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Lee I, Nielsen K, Nawaz U, Hall MH, Öngür D, Keshavan M, Brady R. Diverse pathophysiological processes converge on network disruption in mania. J Affect Disord 2019; 244:115-123. [PMID: 30340100 PMCID: PMC6785980 DOI: 10.1016/j.jad.2018.10.087] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/19/2018] [Accepted: 10/05/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Neuroimaging of psychiatric disease is challenged by the difficulty of establishing the causal role of neuroimaging abnormalities. Lesions that cause mania present a unique opportunity to understand how brain network disruption may cause mania in both lesions and in bipolar disorder. METHODS A literature search revealed 23 case reports with imaged lesions that caused mania in patients without history of bipolar disorder. We traced these lesions and examined resting-state functional Magnetic Resonance Imaging (rsfMRI) connectivity to these lesions and control lesions to find networks that would be disrupted specifically by mania-causing lesions. The results were then used as regions-of-interest to examine rsfMRI connectivity in patients with bipolar disorder (n = 16) who underwent imaging longitudinally across states of both mania and euthymia alongside a cohort of healthy participants scanned longitudinally. We then sought to replicate these results in independent cohorts of manic (n = 26) and euthymic (n = 21) participants with bipolar disorder. RESULTS Mania-inducing lesions overlap significantly in network connectivity. Mania-causing lesions selectively disrupt networks that include orbitofrontal cortex, dorsolateral prefrontal cortex, and temporal lobes. In bipolar disorder, the manic state was reflected in strong, significant, and specific disruption in network communication between these regions and regions implicated in bipolar pathophysiology: the amygdala and ventro-lateral prefrontal cortex. LIMITATIONS There was heterogeneity in the clinical characterization of mania causing lesions. CONCLUSIONS Lesions causing mania demonstrate shared and specific network disruptions. These disruptions are also observed in bipolar mania and suggest a convergence of multiple disorders on shared circuit dysfunction to cause mania.
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Affiliation(s)
- Ivy Lee
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kathryn Nielsen
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA,Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA
| | - Uzma Nawaz
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Mei-Hua Hall
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA
| | - Dost Öngür
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Roscoe Brady
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA.
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102
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Yalin N, Saricicek A, Hidiroglu C, Zugman A, Direk N, Ada E, Cavusoglu B, Er A, Isik G, Ceylan D, Tunca Z, Kempton MJ, Ozerdem A. Cortical thickness and surface area as an endophenotype in bipolar disorder type I patients and their first-degree relatives. Neuroimage Clin 2019; 22:101695. [PMID: 30738374 PMCID: PMC6370861 DOI: 10.1016/j.nicl.2019.101695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 01/14/2019] [Accepted: 01/27/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVES So far, few studies have investigated cortical thickness (CT) and surface area (SA) measures in bipolar disorder type I (BDI) in comparison to a high genetic risk group such as first-degree relatives (FR). This study aimed to examine CT and SA differences between BDI, FR and healthy controls (HC). METHODS 3D T1 magnetic resonance images were acquired from 27 euthymic BDI patients, 24 unaffected FR and 29 HC. CT and SA measures were obtained with FreeSurfer version 5.3.0. Generalized estimating equations were used to compare CT and SA between groups. Group comparisons were repeated with restricting the FR group to 17 siblings (FR-SB) only. RESULTS \Mean age in years was 36.3 ± 9.5 for BDI, 32.1 ± 10.9 for FR, 34.7 ± 9.8 for FR-SB and 33.1 ± 9.0 for HC group respectively. BDI patients revealed larger SA of left pars triangularis (LPT) compared to HC (p = .001). In addition, increased SA in superior temporal cortex (STC) in FR-SB group compared to HC was identified (p = .0001). CONCLUSIONS Our result of increased SA in LPT of BDI could be a disease marker and increased SA in STC of FR-SB could be a marker related with resilience to illness.
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Affiliation(s)
- Nefize Yalin
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey.
| | - Aybala Saricicek
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, Faculty of Medicine, Katip Celebi University, Izmir, Turkey
| | - Ceren Hidiroglu
- Department of Psychology, Faculty of Arts, Dokuz Eylul University, Izmir, Turkey
| | - Andre Zugman
- Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Nese Direk
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Emel Ada
- Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Berrin Cavusoglu
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Ayşe Er
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Gizem Isik
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Deniz Ceylan
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Zeliha Tunca
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Aysegul Ozerdem
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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103
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Ambrosi E, Arciniegas DB, Curtis KN, Patriquin M, Spalletta G, Sani G, Frueh BC, Fowler JC, Madan A, Salas R. Resting-State Functional Connectivity of the Habenula in Mood Disorder Patients With and Without Suicide-Related Behaviors. J Neuropsychiatry Clin Neurosci 2019; 31:49-56. [PMID: 30282513 PMCID: PMC6697145 DOI: 10.1176/appi.neuropsych.17120351] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The habenula is a small midbrain structure that is important for brain signaling and learning from negative events. Thus, the habenula is strongly connected to both the reward system and motor regions. Increasing evidence suggests a role for the habenula in the etiology of psychiatric disorders, including mood and substance use disorders. However, no studies to date have investigated habenular resting-state functional connectivity (rsFC) in suicide-related behaviors (SB). The authors enrolled 123 individuals with major depressive disorder (MDD) or bipolar disorder and a history of suicide-related behaviors (SB+), 74 individuals with MDD or bipolar disorder and a history of suicidal ideation but no history of SB (SB-), and 75 healthy control subjects (HC). A seed-based approach was used to identify regions showing different rsFC with the habenula followed by region of interest to region of interest post hoc comparisons. Compared with both the SB- and HC groups, the SB+ group showed higher connectivity between the left habenula and the left parahippocampal gyrus, the right amygdala, and the right precentral and postcentral gyri. Patients with mood disorders displayed higher rsFC between the left habenula and left middle temporal gyrus, the left angular gyrus, and the left posterior cingulate cortex, as well as lower rsFC between the right habenula and the left thalamus, when compared with HCs. These findings suggest that the habenula is involved in the neural circuitry of suicide. The higher habenular rsFC found in the SB+ group may mediate a dysfunction in the mechanism that links the habenula with motor activity and contextual associative processing.
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Affiliation(s)
- Elisa Ambrosi
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX,Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Baylor College of Medicine, Houston, TX,IRCCS Santa Lucia Foundation, Department of Clinical and Behavioral Neurology, Rome, Italy
| | - David B Arciniegas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX,Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Baylor College of Medicine, Houston, TX
| | - Kaylah N Curtis
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX,Michael E DeBakey VA Medical Center, Houston TX, USA
| | - Michelle Patriquin
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX,Michael E DeBakey VA Medical Center, Houston TX, USA
| | - Gianfranco Spalletta
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX,Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Baylor College of Medicine, Houston, TX,IRCCS Santa Lucia Foundation, Department of Clinical and Behavioral Neurology, Rome, Italy
| | - Gabriele Sani
- Neurosciences, Mental Health, and Sensory Organs Department (NESMOS), Sapienza University, Rome, School of Medicine and Psychology, Sant’ Andrea Hospital, Rome, Italy,Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | | | - J Christopher Fowler
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Alok Madan
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX,Michael E DeBakey VA Medical Center, Houston TX, USA
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104
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Deng W, Zhang B, Zou W, Zhang X, Cheng X, Guan L, Lin Y, Lao G, Ye B, Li X, Yang C, Ning Y, Cao L. Abnormal Degree Centrality Associated With Cognitive Dysfunctions in Early Bipolar Disorder. Front Psychiatry 2019; 10:140. [PMID: 30949078 PMCID: PMC6435527 DOI: 10.3389/fpsyt.2019.00140] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 02/26/2019] [Indexed: 01/09/2023] Open
Abstract
Delayed diagnosis of bipolar disorder (BD) is common. However, diagnostic validity may be enhanced using reliable neurobiological markers for BD. Degree centrality (DC) is one such potential marker that enables researchers to visualize neuronal network abnormalities in the early stages of some neuropsychiatric disorders. In the present study, we measured resting-state DC abnormalities and cognitive deficits in order to identify early neurobiological markers for BD. We recruited 23 patients with BD who had recently experienced manic episodes (duration of illness <2 years) and 46 matched healthy controls. Our findings indicated that patients with BD exhibited DC abnormalities in frontal areas, temporal areas, the right postcentral gyrus, and the posterior lobe of the cerebellum. Moreover, correlation analysis revealed that psychomotor speed indicators were associated with DC in the superior temporal and inferior temporal gyri, while attention indicators were associated with DC in the inferior temporal gyrus, in patients with early BD. Our findings suggest that DC abnormalities in neural emotion regulation circuits are present in patients with early BD, and that correlations between attention/psychomotor speed deficits and temporal DC abnormalities may represent early markers of BD.
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Affiliation(s)
- Wenhao Deng
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bin Zhang
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wenjin Zou
- Department of Radiology, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaofei Zhang
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiongchao Cheng
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lijie Guan
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yin Lin
- Department of Child and Adolescent, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Guohui Lao
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Biyu Ye
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xuan Li
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chanjuan Yang
- Department of Child and Adolescent, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuping Ning
- Mental Health Institute, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Liping Cao
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,Department of Child and Adolescent, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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105
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Godlewska BR. Cognitive neuropsychological theory: Reconciliation of psychological and biological approaches for depression. Pharmacol Ther 2018; 197:38-51. [PMID: 30578809 DOI: 10.1016/j.pharmthera.2018.12.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
New antidepressants and individualized approaches to treatment, matching specific therapies to individual patients, are urgently needed. For this, a better understanding of processes underpinning the development of depressive symptoms and response to medications are required. The cognitive neuropsychological model offers a novel approach uniquely combining biological and psychological approaches to explain how antidepressants exert their effect, why there is a delay in the onset of their clinical effect, and how changes in emotional processing are an essential step for a clinical antidepressant effect to take place. The paper presents the model and its underpinnings in the form of research in both healthy and depressed individuals, as well as the potential for its practical use.
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Affiliation(s)
- Beata R Godlewska
- Psychopharmacology Research Unit, University Department of Psychiatry (PPRU), University of Oxford, Oxford, UK.
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106
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Whittaker JR, Foley SF, Ackling E, Murphy K, Caseras X. The Functional Connectivity Between the Nucleus Accumbens and the Ventromedial Prefrontal Cortex as an Endophenotype for Bipolar Disorder. Biol Psychiatry 2018; 84:803-809. [PMID: 30227973 PMCID: PMC6218647 DOI: 10.1016/j.biopsych.2018.07.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/12/2018] [Accepted: 07/25/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Alterations in functional connectivity between the nucleus accumbens (NAcc) and frontal cortices have been previously associated with the presence of psychiatric syndromes, including bipolar disorder (BD). Whether these alterations are a consequence or a risk factor for mental disorders remains unresolved. METHODS This study included 35 patients with BD, 30 nonaffected siblings of patients with BD, and 23 healthy control subjects to probe functional connectivity at rest between NAcc and the rest of the brain in a cross-sectional design. Blood oxygen level-dependent time series at rest from NAcc were used as seed region in a voxelwise correlational analysis. The strength of the correlations found was compared across groups after Fisher's Z transformation. RESULTS We found increased functional connectivity between the NAcc and the ventromedial prefrontal cortex-comprising mainly the subgenual anterior cingulate-in patients compared with healthy control subjects. Participants at increased genetic risk but yet resilient-nonaffected siblings-showed functional connectivity values midway between the former two groups. CONCLUSIONS Our results are indicative of the potential for the connectivity between NAcc and the ventromedial prefrontal cortex to represent an endophenotype for BD.
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Affiliation(s)
- Joseph R Whittaker
- Cardiff University Brain Research Imaging Centre - CUBRIC, Cardiff, United Kingdom; School of Physics and Astronomy at Cardiff University, Cardiff, United Kingdom
| | - Sonya F Foley
- Cardiff University Brain Research Imaging Centre - CUBRIC, Cardiff, United Kingdom
| | - Edward Ackling
- Division of Psychological Medicine and Clinical Neurosciences at Cardiff University, Cardiff, United Kingdom
| | - Kevin Murphy
- Cardiff University Brain Research Imaging Centre - CUBRIC, Cardiff, United Kingdom; School of Physics and Astronomy at Cardiff University, Cardiff, United Kingdom
| | - Xavier Caseras
- MRC Centre for Neuropsychiatric Genetics and Genomics at Cardiff University, Cardiff, United Kingdom; Division of Psychological Medicine and Clinical Neurosciences at Cardiff University, Cardiff, United Kingdom.
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107
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Huhtaniska S, Korkala I, Heikka T, Björnholm L, Lehtiniemi H, Hulkko AP, Moilanen J, Tohka J, Manjón J, Coupé P, Kiviniemi V, Isohanni M, Koponen H, Murray GK, Miettunen J, Jääskeläinen E. Antipsychotic and benzodiazepine use and brain morphology in schizophrenia and affective psychoses - Systematic reviews and birth cohort study. Psychiatry Res Neuroimaging 2018; 281:43-52. [PMID: 30219591 DOI: 10.1016/j.pscychresns.2018.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 08/23/2018] [Accepted: 08/23/2018] [Indexed: 10/28/2022]
Abstract
The aim of this paper was to investigate differences in brain structure volumes between schizophrenia and affective psychoses, and whether cumulative lifetime antipsychotic or benzodiazepine doses relate to brain morphology in these groups. We conducted two systematic reviews on the topic and investigated 44 schizophrenia cases and 19 with affective psychoses from the Northern Finland Birth Cohort 1966. The association between lifetime antipsychotic and benzodiazepine dose and brain MRI scans at the age of 43 was investigated using linear regression. Intracranial volume, sex, illness severity, and antipsychotic/benzodiazepine doses were used as covariates. There were no differences between the groups in brain structure volumes. In schizophrenia, after adjusting for benzodiazepine dose and symptoms, a negative association between lifetime antipsychotic dose and the nucleus accumbens volume remained. In affective psychoses, higher lifetime benzodiazepine dose associated with larger volumes of total gray matter and hippocampal volume after controlling for antipsychotic use and symptoms. It seems that in addition to antipsychotics, the severity of symptoms and benzodiazepine dose are also associated with brain structure volumes. These results suggest, that benzodiazepine effects should also be investigated also independently and not only as a confounder.
