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Culicetto L, Ferraioli F, Lucifora C, Falzone A, Martino G, Craparo G, Avenanti A, Vicario CM. Disgust as a transdiagnostic index of mental illness: A narrative review of clinical populations. Bull Menninger Clin 2023; 87:53-91. [PMID: 37871195 DOI: 10.1521/bumc.2023.87.suppa.53] [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] [Indexed: 10/25/2023]
Abstract
Disgust is a basic emotion of rejection, providing an ancestral defensive mechanism against illness. Based on research that documents altered experiences of disgust across several psychopathological conditions, we conducted a narrative review to address the hypothesis that altered disgust may serve as a transdiagnostic index of mental illness. Our synthesis of the literature from past decades suggests that, compared to healthy populations, patients with mental disorders exhibit abnormal processing of disgust in at least one of the analyzed dimensions. We also outline evidence of alterations in brain areas relevant to disgust processing, such as the insula and the interconnected limbic network. Overall, we provide preliminary support for the hypothesis that altered disgust processing may serve as a transdiagnostic index of mental illness.
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Affiliation(s)
- Laura Culicetto
- Department of Cognitive Science, University of Messina, Messina, Italy
| | | | - Chiara Lucifora
- Institute of Cognitive Science and Technology, ISTC-CNR, Rome, Italy
| | | | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, UKE-Kore University of Enna, Cittadella Universitaria, Enna, Italy
| | - Alessio Avenanti
- Neuropsychology and Cognitive Neurosciences Research Center, Universidad Católica del Maule, Talca, Chile, and the Center for Studies and Research in Cognitive Neuroscience, Department of Psychology "Renzo Canestrari," Alma Mater Studiorum-University of Bologna, Cesena Campus, Cesena, Italy
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2
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Working memory updating in individuals with bipolar and unipolar depression: fMRI study. Transl Psychiatry 2022; 12:441. [PMID: 36220840 PMCID: PMC9553934 DOI: 10.1038/s41398-022-02211-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 01/10/2023] Open
Abstract
Understanding neurobiological characteristics of cognitive dysfunction in distinct psychiatric disorders remains challenging. In this secondary data analysis, we examined neurobiological differences in brain response during working memory updating among individuals with bipolar disorder (BD), those with unipolar depression (UD), and healthy controls (HC). Individuals between 18-45 years of age with BD (n = 100), UD (n = 109), and HC (n = 172) were scanned using fMRI while performing 0-back (easy) and 2-back (difficult) tasks with letters as the stimuli and happy, fearful, or neutral faces as distractors. The 2(n-back) × 3(groups) × 3(distractors) ANCOVA examined reaction time (RT), accuracy, and brain activation during the task. HC showed more accurate and faster responses than individuals with BD and UD. Difficulty-related activation in the prefrontal, posterior parietal, paracingulate cortices, striatal, lateral occipital, precuneus, and thalamic regions differed among groups. Individuals with BD showed significantly lower difficulty-related activation differences in the left lateral occipital and the right paracingulate cortices than those with UD. In individuals with BD, greater difficulty-related worsening in accuracy was associated with smaller activity changes in the right precuneus, while greater difficulty-related slowing in RT was associated with smaller activity changes in the prefrontal, frontal opercular, paracingulate, posterior parietal, and lateral occipital cortices. Measures of current depression and mania did not correlate with the difficulty-related brain activation differences in either group. Our findings suggest that the alterations in the working memory circuitry may be a trait characteristic of reduced working memory capacity in mood disorders. Aberrant patterns of activation in the left lateral occipital and paracingulate cortices may be specific to BD.
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Siegel-Ramsay JE, Bertocci MA, Wu B, Phillips ML, Strakowski SM, Almeida JRC. Distinguishing between depression in bipolar disorder and unipolar depression using magnetic resonance imaging: a systematic review. Bipolar Disord 2022; 24:474-498. [PMID: 35060259 DOI: 10.1111/bdi.13176] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Magnetic resonance imaging (MRI) studies comparing bipolar and unipolar depression characterize pathophysiological differences between these conditions. However, it is difficult to interpret the current literature due to differences in MRI modalities, analysis methods, and study designs. METHODS We conducted a systematic review of publications using MRI to compare individuals with bipolar and unipolar depression. We grouped studies according to MRI modality and task design. Within the discussion, we critically evaluated and summarized the functional MRI research and then further complemented these findings by reviewing the structural MRI literature. RESULTS We identified 88 MRI publications comparing participants with bipolar depression and unipolar depressive disorder. Compared to individuals with unipolar depression, participants with bipolar disorder exhibited heightened function, increased within network connectivity, and reduced grey matter volume in salience and central executive network brain regions. Group differences in default mode network function were less consistent but more closely associated with depressive symptoms in participants with unipolar depression but distractibility in bipolar depression. CONCLUSIONS When comparing mood disorder groups, the neuroimaging evidence suggests that individuals with bipolar disorder are more influenced by emotional and sensory processing when responding to their environment. In contrast, depressive symptoms and neurofunctional response to emotional stimuli were more closely associated with reduced central executive function and less adaptive cognitive control of emotionally oriented brain regions in unipolar depression. Researchers now need to replicate and refine network-level trends in these heterogeneous mood disorders and further characterize MRI markers associated with early disease onset, progression, and recovery.
