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Gifuni AJ, Olié E, Ding Y, Cyprien F, le Bars E, Bonafé A, Courtet P, Jollant F. Corpus callosum volumes in bipolar disorders and suicidal vulnerability. Psychiatry Res Neuroimaging 2017; 262:47-54. [PMID: 28232274 DOI: 10.1016/j.pscychresns.2017.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/22/2017] [Accepted: 02/09/2017] [Indexed: 12/30/2022]
Abstract
Reduced size of the corpus callosum (CC) has been associated with bipolar disorders and suicidality. Here, we aimed at investigating the relative independence of these associations in a large sample of patients. Two samples of males and females totaling 209 euthymic participants were recruited, including 72 patients with a major depressive disorder, 64 with bipolar disorders and 73 healthy controls. Among patients, 61 had a lifetime history of suicide attempt and 75 had none. Structural scans were acquired with 1.5T magnetic resonance imaging. Surface-based morphometry (Freesurfer) analysis was used to compute the volumes of the CC. In the whole sample, there was a significant reduction in the volume of mid-anterior, central, and mid-posterior (all p<0.008) CC in bipolar patients independently from suicidality, with medium effect sizes between unipolar and bipolar patients (Cohen's d between 0.46 and 0.62). In contrast, suicide attempters did not differ from non-attempters. This significant association between CC volumes and bipolar disorders was mainly found in the male sample, while a trend was found in the female sample. Within each patient group, medication had no major effect. Our study adds to the growing body of evidence linking corpus callosum alterations and bipolar disorders.
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Affiliation(s)
- Anthony J Gifuni
- McGill University & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montreal, Québec, Canada
| | - Emilie Olié
- Université Montpellier I, Montpellier, France & Montpellier Academic Hospital (CHU), Department of psychiatry, Montpellier, France & Inserm, U1061 Montpellier, France
| | - Yang Ding
- McGill University & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montreal, Québec, Canada
| | - Fabienne Cyprien
- Université Montpellier I, Montpellier, France & Montpellier Academic Hospital (CHU), Department of psychiatry, Montpellier, France & Inserm, U1061 Montpellier, France
| | - Emmanuelle le Bars
- Université Montpellier I, Montpellier, France & Montpellier Academic Hospital (CHU), Department of radiology, Montpellier, France
| | - Alain Bonafé
- Université Montpellier I, Montpellier, France & Montpellier Academic Hospital (CHU), Department of radiology, Montpellier, France
| | - Philippe Courtet
- Université Montpellier I, Montpellier, France & Montpellier Academic Hospital (CHU), Department of psychiatry, Montpellier, France & Inserm, U1061 Montpellier, France
| | - Fabrice Jollant
- McGill University & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montreal, Québec, Canada; Department of Psychiatry, Nîmes Academic Hospital (CHU), Nîmes, France.
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Minor physical anomalies in bipolar I and bipolar II disorders - Results with the Méhes Scale. Psychiatry Res 2017; 249:120-124. [PMID: 28092791 DOI: 10.1016/j.psychres.2017.01.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 11/21/2022]
Abstract
Minor physical anomalies (MPAs) are external markers of abnormal brain development, so the more common appearence of these signs among bipolar I and bipolar II patients can confirm the possibility of a neurodevelopmental deficit in these illnesses. The aim of the present study was to investigate the rate and topological profile of minor physical anomalies in patients with bipolar I and - first in literature - with bipolar II disorders compared to matched healthy control subjects. Using a list of 57 minor physical anomalies (the Méhes Scale), 30 bipolar I and 30 bipolar II patients, while as a comparison 30 matched healthy control subjects were examined. Significant differences were detected between the three groups comparing the total number of minor physical anomalies, minor malformations and phenogenetic variants and in the cases of the ear and the mouth regions. The individual analyses of the 57 minor physical anomalies by simultaneous comparison of the three groups showed, that in the cases of furrowed tongue and high arched palate were significant differences between the three groups. The results can promote the concept, that a neurodevelopmental deficit may play a role in the etiology of both bipolar I and bipolar II disorders.