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Affiliation(s)
- Sanna Huhtaniska
- Center for Life Course Health Research, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland.
| | - Iikka Korkala
- Center for Life Course Health Research, University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Tuomas Heikka
- Center for Life Course Health Research, University of Oulu, Finland
| | - Lassi Björnholm
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Heli Lehtiniemi
- Center for Life Course Health Research, University of Oulu, Finland
| | - Anja P Hulkko
- Center for Life Course Health Research, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Jani Moilanen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Jussi Tohka
- AI Virtanen Institute for Molecular Sciences, University of Eastern Finland, Finland
| | - José Manjón
- Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Spain
| | - Pierrick Coupé
- Laboratoire Bordelais de Recherche en Informatique, Unité Mixte de Recherche CNRS (UMR 5800), PICTURA Research Group, France
| | - Vesa Kiviniemi
- Department of Diagnostic Radiology, Oulu University Hospital, Finland
| | - Matti Isohanni
- Center for Life Course Health Research, University of Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland
| | - Hannu Koponen
- University of Helsinki, Helsinki University Hospital, Psychiatry, Helsinki, Finland
| | - Graham K Murray
- University of Cambridge, Department of Psychiatry, United Kingdom; University of Cambridge, Behavioural and Clinical Neuroscience Institute, United Kingdom
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Erika Jääskeläinen
- Center for Life Course Health Research, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland
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108
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Wang Y, Zhong S, Chen G, Liu T, Zhao L, Sun Y, Jia Y, Huang L. Altered cerebellar functional connectivity in remitted bipolar disorder: A resting-state functional magnetic resonance imaging study. Aust N Z J Psychiatry 2018; 52:962-971. [PMID: 29232968 DOI: 10.1177/0004867417745996] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Several recent studies have reported a strong association between the cerebellar structural and functional abnormalities and psychiatric disorders. However, there are no studies to investigate possible changes in cerebellar functional connectivity in bipolar disorder. This study aimed to examine the whole-brain functional connectivity pattern of patients with remitted bipolar disorder II, in particular in the cerebellum. METHODS A total of 25 patients with remitted bipolar disorder II and 25 controls underwent resting-state functional magnetic resonance imaging and neuropsychological tests. Voxel-wise whole-brain connectivity was analyzed using a graph theory approach: functional connectivity strength. A seed-based resting-state functional connectivity analysis was further performed to investigate abnormal functional connectivity pattern of those regions with changed functional connectivity strength. RESULTS Remitted bipolar disorder II patients had significantly decreased functional connectivity strength in the bilateral posterior lobes of cerebellum (mainly lobules VIIb/VIIIa). The seed-based functional connectivity analyses revealed decreased functional connectivity between the right posterior cerebellum and the default mode network (i.e. right posterior cingulate cortex/precuneus and right superior temporal gyrus), bilateral hippocampus, right putamen, left paracentral lobule and bilateral posterior cerebellum and decreased functional connectivity between the left posterior cerebellum and the right inferior parietal lobule and bilateral posterior cerebellum in patients with remitted bipolar disorder II. CONCLUSION Our results suggest that cerebellar dysconnectivity, in particular distributed cerebellar-cerebral functional connectivity, might be associated with the pathogenesis of bipolar disorder.
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Affiliation(s)
- Ying Wang
- 1 Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China.,2 Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Shuming Zhong
- 3 Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guanmao Chen
- 1 Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Tao Liu
- 3 Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China.,4 The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, China
| | - Lianping Zhao
- 1 Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yao Sun
- 2 Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Yanbin Jia
- 3 Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Li Huang
- 2 Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
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109
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Abé C, Rolstad S, Petrovic P, Ekman C, Sparding T, Ingvar M, Landén M. Bipolar disorder type I and II show distinct relationships between cortical thickness and executive function. Acta Psychiatr Scand 2018; 138:325-335. [PMID: 29907968 PMCID: PMC6175455 DOI: 10.1111/acps.12922] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Frontal cortical abnormalities and executive function impairment co-occur in bipolar disorder. Recent studies have shown that bipolar subtypes differ in the degree of structural and functional impairments. The relationships between cognitive performance and cortical integrity have not been clarified and might differ across patients with bipolar disorder type I, II, and healthy subjects. METHOD Using a vertex-wise whole-brain analysis, we investigated how cortical integrity, as measured by cortical thickness, correlates with executive performance in patients with bipolar disorder type I, II, and controls (N = 160). RESULTS We found focal associations between executive function and cortical thickness in the medial prefrontal cortex in bipolar II patients and controls, but not in bipolar I disorder. In bipolar II patients, we observed additional correlations in lateral prefrontal and occipital regions. CONCLUSIONS Our findings suggest that bipolar disorder patients show altered structure-function relationships, and importantly that those relationships may differ between bipolar subtypes. The findings are line with studies suggesting subtype-specific neurobiological and cognitive profiles. This study contributes to a better understanding of brain structure-function relationships in bipolar disorder and gives important insights into the neuropathophysiology of diagnostic subtypes.
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Affiliation(s)
- C. Abé
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - S. Rolstad
- Institute of Neuroscience and PhysiologySahlgrenska Academy at the Gothenburg UniversityGothenburgSweden
| | - P. Petrovic
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - C.‐J. Ekman
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - T. Sparding
- Institute of Neuroscience and PhysiologySahlgrenska Academy at the Gothenburg UniversityGothenburgSweden
| | - M. Ingvar
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - M. Landén
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden,Institute of Neuroscience and PhysiologySahlgrenska Academy at the Gothenburg UniversityGothenburgSweden,Center for Experimental Drugs and DiagnosticsMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA
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110
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Foley SF, Bracher-Smith M, Tansey KE, Harrison JR, Parker GD, Caseras X. Fractional anisotropy of the uncinate fasciculus and cingulum in bipolar disorder type I, type II, unaffected siblings and healthy controls. Br J Psychiatry 2018; 213:548-554. [PMID: 30113288 PMCID: PMC6130806 DOI: 10.1192/bjp.2018.101] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Fractional anisotropy in the uncinate fasciculus and the cingulum may be biomarkers for bipolar disorder and may even be distinctly affected in different subtypes of bipolar disorder, an area in need of further research.AimsThis study aims to establish if fractional anisotropy in the uncinate fasciculus and cingulum shows differences between healthy controls, patients with bipolar disorder type I (BD-I) and type II (BD-II), and their unaffected siblings. METHOD Fractional anisotropy measures from the uncinate fasciculus, cingulum body and parahippocampal cingulum were compared with tractography methods in 40 healthy controls, 32 patients with BD-I, 34 patients with BD-II, 17 siblings of patients with BD-I and 14 siblings of patients with BD-II. RESULTS The main effects were found in both the right and left uncinate fasciculus, with patients with BD-I showing significantly lower fractional anisotropy than both patients with BD-II and healthy controls. Participants with BD-II did not differ from healthy controls. Siblings showed similar effects in the left uncinate fasciculus. In a subsequent complementary analysis, we investigated the association between fractional anisotropy in the uncinate fasciculus and polygenic risk for bipolar disorder and psychosis in a large cohort (n = 570) of healthy participants. However, we found no significant association. CONCLUSIONS Fractional anisotropy in the uncinate fasciculus differs significantly between patients with BD-I and patients with BD-II and healthy controls. This supports the hypothesis of differences in the physiological sub-tract between bipolar disorder subtypes. Similar results were found in unaffected siblings, suggesting the potential for this biomarker to represent an endophenotype for BD-I. However, fractional anisotropy in the uncinate fasciculus seems unrelated to polygenic risk for bipolar disorder or psychosis.Declaration of interestNone.
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Affiliation(s)
- Sonya F. Foley
- scientific support staff, Cardiff University Brain Research Imaging Centre, Cardiff University, UK
| | - Matthew Bracher-Smith
- PhD student, MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Katherine E. Tansey
- Core Bioinformatics and Statistics Team, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Judith R. Harrison
- clinical research fellow, MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Greg D. Parker
- senior data analyst, Cardiff University Brain Research Imaging Centre, Cardiff University, UK
| | - Xavier Caseras
- faculty member, MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK,Correspondence: Xavier Caseras, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Hadyn Ellis building, Maindy Road, Cardiff CF24 4HQ, UK.
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111
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Poels EMP, Schrijver L, Kamperman AM, Hillegers MHJ, Hoogendijk WJG, Kushner SA, Roza SJ. Long-term neurodevelopmental consequences of intrauterine exposure to lithium and antipsychotics: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2018; 27:1209-1230. [PMID: 29948232 PMCID: PMC6133089 DOI: 10.1007/s00787-018-1177-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/31/2018] [Indexed: 12/14/2022]
Abstract
Lithium and antipsychotics are often prescribed to treat bipolar disorder or psychotic disorders in women of childbearing age. Little is known about the consequences of these medications during pregnancy for the developing child. The objective of this article is to systematically review findings from preclinical and clinical studies that have examined the neurodevelopmental consequences of intrauterine exposure to lithium and antipsychotics. A systematic search was performed in Embase, Medline, Web of Science, PsychINFO, Cochrane, and Google Scholar. Clinical and experimental studies were selected if they investigated neurodevelopment of offspring exposed to lithium or antipsychotics during gestation. Quality of clinical and preclinical studies was assessed by the Newcastle-Ottawa Scale and the SYRCLE's risk of Bias tool, respectively. In total, 73 studies were selected for qualitative synthesis and three studies were selected for quantitative synthesis. Of preclinical studies, 93% found one or more adverse effects of prenatal exposure to antipsychotics or lithium on neurodevelopment or behaviour. Only three clinical cohort studies have investigated the consequences of lithium exposure, all of which reported normal development. In 66% of clinical studies regarding antipsychotic exposure, a transient delay in neurodevelopment was observed. The relative risk for neuromotor deficits after in utero exposure to antipsychotics was estimated to be 1.63 (95% CI 1.22-2.19; I2 = 0%). Preclinical studies suggest long-term adverse neurodevelopmental consequences of intrauterine exposure to either lithium or antipsychotics. However, there is a lack of high-quality clinical studies. Interpretation is difficult, since most studies have compared exposed children with their peers from the unaffected population, which did not allow correction for potential influences regarding genetic predisposition or parental psychiatric illness.
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Affiliation(s)
- Eline M P Poels
- Department of Psychiatry, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
| | - Lisanne Schrijver
- Department of Psychiatry, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Astrid M Kamperman
- Department of Psychiatry, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Witte J G Hoogendijk
- Department of Psychiatry, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Steven A Kushner
- Department of Psychiatry, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Sabine J Roza
- Department of Psychiatry, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
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Bauer IE, Suchting R, Cazala F, Alpak G, Sanches M, Nery FG, Zunta-Soares GB, Soares JC. Changes in amygdala, cerebellum, and nucleus accumbens volumes in bipolar patients treated with lamotrigine. Psychiatry Res Neuroimaging 2018; 278:13-20. [PMID: 29944976 DOI: 10.1016/j.pscychresns.2018.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/08/2018] [Accepted: 06/09/2018] [Indexed: 12/21/2022]
Abstract
The neural mechanisms underlying the therapeutic effects of lamotrigine in bipolar depression are still unexplored. This preliminary study compares the effects of a 12-week treatment with lamotrigine on brain volumes in adults with bipolar disorder (BD).12 BD type II patients (age: 49.33 ± 9.95 years, 3 males, 9 females) and 12 age and gender-matched healthy controls (HC) (HC; age: 41 ± 8.60 years, 3 males, 9 females). BD patients were initially administered 25 mg/day of lamotrigine, which was progressively escalated to 200 mg/d. BD participants underwent brain imaging prior to and following lamotrigine treatment. A 50% reduction in depressive scores indicated "remission". Bayesian general linear models controlled for age, gender and intracranial volume were used to examine changes in relevant brain region following treatment. A posterior probability > 0.90 indicated evidence that there was an effect of diagnosis or remission on brain volumes. Probability distributions of interaction effects between remission and time indicated that BD responders displayed decreased amygdala, cerebellum and nucleus accumbens volumes following lamotrigine treatment. No serious adverse side effects were reported. The antidepressant effects of lamotrigine may be linked to volumetric changes in brain regions involved in mood and emotional regulation. These findings are preliminary and replication in a larger sample is warranted.
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Affiliation(s)
- Isabelle E Bauer
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States.
| | - Robert Suchting
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States
| | - Fadwa Cazala
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States
| | - Gokay Alpak
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States
| | - Marsal Sanches
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States
| | - Fabiano G Nery
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - Giovana B Zunta-Soares
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States
| | - Jair C Soares
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States
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113
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Li L, Ji E, Han X, Tang F, Bai Y, Peng D, Fang Y, Zhang S, Zhang Z, Yang H. Cortical thickness and subcortical volumes alterations in euthymic bipolar I patients treated with different mood stabilizers. Brain Imaging Behav 2018; 13:1255-1264. [DOI: 10.1007/s11682-018-9950-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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114
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Wang X, Tian F, Wang S, Cheng B, Qiu L, He M, Wang H, Duan M, Dai J, Jia Z. Gray matter bases of psychotic features in adult bipolar disorder: A systematic review and voxel-based meta-analysis of neuroimaging studies. Hum Brain Mapp 2018; 39:4707-4723. [PMID: 30096212 DOI: 10.1002/hbm.24316] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 07/05/2018] [Indexed: 02/05/2023] Open
Abstract
Psychotic bipolar disorder (P-BD) is a specific subset that presents greater risk of relapse and worse outcomes than nonpsychotic bipolar disorder (NP-BD). To explore the neuroanatomical bases of psychotic dimension in bipolar disorder (BD), a systematic review was carried out based on the gray matter volume (GMV) among P-BD and NP-BD patients and healthy controls (HC). Further, we conducted a meta-analysis of GMV differences between P-BD patients and HC using a whole-brain imaging approach. Our review revealed that P-BD patients exhibited smaller GMVs mainly in the prefronto-temporal and cingulate cortices, the precentral gyrus, and insula relative to HC both qualitatively and quantitatively. Qualitatively the comparison between P-BD and NP-BD patients suggested inconsistent GMV alterations mainly involving the prefrontal cortex, while NP-BD patients showed GMV deficits in local regions compared with HC. The higher proportions of female patients and patients taking psychotropic medication in P-BD and P-BD type I were associated with smaller GMV in the right precentral gyrus, and the right insula, respectively. In conclusions, psychosis in BD might be associated with specific cortical GMV deficits. Gender and psychotropic medication might have effects on the regional GMVs in P-BD patients. It is necessary to distinguish psychotic dimension in neuroimaging studies of BD.
