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Alrfooh A, Casten LG, Richards JG, Wemmie JA, Magnotta VA, Fiedorowicz JG, Michaelson J, Williams AJ, Gaine ME. Investigating the relationship between DNA methylation, genetic variation, and suicide attempt in bipolar disorder. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.03.24305263. [PMID: 38633806 PMCID: PMC11023653 DOI: 10.1101/2024.04.03.24305263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Individuals with bipolar disorder are at increased risk for suicide, and this can be influenced by a range of biological, clinical, and environmental risk factors. Biological components associated with suicide include DNA modifications that lead to changes in gene expression. Common genetic variation and DNA methylation changes are some of the most frequent types of DNA findings associated with an increased risk for suicidal behavior. Importantly, the interplay between genetic predisposition and DNA methylation patterns is becoming more prevalent in genetic studies. We hypothesized that DNA methylation patterns in specific loci already genetically associated with suicide would be altered in individuals with bipolar disorder and a history of suicide attempt. To test this hypothesis, we searched the literature to identify common genetic variants (N=34) previously associated with suicidal thoughts and behaviors in individuals with bipolar disorder. We then created a customized sequencing panel that covered our chosen genomic loci. We profiled DNA methylation patterns from blood samples collected from bipolar disorder participants with suicidal behavior (N=55) and without suicidal behavior (N=51). We identified seven differentially methylated CpG sites and five differentially methylated regions between the two groups. Additionally, we found that DNA methylation changes in MIF and CACNA1C were associated with lethality or number of suicide attempts. Finally, we identified three meQTLs in SIRT1 , IMPA2 , and INPP1 . This study illustrates that DNA methylation is altered in individuals with bipolar disorder and a history of suicide attempts in regions known to harbor suicide-related variants.
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Ewald VAM, Purnell JR, Bruss JE, Barsotti EJ, Aldine AS, Mahachi KG, Wemmie JA, Magnotta VA, Boes AD, Parker KL, Fiedorowicz JG. Posterior Fossa Sub-Arachnoid Cysts Observed in Patients with Bipolar Disorder: a Retrospective Cohort Study. CEREBELLUM (LONDON, ENGLAND) 2023; 22:370-378. [PMID: 35568792 PMCID: PMC9659668 DOI: 10.1007/s12311-022-01408-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 11/29/2022]
Abstract
Posterior fossa arachnoid cysts (PFACs) are rare congenital abnormalities observed in 0.3 to 1.7% of the population and are traditionally thought to be benign. While conducting a neuroimaging study investigating cerebellar structure in bipolar disorder, we observed a higher incidence of PFACs in bipolar patients (5 of 75; 6.6%) compared to the neuronormative control group (1 of 54; 1.8%). In this report, we detail the cases of the five patients with bipolar disorder who presented with PFACs. Additionally, we compare neuropsychiatric measures and cerebellar volumes of these patients to neuronormative controls and bipolar controls (those with bipolar disorder without neuroanatomical abnormalities). Our findings suggest that patients with bipolar disorder who also present with PFACs may have a milder symptom constellation relative to patients with bipolar disorder and no neuroanatomical abnormalities. Furthermore, our observations align with prior literature suggesting an association between PFACs and psychiatric symptoms that warrants further study. While acknowledging sample size limitations, our primary aim in the present work is to highlight a connection between PFACs and BD-associated symptoms and encourage further study of cerebellar abnormalities in psychiatry.