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Affiliation(s)
- Jennifer E Siegel-Ramsay
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Michele A Bertocci
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Bryan Wu
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Stephen M Strakowski
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Jorge R C Almeida
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
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Li L, Han X, Ji E, Tao X, Shen M, Zhu D, Zhang L, Li L, Yang H, Zhang Z. Altered task-modulated functional connectivity during emotional face processing in euthymic bipolar patients: A whole-brain psychophysiological interaction study. J Affect Disord 2022; 301:162-171. [PMID: 35031332 DOI: 10.1016/j.jad.2022.01.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/10/2021] [Accepted: 01/10/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Patients with bipolar disorder (BD) show deficits of facial emotion processing even in the euthymic phase. However, the large-scale functional brain network mechanism underlying the emotional deficit of BD remains unclear. Specifically, it is of importance to understand how the task-modulated functional connectivity (FC) was alternated over distributed brain networks in BD. METHODS In this study, we analyzed functional MRI data of a face-matching task from 29 euthymic BD patients and 29 healthy controls (HC), and performed whole-brain psychophysiological interaction (PPI) analysis to obtain task-modulated FC. Abnormal FC patterns were identified through support vector machine-based classification. The topological organization of task-modulated FC networks was estimated by the graph theoretical analysis and compared between BD and HC. RESULTS BD exhibited widely distributed aberrant task-modulated FC patterns not only in core neurocognitive intrinsic brain networks (the fronto-parietal, cingulo-opercular, and default mode networks), but also in the cerebellum and primary processing networks (sensorimotor and visual). Furthermore, the local efficiency of the frontal-parietal network was significantly increased in BD. LIMITATIONS The modest sample size. Only face pictures with negative emotion were used. Only unidirectional task-modulated FC was investigated. CONCLUSIONS BD patients showed a widely distributed aberrant task-modulated FC pattern. Particularly, the fronto-parietal network, as one of the core neurocognitive intrinsic brain networks, was the primary network that demonstrated changes of both FC strength and local efficiency in BD. These findings on the task-modulated FC between these intrinsic brain networks might be considered an endophenotype of the BD condition persistent in the euthymic state.
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Affiliation(s)
- Linling Li
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen 518060, China; Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen 518060, China.
| | - Xue Han
- Department of Mental Health, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518060, China.
| | - Erni Ji
- Department for Bipolar Disorders, Shenzhen Mental Health Centre, Shenzhen Key Lab for Psychological Healthcare, Shenzhen 518020, China.
| | - Xiangrong Tao
- Department for Depression, Shenzhen Mental Health Centre, Shenzhen Key Lab for Psychological Healthcare, Shenzhen 518020, China
| | - Manjun Shen
- Department of Mental Health, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518060, China
| | - Dongjian Zhu
- Department of Mental Health, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518060, China
| | - Li Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen 518060, China; Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen 518060, China.
| | - Lingjiang Li
- Department of Mental Health, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518060, China; National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Haichen Yang
- Department for Bipolar Disorders, Shenzhen Mental Health Centre, Shenzhen Key Lab for Psychological Healthcare, Shenzhen 518020, China.
| | - Zhiguo Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen 518060, China; Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen 518060, China; Peng Cheng Laboratory, Shenzhen 518055, China; Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen 518055, China.
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5
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Li L, Li R, Shen F, Wang X, Zou T, Deng C, Wang C, Li J, Wang H, Huang X, Lu F, He Z, Chen H. Negative bias effects during audiovisual emotional processing in major depression disorder. Hum Brain Mapp 2021; 43:1449-1462. [PMID: 34888973 PMCID: PMC8837587 DOI: 10.1002/hbm.25735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/17/2021] [Accepted: 11/25/2021] [Indexed: 12/27/2022] Open
Abstract
Aberrant affective neural processing and negative emotional bias are trait‐marks of major depression disorders (MDDs). However, most research on biased emotional perception in depression has only focused on unimodal experimental stimuli, the neural basis of potentially biased emotional processing of multimodal inputs remains unclear. Here, we addressed this issue by implementing an audiovisual emotional task during functional MRI scanning sessions with 37 patients with MDD and 37 gender‐, age‐ and education‐matched healthy controls. Participants were asked to distinguish laughing and crying sounds while being exposed to faces with different emotional valences as background. We combined general linear model and psychophysiological interaction analyses to identify abnormal local functional activity and integrative processes during audiovisual emotional processing in MDD patients. At the local neural level, MDD patients showed increased bias activity in the ventromedial prefrontal cortex (vmPFC) while listening to negative auditory stimuli and concurrently processing visual facial expressions, along with decreased dorsolateral prefrontal cortex (dlPFC) activity in both the positive and negative visual facial conditions. At the network level, MDD exhibited significantly decreased connectivity in areas involved in automatic emotional processes and voluntary control systems during perception of negative stimuli, including the vmPFC, dlPFC, insula, as well as the subcortical regions of posterior cingulate cortex and striatum. These findings support a multimodal emotion dysregulation hypothesis for MDD by demonstrating that negative bias effects may be facilitated by the excessive ventral bottom‐up negative emotional influences along with incapability in dorsal prefrontal top‐down control system.