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Affiliation(s)
- Xiuli Wang
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Fangfang Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Song Wang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Lihua Qiu
- Department of Radiology, The Second People's Hospital of Yibin, Yibin, China
| | - Manxi He
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Hongming Wang
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Mingjun Duan
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Jing Dai
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
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115
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Godwin D, Alpert KI, Wang L, Mamah D. Regional cortical thinning in young adults with schizophrenia but not psychotic or non-psychotic bipolar I disorder. Int J Bipolar Disord 2018; 6:16. [PMID: 29992455 PMCID: PMC6161965 DOI: 10.1186/s40345-018-0124-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/06/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Schizophrenia shares some genetic risk and clinical symptoms with bipolar disorder. Clinical heterogeneity across subjects is thought to contribute to variable structural imaging findings across studies. The current study investigates cortical thickness in young adults diagnosed with schizophrenia or bipolar I disorder with a history of hyperthymic mania. We hypothesize that cortical thickness will be most similar between SCZ and the psychotic bipolar 1 disorder subtype. METHODS Patients with schizophrenia (n = 52), psychotic bipolar I disorder (PBD; n = 49) and non-psychotic bipolar I disorder (NPBD; n = 24) and healthy controls (n = 40) were scanned in a 3T Trio MRI. The thickness of 34 cortical regions was estimated with FreeSurfer, and analyzed using univariate analyses of variance. Relationships to psychotic (SAPS) and negative (SANS) symptoms were investigated using linear regression. RESULTS Cortical thickness showed significant group effects, after covarying for sex, age, and intracranial volume (p = 0.001). SCZ subjects had thinner paracentral, inferior parietal, supramarginal and fusiform cortices compared to CON. Caudal anterior cingulate cortical thickness was increased in SCZ, PBD and NPBD. Cortical thickness in PBD and NPBD were not significantly different from controls. Significant partial correlations were observed for SAPS severity with middle temporal (r = - 0.26; p = 0.001) and fusiform (- 0.26; p = 0.001) cortical thickness. CONCLUSIONS Individuals with SCZ displayed significantly reduced cortical thickness in several cortical regions compared to both CON and bipolar. We found that SCZ participants had significant cortical thinning relative to CON and bipolar disorder most significantly in the frontal (i.e. paracentral), parietal (i.e. inferior parietal, supramarginal), and temporal (i.e. middle temporal, fusiform) cortices.
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Affiliation(s)
- Douglass Godwin
- Department of Psychiatry, Washington University Medical School, St. Louis, USA
| | - Kathryn I. Alpert
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, USA
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116
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Mitchell RH, Metcalfe AW, Islam AH, Toma S, Patel R, Fiksenbaum L, Korczak D, MacIntosh BJ, Goldstein BI. Sex differences in brain structure among adolescents with bipolar disorder. Bipolar Disord 2018; 20:448-458. [PMID: 29956452 DOI: 10.1111/bdi.12663] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Bipolar disorder (BD) is twice as prevalent amongst female as amongst male adolescents. Thus far, little is known regarding the neurostructural substrates underlying this disparity. We therefore examined sex differences in neurostructural magnetic resonane imaging (MRI) phenotypes amongst adolescents with BD. METHODS T1-weighted structural MRI was acquired from 44 BD (25 female [F] and 19 male [M]) and 58 (28 F and 30 M) healthy control (HC) adolescents (13-21 years old). Whole-brain and region-of-interest (ROI) analyses examined structural volume and cortical thickness using FreeSurfer. ROIs included the ventrolateral prefrontal cortex (vlPFC), anterior cingulate cortex (ACC), amygdala and hippocampus. General linear models evaluated sex-by-diagnosis interactions, controlling for age and intracranial volume. RESULTS Whole-brain analysis revealed sex-by-diagnosis interactions in the left supramarginal gyrus (SMG) (P = .02, η2 = 0.02) and right inferior parietal lobule (IPL) volumes (P = .04, η2 = 0.01). Sex differences in HCs were found in the SMG (M > F) and IPL (F > M). In BD, sex differences were reversed and of smaller magnitude in the SMG (M < F) and of greater magnitude in the IPL (F > M), driven by trends towards smaller SMG and IPL in BD vs HC male participants (P = .05 and .14). Whole-brain analyses for cortical thickness, and ROI analyses for volume and cortical thickness, were not significant. CONCLUSIONS Normative sex differences may be disrupted in adolescent BD in the SMG and IPL, heteromodal association network hubs responsible for higher order integration of cognitive and emotional processing. Unexpectedly, these findings may inform our understanding of aberrant brain structure in adolescent BD male patients, rather than female patients. Future work should focus on replication, as well as the impact of puberty status and sex hormones on measures of brain structure and function.
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Affiliation(s)
- Rachel Hb Mitchell
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada
| | - Arron Ws Metcalfe
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Alvi H Islam
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Simina Toma
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Ronak Patel
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Lisa Fiksenbaum
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Daphne Korczak
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of Psychiatry, Hospital for Sick Children, Toronto, Canada
| | - Bradley J MacIntosh
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Pharmacology, University of Toronto, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
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117
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Abramovic L, Boks MPM, Vreeker A, Verkooijen S, van Bergen AH, Ophoff RA, Kahn RS, van Haren NEM. White matter disruptions in patients with bipolar disorder. Eur Neuropsychopharmacol 2018; 28:743-751. [PMID: 29779901 PMCID: PMC6008233 DOI: 10.1016/j.euroneuro.2018.01.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 10/27/2017] [Accepted: 01/12/2018] [Indexed: 01/03/2023]
Abstract
Bipolar disorder (BD) patients show aberrant white matter microstructure compared to healthy controls but little is known about the relation with clinical characteristics. We therefore investigated the relation of white matter microstructure with the main pharmacological treatments as well its relation with IQ. Patients with BD (N = 257) and controls (N = 167) underwent diffusion tensor imaging (DTI) and comprehensive clinically assessments including IQ estimates. DTI images were analyzed using tract-based spatial statistics. Fractional anisotropy (FA) and Mean Diffusivity (MD) were determined. Patients had significantly lower FA and higher MD values throughout the white matter skeleton compared to controls. Within the BD patients, lithium use was associated with higher FA and lower MD. Antipsychotic medication use in the BD patients was not associated with FA but, in contrast to lithium, was associated with higher MD. IQ was significantly positively correlated with FA and negatively with MD in patients as well as in controls. In this large DTI study we found evidence for marked differences in FA and MD particularly in (but not restricted to) corpus callosum, between BD patients and controls. This effect was most pronounced in lithium-free patients, implicating that lithium affects white matter microstructure and attenuates differences associated with bipolar disorder. Effects of antipsychotic medication intake were absent in FA and only subtle in MD relative to those of lithium. The abnormal white matter microstructure was associated with IQ but not specifically for either group.
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Affiliation(s)
- Lucija Abramovic
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
| | - Marco P M Boks
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
| | - Annabel Vreeker
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
| | - Sanne Verkooijen
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
| | - Annet H van Bergen
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
| | - Roel A Ophoff
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands; Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA; Department of Human Genetics, University of California, Los Angeles, CA, USA
| | - René S Kahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands; Icahn School of Medicine at Mount Sinai, New York, USA
| | - Neeltje E M van Haren
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands.
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118
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Zhang L, Opmeer EM, van der Meer L, Aleman A, Ćurčić-Blake B, Ruhé HG. Altered frontal-amygdala effective connectivity during effortful emotion regulation in bipolar disorder. Bipolar Disord 2018; 20:349-358. [PMID: 29430790 DOI: 10.1111/bdi.12611] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 12/15/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Sufficient prefrontal top-down control of limbic affective areas, especially the amygdala, is essential for successful effortful emotion regulation (ER). Difficulties in effortful ER have been seen in patients with bipolar disorder (BD), which could be suggestive of a disturbed prefrontal-amygdala regulation circuit. The aim of this study was to investigate whether BD patients show abnormal effective connectivity from the prefrontal areas to the amygdala during effortful ER (reappraisal). METHODS Forty participants (23 BD patients and 17 healthy controls [HC]) performed an ER task during functional magnetic resonance imaging. Using dynamic causal modeling, we investigated effective connectivity from the dorsolateral prefrontal cortex (DLPFC) and ventrolateral prefrontal cortex (VLPFC) to the amygdala, as well as connectivity between the DLPFC and VLPFC during reappraisal. RESULTS Both BD patients and HC showed decreased negative affect ratings following reappraisal compared to attending negative pictures (P < .001). There were no group differences (P = .10). There was a differential modulatory effect of reappraisal on the connectivity from the DLPFC to amygdala between BD patients and HC (P = .04), with BD patients showing a weaker modulatory effect on this connectivity compared to HC. There were no other group differences. CONCLUSION The disturbance in BD patients in effective connectivity from the DLPFC to the amygdala while reappraising is indicative of insufficient prefrontal control. This impairment should be studied further in relation to cycling frequency and polarity of switches in BD patients.
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Affiliation(s)
- Liwen Zhang
- Department of Neuroscience, NeuroImaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Esther M Opmeer
- Department of Neuroscience, NeuroImaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lisette van der Meer
- Department of Neuroscience, NeuroImaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, , The Netherlands.,Rob Giel Research Center, University of Groningen, Groningen, The Netherlands
| | - André Aleman
- Department of Neuroscience, NeuroImaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Psychology, University of Groningen, Groningen, The Netherlands
| | - Branislava Ćurčić-Blake
- Department of Neuroscience, NeuroImaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henricus G Ruhé
- Department of Psychiatry, Mood and Anxiety Disorders, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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119
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Sani G, Simonetti A, Janiri D, Banaj N, Ambrosi E, De Rossi P, Ciullo V, Arciniegas DB, Piras F, Spalletta G. Association between duration of lithium exposure and hippocampus/amygdala volumes in type I bipolar disorder. J Affect Disord 2018; 232:341-348. [PMID: 29510351 DOI: 10.1016/j.jad.2018.02.042] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/17/2018] [Accepted: 02/16/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Prior studies on the effects of lithium on limbic and subcortical gray matter volumes are mixed. It is possible that discrepant findings may be explained by the duration of lithium exposure. We investigated this issue in individuals with type I bipolar disorder (BP-I). METHODS Limbic and subcortical gray matter volume was measured using FreeSurfer in 60 subjects: 15 with BP-I without prior lithium exposure [no-exposure group (NE)]; 15 with BP-I and lithium exposure < 24 months [short-exposure group (SE)]; 15 with BP-I and lithium exposure > 24 months [long-exposure group (LE)]; and 15 healthy controls (HC). RESULTS No differences in limbic and subcortical gray matter volumes were found between LE and HC. Hippocampal and amygdalar volumes were larger bilaterally in both LE and HC when compared to NE. Amygdalar volumes were larger bilaterally in SE when compared to NE but did not differ from LE. Hippocampal volumes were smaller bilaterally in SE when compared to LE and HC but did not differ from NE. No between-group differences on subcortical gray matter or other limbic structure volumes were observed. LIMITATIONS Cross-sectional design and concurrent treatment with other medications limit attribution of between-group differences to lithium exposure alone. CONCLUSIONS The effect of lithium exposure on limbic and subcortical gray matter volumes appears to be time-dependent and relatively specific to the hippocampus and the amygdala, with short-term effects on the amygdala and long-term effects on both structures. These results support the clinical importance of long-term lithium treatment in BP-I.
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Affiliation(s)
- Gabriele Sani
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy; Centro Lucio Bini, Rome, Italy; School of Medicine, Mood Disorder Program, Tufts University, Boston, MA, USA
| | - Alessio Simonetti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Centro Lucio Bini, Rome, Italy; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Delfina Janiri
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Nerisa Banaj
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Elisa Ambrosi
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Pietro De Rossi
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Valentina Ciullo
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, 50139 Italy
| | - David B Arciniegas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Departments of Neurology and Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Fabrizio Piras
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Gianfranco Spalletta
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy.
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120
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Bednarz HM, Kana RK. Advances, challenges, and promises in pediatric neuroimaging of neurodevelopmental disorders. Neurosci Biobehav Rev 2018; 90:50-69. [PMID: 29608989 DOI: 10.1016/j.neubiorev.2018.03.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 02/26/2018] [Accepted: 03/22/2018] [Indexed: 10/17/2022]
Abstract
Recent years have witnessed the proliferation of neuroimaging studies of neurodevelopmental disorders (NDDs), particularly of children with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and Tourette's syndrome (TS). Neuroimaging offers immense potential in understanding the biology of these disorders, and how it relates to clinical symptoms. Neuroimaging techniques, in the long run, may help identify neurobiological markers to assist clinical diagnosis and treatment. However, methodological challenges have affected the progress of clinical neuroimaging. This paper reviews the methodological challenges involved in imaging children with NDDs. Specific topics include correcting for head motion, normalization using pediatric brain templates, accounting for psychotropic medication use, delineating complex developmental trajectories, and overcoming smaller sample sizes. The potential of neuroimaging-based biomarkers and the utility of implementing neuroimaging in a clinical setting are also discussed. Data-sharing approaches, technological advances, and an increase in the number of longitudinal, prospective studies are recommended as future directions. Significant advances have been made already, and future decades will continue to see innovative progress in neuroimaging research endeavors of NDDs.