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Affiliation(s)
- Victόria A Müller Ewald
- Department of Psychiatry, The University of Iowa, 195-207 Newton Road, Iowa City, IA, 52246, USA
| | - Jessica R Purnell
- Department of Psychiatry, The University of Iowa, 195-207 Newton Road, Iowa City, IA, 52246, USA
| | - Joel E Bruss
- Department of Neurology, The University of Iowa, Iowa City, IA, USA
| | - Ercole J Barsotti
- Department of Epidemiology, The University of Iowa, Iowa City, IA, USA
| | - Amro S Aldine
- Department of Radiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Kurayi G Mahachi
- Department of Epidemiology, The University of Iowa, Iowa City, IA, USA
| | - John A Wemmie
- Department of Psychiatry, The University of Iowa, 195-207 Newton Road, Iowa City, IA, 52246, USA
| | - Vincent A Magnotta
- Department of Psychiatry, The University of Iowa, 195-207 Newton Road, Iowa City, IA, 52246, USA
- Department of Radiology, The University of Iowa, Iowa City, IA, USA
- Department of Biomedical Engineering, The University of Iowa, Iowa City, IA, USA
| | - Aaron D Boes
- Department of Psychiatry, The University of Iowa, 195-207 Newton Road, Iowa City, IA, 52246, USA
- Department of Pediatrics, The University of Iowa, Iowa City, IA, USA
| | - Krystal L Parker
- Department of Psychiatry, The University of Iowa, 195-207 Newton Road, Iowa City, IA, 52246, USA.
| | - Jess G Fiedorowicz
- Brain and Mind Institute, University of Ottawa, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, ON, Canada
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3
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Lima CNC, Kovács EHC, Mirza S, Del Favero-Campbell A, Diaz AP, Quevedo J, Argue BMR, Richards JG, Williams A, Wemmie JA, Magnotta VA, Fiedorowicz JG, Soares JC, Gaine ME, Fries GR. Association between the epigenetic lifespan predictor GrimAge and history of suicide attempt in bipolar disorder. Neuropsychopharmacology 2023; 48:954-962. [PMID: 36878995 PMCID: PMC10156727 DOI: 10.1038/s41386-023-01557-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/07/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023]
Abstract
Bipolar disorder (BD) has been previously associated with premature mortality and aging, including acceleration of epigenetic aging. Suicide attempts (SA) are greatly elevated in BD and are associated with decreased lifespan, biological aging, and poorer clinical outcomes. We investigated the relationship between GrimAge, an epigenetic clock trained on time-to-death and associated with mortality and lifespan, and SA in two independent cohorts of BD individuals (discovery cohort - controls (n = 50), BD individuals with (n = 77, BD/SA) and without (n = 67, BD/non-SA) lifetime history of SA; replication cohort - BD/SA (n = 48) and BD/non-SA (n = 47)). An acceleration index for the GrimAge clock (GrimAgeAccel) was computed from blood DNA methylation (DNAm) and compared between groups with multiple general linear models. Differences in epigenetic aging from the discovery cohort were validated in the independent replication cohort. In the discovery cohort, controls, BD/non-SA, and BD/SA significantly differed on GrimAgeAccel (F = 5.424, p = 0.005), with the highest GrimAgeAccel in BD/SA (p = 0.004, BD/SA vs. controls). Within the BD individuals, BD/non-SA and BD/SA differed on GrimAgeAccel in both cohorts (p = 0.008) after covariate adjustment. Finally, DNAm-based surrogates revealed possible involvement of plasminogen activator inhibitor 1, leptin, and smoking pack-years in driving accelerated epigenetic aging. These findings pair with existing evidence that not only BD, but also SA, may be associated with an accelerated biological aging and provide putative biological mechanisms for morbidity and premature mortality in this population.
