciufolini S, Schönborn-Harrisberger F, Langbein K, Gussew A, Reichenbach JR, Zaytseva Y, Piras F, Delvecchio G, Bellani M, Ruggeri M, Lasalvia A, Tordesillas-Gutiérrez D, Ortiz V, Murray RM, Reis-Marques T, Di Forti M, Koutsouleris N, Brambilla P. Classification of first-episode psychosis using cortical thickness: A large multicenter MRI study. Eur Neuropsychopharmacol 2021; 47:34-47. [PMID: 33957410 DOI: 10.1016/j.euroneuro.2021.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/21/2021] [Accepted: 04/06/2021] [Indexed: 12/19/2022]
Abstract
Machine learning classifications of first-episode psychosis (FEP) using neuroimaging have predominantly analyzed brain volumes. Some studies examined cortical thickness, but most of them have used parcellation approaches with data from single sites, which limits claims of generalizability. To address these limitations, we conducted a large-scale, multi-site analysis of cortical thickness comparing parcellations and vertex-wise approaches. By leveraging the multi-site nature of the study, we further investigated how different demographical and site-dependent variables affected predictions. Finally, we assessed relationships between predictions and clinical variables. 428 subjects (147 females, mean age 27.14) with FEP and 448 (230 females, mean age 27.06) healthy controls were enrolled in 8 centers by the ClassiFEP group. All subjects underwent a structural MRI and were clinically assessed. Cortical thickness parcellation (68 areas) and full cortical maps (20,484 vertices) were extracted. Linear Support Vector Machine was used for classification within a repeated nested cross-validation framework. Vertex-wise thickness maps outperformed parcellation-based methods with a balanced accuracy of 66.2% and an Area Under the Curve of 72%. By stratifying our sample for MRI scanner, we increased generalizability across sites. Temporal brain areas resulted as the most influential in the classification. The predictive decision scores significantly correlated with age at onset, duration of treatment, and positive symptoms. In conclusion, although far from the threshold of clinical relevance, temporal cortical thickness proved to classify between FEP subjects and healthy individuals. The assessment of site-dependent variables permitted an increase in the across-site generalizability, thus attempting to address an important machine learning limitation.
Collapse
Affiliation(s)
- A Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - D Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - L Squarcina
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy
| | - S Borgwardt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland; Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - B Crespo-Facorro
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain; University Hospital Virgen del Rocio, Department of Psychiatry, School of Medicine, University of Sevilla-IBiS, CIBERSAM, Sevilla, Spain
| | - P Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - S Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - F Spaniel
- Department of Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany Czechia
| | - G Spalletta
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - R Sanfelici
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; Max Planck School of Cognition, Stephanstrasse 1a, Leipzig, Germany
| | - L A Antonucci
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - A Reuf
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Oe F Oeztuerk
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - A Schmidt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - S Ciufolini
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | | | - K Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - A Gussew
- Department of Radiology, University Hospital Halle (Saale), Germany
| | - J R Reichenbach
- Medical Physics Group, Department of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - Y Zaytseva
- Department of Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany Czechia
| | - F Piras
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - G Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - M Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy; UOC of Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI) of Verona, Italy
| | - M Ruggeri
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy; UOC of Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI) of Verona, Italy
| | - A Lasalvia
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy; UOC of Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI) of Verona, Italy
| | - D Tordesillas-Gutiérrez
- Department of Radiology, Marqués de Valdecilla University Hospital, Valdecilla Biomedical Research Institute IDIVAL, Spain
| | - V Ortiz
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
| | - R M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - T Reis-Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - M Di Forti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - N Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - P Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| |
Collapse
|
55
|
Cattarinussi G, Delvecchio G, Prunas C, Moltrasio C, Brambilla P. Effects of pharmacological treatments on emotional tasks in borderline personality disorder: A review of functional magnetic resonance imaging studies. J Affect Disord 2021; 288:50-57. [PMID: 33839558 DOI: 10.1016/j.jad.2021.03.088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/17/2021] [Accepted: 03/29/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND Borderline personality disorder (BPD) is a common mental disorder characterized by instability in interpersonal relationships, impaired self-image, impulsivity and aggressive behaviors that often requires pharmacological treatments. Neuroimaging alterations have been extensively reported in BPD, especially in regions within the fronto-limbic system. Although medications can be an important confounding factor in functional Magnetic Resonance Imaging (fMRI) studies, their role on brain function in BPD patients still remains uncertain. Therefore, this review aims to improve our understanding on the potential effect of the most commonly prescribed drugs for BPD on brain function during processing of emotional tasks. METHODS A search on PubMed, Scopus and Web of Science of fMRI studies exploring the effect of antipsychotics, antidepressants and mood stabilizers on brain activity during processing of emotional tasks on BPD was conducted. RESULTS Overall the studies showed small or no effect of pharmacological treatments on brain activity and connectivity in BPD patients during processing of emotional tasks. LIMITATIONS The small sample size, the observational design, the elevated percentage of women, the concomitant use of psychostimulants, anticholinergics and opioids substitute treatments and the high rate of comorbidities limit the conclusion of this review. CONCLUSIONS Pharmacological treatments seem to have minor role on brain activity/connectivity in BPD patients during emotional tasks, ultimately suggesting that in BPD patients brain deficits seem not be influenced by medications. This might be due to functional brain specificities of BPD and to the differences in pharmacological regimens and compliance to therapy between BPD and other common psychiatric disorders.
Collapse
Affiliation(s)
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Cecilia Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
56
|
Giomi S, Siri F, Ferro A, Moltrasio C, Ariyo M, Delvecchio G, Brambilla P. Executive Functions in panic disorder: A mini-review. J Affect Disord 2021; 288:107-113. [PMID: 33848752 DOI: 10.1016/j.jad.2021.03.084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Panic disorder (PD) is an anxiety disorder characterized by recurrent panic attacks whose aetiology might be associated with alterations of the prefrontal-amygdala circuitry. The prefrontal cortex is a key region involved in executive functioning (EF) whose disturbance may imply harsh consequences over personal, social, and working aspects of PD patients. Indeed, defining the real involvement of EF in PD could lead to early assessment, better treatment, and rehabilitation options. These could have a substantial impact on the quality of life of these patients and their caregivers, thus reducing long-term health care needs. METHODS We reviewed findings from different studies that investigated executive functioning in PD patients using standardized neuropsychological measures. The review was conducted with the Preferred Reported Items for Systematic Reviews and Meta-Analysis (PRISMA). In addition, peer-reviewed human-based research articles were selected and twelve studies were retrieved through a search on PubMed. Four uniquely focused on PD patients, two also included a sample of first-degree relatives, while six included a mixed sample of different psychiatric illnesses, including PD. RESULTS The majority of the studies found no alterations in PD patients, suggesting that EF might not be a core deficit in this disorder. However, some studies (N = 4) found EF deficits in selective domains, which included attention and set-shifting processes, cognitive flexibility, decision-making abilities, and working memory in PD patients and/or in their first-degree relatives. LIMITATIONS Unbalanced and small samples, unmonitored therapies, and the heterogeneity of cognitive and diagnostic assessment measures might have limited the generalizability of the results. CONCLUSIONS Overall, the results point towards the hypothesis that PD patients had preserved EF. However, future studies with standardized methodological procedures and with a gold standard assessment of EF will be required to finally exclude its involvement in the disease.
Collapse
Affiliation(s)
- Serena Giomi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesca Siri
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Adele Ferro
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mayowa Ariyo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| |
Collapse
|
57
|
Bottinelli F, Delvecchio G, Moltrasio C, Ferro A, Diwadkar VA, Brambilla P. Facial emotion recognition in panic disorder: a mini-review of behavioural studies. J Affect Disord 2021; 282:173-178. [PMID: 33418364 DOI: 10.1016/j.jad.2020.12.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Panic Disorder (PD) is characterized by unexpected and repeated moments of intense fear or anxiety, which manifest themselves through strong cognitive and behavioural symptoms. However, a clear picture of how impairments in recognition and processing of facial emotions affect the everyday life of PD patients has yet to be delineated. This review attempts to provide an overview of behavioural studies of emotion detection from facial stimuli in PD patients. METHODS A bibliographic research on PubMed of all studies investigating the recognition and processing of facial emotion stimuli in patients with PD and in high-risk offspring was performed, and nine articles (yrs: 2000 to 2019) were discovered. RESULTS In several of the reviewed studies, PD patients showed significant deficits in detecting (particularly negative) emotions in facial stimuli. These impairments were also found in the offspring of parents with PD and high-risk individuals. LIMITATIONS Inferences are constrained by methodological heterogeneity, included but not limited to cross-study variability in the stimuli employed, and in the clinical characterization of PD patients. CONCLUSIONS In general, the results of this survey confirm that deficits in processing facially conveyed negative emotions should be considered a core impairment in PD. However, future larger and more homogenous studies are warranted to better highlight the connection between emotion recognition and PD.
Collapse
Affiliation(s)
- Francesca Bottinelli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Adele Ferro
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| |
Collapse
|
58
|
Oliva A, Torre S, Taranto P, Delvecchio G, Brambilla P. Neural correlates of emotional processing in panic disorder: A mini review of functional magnetic resonance imaging studies. J Affect Disord 2021; 282:906-914. [PMID: 33601734 DOI: 10.1016/j.jad.2020.12.085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Panic Disorder (PD) is mainly characterized by recurrent unexpected panic attacks. Although the presence of emotional functioning deficits in PD is well established, their neuronal bases are still less known. Therefore, in this review, we aim to summarize the available functional Magnetic Resonance Imaging (fMRI) studies investigating the neural correlates associated with the processing of facial emotional expressions in patients with PD. METHODS A comprehensive search on PubMed was performed and 10 fMRI studies meeting our inclusion criteria were included in this review. RESULTS The majority of the studies reported selective deficits in key brain regions within the prefronto-limbic network in PD patients. Specifically, a mixed picture of hyperactivation and hypoactivation patterns were observed in limbic regions, including the amygdala and the anterior cingulate cortex (ACC), as well as in areas within the prefrontal cortex (PFC), either during negative or positive valenced stimuli, as compared to healthy controls (HC) or other anxiety disorders. LIMITATIONS The limited number of studies and the clinical and methodological heterogeneity make it difficult to draw definite conclusions on the neural mechanism of emotional processing associated with PD. CONCLUSION Although the results of the available evidence suggest the presence of selective dysfunctions in regions within the cortico-limbic network in PD patients during processing of emotional stimuli, the direction of these abnormalities is still unclear. Therefore, future larger and more homogeneous studies are needed to elucidate the neural mechanisms underpinning the emotional processing dysfunctions often observed in PD patients.
Collapse
Affiliation(s)
- Anna Oliva
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Torre
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Paola Taranto
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| |
Collapse
|
59
|
Delvecchio G, Maggioni E, Pigoni A, Crespo-Facorro B, Nenadić I, Benedetti F, Gaser C, Sauer H, Roiz-Santiañez R, Poletti S, Rossetti MG, Bellani M, Perlini C, Ruggeri M, Diwadkar VA, Brambilla P. Sexual Regional Dimorphism of Post-Adolescent and Middle Age Brain Maturation. A Multi-center 3T MRI Study. Front Aging Neurosci 2021; 13:622054. [PMID: 33613268 PMCID: PMC7892767 DOI: 10.3389/fnagi.2021.622054] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/11/2021] [Indexed: 12/16/2022] Open
Abstract
Sex-related differences are tied into neurodevelopmental and lifespan processes, beginning early in the perinatal and developmental phases and continue into adulthood. The present study was designed to investigate sexual dimorphism of changes in gray matter (GM) volume in post-adolescence, with a focus on early and middle-adulthood using a structural magnetic resonance imaging (MRI) dataset of healthy controls from the European Network on Psychosis, Affective disorders and Cognitive Trajectory (ENPACT). Three hundred and seventy three subjects underwent a 3.0 T MRI session across four European Centers. Age by sex effects on GM volumes were investigated using voxel-based morphometry (VBM) and the Automated Anatomical Labeling atlas regions (ROI). Females and males showed overlapping and non-overlapping patterns of GM volume changes during aging. Overlapping age-related changes emerged in bilateral frontal and temporal cortices, insula and thalamus. Both VBM and ROI analyses revealed non-overlapping changes in multiple regions, including cerebellum and vermis, bilateral mid frontal, mid occipital cortices, left inferior temporal and precentral gyri. These findings highlight the importance of accounting for sex differences in cross-sectional analyses, not only in the study of normative changes, but particularly in the context of psychiatric and neurologic disorders, wherein sex effects may be confounded with disease-related changes.