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Niu M, Wang Y, Jia Y, Wang J, Zhong S, Lin J, Sun Y, Zhao L, Liu X, Huang L, Huang R. Common and Specific Abnormalities in Cortical Thickness in Patients with Major Depressive and Bipolar Disorders. EBioMedicine 2017; 16:162-171. [PMID: 28109831 PMCID: PMC5474436 DOI: 10.1016/j.ebiom.2017.01.010] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 01/08/2017] [Accepted: 01/09/2017] [Indexed: 01/10/2023] Open
Abstract
Major depressive disorder (MDD) and bipolar disorder (BD) are severe psychiatric diseases with overlapping symptomatology. Although previous studies reported abnormal brain structures in MDD or BD patients, the disorder-specific underlying neural mechanisms remain poorly understood. The purpose of this study was to investigate the whole-brain gray matter morphological patterns in unmedicated patients with MDD or BD and to identify the shared and disease-specific brain morphological alterations in these two disorders. We acquired high-resolution brain structural MRI data from a sample of 36 MDD patients, 32 BD patients, and 30 healthy controls. Using FreeSurfer, we estimated their brain cortical thickness (CT) and compared between-group difference in multiple locations across the continuous cortical surface. Compared to the healthy controls, both the MDD and BD patient groups showed significantly reduced CT in the left inferior temporal cortex (ITC). However, compared to the MDD patients, the BD patients showed a significantly thinner CT in the left rostral middle frontal region. In addition, compared to the healthy controls, the BD patients displayed thinner CT in the left ITC, left frontal pole (FPO), left superior frontal, right lateral occipital, right pars triangularis (PTRI) and right lateral orbitofrontal regions. Further analysis revealed a significantly positive correlation between the mean CT in the left FPO and the onset age, but a negative correlation between the mean CT in the right PTRI and the number of episodes, in the BD patients. Our findings revealed that the BD and MDD patients had variations in CT that were in common, but many more that were distinct, suggesting potential differences in their neural mechanisms. We found thinner CT in the left ITC in both MDD and BD groups compared to controls. We detected thinner CT in the left rMFC in the BD group compared to the MDD group. The BD group had more pronounced abnormality in CT primarily in the PFC than the MDD group. Clinical variables of BD group were associated with decreased CT in the left FPO and right PTRI.
This study aims to detect abnormal cortical thickness in patients with major depressive disorder (MDD) or bipolar disorder (BD), and to identify the shared and disease-specific brain morphological alterations in these two disorders. The two patient groups showed several common but more distinct variation patterns in cortical thickness, and the BD patients had lower cortical thickness in widespread brain areas than the MDD and the controls. These findings may have potential clinical implications for distinguishing BD from MDD patients.
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Affiliation(s)
- Meiqi Niu
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Brain Study Institute, South China Normal University, Guangzhou 510631, China
| | - Ying Wang
- Clinical Experimental Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Junjing Wang
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Brain Study Institute, South China Normal University, Guangzhou 510631, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jiabao Lin
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Brain Study Institute, South China Normal University, Guangzhou 510631, China
| | - Yao Sun
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Ling Zhao
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Brain Study Institute, South China Normal University, Guangzhou 510631, China
| | - Xiaojin Liu
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Brain Study Institute, South China Normal University, Guangzhou 510631, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
| | - Ruiwang Huang
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Brain Study Institute, South China Normal University, Guangzhou 510631, China.
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Maller JJ, Anderson RJ, Thomson RH, Daskalakis ZJ, Rosenfeld JV, Fitzgerald PB. Occipital bending in schizophrenia. Aust N Z J Psychiatry 2017; 51:32-41. [PMID: 27066817 DOI: 10.1177/0004867416642023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate the prevalence of occipital bending (an occipital lobe crossing or twisting across the midline) in subjects with schizophrenia and matched healthy controls. METHOD Occipital bending prevalence was investigated in 37 patients with schizophrenia and 44 healthy controls. RESULTS Ratings showed that prevalence was nearly three times higher among schizophrenia patients (13/37 [35.1%]) than in control subjects (6/44 [13.6%]). Furthermore, those with schizophrenia had greater normalized gray matter volume but less white matter volume and had larger brain-to-cranial ratio. CONCLUSION The results suggest that occipital bending is more prevalent among schizophrenia patients than healthy subjects and that schizophrenia patients have different gray matter-white matter proportions. Although the cause and clinical ramifications of occipital bending are unclear, the results infer that occipital bending may be a marker of psychiatric illness.