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Affiliation(s)
- Camila N C Lima
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
| | - Emese H C Kovács
- Department of Neuroscience and Pharmacology, The University of Iowa, 51 Newton Rd, 52242, Iowa City, IA, USA
| | - Salahudeen Mirza
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
- Institute of Child Development, University of Minnesota, 51 E River Rd, 55455, Minneapolis, MN, USA
| | - Alexandra Del Favero-Campbell
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
| | - Alexandre Paim Diaz
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Joao Quevedo
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
- Center of Excellence in Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 6767 Bertner Ave, 77030, Houston, TX, USA
| | - Benney M R Argue
- Pharmaceutical Sciences and Experimental Therapeutics, The University of Iowa, 180 South Grand Ave, 52242, Iowa City, IA, USA
| | - Jenny Gringer Richards
- Department of Radiology, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
| | - Aislinn Williams
- Department of Psychiatry, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, 169 Newton Rd, 52242, Iowa City, IA, USA
| | - John A Wemmie
- Department of Psychiatry, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
| | - Vincent A Magnotta
- Department of Radiology, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
- Department of Psychiatry, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
| | - Jess G Fiedorowicz
- University of Ottawa Brain and Mind Research Institute, Ottawa Hospital Research Institute, 501 Smyth, K1H 8L6, Ottawa, ON, Canada
| | - Jair C Soares
- Center of Excellence in Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 6767 Bertner Ave, 77030, Houston, TX, USA
| | - Marie E Gaine
- Pharmaceutical Sciences and Experimental Therapeutics, The University of Iowa, 180 South Grand Ave, 52242, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, 169 Newton Rd, 52242, Iowa City, IA, USA
| | - Gabriel R Fries
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA.
- Center of Excellence in Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA.
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 6767 Bertner Ave, 77030, Houston, TX, USA.
- Center for Precision Health, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, 7000 Fannin, 77030, Houston, TX, USA.
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Saleem A, Harmata G, Jain S, Voss MW, Fiedorowicz JG, Williams A, Shaffer JJ, Richards JG, Barsotti EJ, Sathyaputri L, Schmitz SL, Christensen GE, Long JD, Xu J, Wemmie JA, Magnotta VA. Functional Connectivity of the Cerebellar Vermis in Bipolar Disorder and Associations with Mood. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.02.526878. [PMID: 36778335 PMCID: PMC9915674 DOI: 10.1101/2023.02.02.526878] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Purpose Studies of the neural underpinnings of bipolar type I disorder have focused on the emotional control network. However, there is also growing evidence for cerebellar involvement, including abnormal structure, function, and metabolism. Here, we sought to assess functional connectivity of the cerebellum with the cerebrum in bipolar disorder and to assess whether any effects might depend on mood. Methods This cross-sectional study enrolled 128 participants with bipolar type I disorder and 83 control comparison participants who completed a 3T MRI scan, which included anatomical imaging as well as resting state BOLD imaging. Functional connectivity of the cerebellar vermis to all other brain regions was assessed. Based on quality control metrics of the fMRI data, 109 participants with bipolar disorder and 79 controls were used to in the statistical analysis comparing connectivity of the vermis as well as associations with mood. Potential impacts of medications were also explored. Results Functional connectivity of the cerebellar vermis in bipolar disorder was found to differ significantly between brain regions known to be involved in the control of emotion, motor function, and language. While connections with emotion and motor control areas were significantly stronger in bipolar disorder, connection to a region associated language production was significantly weaker. In the participants with bipolar disorder, ratings of depression and mania were inversely associated with vermis functional connectivity. No effect of medications on these connections were observed. Conclusion Together the findings suggest cerebellum may play a compensatory role in bipolar disorder and when it can no longer fulfill this role, depression and mania develop. The proximity of the cerebellar vermis to the skull may make this region a potential target for treatment with transcranial magnetic stimulation.