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Affiliation(s)
- Haley M Bednarz
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rajesh K Kana
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
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121
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Buff C, Schmidt C, Brinkmann L, Gathmann B, Tupak S, Straube T. Directed threat imagery in generalized anxiety disorder. Psychol Med 2018; 48:617-628. [PMID: 28735579 DOI: 10.1017/s0033291717001957] [Citation(s) in RCA: 12] [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: 01/19/2023]
Abstract
BACKGROUND Worrying has been suggested to prevent emotional and elaborative processing of fears. In cognitive-behavioral therapy (CBT), generalized anxiety disorder (GAD) patients are exposed to their fears during the method of directed threat imagery by inducing emotional reactivity. However, studies investigating neural correlates of directed threat imagery and emotional reactivity in GAD patients are lacking. The present functional magnetic resonance imaging (fMRI) study aimed at delineating neural correlates of directed threat imagery in GAD patients. METHOD Nineteen GAD patients and 19 healthy controls (HC) were exposed to narrative scripts of either disorder-related or neutral content and were encouraged to imagine it as vividly as possible. RESULTS Rating results showed that GAD patients experienced disorder-related scripts as more anxiety inducing and arousing than HC. These results were also reflected in fMRI data: Disorder-related v. neutral scripts elicited elevated activity in the amygdala, dorsomedial prefrontal cortex, ventrolateral prefrontal cortex and the thalamus as well as reduced activity in the ventromedial prefrontal cortex/subgenual anterior cingulate cortex in GAD patients relative to HC. CONCLUSION The present study presents the first behavioral and neural evidence for emotional reactivity during directed threat imagery in GAD. The brain activity pattern suggests an involvement of a fear processing network as a neural correlate of initial exposure during directed imagery in CBT in GAD.
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Affiliation(s)
- C Buff
- Institute of Medical Psychology and Systems Neuroscience,University of Muenster,Von-Esmarch-Str. 52, 48149 Muenster,Germany
| | - C Schmidt
- Institute of Medical Psychology and Systems Neuroscience,University of Muenster,Von-Esmarch-Str. 52, 48149 Muenster,Germany
| | - L Brinkmann
- Institute of Medical Psychology and Systems Neuroscience,University of Muenster,Von-Esmarch-Str. 52, 48149 Muenster,Germany
| | - B Gathmann
- Institute of Medical Psychology and Systems Neuroscience,University of Muenster,Von-Esmarch-Str. 52, 48149 Muenster,Germany
| | - S Tupak
- Institute of Medical Psychology and Systems Neuroscience,University of Muenster,Von-Esmarch-Str. 52, 48149 Muenster,Germany
| | - T Straube
- Institute of Medical Psychology and Systems Neuroscience,University of Muenster,Von-Esmarch-Str. 52, 48149 Muenster,Germany
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122
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Qiu M, Zhang H, Mellor D, Shi J, Wu C, Huang Y, Zhang J, Shen T, Peng D. Aberrant Neural Activity in Patients With Bipolar Depressive Disorder Distinguishing to the Unipolar Depressive Disorder: A Resting-State Functional Magnetic Resonance Imaging Study. Front Psychiatry 2018; 9:238. [PMID: 29922189 PMCID: PMC5996277 DOI: 10.3389/fpsyt.2018.00238] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/15/2018] [Indexed: 01/21/2023] Open
Abstract
This study aims to explore the intrinsic patterns of spontaneous activity of bipolar depression (BD) patients by analyzing the fractional amplitude of low frequency fluctuation (fALFF) that help differentiate BD from unipolar depressive disorder(UD). Twenty eight patients with BD, 47 patients with UD and 29 healthy controls were enrolled to receive the resting-state functional magnetic resonance imaging (rs-fMRI) scans. The group differences of fALFF values were calculated among three groups. In addition, the correlations between the clinical variables and mfALFF values were estimated. The brain regions with activation discrepancies among three groups are located in precuneus, the left middle temporal gyrus (MTG) and left inferior parietal lobe (IPL) and lingual gyrus. Compared with HC group, BD group shows decreased fALFF in precuneus, the left IPL and increased fALFF in lingual gyrus remarkably; UD group shows significantly decreased fALFF in precuneus, the left MTG and the left IPL. On the contrast of patients with UD, patients with BD have significantly increased fALFF value in the left precuneus, the left MGT and lingual gyrus. Furthermore, a negative correlation is found between the mfALFF values in precuneus and the scores of cognitive impairment factor in the UD group. The similar pattern of intrinsic activity in PCC suggests depressive state-dependent change. The aberrant patterns of intrinsic activity in precuneus, the IPL and lingual gyrus might be provide quantitative nodes that help to conduct further study for better distinguishing between BD and UD.
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Affiliation(s)
- Meihui Qiu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huifeng Zhang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - David Mellor
- School of Psychology, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - Jun Shi
- Institute of Biomedical Engineering, School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Chuangxin Wu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yueqi Huang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianye Zhang
- Department of Medical Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Shen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daihui Peng
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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123
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Robinson OJ, Chase HW. Learning and Choice in Mood Disorders: Searching for the Computational Parameters of Anhedonia. COMPUTATIONAL PSYCHIATRY (CAMBRIDGE, MASS.) 2017; 1:208-233. [PMID: 29400358 PMCID: PMC5796642 DOI: 10.1162/cpsy_a_00009] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 06/06/2017] [Indexed: 12/19/2022]
Abstract
Computational approaches are increasingly being used to model behavioral and neural processes in mood and anxiety disorders. Here we explore the extent to which the parameters of popular learning and decision-making models are implicated in anhedonic symptoms of major depression. We first highlight the parameters of reinforcement learning that have been implicated in anhedonia, focusing, in particular, on the role that choice variability (i.e., "temperature") may play in explaining heterogeneity across previous findings. We then turn to neuroimaging findings implicating attenuated ventral striatum response in anhedonic responses and discuss possible causes of the heterogeneity in the literature. Taken together, the reviewed findings highlight the potential of the computational approach in teasing apart the observed heterogeneity in both behavioral and functional imaging results. Nevertheless, considerable challenges remain, and we conclude with five unresolved questions that seek to address issues highlighted by the reviewed data.
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Affiliation(s)
- Oliver J. Robinson
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Henry W. Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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124
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Lee J, Choi S, Kang J, Won E, Tae WS, Lee MS, Ham BJ. Structural characteristics of the brain reward circuit regions in patients with bipolar I disorder: A voxel-based morphometric study. Psychiatry Res Neuroimaging 2017; 269:82-89. [PMID: 28963911 DOI: 10.1016/j.pscychresns.2017.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 08/11/2017] [Accepted: 09/18/2017] [Indexed: 12/30/2022]
Abstract
Bipolar I disorder (BD-I) is often misdiagnosed, leading to inadequate treatment and significant disability along with reduced quality of life. Recent neural models suggest that the reward circuitry is affected in bipolar disorder. The purpose of the present study was to identify structural abnormalities in the brain reward-processing neural circuitry among patients with BD-I. 21 patients with BD-I and 21 healthy controls (HC) participated in this study. Structural magnetic resonance imaging was performed. Region-of-interest (ROI) voxel-based morphometry analysis was applied to assess the presence of structural changes between the BD-I patient group and the control group. The results of the reward circuitry ROI analysis revealed lower gray matter volumes in the left ventromedial prefrontal cortex (VMPFC), left dorsomedial prefrontal cortex (DMPFC), and left ventrolateral prefrontal cortex (VLPFC) in patients with BD-I compared to HC. Our results suggest that abnormalities in the brain reward-processing neural circuitry, especially those in the left VMPFC, left DMPFC, and left VLPFC, may play an important role in the pathophysiology of BD-I.
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Affiliation(s)
- Junyong Lee
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sunyoung Choi
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - June Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eunsoo Won
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo-Suk Tae
- Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Min-Soo Lee
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea; Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea.
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125
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Kim JH, Kim JB, Suh SI, Kim DW. Subcortical grey matter changes in juvenile myoclonic epilepsy. NEUROIMAGE-CLINICAL 2017; 17:397-404. [PMID: 29159052 PMCID: PMC5683808 DOI: 10.1016/j.nicl.2017.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 10/29/2017] [Accepted: 11/01/2017] [Indexed: 12/18/2022]
Abstract
Recent neuroimaging studies have provided converging evidence of structural and functional abnormalities of the thalamus in patients with juvenile myoclonic epilepsy (JME). There has also been limited evidence indicating involvement of the subcortical grey matter structures other than thalamus in JME, but with inconsistent findings across the studies. In the present study, we combined volumetric MRI and diffusion tensor imaging analyses to investigate macrostructural and microstructural alterations of the subcortical grey matter in 64 JME patients compared to 58 matched control subjects. Raw volume, fractional anisotropy (FA), and mean diffusivity (MD) of 6 subcortical grey matter structures (amygdala, hippocampus, caudate, pallidum, putamen, thalamus) were measured in both hemispheres. Between-group (controls versus patients) comparisons of normalized volume, FA, and MD, as well as within-group (patients) correlation analyses between structural changes and clinical variables were carried out. Compared to controls, JME patients exhibited significant volume reductions in left pallidum and bilateral putamen and thalamus. Duration of epilepsy negatively correlated with bilateral putamen volumes. Patients and controls did not differ in FA values of all structures. Compared to controls, JME patients showed significant MD increases in left pallidum and bilateral hippocampus, putamen, and thalamus. Significant positive correlations were found between duration of epilepsy and MD values of bilateral hippocampus and thalamus. We have provided evidence that macrostructural and microstructural abnormalities may not only be confined to the thalamus but also affect basal ganglia and hippocampus in JME. Our findings could further support the pathophysiological hypothesis of striato-thalamo-frontal network abnormality underlying JME, and may implicate disease progression. Reduced volumes of left pallidum and bilateral putamen and thalamus in JME patients Negative correlation between disease duration and putamen volumes Increased MD of left pallidum and bilateral hippocampus, putamen, and thalamus in JME patients Positive correlation between disease duration and MD of bilateral hippocampus and thalamus Structural changes may not only be confined to the thalamus but also affect basal ganglia and hippocampus in JME.
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Affiliation(s)
- Ji Hyun Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Jung Bin Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sang-Il Suh
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Dong Wook Kim
- Department of Neurology, Konkuk University School of Medicine, Seoul, Republic of Korea
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126
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Arumugham SS, Torres IJ, Lang DJ, Su W, Lam RW, Honer WG, Yatham LN. Subcortical structural volumes in recently remitted first episode mania. J Affect Disord 2017; 222:23-27. [PMID: 28667890 DOI: 10.1016/j.jad.2017.06.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/07/2017] [Accepted: 06/23/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) studies have yielded inconsistent findings with regard to subcortical volumetric abnormalities in patients with bipolar I disorder. Duration of illness and long term medication intake could have confounded the findings. METHOD Volumes of nine subcortical structures were compared between 63 patients who recently remitted from their first manic episode and 77 healthy volunteers. The volumetric segmentation was performed with the automated segmentation algorithm Freesurfer version 5.1. RESULTS There were no significant volumetric differences between the two groups in any of the structures examined including caudate, putamen, globus pallidum, nucleus accumbens, amygdala, thalamus, cerebellum, hippocampus and lateral ventricles (q > 0.05-false discovery rate corrected). LIMITATIONS All patients were on psychotropic medications at the time of scanning, which might have confounded the results. Sample size may not be large enough to detect small volumetric changes. CONCLUSIONS Patients with bipolar I disorder do not appear to have any significant subcortical volumetric abnormalities during the early stage of the disease. Thus, early stage bipolar disorder may present an opportunity for intervention to arrest neuroprogression of the disease.
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Affiliation(s)
| | - Ivan J Torres
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Donna J Lang
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Wayne Su
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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127
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Kafantaris V, Spritzer L, Doshi V, Saito E, Szeszko PR. Changes in white matter microstructure predict lithium response in adolescents with bipolar disorder. Bipolar Disord 2017; 19:587-594. [PMID: 28992395 DOI: 10.1111/bdi.12544] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 07/29/2017] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To investigate whether response to lithium treatment in pediatric bipolar disorder can be predicted by changes in white matter microstructure in key cortico-limbic tracts involved in emotion regulation. METHODS Eighteen clinically referred lithium-naive patients (mean age 15.5 years) were administered clinical rating scales and diffusion tensor imaging (DTI) examinations at baseline and following 4 weeks of lithium treatment. Clinical ratings were repeated following 8 weeks of treatment. Patients with Clinical Global Impressions (CGI) ratings of 1 ("very much improved") or 2 ("much improved") were classified as responders. Ten healthy volunteers received baseline and follow-up DTI examinations. Using the ENIGMA pipeline, we investigated the relationship between changes in fractional anisotropy (FA) in the cingulum hippocampus (CGH) and clinical response to lithium. RESULTS Patients demonstrated significantly lower FA compared to healthy volunteers in the left and right CGH white matter at baseline. Following 4 weeks of lithium treatment, FA in the left CGH increased in patients, but no significant changes in FA were observed among the untreated healthy volunteers. Lithium responders had a significantly greater increase in FA compared to non-responders. Moreover, baseline (pre-treatment) FA in the left CGH white matter significantly predicted week 8 overall CGI severity score, with post hoc analyses indicating that these effects were evident for both severity of depression and mania. CONCLUSIONS Our findings suggest that response to lithium treatment in pediatric bipolar disorder is associated with normalization of white matter microstructure in regions associated with emotion processing.
