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Meng X, Zhang S, Zhou S, Ma Y, Yu X, Guan L. Putative Risk Biomarkers of Bipolar Disorder in At-risk Youth. Neurosci Bull 2024:10.1007/s12264-024-01219-w. [PMID: 38710851 DOI: 10.1007/s12264-024-01219-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/08/2024] [Indexed: 05/08/2024] Open
Abstract
Bipolar disorder is a highly heritable and functionally impairing disease. The recognition and intervention of BD especially that characterized by early onset remains challenging. Risk biomarkers for predicting BD transition among at-risk youth may improve disease prognosis. We reviewed the more recent clinical studies to find possible pre-diagnostic biomarkers in youth at familial or (and) clinical risk of BD. Here we found that putative biomarkers for predicting conversion to BD include findings from multiple sample sources based on different hypotheses. Putative risk biomarkers shown by perspective studies are higher bipolar polygenetic risk scores, epigenetic alterations, elevated immune parameters, front-limbic system deficits, and brain circuit dysfunction associated with emotion and reward processing. Future studies need to enhance machine learning integration, make clinical detection methods more objective, and improve the quality of cohort studies.
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Affiliation(s)
- Xinyu Meng
- Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Shengmin Zhang
- Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Shuzhe Zhou
- Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Yantao Ma
- Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Xin Yu
- Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Lili Guan
- Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
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2
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Song YM, Jeong J, de Los Reyes AA, Lim D, Cho CH, Yeom JW, Lee T, Lee JB, Lee HJ, Kim JK. Causal dynamics of sleep, circadian rhythm, and mood symptoms in patients with major depression and bipolar disorder: insights from longitudinal wearable device data. EBioMedicine 2024; 103:105094. [PMID: 38579366 PMCID: PMC11002811 DOI: 10.1016/j.ebiom.2024.105094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/14/2024] [Accepted: 03/17/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Sleep and circadian rhythm disruptions are common in patients with mood disorders. The intricate relationship between these disruptions and mood has been investigated, but their causal dynamics remain unknown. METHODS We analysed data from 139 patients (76 female, mean age = 23.5 ± 3.64 years) with mood disorders who participated in a prospective observational study in South Korea. The patients wore wearable devices to monitor sleep and engaged in smartphone-delivered ecological momentary assessment of mood symptoms. Using a mathematical model, we estimated their daily circadian phase based on sleep data. Subsequently, we obtained daily time series for sleep/circadian phase estimates and mood symptoms spanning >40,000 days. We analysed the causal relationship between the time series using transfer entropy, a non-linear causal inference method. FINDINGS The transfer entropy analysis suggested causality from circadian phase disturbance to mood symptoms in both patients with MDD (n = 45) and BD type I (n = 35), as 66.7% and 85.7% of the patients with a large dataset (>600 days) showed causality, but not in patients with BD type II (n = 59). Surprisingly, no causal relationship was suggested between sleep phase disturbances and mood symptoms. INTERPRETATION Our findings suggest that in patients with mood disorders, circadian phase disturbances directly precede mood symptoms. This underscores the potential of targeting circadian rhythms in digital medicine, such as sleep or light exposure interventions, to restore circadian phase and thereby manage mood disorders effectively. FUNDING Institute for Basic Science, the Human Frontiers Science Program Organization, the National Research Foundation of Korea, and the Ministry of Health & Welfare of South Korea.
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Affiliation(s)
- Yun Min Song
- Department of Mathematical Sciences, KAIST, Daejeon, 34141, Republic of Korea; Biomedical Mathematics Group, Pioneer Research Center for Mathematical and Computational Sciences, Institute for Basic Science, Daejeon, 34126, Republic of Korea
| | - Jaegwon Jeong
- Department of Psychiatry, Korea University College of Medicine, Seoul, 02841, Republic of Korea; Chronobiology Institute, Korea University, Seoul, 02841, Republic of Korea
| | - Aurelio A de Los Reyes
- Biomedical Mathematics Group, Pioneer Research Center for Mathematical and Computational Sciences, Institute for Basic Science, Daejeon, 34126, Republic of Korea; Institute of Mathematics, University of the Philippines Diliman, Quezon City, 1101, Philippines
| | - Dongju Lim
- Department of Mathematical Sciences, KAIST, Daejeon, 34141, Republic of Korea; Biomedical Mathematics Group, Pioneer Research Center for Mathematical and Computational Sciences, Institute for Basic Science, Daejeon, 34126, Republic of Korea
| | - Chul-Hyun Cho
- Department of Psychiatry, Korea University College of Medicine, Seoul, 02841, Republic of Korea; Chronobiology Institute, Korea University, Seoul, 02841, Republic of Korea
| | - Ji Won Yeom
- Department of Psychiatry, Korea University College of Medicine, Seoul, 02841, Republic of Korea; Chronobiology Institute, Korea University, Seoul, 02841, Republic of Korea
| | - Taek Lee
- Division of Computer Science and Engineering, Sun Moon University, Asan, 31460, Republic of Korea
| | - Jung-Been Lee
- Division of Computer Science and Engineering, Sun Moon University, Asan, 31460, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, 02841, Republic of Korea; Chronobiology Institute, Korea University, Seoul, 02841, Republic of Korea.
| | - Jae Kyoung Kim
- Department of Mathematical Sciences, KAIST, Daejeon, 34141, Republic of Korea; Biomedical Mathematics Group, Pioneer Research Center for Mathematical and Computational Sciences, Institute for Basic Science, Daejeon, 34126, Republic of Korea.
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3
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Lewis P, Gottlieb JF, Morfeld P, Hellmich M, Erren TC. Perinatal photoperiod associations with bipolar disorder and depression: A systematic literature review and cross-sectional analysis of the UK Biobank database. Psychiatry Res 2024; 335:115878. [PMID: 38581863 DOI: 10.1016/j.psychres.2024.115878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/07/2024] [Accepted: 03/24/2024] [Indexed: 04/08/2024]
Abstract
Season-of-birth associations with psychiatric disorders point to environmental (co-)aetiological factors such as natural photoperiod that, if clarified, may allow interventions toward prevention. We systematically reviewed the literature concerning season-of-birth and bipolar disorder and depression and explored associations between the perinatal natural photoperiod and these outcomes in a cross-sectional analysis of the UK Biobank database. We used mean daily photoperiod and relative photoperiod range (relative to the mean) in the 3rd trimester and, separately, in the first 3 months post birth as metrics. From review, increased risk of depression with late spring birth is compatible with increased odds of probable single episode-, probable recurrent-, and diagnosed depression (OR 2.85 95 %CI 1.6-5.08, OR 2.20 95 %CI 1.57-3.1, and OR 1.48 95 %CI 1.11-1.97, respectively) with increasing 3rd trimester relative photoperiod range for participants who experienced relatively non-extreme daily photoperiods. Risk of bipolar disorder with winter-spring birth contrasted with no consistent patterns of perinatal photoperiod metric associations with bipolar disorder in the UK Biobank. As natural photoperiod varies by both time-of-year and latitude, perinatal natural photoperiods (and a hypothesized mechanism of action via the circadian timing system and/or serotonergic circuitry associated with the dorsal raphe nucleus) may reconcile inconsistencies in season-of-birth associations. Further studies are warranted.
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Affiliation(s)
- Philip Lewis
- Institute and Policlinic for Occupational Medicie, Environmental Medicine, and Prevention Research, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany.
| | - John F Gottlieb
- Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Peter Morfeld
- Institute and Policlinic for Occupational Medicie, Environmental Medicine, and Prevention Research, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Thomas C Erren
- Institute and Policlinic for Occupational Medicie, Environmental Medicine, and Prevention Research, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany
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4
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Lipschitz JM, Perez-Rodriguez M, Majd M, Larsen E, Locascio J, Pike CK, Shanahan M, Burdick KE. Modafinil's effects on cognition and sleep quality in affectively-stable patients with bipolar disorder: a pilot study. Front Psychiatry 2023; 14:1246149. [PMID: 37732080 PMCID: PMC10507316 DOI: 10.3389/fpsyt.2023.1246149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction Despite advances in the treatment of bipolar disorder (BD), most patients do not achieve complete inter-episode recovery and functional disability is common. During periods of relative remission, many patients continue to experience neurocognitive dysfunction, reduced daytime activity levels, and sleep disturbances. This 8-week, randomized, placebo-controlled pilot study evaluated the feasibility, safety and preliminary efficacy of the wake-promoting drug, modafinil (Provigil®), on neurocognitive functioning, daytime sleepiness, and sleep quality in affectively-stable BD patients. Methods Twelve individuals with affectively-stable BD were recruited and randomized to a flexible dose of modafinil (100 to 200 mg/day) or placebo, adjunctive to a therapeutic dose of a mood stabilizer. Weekly in-person visits tracked sleep quality and daytime sleepiness as well as side effects and mood symptoms. Neurocognitive functioning was assessed at baseline, week 4, and week 8. Results No serious adverse events were reported. Newly emergent side effects in the modafinil group included heart palpitations, itching, fatigue, and decreased energy. Two patients discontinued modafinil owing to side effects and one of these patients withdrew from the study. One patient discontinued placebo and was withdrawn from the study. Preliminary evaluations of clinical efficacy showed a marginally significant interaction between treatment group and time in two cognitive domains (speed of processing and verbal learning), indicating greater improvement in the modafinil group versus placebo. Additionally, there was a marginally significant effect of treatment group on daytime sleepiness, suggesting lower daytime sleepiness in the modafinil group versus placebo. Counterintuitively, we found a significant treatment group by time interaction effect on sleep quality, suggesting greater improvement in sleep quality in the placebo group versus the modafinil group. Discussion Results suggest that modafinil is a relatively safe medication for affectively-stable BD patients when given with adjunctive mood stabilizers. Results are suggestive of cognitive benefit and improved daytime sleepiness, but worse sleep quality in those patients prescribed modafinil. A fully powered clinical trial is warranted with specific attention to the characteristics of patients who are most likely to benefit from treatment with modafinil and other methodological lessons learned from this pilot. Clinical trial registration ClinicalTrials.gov, identifier NCT01965925.
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Affiliation(s)
- Jessica M. Lipschitz
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | | | - Marzieh Majd
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Emmett Larsen
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Joseph Locascio
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Department of Neurology and Harvard Catalyst Biostatistical Group, Harvard Medical School, Boston, MA, United States
| | - Chelsea K. Pike
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United States
| | - Megan Shanahan
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United States
| | - Katherine E. Burdick
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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5
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Melloni EMT, Paolini M, Dallaspezia S, Lorenzi C, Poletti S, d'Orsi G, Yoshiike T, Zanardi R, Colombo C, Benedetti F. Melatonin secretion patterns are associated with cognitive vulnerability and brain structure in bipolar depression. Chronobiol Int 2023; 40:1279-1290. [PMID: 37781880 DOI: 10.1080/07420528.2023.2262572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
Circadian rhythm disruption is a core symptom of bipolar disorder (BD), also reflected in altered patterns of melatonin release. Reductions of grey matter (GM) volumes are well documented in BD. We hypothesized that levels and timing of melatonin secretion in bipolar depression could be associated with depressive psychopathology and brain GM integrity. The onset of melatonin secretion under dim light conditions (DLMO) and the amount of time between DLMO and midsleep (i.e. phase angle difference; PAD) were used as circadian rhythm markers. To study the time course of melatonin secretion, an exponential curve fitting the melatonin values was calculated, and the slope coefficients (SLP) were obtained for each participant. Significant differences were found between HC and BD in PAD measures and melatonin profiles. Correlations between PAD and depressive psychopathology were identified. Melatonin secretion patterns were found to be associated with GM volumes in the Striatum and Supramarginal Gyrus in BD. Our findings emphasized the role of melatonin secretion role as a biological marker of circadian synchronization in bipolar depression and provided a novel insight for a link between melatonin release and brain structure.