Collapse
Affiliation(s)
- Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandro Pigoni
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - B Crespo-Facorro
- Department of Psychiatry, University Hospital Virgen del Rocío, IBiS, University of Sevilla, Sevilla, Spain.,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg/Marburg University Hospital - UKGM, Marburg, Germany
| | - Francesco Benedetti
- Division of Neuroscience, Unit of Psychiatry and Clinical Psychobiology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Christian Gaser
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - Heinrich Sauer
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - Roberto Roiz-Santiañez
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain.,Department of Psychiatry, School of Medicine, University Hospital Marqués de Valdecilla, University of Cantabria-IDIVAL, Santander, Spain
| | - Sara Poletti
- Division of Neuroscience, Unit of Psychiatry and Clinical Psychobiology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Maria G Rossetti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Mirella Ruggeri
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, United States
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
60
|
Sciortino D, Pigoni A, Delvecchio G, Maggioni E, Schiena G, Brambilla P. Role of rTMS in the treatment of cognitive impairments in Bipolar Disorder and Schizophrenia: a review of Randomized Controlled Trials. J Affect Disord 2021; 280:148-155. [PMID: 33212406 DOI: 10.1016/j.jad.2020.11.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Schizophrenia (SCZ) and Bipolar Disorder (BD) are severe psychiatric illnesses often characterized by mild-to-severe cognitive deficits. Since available pharmacotherapy showed poor efficacy in treating these cognitive impairments, new strategies are needed. Repeated Transcranial Magnetic Stimulation (rTMS) represents a safe non-invasive technique that has been hypothesized to improve cognitive symptoms in these pathologies. Therefore, our brief review aims at summarizing the results of Randomized Controlled Trials (RCTs) using rTMS for improving cognitive symptoms in SCZ and BD. METHODS We performed a bibliographic research on PubMed, Google Scholar and Medline of RCTs conducted in patients with BD and SCZ, which evaluated cognitive outcomes after rTMS treatment. RESULTS The inclusion criteria were met by fifteen RCTs, twelve in SCZ and three in BD. Regarding patients with SCZ, the results showed that rTMS seemed to have poor effects on improving cognitive performances, with mixed results also observed for schizoaffective patients. In BD, overall the RCTs showed that rTMS in these patients seemed to improve cognitive domains in euthymic patients, while its effect during acute phases, especially depression, appeared limited. LIMITATIONS Studies employed different rTMS protocols and evaluated different cognitive domains. CONCLUSIONS Although the available evidence from RCTs evaluating the efficacy of rTMS on cognitive deficits in SCZ and BD are still mixed and heterogenous, overall they suggest that rTMS represents a potential clinical tool that could ameliorate cognitive symptoms, especially in specific patients' subtypes. However, standardized protocols and further research are still necessary to evaluate the real efficacy of rTMS.
Collapse
Affiliation(s)
- Domenico Sciortino
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandro Pigoni
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giandomenico Schiena
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
61
|
Cantù F, Ciappolino V, Enrico P, Moltrasio C, Delvecchio G, Brambilla P. Augmentation with Atypical Antipsychotics for Treatment-Resistant Depression. J Affect Disord 2021; 280:45-53. [PMID: 33202337 DOI: 10.1016/j.jad.2020.11.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Treatment-resistant depression (TRD) is considered a common clinical condition often associated with relevant suicidal ideation and characterized by a severe functional impairment lifetime. Among the available drugs for the TRD treatment, second-generation antipsychotics (SGAs) have been reported as effective. In this context, the aim of this study was to review the clinical studies evaluating the efficacy of SGAs as add-on therapy in TRD. METHODS A comprehensive search on PubMed, Medline and PsychINFO of all randomized clinical trials (RCTs) assessing the augmentation with antipsychotics in TRD, published from January 2000 until March 2020, was performed. Sixteen RCTs studies met the inclusion criteria. RESULTS The reviewed studies showed that the add-on therapy with aripiprazole could be beneficial in the treatment of TRD. Furthermore, RCTs on quetiapine augmentation support its use in TRD, especially when comorbid anxiety or insomnia are present. The effects of risperidone and olanzapine as add-on in TRD were less studied, but preliminary data indicated an efficacy respect to placebo, making them a possible therapeutic option in TRD. LIMITATIONS The lack of consistency in the definition of TRD together with the small sample sizes and the heterogeneity of antipsychotics dosages used in the reviewed RCTs may have limited the strength of evidences obtained. CONCLUSION Overall, the available RCTs studies seem to support the hypothesis that the augmentation with SGAs, in particular aripiprazole and quetiapine, is a valid therapeutic option for TRD. However, to improve the therapeutic outcome of patients with TRD, larger and more homogeneous RCTs are needed.
Collapse
Affiliation(s)
- Filippo Cantù
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
62
|
Cereda G, Enrico P, Ciappolino V, Delvecchio G, Brambilla P. The role of vitamin D in bipolar disorder: Epidemiology and influence on disease activity. J Affect Disord 2021; 278:209-217. [PMID: 32971313 DOI: 10.1016/j.jad.2020.09.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Although many studies found an association between psychiatric disorders, especially major depressive disorder, and vitamin D deficiency, little is still known about the association between vitamin D and bipolar disorder (BD). Therefore, the present review aims at providing an overview of the available literature exploring the role of vitamin D in BD patients in different phases of the disease. METHODS From a bibliographic research in PubMed until April 2020, we collected ten original studies that fulfilled our inclusion criteria. RESULTS No significant differences in vitamin D levels between BD patients and other psychiatric disorders were found by most of the studies. In the majority of the studies, the average values of vitamin D in BD population were sub-threshold for vitamin D deficiency. Moreover, although an association between vitamin D levels and clinical symptomatology was observed in BD patients, it cannot be considered a specific marker of this disorder but a common characteristic shared with other psychiatric disorders, including schizophrenia and major depressive disorder. Finally, vitamin D supplementation was associated with a reduction in both depressive and manic symptoms. LIMITATIONS Few studies with small and heterogeneous populations. Methodological heterogeneity in terms of vitamin D measurement and threshold. CONCLUSIONS The results showed that vitamin D status does not differ between BD and other psychiatric conditions. However, given the correlation between vitamin D levels and depressive or manic symptoms, we could hypothesize that an adequate vitamin D status could positively affect the mood balance thanks to its immunomodulatory activity.
Collapse
Affiliation(s)
- Guido Cereda
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
63
|
Bergamelli E, Del Fabro L, Delvecchio G, D’Agostino A, Brambilla P. The Impact of Lithium on Brain Function in Bipolar Disorder: An Updated Review of Functional Magnetic Resonance Imaging Studies. CNS Drugs 2021; 35:1275-1287. [PMID: 34773217 PMCID: PMC9537229 DOI: 10.1007/s40263-021-00869-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 11/13/2022]
Abstract
Lithium remains a gold standard treatment for bipolar disorder (BD), and functional magnetic resonance imaging (fMRI) studies have contributed to clarifying its impact on neural circuitries in affected individuals. However, the specific neurobiological mechanisms through which lithium exerts its effects on brain function are not fully understood. In this review, we aimed to summarize the results of recent fMRI studies evaluating the impact of lithium on brain functional activity and connectivity in patients diagnosed with BD. We performed a literature search of available sources found in the PubMed database reported in English since 2016, when the last available review on this topic was published. Five fMRI studies in resting-state condition and six studies performed during the execution of emotional tasks met the inclusion criteria. Overall, the available evidence supports normalizing effects of lithium on brain activity and connectivity. Most of these studies reported a normalization in prefrontal regions and interconnected areas involved in emotion regulation and processing, regardless of the task employed. Importantly, lithium treatment showed distinct patterns of activity/connectivity changes compared with other treatments. Finally, lithium modulation of neural circuitries was found to be associated with clinical improvement in BD. These results are consistent with the hypothesis that selective abnormalities in neural circuitries supporting emotion processing and regulation improve during lithium treatment in BD. However, the heterogeneity of the examined studies regarding study design, sample selection, and analysis methods might limit the generalizability of the findings and lead to difficulties in comparing the results. Therefore, in future studies, larger cohorts and homogeneous experimental tasks are needed to further corroborate these findings.
Collapse
Affiliation(s)
- Emilio Bergamelli
- grid.415093.a0000 0004 1793 3800Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Health Sciences, University of Milan, Milan, Italy
| | - Lorenzo Del Fabro
- grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, 20122 Milan, Italy ,grid.414818.00000 0004 1757 8749Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Armando D’Agostino
- grid.415093.a0000 0004 1793 3800Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Health Sciences, University of Milan, Milan, Italy
| | - Paolo Brambilla
- grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, 20122 Milan, Italy ,grid.414818.00000 0004 1757 8749Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
64
|
Esposito CM, Mandolini GM, Delvecchio G, Fiorentini A, Brambilla P. Psychomotor Agitation Non-responsive to Treatment: A Case Report of Phenibut Withdrawal Syndrome. Front Psychiatry 2021; 12:688147. [PMID: 34262493 PMCID: PMC8273510 DOI: 10.3389/fpsyt.2021.688147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/14/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives: Phenibut (4-amino-3-phenyl-butyric acid), acting as a GABA-B receptor agonist, has a beneficial effect on anxiety. Although its medical use is not approved in western countries, it can be easily obtained worldwide via the Internet, so it spread as a substance of abuse. In recent years, some case reports have, therefore, highlighted episodes of acute toxicity or withdrawal, but it is still a largely unknown phenomenon. Methods: In this case report, a 50-year-old woman was admitted to the emergency room with psychomotor agitation, psychotic symptoms, and insomnia, and was non-responsive to treatment. She was hospitalized at the psychiatry ward for 25 days and gave her consent for the publication of the present case report. Results: The suspicion of phenibut withdrawal allowed to establish the appropriate management, leading to the restitutio ad integrum of the psychopathological case. Conclusions: In the face of an incoercible psychomotor agitation case, the knowledge of the so-called novel psychoactive substances allows for more appropriate clinical management of intoxication and withdrawal syndromes. This is a scientifically significant report as it provides therapeutic and outcome data concerning a syndrome that is still quite unfamiliar.
Collapse
Affiliation(s)
- Cecilia Maria Esposito
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Gian Mario Mandolini
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessio Fiorentini
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| |
Collapse
|
65
|
Piani MC, Maggioni E, Delvecchio G, Ferro A, Gritti D, Pozzoli SM, Fontana E, Enrico P, Cinnante CM, Triulzi FM, Stanley JA, Battaglioli E, Brambilla P. Sexual Dimorphism in the Brain Correlates of Adult-Onset Depression: A Pilot Structural and Functional 3T MRI Study. Front Psychiatry 2021; 12:683912. [PMID: 35069272 PMCID: PMC8766797 DOI: 10.3389/fpsyt.2021.683912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 12/09/2021] [Indexed: 12/12/2022] Open
Abstract
Major Depressive Disorder (MDD) is a disabling illness affecting more than 5% of the elderly population. Higher female prevalence and sex-specific symptomatology have been observed, suggesting that biologically-determined dimensions might affect the disease onset and outcome. Rumination and executive dysfunction characterize adult-onset MDD, but sex differences in these domains and in the related brain mechanisms are still largely unexplored. The present pilot study aimed to explore any interactions between adult-onset MDD and sex on brain morphology and brain function during a Go/No-Go paradigm. We hypothesized to detect diagnosis by sex effects on brain regions involved in self-referential processes and cognitive control. Twenty-four subjects, 12 healthy (HC) (mean age 68.7 y, 7 females and 5 males) and 12 affected by adult-onset MDD (mean age 66.5 y, 5 females and 7 males), underwent clinical evaluations and a 3T magnetic resonance imaging (MRI) session. Diagnosis and diagnosis by sex effects were assessed on regional gray matter (GM) volumes and task-related functional MRI (fMRI) activations. The GM volume analyses showed diagnosis effects in left mid frontal cortex (p < 0.01), and diagnosis by sex effects in orbitofrontal, olfactory, and calcarine regions (p < 0.05). The Go/No-Go fMRI analyses showed MDD effects on fMRI activations in left precuneus and right lingual gyrus, and diagnosis by sex effects on fMRI activations in right parahippocampal gyrus and right calcarine cortex (p < 0.001, ≥ 40 voxels). Our exploratory results suggest the presence of sex-specific brain correlates of adult-onset MDD-especially in regions involved in attention processing and in the brain default mode-potentially supporting cognitive and symptom differences between sexes.
Collapse
Affiliation(s)
- Maria Chiara Piani
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Adele Ferro
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Davide Gritti
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara M Pozzoli
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Fontana
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Claudia M Cinnante
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio M Triulzi
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Jeffrey A Stanley
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Elena Battaglioli
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Segrate, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
66
|
Rossetti MG, Delvecchio G, Calati R, Perlini C, Bellani M, Brambilla P. Structural neuroimaging of somatoform disorders: A systematic review. Neurosci Biobehav Rev 2020; 122:66-78. [PMID: 33359097 DOI: 10.1016/j.neubiorev.2020.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/25/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022]
Abstract
Although there has been an increment in neuroimaging research in somatoform disorders (SD), to date little is known about the neural correlates of these diseases. Therefore, in this systematic, review we aimed at summarizing the existing evidence of structural brain alterations in SD as per DSM-IV and DSM-5 criteria. Three electronic databases (Scopus, PubMed and Web of Science) were searched. Only case-control studies using structural neuroimaging were included. Forty-five out of 369 articles fulfilled inclusion criteria and were reviewed. Compared to controls, subjects with SD showed morphological alterations encompassing motor, limbic and somatosensory circuits. Although far from being conclusive, the results suggested that SD are characterized by selective alterations of large-scale brain networks implicated in cognitive control, emotion regulation and processing, stress and somatic-visceral perception. This review highlights the need for further multimodal neuroimaging studies with longitudinal designs, in larger and better-characterized samples, to elucidate the temporal and causal relationship between neuroanatomical changes and SD, which is paramount for informing tailored treatments.