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Affiliation(s)
- Vivian Kafantaris
- Division of Child and Adolescent Psychiatry, The Zucker Hillside Hospital of Northwell Health, Glen Oaks, NY, USA.,Hofstra Northwell School of Medicine, Hempstead, NY, USA.,Center for Psychiatric Neuroscience of The Feinstein Institute for Medical Research of Northwell Health, Manhasset, NY, USA
| | - Linda Spritzer
- Center for Psychiatric Neuroscience of The Feinstein Institute for Medical Research of Northwell Health, Manhasset, NY, USA
| | - Vishal Doshi
- Division of Child and Adolescent Psychiatry, The Zucker Hillside Hospital of Northwell Health, Glen Oaks, NY, USA.,Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Ema Saito
- Division of Child and Adolescent Psychiatry, The Zucker Hillside Hospital of Northwell Health, Glen Oaks, NY, USA.,Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Philip R Szeszko
- James J. Peters VA Medical Center, Bronx, NY, USA.,The Icahn School of Medicine at Mount Sinai, New York, NY, USA
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128
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Anomalous prefrontal-limbic activation and connectivity in youth at high-risk for bipolar disorder. J Affect Disord 2017; 222:7-13. [PMID: 28667891 DOI: 10.1016/j.jad.2017.05.051] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/24/2017] [Accepted: 05/30/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Abnormal prefrontal-limbic brain activation in response to facial expressions has been reported in pediatric bipolar disorder (BD). However, it is less clear whether these abnormalities exist prior to onset of mania, thus representing a biomarker predicting development of BD. METHODS We examined brain activation in 50 youth at high risk for BD (HR-BD), compared with 29 age- and gender-matched healthy control (HC) subjects. HR-BD was defined as having a parent with BD, as well as current mood or attentiondeficit/ hyperactivity disorder (ADHD) symptoms, or a history of at least one depressive episode. FMRI data were collected during an implicit emotion perception task using facial expression stimuli. Activation to fearful faces versus calm faces was compared between HR-BD and HC groups, including analyses of functional connectivity, and comparison of allele subgroups of the serotonin transporter (5-HTTLPR) gene. RESULTS While viewing fearful versus calm faces, HR-BD youth had significantly greater activation than HC youth in the right amygdala, ventrolateral prefrontal cortex (VLPFC), superior frontal cortex, cerebellum, and lingual gyrus. HR-BD youth, relative to HC youth, had greater functional connectivity between the right amygdala and the VLPFC as well as visual cortical regions Within the HR-BD group, youth with the s-allele had a trend for greater activation in the right amygdala and subgenual cingulate cortex CONCLUSIONS: Similar to youth with BD, youth at high risk for BD have greater activation than healthy controls in the amygdala and ventrolateral prefrontal cortex in response to fearful faces, as well greater functional connectivity between these regions. HR-BD youth with the s-allele of the 5-HTTLPR gene may be at greatest risk for developing BD.
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129
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van Zutphen L, Siep N, Jacob GA, Domes G, Sprenger A, Willenborg B, Goebel R, Arntz A. Always on guard: emotion regulation in women with borderline personality disorder compared to nonpatient controls and patients with cluster-C personality disorder. J Psychiatry Neurosci 2017; 43:170008. [PMID: 29083990 PMCID: PMC5747534 DOI: 10.1503/jpn.170008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 05/04/2017] [Accepted: 07/04/2017] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Borderline personality disorder (BPD) is characterized by emotion dysregulation; however, it is unclear whether this is restricted to negative emotional stimuli or to what degree this is specific to BPD. We investigated neural correlates of hypothesized increased emotional sensitivity and impaired emotion regulation in patients with BPD. METHODS During fMRI scanning, patients with BPD, nonpatient controls and patients with cluster-C personality disorder completed an emotion regulation task, including negative, positive and erotic social pictures. RESULTS We included 55 patients with BPD, 42 nonpatient controls and 24 patients with cluster-C personality disorder in our analyses. Passive viewing of negative stimuli resulted in greater activity in the anterior insula, temporoparietal junction and dorsolateral prefrontal cortex in patients with BPD than in nonpatient controls. The increased activity in the anterior insula and temporoparietal junction was also present when patients with BPD viewed positive stimuli. During regulation of negative stimuli compared with passive viewing, nonpatient controls showed greater activity in the dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, middle temporal gyrus and bilateral inferior parietal lobule. Patients with BPD did not show this increase in activity. LIMITATIONS Findings cannot be generalized to men, and patients represented a heterogeneous group regarding comorbid diagnoses and medication. CONCLUSION When looking at emotional stimuli, patients with BPD showed a unique pattern of activity, suggesting an increase in brain activity involved in emotion generation. In the case of negative stimuli this is accompanied by increased activity in regulation areas. In contrast, increase of regulation processes seems absent when patients with BPD are explicitly instructed to regulate. Results of diagnosis specificity support a dimensional rather than a dichotomous differentiation between BPD and cluster-C personality disorder regarding emotional sensitivity and emotional regulation of social stimuli.
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Affiliation(s)
- Linda van Zutphen
- From the Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands (van Zutphen, Siep, Arntz); the Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany (Jacob); the Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany (Domes); the Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Freiburg, Germany (Domes); the Department of Biological and Clinical Psychology, University of Trier, Trier, Germany (Domes); the Departments of Neurology and Psychology, University of Lübeck, Lübeck, Germany (Sprenger); the Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany (Willenborg); the Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands (Goebel); the Department of Neuroimaging and Neuromodeling, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, the Netherlands (Goebel); and the Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands (Arntz)
| | - Nicolette Siep
- From the Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands (van Zutphen, Siep, Arntz); the Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany (Jacob); the Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany (Domes); the Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Freiburg, Germany (Domes); the Department of Biological and Clinical Psychology, University of Trier, Trier, Germany (Domes); the Departments of Neurology and Psychology, University of Lübeck, Lübeck, Germany (Sprenger); the Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany (Willenborg); the Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands (Goebel); the Department of Neuroimaging and Neuromodeling, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, the Netherlands (Goebel); and the Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands (Arntz)
| | - Gitta A. Jacob
- From the Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands (van Zutphen, Siep, Arntz); the Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany (Jacob); the Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany (Domes); the Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Freiburg, Germany (Domes); the Department of Biological and Clinical Psychology, University of Trier, Trier, Germany (Domes); the Departments of Neurology and Psychology, University of Lübeck, Lübeck, Germany (Sprenger); the Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany (Willenborg); the Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands (Goebel); the Department of Neuroimaging and Neuromodeling, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, the Netherlands (Goebel); and the Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands (Arntz)
| | - Gregor Domes
- From the Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands (van Zutphen, Siep, Arntz); the Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany (Jacob); the Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany (Domes); the Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Freiburg, Germany (Domes); the Department of Biological and Clinical Psychology, University of Trier, Trier, Germany (Domes); the Departments of Neurology and Psychology, University of Lübeck, Lübeck, Germany (Sprenger); the Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany (Willenborg); the Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands (Goebel); the Department of Neuroimaging and Neuromodeling, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, the Netherlands (Goebel); and the Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands (Arntz)
| | - Andreas Sprenger
- From the Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands (van Zutphen, Siep, Arntz); the Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany (Jacob); the Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany (Domes); the Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Freiburg, Germany (Domes); the Department of Biological and Clinical Psychology, University of Trier, Trier, Germany (Domes); the Departments of Neurology and Psychology, University of Lübeck, Lübeck, Germany (Sprenger); the Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany (Willenborg); the Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands (Goebel); the Department of Neuroimaging and Neuromodeling, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, the Netherlands (Goebel); and the Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands (Arntz)
| | - Bastian Willenborg
- From the Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands (van Zutphen, Siep, Arntz); the Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany (Jacob); the Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany (Domes); the Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Freiburg, Germany (Domes); the Department of Biological and Clinical Psychology, University of Trier, Trier, Germany (Domes); the Departments of Neurology and Psychology, University of Lübeck, Lübeck, Germany (Sprenger); the Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany (Willenborg); the Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands (Goebel); the Department of Neuroimaging and Neuromodeling, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, the Netherlands (Goebel); and the Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands (Arntz)
| | - Rainer Goebel
- From the Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands (van Zutphen, Siep, Arntz); the Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany (Jacob); the Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany (Domes); the Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Freiburg, Germany (Domes); the Department of Biological and Clinical Psychology, University of Trier, Trier, Germany (Domes); the Departments of Neurology and Psychology, University of Lübeck, Lübeck, Germany (Sprenger); the Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany (Willenborg); the Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands (Goebel); the Department of Neuroimaging and Neuromodeling, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, the Netherlands (Goebel); and the Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands (Arntz)
| | - Arnoud Arntz
- From the Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands (van Zutphen, Siep, Arntz); the Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany (Jacob); the Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Freiburg, Germany (Domes); the Freiburg Brain Imaging Center, University Medical Center, University of Freiburg, Freiburg, Germany (Domes); the Department of Biological and Clinical Psychology, University of Trier, Trier, Germany (Domes); the Departments of Neurology and Psychology, University of Lübeck, Lübeck, Germany (Sprenger); the Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany (Willenborg); the Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands (Goebel); the Department of Neuroimaging and Neuromodeling, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), Amsterdam, the Netherlands (Goebel); and the Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands (Arntz)
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Islam AH, Metcalfe AWS, MacIntosh BJ, Korczak DJ, Goldstein BI. Greater body mass index is associated with reduced frontal cortical volumes among adolescents with bipolar disorder. J Psychiatry Neurosci 2017; 43:170041. [PMID: 29077553 PMCID: PMC5837884 DOI: 10.1503/jpn.170041] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 07/05/2017] [Accepted: 09/05/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Higher body mass index (BMI) and obesity is common among youth with bipolar disorder (BD) and is associated with greater psychiatric illness severity, including suicidality. Obesity has been associated with frontal, temporal and subcortical volumetric reductions in adults with BD. We examined the neurostructural correlates of BMI in adolescents early in their course of BD. METHODS We processed T1-weighted images of adolescents with BD and psychiatrically healthy controls using FreeSurfer to derive a priori region of interest (ROI) volumes/cortical thickness for the frontal lobe (FL), prefrontal cortex (PFC) and orbitofrontal cortex (OFC) as well as volumes for the amygdala and hippocampus. General linear models assessed the association between BMI and the ROIs, controlling for age, sex and intracranial volume. We also conducted exploratory within-BD group and whole brain vertex-wise analyses. RESULTS We included 40 adolescents with BD and 48 controls in our analyses. In addition to a main effect of BMI on the ROIs, there were significant diagnosis × BMI interaction effects on FL volumes. In the BD group only, BMI was negatively associated with FL, OFC and PFC cortical thickness. Whole brain analysis of BMI-volume correlations revealed 2 significant interaction clusters: 1 in the medial OFC and 1 in the caudal anterior cingulate cortex, with BD showing a stronger negative correlation. LIMITATIONS Reliance on BMI rather than a more nuanced measure of obesity may have influenced the findings. CONCLUSION Our results suggest that elevated BMI among adolescents with BD is associated with frontal neurostructural differences that are not observed in controls. Prospective studies examining the direction of the observed associations and the effect of BMI optimization on brain structure in adolescents with BD are warranted.
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Affiliation(s)
- Alvi H Islam
- From the Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ont., Canada (Islam, Metcalfe, Goldstein); the Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Korczak, Goldstein); the Hurvitz Brain Sciences, Sunnybrook Research Institute, Toronto, Ont., Canada (Metcalfe, MacIntosh); the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ont., Canada (Metcalfe, MacIntosh, Goldstein); the Hospital for Sick Children, Toronto, Ont., Canada (Korczak); the Department of Medical Biophysics, University of Toronto, Toronto, Ont., Canada (MacIntosh); the Department of Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ont., Canada (MacIntosh); and the Department of Pharmacology, University of Toronto, Toronto, Ont., Canada (Goldstein)
| | - Arron W S Metcalfe
- From the Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ont., Canada (Islam, Metcalfe, Goldstein); the Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Korczak, Goldstein); the Hurvitz Brain Sciences, Sunnybrook Research Institute, Toronto, Ont., Canada (Metcalfe, MacIntosh); the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ont., Canada (Metcalfe, MacIntosh, Goldstein); the Hospital for Sick Children, Toronto, Ont., Canada (Korczak); the Department of Medical Biophysics, University of Toronto, Toronto, Ont., Canada (MacIntosh); the Department of Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ont., Canada (MacIntosh); and the Department of Pharmacology, University of Toronto, Toronto, Ont., Canada (Goldstein)
| | - Bradley J MacIntosh
- From the Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ont., Canada (Islam, Metcalfe, Goldstein); the Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Korczak, Goldstein); the Hurvitz Brain Sciences, Sunnybrook Research Institute, Toronto, Ont., Canada (Metcalfe, MacIntosh); the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ont., Canada (Metcalfe, MacIntosh, Goldstein); the Hospital for Sick Children, Toronto, Ont., Canada (Korczak); the Department of Medical Biophysics, University of Toronto, Toronto, Ont., Canada (MacIntosh); the Department of Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ont., Canada (MacIntosh); and the Department of Pharmacology, University of Toronto, Toronto, Ont., Canada (Goldstein)
| | - Daphne J Korczak
- From the Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ont., Canada (Islam, Metcalfe, Goldstein); the Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Korczak, Goldstein); the Hurvitz Brain Sciences, Sunnybrook Research Institute, Toronto, Ont., Canada (Metcalfe, MacIntosh); the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ont., Canada (Metcalfe, MacIntosh, Goldstein); the Hospital for Sick Children, Toronto, Ont., Canada (Korczak); the Department of Medical Biophysics, University of Toronto, Toronto, Ont., Canada (MacIntosh); the Department of Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ont., Canada (MacIntosh); and the Department of Pharmacology, University of Toronto, Toronto, Ont., Canada (Goldstein)
| | - Benjamin I Goldstein
- From the Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ont., Canada (Islam, Metcalfe, Goldstein); the Department of Psychiatry, University of Toronto, Toronto, Ont., Canada (Korczak, Goldstein); the Hurvitz Brain Sciences, Sunnybrook Research Institute, Toronto, Ont., Canada (Metcalfe, MacIntosh); the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ont., Canada (Metcalfe, MacIntosh, Goldstein); the Hospital for Sick Children, Toronto, Ont., Canada (Korczak); the Department of Medical Biophysics, University of Toronto, Toronto, Ont., Canada (MacIntosh); the Department of Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ont., Canada (MacIntosh); and the Department of Pharmacology, University of Toronto, Toronto, Ont., Canada (Goldstein)
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Linke AC, Olson L, Gao Y, Fishman I, Müller RA. Psychotropic medication use in autism spectrum disorders may affect functional brain connectivity. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:518-527. [PMID: 29104944 PMCID: PMC5667652 DOI: 10.1016/j.bpsc.2017.06.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Prescription of psychotropic medications is common in autism spectrum disorders (ASDs), either off-label or to treat comorbid conditions such as ADHD or depression. Psychotropic medications are intended to alter brain function. Yet, studies investigating the functional brain organization in ASDs rarely take medication usage into account. This could explain some of the inconsistent findings of atypical brain network connectivity reported in the autism literature. METHODS The current study tested whether functional connectivity patterns, as assessed with functional magnetic resonance imaging (fMRI), differed in a cohort of 49 children and adolescents with ASDs based on psychotropic medication status, and in comparison with 50 matched typically developing (TD) participants. Twenty-five participants in the ASD group (51%) reported current psychotropic medication usage, including stimulants, antidepressants, antipsychotics, and anxiolytics. Age, IQ, head motion, and ASD symptom severity did not differ between groups. Whole-brain functional connectivity between 132 regions of interest was assessed. RESULTS Different functional connectivity patterns were identified in the ASD group taking psychotropic medications (ASD-on), as compared to the TD group and the ASD subgroup not using psychotropic medications (ASD-none). The ASD-on group showed distinct underconnectivity between the cerebellum and basal ganglia but cortico-cortical overconnectivity compared to the TD group. Cortical underconnectivity relative to the TD pattern, on the other hand, was pronounced in the ASD-none group. CONCLUSIONS These results suggest that psychotropic medications may affect functional connectivity, and that medication status should be taken into consideration when studying brain function in autism.