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Affiliation(s)
- Liyuan Li
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China
| | - Rong Li
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China
| | - Fei Shen
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China
| | - Xuyang Wang
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China
| | - Ting Zou
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China
| | - Chijun Deng
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China
| | - Chong Wang
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China
| | - Jiyi Li
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China
| | - Hongyu Wang
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China
| | - Xinju Huang
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China
| | - Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China
| | - Zongling He
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, P. R. China.,Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, P. R. China
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Korgaonkar MS. Precision in psychiatry-A roadmap to translate neurobiological measures to the clinic. Bipolar Disord 2021; 23:747-750. [PMID: 34932256 DOI: 10.1111/bdi.13160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 11/14/2021] [Accepted: 11/20/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Mayuresh S Korgaonkar
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia.,Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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7
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Rai S, Griffiths KR, Breukelaar IA, Barreiros AR, Chen W, Boyce P, Hazell P, Foster SL, Malhi GS, Harris AWF, Korgaonkar MS. Default-mode and fronto-parietal network connectivity during rest distinguishes asymptomatic patients with bipolar disorder and major depressive disorder. Transl Psychiatry 2021; 11:547. [PMID: 34689161 PMCID: PMC8542033 DOI: 10.1038/s41398-021-01660-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/21/2021] [Accepted: 10/01/2021] [Indexed: 11/08/2022] Open
Abstract
Bipolar disorder (BD) is commonly misdiagnosed as major depressive disorder (MDD). This is understandable, as depression often precedes mania and is otherwise indistinguishable in both. It is therefore imperative to identify neural mechanisms that can differentiate the two disorders. Interrogating resting brain neural activity may reveal core distinguishing abnormalities. We adopted an a priori approach, examining three key networks documented in previous mood disorder literature subserving executive function, salience and rumination that may differentiate euthymic BD and MDD patients. Thirty-eight patients with BD, 39 patients with MDD matched for depression severity, and 39 age-gender matched healthy controls, completed resting-state fMRI scans. Seed-based and data-driven Independent Component analyses (ICA) were implemented to examine group differences in resting-state connectivity (pFDR < 0.05). Seed analysis masks were target regions identified from the fronto-parietal (FPN), salience (SN) and default-mode (DMN) networks. Seed-based analyses identified significantly greater connectivity between the subgenual cingulate cortex (DMN) and right dorsolateral prefrontal cortex (FPN) in BD relative to MDD and controls. The ICA analyses also found greater connectivity between the DMN and inferior frontal gyrus, an FPN region in BD relative to MDD. There were also significant group differences across the three networks in both clinical groups relative to controls. Altered DMN-FPN functional connectivity is thought to underlie deficits in the processing, management and regulation of affective stimuli. Our results suggest that connectivity between these networks could potentially distinguish the two disorders and could be a possible trait mechanism in BD persisting even in the absence of symptoms.
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Affiliation(s)
- Sabina Rai
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, Sydney, NSW, Australia.
| | - Kristi R Griffiths
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, Sydney, NSW, Australia
| | - Isabella A Breukelaar
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Ana R Barreiros
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, Sydney, NSW, Australia
| | - Wenting Chen
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, Sydney, NSW, Australia
| | - Philip Boyce
- Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Philip Hazell
- Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Sheryl L Foster
- Department of Radiology, Westmead Hospital, Sydney, NSW, Australia
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Gin S Malhi
- Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Anthony W F Harris
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, Sydney, NSW, Australia
- Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Mayuresh S Korgaonkar
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, Sydney, NSW, Australia.
- Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
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8
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Nimarko AF, Fischer AS, Hagan KE, Gorelik AJ, Lu Y, Young CJ, Singh MK. Neural Correlates of Positive Emotion Processing That Distinguish Healthy Youths at Familial Risk for Bipolar Versus Major Depressive Disorder. J Am Acad Child Adolesc Psychiatry 2021; 60:887-901. [PMID: 32738282 PMCID: PMC7855111 DOI: 10.1016/j.jaac.2020.07.890] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 06/17/2020] [Accepted: 07/23/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Familial risk for bipolar disorder (BD) or major depressive disorder (MDD) may lead to differential emotion processing signatures, resulting in unique neural vulnerability. METHOD Healthy offspring of a parent with BD (n = 29, "BD-risk") or MDD (n = 44, "MDD-risk") and healthy control youths without any personal or family psychopathology (n = 28, "HC") aged 8 to 17 years (13.64 ± 2.59 years) completed an implicit emotion-perception functional magnetic resonance imaging task. Whole-brain voxelwise and psychophysiological interaction analyses examined neural differences in activation and connectivity during emotion processing. Regression modeling tested for neural associations with behavioral strengths and difficulties and conversion to psychopathology at follow-up (3.71 ± 1.91 years). RESULTS BD-risk youth showed significantly reduced bilateral putamen activation, and decreased connectivity between the left putamen and the left ventral anterior cingulate cortex (vACC) and the right posterior cingulate cortex (PCC) during positive-valence emotion processing compared to MDD-risk and HC (Z >2.3; p <.001). Decreased left putamen-right PCC connectivity correlated with subsequent peer problems in BD-risk (β = -2.90; p <.05) and MDD-risk (β = -3.64; p < .05) groups. Decreased left (β = -0.09; p < .05) and right putamen activation (β = -0.07; p = .04) were associated with conversion to a mood or anxiety disorder in BD-risk youths. Decreased left putamen-right PCC connectivity was associated with a higher risk of conversion in BD-risk (HR = 8.28 , p < .01) and MDD-risk (HR = 2.31, p = .02) groups. CONCLUSION Reduced putamen activation and connectivity during positive emotion processing appear to distinguish BD-risk youths from MDD-risk and HC youths, and may represent a marker of vulnerability.
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Affiliation(s)
| | | | | | | | - Yvonne Lu
- Stanford University School of Medicine, California
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9
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Rai S, Griffiths K, Breukelaar IA, Barreiros AR, Chen W, Boyce P, Hazell P, Foster S, Malhi GS, Bryant RA, Harris AWF, Korgaonkar MS. Investigating neural circuits of emotion regulation to distinguish euthymic patients with bipolar disorder and major depressive disorder. Bipolar Disord 2021; 23:284-294. [PMID: 33369067 DOI: 10.1111/bdi.13042] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/20/2020] [Accepted: 12/20/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Up to 40% of patients with bipolar disorder (BD) are initially diagnosed as having major depressive disorder (MDD), and emotional lability is a key aspect of both sets of mood disorders. However, it remains unknown whether differences in the regulation of emotions through cognitive reappraisal may serve to distinguish BD and MDD. Therefore, we examined this question in euthymic BD and MDD patients. METHODS Thirty-eight euthymic BD, 33 euthymic MDD and 37 healthy control (HC) participants, matched for age, gender and depression severity, engaged in an emotion regulation (ER) cognitive reappraisal task during an fMRI scan were examined. Participants either reappraised (Think condition) or passively watched negative (Watch condition) or neutral (Neutral condition) pictures and rated their affect. Activation and connectivity analyses were used to examine group differences in reappraisal (Think vs Watch) and reactivity (Watch vs Neutral) conditions in ER-specific neural circuits. RESULTS Irrespective of group, participants rated most negatively the images during the Watch condition relative to Think and Neutral conditions, and more negatively to Think relative to Neutral. Notably, BD participants exhibited reduced subgenual anterior cingulate activation (sgACC) relative to MDD during reappraisal, but exhibited greater sgACC activation relative to MDD during reactivity, whereas MDD participants elicited greater activation in right amygdala relative to BD during reactivity. We found no group differences in task-related connectivity. CONCLUSIONS Euthymic BD and MDD patients engage differential brain regions to process and regulate emotional information. These differences could serve to distinguish the clinical groups and provide novel insights into the underlying pathophysiology of BD.
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Affiliation(s)
- Sabina Rai
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Kristi Griffiths
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Isabella A Breukelaar
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Ana R Barreiros
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Wenting Chen
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Philip Boyce
- Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Philip Hazell
- Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Sheryl Foster
- Department of Radiology, Westmead Hospital, Westmead, NSW, Australia.,Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Gin S Malhi
- Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Anthony W F Harris
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia.,Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Mayuresh S Korgaonkar
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia.,Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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10
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McCorkle TA, Barson JR, Raghupathi R. A Role for the Amygdala in Impairments of Affective Behaviors Following Mild Traumatic Brain Injury. Front Behav Neurosci 2021; 15:601275. [PMID: 33746719 PMCID: PMC7969709 DOI: 10.3389/fnbeh.2021.601275] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/29/2021] [Indexed: 11/30/2022] Open
Abstract
Mild traumatic brain injury (TBI) results in chronic affective disorders such as depression, anxiety, and fear that persist up to years following injury and significantly impair the quality of life for patients. Although a great deal of research has contributed to defining symptoms of mild TBI, there are no adequate drug therapies for brain-injured individuals. Preclinical studies have modeled these deficits in affective behaviors post-injury to understand the underlying mechanisms with a view to developing appropriate treatment strategies. These studies have also unveiled sex differences that contribute to the varying phenotypes associated with each behavior. Although clinical and preclinical studies have viewed these behavioral deficits as separate entities with unique neurobiological mechanisms, mechanistic similarities suggest that a novel approach is needed to advance research on drug therapy. This review will discuss the circuitry involved in the expression of deficits in affective behaviors following mild TBI in humans and animals and provide evidence that the manifestation of impairment in these behaviors stems from an amygdala-dependent emotional processing deficit. It will highlight mechanistic similarities between these different types of affective behaviors that can potentially advance mild TBI drug therapy by investigating treatments for the deficits in affective behaviors as one entity, requiring the same treatment.