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Affiliation(s)
- Jerome J Maller
- 1 Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School, Melbourne, VIC, Australia
| | - Rodney J Anderson
- 1 Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School, Melbourne, VIC, Australia
| | - Richard H Thomson
- 1 Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School, Melbourne, VIC, Australia
| | - Zafiris J Daskalakis
- 2 Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jeffrey V Rosenfeld
- 3 The Alfred Hospital, Prahran, VIC, Australia
- 4 Monash Institute of Medical Engineering (MIME), Melbourne, VIC, Australia
- 5 F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Paul B Fitzgerald
- 1 Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School, Melbourne, VIC, Australia
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Joshi SH, Vizueta N, Foland-Ross L, Townsend JD, Bookheimer SY, Thompson PM, Narr KL, Altshuler LL. Relationships Between Altered Functional Magnetic Resonance Imaging Activation and Cortical Thickness in Patients With Euthymic Bipolar I Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:507-517. [PMID: 27990494 PMCID: PMC5157843 DOI: 10.1016/j.bpsc.2016.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Performance during cognitive control functional magnetic resonance imaging (fMRI) tasks are associated with frontal lobe hypoactivation in patients with bipolar disorder, even while euthymic. Here, we study the structural underpinnings for this functional abnormality simultaneously with brain activation data. METHODS In a sample of ninety adults (45 with inter-episode Bipolar I disorder and 45 healthy controls), we explored whether abnormal functional activation patterns in bipolar euthymic subjects during a Go-NoGo fMRI task are associated with regional deficits in cortical gray matter thickness in the same regions. Cross-sectional differences in fMRI activation were used to form a-priori hypotheses for region-of-interest cortical gray matter thickness analyses. fMRI BOLD to structural magnetic resonance imaging (sMRI) thickness correlations were conducted across the sample and within patients and controls separately. RESULTS During response inhibition (NoGo minus Go), bipolar subjects showed significant hypoactivation and reduced thickness in the inferior frontal cortex (IFC), superior frontal gyrus and cingulate compared to controls. Cingulate hypoactivation corresponded with reduced regional thickness. A significant activation by disease state interaction was observed with thickness in left prefrontal areas. CONCLUSIONS Reduced cingulate fMRI activation is associated with reduced cortical thickness. In the left frontal lobe, a thinner cortex was associated with increased fMRI activation in patients, but showed a reverse trend in controls. These findings suggest that reduced activation in the IFC and cingulate during a response inhibition task may have an underlying structural etiology, which may explain task-related functional hypoactivation that persists even when patients are euthymic.
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Affiliation(s)
- Shantanu H. Joshi
- Ahmanson Lovelace Brain Mapping Center, Department of
Neurology, University of California, Los Angeles, CA
| | - Nathalie Vizueta
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
| | | | - Jennifer D. Townsend
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
| | - Susan Y. Bookheimer
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
| | - Paul M. Thompson
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
- Imaging Genetics Center, University of Southern California,
Marina del Rey, CA
| | - Katherine L. Narr
- Ahmanson Lovelace Brain Mapping Center, Department of
Neurology, University of California, Los Angeles, CA
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
| | - Lori L. Altshuler
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
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Rolstad S, Abé C, Olsson E, Eckerström C, Landén M. Cognitive reserve lessens the burden of white matter lesions on executive functions in bipolar disorder. Psychol Med 2016; 46:3095-3104. [PMID: 27534695 DOI: 10.1017/s0033291716001641] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The concept of cognitive reserve (CR) hypothesizes that intellectually stimulating activities provide resilience against brain pathology/disease. Whereas brain abnormalities and cognitive impairment are frequently reported in bipolar disorder (BD), it is unknown whether the impact of brain alterations can be lessened by higher CR in BD. METHOD We tested if higher CR would reduce the influence of total volumes of deep white matter hypointensities (WMH), ventricular cerebrospinal fluid (CSF), and prefrontal cortex on memory, executive, and attention/speed functions in patients with BD (n = 75). Linear regression models with interaction terms for CR and brain volumes were applied to directly test if CR reduces the influence of brain pathology on cognitive domains. RESULTS CR reduced the influence of total volumes of deep WMH (β = -0.38, Q = 0.003) and ventricular CSF (β = -41, Q = 006) on executive functions. CONCLUSIONS The interactions between CR and total volumes of deep WMH/ventricular CSF appear to account for executive functioning in BD. The results suggest that the concept of CR is applicable in BD. Higher reserve capacity in BD alters the relationship between brain pathology and clinical presentation.