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Affiliation(s)
- Annika C. Linke
- Brain Development Imaging Laboratory, Department of Psychology San Diego State University, 6363 Alvarado CT, Suite 200, San Diego, CA 92120, USA
| | - Lindsay Olson
- Brain Development Imaging Laboratory, Department of Psychology San Diego State University, 6363 Alvarado CT, Suite 200, San Diego, CA 92120, USA
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado CT, Suite 103, San Diego, CA 92120, USA
| | - Yangfeifei Gao
- Brain Development Imaging Laboratory, Department of Psychology San Diego State University, 6363 Alvarado CT, Suite 200, San Diego, CA 92120, USA
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado CT, Suite 103, San Diego, CA 92120, USA
| | - Inna Fishman
- Brain Development Imaging Laboratory, Department of Psychology San Diego State University, 6363 Alvarado CT, Suite 200, San Diego, CA 92120, USA
| | - Ralph-Axel Müller
- Brain Development Imaging Laboratory, Department of Psychology San Diego State University, 6363 Alvarado CT, Suite 200, San Diego, CA 92120, USA
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132
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Herold D, Usnich T, Spengler S, Sajonz B, Bauer M, Bermpohl F. Decreased medial prefrontal cortex activation during self-referential processing in bipolar mania. J Affect Disord 2017; 219:157-163. [PMID: 28551555 DOI: 10.1016/j.jad.2017.04.065] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 03/21/2017] [Accepted: 04/24/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Patients with bipolar disorder in mania exhibit symptoms pointing towards altered self-referential processing, such as decreased self-focus, flight of ideas and high distractibility. In depression, the opposite pattern of symptoms has been connected to increased activation of medial prefrontal cortex (mPFC) during self-referential processing. In this study, we hypothesized that (1) patients with mania will exhibit decreased activation in the mPFC during self-referential processing and (2) will be more alexithymic and that levels of alexithymia will correlate negatively with mPFC activation. METHODS The neural response to standardized pictures was compared in 14 patients with bipolar I disorder in mania to 14 healthy controls using blood oxygen level dependent contrast magnetic resonance imaging. Participants were asked to indicate with button press during the scanning session for each picture whether the pictures personally related to them or not. Toronto alexithymia scale (TAS) scores were recorded from all participants. RESULTS In the group analysis, patients with mania exhibited decreased activation in a predefined region of interest in the mPFC during self-referential processing compared to healthy controls. Patients with mania showed significantly higher levels of alexithymia, attributable to difficulties in identifying and describing emotions. Activation in the mPFC correlated negatively with levels of alexithymia. LIMITATIONS Results presented here should be replicated in a larger group, potentially including unmedicated patients. CONCLUSIONS The finding of decreased mPFC activation during self-referential processing in mania may reflect decreased self-focus and high distractibility. Support for this view comes from the negative correlation between higher alexithymia scores and decreased mPFC activation. These findings represent an opposite clinical and neuroimaging pattern to findings in depression.
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Affiliation(s)
- Dorrit Herold
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Ruppiner Kliniken, Brandenburg Medical School, Neuruppin, Germany.
| | - Tatiana Usnich
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Germany
| | - Stephanie Spengler
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Germany
| | - Bastian Sajonz
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Germany; Department of Stereotaxy and Functional Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Germany; Berlin School of Mind and Brain, Berlin, Germany
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133
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Kurumaji A, Itasaka M, Uezato A, Takiguchi K, Jitoku D, Hobo M, Nishikawa T. A distinctive abnormality of diffusion tensor imaging parameters in the fornix of patients with bipolar II disorder. Psychiatry Res Neuroimaging 2017; 266:66-72. [PMID: 28609689 DOI: 10.1016/j.pscychresns.2017.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 06/05/2017] [Accepted: 06/06/2017] [Indexed: 12/01/2022]
Abstract
Diffusion tensor imaging (DTI) studies have revealed a changed integrity in the white matter of bipolar disorder. However, only a few investigations have examined bipolar II disorder (BP-II). A cross-sectional study was conducted to compare thirty-eight patients with BP-II (mean age = 38.26 years, F/M = 19/19) with thirty-eight age- and gender-matched healthy controls (mean age = 34.45 years, F/M = 18/20). Tract Based Spatial Statistics (TBSS) analysis of the fractional anisotropy (FA) was done with age, gender and education years as covariates, then a complementary atlas-based region-of-interest (ROI) analysis including the axial diffusivity (AD) and radial diffusivity (RD) was conducted to obtain further information. The patients with BP-II showed a significant decrease in FA in the corpus callosum (commissure fibers), fornix (association fibers) and right anterior corona radiata (projection fibers) compared to the controls. Moreover, a significant increase in the RD was observed in all of the fibers of the BP-II patients, while the AD significantly increased only in the fornix of the patients. Thus, in addition to the abnormal integrity of the commissure and projection fibers, the present study suggested an involvement of the limbic association fibers in the pathophysiology of BP-II induced by a distinctive neuropathology.
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Affiliation(s)
- Akeo Kurumaji
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
| | - Michio Itasaka
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Akihito Uezato
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Kazuo Takiguchi
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Daisuke Jitoku
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Mizue Hobo
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Toru Nishikawa
- Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
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Rodríguez-Cano E, Alonso-Lana S, Sarró S, Fernández-Corcuera P, Goikolea JM, Vieta E, Maristany T, Salvador R, McKenna PJ, Pomarol-Clotet E. Differential failure to deactivate the default mode network in unipolar and bipolar depression. Bipolar Disord 2017; 19:386-395. [PMID: 28714580 DOI: 10.1111/bdi.12517] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 05/31/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Neuroimaging studies have revealed evidence of brain functional abnormalities in bipolar depressive disorder (BDD) and major depressive disorder (MDD). However, few studies to date have compared these two mood disorders directly. METHODS Matched groups of 26 BDD type I patients, 26 MDD patients and 26 healthy controls underwent functional magnetic resonance imaging (fMRI) while performing the n-back working memory task. A whole-brain ANOVA was used to compare the three groups and clusters of significant difference were examined further using region-of-interest (ROI) analysis. RESULTS The whole-brain ANOVA revealed a single cluster of significant difference in the medial frontal cortex. The BDD and MDD patients both showed failure to deactivate in this area compared to the controls. The BDD patients showed significantly greater failure of deactivation than the MDD patients, which was not accounted for by differences in severity or chronicity of illness between them. CONCLUSIONS Failure of deactivation, considered to reflect default mode network dysfunction, is present to a greater extent in bipolar than unipolar depression. The study of this network may be useful in the search for brain markers that distinguish the two disorders.
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Affiliation(s)
- Elena Rodríguez-Cano
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,Benito Menni Complex Assistencial en Salut Mental, Sant Boi, Spain.,Escola de Doctorat, Universitat de Barcelona, Barcelona, Spain
| | - Silvia Alonso-Lana
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,CIBERSAM, Barcelona, Spain
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,CIBERSAM, Barcelona, Spain
| | | | - José M Goikolea
- CIBERSAM, Barcelona, Spain.,Hospital Clinic, Bipolar Disorders Program, Barcelona, Spain
| | - Eduard Vieta
- CIBERSAM, Barcelona, Spain.,Hospital Clinic, Bipolar Disorders Program, Barcelona, Spain
| | | | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,CIBERSAM, Barcelona, Spain
| | - Peter J McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,CIBERSAM, Barcelona, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,CIBERSAM, Barcelona, Spain
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Ambrosi E, Arciniegas DB, Madan A, Curtis KN, Patriquin MA, Jorge RE, Spalletta G, Fowler JC, Frueh BC, Salas R. Insula and amygdala resting-state functional connectivity differentiate bipolar from unipolar depression. Acta Psychiatr Scand 2017; 136:129-139. [PMID: 28369737 PMCID: PMC5464981 DOI: 10.1111/acps.12724] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Distinguishing depressive episodes due to bipolar disorder (BD) or major depressive disorder (MDD) solely on clinical grounds is challenging. We aimed at comparing resting-state functional connectivity (rsFC) of regions subserving emotional regulation in similarly depressed BD and MDD. METHOD We enrolled 76 in-patients (BD, n = 36; MDD, n = 40) and 40 healthy controls (HC). A seed-based approach was used to identify regions showing different rsFC with the insula and the amygdala. Insular and amygdalar parcellations were then performed along with diagnostic accuracy of the main findings. RESULTS Lower rsFC between the left insula and the left mid-dorsolateral prefrontal cortex and between bilateral insula and right frontopolar prefrontal cortex (FPPFC) was observed in BD compared to MDD and HC. These results were driven by the dorsal anterior and posterior insula (PI). Lower rsFC between the right amygdala and the left anterior hippocampus was observed in MDD compared to BD and HC. These results were driven by the centromedial and laterobasal amygdala. Left PI/right FPPC rsFC showed 78% accuracy differentiating BD and MDD. CONCLUSION rsFC of amygdala and insula distinguished between depressed BD and MDD. The observed differences suggest the possibility of differential pathophysiological mechanisms of emotional dysfunction in bipolar and unipolar depression.
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Affiliation(s)
- Elisa Ambrosi
- Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Baylor College of Medicine, Houston, TX, USA,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA,The Menninger Clinic, Houston TX, USA,IRCCS Santa Lucia Foundation, Department of Clinical and Behavioral Neurology, Rome, Italy
| | - David B Arciniegas
- Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Baylor College of Medicine, Houston, TX, USA,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Alok Madan
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA,The Menninger Clinic, Houston TX, USA
| | - Kaylah N Curtis
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA,Micheal E DeBakey VA Medical Center, Houston TX, USA
| | - Michelle A Patriquin
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA,The Menninger Clinic, Houston TX, USA
| | - Ricardo E Jorge
- Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Baylor College of Medicine, Houston, TX, USA,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA,Micheal E DeBakey VA Medical Center, Houston TX, USA
| | - Gianfranco Spalletta
- Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Baylor College of Medicine, Houston, TX, USA,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA,IRCCS Santa Lucia Foundation, Department of Clinical and Behavioral Neurology, Rome, Italy
| | - J Christopher Fowler
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA,The Menninger Clinic, Houston TX, USA
| | - B Christopher Frueh
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA,Department of Psychology, University of Hawaii, Hilo, HI
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA,Micheal E DeBakey VA Medical Center, Houston TX, USA,Corresponding Author: Ramiro Salas, PhD, Baylor College of Medicine, One Baylor Plaza – room A277 Houston, TX 77030, USA. ; TE 713-798-3502; Fax 713-798-4488
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Prisciandaro JJ, Tolliver BK, Prescot AP, Brenner HM, Renshaw PF, Brown TR, Anton RF. Unique prefrontal GABA and glutamate disturbances in co-occurring bipolar disorder and alcohol dependence. Transl Psychiatry 2017; 7:e1163. [PMID: 28675386 PMCID: PMC5538121 DOI: 10.1038/tp.2017.141] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/09/2017] [Accepted: 05/15/2017] [Indexed: 12/25/2022] Open
Abstract
Bipolar disorder (BD) and alcohol dependence (AD) frequently co-occur, and co-occurring BD and AD are associated with devastating public health costs. Minimal neurobiological research exists to guide the development of effective treatments for this treatment-resistant population. We believe the present study represents the first investigation of prefrontal gamma-aminobutyric acid (GABA) and glutamate levels in co-occurring BD and current AD. The participants were 78 individuals who met DSM-IV criteria for BD I/II and current AD (n=20), BD I/II alone (n=19), current AD alone (n=20) or no diagnosis (n=19). The participants completed a baseline diagnostic visit, then returned approximately 4 days later for a two-dimensional J-resolved proton magnetic resonance spectroscopy (1H-MRS) acquisition in dorsal anterior cingulate cortex (dACC). All participants were required to demonstrate ⩾1 week of abstinence from alcohol/drugs via serial biomarker testing before 1H-MRS. A 2 × 2 factorial analysis of variance of cerebrospinal fluid (CSF)-corrected GABA/water concentrations demonstrated a significant BD × AD interaction (F=2.91, P<0.05), signifying uniquely low levels of GABA in BD+AD; this effect doubled when the sample was restricted to individuals who consumed alcohol within 2 weeks of 1H-MRS. There were no overall effects of BD/AD on CSF-corrected glutamate/water levels. However, the BD × AD interaction, signifying uniquely low levels of glutamate in BD+AD, approached statistical significance (F=3.83, P=0.06) in individuals who consumed alcohol within 2 weeks of 1H-MRS. The dACC GABA levels were significantly, negatively associated with Barratt Impulsiveness Scale (r=-0.28, P=0.02) and Obsessive Compulsive Drinking Scale (r=-0.35, P<0.01) scores. If replicated, these results may suggest that future treatment studies should preferentially evaluate therapeutics in BD+AD known to increase prefrontal GABA and glutamate levels.
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Affiliation(s)
- J J Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, PO Box 250861, Charleston, SC 29425, USA. E-mail:
| | - B K Tolliver
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - A P Prescot
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - H M Brenner
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - P F Renshaw
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - T R Brown
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
| | - R F Anton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Zhu Q, Wang J, Shen C, Fan H, Zhang B, Ma G, Lu Y, Wang W. Inhibitory brainstem reflexes under external emotional-stimuli in bipolar I and II disorders. BMC Psychiatry 2017; 17:224. [PMID: 28629452 PMCID: PMC5477268 DOI: 10.1186/s12888-017-1390-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Bipolar disorder types I (BD I) and II (BD II) might present different dysfunctions of the cortex and brainstem, as reflected by the second exteroceptive suppression period of temporalis muscle activity (ES2) under different stimuli of external emotions. METHODS This study included 30 BD I and 20 BD II patients, and 40 healthy volunteers. All participants were invited to answer the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik-van Praag Depression inventory, as well as to undergo the ES2 test under external emotional-stimuli (emotional pictures plus sounds) of Disgust, Erotica, Fear, Happiness, and Sadness. RESULTS The scale scores were elevated in both patient groups, but were not correlated with ES2 parameters. Compared to healthy controls, BD I showed prolonged ES2 latency under Erotica, and their perceived happiness and sadness intensities were negatively correlated with the respective ES2 durations, while BD II showed prolonged ES2 latencies under Disgust and Happiness, and shortened ES2 durations under Disgust, Happiness and Sadness. Moreover, ES2 duration under Sadness was significantly shorter in BD II than that in BD I. CONCLUSIONS The cortico-brainstem inhibitory dysfunctions in BD I and BD II was different, and this difference was independent of the patient's ongoing emotions. Our study thus provides some hints to distinguish the two types of bipolar disorders.