Collapse
Affiliation(s)
- Maria Gloria Rossetti
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy
| | - Raffaella Calati
- Department of Psychology, University of Milano-Bicocca, Milan, Italy; Department of Adult Psychiatry, Nîmes University Hospital, Nîmes, France
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy; USD Clinical Psychology, Azienda Ospedaliera Universitaria Integrata (AOUI) of Verona, Verona, Italy
| | - Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy; UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI) of Verona, Verona, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| |
Collapse
|
67
|
Caletti E, Pagliari C, Vai B, Delvecchio G, Brambilla P. Which are the best questionnaires to longitudinally evaluate mindfulness skills in personality disorders? J Affect Disord 2020; 277:169-174. [PMID: 32829192 DOI: 10.1016/j.jad.2020.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Personality disorders (PDs) are severe mental illnesses, characterized by inflexible and enduring response patterns in a broad range of personal and social situations. With the aim of identifying effective and evidence-based interventions, in the last decades we observed a flourishing of the so-called "thirdwave" cognitive-behavioural therapies, where mindfulness appears as relevant factor in promoting individual well-being and treatment response. In this regard, several authors tried to develop new instruments that enable to measure mindfulness skills, such as the Kentucky Inventory of Mindfulness Skills (KIMS), the Five Facet Mindfulness Questionnaire (FFMQ) and the Philadelphia Mindfulness Scale (PHLMS). The aim of this review is to provide new insights about the mindfulness questionnaires currently used in longitudinal studies in PDs by providing a benchmark for future studies evaluating mindfulness changes associated to therapeutic interventions. METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search in PubMed was performed. Three reviewers conducted the data extraction. Longitudinal studies on PDs evaluating mindfulness skills through a validated questionnaire were selected. Ten studies met the selection criteria. RESULTS The majority of the studies reviewed (N=7) detected an increase in mindfulness skills (4 rated with FFMQ, 2 KIMS, and 1 Philadelphia Mindfulness Scale). Finally, from the selected studies mindfulness changes were also associated with clinical amelioration. LIMITATIONS Few studies evaluate male patients and PDs other than borderline personality disorder. CONCLUSION Although mindfulness is a complex construct to operationalize, the considered questionnaires emerged as useful instruments for clinicians to detect changes in mindfulness abilities. In particular, currently the FFMQ appears as the most suitable measure.
Collapse
Affiliation(s)
- Elisabetta Caletti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy
| | | | - Benedetta Vai
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS Ospedale San Raffaele, Fondazione Centro San Raffaele, Milano, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| |
Collapse
|
68
|
Pigoni A, Delvecchio G, Squarcina L, Bonivento C, Girardi P, Finos L, Crisanti C, Balestrieri M, D'Agostini S, Stanley JA, Brambilla P. Sex differences in brain metabolites in anxiety and mood disorders. Psychiatry Res Neuroimaging 2020; 305:111196. [PMID: 33010582 DOI: 10.1016/j.pscychresns.2020.111196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 01/16/2023]
Abstract
Gender differences in mood and anxiety disorders are well-established. However, the neural basis of these differences is not clear yet, especially in terms of brain metabolism. Indeed, although several proton Magnetic Resonance Spectroscopy (¹H MRS) investigations reported different metabolic levels in both depression and anxiety disorders, which have been also linked to symptoms severity and response to treatment, the role of gender on these differences have not been explored yet. Therefore, this study aims at investigating the role of sex in neurometabolic alterations associated with both mood and anxiety disorders. A 3T single-voxel ¹H MRS acquisition of the dorsolateral prefrontal cortex was acquired from 14 Major Depressive Disorder, 10 Generalized Anxiety Disorder (GAD), 11 Panic Disorder (PD), patients and 16 healthy controls (HC). Among males, PD patients showed significantly lower GPC+PC (also observed in GAD+PD) and Glu levels compared to HC. Finally, a significant group x sex interaction effect was observed in the GPC+PC and Glu levels. We proved the presence of an association between sex and brain metabolites in anxiety spectrum.
Collapse
Affiliation(s)
- Alessandro Pigoni
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Carolina Bonivento
- Scientific Institute, IRCCS E. Medea, via della Bontà 7, San Vito al Tagliamento, Pordenone, Italy
| | - Paolo Girardi
- Department of Developmental Psychology and Socialization, University of Padua, Italy
| | - Livio Finos
- Department of Developmental Psychology and Socialization, University of Padua, Italy
| | - Camilla Crisanti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Serena D'Agostini
- Department of Neuroradiology, Azienda Ospedaliero Universitaria 'S.Maria della Misericordia', P.za S. Maria della Misericordia, Udine, Italy
| | - Jeffrey A Stanley
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI,USA
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| |
Collapse
|
69
|
Crisanti C, Enrico P, Fiorentini A, Delvecchio G, Brambilla P. Neurocognitive impact of ketamine treatment in major depressive disorder: A review on human and animal studies. J Affect Disord 2020; 276:1109-1118. [PMID: 32777649 DOI: 10.1016/j.jad.2020.07.119] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/29/2020] [Accepted: 07/22/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Most recent evidence support a rapid and sustained antidepressant effect of subanesthetic dose of intravenous ketamine in patients with major depressive disorder (MDD). However, clinical and animal studies investigating the effects of intravenous ketamine on specific functional domains disrupted by depression reported conflicting results. Therefore, the aim of this review is to provide an overview of the recent findings exploring the cognitive effects of ketamine in depression. METHODS After a bibliographic search on PubMed, Medline and PsycInfo, we retrieved 11 original studies meeting our research criteria, 7 in humans with MDD or Treatment Resistant Disorder and 4 using rats models for depression. RESULTS Overall the results showed that a) ketamine reduced activation and normalized connectivity measures of several brain regions related to depressive behaviors and reversed deficits in cognitive flexibility and coping response strategy in rats with depressive features, and b) ketamine leads to a no significant impairment on neurocognitive functions in most of the studies, with only three studies observing improvements in speed of processing, verbal learning, sustained attention and response control, verbal and working memory. LIMITATIONS The methodological heterogeneity, in terms of neuropsychological tests used and cognitive domain explored, of the studies included. CONCLUSIONS Most of the studies included showed no significant cognitive impairments in MDD patients after ketamine treatment. Furthermore, the results of the fMRI studies considered suggest that ketamine may have a normalizing effect on brain functions during attentional and emotional processing in MDD patients. However, further studies are needed to confirm these preliminary evidences.
Collapse
Affiliation(s)
- Camilla Crisanti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessio Fiorentini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
70
|
Cattarinussi G, Delvecchio G, Prunas C, Brambilla P. Effects of pharmacological treatments on neuroimaging findings in first episode affective psychosis: A review of longitudinal studies. J Affect Disord 2020; 276:1046-1051. [PMID: 32763589 DOI: 10.1016/j.jad.2020.07.118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/30/2020] [Accepted: 07/22/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Affective psychosis is a common mental disorder characterized by structural/functional brain abnormalities, which seem to occur also at the early stages of the disease. However, the role of psychotropic medications on brain structure and function in affective first episode psychosis (A-FEP) still remains uncertain. Therefore, with this review we aim to gain more robust understanding regarding the potential effect of pharmacological treatments on the brain in A-FEP patients also experiencing a first manic episode. METHODS A search on PuBMed and Web of Science of longitudinal structural and functional Magnetic Resonance Imaging (MRI) as well as Diffusion Tensor Imaging (DTI) studies, exploring the effect of medications on the brain in A-FEP, was conducted. We selected nine studies, three randomized or pseudo-randomized controlled trials and six observational studies. RESULTS Overall the studies showed that a) mood stabilizers (MS) have no effect on gray matter (GM) volumes and a protective role on white matter (WM) volumes, b) antipsychotics (AP) have an unclear effect on GM volumes and a less potent effect on WM volumes compared to MS and c) both MS and AP tend to normalize brain activation and connectivity. LIMITATIONS The small sample size, the observational design of the majority of the studies and the different methodological approaches limit the conclusion of this review. CONCLUSIONS Medications seem to have a minor role on structural changes occurring in A-FEP patients during the early stages of the disease, while their effect on brain activation and connectivity seems more pronounced, but far to be conclusive.
Collapse
Affiliation(s)
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Cecilia Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
71
|
Haukvik UK, Gurholt TP, Nerland S, Elvsåshagen T, Akudjedu TN, Alda M, Alnæs D, Alonso‐Lana S, Bauer J, Baune BT, Benedetti F, Berk M, Bettella F, Bøen E, Bonnín CM, Brambilla P, Canales‐Rodríguez EJ, Cannon DM, Caseras X, Dandash O, Dannlowski U, Delvecchio G, Díaz‐Zuluaga AM, Erp TGM, Fatjó‐Vilas M, Foley SF, Förster K, Fullerton JM, Goikolea JM, Grotegerd D, Gruber O, Haarman BCM, Haatveit B, Hajek T, Hallahan B, Harris M, Hawkins EL, Howells FM, Hülsmann C, Jahanshad N, Jørgensen KN, Kircher T, Krämer B, Krug A, Kuplicki R, Lagerberg TV, Lancaster TM, Lenroot RK, Lonning V, López‐Jaramillo C, Malt UF, McDonald C, McIntosh AM, McPhilemy G, Meer D, Melle I, Melloni EMT, Mitchell PB, Nabulsi L, Nenadić I, Oertel V, Oldani L, Opel N, Otaduy MCG, Overs BJ, Pineda‐Zapata JA, Pomarol‐Clotet E, Radua J, Rauer L, Redlich R, Repple J, Rive MM, Roberts G, Ruhe HG, Salminen LE, Salvador R, Sarró S, Savitz J, Schene AH, Sim K, Soeiro‐de‐Souza MG, Stäblein M, Stein DJ, Stein F, Tamnes CK, Temmingh HS, Thomopoulos SI, Veltman DJ, Vieta E, Waltemate L, Westlye LT, Whalley HC, Sämann PG, Thompson PM, Ching CRK, Andreassen OA, Agartz I. In vivo hippocampal subfield volumes in bipolar disorder—A mega‐analysis from The Enhancing Neuro Imaging Genetics through
Meta‐Analysis
Bipolar Disorder Working Group. Hum Brain Mapp 2020; 43:385-398. [PMID: 33073925 PMCID: PMC8675404 DOI: 10.1002/hbm.25249] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/18/2020] [Accepted: 10/06/2020] [Indexed: 01/02/2023] Open
Abstract
The hippocampus consists of anatomically and functionally distinct subfields that may be differentially involved in the pathophysiology of bipolar disorder (BD). Here we, the Enhancing NeuroImaging Genetics through Meta‐Analysis Bipolar Disorder workinggroup, study hippocampal subfield volumetry in BD. T1‐weighted magnetic resonance imaging scans from 4,698 individuals (BD = 1,472, healthy controls [HC] = 3,226) from 23 sites worldwide were processed with FreeSurfer. We used linear mixed‐effects models and mega‐analysis to investigate differences in hippocampal subfield volumes between BD and HC, followed by analyses of clinical characteristics and medication use. BD showed significantly smaller volumes of the whole hippocampus (Cohen's d = −0.20), cornu ammonis (CA)1 (d = −0.18), CA2/3 (d = −0.11), CA4 (d = −0.19), molecular layer (d = −0.21), granule cell layer of dentate gyrus (d = −0.21), hippocampal tail (d = −0.10), subiculum (d = −0.15), presubiculum (d = −0.18), and hippocampal amygdala transition area (d = −0.17) compared to HC. Lithium users did not show volume differences compared to HC, while non‐users did. Antipsychotics or antiepileptic use was associated with smaller volumes. In this largest study of hippocampal subfields in BD to date, we show widespread reductions in nine of 12 subfields studied. The associations were modulated by medication use and specifically the lack of differences between lithium users and HC supports a possible protective role of lithium in BD.