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Affiliation(s)
- Taylor A. McCorkle
- Graduate Program in Neuroscience, Graduate School of Biomedical Sciences and Professional Studies, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Jessica R. Barson
- Graduate Program in Neuroscience, Graduate School of Biomedical Sciences and Professional Studies, Drexel University College of Medicine, Philadelphia, PA, United States
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Ramesh Raghupathi
- Graduate Program in Neuroscience, Graduate School of Biomedical Sciences and Professional Studies, Drexel University College of Medicine, Philadelphia, PA, United States
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, United States
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11
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Cha J, Speaker S, Hu B, Altinay M, Koirala P, Karne H, Spielberg J, Kuceyeski A, Dhamala E, Anand A. Neuroimaging correlates of emotional response-inhibition discriminate between young depressed adults with and without sub-threshold bipolar symptoms (Emotional Response-inhibition in Young Depressed Adults). J Affect Disord 2021; 281:303-311. [PMID: 33341013 PMCID: PMC8311442 DOI: 10.1016/j.jad.2020.12.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/25/2020] [Accepted: 12/07/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Many subjects with major depression (MDD) exhibit subthreshold mania symptoms (MDD+). This study investigated, for the first time, using emotional inhibition tasks, whether the neural organization of MDD+ subjects is more similar to bipolar depression (BDD) or to MDD subjects without subthreshold bipolar symptoms (MDD-). METHOD This study included 118 medication-free young adults (15 - 30 yrs.): 20 BDD, 28 MDD+, 41 MDD- and 29 HC subjects. Participants underwent fMRI during emotional and non-emotional Go/No-go tasks during which they responded for Go stimuli and inhibited response for happy, fear, and non-emotional (gender) faces No-go stimuli. Univariate linear mixed-effects (LME) analysis for group effects and multivariate Gaussian Process Classifier (GPC) analyses were conducted. RESULTS MDD- group compared to both the BDD and MDD+ groups, exhibited significantly lower activation in parietal, temporal and frontal regions (cluster-wise corrected p <0.05) for emotional inhibition conditions vs. non-emotional condition. GPC classification of emotional (happy + fear) vs. non-emotional response-inhibition activation pattern showed good discrimination between BDD and MDD- subjects (AUC: 0.70; balanced accuracy: 70% (corrected p = 0.018)) as well as between MDD+ and MDD- subjects (AUC: 0.72; balanced accuracy: 67% (corrected p = 0.045)) but less efficient discrimination between BDD and MDD+ groups (AUC: 0.68; balanced accuracy: 61% (corrected p = 0.273)). Notably, classification of the MDD- group was weighted for left amygdala activation pattern. LIMITATIONS Results also need to be tested in a different independent dataset. CONCLUSION Using an fMRI emotional Go-Nogo task, MDD- subjects can be discriminated from BDD and MDD+ subjects.
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Affiliation(s)
- Jungwon Cha
- Center for Behavioral Health, Cleveland Clinic
| | | | - Bo Hu
- Center for Quantitative Health Sciences, Cleveland Clinic
| | | | | | | | | | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medicine, Brain and Mind Research Institute, Weill Cornell Medicine
| | - Elvisha Dhamala
- Department of Radiology, Weill Cornell Medicine, Brain and Mind Research Institute, Weill Cornell Medicine
| | - Amit Anand
- Center for Behavioral Health, Cleveland Clinic.