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Affiliation(s)
- S Rolstad
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University,Gothenburg,Sweden
| | - C Abé
- Department of Clinical Neuroscience,Osher Center, Karolinska Institutet,Stockholm,Sweden
| | - E Olsson
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University,Gothenburg,Sweden
| | - C Eckerström
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University,Gothenburg,Sweden
| | - M Landén
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University,Gothenburg,Sweden
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57
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Abé C, Ekman CJ, Sellgren C, Petrovic P, Ingvar M, Landén M. Cortical thickness, volume and surface area in patients with bipolar disorder types I and II. J Psychiatry Neurosci 2016; 41:240-50. [PMID: 26645741 PMCID: PMC4915933 DOI: 10.1503/jpn.150093] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a common chronic psychiatric disorder mainly characterized by episodes of mania, hypomania and depression. The disorder is associated with cognitive impairments and structural brain abnormalities, such as lower cortical volumes in primarily frontal brain regions than healthy controls. Although bipolar disorder types I (BDI) and II (BDII) exhibit different symptoms and severity, previous studies have focused on BDI. Furthermore, the most frequently investigated measure in this population is cortical volume. The aim of our study was to investigate abnormalities in patients with BDI and BDII by simultaneously analyzing cortical volume, thickness and surface area, which yields more information about disease- and symptom-related neurobiology. METHODS We used MRI to measure cortical volume, thickness and area in patients with BDI and BDII as well as in healthy controls. The large study cohort enabled us to adjust for important confounding factors. RESULTS We included 81 patients with BDI, 59 with BDII and 85 controls in our analyses. Cortical volume, thickness and surface area abnormalities were present in frontal, temporal and medial occipital regions in patients with BD. Lithium and antiepileptic drug use had an effect on the observed differences in medial occipital regions. Patients with the subtypes BDI and BDII displayed common cortical abnormalities, such as lower volume, thickness and surface area than healthy controls in frontal brain regions but differed in temporal and medial prefrontal regions, where only those with BDI had abnormally low cortical volume and thickness. LIMITATIONS The group differences can be explained by progressive changes, but also by premorbid conditions. They could also have been influenced by unknown factors, such as social, environmental or genetic factors. CONCLUSION Our findings suggest diagnosis-related neurobiological differences between the BD subtypes, which could explain distinct symptoms and point to potential biomarkers that could inform the subtype diagnosis of BD.
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Affiliation(s)
- Christoph Abé
- Correspondence to: C. Abé, Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Nobelsväg 9, 17177 Stockholm, Sweden;
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Cao B, Bauer IE, Sharma AN, Mwangi B, Frazier T, Lavagnino L, Zunta-Soares GB, Walss-Bass C, Glahn DC, Kapczinski F, Nielsen DA, Soares JC. Reduced hippocampus volume and memory performance in bipolar disorder patients carrying the BDNF val66met met allele. J Affect Disord 2016; 198:198-205. [PMID: 27018938 PMCID: PMC5214589 DOI: 10.1016/j.jad.2016.03.044] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/08/2016] [Accepted: 03/09/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previous studies investigated the impact of brain-derived neurotrophic factor (BDNF) val66met (rs6265) on hippocampus volumes and neurocognition in bipolar disorders (BD), but the results were not consistent. This study aimed to investigate the effect of BDNF polymorphism on hippocampus volumes and memory performance in well-characterized adult populations diagnosed with type I BD (BD-I) and major depressive disorder (MDD) compared with healthy controls (HC). METHODS 48 BD-I patients, 33 MDD patients and 60 HC were genotyped for BDNF rs6265 using DNA isolated from white blood cells. Individuals with val/met and met/met genotypes were grouped as met carriers and compared to those with the val/val. Brain segmentations were obtained from structural magnetic resonance imaging (MRI) using the Freesurfer. Memory performance was assessed with the California Verbal Learning Task (CVLT). RESULTS We found a significant diagnosis effect and marginal interaction between diagnosis and BDNF genotype group for both hippocampus volumes and memory performance. BDNF met allele carrier BD patients had smaller hippocampus volumes and reduced performance on multiple CVLT scores compared to MDD patients and HC. CONCLUSIONS We provide strong evidence for the BDNF val66met polymorphism as a putative biological signature for the neuroanatomical and cognitive abnormalities commonly observed in BD patients.