Collapse
Affiliation(s)
- Unn K. Haukvik
- Department of Adult Mental Health Institute of Clinical Medicine, University of Oslo Oslo Norway
- Norwegian Centre for Mental Disorders Research (NORMENT) Division of Mental Health and Addiction, Oslo University Hospital Oslo Norway
| | - Tiril P. Gurholt
- Norwegian Centre for Mental Disorders Research (NORMENT) Division of Mental Health and Addiction, Oslo University Hospital Oslo Norway
- Norwegian Centre for Mental Disorders Research (NORMENT) Institute of Clinical Medicine, University of Oslo Oslo Norway
- Department of Psychiatric Research Diakonhjemmet Hospital Oslo Norway
| | - Stener Nerland
- Norwegian Centre for Mental Disorders Research (NORMENT) Institute of Clinical Medicine, University of Oslo Oslo Norway
- Department of Psychiatric Research Diakonhjemmet Hospital Oslo Norway
| | - Torbjørn Elvsåshagen
- Norwegian Centre for Mental Disorders Research (NORMENT) Division of Mental Health and Addiction, Oslo University Hospital Oslo Norway
- Department of Neurology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Theophilus N. Akudjedu
- Centre for Neuroimaging & Cognitive Genomics (NICOG) Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway Galway Ireland
- Institute of Medical Imaging & Visualisation Faculty of Health & Social Sciences, Bournemouth University Bournemouth UK
| | - Martin Alda
- Department of Psychiatry Dalhousie University Halifax Nova Scotia Canada
- National Institute of Mental Health Klecany Czech Republic
| | - Dag Alnæs
- Norwegian Centre for Mental Disorders Research (NORMENT) Division of Mental Health and Addiction, Oslo University Hospital Oslo Norway
- Norwegian Centre for Mental Disorders Research (NORMENT) Institute of Clinical Medicine, University of Oslo Oslo Norway
| | - Silvia Alonso‐Lana
- FIDMAG Germanes Hospitalàries Research Foundation CIBERSAM Barcelona Spain
| | - Jochen Bauer
- Institute of Clinical Radiology University of Münster Münster Germany
| | - Bernhard T. Baune
- Department of Psychiatry University of Münster Münster Germany
- Department of Psychiatry Melbourne Medical School, The University of Melbourne Melbourne Australia
- The Florey Institute of Neuroscience and Mental Health The University of Melbourne Parkville Australia
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology Scientific Institute Ospedale San Raffaele Milan Italy
- University Vita‐Salute San Raffaele Milan Italy
| | - Michael Berk
- Deakin University IMPACT, the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health Geelong Victoria Australia
- Orygen, The National Centre of Excellence in Youth Mental Health and Centre for Youth Mental Health, the Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health The University of Melbourne Melbourne Victoria Australia
| | - Francesco Bettella
- Norwegian Centre for Mental Disorders Research (NORMENT) Division of Mental Health and Addiction, Oslo University Hospital Oslo Norway
| | - Erlend Bøen
- Psychosomatic and CL Psychiatry Division of Mental Health and Addiction, Oslo University Hospital Oslo Norway
| | - Caterina M. Bonnín
- Barcelona Bipolar Disorders and Depressive Unit Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM Barcelona Spain
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy
- Department of Pathophysiology and Transplantation University of Milan Milan Italy
| | | | - Dara M. Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG) Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway Galway Ireland
| | - Xavier Caseras
- MRC Centre for Neuropsychiatric Genetics and Genomics, Department of Psychological Medicine and Clinical Neurosciences Cardiff University Cardiff UK
| | - Orwa Dandash
- Brain, Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry University of Melbourne and Melbourne Health Melbourne Victoria Australia
| | - Udo Dannlowski
- Department of Psychiatry University of Münster Münster Germany
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation University of Milan Milan Italy
| | - Ana M. Díaz‐Zuluaga
- Research Group in Psychiatry, Department of Psychiatry Faculty of Medicine, Universidad de Antioquia Medellín Antioquia Colombia
| | - Theo G. M. Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior University of California Irvine Irvine California USA
- Center for the Neurobiology of Learning University of California Irvine and Memory Irvine California USA
| | - Mar Fatjó‐Vilas
- FIDMAG Germanes Hospitalàries Research Foundation CIBERSAM Barcelona Spain
| | - Sonya F. Foley
- Cardiff University Brain Research Imaging Centre (CUBRIC) Cardiff University Cardiff UK
| | | | - Janice M. Fullerton
- Neuroscience Research Australia Randwick New South Wales Australia
- School of Medical Sciences The University of New South Wales Sydney New South Wales Australia
| | - José M. Goikolea
- Barcelona Bipolar Disorders and Depressive Unit Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM Barcelona Spain
| | | | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry Heidelberg University Hospital Heidelberg Germany
| | - Bartholomeus C. M. Haarman
- Department of Psychiatry University Medical Center Groningen, University of Groningen Groningen The Netherlands
| | - Beathe Haatveit
- Norwegian Centre for Mental Disorders Research (NORMENT) Division of Mental Health and Addiction, Oslo University Hospital Oslo Norway
- Norwegian Centre for Mental Disorders Research (NORMENT) Institute of Clinical Medicine, University of Oslo Oslo Norway
| | - Tomas Hajek
- Department of Psychiatry Dalhousie University Halifax Nova Scotia Canada
- National Institute of Mental Health Klecany Czech Republic
| | - Brian Hallahan
- Centre for Neuroimaging & Cognitive Genomics (NICOG) Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway Galway Ireland
| | - Mathew Harris
- Division of Psychiatry University of Edinburgh Edinburgh UK
| | | | - Fleur M. Howells
- Department of Psychiatry and Mental Health University of Cape Town Cape Town Western Cape South Africa
- Neuroscience Institute University of Cape Town Cape Town Western Cape South Africa
| | - Carina Hülsmann
- Department of Psychiatry University of Münster Münster Germany
| | - Neda Jahanshad
- Imaging Genetics Center USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California Marina del Rey California USA
| | - Kjetil N. Jørgensen
- Norwegian Centre for Mental Disorders Research (NORMENT) Institute of Clinical Medicine, University of Oslo Oslo Norway
- Department of Psychiatric Research Diakonhjemmet Hospital Oslo Norway
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy Philipps‐University Marburg Marburg Germany
- Center for Mind Brain and Behavior (CMBB) Marburg Germany
| | - Bernd Krämer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry Heidelberg University Hospital Heidelberg Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy Philipps‐University Marburg Marburg Germany
- Center for Mind Brain and Behavior (CMBB) Marburg Germany
- Department of Psychiatry and Psychotherapy University of Bonn Bonn Germany
| | - Rayus Kuplicki
- Laureate Institute for Brain Research Tulsa Oklahoma USA
| | - Trine V. Lagerberg
- Norwegian Centre for Mental Disorders Research (NORMENT) Division of Mental Health and Addiction, Oslo University Hospital Oslo Norway
| | - Thomas M. Lancaster
- Cardiff University Brain Research Imaging Centre (CUBRIC) Cardiff University Cardiff UK
- School of Psychology Bath University Bath UK
| | - Rhoshel K. Lenroot
- Neuroscience Research Australia Randwick New South Wales Australia
- School of Psychiatry University of New South Wales Sydney New South Wales Australia
- University of New Mexico Albuquerque New Mexico USA
| | - Vera Lonning
- Norwegian Centre for Mental Disorders Research (NORMENT) Institute of Clinical Medicine, University of Oslo Oslo Norway
- Department of Psychiatric Research Diakonhjemmet Hospital Oslo Norway
| | - Carlos López‐Jaramillo
- Research Group in Psychiatry, Department of Psychiatry Faculty of Medicine, Universidad de Antioquia Medellín Antioquia Colombia
- Mood Disorders Program Hospital Universitario San Vicente Fundación Medellín Antioquia Colombia
| | - Ulrik F. Malt
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG) Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway Galway Ireland
| | | | - Genevieve McPhilemy
- Centre for Neuroimaging & Cognitive Genomics (NICOG) Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway Galway Ireland
| | - Dennis Meer
- Norwegian Centre for Mental Disorders Research (NORMENT) Institute of Clinical Medicine, University of Oslo Oslo Norway
- School of Mental Health and Neuroscience Faculty of Health, Medicine and Life Sciences, Maastricht University Maastricht The Netherlands
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research (NORMENT) Division of Mental Health and Addiction, Oslo University Hospital Oslo Norway
- Norwegian Centre for Mental Disorders Research (NORMENT) Institute of Clinical Medicine, University of Oslo Oslo Norway
| | - Elisa M. T. Melloni
- Psychiatry and Clinical Psychobiology Scientific Institute Ospedale San Raffaele Milan Italy
- University Vita‐Salute San Raffaele Milan Italy
| | - Philip B. Mitchell
- School of Psychiatry University of New South Wales Sydney New South Wales Australia
- Black Dog Institute Sydney New South Wales Australia
| | - Leila Nabulsi
- Centre for Neuroimaging & Cognitive Genomics (NICOG) Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway Galway Ireland
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy Philipps‐University Marburg Marburg Germany
- Center for Mind Brain and Behavior (CMBB) Marburg Germany
| | - Viola Oertel
- Department of Psychiatry Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt Frankfurt am Main Germany
| | - Lucio Oldani
- Department of Neurosciences and Mental Health Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy
| | - Nils Opel
- Department of Psychiatry University of Münster Münster Germany
| | - Maria C. G. Otaduy
- LIM44, Department of Radiology and Oncology University of São Paulo São Paulo Brazil
| | - Bronwyn J. Overs
- Neuroscience Research Australia Randwick New South Wales Australia
| | - Julian A. Pineda‐Zapata
- Research Group in Psychiatry, Department of Psychiatry Faculty of Medicine, Universidad de Antioquia Medellín Antioquia Colombia
- Research Group Instituto de Alta Tecnología Médica Medellín Antioquia Colombia
| | | | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM Barcelona Spain
- Department of Psychosis Studies Institute of Psychiatry, Psychology and Neuroscience, King's College London London UK
- Department of Clinical Neuroscience Centre for Psychiatry Research, Karolinska Institutet Stockholm Sweden
| | - Lisa Rauer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry Heidelberg University Hospital Heidelberg Germany
| | - Ronny Redlich
- Department of Psychiatry University of Münster Münster Germany
| | - Jonathan Repple
- Department of Psychiatry University of Münster Münster Germany
| | - Maria M. Rive
- Psychiatry Amsterdam UMC, Location AMC Amsterdam The Netherlands
| | - Gloria Roberts
- School of Psychiatry University of New South Wales Sydney New South Wales Australia
- Black Dog Institute Sydney New South Wales Australia
| | - Henricus G. Ruhe
- Psychiatry Amsterdam UMC, Location AMC Amsterdam The Netherlands
- Donders Institute for Brain, Cognition and Behavior Radboud University Nijmegen The Netherlands
- Department of Psychiatry Radboudumc Nijmegen The Netherlands
| | - Lauren E. Salminen
- Imaging Genetics Center USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California Marina del Rey California USA
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation CIBERSAM Barcelona Spain
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation CIBERSAM Barcelona Spain
| | - Jonathan Savitz
- Laureate Institute for Brain Research Tulsa Oklahoma USA
- Oxley College of Health Sciences The University of Tulsa Tulsa Oklahoma USA
| | - Aart H. Schene
- Donders Institute for Brain, Cognition and Behavior Radboud University Nijmegen The Netherlands
- Department of Psychiatry Radboudumc Nijmegen The Netherlands
| | - Kang Sim
- West Region/Institute of Mental Health Singapore Singapore
- Yong Loo Lin School of Medicine/National University of Singapore Singapore Singapore
- Lee Kong Chian School of Medicine/Nanyang Technological University Singapore Singapore
| | | | - Michael Stäblein
- Department of Psychiatry Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt Frankfurt am Main Germany
| | - Dan J. Stein
- Department of Psychiatry and Mental Health University of Cape Town Cape Town Western Cape South Africa
- Neuroscience Institute University of Cape Town Cape Town Western Cape South Africa
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute University of Cape Town Cape Town Western Cape South Africa
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy Philipps‐University Marburg Marburg Germany
- Center for Mind Brain and Behavior (CMBB) Marburg Germany
| | - Christian K. Tamnes
- Norwegian Centre for Mental Disorders Research (NORMENT) Division of Mental Health and Addiction, Oslo University Hospital Oslo Norway
- Norwegian Centre for Mental Disorders Research (NORMENT) Institute of Clinical Medicine, University of Oslo Oslo Norway
- Department of Psychiatric Research Diakonhjemmet Hospital Oslo Norway
- PROMENTA Research Center, Department of Psychology University of Oslo Oslo Norway
| | - Henk S. Temmingh
- Department of Psychiatry and Mental Health University of Cape Town Cape Town Western Cape South Africa
- General Adult Psychiatry Division Valkenberg Hospital Cape Town Western Cape South Africa
| | - Sophia I. Thomopoulos
- Imaging Genetics Center USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California Marina del Rey California USA
| | - Dick J. Veltman
- Department of Psychiatry Amsterdam UMC, Location VUMC Amsterdam The Netherlands
- Amsterdam Neuroscience Amsterdam UMC Amsterdam The Netherlands
| | - Eduard Vieta
- Hospital Clinic University of Barcelona, IDIBAPS, CIBERSAM Barcelona Catalonia Spain
| | - Lena Waltemate
- Department of Psychiatry University of Münster Münster Germany
| | - Lars T. Westlye
- Norwegian Centre for Mental Disorders Research (NORMENT) Division of Mental Health and Addiction, Oslo University Hospital Oslo Norway
- Department of Psychology University of Oslo Oslo Norway
| | | | | | - Paul M. Thompson
- Imaging Genetics Center USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California Marina del Rey California USA
| | - Christopher R. K. Ching
- Imaging Genetics Center USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California Marina del Rey California USA
| | - Ole A. Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT) Division of Mental Health and Addiction, Oslo University Hospital Oslo Norway
- Norwegian Centre for Mental Disorders Research (NORMENT) Institute of Clinical Medicine, University of Oslo Oslo Norway
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research (NORMENT) Institute of Clinical Medicine, University of Oslo Oslo Norway
- Department of Psychiatric Research Diakonhjemmet Hospital Oslo Norway
- Department of Clinical Neuroscience Centre for Psychiatric Research, Karolinska Institutet Stockholm Sweden
| | | |
Collapse
|
72
|
Delvecchio G, Oldani L, Mandolini GM, Pigoni A, Ciappolino V, Schiena G, Lazzaretti M, Caletti E, Barbieri V, Cinnante C, Triulzi F, Brambilla P. Brain Morphology of Cannabis Users With or Without Psychosis: A Pilot MRI Study. J Vis Exp 2020. [PMID: 32894263 DOI: 10.3791/60881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Cannabis is the illicit drug most commonly used worldwide, and its consumption can both induce psychiatric symptoms in otherwise healthy subjects and unmask a florid psychotic picture in patients with a prior psychotic risk. Previous studies suggest that chronic and long-term cannabis exposure may exert significant negative effects in brain areas enriched with cannabinoid receptors. However, whether brain alterations determined by cannabis dependency will lead to a clinically significant phenotype or to a psychotic outbreak at some point of an abuser's life remains unclear. The aim of this study was to investigate morphological brain differences between chronic cannabis users with cannabis-induced psychosis (CIP) and non-psychotic cannabis users (NPCU) without any psychiatric conditions and correlate brain deficits with selective socio-demographic, clinical and psychosocial variables. 3T magnetic resonance imaging (MRI) scans of 10 CIP patients and 12 NPCU were acquired. The type of drug, the frequency, and the duration, as well socio-demographic, clinical and psychosocial parameters of dependency were measured. CIP patients had extensive grey matter (GM) decreases in right superior frontal gyrus, right precentral, right superior temporal gyrus, insula bilaterally, right precuneus, right medial occipital gyrus, right fusiform gyrus, and left hippocampus in comparison to chronic cannabis users without psychosis. Finally, in CIP patients, the results showed a negative correlation between a domain of the Brief Psychiatric Rating Scale (BPRS), BPRS-Activity, and selective GM volumes. Overall, the results suggest that cannabis-induced psychosis is characterized by selective brain reductions that are not present in NPCU. Therefore, neuroimaging studies may provide a potential ground for identifying putative biomarkers associated with the risk of developing psychosis in cannabis users.