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Affiliation(s)
- Elisa M T Melloni
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
- University Vita-Salute San Raffaele, Milano, Italy
| | - Marco Paolini
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
- University Vita-Salute San Raffaele, Milano, Italy
| | - Sara Dallaspezia
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
- University Vita-Salute San Raffaele, Milano, Italy
| | - Cristina Lorenzi
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
- University Vita-Salute San Raffaele, Milano, Italy
| | - Greta d'Orsi
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Takuya Yoshiike
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Raffaella Zanardi
- University Vita-Salute San Raffaele, Milano, Italy
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Mood Disorder Unit, Milano, Italy
| | - Cristina Colombo
- University Vita-Salute San Raffaele, Milano, Italy
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Mood Disorder Unit, Milano, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
- University Vita-Salute San Raffaele, Milano, Italy
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6
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Is Poor Lithium Response in Individuals with Bipolar Disorder Associated with Increased Degradation of Tryptophan along the Kynurenine Pathway? Results of an Exploratory Study. J Clin Med 2022; 11:jcm11092517. [PMID: 35566641 PMCID: PMC9103936 DOI: 10.3390/jcm11092517] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/15/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022] Open
Abstract
Bipolar disorder is associated with an inflammation-triggered elevated catabolism of tryptophan to the kynurenine pathway, which impacts psychiatric symptoms and outcomes. The data indicate that lithium exerts anti-inflammatory effects by inhibiting indoleamine-2,3-dioxygenase (IDO)-1 activity. This exploratory study aimed to investigate the tryptophan catabolism in individuals with bipolar disorder (n = 48) compared to healthy controls (n = 48), and the associations with the response to mood stabilizers such as lithium, valproate, or lamotrigine rated with the Retrospective Assessment of the Lithium Response Phenotype Scale (or the Alda scale). The results demonstrate an association of a poorer response to lithium with higher levels of kynurenine, kynurenine/tryptophan ratio as a proxy for IDO-1 activity, as well as quinolinic acid, which, overall, indicates a pro-inflammatory state with a higher degradation of tryptophan towards the neurotoxic branch. The treatment response to valproate and lamotrigine was not associated with the levels of the tryptophan metabolites. These findings support the anti-inflammatory properties of lithium. Furthermore, since quinolinic acid has neurotoxic features via the glutamatergic pathway, they also strengthen the assumption that the clinical drug response might be associated with biochemical processes. The relationship between the lithium response and the measurements of the tryptophan to the kynurenine pathway is of clinical relevance and may potentially bring advantages towards a personalized medicine approach to bipolar disorder that allows for the selection of the most effective mood-stabilizing drug.
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7
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Panchal P, de Queiroz Campos G, Goldman DA, Auerbach RP, Merikangas KR, Swartz HA, Sankar A, Blumberg HP. Toward a Digital Future in Bipolar Disorder Assessment: A Systematic Review of Disruptions in the Rest-Activity Cycle as Measured by Actigraphy. Front Psychiatry 2022; 13:780726. [PMID: 35677875 PMCID: PMC9167949 DOI: 10.3389/fpsyt.2022.780726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Disruptions in rest and activity patterns are core features of bipolar disorder (BD). However, previous methods have been limited in fully characterizing the patterns. There is still a need to capture dysfunction in daily activity as well as rest patterns in order to more holistically understand the nature of 24-h rhythms in BD. Recent developments in the standardization, processing, and analyses of wearable digital actigraphy devices are advancing longitudinal investigation of rest-activity patterns in real time. The current systematic review aimed to summarize the literature on actigraphy measures of rest-activity patterns in BD to inform the future use of this technology. METHODS A comprehensive systematic review using PRISMA guidelines was conducted through PubMed, MEDLINE, PsycINFO, and EMBASE databases, for papers published up to February 2021. Relevant articles utilizing actigraphy measures were extracted and summarized. These papers contributed to three research areas addressed, pertaining to the nature of rest-activity patterns in BD, and the effects of therapeutic interventions on these patterns. RESULTS Seventy articles were included. BD was associated with longer sleep onset latency and duration, particularly during depressive episodes and with predictive value for worsening of future manic symptoms. Lower overall daily activity was also associated with BD, especially during depressive episodes, while more variable activity patterns within a day were seen in mania. A small number of studies linked these disruptions with differential patterns of brain functioning and cognitive impairments, as well as more adverse outcomes including increased suicide risk. The stabilizing effect of therapeutic options, including pharmacotherapies and chronotherapies, on activity patterns was supported. CONCLUSION The use of actigraphy provides valuable information about rest-activity patterns in BD. Although results suggest that variability in rhythms over time may be a specific feature of BD, definitive conclusions are limited by the small number of studies assessing longitudinal changes over days. Thus, there is an urgent need to extend this work to examine patterns of rhythmicity and regularity in BD. Actigraphy research holds great promise to identify a much-needed specific phenotypic marker for BD that will aid in the development of improved detection, treatment, and prevention options.
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Affiliation(s)
- Priyanka Panchal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | - Danielle A Goldman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, United States
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, United States
| | - Holly A Swartz
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Anjali Sankar
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Department of Radiology and Biomedical Imaging, and the Child Study Center, Yale School of Medicine, New Haven, CT, United States
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8
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Huang Y, Zhao M, Chen X, Zhang R, Le A, Hong M, Zhang Y, Jia L, Zang W, Jiang C, Wang J, Fan X, Wang J. Tryptophan Metabolism in Central Nervous System Diseases: Pathophysiology and Potential Therapeutic Strategies. Aging Dis 2022; 14:858-878. [PMID: 37191427 DOI: 10.14336/ad.2022.0916] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 09/16/2022] [Indexed: 11/19/2022] Open
Abstract
The metabolism of L-tryptophan (TRP) regulates homeostasis, immunity, and neuronal function. Altered TRP metabolism has been implicated in the pathophysiology of various diseases of the central nervous system. TRP is metabolized through two main pathways, the kynurenine pathway and the methoxyindole pathway. First, TRP is metabolized to kynurenine, then kynurenic acid, quinolinic acid, anthranilic acid, 3-hydroxykynurenine, and finally 3-hydroxyanthranilic acid along the kynurenine pathway. Second, TRP is metabolized to serotonin and melatonin along the methoxyindole pathway. In this review, we summarize the biological properties of key metabolites and their pathogenic functions in 12 disorders of the central nervous system: schizophrenia, bipolar disorder, major depressive disorder, spinal cord injury, traumatic brain injury, ischemic stroke, intracerebral hemorrhage, multiple sclerosis, Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, and Huntington's disease. Furthermore, we summarize preclinical and clinical studies, mainly since 2015, that investigated the metabolic pathway of TRP, focusing on changes in biomarkers of these neurologic disorders, their pathogenic implications, and potential therapeutic strategies targeting this metabolic pathway. This critical, comprehensive, and up-to-date review helps identify promising directions for future preclinical, clinical, and translational research on neuropsychiatric disorders.
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9
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Mulayim E, Karababa İF, Akbaş H, Bayazıt H, Selek S. Melatonin Receptor Gene Polymorphism in Bipolar-I Disorder. Arch Med Res 2021; 52:523-528. [DOI: 10.1016/j.arcmed.2021.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/13/2020] [Accepted: 01/14/2021] [Indexed: 01/01/2023]
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10
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Yeom JW, Cho CH, Jeon S, Seo JY, Son S, Ahn YM, Kim SJ, Ha TH, Cha B, Moon E, Park DY, Baek JH, Kang HJ, An H, Lee HJ. Bipolar II disorder has the highest prevalence of seasonal affective disorder in early-onset mood disorders: Results from a prospective observational cohort study. Depress Anxiety 2021; 38:661-670. [PMID: 33818866 DOI: 10.1002/da.23153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 02/18/2021] [Accepted: 03/16/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Many mood disorder patients experience seasonal changes in varying degrees. Studies on seasonality have shown that bipolar disorder has a higher prevalence rate in such patients; however, there is limited research on seasonality in early-onset mood disorder patients. This study estimated the prevalence of seasonality in early-onset mood disorder patients, and examined the association between seasonality and mood disorders. METHODS Early-onset mood disorder patients (n = 378; 138 major depressive disorder; 101 bipolar I disorder; 139 bipolar II disorder) of the Mood Disorder Cohort Research Consortium and healthy control subjects (n = 235) were assessed for seasonality with Seasonality Pattern Assessment Questionnaire (SPAQ). RESULTS A higher global seasonality score, an overall seasonal impairment score, and the prevalence of seasonal affective disorder (SAD) and subsyndromal SAD showed that mood disorder subjects had higher seasonality than the healthy subjects. The former subject group had a significantly higher mean overall seasonal impairment score than the healthy subjects (p < .001); in particular, bipolar II disorder subjects had the highest prevalence of SAD, and the diagnosis of bipolar II disorder had significantly higher odds ratios for SAD when compared to major depression and bipolar I disorder (p < .05). CONCLUSIONS Early-onset mood disorders, especially bipolar II disorder, were associated with high seasonality. A thorough assessment of seasonality in early-onset mood disorders may be warranted for more personalized treatment and proactive prevention of mood episodes.
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Affiliation(s)
- Ji Won Yeom
- Department of Psychiatry, Biomedical Science, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chul-Hyun Cho
- Chronobiology Institute, Korea University, Seoul, Republic of Korea.,Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Republic of Korea.,Department of Psychiatry, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Biomedical Science, Korea University College of Medicine, Seoul, Republic of Korea.,Chronobiology Institute, Korea University, Seoul, Republic of Korea
| | - Ju Yeon Seo
- Department of Psychiatry, Biomedical Science, Korea University College of Medicine, Seoul, Republic of Korea.,Chronobiology Institute, Korea University, Seoul, Republic of Korea
| | - Serhim Son
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yong-Min Ahn
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Se Joo Kim
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae Hyon Ha
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Boseok Cha
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Eunsoo Moon
- Department of Psychiatry, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Dong Yeon Park
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Ji Hyun Baek
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University College of Medicine, Gwangju, Republic of Korea
| | - Hyonggin An
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Biomedical Science, Korea University College of Medicine, Seoul, Republic of Korea.,Chronobiology Institute, Korea University, Seoul, Republic of Korea
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11
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Guglielmo R, Miskowiak KW, Hasler G. Evaluating endophenotypes for bipolar disorder. Int J Bipolar Disord 2021; 9:17. [PMID: 34046710 PMCID: PMC8160068 DOI: 10.1186/s40345-021-00220-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Phenotypic heterogeneity is a major impediment to the elucidation of the neurobiology and genetics of bipolar disorder. Endophenotype could help in reducing heterogeneity by defining biological traits that are more direct expressions of gene effects. The aim of this review is to examine the recent literature on clinical, epidemiological, neurobiological, and genetic findings and to select and evaluate candidate endophenotypes for bipolar disorder. Evaluating putative endophenotype could be helpful in better understanding the neurobiology of bipolar disorder by improving the definition of bipolar-related phenotypes in genetic studies. In this manner, research on endophenotypes could be useful to improve psychopathological diagnostics in the long-run by dissecting psychiatric macro phenotypes into biologically valid components. MAIN BODY The associations among the psychopathological and biological endophenotypes are discussed with respect to specificity, temporal stability, heritability, familiarity, and clinical and biological plausibility. Numerous findings regarding brain function, brain structure, neuropsychology and altered neurochemical pathways in patients with bipolar disorder and their relatives deserve further investigation. Overall, major findings suggest a developmental origin of this disorder as all the candidate endophenotypes that we have been able to select are present both in the early stages of the disorder as well as in subjects at risk. CONCLUSIONS Among the stronger candidate endophenotypes, we suggest circadian rhythm instability, dysmodulation of emotion and reward, altered neuroimmune state, attention and executive dysfunctions, anterior cingulate cortex thickness and early white matter abnormalities. In particular, early white matter abnormalities could be the result of a vulnerable brain on which new stressors are added in young adulthood which favours the onset of the disorder. Possible pathways that lead to a vulnerable brain are discussed starting from the data about molecular and imaging endophenotypes of bipolar disorder.
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Affiliation(s)
- Riccardo Guglielmo
- Psychiatry Research Unit, Fribourg Network for Mental Health (RFSM), University of Fribourg, Chemin du Cardinal-Journet 3, 1752, Villars-sur-Glâne, Switzerland.,Department of Neuroscience, Institute of Psychiatry, Catholic University Medical School, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Gregor Hasler
- Psychiatry Research Unit, Fribourg Network for Mental Health (RFSM), University of Fribourg, Chemin du Cardinal-Journet 3, 1752, Villars-sur-Glâne, Switzerland.