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Affiliation(s)
- Bo Cao
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States.
| | | | | | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Thomas Frazier
- The Center for Pediatric Behavioral Health and Center for Autism, Cleveland Clinic, Cleveland, OH, United States
| | - Luca Lavagnino
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Giovana B. Zunta-Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Consuelo Walss-Bass
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - David C. Glahn
- The Olin Neuropsychiatry Research Center, Institute of Living, and Department of Psychiatry, Yale University School of Medicine, CT, United States
| | - Flavio Kapczinski
- Department of Psychiatry, Universidade Federal Rio Grande do Sul, Rua Ramiro Barcelos, 2350, 90035-903, Rio Grande do Sul, Brazil
| | - David A. Nielsen
- Department of Psychiatry and Behavioral Sciences, Michael E. DeBakey V.A. Medical Center, Baylor College of Medicine, Houston, TX, United States
| | - Jair C. Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
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Hozer F, Houenou J. Can neuroimaging disentangle bipolar disorder? J Affect Disord 2016; 195:199-214. [PMID: 26896814 DOI: 10.1016/j.jad.2016.01.039] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 01/02/2016] [Accepted: 01/24/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Bipolar disorder heterogeneity is large, leading to difficulties in identifying neuropathophysiological and etiological mechanisms and hindering the formation of clinically homogeneous patient groups in clinical trials. Identifying markers of clinically more homogeneous groups would help disentangle BD heterogeneity. Neuroimaging may aid in identifying such groups by highlighting specific biomarkers of BD subtypes or clinical dimensions. METHODS We performed a systematic literature search of the neuroimaging literature assessing biomarkers of relevant BD phenotypes (type-I vs. II, presence vs. absence of psychotic features, suicidal behavior and impulsivity, rapid cycling, good vs. poor medication response, age at onset, cognitive performance and circadian abnormalities). RESULTS Consistent biomarkers were associated with suicidal behavior, i.e. frontal/anterior alterations (prefrontal and cingulate grey matter, prefrontal white matter) in patients with a history of suicide attempts; and with cognitive performance, i.e. involvement of frontal and temporal regions, superior and inferior longitudinal fasciculus, right thalamic radiation, and corpus callosum in executive dysfunctions. For the other dimensions and sub-types studied, no consistent biomarkers were identified. LIMITATIONS Studies were heterogeneous both in methodology and outcome. CONCLUSIONS Though theoretically promising, neuroimaging has not yet proven capable of disentangling subtypes and dimensions of bipolar disorder, due to high between-study heterogeneity. We issue recommendations for future studies.
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Affiliation(s)
- Franz Hozer
- Neurospin, UNIACT, Psychiatry Team, I2BM, CEA Saclay, F-91191 Gif-Sur-Yvette, France; INSERM U955, IMRB, Université Paris Est, Equipe 15 "Psychiatrie Translationnelle", Créteil F-94000, France; Fondation Fondamental, Créteil F-94010, France
| | - Josselin Houenou
- Neurospin, UNIACT, Psychiatry Team, I2BM, CEA Saclay, F-91191 Gif-Sur-Yvette, France; INSERM U955, IMRB, Université Paris Est, Equipe 15 "Psychiatrie Translationnelle", Créteil F-94000, France; Fondation Fondamental, Créteil F-94010, France; AP-HP, Hôpitaux Universitaires Mondor, DHU PePsy, Pôle de Psychiatrie, Créteil F-94000, France.