Collapse
Affiliation(s)
| | - Lucio Oldani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Gian Mario Mandolini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | | | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Giandomenico Schiena
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Matteo Lazzaretti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Elisabetta Caletti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Viviana Barbieri
- Department of Pathophysiology and Transplantation, University of Milan
| | - Claudia Cinnante
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Fabio Triulzi
- Department of Pathophysiology and Transplantation, University of Milan; Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico;
| |
Collapse
|
73
|
Botturi A, Ciappolino V, Delvecchio G, Boscutti A, Viscardi B, Brambilla P. The Role and the Effect of Magnesium in Mental Disorders: A Systematic Review. Nutrients 2020; 12:nu12061661. [PMID: 32503201 PMCID: PMC7352515 DOI: 10.3390/nu12061661] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/13/2020] [Accepted: 05/25/2020] [Indexed: 12/25/2022] Open
Abstract
Introduction: Magnesium is an essential cation involved in many functions within the central nervous system, including transmission and intracellular signal transduction. Several studies have shown its usefulness in neurological and psychiatric diseases. Furthermore, it seems that magnesium levels are lowered in the course of several mental disorders, especially depression. Objectives: In this study, we wish to evaluate the presence of a relationship between the levels of magnesium and the presence of psychiatric pathology as well as the effectiveness of magnesium as a therapeutic supplementation. Methods: A systematic search of scientific records concerning magnesium in psychiatric disorders published from 2010 up to March 2020 was performed. We collected a total of 32 articles: 18 on Depressive Disorders (DD), four on Anxiety Disorders (AD), four on Attention Deficit Hyperactivity Disorder (ADHD), three on Autism Spectrum Disorder (ASD), one on Obsessive–Compulsive Disorder (OCD), one on Schizophrenia (SCZ) and one on Eating Disorders (ED). Results: Twelve studies highlighted mainly positive results in depressive symptoms. Seven showed a significant correlation between reduced plasma magnesium values and depression measured with psychometric scales. Two papers reported improved depressive symptoms after magnesium intake, two in association with antidepressants, compared to controls. No significant association between magnesium serum levels and panic or Generalized Anxiety Disorder (GAD) patients, in two distinct papers, was found. In two other papers, a reduced Hamilton Anxiety Rating Scale (HAM-A) score in depressed patients correlated with higher levels of magnesium and beneficial levels of magnesium in stressed patients was found. Two papers reported low levels of magnesium in association with ADHD. Only one of three papers showed lower levels of magnesium in ASD. ED and SCZ reported a variation in magnesium levels in some aspects of the disease. Conclusion: The results are not univocal, both in terms of the plasma levels and of therapeutic effects. However, from the available evidence, it emerged that supplementation with magnesium could be beneficial. Therefore, it is necessary to design ad hoc clinical trials to evaluate the efficacy of magnesium alone or together with other drugs (antidepressants) in order to establish the correct use of this cation with potential therapeutic effects.
Collapse
Affiliation(s)
- Andrea Botturi
- Neurologic Clinic, Fondazione IRCCS Istituto neurologico Carlo Besta, 20133 Milan, Italy
- Correspondence:
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.C.); (A.B.); (B.V.); (P.B.)
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| | - Andrea Boscutti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.C.); (A.B.); (B.V.); (P.B.)
| | - Bianca Viscardi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.C.); (A.B.); (B.V.); (P.B.)
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.C.); (A.B.); (B.V.); (P.B.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
| |
Collapse
|
74
|
Delvecchio G, Maggioni E, Squarcina L, Arighi A, Galimberti D, Scarpini E, Bellani M, Brambilla P. A Critical Review on Structural Neuroimaging Studies in BD: a Transdiagnostic Perspective from Psychosis to Fronto-Temporal Dementia. Curr Behav Neurosci Rep 2020. [DOI: 10.1007/s40473-020-00204-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
75
|
Grottaroli M, Delvecchio G, Bressi C, Moltrasio C, Soares JC, Brambilla P. Microstructural white matter alterations in borderline personality disorder: A minireview. J Affect Disord 2020; 264:249-255. [PMID: 32056758 DOI: 10.1016/j.jad.2019.12.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/17/2019] [Accepted: 12/30/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Borderline personality disorder (BPD) affects 1-5% of the population and is characterized by a complex symptomatology and selective functional impairments. Although brain imaging studies have contributed to better characterizing the pathophysiological mechanisms underlying BPD, the white matter (WM) deficits associated with this disorder are still unclear. Therefore, the present review aims at providing an overview of the findings emerged from the available diffusion tensor imaging (DTI) studies on BPD. METHODS From a bibliographic research in PubMed until May 2019, we collected 12 studies that fulfilled our inclusion criteria, including a total sample of 291 BPD subjects and 293 healthy controls. RESULTS Overall, the DTI studies reviewed showed impairments in selective WM tracts that are part of the prefronto-limbic system, including frontal WM (short and long tracts), anterior cingulate cortex, corpus callosum, corona radiata, hippocampal fornix and thalamic radiation, in BPD patients compared to healthy controls. LIMITATIONS Few DTI studies with heterogeneous findings. CONCLUSIONS Overall these results reported that BPD is characterized by selective structural connectivity alterations in prefronto-limbic structures, further supporting the neurobiological model of BPD that suggests the presence of an abnormal modulation of frontal regions over limbic structures. Finally, the results also highlighted that the disrupted WM integrity in selective brain regions may also explain key-aspects of BPD symptomatology, including emotional dysregulation, ambivalence, contradictory behaviors and cognitive dysfunctions.
Collapse
Affiliation(s)
- M Grottaroli
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - G Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - C Bressi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - C Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - J C Soares
- Department of Psychiatry and Behavioural Sciences, UT Houston Medical School, Houston, TX, USA
| | - P Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| |
Collapse
|
76
|
Serati M, Delvecchio G, Orsenigo G, Mandolini GM, Lazzaretti M, Scola E, Triulzi F, Brambilla P. Corrigendum to “The Role of the Subplate in Schizophrenia and Autism: A Systematic Review” [Neuroscience 408C (2019) 58–67]. Neuroscience 2020; 426:87. [DOI: 10.1016/j.neuroscience.2019.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
77
|
Pigoni A, Mandolini GM, Delvecchio G, Bressi C, Soares JC, Brambilla P. A focus on valproate and cognitive deficits in Bipolar Disorders: A mini-review: Special Section on "Translational and Neuroscience Studies in Affective Disorders" Section Editor, Maria Nobile MD, PhD. J Affect Disord 2020; 261:277-281. [PMID: 31421858 DOI: 10.1016/j.jad.2019.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/01/2019] [Accepted: 08/07/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Cognitive deficits represent a core feature of Bipolar Disorder (BD), which seem to characterize this disorder regardless of the mood phase. However, the role of pharmacological treatment in determining cognitive alterations is still not clear. Indeed, although drugs improve cognition by targeting mood symptoms, they could also carry their own cognitive side effects. This is true especially for mood stabilizers as they are the most commonly prescribed drugs in patients affected by BD and they are usually administered also during euthymic phases. METHODS In this context, the present review aimed at summarizing the results of the studies evaluating the impact of valproate on cognitive functions in patients suffering from BD, as primary or secondary results. The inclusion criteria were met by ten studies. Specifically, we included one double-blind quasi-randomized study and nine cross-sectional or naturalistic studies, which a) used healthy subjects as control group (N = 1), b) compared valproate treated patients with healthy individuals and other treatments (N = 5), and c) compared valproate treated patients just with other treatments, with a specific focus on lithium (N = 3). RESULTS Overall the results suggested a negative effect of valproate on cognitive functions in chronically-treated patients affected by BD. Notably, it has been found that the working memory was the most affected cognitive domain. LIMITATIONS Few studies directly explored the effect of valproate on cognition in BD. CONCLUSIONS These findings seem to suggest that valproate might have a negative effect on cognitive functions, especially on working memory domain. However, the results should be taken cautiously since the limited number of available studies published so far. In conclusion, these evidences seem to point out that the possible cognitive side effects of pharmacological treatments should be carefully taken into account, especially in chronic patients.
Collapse
Affiliation(s)
- A Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - G M Mandolini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - G Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - C Bressi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - J C Soares
- Department of Psychiatry and Behavioural Sciences, UT Houston Medical School, Houston, TX, USA
| | - P Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| |
Collapse
|
78
|
Dossi G, Delvecchio G, Prunas C, Soares JC, Brambilla P. Neural Bases of Cognitive Impairments in Post-Traumatic Stress Disorders: A Mini-Review of Functional Magnetic Resonance Imaging Findings. Front Psychiatry 2020; 11:176. [PMID: 32256405 PMCID: PMC7090214 DOI: 10.3389/fpsyt.2020.00176] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 02/24/2020] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Post-Traumatic Stress Disorder (PTSD) is often associated with impairments in emotional and cognitive domains. Contrarily to the emotional sphere, neural basis underpinnings to cognitive impairments are still not well known. METHODS We performed a bibliographic search on PUBMED of all the studies investigating the cognitive impairments in PTSD individuals. We considered only studies that applied cognitive tasks using a functional Magnetic Resonance Imaging technique. The inclusion criteria were met by nine studies. RESULTS Overall, PTSD individuals reported significant impairments in the dorsolateral prefrontal cortex, anterior cingulate cortex, inferior frontal gyrus, insula, inferior temporal cortex, supplement motor area, and Default Mode Network (DMN). Moreover, abnormal activity was reported in subcortical structures (e.g. hippocampus, amygdala, thalamus) and in the cerebellum. LIMITATIONS Cognitive functioning was assessed using different cognitive tasks. Potential confounding factors such as age, sex, symptoms intensity, and comorbidities might have influenced the results. CONCLUSION So far, the evidence reported that PTSD is characterized by cognitive impairments in several domains, such as attention, memory and autonomic arousal, which may be due to selective dysfunctions in brain regions that are part of cortical networks, the limbic system and DMN. However, further studies are needed in order to better assess the role of cognitive impairments in PTSD and to develop more targeted therapeutic approaches.
Collapse
Affiliation(s)
- Gabriele Dossi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Cecilia Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Jair C Soares
- Department of Psychiatry and Behavioural Sciences, UT Houston Medical School, Houston, TX, United States
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| |
Collapse
|
79
|
Delvecchio G, Ciappolino V, Perlini C, Barillari M, Ruggeri M, Altamura AC, Bellani M, Brambilla P. Correction to: Cingulate abnormalities in bipolar disorder relate to gender and outcome: a region-based morphometry study. Eur Arch Psychiatry Clin Neurosci 2019; 269:993. [PMID: 29948252 DOI: 10.1007/s00406-018-0913-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In the original publication of the article, the title was incorrect. The correct title should read as given below.
Collapse
Affiliation(s)
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
| | - Cinzia Perlini
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy
| | - Marco Barillari
- Section of Radiology, Department of Neurological and Movement Sciences, University Hospital of Verona, Verona, Italy
| | - Mirella Ruggeri
- Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy.,Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - A Carlo Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
| | - Marcella Bellani
- Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy.,Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy. .,Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA.
| |
Collapse
|
80
|
Delvecchio G, Pigoni A, Bauer IE, Soares JC, Brambilla P. Disease-discordant twin structural MRI studies on affective disorders. Neurosci Biobehav Rev 2019; 108:459-471. [PMID: 31790709 DOI: 10.1016/j.neubiorev.2019.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/24/2019] [Accepted: 11/26/2019] [Indexed: 01/01/2023]
Abstract
Magnetic resonance imaging (MRI) studies have identified neural structures implicated in the pathophysiology of mood disorders, especially bipolar disorder (BD) and major depressive disorder (MDD). However, the role of genetic and environmental influences on such brain deficits is still unclear. In this context, the present review summarizes the current evidence from structural MRI and Diffusion Tensor Imaging (DTI) studies on twin samples concordant or discordant for BD or MDD, with the aim of clarifying the role of genetic and environmental risk factors on brain alterations. Although the results showed a complex interplay between gene and environment in affective disorders, the evidence seem to underline that both genetic and environmental risk factors have an impact on brain areas and vulnerability to MDD and BD. However, the precise mechanism of action and the interaction between these factors still needs to be unveiled. Therefore, future larger studies on concordant or discordant twins should be encouraged, because this population provides a unique opportunity to probe separately genetic and environmental markers of disease vulnerability.