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Affiliation(s)
- Arshaq Saleem
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Gail Harmata
- Department of Radiology, University of Iowa, Iowa City, IA, 52242
| | - Shivangi Jain
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Michelle W. Voss
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Jess G. Fiedorowicz
- The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa Brain & Mind Research Institute, Ottawa ON Canada K1H 8L6
| | - Aislinn Williams
- Department of Psychiatry, University of Iowa, Iowa City, IA, 52242
| | | | | | | | - Leela Sathyaputri
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Samantha L. Schmitz
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Gary E. Christensen
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IA, 52242,Department of Radiation Oncology, University of Iowa, Iowa City, IA, 52242
| | - Jeffrey D. Long
- Department of Psychiatry, University of Iowa, Iowa City, IA, 52242,Department of Biostatistics, University of Iowa, Iowa City, IA, 52242
| | - Jia Xu
- Department of Radiology, University of Iowa, Iowa City, IA, 52242
| | - John A. Wemmie
- Department of Psychiatry, University of Iowa, Iowa City, IA, 52242,Veterans Affairs Medical Center, Iowa City, Iowa, USA,Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, Iowa, USA,Department of Neurosurgery, University of Iowa, Iowa City, IA, 52242
| | - Vincent A. Magnotta
- Department of Radiology, University of Iowa, Iowa City, IA, 52242,Department of Psychiatry, University of Iowa, Iowa City, IA, 52242,Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242
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5
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Distinct patterns of altered quantitative T1ρ and functional BOLD response associated with history of suicide attempts in bipolar disorder. Brain Imaging Behav 2022; 16:820-833. [PMID: 34601647 PMCID: PMC8975910 DOI: 10.1007/s11682-021-00552-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
Despite the high risk for suicide, relatively few studies have explored the relationship between suicide and brain imaging measures in bipolar disorder. In addition, fewer studies have explored the possibility that altered brain metabolism may be associated with suicide attempt. To begin to fill in these gaps, we evaluated functional (task based fMRI) and metabolic (quantitative T1ρ) differences associated with suicide attempt in participants with bipolar disorder. Thirty-nine participants with bipolar disorder underwent fMRI during a flashing checkerboard task and 27 also underwent quantitative T1ρ. The relationship between neuroimaging and history of suicide attempt was tested using multiple regression while adjusting for age, sex, and current mood state. Differences between two measures of suicide attempt (binary: yes/no and continuous: number of attempts) were quantified using the corrected Akaike Information Criterion. Participants who had attempted suicide had greater fMRI task-related activation in visual areas and the cerebellum. The number of suicide attempts was associated with a difference in BOLD response in the amygdala, prefrontal cortex, and cerebellum. Increased quantitative T1ρ was associated with number of suicide attempts in limbic, basal ganglia, and prefrontal cortex regions. This study is a secondary analysis with a modest sample size. Differences between measures of suicide history may be due to differences in statistical power. History of suicide was associated with limbic, prefrontal, and cerebellar alterations. Results comparing those with and without suicide attempts differed from results using number of suicide attempts, suggesting that these variables have different neurobiological underpinnings.
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6
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Argyropoulos GD, Christidi F, Karavasilis E, Velonakis G, Antoniou A, Bede P, Seimenis I, Kelekis N, Douzenis A, Papakonstantinou O, Efstathopoulos E, Ferentinos P. Cerebro-cerebellar white matter connectivity in bipolar disorder and associated polarity subphenotypes. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110034. [PMID: 32710925 DOI: 10.1016/j.pnpbp.2020.110034] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/08/2020] [Accepted: 07/12/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The cerebellum has a crucial role in mood regulation. While cerebellar grey matter (GM) alterations have been previously reported in bipolar disorder (BD), cerebro-cerebellar white matter (WM) connectivity alterations and cerebellar GM profiles have not been characterised in the context of predominant polarity (PP) and onset polarity (OP) subphenotypes of BD patients which is the aim of the present study. METHODS Forty-two euthymic BD patients stratified for PP and OP and 42 healthy controls (HC) were included in this quantitative neuroimaging study to evaluate cerebellar GM patterns and cerebro-cerebellar WM connections. Diffusion tensor tractography was used to characterise afferent and efferent cerebro-cerebellar tract integrity. False discovery rate corrections were applied in post-hoc comparisons. RESULTS BD patients exhibited higher fractional anisotropy (FA) in fronto-ponto-cerebellar tracts bilaterally compared to HC. Subphenotype-specific FA profiles were identified within the BD cohort. Regarding PP subgroups, we found FA changes in a) left contralateral fronto-ponto-cerebellar tract (depressive-PP > HC) and b) contralateral/ipsilateral fronto-ponto-cerebellar tracts bilaterally (manic-PP > HC). Regarding OP subgroups, we observed FA changes in a) left/right contralateral fronto-ponto-cerebellar tracts (depressive-OP > HC) and b) all fronto-ponto-cerebellar, most parieto-ponto-cerebellar and right contralateral occipito-ponto-cerebellar tracts (manic-OP>HC). In general, greater and more widespread cerebro-cerebellar changes were observed in manic-OP patients than in depressive-OP patients compared to HC. Manic-OP showed higher FA compared to depressive-OP patients in several afferent WM tracts. No GM differences were identified between BD and HC and across BD subgroups. CONCLUSIONS Our findings highlight fronto-ponto-cerebellar connectivity alterations in euthymic BD. Polarity-related subphenotypes have distinctive cerebro-cerebellar WM signatures with potential clinical and pathobiological implications.
