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Wei Y, Womer FY, Sun K, Zhu Y, Sun D, Duan J, Zhang R, Wei S, Jiang X, Zhang Y, Tang Y, Zhang X, Wang F. Applying dimensional psychopathology: transdiagnostic prediction of executive cognition using brain connectivity and inflammatory biomarkers. Psychol Med 2023; 53:3557-3567. [PMID: 35536000 DOI: 10.1017/s0033291722000174] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The association between executive dysfunction, brain dysconnectivity, and inflammation is a prominent feature across major psychiatric disorders (MPDs), schizophrenia, bipolar disorder, and major depressive disorder. A dimensional approach is warranted to delineate their mechanistic interplay across MPDs. METHODS This single site study included a total of 1543 participants (1058 patients and 485 controls). In total, 1169 participants underwent diffusion tensor and resting-state functional magnetic resonance imaging (745 patients and 379 controls completed the Wisconsin Card Sorting Test). Fractional anisotropy (FA) and regional homogeneity (ReHo) assessed structural and functional connectivity, respectively. Pro-inflammatory cytokine levels [interleukin (IL)-1β, IL-6, and tumor necrosis factor-α] were obtained in 325 participants using blood samples collected with 24 h of scanning. Group differences were determined for main measures, and correlation and mediation analyses and machine learning prediction modeling were performed. RESULTS Executive deficits were associated with decreased FA, increased ReHo, and elevated IL-1β and IL-6 levels across MPDs, compared to controls. FA and ReHo alterations in fronto-limbic-striatal regions contributed to executive deficits. IL-1β mediated the association between FA and cognition, and IL-6 mediated the relationship between ReHo and cognition. Executive cognition was better predicted by both brain connectivity and cytokine measures than either one alone for FA-IL-1β and ReHo-IL-6. CONCLUSIONS Transdiagnostic associations among brain connectivity, inflammation, and executive cognition exist across MPDs, implicating common neurobiological substrates and mechanisms for executive deficits in MPDs. Further, inflammation-related brain dysconnectivity within fronto-limbic-striatal regions may represent a transdiagnostic dimension underlying executive dysfunction that could be leveraged to advance treatment.
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Affiliation(s)
- Yange Wei
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Fay Y Womer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63130, USA
| | - Kaijin Sun
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yue Zhu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Dandan Sun
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Jia Duan
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Ran Zhang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Shengnan Wei
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Xiaowei Jiang
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Yanbo Zhang
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2B7, Canada
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Xizhe Zhang
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu 210001, China
| | - Fei Wang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
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Massalha Y, Maggioni E, Callari A, Brambilla P, Delvecchio G. A review of resting-state fMRI correlations with executive functions and social cognition in bipolar disorder. J Affect Disord 2023; 334:337-351. [PMID: 37003435 DOI: 10.1016/j.jad.2023.03.084] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 03/20/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Deficits in executive functions (EF) and social cognition (SC) are often observed in bipolar disorder (BD), leading to a severe impairment in engaging a functional interaction with the others and the surrounding environment. Therefore, in recent years, resting-state functional magnetic resonance imaging (rs-fMRI) studies on BD tried to identify the neural underpinnings of these cognitive domains by exploring the association between the intrinsic functional connectivity (FC) and the scores in clinical scales evaluating these domains. METHODS A bibliographic search on PubMed and Scopus of studies evaluating the correlations between rs-fMRI findings and EF and/or SC in BD was conducted until March 2022. Ten studies met the inclusion criteria. RESULTS Overall, the results of the reviewed studies showed that BD patients had FC deficits compared to healthy controls (HC) in selective resting-state networks involved in EF and SC, which include the default mode network, especially the link between medial prefrontal cortex and posterior cingulate cortex, and the sensory-motor network. Finally, it also emerged the predominant role of alterations in prefrontal connections in explaining the cognitive deficits in BD patients. LIMITATIONS The heterogeneity of the reviewed studies, in terms of cognitive domains explored and neuroimaging acquisitions, limited the comparability of the findings. CONCLUSIONS rs-fMRI studies could help deepen the brain network alterations underlying EF and SC deficits in BD, pointing the attention on the neuronal underpinning of cognition, whose knowledge may lead to the development of new neurobiological-based approaches to improve the quality of life of these patients.
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Affiliation(s)
- Yara Massalha
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Eleonora Maggioni
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20122 Milan, Italy
| | - Antonio Callari
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy
| | - Giuseppe Delvecchio
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy.