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12
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Janiri D, Kotzalidis GD, di Luzio M, Giuseppin G, Simonetti A, Janiri L, Sani G. Genetic neuroimaging of bipolar disorder: a systematic 2017-2020 update. Psychiatr Genet 2021; 31:50-64. [PMID: 33492063 DOI: 10.1097/ypg.0000000000000274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
There is evidence of genetic polymorphism influences on brain structure and function, genetic risk in bipolar disorder (BD), and neuroimaging correlates of BD. How genetic influences related to BD could be reflected on brain changes in BD has been efficiently reviewed in a 2017 systematic review. We aimed to confirm and extend these findings through a Preferred Reporting Items for Systematic reviews and Meta-Analyses-based systematic review. Our study allowed us to conclude that there is no replicated finding in the timeframe considered. We were also unable to further confirm prior results of the BDNF gene polymorphisms to affect brain structure and function in BD. The most consistent finding is an influence of the CACNA1C rs1006737 polymorphism in brain connectivity and grey matter structure and function. There was a tendency of undersized studies to obtain positive results and large, genome-wide polygenic risk studies to find negative results in BD. The neuroimaging genetics in BD field is rapidly expanding.
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Affiliation(s)
- Delfina Janiri
- Department of Neurology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Department of Psychiatry and Neurology, Sapienza University of Rome
| | - Georgios D Kotzalidis
- NESMOS Department, Sant'Andrea University Hospital, School of Medicine and Psychology, Sapienza University
| | - Michelangelo di Luzio
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Giuseppin
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessio Simonetti
- Department of Psychiatry and Neurology, Sapienza University of Rome
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Luigi Janiri
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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13
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Bipolar disorder: An evolutionary psychoneuroimmunological approach. Neurosci Biobehav Rev 2021; 122:28-37. [PMID: 33421542 DOI: 10.1016/j.neubiorev.2020.12.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/19/2020] [Accepted: 12/27/2020] [Indexed: 12/19/2022]
Abstract
Bipolar disorder is a mental health disorder characterized by extreme shifts in mood, high suicide rate, sleep problems, and dysfunction of psychological traits like self-esteem (feeling inferior when depressed and superior when manic). Bipolar disorder is rare among populations that have not adopted contemporary Western lifestyles, which supports the hypothesis that bipolar disorder results from a mismatch between Homo sapiens's evolutionary and current environments. Recent studies have connected bipolar disorder with low-grade inflammation, the malfunctioning of the internal clock, and the resulting sleep disturbances. Stress is often a triggering factor for mania and sleep problems, but stress also causes low-grade inflammation. Since inflammation desynchronizes the internal clock, chronic stress and inflammation are the primary biological mechanisms behind bipolar disorder. Chronic stress and inflammation are driven by contemporary Western lifestyles, including stressful social environments, unhealthy dietary patterns, limited physical activity, and obesity. The treatment of bipolar disorder should focus on reducing stress, stress sensitivity, and inflammation by lifestyle changes rather than just temporarily alleviating symptoms with psychopharmacological interventions.
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14
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Dunster GP, Swendsen J, Merikangas KR. Real-time mobile monitoring of bipolar disorder: a review of evidence and future directions. Neuropsychopharmacology 2021; 46:197-208. [PMID: 32919408 PMCID: PMC7688933 DOI: 10.1038/s41386-020-00830-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/17/2020] [Accepted: 07/30/2020] [Indexed: 02/07/2023]
Abstract
Rapidly accumulating data from mobile assessments are facilitating our ability to track patterns of emotions, behaviors, biologic rhythms, and their contextual influences in real time. These approaches have been widely applied to study the core features, traits, changes in states, and the impact of treatments in bipolar disorder (BD). This paper reviews recent evidence on the application of both passive and active mobile technologies to gain insight into the role of the circadian system and patterns of sleep and motor activity in people with BD. Findings of more than two dozen studies converge in demonstrating a broad range of sleep disturbances, particularly longer duration and variability of sleep patterns, lower average and greater variability of motor activity, and a shift to later peak activity and sleep midpoint, indicative of greater evening orientation among people with BD. The strong associations across the domains tapped by real-time monitoring suggest that future research should shift focus on sleep, physical/motor activity, or circadian patterns to identify common biologic pathways that influence their interrelations. The development of novel data-driven functional analytic tools has enabled the derivation of individualized multilevel dynamic representations of rhythms of multiple homeostatic regulatory systems. These multimodal tools can inform clinical research through identifying heterogeneity of the manifestations of BD and provide more objective indices of treatment response in real-world settings. Collaborative efforts with common protocols for the application of multimodal sensor technology will facilitate our ability to gain deeper insight into mechanisms and multisystem dynamics, as well as environmental, physiologic, and genetic correlates of BD.
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Affiliation(s)
- Gideon P. Dunster
- grid.416868.50000 0004 0464 0574Intramural Research Program, National Institute of Mental Health, Bethesda, MD USA
| | - Joel Swendsen
- grid.412041.20000 0001 2106 639XUniversity of Bordeaux, National Center for Scientific Research; EPHE PSL Research University, Bordeaux, France
| | - Kathleen Ries Merikangas
- Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA. .,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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15
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Scaini G, Valvassori SS, Diaz AP, Lima CN, Benevenuto D, Fries GR, Quevedo J. Neurobiology of bipolar disorders: a review of genetic components, signaling pathways, biochemical changes, and neuroimaging findings. ACTA ACUST UNITED AC 2020; 42:536-551. [PMID: 32267339 PMCID: PMC7524405 DOI: 10.1590/1516-4446-2019-0732] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/27/2019] [Indexed: 01/10/2023]
Abstract
Bipolar disorder (BD) is a chronic mental illness characterized by changes in mood that alternate between mania and hypomania or between depression and mixed states, often associated with functional impairment. Although effective pharmacological and non-pharmacological treatments are available, several patients with BD remain symptomatic. The advance in the understanding of the neurobiology underlying BD could help in the identification of new therapeutic targets as well as biomarkers for early detection, prognosis, and response to treatment in BD. In this review, we discuss genetic, epigenetic, molecular, physiological and neuroimaging findings associated with the neurobiology of BD. Despite the advances in the pathophysiological knowledge of BD, the diagnosis and management of the disease are still essentially clinical. Given the complexity of the brain and the close relationship between environmental exposure and brain function, initiatives that incorporate genetic, epigenetic, molecular, physiological, clinical, environmental data, and brain imaging are necessary to produce information that can be translated into prevention and better outcomes for patients with BD.
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Affiliation(s)
- Giselli Scaini
- Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Samira S Valvassori
- Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - Alexandre P Diaz
- Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Center of Excellence on Mood Disorders Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, UTHealth, Houston, TX, USA
| | - Camila N Lima
- Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Deborah Benevenuto
- Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Gabriel R Fries
- Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Center for Precision Health, School of Biomedical Informatics, UTHealth, Houston, TX, USA.,Neuroscience Graduate Program, Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center, UTHealth, Houston, TX, USA
| | - Joao Quevedo
- Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil.,Center of Excellence on Mood Disorders Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, UTHealth, Houston, TX, USA.,Neuroscience Graduate Program, Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center, UTHealth, Houston, TX, USA
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16
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Melloni EMT, Poletti S, Dallaspezia S, Bollettini I, Vai B, Barbini B, Zanardi R, Colombo C, Benedetti F. Changes of white matter microstructure after successful treatment of bipolar depression. J Affect Disord 2020; 274:1049-1056. [PMID: 32663931 DOI: 10.1016/j.jad.2020.05.146] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/22/2020] [Accepted: 05/27/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) measures suggest a widespread alteration of white matter (WM) microstructure in patients with bipolar disorder (BD). The chronotherapeutic combination of repeated total sleep deprivation and morning light therapy (TSD+LT) can acutely reverse depressive symptoms in approximately 60% of patients, and it has been confirmed as a model antidepressant treatment to investigate the neurobiological correlates of rapid antidepressant response. METHODS We tested if changes in DTI measures of WM microstructure could parallel antidepressant response in a sample of 44 patients with a major depressive episode in course of BD, treated with chronoterapeutics for one week. We used both a tract-wise and a voxel-wise approach for the whole-brain extraction of DTI measures of WM microstructure: axial (AD), radial (RD), and mean diffusivity (MD), and fractional anisotropy (FA). RESULTS Compared to baseline level, at one-week follow up we observed a significant increase in average FA measures paralleled by a significant decrease in MD measures of several WM tracts including cingulum, corpus callosum, corona radiata, cortico-spinal tract, internal capsule, fornix and uncinate fasciculus. The degree of change was associated to clinical response. CONCLUSIONS This is the first study to show changes of individual DTI measures of WM microstructure in response to antidepressant treatment in BD. Our results add new evidence to warrant a role for chronotherapeutics as a first-line treatment for bipolar depression and contribute identifying generalizable neuroimaging-based biomarkers of antidepressant response.
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Affiliation(s)
- Elisa M T Melloni
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy.
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Sara Dallaspezia
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Irene Bollettini
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy; Fondazione Centro San Raffaele, Milano, Italy
| | - Barbara Barbini
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Raffaella Zanardi
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Cristina Colombo
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
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17
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Rosenthal SJ, Josephs T, Kovtun O, McCarty R. Seasonal effects on bipolar disorder: A closer look. Neurosci Biobehav Rev 2020; 115:199-219. [DOI: 10.1016/j.neubiorev.2020.05.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 11/15/2022]
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18
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Zhou Y, Liao L, Liu X, Liu B, Chen X, Guo Y, Huang C, Zhao Y, Zeng Z. Crystal structure of Oryza sativa TDC reveals the substrate specificity for TDC-mediated melatonin biosynthesis. J Adv Res 2020; 24:501-511. [PMID: 32595985 PMCID: PMC7306523 DOI: 10.1016/j.jare.2020.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 04/20/2020] [Accepted: 06/08/2020] [Indexed: 01/01/2023] Open
Abstract
Plant tryptophan decarboxylase (TDC) is a type II Pyridoxal-5'-phosphate-dependent decarboxylase (PLP_DC) that could be used as a target to genetically improve crops. However, lack of accurate structural information on plant TDC hampers the understanding of its decarboxylation mechanisms. In the present study, the crystal structures of Oryza sativa TDC (OsTDC) in its complexes with pyridoxal-5'-phosphate, tryptamine and serotonin were determined. The structures provide detailed interaction information between TDC and its substrates. The Y359 residue from the loop gate is a proton donor and forms a Lewis acid-base pair with serotonin/tryptamine, which is associated with product release. The H214 residue is responsible for PLP binding and proton transfer, and its proper interaction with Y359 is essential for OsTDC enzyme activity. The extra hydrogen bonds formed between the 5-hydroxyl group of serotonin and the backbone carboxyl groups of F104 and P105 explain the discrepancy between the catalytic activity of TDC in tryptophan and in 5-hydroxytryptophan. In addition, an evolutionary analysis revealed that type II PLP_DC originated from glutamic acid decarboxylase, potentially as an adaptive evolution of mechanism in organisms in extreme environments. This study is, to our knowledge, the first to present a detailed analysis of the crystal structure of OsTDC in these complexes. The information regarding the catalytic mechanism described here could facilitate the development of protocols to regulate melatonin levels and thereby contribute to crop improvement efforts to improve food security worldwide.