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Duarte JA, de Araújo e Silva JQ, Goldani AA, Massuda R, Gama CS. Neurobiological underpinnings of bipolar disorder focusing on findings of diffusion tensor imaging: a systematic review. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2016; 38:167-75. [PMID: 27007148 PMCID: PMC7111360 DOI: 10.1590/1516-4446-2015-1793] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 09/02/2015] [Indexed: 04/05/2023]
Abstract
OBJECTIVE To review the available data on diffusion tensor imaging (DTI) of subjects with bipolar disorder (BD), with a particular focus on fractional anisotropy (FA) in white matter (WM) tracts. METHODS The PubMed/MEDLINE database was searched for relevant articles, which were included in a systematic review of the literature. FA reductions and WM abnormalities were divided anatomically into three groups: commissural tracts, association tracts, and projection tracts. RESULTS Eighteen studies met the inclusion criteria. The corpus callosum was the main impaired commissural tract as demonstrated by FA reductions. Five studies reported FA reductions in the cingulum. Two studies reported decreased FA in the anterior thalamic radiation, and one in the corticospinal tract. Conversely, three studies found increased FA values in WM tracts involved in BD pathophysiology. CONCLUSION Despite considerable heterogeneity, these results indicate a direct link between executive cognitive functioning and abnormal WM microstructural integrity of fronto-limbic tracts in patients with remitted BD, providing further evidence of the neuronal disruption that underlies BD symptomatology.
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Affiliation(s)
- Juliana A. Duarte
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia – Medicina Translacional (INCT-TM), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Departamento de Radiologia e Ressonância Magnética, HCPA, Porto Alegre, RS, Brazil
- Tomoclínica, Canoas, RS, Brazil
| | | | - André A. Goldani
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia – Medicina Translacional (INCT-TM), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Raffael Massuda
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia – Medicina Translacional (INCT-TM), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- UFRGS, Porto Alegre, RS, Brazil
- Departamento de Psiquiatria, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | - Clarissa S. Gama
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia – Medicina Translacional (INCT-TM), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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61
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Hanford LC, Nazarov A, Hall GB, Sassi RB. Cortical thickness in bipolar disorder: a systematic review. Bipolar Disord 2016; 18:4-18. [PMID: 26851067 DOI: 10.1111/bdi.12362] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 10/19/2015] [Accepted: 11/16/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Bipolar disorder (BD) is a debilitating illness, the psychopathology of which is associated with aberrant structural and functional differences in the brain. Despite the many advances in psychiatric research, our understanding of the complex neurobiological underpinnings of BD remains incomplete. The aim of this review was to critically examine all available published magnetic resonance imaging (MRI) research reporting cortical thickness in BD with respect to a healthy population and/or other psychiatric samples. METHODS The systematic search encompassed all relevant studies published until November 2014. Relevant papers were identified through an online search of select databases (MEDLINE and EMBASE) using key terms bipolar disorder or mania, and cortical thickness. Two independent raters determined the eligibility of papers and performed separate data extraction to ensure quality and accuracy of reporting. RESULTS A total of 17 papers met the criteria and were included in this review. Compared to a healthy population, the majority of studies reported decreased cortical thickness in the left anterior cingulate/paracingulate and the left superior temporal gyrus, as well as several prefrontal regions bilaterally in patients with BD. Studies also show consistency of cortical thinning in individuals with BD and schizophrenia in frontal and temporal regions, suggesting some common neuropathology. CONCLUSIONS This systematic review further supports a link between specific structural brain abnormalities and BD. Future studies should investigate cortical thickness with respect to at-risk populations to determine whether these neuropathologies develop before or after the onset of BD.