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12
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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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13
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Jiang H, Dai Z, Lu Q, Yao Z. Magnetoencephalography resting-state spectral fingerprints distinguish bipolar depression and unipolar depression. Bipolar Disord 2020; 22:612-620. [PMID: 31729112 DOI: 10.1111/bdi.12871] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES In clinical practice, bipolar depression (BD) and unipolar depression (UD) appear to have similar symptoms, causing BD being frequently misdiagnosed as UD, leading to improper treatment decision and outcome. Therefore, it is in urgent need of distinguishing BD from UD based on clinical objective biomarkers as early as possible. Here, we aimed to integrate brain neuroimaging data and an advanced machine learning technique to predict different types of mood disorder patients at the individual level. METHODS Eyes closed resting-state magnetoencephalography (MEG) data were collected from 23 BD, 30 UD, and 31 healthy controls (HC). Individual power spectra were estimated by Fourier transform, and statistic spectral differences were assessed via a cluster permutation test. A support vector machine classifier was further applied to predict different mood disorder types based on discriminative oscillatory power. RESULTS Both BD and UD showed decreased frontal-central gamma/beta ratios comparing to HC, in which gamma power (30-75 Hz) was decreased in BD while beta power (14-30 Hz) was increased in UD vs HC. The support vector machine model obtained significant high classification accuracies distinguishing three groups based on mean gamma and beta power (BD: 79.9%, UD: 81.1%, HC: 76.3%, P < .01). CONCLUSIONS In combination with resting-state MEG data and machine learning technique, it is possible to make an individual and objective prediction for mode disorder types, which in turn has implications for diagnosis precision and treatment decision of mood disorder patients.
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Affiliation(s)
- Haiteng Jiang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhongpeng Dai
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China.,Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, China
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China.,Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, China
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Medical College of Nanjing University, Nanjing, China
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14
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Pang Y, Zhang H, Cui Q, Yang Q, Lu F, Chen H, He Z, Wang Y, Wang J, Chen H. Combined static and dynamic functional connectivity signatures differentiating bipolar depression from major depressive disorder. Aust N Z J Psychiatry 2020; 54:832-842. [PMID: 32456443 DOI: 10.1177/0004867420924089] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Bipolar disorder in the depressive phase (BDd) may be misdiagnosed as major depressive disorder (MDD), resulting in poor treatment outcomes. To identify biomarkers distinguishing BDd from MDD is of substantial clinical significance. This study aimed to characterize specific alterations in intrinsic functional connectivity (FC) patterns in BDd and MDD by combining whole-brain static and dynamic FC. METHODS A total of 40 MDD and 38 BDd patients, and 50 age-, sex-, education-, and handedness-matched healthy controls (HCs) were included in this study. Static and dynamic FC strengths (FCSs) were analyzed using complete time-series correlations and sliding window correlations, respectively. One-way analysis of variance was performed to test group effects. The combined static and dynamic FCSs were then used to distinguish BDd from MDD and to predict clinical symptom severity. RESULTS Compared with HCs, BDd patients showed lower static FCS in the medial orbitofrontal cortex and greater static FCS in the caudate, while MDD patients exhibited greater static FCS in the medial orbitofrontal cortex. BDd patients also demonstrated greater static and dynamic FCSs in the thalamus compared with both MDD patients and HCs, while MDD patients exhibited greater dynamic FCS in the precentral gyrus compared with both BDd patients and HCs. Combined static and dynamic FCSs yielded higher accuracy than either static or dynamic FCS analysis alone, and also predicted anhedonia severity in BDd patients and negative mood severity in MDD patients. CONCLUSION Altered FC within frontal-striatal-thalamic circuits of BDd patients and within the default mode network/sensorimotor network of MDD patients accurately distinguishes between these disorders. These unique FC patterns may serve as biomarkers for differential diagnosis and provide clues to the pathogenesis of mood disorders.
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Affiliation(s)
- Yajing Pang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Huangbin Zhang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Cui
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Qi Yang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Heng Chen
- School of Medicine, Guizhou University, Guiyang, China
| | - Zongling He
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yifeng Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiaojian Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,Department of Radiology, First Affiliated Hospital to Army Medical University, Chongqing, China
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15
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Tseng CEJ, Gilbert TM, Catanese MC, Hightower BG, Peters AT, Parmar AJ, Kim M, Wang C, Roffman JL, Brown HE, Perlis RH, Zürcher NR, Hooker JM. In vivo human brain expression of histone deacetylases in bipolar disorder. Transl Psychiatry 2020; 10:224. [PMID: 32641695 PMCID: PMC7343804 DOI: 10.1038/s41398-020-00911-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/11/2020] [Accepted: 06/18/2020] [Indexed: 02/08/2023] Open
Abstract
The etiology of bipolar disorder (BD) is unknown and the neurobiological underpinnings are not fully understood. Both genetic and environmental factors contribute to the risk of BD, which may be linked through epigenetic mechanisms, including those regulated by histone deacetylase (HDAC) enzymes. This study measures in vivo HDAC expression in individuals with BD for the first time using the HDAC-specific radiotracer [11C]Martinostat. Eleven participants with BD and 11 age- and sex-matched control participants (CON) completed a simultaneous magnetic resonance - positron emission tomography (MR-PET) scan with [11C]Martinostat. Lower [11C]Martinostat uptake was found in the right amygdala of BD compared to CON. We assessed uptake in the dorsolateral prefrontal cortex (DLPFC) to compare previous findings of lower uptake in the DLPFC in schizophrenia and found no group differences in BD. Exploratory whole-brain voxelwise analysis showed lower [11C]Martinostat uptake in the bilateral thalamus, orbitofrontal cortex, right hippocampus, and right amygdala in BD compared to CON. Furthermore, regional [11C]Martinostat uptake was associated with emotion regulation in BD in fronto-limbic areas, which aligns with findings from previous structural, functional, and molecular neuroimaging studies in BD. Regional [11C]Martinostat uptake was associated with attention in BD in fronto-parietal and temporal regions. These findings indicate a potential role of HDACs in BD pathophysiology. In particular, HDAC expression levels may modulate attention and emotion regulation, which represent two core clinical features of BD.