Collapse
Affiliation(s)
- G Delvecchio
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy
| | - A Pigoni
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy
| | - I E Bauer
- Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - J C Soares
- Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - P Brambilla
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
| |
Collapse
|
81
|
Delvecchio G, Ciappolino V, Perlini C, Barillari M, Ruggeri M, Altamura AC, Bellani M, Brambilla P. Cingulate abnormalities in bipolar disorder relate to gender and outcome: a region-based morphometry study [corrected]. Eur Arch Psychiatry Clin Neurosci 2019; 269:777-784. [PMID: 29594394 DOI: 10.1007/s00406-018-0887-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 03/16/2018] [Indexed: 12/22/2022]
Abstract
Structural magnetic resonance imaging (MRI) studies reported gray matter (GM) loss in bipolar disorder (BD) in cingulate cortices, key regions subserving emotional regulation and cognitive functions in humans. The aim of this study was to further explore cingulate GM volumes in a sizeable group of BD patients with respect to healthy controls, particularly investigating the impact of gender and clinical variables. 39 BD patients (mean Age = 48.6 ± 9.7, 15 males and 24 females) and 39 demographically matched healthy subjects (mean Age = 47.9 ± 9.1, 15 males and 24 females) underwent a 1.5T MRI scan. GM volumes within the cingulate cortex were manually detected, including anterior and posterior regions. BD patients had decreased left anterior cingulate volumes compared with healthy controls (F = 6.7, p = 0.01). Additionally, a significant gender effect was observed, with male patients showing reduced left anterior cingulate cortex (ACC) volumes compared to healthy controls (F = 5.1, p = 0.03). Furthermore, a significant inverse correlation between right ACC volumes and number of hospitalizations were found in the whole group of BD patients (r = - 0.51, p = 0.04) and in male BD patients (r = - 0.88, p = 0.04). Finally, no statistically significant correlations were observed in female BD patients. Our findings further confirm the putative role of the ACC in the pathophysiology of BD. Interestingly, this study also suggested the presence of gender-specific GM volume reductions in ACC in BD, which may also be associated to poor outcome.
Collapse
Affiliation(s)
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
| | - Cinzia Perlini
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy
| | - Marco Barillari
- Section of Radiology, Department of Neurological and Movement Sciences, University Hospital of Verona, Verona, Italy
| | - Mirella Ruggeri
- Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy.,Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - A Carlo Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
| | - Marcella Bellani
- Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy.,Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy. .,Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA.
| |
Collapse
|
82
|
Maggioni E, Delvecchio G, Grottaroli M, Garzitto M, Piccin S, Bonivento C, Maieron M, D'Agostini S, Perna G, Balestrieri M, Brambilla P. Common and different neural markers in major depression and anxiety disorders: A pilot structural magnetic resonance imaging study. Psychiatry Res Neuroimaging 2019; 290:42-50. [PMID: 31279954 DOI: 10.1016/j.pscychresns.2019.06.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 02/04/2023]
Abstract
Although anxiety and depression often co-occur and share some clinical features, it is still unclear if they are neurobiologically distinct or similar processes. In this study, we explored common and specific cortical morphology alterations in depression and anxiety disorders. Magnetic Resonance Imaging data were acquired from 13 Major Depressive Disorder (MDD), 11 Generalized Anxiety Disorder (GAD), 11 Panic Disorder (PD) patients and 21 healthy controls (HC). Regional cortical thickness, surface area (SA), volume and gyrification were measured and compared among groups. We found left orbitofrontal thinning in all patient groups, as well as disease-specific alterations. MDD showed volume deficits in left precentral gyrus compared to all groups, volume and area deficits in right fusiform gyrus compared to GAD and HC. GAD showed lower SA than MDD and PD in right superior parietal cortex, higher gyrification than HC in right frontal gyrus. PD showed higher gyrification in left superior parietal cortex when compared to MDD and higher SA in left postcentral gyrus compared to all groups. Our results suggest that clinical phenotypic similarities between major depression and anxiety disorders might rely on common prefrontal alterations. Frontotemporal and parietal abnormalities may represent unique biological signatures of depression and anxiety.
Collapse
Affiliation(s)
- Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, Milan, Italy
| | - Marika Grottaroli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Garzitto
- Scientific Institute, IRCCS E. Medea, via della Bontà 7, San Vito al Tagliamento, Pordenone, Italy
| | - Sara Piccin
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, via Colugna 50, Udine, Italy
| | - Carolina Bonivento
- Scientific Institute, IRCCS E. Medea, via della Bontà 7, San Vito al Tagliamento, Pordenone, Italy
| | - Marta Maieron
- Department of Physics, Azienda Ospedaliero Universitaria 'S.Maria della Misericordia', P.za S. Maria della Misericordia, Udine, Italy
| | - Serena D'Agostini
- Department of Neuroradiology, Azienda Ospedaliero Universitaria 'S.Maria della Misericordia', P.za S. Maria della Misericordia, Udine, Italy
| | - Giampaolo Perna
- Department of Clinical Neurosciences, Villa San Benedetto Menni, Hermanas Hospitalarias, via Roma 16, Albese con Cassano, Como, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, via Colugna 50, Udine, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, Milan, Italy.
| |
Collapse
|
83
|
Delvecchio G, Caletti E, Perlini C, Siri FM, Andreella A, Finos L, Bellani M, Fabbro F, Lasalvia A, Bonetto C, Cristofalo D, Scocco P, D'Agostino A, Torresani S, Imbesi M, Bellini F, Veronese A, Bressi C, Ruggeri M, Brambilla P. Altered syntactic abilities in first episode patients: An inner phenomenon characterizing psychosis. Eur Psychiatry 2019; 61:119-126. [PMID: 31442739 DOI: 10.1016/j.eurpsy.2019.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Research has consistently shown that language abilities represent a core dimension of psychosis; however, to date, very little is known about syntactic comprehension performance in the early stages of psychosis. This study aims to compare the linguistic abilities involved in syntactic comprehension in a large group of First Episode Psychosis (FEP) patients and healthy controls (HCs). METHODS A multiple choice test of comprehension of syntax was administered to 218 FEP patients (166 non-affective FEP patients [FEP-NA] and 52 affective FEP patients [FEP-A]) and 106 HCs. All participants were asked to match a sentence they listen with one out of four vignettes on a pc screen. Only one vignette represents the stimulus target, while the others are grammatical or non-grammatical (visual) distractors. Both grammatical and non-grammatical errors and performance in different syntactic constructions were considered. RESULTS FEP committed greater number of errors in the majority of TCGB language domains compared to HCs. Moreover, FEP-NA patients committed significantly more non-grammatical (z = -3.2, p = 0.007), locative (z = -4.7, p < 0.001), passive-negative (z = -3.2, p = 0.02), and relative (z = -4.6, p < 0.001) errors compared to HCs as well as more passive-affirmative errors compared to both HCs (z = -4.3, p < 0.001) and FEP-A (z = 3.1, p = 0.04). Finally, we also found that both FEP-NA and FEP-A committed more grammatical (FEP-NA: z = -9.2, p < 0.001 and FEP-A: z = -4.4, p < 0.001), total (FEP-NA: z = -8.2, p < 0.001 and FEP-A: z = 3.9, p = 0.002), and active-negative (FEP-NA: z = -5.8, p < 0.001 and FEP-A: z = -3.5, p = 0.01) errors compared to HCs. CONCLUSIONS This study shows that the access to syntactic structures is already impaired in FEP patients, especially in those with FEP-NA, ultimately suggesting that language impairments represent a core and inner feature of psychosis even at early stages.
Collapse
Affiliation(s)
- Giuseppe Delvecchio
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy
| | - Elisabetta Caletti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Italy
| | - Francesca Marzia Siri
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy
| | | | - Livio Finos
- Department of Developmental Psychology and Socialization, University of Padua, Italy
| | - Marcella Bellani
- UOC of Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI) of Verona, Italy
| | - Franco Fabbro
- Department of Medicine, University of Udine, Udine, Italy
| | - Antonio Lasalvia
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Italy; UOC of Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI) of Verona, Italy
| | - Chiara Bonetto
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Italy
| | - Doriana Cristofalo
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Italy
| | - Paolo Scocco
- Department of Mental Health, AULSS 6 Euganea, Padua, Italy
| | - Armando D'Agostino
- Department of Health Sciences, San Paolo University Hospital, University of Milan, Milan, Italy
| | | | | | | | | | - Cinzia Bressi
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy
| | - Mirella Ruggeri
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Italy; UOC of Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI) of Verona, Italy
| | - Paolo Brambilla
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
| | | |
Collapse
|
84
|
Madonna D, Delvecchio G, Soares JC, Brambilla P. Structural and functional neuroimaging studies in generalized anxiety disorder: a systematic review. ACTA ACUST UNITED AC 2019; 41:336-362. [PMID: 31116259 PMCID: PMC6804309 DOI: 10.1590/1516-4446-2018-0108] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/16/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Brain imaging studies carried out in patients suffering from generalized anxiety disorder (GAD) have contributed to better characterize the pathophysiological mechanisms underlying this disorder. The present study reviews the available functional and structural brain imaging evidence on GAD, and suggests further strategies for investigations in this field. METHODS A systematic literature review was performed in PubMed, PsycINFO, and Google Scholar, aiming to identify original research evaluating GAD patients with the use of structural and functional magnetic resonance imaging as well as diffusion tensor imaging. RESULTS The available studies have shown impairments in ventrolateral and dorsolateral prefrontal cortex, anterior cingulate, posterior parietal regions, and amygdala in both pediatric and adult GAD patients, mostly in the right hemisphere. However, the literature is often tentative, given that most studies have employed small samples and included patients with comorbidities or in current use of various medications. Finally, different methodological aspects, such as the type of imaging equipment used, also complicate the generalizability of the findings. CONCLUSIONS Longitudinal neuroimaging studies with larger samples of both juvenile and adult GAD patients, as well as at risk individuals and unaffected relatives, should be carried out in order to shed light on the specific biological signature of GAD.
Collapse
Affiliation(s)
- Domenico Madonna
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Universitá di Milano, Milano, Italy.,Dipartimento di Neuroscienze e Salute Mentale, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giuseppe Delvecchio
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Universitá di Milano, Milano, Italy
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Paolo Brambilla
- Dipartimento di Neuroscienze e Salute Mentale, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Psychiatry and Behavioral Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| |
Collapse
|
85
|
Del Fabro L, Delvecchio G, D'Agostino A, Brambilla P. Effects of olanzapine during cognitive and emotional processing in schizophrenia: A review of functional magnetic resonance imaging findings. Hum Psychopharmacol 2019; 34:e2693. [PMID: 30901117 DOI: 10.1002/hup.2693] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 01/25/2019] [Accepted: 02/04/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Olanzapine is an atypical antipsychotic that is widely used in the treatment of schizophrenia and has shown some degree of efficacy on negative and cognitive symptoms. We aimed to review the effects of olanzapine treatment on brain regions that are directly involved in cognitive and emotional processing. METHODS We used the PubMed database to perform a bibliographic search on functional magnetic resonance imaging studies that investigated the effects of olanzapine treatment on neural activity in patients with schizophrenia during cognitive and emotional tasks. RESULTS Despite the high variability of tasks and analysis methods employed, the weight of the evidence was consistent with the hypothesis that olanzapine treatment is associated with a normalization of brain activity in schizophrenia. Distinctive functional changes were found in frontal cortex and cingulate cortex activity during both cognitive and emotional tasks. During emotional processing, olanzapine treatment seems to specifically regulate the activity of the striatum and limbic system. CONCLUSIONS The results of the reviewed studies suggest that in patients with schizophrenia, olanzapine treatment might lead to a more physiological brain activity coupled with regulation of dopamine release. Future studies should further corroborate these hypotheses using larger samples and homogeneous experimental tasks.
Collapse
Affiliation(s)
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, Milan.,Department of Psychiatry and Behavioural Sciences, UT Houston Medical School, Houston, TX, USA
| |
Collapse
|
86
|
Delvecchio G, Rossetti MG, Caletti E, Arighi A, Galimberti D, Basilico P, Mercurio M, Paoli R, Cinnante C, Triulzi F, Altamura AC, Scarpini E, Brambilla P. The Neuroanatomy of Somatoform Disorders: A Magnetic Resonance Imaging Study. Psychosomatics 2019; 60:278-288. [DOI: 10.1016/j.psym.2018.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 11/16/2022]
|
87
|
Delvecchio G, Mandolini GM, Arighi A, Prunas C, Mauri CM, Pietroboni AM, Marotta G, Cinnante CM, Triulzi FM, Galimberti D, Scarpini E, Altamura AC, Brambilla P. Structural and metabolic cerebral alterations between elderly bipolar disorder and behavioural variant frontotemporal dementia: A combined MRI-PET study. Aust N Z J Psychiatry 2019; 53:413-423. [PMID: 30545239 DOI: 10.1177/0004867418815976] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Elderly bipolar disorder (BD) and behavioural variant of frontotemporal dementia (bvFTD) may exhibit similar symptoms and both disorders are characterized by selective abnormalities in cortical and subcortical regions that are associated with cognitive and emotional impairments. We aimed to investigate common and distinct neural substrates of BD and bvFTD by coupling, for the first time, magnetic resonance imaging (MRI) and positron emission tomography (PET) techniques. METHODS 3-Tesla MRI and 18 fluorodeoxyglucose-PET scans were acquired for 16 elderly BD patients, 23 bvFTD patients with mild cognitive impairments and 68 healthy controls (48 for PET and 20 for MRI analyses). RESULTS BD and bvFTD patients exhibit a different localization of grey matter reductions in the lateral prefrontal cortex, with the first group showing grey matter decrease in the ventrolateral prefrontal cortex and the latter group showing grey matter reductions in the dorsolateral prefrontal cortex as well as unique grey matter and metabolic alterations within the orbitofrontal cortex. The bvFTD group also displayed unique volumetric shrinkage in regions within the temporo-parietal network together with greater metabolic impairments within the temporal cortex and more extensive volumetric and metabolic abnormalities within the limbic lobe. Finally, while the BD group showed greater grey matter volumes in caudate nucleus, bvFTD subjects displayed lower metabolism. CONCLUSION This MRI-PET study explored, for the first time to the best of our knowledge, structural and functional abnormalities in bvFTD and elderly BD patients, with the final aim of identifying the specific biological signature of these disorders, which might have important implications not only in prevention but also in differential diagnosis and treatment.