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Affiliation(s)
- Yuanze Zhou
- National Key Laboratory of Crop Genetic Improvement, Huazhong Agricultural University, Wuhan 430070, China
| | - Lijing Liao
- National Key Laboratory of Crop Genetic Improvement, Huazhong Agricultural University, Wuhan 430070, China
| | - Xikai Liu
- National Key Laboratory of Crop Genetic Improvement, Huazhong Agricultural University, Wuhan 430070, China
| | - Biao Liu
- National Key Laboratory of Crop Genetic Improvement, Huazhong Agricultural University, Wuhan 430070, China
| | - Xinxin Chen
- National Key Laboratory of Crop Genetic Improvement, Huazhong Agricultural University, Wuhan 430070, China
| | - Yan Guo
- National Key Laboratory of Crop Genetic Improvement, Huazhong Agricultural University, Wuhan 430070, China
| | - Chuanlong Huang
- Jiangsu Key Laboratory of Bioactive Natural Product Research and State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210014, China
| | - Yucheng Zhao
- Jiangsu Key Laboratory of Bioactive Natural Product Research and State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 210014, China
| | - Zhixiong Zeng
- Shandong Provincial Key Laboratory of Microbial Engineering, College of Bioengineering, Qilu University of Technology, Jinan 250353, China
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19
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Chen Y, Hong W, Fang Y. Role of biological rhythm dysfunction in the development and management of bipolar disorders: a review. Gen Psychiatr 2020; 33:e100127. [PMID: 32090195 PMCID: PMC7003374 DOI: 10.1136/gpsych-2019-100127] [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: 08/13/2019] [Revised: 09/24/2019] [Accepted: 11/28/2019] [Indexed: 01/10/2023] Open
Abstract
Disturbance of biological rhythms contributes to the onset of bipolar disorders and is an important clinical feature of the condition. To further explore the role of biological rhythms in bipolar disorders, 95 English articles published between 1968 and 2019 were retrieved from the PubMed database and analysed. We herein review the outcomes of studies on biological rhythm disturbance in bipolar disorders, including the epidemiology, aetiology, clinical features (eg, sleep, feeding and eating disorders) and treatment of the condition evaluated by patients’ self-report and biological indicators such as melatonin. Our report supports the characterisation of biological rhythm disturbance as a significant clinical feature affecting the onset and development of bipolar disorders and reviews classical and novel treatments, such as chronotherapy, that can be applied in the clinical practice. Our analysis indicates that a more comprehensive study of the pathophysiology, clinical phenomenology and treatment of biological rhythm disturbance is required.
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Affiliation(s)
- Yiming Chen
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wu Hong
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiru Fang
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China
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20
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Manchia M, Squassina A, Pisanu C, Congiu D, Garzilli M, Guiso B, Suprani F, Paribello P, Pulcinelli V, Iaselli MN, Pinna F, Valtorta F, Carpiniello B, Comai S. Investigating the relationship between melatonin levels, melatonin system, microbiota composition and bipolar disorder psychopathology across the different phases of the disease. Int J Bipolar Disord 2019; 7:27. [PMID: 31814040 PMCID: PMC6900376 DOI: 10.1186/s40345-019-0163-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/24/2019] [Indexed: 01/27/2023] Open
Abstract
Background Bipolar disorder (BD) is characterized by recurrent episodes of depression and mania/hypomania alternating with intervals of well-being. The neurobiological underpinnings of BD are still veiled although there is evidence pointing to a malfunction of the circadian clock system that is regulated by the neuromodulator melatonin (MLT). Small sample size studies in BD patients have shown that changes in the levels of MLT are associated with shifts in illness status. Moreover, mood stabilizers (including lithium and valproic acid) influence the MLT system. Of interest, MLT also modulates intestinal microbiota, and recent work suggests an important role of microbiota alterations in neuropsychiatric disorders, including BD. This study is designed to explore whether the possible patterns of associations between changes in the levels of MLT and its precursors and BD mood phases are modulated by variants within the genes encoding for the elements of the MLT system and/or by the microbiota composition. Methods We will conduct a 2-year follow-up study in 50 BD patients during the three different mood phases of the disease. For each phase, we will perform a blood withdrawal for the analysis of MLT levels and of variants of the genes related to the MLT pathway between 8 and 10 a.m. after an overnight fasting, a stool specimen collection for the analysis of microbiota composition, and a detailed psychometric assessment for depression, mania, impulsivity and cognitive abilities. We will also recruit 50 healthy age-matched controls in whom we will perform a blood withdrawal between 8 and 10 a.m. after an overnight fasting, a stool specimen collection, and a psychometric assessment to exclude the presence of psychiatric disorders. Discussion In this cross sectional (case–control vs. BD comparisons) and longitudinal (24 months) study, we expect to clarify the link between the MLT system, microbiota and BD psychopathology. We expect to identify some typical BD symptomatic clusters that will be more strictly associated with variations in the MLT system. In a personalized medicine perspective, this subgroup of BD patients may benefit from a pharmacological therapy targeting the MLT system. Trial registration This study protocol was approved by the Ethics Committee of the University Hospital Agency of Cagliari (PG/2019/6277)
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Affiliation(s)
- Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Alessio Squassina
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Claudia Pisanu
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Donatella Congiu
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Mario Garzilli
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Beatrice Guiso
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federico Suprani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Vittoria Pulcinelli
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Maria Novella Iaselli
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Flavia Valtorta
- San Raffaele Scientific Institute and Vita Salute University, Via Olgettina 58, 20132, Milan, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Stefano Comai
- San Raffaele Scientific Institute and Vita Salute University, Via Olgettina 58, 20132, Milan, Italy. .,Department of Psychiatry, McGill University, Montreal, QC, Canada.
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21
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Park M, Kim SA, Yee J, Shin J, Lee KY, Joo EJ. Significant role of gene-gene interactions of clock genes in mood disorder. J Affect Disord 2019; 257:510-517. [PMID: 31323592 DOI: 10.1016/j.jad.2019.06.056] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/24/2019] [Accepted: 06/30/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The genetic interactions in the circadian rhythm biological system are promising as a source of pathophysiology in mood disorder. We examined the role of the gene-gene interactions of clock genes in mood disorder. METHODS We included 413 patients with mood disorder and 1294 controls. The clock genes investigated were BHLHB2, CLOCK, CSNK1E, NR1D1, PER2, PER3, and TIMELESS. Allele, genotype, and haplotype associations were tested. Gene--gene interactions were analyzed using the non-parametric model-free multifactor-dimensionality reduction (MDR) method. RESULTS TIMELESS rs4630333 and CSNK1E rs135745 were significantly associated with both major depressive disorder and bipolar disorder. The CLOCK haplotype was also strongly associated. The genetic roles of these SNPs were consistent from the allele and genotypic associations to the MDR interaction results. In MDR analysis, the combination of TIMELESS rs4630333 and CSNK1E rs135745 exhibited the most significant association with mood disorders in the two-locus model. BHLHB2 rs2137947 for major depressive disorder and CLOCK rs12649507 for bipolar disorder were the most significant third loci in the three-locus combination model. The four-locus SNP combination model showed the best balanced accuracy (BA), but its cross-validation consistency (CVC) was unsatisfactory. LIMITATIONS We included only 17 SNPs for seven circadian genes due to our limited resources; all subjects were ethnically Korean. CONCLUSIONS Our results suggest significant single-gene associations and gene-gene interactions of circadian genes with mood disorder. Gene-gene interactions play a crucial role in mood disorder, even when individual clock genes do not have significant roles.
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Affiliation(s)
- Mira Park
- Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Republic of Korea
| | - Soon Ae Kim
- Department of Pharmacology, School of Medicine, Eulji University, Daejeon, Republic of Korea
| | - Jaeyong Yee
- Department of Physiology and Biophysics, School of Medicine, Eulji University, Daejeon, Republic of Korea
| | - Jieun Shin
- Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Republic of Korea
| | - Kyu Young Lee
- Department of Neuropsychiatry, School of Medicine, Eulji University, Daejeon, Republic of Korea; Department of Psychiatry, Nowon Eulji Meical Center, Eulji University, Seoul, Republic of Korea
| | - Eun-Jeong Joo
- Department of Neuropsychiatry, School of Medicine, Eulji University, Daejeon, Republic of Korea; Department of Psychiatry, Nowon Eulji Meical Center, Eulji University, Seoul, Republic of Korea.
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22
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Melloni EMT, Poletti S, Vai B, Bollettini I, Colombo C, Benedetti F. Effects of illness duration on cognitive performances in bipolar depression are mediated by white matter microstructure. J Affect Disord 2019; 249:175-182. [PMID: 30772745 DOI: 10.1016/j.jad.2019.02.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/31/2019] [Accepted: 02/05/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cognitive deficits are a core feature of bipolar disorder (BD), and persist during the euthymic phase. White matter (WM) microstructural abnormalities are widely considered a structural marker of BD. Features of illness chronicity, such as illness duration and number of mood episodes, have been associated with worsening of both clinical profile and brain structural alterations. This study examined the role of WM integrity as a possible mediator between illness duration and cognitive performances in a sample of BD patients. METHODS We assessed 88 inpatients affected by a depressive episode in course of type I BD for verbal memory, visual memory, working memory, visuospatial constructional abilities, psychomotor coordination, executive functions, processing speed, and verbal fluency. White matter integrity was evaluated through FA measurements derived using the Enhancing Neuro Imaging Genetics Through Meta-Analysis (ENIGMA)-DTI protocol. RESULTS The effect of illness duration on processing speed, verbal memory, and visual memory was mediated by the FA values of bilateral anterior corona radiata, bilateral corona radiata, genu of corpus callosum, and fornix, adjusting for age, sex, education and lithium treatment (p < 0.05). LIMITATIONS Potential interaction factors were not examined in this study. CONCLUSIONS This is the first study to show the role of WM integrity as a mediator of the negative effect of illness duration on cognitive performances. Our data provide new insight into the neuroprogressive hypothesis of BD.
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Affiliation(s)
| | - Sara Poletti
- University Vita-Salute San Raffaele, Milano, Italy
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Irene Bollettini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
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23
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Takaesu Y. Circadian rhythm in bipolar disorder: A review of the literature. Psychiatry Clin Neurosci 2018; 72:673-682. [PMID: 29869403 DOI: 10.1111/pcn.12688] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/16/2018] [Accepted: 05/28/2018] [Indexed: 12/15/2022]
Abstract
Sleep disturbances and circadian rhythm dysfunction have been widely demonstrated in patients with bipolar disorder (BD). Irregularity of the sleep-wake rhythm, eveningness chronotype, abnormality of melatonin secretion, vulnerability of clock genes, and the irregularity of social time cues have also been well-documented in BD. Circadian rhythm dysfunction is prominent in BD compared with that in major depressive disorders, implying that circadian rhythm dysfunction is a trait marker of BD. In the clinical course of BD, the circadian rhythm dysfunctions may act as predictors for the first onset of BD and the relapse of mood episodes. Treatments focusing on sleep disturbances and circadian rhythm dysfunction in combination with pharmacological, psychosocial, and chronobiological treatments are believed to be useful for relapse prevention. Further studies are therefore warranted to clarify the relation between circadian rhythm dysfunction and the pathophysiology of BD to develop treatment strategies for achieving recovery in BD patients.
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Affiliation(s)
- Yoshikazu Takaesu
- Department of Neuropsychiatry, Kyorin University, School of Medicine, Tokyo, Japan
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24
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Semenova NV, Madaeva IM, Bairova TA, Zhambalova RM, Kalyuzhnaya OV, Rashidova MA, Kolesnikova LI. Association of 3111T/C Polymorphism of the Clock Gene with Circadian Rhythm of Melatonin in Menopausal Women with Insomnia. Bull Exp Biol Med 2018; 165:331-333. [PMID: 30003419 DOI: 10.1007/s10517-018-4162-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Indexed: 01/21/2023]
Abstract
We carried out a comparative analysis of circadian rhythms of melatonin secretion in Caucasian menopausal women with and without insomnia depending on the 3111T/C polymorphism of the Clock gene. Melatonin levels was measured in the saliva 4 times a day (06.00-07.00, 12.00-13.00, 18.00-19.00, and 23.00-00.00 h). Carriers of the TT genotype with insomnia demonstrated significantly higher level of melatonin in the early morning hours compared to the carriers of the minor allele C (12.60±7.58 and 8.98±8.62 pg/ml, respectively, p=0.023). In the control group, no statistically significant differences were revealed. The carriers of the TT genotype with sleep disorders have higher morning melatonin level compared to control group women (12.60±7.58 and 5.48±4.74 pg/ml, respectively, p=0.005) and low nocturnal melatonin level (6.42±4.97 and 12.52±10.40 pg/ml, respectively, p=0.039).