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Affiliation(s)
- Chieh-En J. Tseng
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129 USA
| | - Tonya M. Gilbert
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129 USA
| | - Mary C. Catanese
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129 USA
| | - Baileigh G. Hightower
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129 USA
| | - Amy T. Peters
- grid.32224.350000 0004 0386 9924Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Anjali J. Parmar
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129 USA
| | - Minhae Kim
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129 USA
| | - Changning Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129 USA
| | - Joshua L. Roffman
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129 USA ,grid.32224.350000 0004 0386 9924Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Hannah E. Brown
- grid.475010.70000 0004 0367 5222Department of Psychiatry, Boston University School of Medicine, Boston, MA 02118 USA
| | - Roy H. Perlis
- grid.32224.350000 0004 0386 9924Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA ,grid.32224.350000 0004 0386 9924Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Nicole R. Zürcher
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129 USA
| | - Jacob M. Hooker
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129 USA
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16
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Breukelaar IA, Erlinger M, Harris A, Boyce P, Hazell P, Grieve SM, Antees C, Foster S, Gomes L, Williams LM, Malhi GS, Korgaonkar MS. Investigating the neural basis of cognitive control dysfunction in mood disorders. Bipolar Disord 2020; 22:286-295. [PMID: 31604366 DOI: 10.1111/bdi.12844] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Dysfunction of cognitive control is a feature of both bipolar disorder (BP) and major depression (MDD) and persists through to remission. However, it is unknown whether these disorders are characterized by common or distinct disruptions of cognitive control function and its neural basis. We investigated this gap in knowledge in asymptomatic BP and MDD participants, interpreted within a framework of normative function. METHODS Participants underwent fMRI scans engaging cognitive control through a working memory task and completed a cognitive battery evaluating performance across multiple subdomains of cognitive control, including attention, impulsivity, processing speed, executive function, and memory. Analysis was performed in two stages: (i) cognitive control-related brain activation and deactivation were correlated with cognitive control performance in 115 healthy controls (HCs), then, (ii) significantly correlated regions from (i) were compared between 25 asymptomatic BP, 25 remitted MDD, and with 25 different HCs, matched for age and gender. RESULTS Impulsivity and executive function performance were significantly worse in BP compared to both MDD and HCs. Both BP and MDD had significantly poorer memory performance compared to HCs. Greater deactivation of the medial prefrontal cortex (MPFC) during the fMRI task was associated with better executive function in healthy controls. Significantly less deactivation in this region was present in both BP and MDD compared to HCs. CONCLUSIONS Failure to deactivate the MPFC, a key region of the default mode network, during working memory processing is a shared neural feature present in both bipolar and major depression and could be a source of common cognitive dysfunction.
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Affiliation(s)
- Isabella A Breukelaar
- Brain Dynamics Centre, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia
| | - May Erlinger
- Brain Dynamics Centre, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia
| | - Anthony Harris
- Brain Dynamics Centre, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia.,Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Philip Boyce
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Philip Hazell
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Stuart M Grieve
- Brain Dynamics Centre, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia.,Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre and Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.,Department of Radiology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Cassandra Antees
- Brain Dynamics Centre, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia
| | - Sheryl Foster
- Department of Radiology, Westmead Hospital, Westmead, NSW, Australia.,The Discipline of Medical Radiation Sciences, Faculty of Health Science, The University of Sydney, Lidcombe, NSW, Australia
| | - Lavier Gomes
- Department of Radiology, Westmead Hospital, Westmead, NSW, Australia
| | - Leanne M Williams
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.,Palo Alto VA, MIRECC, Palo Alto, CA, USA
| | - Gin S Malhi
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Saint Leonards, NSW, Australia
| | - Mayuresh S Korgaonkar
- Brain Dynamics Centre, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia.,Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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17
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Lorenzetti V, Costafreda SG, Rimmer RM, Rasenick MM, Marangell LB, Fu CHY. Brain-derived neurotrophic factor association with amygdala response in major depressive disorder. J Affect Disord 2020; 267:103-106. [PMID: 32063560 PMCID: PMC8020847 DOI: 10.1016/j.jad.2020.01.159] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 12/09/2019] [Accepted: 01/26/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) has an essential role in synaptic plasticity and neurogenesis. BDNF mediates amygdala-dependent learning for both aversive and appetitive emotional memories. The expression of BDNF in limbic regions is posited to contribute the development of depression, and amygdala responsivity is a potential marker of depressive state. METHODS The present study examined the relationship between platelet BDNF levels and amygdala volume and function in major depressive disorder (MDD). Participants were 23 MDD (mean age 38.9 years) and 23 healthy controls (mean age 38.8 years). All participants were recruited from the community. MDD participants were in a current depressive episode of moderate severity and medication-free. Amygdala responses were acquired during a functional MRI task of implicit emotional processing with sad facial expressions. RESULTS Significant correlation was observed between platelet BDNF levels and left amygdala responses, but no significant correlations were found with right amygdala responses or with amygdala volumes. LIMITATIONS Interactions with neuroprotective as well as neurotoxic metabolites in the kyneurenine pathway were not examined. CONCLUSIONS Relationship between BDNF levels and amygdala responsivity to emotionally salient stimuli in MDD could reflect the importance of BDNF in amygdala-dependent learning with clinical implications for potential pathways for treatment.