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Affiliation(s)
- Qisha Zhu
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Jiawei Wang
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Chanchan Shen
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Hongying Fan
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Bingren Zhang
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Guorong Ma
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Yanxia Lu
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang, 310058, China.
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Arjmand S, Behzadi M, Stephens GJ, Ezzatabadipour S, Seifaddini R, Arjmand S, Shabani M. A Brain on a Roller Coaster: Can the Dopamine Reward System Act as a Protagonist to Subdue the Ups and Downs of Bipolar Disorder? Neuroscientist 2017; 24:423-439. [DOI: 10.1177/1073858417714226] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
One of the most interesting but tenebrous parts of the bipolar disorder (BD) story is the switch between (hypo)mania and depression, which can give bipolar patients a thrilling, but somewhat perilous, ‘ride’. Numerous studies have pointed out that there are some recognizable differences (either state-dependent or state-independent) in several brain regions of people with BD, including components of the brain’s reward system. Understanding the underpinning mechanisms of high and low mood statuses in BD has potential, not only for the development of highly specific and selective pharmaceutical agents, but also for better treatment approaches and psychological interventions to manage BD and, thus, give patients a safer ride. Herein, we review evidence that supports involvement of the reward system in the pathophysiology of mood swings, with the main focus on the mesocorticolimbic dopaminergic neural circuitry. Principally using findings from neuroimaging studies, we aim to signpost readers as to how mood alterations may affect different areas of the reward system and how antipsychotic drugs can influence the activity of these brain areas. Finally, we critically evaluate the hypothesis that the mesocorticolimbic dopamine reward system may act as a functional rheostat for different mood states.
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Affiliation(s)
- Shokouh Arjmand
- Kerman Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Mina Behzadi
- Kerman Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Gary J. Stephens
- School of Pharmacy, Reading University, Whiteknights, Reading, UK
| | - Sara Ezzatabadipour
- Kerman Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Rostam Seifaddini
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahrad Arjmand
- Department of Psychology, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Mohammad Shabani
- Kerman Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
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Delaparte L, Yeh FC, Adams P, Malchow A, Trivedi MH, Oquendo MA, Deckersbach T, Ogden T, Pizzagalli DA, Fava M, Cooper C, McInnis M, Kurian BT, Weissman MM, McGrath PJ, Klein DN, Parsey RV, DeLorenzo C. A comparison of structural connectivity in anxious depression versus non-anxious depression. J Psychiatr Res 2017; 89:38-47. [PMID: 28157545 PMCID: PMC5374003 DOI: 10.1016/j.jpsychires.2017.01.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 12/16/2016] [Accepted: 01/19/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) and anxiety disorders are highly co-morbid. Research has shown conflicting evidence for white matter alteration and amygdala volume reduction in mood and anxiety disorders. To date, no studies have examined differences in structural connectivity between anxious depressed and non-anxious depressed individuals. This study compared fractional anisotropy (FA) and density of selected white matter tracts and amygdala volume between anxious depressed and non-anxious depressed individuals. METHODS 64- direction DTI and T1 scans were collected from 110 unmedicated subjects with MDD, 39 of whom had a co-morbid anxiety disorder diagnosis. Region of interest (ROI) and tractography methods were performed to calculate amygdala volume and FA in the uncinate fasciculus, respectively. Diffusion connectometry was performed to identify whole brain group differences in white matter health. Correlations were computed between biological and clinical measures. RESULTS Tractography and ROI analyses showed no significant differences between bilateral FA values or bilateral amygdala volumes when comparing the anxious depressed and non-anxious depressed groups. The diffusion connectometry analysis showed no significant differences in anisotropy between the groups. Furthermore, there were no significant relationships between MRI-based and clinical measures. CONCLUSION The lack of group differences could indicate that structural connectivity and amygdalae volumes of those with anxious-depression are not significantly altered by a co-morbid anxiety disorder. Improving understanding of anxiety co-morbid with MDD would facilitate development of treatments that more accurately target the underlying networks.
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Affiliation(s)
- Lauren Delaparte
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA; Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA.
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pittsburgh
| | - Phil Adams
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, New York
| | - Ashley Malchow
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Madhukar H. Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Maria A. Oquendo
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, New York
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Todd Ogden
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, New York
| | | | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Crystal Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Melvin McInnis
- Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, Michigan
| | - Benji T. Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Myrna M. Weissman
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, New York
| | - Patrick J. McGrath
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, New York
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | - Ramin V. Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, New York,Department of Radiology, Stony Brook University, Stony Brook, New York
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Phillips C. Physical Activity Modulates Common Neuroplasticity Substrates in Major Depressive and Bipolar Disorder. Neural Plast 2017; 2017:7014146. [PMID: 28529805 PMCID: PMC5424494 DOI: 10.1155/2017/7014146] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/10/2017] [Accepted: 03/16/2017] [Indexed: 12/13/2022] Open
Abstract
Mood disorders (MDs) are chronic, recurrent mental diseases that affect millions of individuals worldwide. Although the biogenic amine model has provided some clinical utility, a need remains to better understand the interrelated mechanisms that contribute to neuroplasticity deficits in MDs and the means by which various therapeutics mitigate them. Of those therapeutics being investigated, physical activity (PA) has shown clear and consistent promise. Accordingly, the aims of this review are to (1) explicate key modulators, processes, and interactions that impinge upon multiple susceptibility points to effectuate neuroplasticity deficits in MDs; (2) explore the putative mechanisms by which PA mitigates these features; (3) review protocols used to induce the positive effects of PA in MDs; and (4) highlight implications for clinicians and researchers.
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Riederer F, Landmann G, Gantenbein AR, Stockinger L, Egloff N, Sprott H, Schleinzer W, Pirrotta R, Dumat W, Luechinger R, Baumgartner C, Kollias S, Sándor PS. Nondermatomal somatosensory deficits in chronic pain are associated with cerebral grey matter changes. World J Biol Psychiatry 2017; 18:227-238. [PMID: 26492569 DOI: 10.3109/15622975.2015.1073356] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Widespread sensory deficits occur in 20-40% of chronic pain patients on the side of pain, independent of pain aetiology, and are known as nondermatomal sensory deficits (NDSDs). NDSDs can occur in absence of central or peripheral nervous system lesions. We hypothesised that NDSDs were associated with cerebral grey matter changes in the sensory system and in pain processing regions, detectable with voxel-based morphometry. METHODS Twenty-five patients with NDSDs, 23 patients without NDSDs ("pain-only"), and 29 healthy controls were studied with high resolution structural MRI of the brain. A comprehensive clinical and psychiatric evaluation based on Diagnostic and Statistical Manual was performed in all patients. RESULTS Patients with NDSDs and "pain-only" did not differ concerning demographic data and psychiatric diagnoses, although anxiety scores (HADS-A) were higher in patients with NDSDs. In patients with NDSDs, grey matter increases were found in the right primary sensory cortex, thalamus, and bilaterally in lateral temporal regions and the hippocampus/fusiform gyrus. "Pain-only" patients showed a bilateral grey matter increase in the posterior insula and less pronounced changes in sensorimotor cortex. CONCLUSIONS Dysfunctional sensory processing in patients with NDSDs is associated with complex changes in grey matter volume, involving the somatosensory system and temporal regions.
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Affiliation(s)
- Franz Riederer
- a Department of Neurology , University Hospital Zurich , Switzerland.,g University of Zurich , Switzerland.,h Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Neurological Center Rosenhuegel , Vienna , Austria
| | - Gunther Landmann
- b Centre for Pain Medicine , Swiss Paraplegic Centre , Nottwil , Switzerland
| | - Andreas R Gantenbein
- a Department of Neurology , University Hospital Zurich , Switzerland.,f RehaClinic , Bad Zurzach/Baden , Switzerland.,g University of Zurich , Switzerland
| | - Lenka Stockinger
- b Centre for Pain Medicine , Swiss Paraplegic Centre , Nottwil , Switzerland
| | - Niklaus Egloff
- c Psychosomatic Division , C.L. Lory-Haus, Department of General Internal Medicine, Inselspital, University Hospital Bern , Switzerland
| | - Haiko Sprott
- e Arztpraxis Hottingen , Zurich , Switzerland , CH-8053.,g University of Zurich , Switzerland
| | - Wolfgang Schleinzer
- c Psychosomatic Division , C.L. Lory-Haus, Department of General Internal Medicine, Inselspital, University Hospital Bern , Switzerland
| | - Roberto Pirrotta
- i Department of Psychiatry , University Hospital Zurich , Switzerland
| | - Wolfgang Dumat
- b Centre for Pain Medicine , Swiss Paraplegic Centre , Nottwil , Switzerland
| | - Roger Luechinger
- j Institute for Biomedical Engineering , Swiss Federal Institute of Technology and the University of Zurich , Switzerland
| | - Christoph Baumgartner
- h Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, Neurological Center Rosenhuegel , Vienna , Austria
| | - Spyridon Kollias
- d Department of Neuroradiology, University Hospital Zurich , Switzerland
| | - Peter S Sándor
- f RehaClinic , Bad Zurzach/Baden , Switzerland.,g University of Zurich , Switzerland
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López-Jaramillo C, Vargas C, Díaz-Zuluaga AM, Palacio JD, Castrillón G, Bearden C, Vieta E. Increased hippocampal, thalamus and amygdala volume in long-term lithium-treated bipolar I disorder patients compared with unmedicated patients and healthy subjects. Bipolar Disord 2017; 19:41-49. [PMID: 28239952 DOI: 10.1111/bdi.12467] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 10/12/2016] [Accepted: 01/04/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Magnetic resonance imaging (MRI) studies in bipolar I disorder (BD-I) suggest that lithium is associated with increased volumes of cortico-limbic structures. However, more rigorous control of confounding factors is needed to obtain further support for this hypothesis. The aim of the present study was to assess differences in brain volumes among long-term lithium-treated BD-I patients, unmedicated BD-I patients, and healthy controls. METHODS This was a cross-sectional study with 32 euthymic BD-I patients (16 on lithium monotherapy for a mean of 180 months, and 16 receiving no medication for at least the 2 months prior to the study) and 20 healthy controls. Patients were euthymic (Hamilton Depression Rating Scale [HDRS] <6 and Young Mania Rating Scale [YMRS] <7) and had not taken psychotropic medications other than lithium for at least 6 months. Brain images were acquired on a 1.5 Tesla MRI (Phillips, Amsterdam, The Netherlands) and segmented to generate volumetric measures of cortical and subcortical brain areas, ventricles and global brain. RESULTS Significant differences were found in the volumes of the left amygdala (P=.0003), right amygdala (P=.030), left hippocampus (P=.022), left thalamus (P=.022), and right thalamus (P=.019) in long-term lithium-treated BD-I patients, compared to unmedicated patients and controls, after multivariable adjustment. No differences were observed in global brain volume or in ventricular size among the three groups. Likewise, there was no correlation between serum lithium levels and the increase in size in the described brain areas. CONCLUSIONS The structural differences found among the three groups, and specifically those between long-term lithium-treated and unmedicated BD-I patients, indicate increased limbic structure volumes in lithium-treated patients.
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Affiliation(s)
- Carlos López-Jaramillo
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellin, Colombia
| | - Cristian Vargas
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellin, Colombia
| | - Ana M Díaz-Zuluaga
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellin, Colombia
| | - Juan David Palacio
- Research Group in Psychiatry GIPSI, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellin, Colombia
| | - Gabriel Castrillón
- Research Group, Instituto de Alta Tecnología Médica IATM, Medellin, Colombia
| | - Carrie Bearden
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Eduard Vieta
- Department of Psychiatry, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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143
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Sun ZY, Houenou J, Duclap D, Sarrazin S, Linke J, Daban C, Hamdani N, d’Albis MA, Le Corvoisier P, Guevara P, Delavest M, Bellivier F, Almeida J, Versace A, Poupon C, Leboyer M, Phillips M, Wessa M, Mangin JF, Mangin JF. Shape analysis of the cingulum, uncinate and arcuate fasciculi in patients with bipolar disorder. J Psychiatry Neurosci 2017; 42:27-36. [PMID: 28234596 PMCID: PMC5373709 DOI: 10.1503/jpn.150291] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Abnormal maturation of brain connectivity is supposed to underlie the dysfunctional emotion regulation in patients with bipolar disorder (BD). To test this hypothesis, white matter integrity is usually investigated using measures of water diffusivity provided by MRI. Here we consider a more intuitive aspect of the morphometry of the white matter tracts: the shape of the fibre bundles, which is associated with neurodevelopment. We analyzed the shape of 3 tracts involved in BD: the cingulum (CG), uncinate fasciculus (UF) and arcuate fasciculus (AF). METHODS We analyzed diffusion MRI data in patients with BD and healthy controls. The fibre bundles were reconstructed using Q-ball-based tractography and automated segmentation. Using Isomap, a manifold learning method, the differences in the shape of the reconstructed bundles were visualized and quantified. RESULTS We included 112 patients and 82 controls in our analysis. We found the left AF of patients to be further extended toward the temporal pole, forming a tighter hook than in controls. We found no significant difference in terms of shape for the left UF, the left CG or the 3 right fasciculi. However, in patients compared with controls, the ventrolateral branch of the left UF in the orbitofrontal region had a tendency to be larger, and the left CG of patients had a tendency to be smaller in the frontal lobe and larger in the parietal lobe. LIMITATIONS This was a cross-sectional study. CONCLUSION Our results suggest neurodevelopmental abnormalities in the left AF in patients with BD. The statistical tendencies observed for the left UF and left CG deserve further study.