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Affiliation(s)
- Georgios D Argyropoulos
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Foteini Christidi
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Efstratios Karavasilis
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Velonakis
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Antoniou
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Peter Bede
- Biomedical Imaging Laboratory, Sorbonne University, CNRS, INSERM, Paris, France; Computational Neuroimaging Group, Trinity College Dublin, Ireland
| | - Ioannis Seimenis
- Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Kelekis
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Douzenis
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Olympia Papakonstantinou
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathios Efstathopoulos
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Ferentinos
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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7
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Shaffer JJ, Mani M, Schmitz SL, Xu J, Owusu N, Wu D, Magnotta VA, Wemmie JA. Proton Exchange Magnetic Resonance Imaging: Current and Future Applications in Psychiatric Research. Front Psychiatry 2020; 11:532606. [PMID: 33192650 PMCID: PMC7542226 DOI: 10.3389/fpsyt.2020.532606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 09/02/2020] [Indexed: 12/20/2022] Open
Abstract
Proton exchange provides a powerful contrast mechanism for magnetic resonance imaging (MRI). MRI techniques sensitive to proton exchange provide new opportunities to map, with high spatial and temporal resolution, compounds important for brain metabolism and function. Two such techniques, chemical exchange saturation transfer (CEST) and T1 relaxation in the rotating frame (T1ρ), are emerging as promising tools in the study of neurological and psychiatric illnesses to study brain metabolism. This review describes proton exchange for non-experts, highlights the current status of proton-exchange MRI, and presents advantages and drawbacks of these techniques compared to more traditional methods of imaging brain metabolism, including positron emission tomography (PET) and MR spectroscopy (MRS). Finally, this review highlights new frontiers for the use of CEST and T1ρ in brain research.