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Affiliation(s)
- Lindsay C Hanford
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Anthony Nazarov
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Geoffrey B Hall
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Roberto B Sassi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Mood Disorders Outpatient Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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Savitz J, Morris HM, Drevets WC. Neuroimaging Studies of Bipolar Depression: Therapeutic Implications. BIPOLAR DEPRESSION: MOLECULAR NEUROBIOLOGY, CLINICAL DIAGNOSIS, AND PHARMACOTHERAPY 2016. [DOI: 10.1007/978-3-319-31689-5_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Ambrosi E, Chiapponi C, Sani G, Manfredi G, Piras F, Caltagirone C, Spalletta G. White matter microstructural characteristics in Bipolar I and Bipolar II Disorder: A diffusion tensor imaging study. J Affect Disord 2016; 189:176-83. [PMID: 26437232 DOI: 10.1016/j.jad.2015.09.035] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 09/08/2015] [Accepted: 09/18/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) studies of bipolar disorder (BD) report contrasting results and are mainly focused on bipolar I (BD-I) samples. We aimed at investigating how and where DTI parameters differ between BD-I and bipolar II (BD-II) and between BD and healthy control subjects (HC). METHODS We conducted a tract-based spatial statistics analysis of DTI derived parameters, namely fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) in a matched sample of 50 BD (25 BD-I and 25 BD-II) during the chronic course of the illness and 50 HC. RESULTS Compared to BD-I and HC, BD-II showed lower FA but no significant AD or RD differences in the right inferior longitudinal fasciculus (ILF). Both patient groups showed lower AD and RD in the left internal capsule and lower AD across the left ILF, the cortico-spinal tract within the right hemisphere and bilaterally in the cerebellum with respect to HC. LIMITATIONS Patients were medicated at the time of scanning; the BD-II group had higher Hamilton Rating Scale for Depression scores than the BD-I group. CONCLUSIONS BD-II patients differ from BD-I in the ILF. Both BD subtypes showed widespread white matter (WM) changes in the internal capsule, cortico-spinal tract and cerebellum. The loss of WM integrity in BD-II might be due to demyelination whereas WM changes common to both subgroups could be attributable to axonal damage.
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Affiliation(s)
- Elisa Ambrosi
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy; NESMOS Department, Sapienza University of Rome, Italy
| | - Chiara Chiapponi
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Systems Medicine, "Tor Vergata" University, Rome, Italy
| | - Gabriele Sani
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy; NESMOS Department, Sapienza University of Rome, Italy; Centro Lucio Bini, Rome, Italy
| | - Giovanni Manfredi
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy; NESMOS Department, Sapienza University of Rome, Italy; Centro Lucio Bini, Rome, Italy
| | - Fabrizio Piras
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Carlo Caltagirone
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Neuroscience, "Tor Vergata" University, Rome, Italy
| | - Gianfranco Spalletta
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy; Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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Bellani M, Boschello F, Delvecchio G, Dusi N, Altamura CA, Ruggeri M, Brambilla P. DTI and Myelin Plasticity in Bipolar Disorder: Integrating Neuroimaging and Neuropathological Findings. Front Psychiatry 2016; 7:21. [PMID: 26973545 PMCID: PMC4771723 DOI: 10.3389/fpsyt.2016.00021] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 02/09/2016] [Indexed: 02/06/2023] Open
Abstract
Bipolar disorder (BD) is a major psychiatric illness with a chronic recurrent course, ranked among the worldwide leading disabling diseases. Its pathophysiology is still not completely understood and findings are still inconclusive, though a great interest on the topic has been constantly raised by magnetic resonance imaging, genetic and neuropathological studies. In recent years, diffusion tensor imaging (DTI) investigations have prompted interest in the key role of white matter (WM) abnormalities in BD. In this report, we summarize and comment recent findings from DTI studies in BD, reporting fractional anisotropy as putative measure of WM integrity, as well as recent data from neuropathological studies focusing on oligodendrocyte involvement in WM alterations in BD. DTI research indicates that BD is most commonly associated with a WM disruption within the fronto-limbic network, which may be accompanied by other WM changes spread throughout temporal and parietal regions. Neuropathological studies, mainly focused on the fronto-limbic network, have repeatedly shown a loss in cortical and subcortical oligodendrocyte cell count, although an increased subcortical oligodendrocyte density has been also documented suggesting a putative role in remyelination processes for oligodendrocytes in BD. According to our review, a greater integration between DTI and morphological findings is needed in order to elucidate processes affecting WM, either glial loss or myelin plasticity, on the basis of a more targeted research in BD.