Collapse
Affiliation(s)
- Giuseppe Delvecchio
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Gian Mario Mandolini
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Arighi
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,3 'Dino Ferrari' Center, Milan, Italy
| | - Cecilia Prunas
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Massimo Mauri
- 2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna M Pietroboni
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,3 'Dino Ferrari' Center, Milan, Italy
| | - Giorgio Marotta
- 2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Maria Cinnante
- 2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Maria Triulzi
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Galimberti
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,3 'Dino Ferrari' Center, Milan, Italy
| | - Elio Scarpini
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,3 'Dino Ferrari' Center, Milan, Italy
| | - Alfredo Carlo Altamura
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,4 Department of Psychiatry and Behavioural Sciences, UT Houston Medical School, Houston, TX, USA
| |
Collapse
|
88
|
Ciappolino V, Mazzocchi A, Botturi A, Turolo S, Delvecchio G, Agostoni C, Brambilla P. The Role of Docosahexaenoic Acid (DHA) on Cognitive Functions in Psychiatric Disorders. Nutrients 2019; 11:nu11040769. [PMID: 30986970 PMCID: PMC6520996 DOI: 10.3390/nu11040769] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 03/25/2019] [Accepted: 03/28/2019] [Indexed: 02/07/2023] Open
Abstract
Cognitive impairment is strongly associated with functional outcomes in psychiatric patients. Involvement of n-3 long chain polyunsaturated fatty acid (n-3 LC-PUFA), in particular docosahexaenoic acid (DHA), in brain functions is largely documented. DHA is incorporated into membrane phospholipids as structural component, especially in the central nervous system where it also has important functional effects. The aim of this review is to investigate the relationship between DHA and cognitive function in relation to mental disorders. Results from few randomized controlled trials (RCTs) on the effects of DHA (alone or in combination) in psychotic, mood and neurodevelopmental disorders, respectively, suggest that no conclusive remarks can be drawn.
Collapse
Affiliation(s)
- Valentina Ciappolino
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy.
| | - Alessandra Mazzocchi
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
| | - Andrea Botturi
- Neurologic Clinic, Fondazione IRCCS Istituto neurologico Carlo Besta, 20122 Milan, Italy.
| | - Stefano Turolo
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Pediatric Nephrology, Dialysis and Transplant Unit, 20122 Milan, Italy.
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, 20122 Milan, Italy.
| | - Paolo Brambilla
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy.
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.
| |
Collapse
|
89
|
Serati M, Delvecchio G, Orsenigo G, Mandolini GM, Lazzaretti M, Scola E, Triulzi F, Brambilla P. The Role of the Subplate in Schizophrenia and Autism: A Systematic Review. Neuroscience 2019; 408:58-67. [PMID: 30930130 DOI: 10.1016/j.neuroscience.2019.03.049] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 02/07/2023]
Abstract
The subplate (SP) represents a transitory cytoarchitectural fetal compartment containing most subcortical and cortico-cortical afferents, and has a fundamental role in the structural development of the healthy adult brain. There is evidence that schizophrenia and autism may be determined by developmental defects in the cortex or cortical circuitry during the earliest stages of pregnancy. This article provides an overview on fetal SP development, considering its role in schizophrenia and autism, as supported by a systematic review of the main databases. The SP has been described as a cortical amplifier with a role in the coordination of cortical activity, and sensitive growth and migration windows have crucial consequences with respect to cognitive functioning. Although there are not enough studies to draw final conclusions, improved knowledge of the SP's role in schizophrenia and autism spectrum disorders may help to elucidate and possibly prevent the onset of these two severe disorders.
Collapse
Affiliation(s)
- Marta Serati
- Department of Mental Health, ASST Rhodense, Rho, Milan, Italy.
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giulia Orsenigo
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Gian Mario Mandolini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Matteo Lazzaretti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Elisa Scola
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Triulzi
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, TX, USA
| |
Collapse
|
90
|
Marotta G, Delvecchio G, Pigoni A, Mandolini G, Ciappolino V, Oldani L, Madonna D, Grottaroli M, Altamura AC, Brambilla P. The metabolic basis of psychosis in bipolar disorder: A positron emission tomography study. Bipolar Disord 2019; 21:151-158. [PMID: 30506616 DOI: 10.1111/bdi.12710] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Psychotic symptoms are a common feature in bipolar disorder (BD), especially during manic phases, and are associated with a more severe course of illness. However, not all bipolar subjects experience psychosis during the course of their illness, and this difference often guides assessment and pharmacological treatment. The aim of the present study is to elucidate, for the first time, the FDG uptake dysfunctions associated with psychosis in BD patients with and without a history of past psychotic symptoms, through a positron emission tomography (PET) approach. METHODS Fifty BD patients with lifetime psychotic symptoms, 40 BD patients without lifetime psychotic symptoms and 27 healthy controls (HC) were recruited and underwent an 18F-FDG-PET session. RESULTS Compared to HC, BD subjects shared common FDG uptake deficits in several brain areas, including insula, inferior temporal gyrus and middle occipital gyrus. Moreover, we found that BD patients with a history of past psychotic symptoms had a unique FDG uptake alteration in the right fusiform gyrus compared to both BD patients without lifetime psychotic symptoms and HC (all P < 0.01, cFWE corrected). CONCLUSIONS Overall, our results suggest that FDG uptake alterations in brain regions involved in emotion regulation are a key feature of BD, regardless the presence of past psychosis. Finally, we demonstrated that the FDG uptake reduction in fusiform gyrus is associated with the presence of past psychotic symptoms in BD, ultimately leading towards the idea that the fusiform gyrus might be considered a putative biomarker of psychosis.
Collapse
Affiliation(s)
- Giorgio Marotta
- Department of Nuclear Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Scientific Institute, IRCCS E. Medea, Pordenone, Italy
| | - Alessandro Pigoni
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianmario Mandolini
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Lucio Oldani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Domenico Madonna
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marika Grottaroli
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Alfredo Carlo Altamura
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Psychiatry and Behavioural Sciences, UT Houston Medical School, Houston, TX, USA
| |
Collapse
|
91
|
Mandolini GM, Lazzaretti M, Pigoni A, Delvecchio G, Soares JC, Brambilla P. The impact of BDNF Val66Met polymorphism on cognition in Bipolar Disorder: A review: Special Section on "Translational and Neuroscience Studies in Affective Disorders" Section Editor, Maria Nobile MD, PhD. This Section of JAD focuses on the relevance of translational and neuroscience studies in providing a better understanding of the neural basis of affective disorders. The main aim is to briefly summaries relevant research findings in clinical neuroscience with particular regards to specific innovative topics in mood and anxiety disorders. J Affect Disord 2019; 243:552-558. [PMID: 30078664 DOI: 10.1016/j.jad.2018.07.054] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/12/2018] [Accepted: 07/20/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Converging lines of evidence suggest that Brain-Derived Neurotrophic Factor (BDNF) may play a central role in the pathogenesis of Bipolar Disorder (BD), thus representing a valid biomarker of the disease. A common genetic variation in the BDNF gene, the Val66Met, is associated with reduced maturation and secretion of BDNF and therefore it has been related to specific mood, cognitive and neuroanatomical alterations in BD. However, so far, only a handful of studies have investigated the association between Val66Met polymorphism and cognitive functioning in BD. METHODS We performed a bibliographic search on PUBMED of all genetic studies investigating Val66Met modulation on cognitive performances in BD subjects. The inclusion criteria were met by nine studies, including a total amount of 897 BD subjects and 803 healthy controls. RESULTS From the analysis of the existing literature emerged that a) Val allele in BD adults, but not in BD adolescents, was associated with better performances in selective cognitive domains including executive functions, verbal learning and memory; b) Met allele may negatively modulate the association between childhood trauma and performances in memory, verbal ability and verbal fluency tasks; c) Met allele may also negatively regulate structural abnormalities in cognitive cerebral structures; d) Val/Met carriers showed greater improvements in cognitive functions compared to Val/Val and Met/Met carriers. LIMITATIONS Few genetic studies exploring the impact of Val66Met on cognition in BD. CONCLUSIONS Val66Met polymorphism likely modulates cognitive functions in BD patients with complex gene-environment interactions and through potential modulations of cerebral structures. Further and larger genetic studies are required in order to detect association between BDNF polymorphism, BDNF levels, brain abnormalities and cognition in BD.
Collapse
Affiliation(s)
- G M Mandolini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
| | - M Lazzaretti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - A Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - G Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - J C Soares
- Department of Psychiatry and Behavioural Neurosciences, University of Texas, Houston, TX, USA
| | - P Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Scientific Institute IRCCS "E. Medea", Bosisio Parini (Lc), Italy.
| |
Collapse
|
92
|
Dusi N, De Carlo V, Delvecchio G, Bellani M, Soares JC, Brambilla P. MRI features of clinical outcome in bipolar disorder: A selected review: Special Section on "Translational and Neuroscience Studies in Affective Disorders". Section Editor, Maria Nobile MD, PhD. This Section of JAD focuses on the relevance of translational and neuroscience studies in providing a better understanding of the neural basis of affective disorders. The main aim is to briefly summaries relevant research findings in clinical neuroscience with particular regards to specific innovative topics in mood and anxiety disorders. J Affect Disord 2019; 243:559-563. [PMID: 29907266 DOI: 10.1016/j.jad.2018.05.066] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 05/31/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is a severe and disabling mental illness, which is characterized by selective gray matter (GM) and white matter (WM) brain alterations, as observed by several imaging studies. However, the clinical course of the disease is uncertain and can vary across BD patients, with some having a benign course and others a severe disability. In this perspective, magnetic resonance imaging (MRI) can help identifying biological markers of worse prognosis. METHODS The present selected review aimed at summarizing structural MRI (sMRI) studies exploring the correlation between brain morphology and features of clinical outcome, which could include treatment response, cognitive impairment and global functioning. RESULTS Overall, the results from the reviewed sMRI studies reported that WM hyperintensities and GM volume reductions, mainly in fronto-limbic areas, correlate with worse outcome in BD. However, the selected outcome measures vary across studies, thus these observations cannot be conclusive. LIMITATIONS Heterogeneity across studies and inconsistency on the outcome measures adopted limit the conclusion of the present review. Absence of widely shared definitions of outcome should be object of further research on BD in order to indicate more stable features of illness course. CONCLUSIONS In summary, WM hyperintensities and fronto-temporo-limbic GM alterations may be potential indices of worse outcome in BD patients, particularly in terms of illness severity and progression. The identification of stable markers of prognosis can help the clinicians in selecting subgroups of bipolar patients who need specific treatment to preserve cognitive / psychosocial functioning, in the light of personalized approaches. To further characterize outcome in BD, future sMRI studies should a) longitudinally investigate patients with either poor or good course of the disease, and b) correlate neuroimaging measures with clinical, cognitive and genetic markers.
Collapse
Affiliation(s)
- N Dusi
- Psychiatry Unit, Department of Mental Health, ASST-Nord Milano, Milan, Italy
| | - V De Carlo
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122, Milan, Italy
| | - G Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - M Bellani
- InterUniversity Centre for Behavioural Neurosciences (ICBN), University of Verona, Verona, Italy; UOC Psychiatry, University Hospital Integrated Trust of Verona (AOUI), Italy
| | - J C Soares
- Department of Psychiatry and Behavioral Sciences, UTHouston Medical School, Houston, TX, United States
| | - P Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; IRCCS "E. Medea" Scientific Institute, Bosisio Parini (Lc), Italy.
| |
Collapse
|
93
|
Calvo A, Delvecchio G, Altamura AC, Soares JC, Brambilla P. Gray matter differences between affective and non-affective first episode psychosis: A review of Magnetic Resonance Imaging studies: Special Section on "Translational and Neuroscience Studies in Affective Disorders" Section Editor, Maria Nobile MD, PhD. This Section of JAD focuses on the relevance of translational and neuroscience studies in providing a better understanding of the neural basis of affective disorders. The main aim is to briefly summaries relevant research findings in clinical neuroscience with particular regards to specific innovative topics in mood and anxiety disorders. J Affect Disord 2019; 243:564-574. [PMID: 29625792 DOI: 10.1016/j.jad.2018.03.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/22/2018] [Accepted: 03/14/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Non-affective and affective psychoses are very common mental disorders. However, their neurobiological underpinnings are still poorly understood. Therefore, the goal of the present review was to evaluate structural Magnetic Resonance Imaging (MRI) studies exploring brain deficits in both non-affective (NA-FEP) and affective first episode psychosis (A-FEP). METHODS A bibliographic search on PUBMED of all MRI studies exploring gray matter (GM) differences between NA-FEP and A-FEP was conducted. RESULTS Overall, the results from the available evidence showed that the two diagnostic groups share common GM alterations in fronto-temporal regions and anterior cingulate cortex. In contrast, unique GM deficits have also been observed, with reductions in amygdala for A-FEP and in hippocampus and insula for NA-FEP. LIMITATIONS Few small MRI studies with heterogeneous methodology. CONCLUSIONS Although the evidences are far to be conclusive, they suggest the presence of common and distinct pattern of GM alterations in NA-FEP and A-FEP. Future larger longitudinal studies are needed to further characterize specific neural biomarkers in homogenous NA-FEP and A-FEP samples.