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Affiliation(s)
- Joseph J Shaffer
- Department of Radiology, University of Iowa, Iowa City, IA, United States
| | - Merry Mani
- Department of Radiology, University of Iowa, Iowa City, IA, United States
| | - Samantha L Schmitz
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States
| | - Jia Xu
- Department of Radiology, University of Iowa, Iowa City, IA, United States
| | - Nana Owusu
- Department of Radiology, University of Iowa, Iowa City, IA, United States.,Pappajohn Biomedical Institute, University of Iowa, Iowa City, IA, United States.,Department of Biomedical Engineering, University of Iowa, Iowa City, IA, United States
| | - Dee Wu
- Department of Radiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Vincent A Magnotta
- Department of Radiology, University of Iowa, Iowa City, IA, United States.,Department of Psychiatry, University of Iowa, Iowa City, IA, United States.,Department of Biomedical Engineering, University of Iowa, Iowa City, IA, United States
| | - John A Wemmie
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States.,Pappajohn Biomedical Institute, University of Iowa, Iowa City, IA, United States.,Department of Veterans Affairs Medical Center, Iowa City, IA, United States.,Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, IA, United States.,Department of Neurosurgery, University of Iowa, Iowa City, IA, United States
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8
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Ali SO, Fessas P, Kaggie JD, Zaccagna F, Houston G, Reid S, Graves MJ, Gallagher FA. Evaluation of the sensitivity of R 1ρ MRI to pH and macromolecular density. Magn Reson Imaging 2019; 58:156-161. [PMID: 30771445 PMCID: PMC6422633 DOI: 10.1016/j.mri.2019.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 11/17/2022]
Abstract
The tumor microenvironment is characteristically acidic and this extracellular acidosis is known to play a role in carcinogenesis and metastasis and can affect tumor chemosensitivity and radiosensitivity. Intracellular pH has been used as a possible biomarker of salvageable tissue in ischemic stroke. A non-invasive MRI-based approach for the determination and imaging of cerebral pH would be a powerful tool in cancer diagnosis and monitoring, as well as stroke treatment planning. Several pH-based MRI imaging approaches have been proposed but for these to be useful, disentangling the effects of pH from other parameters which may affect the measured MRI signal is crucial to ensure accuracy and specificity. R1 relaxation in the rotating frame (R1ρ) is an example of a method that has been proposed to probe pH in vivo using MRI. In this study, we have investigated the relationship between R1ρ, pH, and macromolecular density in vitro using phantoms and in human volunteers. Here we show that the rate of R1ρ relaxation (=1/T1ρ) varies with pH but only in the presence of macromolecules. At constant pH, phantom macromolecular density inversely correlated with R1ρ. R1ρ imaging of the normal human brain demonstrated regional heterogeneity with significant differences between structurally distinct regions, which are likely to be independent of pH. For example, R1ρ was higher in the basal ganglia compared to grey matter and higher in grey matter compared to white matter. We conclude that R1ρ cannot be reliably used to image tissue pH without deconvolution from the effects of local tissue macromolecular composition.
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Affiliation(s)
- Syed O Ali
- University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0SP, United Kingdom
| | - Petros Fessas
- University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0SP, United Kingdom
| | - Joshua D Kaggie
- Department of Radiology, Box 218, University of Cambridge, Cambridge CB2 0QQ, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom, CB2 0QQ.
| | - Fulvio Zaccagna
- Department of Radiology, Box 218, University of Cambridge, Cambridge CB2 0QQ, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom, CB2 0QQ
| | | | - Scott Reid
- GE Healthcare, Amersham, United Kingdom, HP7 9JQ
| | - Martin J Graves
- Department of Radiology, Box 218, University of Cambridge, Cambridge CB2 0QQ, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom, CB2 0QQ
| | - Ferdia A Gallagher
- Department of Radiology, Box 218, University of Cambridge, Cambridge CB2 0QQ, United Kingdom; Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom, CB2 0QQ.