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Affiliation(s)
- N V Semenova
- Research Center of Family Health and Human Reproduction Problems, Irkutsk, Russia.
| | - I M Madaeva
- Research Center of Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - T A Bairova
- Research Center of Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - R M Zhambalova
- Research Center of Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - O V Kalyuzhnaya
- Research Center of Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - M A Rashidova
- Research Center of Family Health and Human Reproduction Problems, Irkutsk, Russia
| | - L I Kolesnikova
- Research Center of Family Health and Human Reproduction Problems, Irkutsk, Russia
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25
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Garbazza C, Benedetti F. Genetic Factors Affecting Seasonality, Mood, and the Circadian Clock. Front Endocrinol (Lausanne) 2018; 9:481. [PMID: 30190706 PMCID: PMC6115502 DOI: 10.3389/fendo.2018.00481] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 08/03/2018] [Indexed: 12/12/2022] Open
Abstract
In healthy humans, seasonality has been documented in psychological variables, chronotype, sleep, feeding, metabolic and autonomic function, thermoregulation, neurotransmission, and hormonal response to stimulation, thus representing a relevant factor to account for, especially when considering the individual susceptibility to disease. Mood is largely recognized as one of the central aspects of human behavior influenced by seasonal variations. This historical notion, already mentioned in ancient medical reports, has been recently confirmed by fMRI findings, which showed that seasonality in human cognitive brain functions may influence affective control with annual variations. Thus, seasonality plays a major role in mood disorders, affecting psychopathology, and representing the behavioral correlate of a heightened sensitivity to factors influencing circannual rhythms in patients. Although the genetic basis of seasonality and seasonal affective disorder (SAD) has not been established so far, there is growing evidence that factors affecting the biological clock, such as gene polymorphisms of the core clock machinery and seasonal changes of the light-dark cycle, exert a marked influence on the behavior of patients affected by mood disorders. Here we review recent findings about the effects of individual gene variants on seasonality, mood, and psychopathological characteristics.
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Affiliation(s)
- Corrado Garbazza
- Centre for Chronobiology, University of Basel, Basel, Switzerland
- Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
- *Correspondence: Corrado Garbazza
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
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26
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Allega OR, Leng X, Vaccarino A, Skelly M, Lanzini M, Hidalgo MP, Soares CN, Kennedy SH, Frey BN. Performance of the biological rhythms interview for assessment in neuropsychiatry: An item response theory and actigraphy analysis. J Affect Disord 2018; 225:54-63. [PMID: 28787704 DOI: 10.1016/j.jad.2017.07.047] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/21/2017] [Accepted: 07/24/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Biological rhythm disturbances are widely associated with the pathophysiology of mood disorders. The Biological Rhythms Interview for Assessment in Neuropsychiatry (BRIAN) is a self-report that indexes rhythm disturbance in sleep, activity, social and eating patterns. The aim of this study was to perform an Item Response Theory (IRT) analysis of the BRIAN and investigate its associations with objective sleep and rhythm disturbance measures. METHODS 103 subjects (31 bipolar, 32 major depression and 40 healthy volunteers) wore an actiwatch for fifteen days, and completed a first morning urine sample and the BRIAN on day 15. IRT analysis assessed individual BRIAN items and their relationship to total score. Individual actiwatch records were processed to produce a sequence of transitions between rest/activity, and a likelihood of transitioning between states was calculated to investigate sleep-wake dynamics. Cosinor analysis produced daily activity rhythms (DARs). Spearman correlations were used to assess the association between sleep/DAR variables and the BRIAN. RESULTS IRT analyses showed that 11 of 18 BRIAN items displayed a high level of discrimination between item options across a range of BRIAN total scores. Total BRIAN score correlated with wake after sleep onset, total activity count during sleep, and urinary 6-sulphatoxymelatonin. BRIAN Activity domain correlated with the daytime transition probability from rest to activity. LIMITATIONS The sample size may have been underpowered for the graded-response model employed in IRT. The study lacked an objective comparison for BRIAN eating and social domain. CONCLUSION The present study reveals the BRIAN displays promising external validity compared to objective parameters of circadian rhythmicity.
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Affiliation(s)
- Olivia R Allega
- Mood Disorders Program, St. Joseph's Healthcare Hamilton, ON, Canada
| | | | | | - Matthew Skelly
- Department of Health Sciences, McMaster University, Canada
| | - Mariana Lanzini
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Canada
| | - Maria Paz Hidalgo
- Department of Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Laboratorio de Chronobiologia HCPA/UFRGS, Brazil
| | - Claudio N Soares
- Department of Psychiatry at Queen's University School of Medicine, Canada
| | | | - Benicio N Frey
- Mood Disorders Program, St. Joseph's Healthcare Hamilton, ON, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
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27
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Bauer M, Glenn T, Alda M, Aleksandrovich MA, Andreassen OA, Angelopoulos E, Ardau R, Ayhan Y, Baethge C, Bharathram SR, Bauer R, Baune BT, Becerra-Palars C, Bellivier F, Belmaker RH, Berk M, Bersudsky Y, Bicakci Ş, Birabwa-Oketcho H, Bjella TD, Bossini L, Cabrera J, Cheung EYW, Del Zompo M, Dodd S, Donix M, Etain B, Fagiolini A, Fountoulakis KN, Frye MA, Gonzalez-Pinto A, Gottlieb JF, Grof P, Harima H, Henry C, Isometsä ET, Janno S, Kapczinski F, Kardell M, Khaldi S, Kliwicki S, König B, Kot TL, Krogh R, Kunz M, Lafer B, Landén M, Larsen ER, Lewitzka U, Licht RW, Lopez-Jaramillo C, MacQueen G, Manchia M, Marsh W, Martinez-Cengotitabengoa M, Melle I, Meza-Urzúa F, Yee Ming M, Monteith S, Morken G, Mosca E, Munoz R, Mythri SV, Nacef F, Nadella RK, Nery FG, Nielsen RE, O'Donovan C, Omrani A, Osher Y, Østermark Sørensen H, Ouali U, Pica Ruiz Y, Pilhatsch M, Pinna M, da Ponte FDR, Quiroz D, Ramesar R, Rasgon N, Reddy MS, Reif A, Ritter P, Rybakowski JK, Sagduyu K, Scippa ÂM, Severus E, Simhandl C, Stein DJ, Strejilevich S, Subramaniam M, Sulaiman AH, Suominen K, Tagata H, Tatebayashi Y, Tondo L, Torrent C, Vaaler AE, Veeh J, Vieta E, Viswanath B, Yoldi-Negrete M, Zetin M, Zgueb Y, Whybrow PC. Solar insolation in springtime influences age of onset of bipolar I disorder. Acta Psychiatr Scand 2017; 136:571-582. [PMID: 28722128 DOI: 10.1111/acps.12772] [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] [Accepted: 06/16/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To confirm prior findings that the larger the maximum monthly increase in solar insolation in springtime, the younger the age of onset of bipolar disorder. METHOD Data were collected from 5536 patients at 50 sites in 32 countries on six continents. Onset occurred at 456 locations in 57 countries. Variables included solar insolation, birth-cohort, family history, polarity of first episode and country physician density. RESULTS There was a significant, inverse association between the maximum monthly increase in solar insolation at the onset location, and the age of onset. This effect was reduced in those without a family history of mood disorders and with a first episode of mania rather than depression. The maximum monthly increase occurred in springtime. The youngest birth-cohort had the youngest age of onset. All prior relationships were confirmed using both the entire sample, and only the youngest birth-cohort (all estimated coefficients P < 0.001). CONCLUSION A large increase in springtime solar insolation may impact the onset of bipolar disorder, especially with a family history of mood disorders. Recent societal changes that affect light exposure (LED lighting, mobile devices backlit with LEDs) may influence adaptability to a springtime circadian challenge.
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Affiliation(s)
- M Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | | | - O A Andreassen
- NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - E Angelopoulos
- Department of Psychiatry, Medical School, Eginition Hospital, National and Capodistrian University of Athens, Athens, Greece
| | - R Ardau
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Y Ayhan
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - C Baethge
- Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany
| | | | - R Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - B T Baune
- Department of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - C Becerra-Palars
- National Institute of Psychiatry '"Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - F Bellivier
- Psychiatry and Addiction Medicine, Assistance Publique - Hôpitaux de Paris, FondaMental Foundation, INSERM UMR-S1144, Denis Diderot University, René Descartes University, Paris, France
| | - R H Belmaker
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - M Berk
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Vic., Australia.,Department of Psychiatry, Orygen, the National Centre for Excellence in Youth Mental Health, the Centre for Youth Mental Health and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Vic., Australia
| | - Y Bersudsky
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Ş Bicakci
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - T D Bjella
- NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - L Bossini
- Department of Molecular Medicine and Department of Mental Health (DAI), University of Siena and University of Siena Medical Center (AOUS), Siena, Italy
| | - J Cabrera
- Mood Disorders Clinic, Dr. Jose Horwitz Psychiatric Institute, Santiago de Chile, Chile
| | - E Y W Cheung
- Department of General Adult Psychiatry, Castle Peak Hospital, Tuen Mun, Hong Kong
| | - M Del Zompo
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - S Dodd
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Vic., Australia.,Department of Psychiatry, University of Melbourneo, Parkville, Vic, Australia
| | - M Donix
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - B Etain
- Psychiatry and Addiction Medicine, Assistance Publique - Hôpitaux de Paris, FondaMental Foundation, INSERM UMR-S1144, Denis Diderot University, René Descartes University, Paris, France
| | - A Fagiolini
- Department of Molecular Medicine and Department of Mental Health (DAI), University of Siena and University of Siena Medical Center (AOUS), Siena, Italy
| | - K N Fountoulakis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M A Frye
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - A Gonzalez-Pinto
- Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - J F Gottlieb
- Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - P Grof
- Mood Disorders Center of Ottawa, University of Toronto, Toronto, ON, Canada
| | - H Harima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - C Henry
- AP-HP, Hopitaux Universitaires Henri Mondor and INSERM U955 (IMRB) and Université Paris Est and Institut Pasteur, Unité Perception et Mémoire, Paris, France
| | - E T Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,National Institute for Health and Welfare, Helsinki, Finland
| | - S Janno
- Department of Psychiatry, University of Tartu, Tartu, Estonia
| | - F Kapczinski
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - M Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - S Khaldi
- Private practice, Tunis, Tunisia
| | - S Kliwicki
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - B König
- BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
| | - T L Kot
- Khanty-Mansiysk Clinical Psychoneurological Hospital, Khanty-Mansiysk, Russia
| | - R Krogh
- Department of Affective Disorders, Q, Mood Disorders Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - M Kunz
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - B Lafer
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - M Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg and Mölndal, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - E R Larsen
- Department of Affective Disorders, Q, Mood Disorders Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - U Lewitzka
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - R W Licht
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - C Lopez-Jaramillo
- Mood Disorders Program, Hospital Universitario San Vicente Fundación, Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - G MacQueen
- Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - M Manchia
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - W Marsh
- Department of Psychiatry, University of Massachusetts, Worcester, MA, USA
| | - M Martinez-Cengotitabengoa
- Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - I Melle
- NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - F Meza-Urzúa
- National Institute of Psychiatry '"Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - M Yee Ming
- Department of General Psychiatry, Mood Disorders Unit, Institute of Mental Health, Singapore City, Singapore
| | - S Monteith
- Traverse City Campus, Michigan State University College of Human Medicine, Traverse City, MI, USA
| | - G Morken
- Department of Mental Health, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.,Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - E Mosca
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - R Munoz
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - S V Mythri
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
| | - F Nacef
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - R K Nadella
- Department of Psychiatry, NIMHANS, Bangalore, India
| | - F G Nery
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - R E Nielsen
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - C O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - A Omrani
- Tunisian Bipolar Forum, Érable Médical Cabinet 324, Tunis, Tunisia
| | - Y Osher
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - H Østermark Sørensen
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark
| | - U Ouali
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Y Pica Ruiz
- Hospital "Ángeles del Pedregal", Mexico City, Mexico
| | - M Pilhatsch
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Pinna
- Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - F D R da Ponte
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - D Quiroz
- Deparment of Psychiatry, Diego Portales University, Santiago de Chile, Chile
| | - R Ramesar
- UCT/MRC Human Genetics Research Unit, Division of Human Genetics, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - N Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - M S Reddy
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - P Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - K Sagduyu
- Department of Psychiatry, University of Missouri Kansas City School of Medicine, Kansas City, MO, USA
| | - Â M Scippa
- Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
| | - E Severus
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Simhandl
- BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
| | - D J Stein
- Department of Psychiatry, MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - S Strejilevich
- Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina
| | - M Subramaniam
- Research Division, Institute of Mental Health, Singapore City, Singapore
| | - A H Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K Suominen
- Department of Social Services and Health Care, Psychiatry, City of Helsinki, Helsinki, Finland
| | - H Tagata
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Y Tatebayashi
- Schizophrenia & Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Seatagaya, Tokyo, Japan
| | - L Tondo
- McLean Hospital-Harvard Medical School, Boston, MA, USA.,Mood Disorder Lucio Bini Centers, Cagliari e Roma, Italy
| | - C Torrent
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A E Vaaler
- Department of Mental Health, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.,Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - J Veeh
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - E Vieta
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Viswanath
- Department of Psychiatry, NIMHANS, Bangalore, India
| | - M Yoldi-Negrete
- Consejo Nacional de Ciencia y Tecnología - Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - M Zetin
- Department of Psychology, Chapman University, Orange, CA, USA
| | - Y Zgueb
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - P C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Abstract
PURPOSE OF REVIEW We review recent evidence for circadian rhythm dysregulation in bipolar spectrum disorders (BSDs). We examine evidence for endogenous abnormalities in the biological clock and disruptions in the external entrainment of circadian rhythms in BSDs. We also address whether circadian dysregulation provides vulnerability to onset of BSD and evidence for a new integration of reward and circadian dysregulation in BSD. RECENT FINDINGS Relative circadian phase delay (e.g., later melatonin peak, evening chronotype) is associated with BSD, particularly in the depressive phase. More consistent evidence supports irregularity of social rhythms, sleep/wake and activity patterns, and disruptions of social rhythms by life events, as stable trait markers of BSD and potential vulnerabilities for BSD onset. Growing research supports an integrative reward/circadian model. Both endogenous abnormalities in the biological clock pacemaking function and disruptions in the external entrainment of circadian rhythms by physical and social cues are involved in BSDs. Circadian dysregulation may provide vulnerability to BSD onset.