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Affiliation(s)
- Valentina Lorenzetti
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Australia; Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
| | - Sergi G Costafreda
- Department of Psychiatry, University College London, London, United Kingdom
| | | | | | | | - Cynthia H Y Fu
- School of Psychology, University of East London, United Kingdom; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
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18
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Poletti S, Melloni E, Aggio V, Colombo C, Valtorta F, Benedetti F, Comai S. Grey and white matter structure associates with the activation of the tryptophan to kynurenine pathway in bipolar disorder. J Affect Disord 2019; 259:404-412. [PMID: 31610997 DOI: 10.1016/j.jad.2019.08.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/21/2019] [Accepted: 08/17/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is a severe mental illness characterised by reduced grey matter (GM) volumes and cortical thickness, and disrupted white matter (WM) microstructure. Activation of indoleamine 2,3-dioxygenase following a pro-inflammatory state could increase the amount of tryptophan (Trp) converted to kynurenine (Kyn) possibly leading to the production of detrimental catabolites of the Kyn pathway with neurotoxic effects. We investigated if peripheral levels of Trp-and Kyn and the breakdown of Trp-into Kyn (Kyn/Trp-ratio) are related to WM and GM integrity in BD. METHODS Peripheral levels of Trp-and Kyn were analysed in 72 patients with BD and 33 controls. Patients also underwent MRI in a Philips 3T scanner. RESULTS Patients showed higher Kyn levels and Kyn/Trp-ratio compared to controls. MRI analyses performed in patients with BD showed a negative association between the Kyn/Trp-ratio and the integrity of corpus callosum microstructure, the volume of the amygdala and cortical thickness in fronto-parietal regions. LIMITATION The lack of information on the levels of downstream metabolites of Kyn prevent us to confirm the possible unbalance between quinolinic and kynurenic acids as well as their possible relationship with changes in GM and WM markers. The activation of the Kyn pathway as suggested by the increased Kyn/Trp-ratio may lead to an imbalance of the neurotoxic vs the neuroprotective arm of the biochemical pathway, resulting in significant changes in GM and WM regions of brain areas strongly implicated in the pathophysiology of BD, such as amygdala and corpus callosum.
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Affiliation(s)
- Sara Poletti
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy.
| | - Elisa Melloni
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy
| | - Veronica Aggio
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy
| | - Cristina Colombo
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy
| | - Flavia Valtorta
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy
| | - Francesco Benedetti
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy
| | - Stefano Comai
- Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Turro, Via Stamira d'Ancona 20, Milan, Italy
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19
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Phillips ML. Neural Markers That Distinguish Bipolar Disorder From Major Depressive Disorder: Moving Closer to a Reality. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:328-330. [PMID: 30961832 DOI: 10.1016/j.bpsc.2019.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Mary L Phillips
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
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20
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Vandekar SN. Two Methodologies in "Amygdala Activation and Connectivity to Emotional Processing Distinguishes Asymptomatic Patients With Bipolar Disorders and Unipolar Depression" That Can Produce False-Positive Results and Some Statistical Recommendations. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:409-410. [PMID: 30733113 DOI: 10.1016/j.bpsc.2018.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Simon N Vandekar
- Department of Biostatistics, Vanderbilt University, Vanderbilt University Medical Center, Nashville, Tennessee.
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21
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Korgaonkar MS. Reply to: Two Methodologies in "Amygdala Activation and Connectivity to Emotional Processing Distinguishes Asymptomatic Patients With Bipolar Disorders and Unipolar Depression" That Can Produce False-Positive Results and Some Statistical Recommendations. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:411-413. [PMID: 30733112 DOI: 10.1016/j.bpsc.2018.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 12/07/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Mayuresh S Korgaonkar
- Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead; and Discipline of Psychiatry, University of Sydney School of Medicine, Sydney, New South Wales, Australia.
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