Collapse
Affiliation(s)
- A Calvo
- Faculty of Health Sciences, Universidad Internacional de la Rioja (UNIR), Spain.
| | - G Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - A C Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - J C Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, TX, USA
| | - P Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; IRCCS "E. Medea" Scientific Institute, Bosisio Parini LC, Italy.
| |
Collapse
|
94
|
Squarcina L, Delvecchio G, Nobile M, Mauri M, Madonna D, Bonivento C, Garzitto M, Piccin S, Molteni M, Tomasino B, Bressi C, Fabbro F, Stanley JA, Brambilla P. The Assertive Brain: Anterior Cingulate Phosphocreatine plus Creatine Levels Correlate With Self-Directedness in Healthy Adolescents. Front Psychiatry 2019; 10:763. [PMID: 31827447 PMCID: PMC6849467 DOI: 10.3389/fpsyt.2019.00763] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/23/2019] [Indexed: 11/13/2022] Open
Abstract
Despite various advances in the study of the neurobiological underpinnings of personality traits, the specific neural correlates associated with character and temperament traits are not yet fully understood. Therefore, this study aims to fill this gap by exploring the biochemical basis of personality, which is explored with the temperament and character inventory (TCI), during brain development in a sample of adolescents. Twenty-six healthy adolescents (aged between 13 and 21 years; 17 males and 9 females) with behavioral and emotional problems underwent a TCI evaluation and a 3T single-voxel proton magnetic resonance spectroscopy (1H MRS) acquisition of the anterior cingulate cortex (ACC). Absolute metabolite levels were estimated using LCModel: significant correlations between metabolite levels and selective TCI scales were identified. Specifically, phosphocreatine plus creatine (PCr+Cre) significantly correlated with self-directedness, positively, and with a self-transcendence (ST), negatively, while glycerophosphocholine plus phosphocholine (GPC+PC) and myo-inositol negatively correlated with ST. To the best of our knowledge, this is the first study reporting associations of brain metabolites with personality traits in adolescents. Therefore, our results represent a step forward for personality neuroscience within the study of biochemical systems and brain structures.
Collapse
Affiliation(s)
- Letizia Squarcina
- Department of Neurosciences and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Maria Nobile
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Maddalena Mauri
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Domenico Madonna
- Department of Neurosciences and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Carolina Bonivento
- Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Italy
| | - Marco Garzitto
- Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Italy
| | - Sara Piccin
- Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Italy
| | - Massimo Molteni
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Barbara Tomasino
- Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Italy
| | - Cinzia Bressi
- Department of Neurosciences and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Franco Fabbro
- Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Italy
| | - Jeffrey A Stanley
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, United States
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
95
|
Squarcina L, Delvecchio G, Nobile M, Mauri M, Madonna D, Bonivento C, Garzitto M, Piccin S, Molteni M, Tomasino B, Bressi C, Fabbro F, Stanley JA, Brambilla P. Corrigendum: The Assertive Brain: Anterior Cingulate Phosphocreatine Plus Creatine Levels Correlate With Self-Directedness in Healthy Adolescents. Front Psychiatry 2019; 10:907. [PMID: 31992996 PMCID: PMC6964643 DOI: 10.3389/fpsyt.2019.00907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 12/03/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2019.00763.].
Collapse
Affiliation(s)
- Letizia Squarcina
- Department of Neurosciences and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Maria Nobile
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Maddalena Mauri
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Domenico Madonna
- Department of Neurosciences and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Carolina Bonivento
- Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Italy
| | - Marco Garzitto
- Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Italy
| | - Sara Piccin
- Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Italy
| | - Massimo Molteni
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Barbara Tomasino
- Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Italy
| | - Cinzia Bressi
- Department of Neurosciences and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Franco Fabbro
- Scientific Institute, IRCCS Eugenio Medea, San Vito al Tagliamento, Italy
| | - Jeffrey A Stanley
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, United States
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
96
|
Caletti E, Delvecchio G, Andreella A, Finos L, Perlini C, Tavano A, Lasalvia A, Bonetto C, Cristofalo D, Lamonaca D, Ceccato E, Pileggi F, Mazzi F, Santonastaso P, Ruggeri M, Bellani M, Brambilla P. Prosody abilities in a large sample of affective and non-affective first episode psychosis patients. Compr Psychiatry 2018; 86:31-38. [PMID: 30056363 DOI: 10.1016/j.comppsych.2018.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/27/2018] [Accepted: 07/10/2018] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE Prosody comprehension deficits have been reported in major psychoses. It is still not clear whether these deficits occur at early psychosis stages. The aims of our study were to investigate a) linguistic and emotional prosody comprehension abilities in First Episode Psychosis (FEP) patients compared to healthy controls (HC); b) performance differences between non-affective (FEP-NA) and affective (FEP-A) patients, and c) association between symptoms severity and prosodic features. METHODS A total of 208 FEP (156 FEP-NA and 52 FEP-A) patients and 77 HC were enrolled and assessed with the Italian version of the "Protocole Montréal d'Evaluation de la Communication" to evaluate linguistic and emotional prosody comprehension. Clinical variables were assessed with a comprehensive set of standardized measures. RESULTS FEP patients displayed significant linguistic and emotional prosody deficits compared to HC, with FEP-NA showing greater impairment than FEP-A. Also, significant correlations between symptom severity and prosodic features in FEP patients were found. CONCLUSIONS Our results suggest that prosodic impairments occur at the onset of psychosis being more prominent in FEP-NA and in those with severe psychopathology. These findings further support the hypothesis that aprosodia is a core feature of psychosis.
Collapse
Affiliation(s)
- Elisabetta Caletti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | - Livio Finos
- Department of Developmental Psychology and Socialization, University of Padua, Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Alessandro Tavano
- Department of Neurosciences, Max Planck Institute for Empirical Aesthetics, Frankfurt am Maine, Germany
| | - Antonio Lasalvia
- UOC Psychiatry, University Hospital Integrated Trust of Verona (AOUI), Italy
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Doriana Cristofalo
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Dario Lamonaca
- Department of Psychiatry, CSM AULSS 21 Legnago, Verona, Italy
| | - Enrico Ceccato
- Department of Mental Health, Azienda ULSS 8 Berica, Vicenza, Italy
| | | | | | | | - Mirella Ruggeri
- UOC Psychiatry, University Hospital Integrated Trust of Verona (AOUI), Italy; Department of Public Health and Community Medicine, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Marcella Bellani
- UOC Psychiatry, University Hospital Integrated Trust of Verona (AOUI), Italy
| | - Paolo Brambilla
- Scientific Institute IRCCS "E.Medea", Bosisio Parini, Italy; Department of Pathophysiology and Transplantantion, University of Milan, Milan, Italy.
| | | |
Collapse
|
97
|
Pigoni A, Delvecchio G, Altamura AC, Soares JC, Fagnani C, Brambilla P. The role of genes and environment on brain alterations in Major Depressive Disorder: A review of twin studies: Special Section on "Translational and Neuroscience Studies in Affective Disorders". Section Editor, Maria Nobile MD, PhD. This Section of JAD focuses on the relevance of translational and neuroscience studies in providing a better understanding of the neural basis of affective disorders. The main aim is to briefly summaries relevant research findings in clinical neuroscience with particular regards to specific innovative topics in mood and anxiety disorders. J Affect Disord 2018; 234:346-350. [PMID: 29100658 DOI: 10.1016/j.jad.2017.10.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/11/2017] [Accepted: 10/22/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND Although it has been consistently reported the important role of genetic and environmental risk factors on structural and functional alterations in Major Depressive Disorder (MDD), the mechanism and the magnitude of the interactions between specific genetic and/or environmental risk factors on brain structures in this disabling disorder are still elusive. Therefore, in the last two decades an increased interest has been devoted to neuroimaging investigations on monozygotic and dizygotic twin samples mainly because their intrinsic characteristics may help to separate the effects of genetic and environmental risk factors on clinical phenotypes, including MDD. METHODS In this context, the present review summarizes results from structural and functional Magnetic Resonance Imaging studies that investigated twin samples in correlation with MDD. RESULTS Overall the results confirmed that a) MDD is characterized by significant alterations in selective brain areas presiding over emotion recognition and evaluation, including amygdala, insula and prefrontal cortices, and b) both genetic and environmental risk factors play a key role in the pathophysiology of this disorder. LIMITATIONS Few MRI studies exploring MDD in twin samples. CONCLUSIONS The specific contribution of both aspects is still not fully elucidated especially because genes and environment have an impact on the same brain areas, which are particularly vulnerable in MDD. Expansion of the current twin sample sizes would help to clearly establish the potential relationship between risk factors and the development of MDD.
Collapse
Affiliation(s)
- A Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - A C Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - J C Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, TX, USA
| | - C Fagnani
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - P Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; IRCCS "E Medea" Scientific Institute, Bosisio Parini, LC, Italy.
| |
Collapse
|
98
|
Serati M, Delvecchio G, Orsenigo G, Perlini C, Barillari M, Ruggeri M, Altamura AC, Bellani M, Brambilla P. Potential Gender-Related Aging Processes Occur Earlier and Faster in the Vermis of Patients with Bipolar Disorder: An MRI Study. Neuropsychobiology 2018; 75:32-38. [PMID: 28803247 DOI: 10.1159/000477967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/29/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND In the last decades, there has been increasing interest in investigating the role of the vermis in bipolar disorder (BD), especially because of its involvement in cognitive processes. The main aims of this study were to explore the integrity of the vermis and elucidate the role of demographic and clinical variables on vermis volumes in BD patients, stratified according to gender. METHODS T1-weighted images were obtained for 38 BD patients and 38 healthy controls using a 1.5-T MRI scanner. Images were analyzed with a PC workstation with BRAINS2 software on a Linux system. Anatomical regions were traced manually from a blinded operator, with respect to subject identity and other clinical variables. RESULTS The direct comparison between the 2 groups showed no significant gray matter differences in vermis volumes. Interestingly, vermis volumes were significantly inversely associated with chronological age and age of BD onset, particularly in male subjects. CONCLUSIONS Our study provides evidence of the impact of aging on the vermis in BD, potentially related to earlier and faster gender-related neurodegenerative phenomena occurring during the progression of the disease.
Collapse
Affiliation(s)
- Marta Serati
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
99
|
Ciappolino V, Mazzocchi A, Enrico P, Syrén ML, Delvecchio G, Agostoni C, Brambilla P. N-3 Polyunsatured Fatty Acids in Menopausal Transition: A Systematic Review of Depressive and Cognitive Disorders with Accompanying Vasomotor Symptoms. Int J Mol Sci 2018; 19:E1849. [PMID: 29937484 PMCID: PMC6073395 DOI: 10.3390/ijms19071849] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/15/2018] [Accepted: 06/19/2018] [Indexed: 01/25/2023] Open
Abstract
Depression is one of the most important health problems worldwide. Women are 2.5 times more likely to experience major depression than men. Evidence suggests that some women might experience an increased risk for developing depression during “windows of vulnerability”, i.e., when exposed to intense hormone fluctuations, such as the menopause transition. Indeed, this period is associated with different symptoms, including vasomotor, depressive, and cognitive symptoms, which have all been shown to worsen as women approach menopause. Even though hormonal therapy represents the most effective treatment, side effects have been reported by several studies. Therefore, an increased number of women might prefer the use of alternative medicine for treating menopausal symptoms. N-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs) are included among these alternative treatments. We here provide a review of studies investigating the effects of n-3 LCPUFAs on hot flashes and depressive and cognitive disorders in menopausal women. The reported results are scattered and heterogeneous. In conclusion, a beneficial role of n-3 LCPUFAs in hot flashes, and depressive and cognitive symptoms related to menopausal transition is still far from conclusive.
Collapse
Affiliation(s)
- Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy.
| | - Alessandra Mazzocchi
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
| | - Paolo Enrico
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy.
| | - Marie-Louise Syrén
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.
| | - Carlo Agostoni
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
- SIGENP (Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition), via Libero Temolo 4 (Torre U8), 20126 Milan, Italy.
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy.
- Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX 77030, USA.
| |
Collapse
|
100
|
Peduzzi M, Torlai F, Delvecchio G. Bilateral Pigmented Retinopathy following Measles: Long-Term Follow-Up and Possible Association with Keratoconus. Eur J Ophthalmol 2018; 1:148-50. [PMID: 1841672 DOI: 10.1177/112067219100100308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A case of pigmentary retinopathy following measles is presented with follow-up of 24 years. A 29-year-old man complained of almost complete blindness during measles infection at the age of 5 (1966). Ophthalmoscopy revealed retinal edema with pallor of the optic disc and in a few months pigment alterations gave the fundus a salt-and-pepper appearance. In 1974 and 1985 a pigmentary retinopathy was present with optic atrophy and typical bone corpuscle deposits, and marked impairment of visual function. In 1990 (i.e. 24 years after the onset of symptoms) the fundus shows pigmentary degeneration with optic atrophy and narrowed vessels, ERG is extinguished and visual fields and dark adaptation cannot be recorded owing to amaurosis. The patient also present bilateral keratoconus. The possible association between these two entities, which to our knowledge has not been previously reported, is discussed.
Collapse
Affiliation(s)
- M Peduzzi
- Department of Ophthalmology, University of Modena, Italy
| | | | | |
Collapse
|