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Affiliation(s)
- Lauren B Alloy
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA, 19122, USA.
| | - Tommy H Ng
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA, 19122, USA
| | - Madison K Titone
- Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA, 19122, USA
| | - Elaine M Boland
- Corporal Michael J. Crescenz Veterans Affairs Medical Center and University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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Bollettini I, Melloni EMT, Aggio V, Poletti S, Lorenzi C, Pirovano A, Vai B, Dallaspezia S, Colombo C, Benedetti F. Clock genes associate with white matter integrity in depressed bipolar patients. Chronobiol Int 2016; 34:212-224. [DOI: 10.1080/07420528.2016.1260026] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Irene Bollettini
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
- PhD program in Philosophy and Sciences of Mind, University Vita-Salute San Raffaele, Milan, Italy
| | - Elisa Maria Teresa Melloni
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
- PhD program in Molecular Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Veronica Aggio
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Sara Poletti
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Cristina Lorenzi
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Adele Pirovano
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Benedetta Vai
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
- PhD program in Evolutionary Psychopathology, Libera Università Maria SS. Assunta, Rome, Italy
| | - Sara Dallaspezia
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Cristina Colombo
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Benedetti
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
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30
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Luca A, Calandra C, Luca M. Gsk3 Signalling and Redox Status in Bipolar Disorder: Evidence from Lithium Efficacy. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:3030547. [PMID: 27630757 PMCID: PMC5007367 DOI: 10.1155/2016/3030547] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/28/2016] [Accepted: 07/20/2016] [Indexed: 12/15/2022]
Abstract
Objective. To discuss the link between glycogen synthase kinase-3 (GSK3) and the main biological alterations demonstrated in bipolar disorder (BD), with special attention to the redox status and the evidence supporting the efficacy of lithium (a GSK3 inhibitor) in the treatment of BD. Methods. A literature research on the discussed topics, using Pubmed and Google Scholar, has been conducted. Moreover, a manual selection of interesting references from the identified articles has been performed. Results. The main biological alterations of BD, pertaining to inflammation, oxidative stress, membrane ion channels, and circadian system, seem to be intertwined. The dysfunction of the GSK3 signalling pathway is involved in all the aforementioned "biological causes" of BD. In a complex scenario, it can be seen as the common denominator linking them all. Lithium inhibition of GSK3 could, at least in part, explain its positive effect on these biological dysfunctions and its superiority in terms of clinical efficacy. Conclusions. Deepening the knowledge on the molecular bases of BD is fundamental to identifying the biochemical pathways that must be targeted in order to provide patients with increasingly effective therapeutic tools against an invalidating disorder such as BD.
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Affiliation(s)
- Antonina Luca
- Department of Medical and Surgical Sciences and Advanced Technologies, University Hospital Policlinico-Vittorio Emanuele, Santa Sofia Street 78, Catania, 95100 Sicily, Italy
| | - Carmela Calandra
- Psychiatry Unit, Department of Medical and Surgical Sciences and Advanced Technologies, University Hospital Policlinico-Vittorio Emanuele, Santa Sofia Street 78, Catania, 95100 Sicily, Italy
| | - Maria Luca
- Psychiatry Unit, Department of Medical and Surgical Sciences and Advanced Technologies, University Hospital Policlinico-Vittorio Emanuele, Santa Sofia Street 78, Catania, 95100 Sicily, Italy
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31
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Russo M, Mahon K, Shanahan M, Ramjas E, Solon C, Purcell SM, Burdick KE. The relationship between sleep quality and neurocognition in bipolar disorder. J Affect Disord 2015; 187:156-62. [PMID: 26339925 PMCID: PMC4598049 DOI: 10.1016/j.jad.2015.08.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 06/15/2015] [Accepted: 08/04/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUNDS Sleep and circadian rhythm disruptions are prominent, trait-like features of bipolar disorder (BD) which precede the onset of mood episodes. Neurocognitive impairments also characterize BD not only during acute phases of the illness but also during remission. Although the relationship between these two debilitating aspects of the illness might seem intuitive, very little is known about their relationship. We examined the association between sleep dysfunction and neurocognition in BD. METHODS In a sample of 117 BD patients (mean age=45.0±10.7; 59.0% (n=69) male), neurocognitive functioning was assessed using the MATRICS Consensus Cognitive Battery (MCCB). Sleep quality data were collected using the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). Partial Pearson correlations tested for a relationship between sleep and neurocognition. Path analyses were conducted to examine the hypothesized direct influence of sleep disruption on neurocognition. RESULTS Higher levels of sleep disruptions were associated with a more severe clinical presentation and poorer performance in social cognition, visual learning and working memory. Social cognition and working memory were directly (negatively) predicted by sleep disruptions. LIMITATIONS The study was limited by a relatively small sample size and the lack of behavioral and biological objectives measure of activity/rest cycles. CONCLUSIONS Our study suggests that in patients with BD, sleep disruptions have a detrimental effect on general level of psychopathology and contribute directly to impaired cognitive functioning in the domains of social cognition and working memory. More research using objective measurement of sleep should be pursued to support these data and to further investigate the causal relationship between these disabling aspects of the illness.
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Affiliation(s)
- Manuela Russo
- Icahn School of Medicine at Mount Sinai; Departments of Psychiatry and Neuroscience
| | - Katie Mahon
- Icahn School of Medicine at Mount Sinai; Departments of Psychiatry and Neuroscience
| | - Megan Shanahan
- Icahn School of Medicine at Mount Sinai; Departments of Psychiatry and Neuroscience
| | - Elizabeth Ramjas
- Icahn School of Medicine at Mount Sinai; Departments of Psychiatry and Neuroscience
| | - Carly Solon
- Icahn School of Medicine at Mount Sinai; Departments of Psychiatry and Neuroscience
| | - Shaun M Purcell
- Icahn School of Medicine at Mount Sinai; Departments of Psychiatry and Neuroscience
| | - Katherine E Burdick
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, United States; James J Peters VA Medical Center Bronx, NY, United States.
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32
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The bipolarity of light and dark: A review on Bipolar Disorder and circadian cycles. J Affect Disord 2015; 185:219-29. [PMID: 26241867 DOI: 10.1016/j.jad.2015.07.017] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/06/2015] [Accepted: 07/08/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Bipolar Disorder is characterized by episodes running the full mood spectrum, from mania to depression. Between mood episodes, residual symptoms remain, as sleep alterations, circadian cycle disturbances, emotional deregulation, cognitive impairment and increased risk for comorbidities. The present review intends to reflect about the most recent and relevant information concerning the biunivocal relation between bipolar disorder and circadian cycles. METHODS It was conducted a literature search on PubMed database using the search terms "bipolar", "circadian", "melatonin", "cortisol", "body temperature", "Clock gene", "Bmal1 gene", "Per gene", "Cry gene", "GSK3β", "chronotype", "light therapy", "dark therapy", "sleep deprivation", "lithum" and "agomelatine". Search results were manually reviewed, and pertinent studies were selected for inclusion as appropriate. RESULTS Several studies support the relationship between bipolar disorder and circadian cycles, discussing alterations in melatonin, body temperature and cortisol rhythms; disruption of sleep/wake cycle; variations of clock genes; and chronotype. Some therapeutics for bipolar disorder directed to the circadian cycles disturbances are also discussed, including lithium carbonate, agomelatine, light therapy, dark therapy, sleep deprivation and interpersonal and social rhythm therapy. LIMITATIONS This review provides a summary of an extensive research for the relevant literature on this theme, not a patient-wise meta-analysis. CONCLUSIONS In the future, it is essential to achieve a better understanding of the relation between bipolar disorder and the circadian system. It is required to establish new treatment protocols, combining psychotherapy, therapies targeting the circadian rhythms and the latest drugs, in order to reduce the risk of relapse and improve affective behaviour.
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33
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Seleem M, Merranko J, Goldstein TR, Goldstein BI, Axelson DA, Brent DA, Nimgaonkar VL, Diler RS, Sakolsky D, Kupfer DJ, Birmaher B. The longitudinal course of sleep timing and circadian preferences in adults with bipolar disorder. Bipolar Disord 2015; 17:392-402. [PMID: 25524085 PMCID: PMC4458164 DOI: 10.1111/bdi.12286] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 10/22/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To study the longitudinal course of sleep timing and circadian preferences in individuals with bipolar disorder (BP) compared to individuals with non-BP psychopathology and healthy controls. METHODS Individuals with bipolar I and bipolar II disorder (n = 257), non-BP psychopathology (n = 105), and healthy controls (n = 55) (mean age 40.2 years, 21.3% male, 85.1% Caucasian) were followed on average every 27 months for a mean of four years. Sleep timing parameters and circadian preference were reported using the Sleep Timing Questionnaire and The Composite Scale for Morningness. Group comparisons were adjusted for multiple comparisons and between-group differences in demographic variables and psychopharmacological treatment. RESULTS Regardless of their current mood state, individuals with BP showed more sleep onset latency (SOL), wakening after sleep onset (WASO), and evening preference in comparison to both individuals with non-BP psychopathology and healthy controls. Individuals with BP also showed less stability of bed and awakening times in comparison to the other two groups, though these results were dependent on mood state. Non-BP individuals only showed more WASO and less stability in bed and awakening times before work/school days than healthy controls. Adjusting for comorbid disorders yielded similar results. Within-group analyses found little to no effect of time and BP subtype on sleep timing and circadian preference. CONCLUSIONS Disturbances of sleep timing are prominent in individuals with BP. These disturbances are worse during mood episodes, but still apparent during euthymic periods. Evening preference was not associated with polarity type, or mood state in BP, suggesting that this characteristic may be a trait marker.