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Affiliation(s)
| | - Josselin Houenou
- Correspondence to: J. Houenou, INSERM U955, IMRB, Equipe 15, Psychiatrie Translationnelle, 40 rue de Mesly, 94000 Créteil, France;
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jean-François Mangin
- From the UNATI, Neurospin, I2BM, CEA Saclay, Gif-Sur-Yvette, France (Sun, Mangin); the UNIACT, Psychiatry Team, Neurospin, I2BM, CEA Saclay, Gif-Sur-Yvette, France (Houenou, Sarrazin); INSERM, U955, IMRB, Equipe 15 Psychiatrie Translationnelle, Créteil F-94000, France (Houenou, Sarrazin, Hamdani, d'Albis, Leboyer); the Fondation Fondamental, Créteil F-94010, France (Houenou, Sarrazin, Hamdani, d'Albis, Delavest, Bellivier, Leboyer); the AP-HP, Hôpitaux Universitaires Mondor, Pôle de Psychiatrie, DHU PePsy, Université Paris Est, Créteil F-94000, France (Sarrazin, Daban, Hamdani, d'Albis, Leboyer); the UNIRS, Neurospin, I2BM, CEA Saclay, Gif-Sur-Yvette, France (Duclap, Poupon); the Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg University, Mainz, Germany (Linke, Wessa); INSERM, Centre d'Investigation Clinique 1430 and APHP, GH Henri Mondor, Créteil F-94000, France (Le Corvoisier); the University of Concepción, Concepción, Chile (Guevara); the AP-HP, Groupe Saint-Louis, Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France (Delavest, Bellivier); the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medecine, Pittsburgh, PA, USA (Almeida, Versace, Phillips); the Faculté de médecine, Universite Paris Est, Créteil, France (Leboyer); and the CATI Multicenter Neuroimaging Platform, France (Sun, Poupon, Mangin)
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Brady RO, Tandon N, Masters GA, Margolis A, Cohen BM, Keshavan M, Öngür D. Differential brain network activity across mood states in bipolar disorder. J Affect Disord 2017; 207:367-376. [PMID: 27744225 PMCID: PMC5107137 DOI: 10.1016/j.jad.2016.09.041] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/21/2016] [Accepted: 09/27/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND This study aimed to identify how the activity of large-scale brain networks differs between mood states in bipolar disorder. The authors measured spontaneous brain activity in subjects with bipolar disorder in mania and euthymia and compared these states to a healthy comparison population. METHODS 23 subjects with bipolar disorder type I in a manic episode, 24 euthymic bipolar I subjects, and 23 matched healthy comparison (HC) subjects underwent resting state fMRI scans. Using an existing parcellation of the whole brain, we measured functional connectivity between brain regions and identified significant differences between groups. RESULTS In unbiased whole-brain analyses, functional connectivity between parietal, occipital, and frontal nodes within the dorsal attention network (DAN) were significantly greater in mania than euthymia or HC subjects. In the default mode network (DMN), connectivity between dorsal frontal nodes and the rest of the DMN differentiated both mood state and diagnosis. LIMITATIONS The bipolar groups were separate cohorts rather than subjects imaged longitudinally across mood states. CONCLUSIONS Bipolar mood states are associated with highly significant alterations in connectivity in two large-scale brain networks. These same networks also differentiate bipolar mania and euthymia from a HC population. State related changes in DAN and DMN connectivity suggest a circuit based pathology underlying cognitive dysfunction as well as activity/reactivity in bipolar mania. Altered activities in neural networks may be biomarkers of bipolar disorder diagnosis and mood state that are accessible to neuromodulation and are promising novel targets for scientific investigation and possible clinical intervention.
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Affiliation(s)
- Roscoe O. Brady
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts,Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts,Corresponding author. 75 Fenwood Road, Room 616, Boston, MA 02115. Tel.: 617 754 1261; Fax: 617 754 1250.
| | - Neeraj Tandon
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Grace A. Masters
- Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Allison Margolis
- Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Bruce M. Cohen
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts,Program for Neuropsychiatric Research, McLean Hospital, Belmont, Massachusetts
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Dost Öngür
- Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Neuroprotection after a first episode of mania: a randomized controlled maintenance trial comparing the effects of lithium and quetiapine on grey and white matter volume. Transl Psychiatry 2017; 7:e1011. [PMID: 28117843 PMCID: PMC5545739 DOI: 10.1038/tp.2016.281] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 11/13/2016] [Accepted: 11/27/2016] [Indexed: 01/13/2023] Open
Abstract
Lithium and quetiapine are effective treatments for bipolar disorder, but their potential neuroprotective effects in humans remain unclear. A single blinded equivalence randomized controlled maintenance trial was conducted in a prospective cohort of first-episode mania (FEM) patients (n=26) to longitudinally compare the putative protective effects of lithium and quetapine on grey and white matter volume. A healthy control sample was also collected (n=20). Using structural MRI scans, voxel-wise grey and white matter volumes at baseline and changes over time in response to treatment were investigated. Patients were assessed at three time points (baseline, 3 and 12-month follow-up), whereas healthy controls were assessed at two time points (baseline and 12-month follow-up). Patients were randomized to lithium (serum level 0.6 mmol l-1, n=20) or quetiapine (flexibly dosed up to 800 mg per day, n=19) monotherapy. At baseline, compared with healthy control subjects, patients with FEM showed reduced grey matter in the orbitofrontal cortex, anterior cingulate, inferior frontal gyrus and cerebellum. In addition, patients had reduced internal capsule white matter volume bilaterally (t1,66>3.20, P<0.01). Longitudinally, there was a significant treatment × time effect only in the white matter of the left internal capsule (F2,112=8.54, P<0.01). Post hoc testing showed that, compared with baseline, lithium was more effective than quetiapine in slowing the progression of white matter volume reduction after 12 months (t1,24=3.76, P<0.01). Our data support the role of lithium but not quetiapine therapy in limiting white matter reduction early in the illness course after FEM.
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146
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Chase HW, Hafeman DM. A Developmental Path Less Traveled: Large-Scale Networks and Age in Pediatric Bipolar Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:5-6. [PMID: 29560887 DOI: 10.1016/j.bpsc.2016.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 11/18/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Danella M Hafeman
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Zhang L, vander Meer L, Opmeer EM, Marsman JBC, Ruhé HG, Aleman A. Altered functional connectivity during self- and close other-reflection in patients with bipolar disorder with past psychosis and patients with schizophrenia. Neuropsychologia 2016; 93:97-105. [DOI: 10.1016/j.neuropsychologia.2016.09.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/13/2016] [Accepted: 09/26/2016] [Indexed: 01/14/2023]
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148
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Cyprien F, de Champfleur NM, Deverdun J, Olié E, Le Bars E, Bonafé A, Mura T, Jollant F, Courtet P, Artero S. Corpus callosum integrity is affected by mood disorders and also by the suicide attempt history: A diffusion tensor imaging study. J Affect Disord 2016; 206:115-124. [PMID: 27472413 DOI: 10.1016/j.jad.2016.07.026] [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: 10/21/2015] [Revised: 06/24/2016] [Accepted: 07/18/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Some MRI studies have noted alterations in the corpus callosum (CC) white matter integrity of individuals with mood disorders and also in patients with suicidal behavior. We investigated the specific impact of suicidal behavior on CC integrity in mood disorders. METHODS CC structural changes were assessed by diffusion tensor imaging (DTI) in 121 women 18-50-year-old): 41 with bipolar disorder (BD), 50 with major depressive disorder (MDD) and 30 healthy controls (HC). Fractional anisotropy (FA) and DTI metrics were calculated for the genu, body and splenium of CC and compared in the three groups by MANCOVA. Then, they were re-analyzed relative to the suicide attempt history within the MDD and BD groups and to the suicide number/severity. RESULTS FA values for the CC genu and body were lower in non-suicide attempters with BD than with MDD and in HC. Conversely, FA values for all CC regions were significantly lower in suicide attempters with BD than in HC. Finally, higher number of suicide attempts (>2) and elevated Suicidal Intent Scale score were associated with significant splenium alterations. LIMITATIONS Limitations include the cross-sectional design (non-causal study), the potential influence of medications and concerns about the generalizability to men. CONCLUSION Genu and body are altered in non-suicide attempters with BD, while splenium is specifically altered in suicide attempters, independently from their psychiatric status. History of suicide attempts may be a source of heterogeneity in the association between CC alterations and BD and may partially explain the variable results of previous studies.
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Affiliation(s)
- Fabienne Cyprien
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France; CHRU Montpellier, Montpellier F-34093, France
| | | | - Jérémy Deverdun
- University of Montpellier, Montpellier F-34000, France; CHRU Montpellier, Montpellier F-34093, France; CNRS, UMR 5221, Montpellier F-34093, France
| | - Emilie Olié
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France; CHRU Montpellier, Montpellier F-34093, France
| | | | - Alain Bonafé
- University of Montpellier, Montpellier F-34000, France; CHRU Montpellier, Montpellier F-34093, France
| | - Thibault Mura
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France; CHRU Montpellier, Montpellier F-34093, France; CIC 1001, Montpellier F-34000, France
| | - Fabrice Jollant
- McGill University, Department of Psychiatry, Canada; Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal, Québec, Canada
| | - Philippe Courtet
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France; CHRU Montpellier, Montpellier F-34093, France; Fondamental Foundation, France.
| | - Sylvaine Artero
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France.
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149
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Comparing Brain Morphometry Across Multiple Childhood Psychiatric Disorders. J Am Acad Child Adolesc Psychiatry 2016; 55:1027-1037.e3. [PMID: 27871637 DOI: 10.1016/j.jaac.2016.08.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 07/30/2016] [Accepted: 09/14/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE In both children and adults, psychiatric illness is associated with structural brain alterations, particularly in the prefrontal cortex (PFC). However, most studies compare gray matter volume (GMV) in healthy volunteers (HVs) to one psychiatric group. We compared GMV among youth with anxiety disorders, bipolar disorder (BD), disruptive mood dysregulation disorder (DMDD), attention-deficit/hyperactivity disorder (ADHD), and HVs. METHOD 3-Tesla T1-weighted magnetic resonance imaging scans were acquired in 184 youths (39 anxious, 20 BD, 52 DMDD, 20 ADHD, and 53 HV). Voxel-based morphometry analyses were conducted. One-way analysis of variance tested GMV differences with whole-brain familywise error (p < .05) correction; secondary, exploratory whole-brain analyses used a threshold of p < .001, ≥200 voxels. Given recent frameworks advocating dimensional approaches in psychopathology research, we also tested GMV associations with continuous anxiety, irritability, and inattention symptoms. RESULTS Specificity emerged in the left dorsolateral PFC (dlPFC), which differed among youth with BD, anxiety, and HVs; GMV was increased in youth with anxiety, but decreased in BD, relative to HVs. Secondary analyses revealed BD-specific GMV decreases in the right lateral PFC, right dlPFC, and dorsomedial PFC, and also anxiety-specific GMV increases in the left dlPFC, right ventrolateral PFC, frontal pole, and right parahippocampal gyrus/lingual gyrus. Both BD and DMDD showed decreased GMV relative to HVs in the right dlPFC/superior frontal gyrus. GMV was not associated with dimensional measures of anxiety, irritability, or ADHD symptoms. CONCLUSION Both disorder-specific and shared GMV differences manifest in pediatric psychopathology. Some differences were specific to anxiety disorders, others specific to BD, and others shared between BD and DMDD. Further developmental research might map commonalities and differences of structure and function in diverse pediatric psychopathologies.
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150
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Laidi C, Houenou J. Brain functional effects of psychopharmacological treatments in bipolar disorder. Eur Neuropsychopharmacol 2016; 26:1695-1740. [PMID: 27617780 DOI: 10.1016/j.euroneuro.2016.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 06/06/2016] [Accepted: 06/18/2016] [Indexed: 12/29/2022]
Abstract
Functional magnetic resonance imaging (fMRI) studies have contributed to the understanding of bipolar disorder. However the effect of medication on brain activation remains poorly understood. We conducted an extensive literature review on PubMed and ScienceDirect to investigate the influence of medication in fMRI studies, including both longitudinal and cross-sectional studies, which aimed at assessing this influence. Although we reported all reviewed studies, we gave greater emphasis to studies with the most robust methodology. One hundred and forty studies matched our inclusion criteria and forty-seven studies demonstrated an effect of pharmacological treatment on fMRI blood oxygen level dependent (BOLD) signal in adults and children with bipolar disorder. Out of these studies, nineteen were longitudinal. Most of cross-sectional studies suffered from methodological bias, due to post-hoc analyses performed on a limited number of patients and did not find any effect of medication. However, both longitudinal and cross-sectional studies showing an impact of treatment tend to suggest that medication prescribed to patients with bipolar disorder mostly influenced brain activation in prefrontal regions, when measured by tasks involving emotional regulation and processing as well as non-emotional cognitive tasks. FMRI promises to elucidate potential new biomarkers in bipolar disorder and could be used to evaluate the effect of new therapeutic compounds. Further research is needed to disentangle the effect of medication and the influence of the changes in mood state on brain activation in patients with bipolar disorder.
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Affiliation(s)
- Charles Laidi
- APHP, Mondor University Hospitals, DHU PePsy, Psychiatry Department, Créteil, France; INSERM, U955, IMRB, Translational Psychiatry, Créteil, France; Faculté de médecine de Créteil, Université Paris Est Créteil (UPEC), France; Fondation FondaMental, Créteil, France; UNIACT Lab, Psychiatry Team, NeuroSpin, I2BM, CEA Saclay, Gif Sur Yvette, Cedex, France.
| | - Josselin Houenou
- APHP, Mondor University Hospitals, DHU PePsy, Psychiatry Department, Créteil, France; INSERM, U955, IMRB, Translational Psychiatry, Créteil, France; Faculté de médecine de Créteil, Université Paris Est Créteil (UPEC), France; Fondation FondaMental, Créteil, France; UNIACT Lab, Psychiatry Team, NeuroSpin, I2BM, CEA Saclay, Gif Sur Yvette, Cedex, France
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