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9
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Bipolar disorder and related mood states are not associated with endothelial function of small arteries in adults without heart disease. Gen Hosp Psychiatry 2018; 51:36-40. [PMID: 29309989 PMCID: PMC5869118 DOI: 10.1016/j.genhosppsych.2017.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 12/18/2017] [Accepted: 12/18/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Individuals with bipolar disorder are at increased risk for adverse cardiovascular disease (CVD) events. This study aimed to assess endothelial function and wave reflection, a risk factor for CVD, as measured by finger plethysmography in bipolar disorder to investigate whether CVD risk was higher in bipolar disorder and altered during acute mood episodes. We hypothesized that EndoPAT would detect a lower reactive hyperemia index (RHI) and higher augmentation index (AIX) in individuals with bipolar disorder compared with controls. Second, we predicted lower RHI and higher AIX during acute mood episodes. METHODS Reactive hyperemia index and augmentation index, measures of microvascular endothelial function and arterial pressure wave reflection respectively, were assessed using the EndoPAT 2000 device in a sample of 56 participants with a DSM-IV diagnosis of bipolar I disorder with 82 measures spanning different mood states (mania, depression, euthymia) and cross-sectionally in 26 healthy controls. RESULTS RHI and AIX were not different between adults with and without bipolar disorder (mean age 40.3 vs. 41.2years; RHI: 2.04±0.67 vs. 2.05±0.51; AIX@75 (AIX adjusted for heart rate of 75): 1.4±19.7 vs. 0.8±22.4). When modeled in linear mixed models with a random intercept (to account for repeated observations of persons with bipolar disorder) and adjusting for age and sex, there were no significant differences between those with bipolar disorder and controls (p=0.89 for RHI; p=0.85 for AIX@75). CONCLUSIONS Microvascular endothelial function and wave reflection estimated by finger plethysmography were unable to detect differences between adults with and without bipolar disorder or changes with mood states. Future research is necessary to identify more proximal and sensitive, yet relevant, biomarkers of abnormal mood-related influences on CVD risk or must target higher risk samples.
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Shaffer JJ, Johnson CP, Long JD, Fiedorowicz JG, Christensen GE, Wemmie JA, Magnotta VA. Relationship altered between functional T1ρ and BOLD signals in bipolar disorder. Brain Behav 2017; 7:e00802. [PMID: 29075562 PMCID: PMC5651386 DOI: 10.1002/brb3.802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 07/06/2017] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Functional neuroimaging typically relies on the blood-oxygen-level-dependent (BOLD) contrast, which is sensitive to the influx of oxygenated blood following neuronal activity. A new method, functional T1 relaxation in the rotating frame (fT1ρ) is thought to reflect changes in local brain metabolism, likely pH, and may more directly measure neuronal activity. These two methods were applied to study activation of the visual cortex in participants with bipolar disorder as compared to controls. METHODS Thirty-nine participants with bipolar disorder and 32 healthy controls underwent functional neuroimaging during a flashing checkerboard paradigm. Functional images were acquired in alternating blocks of BOLD and fT1ρ. Linear mixed-effect models were used to examine the relationship between these two functional imaging modalities and to test whether that relationship was altered in bipolar disorder. RESULTS BOLD and fT1ρ signal were strongly related in visual and cerebellar areas during the task in controls. The relationship between these two measures was reduced in bipolar disorder within the visual areas, cerebellum, striatum, and thalamus. CONCLUSIONS These results support a distinct mechanisms underlying BOLD and fT1ρ signals. The weakened relationship between these imaging modalities may provide a novel tool for measuring pathology in bipolar disorder and other psychiatric illnesses.
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Affiliation(s)
| | | | - Jeffrey D Long
- Department of Psychiatry University of Iowa Iowa City IA USA.,Department of Biostatistics University of Iowa Iowa City IA USA
| | - Jess G Fiedorowicz
- Department of Psychiatry University of Iowa Iowa City IA USA.,Department of Epidemiology University of Iowa Iowa City IA USA.,Department of Internal Medicine University of Iowa Iowa City IA USA
| | - Gary E Christensen
- Department of Electrical and Computer Engineering University of Iowa Iowa City IA USA.,Department of Radiation Oncology University of Iowa Iowa City IA USA
| | - John A Wemmie
- Department of Psychiatry University of Iowa Iowa City IA USA.,Department of Veterans Affairs Medical Center Iowa City IA USA.,Department of Molecular Physiology and Biophysics University of Iowa Iowa City IA USA.,Department of Neurosurgery University of Iowa Iowa City IA USA.,Iowa Neuroscience Institute University of Iowa Iowa City IA USA
| | - Vincent A Magnotta
- Department of Radiology University of Iowa Iowa City IA USA.,Department of Psychiatry University of Iowa Iowa City IA USA.,Department of Biomedical Engineering University of Iowa Iowa City IA USA
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