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Affiliation(s)
- Mohammad Seleem
- Department of Psychiatry and Neurology, Tanta University, Tanta, Egypt
| | - John Merranko
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tina R Goldstein
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Benjamin I Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - David A Axelson
- Department of Psychiatry, Nationwide Children’s Hospital and The Ohio State College of Medicine, Columbus, OH, USA
| | - David A Brent
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Vishwajit L Nimgaonkar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Rasim S Diler
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dara Sakolsky
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David J Kupfer
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Millan MJ, Goodwin GM, Meyer-Lindenberg A, Ove Ögren S. Learning from the past and looking to the future: Emerging perspectives for improving the treatment of psychiatric disorders. Eur Neuropsychopharmacol 2015; 25:599-656. [PMID: 25836356 DOI: 10.1016/j.euroneuro.2015.01.016] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 01/28/2015] [Indexed: 02/06/2023]
Abstract
Modern neuropsychopharmacology commenced in the 1950s with the serendipitous discovery of first-generation antipsychotics and antidepressants which were therapeutically effective yet had marked adverse effects. Today, a broader palette of safer and better-tolerated agents is available for helping people that suffer from schizophrenia, depression and other psychiatric disorders, while complementary approaches like psychotherapy also have important roles to play in their treatment, both alone and in association with medication. Nonetheless, despite considerable efforts, current management is still only partially effective, and highly-prevalent psychiatric disorders of the brain continue to represent a huge personal and socio-economic burden. The lack of success in discovering more effective pharmacotherapy has contributed, together with many other factors, to a relative disengagement by pharmaceutical firms from neuropsychiatry. Nonetheless, interest remains high, and partnerships are proliferating with academic centres which are increasingly integrating drug discovery and translational research into their traditional activities. This is, then, a time of transition and an opportune moment to thoroughly survey the field. Accordingly, the present paper, first, chronicles the discovery and development of psychotropic agents, focusing in particular on their mechanisms of action and therapeutic utility, and how problems faced were eventually overcome. Second, it discusses the lessons learned from past successes and failures, and how they are being applied to promote future progress. Third, it comprehensively surveys emerging strategies that are (1), improving our understanding of the diagnosis and classification of psychiatric disorders; (2), deepening knowledge of their underlying risk factors and pathophysiological substrates; (3), refining cellular and animal models for discovery and validation of novel therapeutic agents; (4), improving the design and outcome of clinical trials; (5), moving towards reliable biomarkers of patient subpopulations and medication efficacy and (6), promoting collaborative approaches to innovation by uniting key partners from the regulators, industry and academia to patients. Notwithstanding the challenges ahead, the many changes and ideas articulated herein provide new hope and something of a framework for progress towards the improved prevention and relief of psychiatric and other CNS disorders, an urgent mission for our Century.
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Affiliation(s)
- Mark J Millan
- Pole for Innovation in Neurosciences, IDR Servier, 125 chemin de ronde, 78290 Croissy sur Seine, France.
| | - Guy M Goodwin
- University Department of Psychiatry, Oxford University, Warneford Hospital, Oxford OX3 7JX, England, UK
| | - Andreas Meyer-Lindenberg
- Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, D-68159 Mannheim, Germany
| | - Sven Ove Ögren
- Department of Neuroscience, Karolinska Institutet, Retzius väg 8, S-17177 Stockholm, Sweden
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35
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Alloy LB, Nusslock R, Boland EM. The development and course of bipolar spectrum disorders: an integrated reward and circadian rhythm dysregulation model. Annu Rev Clin Psychol 2015; 11:213-50. [PMID: 25581235 PMCID: PMC4380533 DOI: 10.1146/annurev-clinpsy-032814-112902] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In this article, we present and review the evidence for two major biopsychosocial theories of the onset and course of bipolar spectrum disorders (BSDs) that integrate behavioral, environmental, and neurobiological mechanisms: the reward hypersensitivity and the social/circadian rhythm disruption models. We describe the clinical features, spectrum, age of onset, and course of BSDs. We then discuss research designs relevant to demonstrating whether a hypothesized mechanism represents a correlate, vulnerability, or predictor of the course of BSDs, as well as important methodological issues. We next present the reward hypersensitivity model of BSD, followed by the social/circadian rhythm disruption model of BSD. For each model, we review evidence regarding whether the proposed underlying mechanism is associated with BSDs, provides vulnerability to the onset of BSDs, and predicts the course of BSDs. We then present a new integrated reward/circadian rhythm (RCR) dysregulation model of BSD and discuss how the RCR model explains the symptoms, onset, and course of BSDs. We end with recommendations for future research directions.
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Affiliation(s)
- Lauren B Alloy
- Department of Psychology, Temple University, Philadelphia, Pennsylvania 19122; ,
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36
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Drago A, Monti B, De Ronchi D, Serretti A. CRY1 Variations Impacts on the Depressive Relapse Rate in a Sample of Bipolar Patients. Psychiatry Investig 2015; 12:118-24. [PMID: 25670954 PMCID: PMC4310909 DOI: 10.4306/pi.2015.12.1.118] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 12/31/2013] [Accepted: 12/31/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE A relevant part of the social and personal burden caused by Bipolar Disorder (BD) is related to depressive phases. Authors investigated the genetic impact of a set of variations located in CRY1, a gene involved in the control of the circadian rhythms, towards depressive episodes in a sample of bipolar patients from the STEP-BD sample. As a secondary analysis, CYR1 variations were analyzed as predictors of sleep disruption. METHODS 654 bipolar patients were included in the analysis. Data were available genome-wide. The part of the genome coding for the CRY1 was imputed and pruned according to standards in the field. 7 SNPs were available for the analysis. A correction for multitesting was applied and we had sufficient power (0.80) to detect a small-medium effect size (0.22) between two allelic frequencies each one represented by at least 300 subjects. RESULTS Intronic rs10861688 was associated with the number of depressive events corrected for the times patients were assessed during the period of observation. In particular, AA subjects (n=21) had 4.46±3.15 events, AG (n=141) had 3.08±3.17 and GG (n=342) 2.65±2.97 (p=0.0048, beta=-0.22). No other significant associations were reported. CONCLUSION We bring further evidence that genes involved in the regulation of circadian rhythms may be relevant to depressive bipolar phases. Independent confirmation analyses are mandatory.
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Affiliation(s)
- Antonio Drago
- I.R.C.C.S. "San Giovanni di Dio", Fatebenefratelli, Brescia, Italy
| | - Barbara Monti
- Department of Pharmacy and Biotechnologies, University of Bologna, Bologna, Italy
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences - DIBINEM -, University of Bologna, Bologna, Italy
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences - DIBINEM -, University of Bologna, Bologna, Italy
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37
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Moro MF, Carta MG, Pintus M, Pintus E, Melis R, Kapczinski F, Vieta E, Colom F. Validation of the Italian Version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN): Some Considerations on its Screening Usefulness. Clin Pract Epidemiol Ment Health 2014; 10:48-52. [PMID: 24987447 PMCID: PMC4076616 DOI: 10.2174/1745017901410010048] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 05/05/2014] [Accepted: 05/09/2014] [Indexed: 11/30/2022]
Abstract
Introduction: Abnormalities in biological rhythms (BR) may have a role in the pathophysiology of Bipolar Disorders (BD). The objective of this study is to validate the Italian version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), a useful tool in studying BR, and measure its accuracy in discriminating BD.
Methods: 44 outpatients with DSM-IV-TR diagnosis of BD and 38 controls balanced for sex and age were consecutively recruited. The discriminant validity of BRIAN for the screening of BD and its test re-test reliability in two evaluations were assessed. Results: BD patients scored 22.22±11.19 in BRIAN against 7.13±5.6 of the control group (P<0.0001). BRIAN showed a good accuracy to screen between BD non-BD at cutoff 16, a sensitivity was 68.2 and specificity was 92.5. The test-retest stability measured using Pearson’s coefficient found very high r values for each section and the total score, thus indicating a correlation at the two times of statistical significance in all measures. Cohen’s Kappa varied from 0.47 in the sociality section to 0.80 in the sleep section, with a total K mean of 0.65. Conclusion: The results show that the Italian version of BRIAN has good discriminant validity in detecting BD from healthy controls and shows good test-retest reliability. The study suggests the possibility of developing mixed screening tools by introducing items on dysregulation of biological rhythms to the usual measures of mood.
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Affiliation(s)
- Maria F Moro
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Mauro G Carta
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Mirra Pintus
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Elisa Pintus
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Riccardo Melis
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Flavio Kapczinski
- Bipolar Disorders Program and Laboratory of Molecular Psychiatry, Hospital de Clinicas de Porto Alegre, Ramiro Barcelos 2350, 90035-000, Porto Alegre, RS, Brazil
| | - Eduard Vieta
- Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Francesc Colom
- Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
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Can A, Schulze TG, Gould TD. Molecular actions and clinical pharmacogenetics of lithium therapy. Pharmacol Biochem Behav 2014; 123:3-16. [PMID: 24534415 DOI: 10.1016/j.pbb.2014.02.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 02/04/2014] [Accepted: 02/05/2014] [Indexed: 12/21/2022]
Abstract
Mood disorders, including bipolar disorder and depression, are relatively common human diseases for which pharmacological treatment options are often not optimal. Among existing pharmacological agents and mood stabilizers used for the treatment of mood disorders, lithium has a unique clinical profile. Lithium has efficacy in the treatment of bipolar disorder generally, and in particular mania, while also being useful in the adjunct treatment of refractory depression. In addition to antimanic and adjunct antidepressant efficacy, lithium is also proven effective in the reduction of suicide and suicidal behaviors. However, only a subset of patients manifests beneficial responses to lithium therapy and the underlying genetic factors of response are not exactly known. Here we discuss preclinical research suggesting mechanisms likely to underlie lithium's therapeutic actions including direct targets inositol monophosphatase and glycogen synthase kinase-3 (GSK-3) among others, as well as indirect actions including modulation of neurotrophic and neurotransmitter systems and circadian function. We follow with a discussion of current knowledge related to the pharmacogenetic underpinnings of effective lithium therapy in patients within this context. Progress in elucidation of genetic factors that may be involved in human response to lithium pharmacology has been slow, and there is still limited conclusive evidence for the role of a particular genetic factor. However, the development of new approaches such as genome-wide association studies (GWAS), and increased use of genetic testing and improved identification of mood disorder patients sub-groups will lead to improved elucidation of relevant genetic factors in the future.
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Affiliation(s)
- Adem Can
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Thomas G Schulze
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Todd D Gould
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States; Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, United States; Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, United States.
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Cojocaru GR, Popa-Wagner A, Stanciulescu EC, Babadan L, Buga AM. Post-stroke depression and the aging brain. J Mol Psychiatry 2013; 1:14. [PMID: 25408907 PMCID: PMC4223891 DOI: 10.1186/2049-9256-1-14] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 07/25/2013] [Indexed: 11/12/2022] Open
Abstract
Ageing is associated with changes in the function of various organ systems. Changes in the cardiovascular system affect both directly and indirectly the function in a variety of organs, including the brain, with consequent neurological (motor and sensory performance) and cognitive impairments, as well as leading to the development of various psychiatric diseases. Post-stroke depression (PSD) is among the most frequent neuropsychiatric consequences of cerebral ischemia. This review discusses several animal models used for the study of PSD and summarizes recent findings in the genomic profile of the ageing brain, which are associated with age-related disorders in the elderly. Since stroke and depression are diseases with increased incidence in the elderly, great clinical benefit may especially accrue from deciphering and targeting basic mechanisms underlying PSD. Finally, we discuss the relationship between ageing, circadian rhythmicity and PSD.