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Affiliation(s)
- Marcella Bellani
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona , Verona , Italy
| | | | | | - Nicola Dusi
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona , Verona , Italy
| | - Carlo Alfredo Altamura
- Department of Neurosciences and Mental Health, Ospedale Maggiore Policlinico, Fondazione IRCCS Ca' Granda, University of Milan , Milan , Italy
| | - Mirella Ruggeri
- Section of Psychiatry, University of Verona , Verona , Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Ospedale Maggiore Policlinico, Fondazione IRCCS Ca' Granda, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA
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Abé C, Ekman CJ, Sellgren C, Petrovic P, Ingvar M, Landén M. Manic episodes are related to changes in frontal cortex: a longitudinal neuroimaging study of bipolar disorder 1. Brain 2015; 138:3440-8. [PMID: 26373602 DOI: 10.1093/brain/awv266] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 07/21/2015] [Indexed: 12/24/2022] Open
Abstract
Higher numbers of manic episodes in bipolar patients has, in cross-sectional studies, been associated with less grey matter volume in prefrontal brain areas. Longitudinal studies are needed to determine if manic episodes set off progressive cortical changes, or if the association is better explained by premorbid brain conditions that increase risk for mania. We followed patients with bipolar disorder type 1 for 6 years. Structural brain magnetic resonance imaging scans were performed at baseline and follow-up. We compared patients who had at least one manic episode between baseline and follow-up (Mania group, n = 13) with those who had no manic episodes (No-Mania group, n = 18). We used measures of cortical volume, thickness, and area to assess grey matter changes between baseline and follow-up. We found significantly decreased frontal cortical volume (dorsolateral prefrontal and inferior frontal cortex) in the Mania group, but no volume changes in the No-Mania group. Our results indicate that volume decrease in frontal brain regions can be attributed to the incidence of manic episodes.
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Affiliation(s)
- Christoph Abé
- 1 Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden
| | - Carl-Johan Ekman
- 1 Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden
| | - Carl Sellgren
- 2 Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden 3 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Predrag Petrovic
- 1 Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden
| | - Martin Ingvar
- 1 Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Landén
- 1 Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden 3 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden 4 Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the Gothenburg University, Sweden
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Oertel-Knöchel V, Reuter J, Reinke B, Marbach K, Feddern R, Alves G, Prvulovic D, Linden DEJ, Knöchel C. Association between age of disease-onset, cognitive performance and cortical thickness in bipolar disorders. J Affect Disord 2015; 174:627-35. [PMID: 25577157 DOI: 10.1016/j.jad.2014.10.060] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 10/29/2014] [Accepted: 10/31/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Neuroimaging studies in patients with bipolar disorder (BD) have indicated a number of structural brain changes, including reduced cortical thickness. However, the effects of the course of illness, clinical and cognitive variables on cortical thickness in BD patients have not yet been evaluated. METHODS A total of 67 individuals (32 patients with euthymic BD and 35 healthy and age-matched controls) underwent 3D-anatomical magnetic resonance imaging (MRI). Whole-brain cortical thickness and group differences were assessed using the Freesurfer software. Course of disease variables, clinical and cognitive parameters were correlated with cortical thickness measures. RESULTS We found reduced cortical thickness in BD patients compared with controls in the frontal and temporal lobes and in several limbic areas. We also report significant associations between cortical thickness and age of disease-onset, speed of cognitive processing, executive function and depression severity in BD patients. CONCLUSIONS Cortical thickness reduction across frontal and limbic areas is a structural correlate of affective symptom severity and cognitive impairments in BD as well of age of disease-onset. We may assume that frontal lobe structural abnormalities are present in bipolar disorder, and might lead to dysfunctional cognitive functioning. The causality and functional relevance beyond mere correlation, however, is yet to be established. Our findings encourage further longitudinal studies in BD patients and in healthy at-risk subjects in order to discern the temporal order and development of morphological changes and clinical symptoms.
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Affiliation(s)
- Viola Oertel-Knöchel
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany.
| | - Johanna Reuter
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Britta Reinke
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany; Brain Imaging Center (BIC), Goethe-University, Frankfurt/Main, Germany
| | - Katharina Marbach
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Richard Feddern
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Gilberto Alves
- Center for Alzheimer׳s Disease and Related Disorders, Universidade Federal do Rio de Janeiro, Brazil
| | - David Prvulovic
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - David E J Linden
- School of Psychology, Cardiff University, United Kingdom; MRC Centre for Neuropsychiatric Genetics & Genomics, Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, United Kingdom
| | - Christian Knöchel
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
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