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Affiliation(s)
- Gabriel R Cojocaru
- Department of Functional Sciences, Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy of Craiova, Petru Rares str., no 2, Craiova, 200349 Romania
| | - Aurel Popa-Wagner
- Department of Psychiatry, University of Medicine Rostock, Rostock, Germany
| | - Elena C Stanciulescu
- Faculty of Pharmacy, Chair of Biochemistry, University of Medicine and Pharmacy of Craiova, Craiova, 200349 Romania
| | - Loredana Babadan
- Department of Functional Sciences, Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy of Craiova, Petru Rares str., no 2, Craiova, 200349 Romania
| | - Ana-Maria Buga
- Department of Functional Sciences, Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy of Craiova, Petru Rares str., no 2, Craiova, 200349 Romania
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Abstract
OBJECTIVE As part of a series of papers examining chronobiology ['Getting depression clinical guidelines right: time for change?' Kuiper et al. Acta Psychiatr Scand 2013;128(Suppl. 444):24-30; and 'Manipulating melatonin in managing mood' Boyce & Hopwood. ActaPsychiatrScand 2013;128(Suppl. 444):16-23], in this article, we review and synthesise the extant literature pertaining to the chronobiology of depression and provide a preliminary model for understanding the neural systems involved. METHOD A selective literature search was conducted using search engines such as MEDLINE/PubMed, combining terms associated with chronobiology and mood disorders. RESULTS We propose that understanding of sleep-wake function and mood can be enhanced by simultaneously considering the circadian system, the sleep homoeostat and the core stress system, all of which are likely to be simultaneously disrupted in major mood disorders. This integrative approach is likely to allow flexible modelling of a much broader range of mood disorder presentations and phenomenology. CONCLUSION A preliminary multifaceted model is presented, which will require further development and testing. Future depression research should aim to examine multiple systems concurrently in order to derive a more sophisticated understanding of the underlying neurobiology.
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Affiliation(s)
- G. S. Malhi
- Department of Psychiatry; CADE Clinic; Royal North Shore Hospital Discipline of Psychiatry; Sydney Medical School; The University of Sydney; Sydney; NSW; Australia
| | - S. Kuiper
- Department of Psychiatry; CADE Clinic; Royal North Shore Hospital Discipline of Psychiatry; Sydney Medical School; The University of Sydney; Sydney; NSW; Australia
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Milhiet V, Yon L, Bellivier F. Traitements non pharmacologiques des troubles bipolaires. ANNALES MEDICO-PSYCHOLOGIQUES 2012. [DOI: 10.1016/j.amp.2012.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Etain B, Dumaine A, Bellivier F, Pagan C, Francelle L, Goubran-Botros H, Moreno S, Deshommes J, Moustafa K, Le Dudal K, Mathieu F, Henry C, Kahn JP, Launay JM, Mühleisen TW, Cichon S, Bourgeron T, Leboyer M, Jamain S. Genetic and functional abnormalities of the melatonin biosynthesis pathway in patients with bipolar disorder. Hum Mol Genet 2012; 21:4030-7. [PMID: 22694957 DOI: 10.1093/hmg/dds227] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Patients affected by bipolar disorder (BD) frequently report abnormalities in sleep/wake cycles. In addition, they showed abnormal oscillating melatonin secretion, a key regulator of circadian rhythms and sleep patterns. The acetylserotonin O-methyltransferase (ASMT) is a key enzyme of the melatonin biosynthesis and has recently been associated with psychiatric disorders such as autism spectrum disorders and depression. In this paper, we analysed rare and common variants of ASMT in patients with BD and unaffected control subjects and performed functional analysis of these variants by assaying the ASMT activity in their B-lymphoblastoid cell lines. We sequenced the coding and the regulatory regions of the gene in a discovery sample of 345 patients with BD and 220 controls. We performed an association study on this discovery sample using common variants located in the promoter region and showed that rs4446909 was significantly associated with BD (P= 0.01) and associated with a lower mRNA level (P< 10(-4)) and a lower enzymatic activity (P< 0.05) of ASMT. A replication study and a meta-analysis using 480 independent patients with BD and 672 controls confirmed the significant association between rs4446909 and BD (P= 0.002). These results correlate with the general lower ASMT enzymatic activity observed in patients with BD (P= 0.001) compared with controls. Finally, several deleterious ASMT mutations identified in patients were associated with low ASMT activity (P= 0.01). In this study, we determined how rare and common variations in ASMT might play a role in BD vulnerability and suggest a general role of melatonin as susceptibility factor for BD.
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Affiliation(s)
- Bruno Etain
- Psychiatrie Génétique, INSERM U 955, Créteil 94000, France
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Quera Salva MA, Hartley S. Mood disorders, circadian rhythms, melatonin and melatonin agonists. J Cent Nerv Syst Dis 2012; 4:15-26. [PMID: 23650464 PMCID: PMC3619438 DOI: 10.4137/jcnsd.s4103] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Recent advances in the understanding of circadian rhythms have led to an interest in the treatment of major depressive disorder with chronobiotic agents. Many tissues have autonomous circadian rhythms, which are orchestrated by the master clock, situated in the suprachiasmatic nucleus (SNC). Melatonin (N-acetyl-5-hydroxytryptamine) is secreted from the pineal gland during darkness. Melatonin acts mainly on MT1 and MT2 receptors, which are present in the SNC, regulating physiological and neuroendocrine functions, including circadian entrainment, referred to as the chronobiotic effet. Circadian rhythms has been shown to be either misaligned or phase shifted or decreased in amplitude in both acute episodes and relapse of major depressive disorder (MDD) and bipolar disorder. Manipulation of circadian rhythms either using physical treatments (such as high intensity light) or behavioral therapy has shown promise in improving symptoms. Pharmacotherapy using melatonin and pure melatonin receptor agonists, while improving sleep, has not been shown to improve symptoms of depression. A novel antidepressant, agomelatine, combines 5HT2c antagonist and melatonin agonist action, and has shown promise in both acute treatment of MDD and in preventing relapse.
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Affiliation(s)
- M A Quera Salva
- Sleep Unit, Physiology Department, Hôpital Raymond Poincaré, 104 Boulevard Raymond Poincaré, 92380 Garches, France
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Sarrazin S, Etain B, Vederine FE, d'Albis MA, Hamdani N, Daban C, Delavest M, Lépine JP, Leboyer M, Mangin JF, Poupon C, Houenou J. MRI exploration of pineal volume in bipolar disorder. J Affect Disord 2011; 135:377-9. [PMID: 21700342 DOI: 10.1016/j.jad.2011.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 05/31/2011] [Accepted: 06/01/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND Circadian rhythm instability and abnormalities of melatonin secretion are considered as trait markers of bipolar disorder. Melatonin is secreted by the pineal gland. We investigated pineal volume in patients with bipolar disorder, and expected to observe smaller than normal pineal glands in cases of bipolar disorder. METHODS The primary outcome was the total pineal volume measured for each pineal gland with T1 MRI sequence. Twenty patients with bipolar I and II disorder and twenty controls were recruited. Pineal glands with large cysts (type 3) were excluded. RESULTS After exclusion of individuals with type 3 cysts, 32 subjects were analyzed for total pineal volume (16 patients with bipolar disorder and 16 controls). Total pineal volume did not differ significantly between patients (total pineal volume=115+/-54.3mm(3)) and controls (total pineal volume=110+/-40.5mm(3)). CONCLUSIONS Contrary to our hypothesis, no difference in total pineal volume between patients with bipolar disorder and healthy subjects was observed. These results indicate that the putative dysfunction of the pineal gland in bipolar disorder could be not directly related to an abnormal volume of the pineal gland.
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Affiliation(s)
- Samuel Sarrazin
- AP-HP, University Paris-East, Department of Psychiatry, Henri Mondor-Albert Chenevier Hospitals, Créteil, F-94010, France
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Coogan AN, Thome J. Chronotherapeutics and psychiatry: setting the clock to relieve the symptoms. World J Biol Psychiatry 2011; 12 Suppl 1:40-3. [PMID: 21905994 DOI: 10.3109/15622975.2011.598389] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Circadian rhythms are near 24-h cycles in a number of physiological and behavioural parameters and the underpinning circadian timing systems is one of the key homeostatic regulatory systems in mammalian physiology. Many common psychiatric conditions are associated with disrupted sleep, including a common occurrence of delayed or advanced phase sleep syndromes, which in themselves may be indicative of dysregulated circadian timing in these disorders. In this article we discuss the evidence for abnormal circadian rhythms in seasonal affective disorder, bipolar disorder and attention deficit/hyperactivity disorder. Much of this evidence suggest that these conditions are associated with either phase delays or phase advances of core phase markers of the circadian clock such as melatonin or core body temperature, suggesting the presence of circadian desynchrony in these conditions. We also highlight findings that pharmacological and/or behavioural interventions that ameliorate circadian misalignments are efficacious in producing symptomatic relief, suggesting an intrinsic link between the circadian and affective systems that can be manipulated for clinical benefit.
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Affiliation(s)
- Andrew N Coogan
- Department of Psychology, National University of Ireland, Maynooth, Republic of Ireland.
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Circadian clock gene Per3 variants influence the postpartum onset of bipolar disorder. Eur Psychiatry 2011; 26:138-40. [PMID: 21316201 DOI: 10.1016/j.eurpsy.2010.11.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 11/24/2010] [Accepted: 11/28/2010] [Indexed: 12/14/2022] Open
Abstract
Postpartum depression can mark the onset of bipolar disorder. The coding region of Per3 gene contains a variable-number tandem-repeat polymorphism, which has been shown to influence bipolar disorder onset and to affect breast cancer risk. We showed a relationship between Per3 polymorphism and postpartum depressive onset in bipolar disorder.
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Milhiet V, Etain B, Boudebesse C, Bellivier F. Circadian biomarkers, circadian genes and bipolar disorders. ACTA ACUST UNITED AC 2011; 105:183-9. [PMID: 21767641 DOI: 10.1016/j.jphysparis.2011.07.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bipolar disorders are associated with circadian deregulations both during acute mood episodes and during euthymic periods, suggesting that these circadian rhythms may represent trait markers of the disease. Several arguments demonstrate that deregulations of circadian rhythms may be part of the pathophysiology of bipolar disorders. Abnormal quantitative and qualitative circadian disturbances have been repeatedly showed in bipolar patients, both during euthymic periods and acute phases, using different assessment tools such as actigraphy, polysomnography, and blood melatonin monitoring. In addition, many circadian physiological functions have been demonstrated to be altered in bipolar patients, such as secretion of hormones and other endogenous substances, core temperature, and fibroblasts activity. Furthermore, mood stabilizers efficiency could partially be explained by their impact on the regulation of the circadian rhythms. The implication of genetic vulnerability factors has long been demonstrated in bipolar disorders and several circadian genes have been tested for association in bipolar disorders. Although preliminary, interesting results have been obtained in several independent studies.
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Affiliation(s)
- Vanessa Milhiet
- INSERM, Unité 955, IMRB, Pôle de Génomique Médicale, Equipe de Psychiatrie Génétique, Créteil, France
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Benedetti F, Radaelli D, Poletti S, Locatelli C, Dallaspezia S, Lorenzi C, Pirovano A, Colombo C, Smeraldi E. Association of the C(-1019)G 5-HT1A promoter polymorphism with exposure to stressors preceding hospitalization for bipolar depression. J Affect Disord 2011; 132:297-300. [PMID: 21397953 DOI: 10.1016/j.jad.2011.02.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 02/21/2011] [Accepted: 02/21/2011] [Indexed: 10/18/2022]
Abstract
RATIONALE In animals, a higher density of 5-HT1A receptors has been associated with increased behavioral despair after stress. In humans, the G variant of the C(-1019)G 5-HT1A receptor promoter gene polymorphism (rs6295) has been associated with higher expression of 5-HT1A receptors, increased depression, and lower stress preceding completed suicide. OBJECTIVES We studied the association of rs6295 with the amount of stress in early life and preceding hospitalization for a major depressive episode in course of bipolar disorder. MATERIALS AND METHODS In 74 consecutively admitted inpatients, early life and recent stressors were rated on the Social Readjustment Rating Scale and on the Risky Family Questionnaire. RESULTS Homozygote carriers of the rs6295 G variant reported less stressful events before current hospitalization for bipolar depression, but not in early life. The G variant was also associated with a higher overall medication load in naturalistic settings before hospitalization. CONCLUSIONS This is the first study that associated 5-HT1A receptor promoter gene variants with stressors preceding the need of hospitalization for bipolar depression. Our findings support the hypothesis that genetic factors affecting serotonergic neurotransmission might contribute to shape the individual resilience to the depressogenic effects of stress in clinical settings.
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Affiliation(s)
- Francesco Benedetti
- Department of Clinical Neurosciences, San Raffaele Scientific Institute and University Vita-Salute, Milan, Italy.
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