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Correa-Ghisays P, Vicent Sánchez-Ortí J, Balanzá-Martínez V, Fuentes-Durá I, Martinez-Aran A, Ruiz-Bolo L, Correa-Estrada P, Ruiz-Ruiz JC, Selva-Vera G, Vila-Francés J, Macias Saint-Gerons D, San-Martín C, Ayesa-Arriola R, Tabarés-Seisdedos R. MICEmi: A method to identify cognitive endophenotypes of mental illnesses. Eur Psychiatry 2022; 65:e85. [PMID: 36440538 PMCID: PMC9807453 DOI: 10.1192/j.eurpsy.2022.2348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Characterizing neurocognitive endophenotypes of mental illnesses (MIs) could be useful for identifying at-risk individuals, increasing early diagnosis, improving disease subtyping, and proposing therapeutic strategies to reduce the negative effects of the symptoms, in addition to serving as a scientific basis to unravel the physiopathology of the disease. However, a standardized algorithm to determine cognitive endophenotypes has not yet been developed. The main objective of this study was to present a method for the identification of endophenotypes in MI research. METHODS For this purpose, a 14-expert working group used a scoping review methodology and designed a method that includes a scoring template with five criteria and indicators, a strategy for their verification, and a decision tree. CONCLUSIONS This work is ongoing since it is necessary to obtain external validation of the applicability of the method in future research.
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Affiliation(s)
- Patricia Correa-Ghisays
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vicent Sánchez-Ortí
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Vicent Balanzá-Martínez
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Inmaculada Fuentes-Durá
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Anabel Martinez-Aran
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,Bipolar Disorders Unit, Neurosciences Institute, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Catalonia, Spain
| | - Lara Ruiz-Bolo
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | | | - Juan Carlos Ruiz-Ruiz
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Gabriel Selva-Vera
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vila-Francés
- Intelligent Data Analysis Laboratory (IDAL), University of Valencia, Spain
| | - Diego Macias Saint-Gerons
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Constanza San-Martín
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Rafael Tabarés-Seisdedos
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
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Zhu W, Tang W, Liang Y, Jiang X, Li Y, Chen Z, Zhu C. Aberrant Functional Connectivity of Sensorimotor Network and Its Relationship With Executive Dysfunction in Bipolar Disorder Type I. Front Neurosci 2022; 15:823550. [PMID: 35264921 PMCID: PMC8898951 DOI: 10.3389/fnins.2021.823550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background The key pathophysiological mechanism of executive dysfunction in patients with bipolar disorder type I (BD-I) is still unclear. Previous studies have demonstrated that it may be related to the disbalance of the sensory motor network (SMN). Objective This study was designed to explore the aberrant functional connectivity (FC) of SMN in BD-I patients and its potential associations with executive dysfunction. Methods Eighteen BD-I patients and 20 healthy controls (HCs) underwent resting-state fMRI scans. The intranetwork and internetwork functional connectivities of SMN were extracted by independent component analysis (ICA). Clinical symptoms were assessed by the Bech–Rafaelsen Mania Rating Scale (BRMS) and Positive and Negative Syndrome Scale (PANSS). Executive function was measured by digit span tasks and a verbal fluency test. Finally, linear regression and correlation analyses were applied to measure the potential associations between clinical symptoms, intranetwork and internetwork functional connectivities, and executive function performance. Results (1) Patients with BD-I showed increased connectivity in the right paracentral lobule and the right postcentral gyrus within the SMN, and the increased connectivity value was positively correlated with the BRMS score (P < 0.05) but negatively correlated with digit span forward scores (P < 0.05). (2) Compared with HC, the connectivity value increased between the SMN and dorsal attention network (DAN) (P < 0.01) and between the default mode network (DMN) and DAN (P < 0.05) but decreased between the DAN and auditory network (AN) (P < 0.05) and between the SMN and DMN (P < 0.01) in patients with BD-I. (3) Digit span forward scores and education of all participants were negatively correlated with FC between SMN and DAN. Age of all subjects was positively correlated with FC between SMN and DMN. Conclusion Our findings suggest that the sensorimotor network of BD-I has abnormal functional connections within and between networks, and the abnormal FC value correlated with clinical symptoms and executive function, which provide new information for exploring the neural physiopathology of executive dysfunction in BD-I patients.
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Affiliation(s)
- Wenjing Zhu
- Hangzhou Seventh People’s Hospital, Hangzhou, China
- Department of Neurology, School of Medicine, Affiliated ZhongDa Hospital, Institution of Neuropsychiatry, Southeast University, Nanjing, China
| | - Wenxin Tang
- Hangzhou Seventh People’s Hospital, Hangzhou, China
| | - Yan Liang
- Hangzhou Seventh People’s Hospital, Hangzhou, China
| | | | - Yi Li
- Hangzhou Seventh People’s Hospital, Hangzhou, China
| | - Zhiyu Chen
- Hangzhou Seventh People’s Hospital, Hangzhou, China
- *Correspondence: Zhiyu Chen,
| | - Cheng Zhu
- Hangzhou Seventh People’s Hospital, Hangzhou, China
- Cheng Zhu,
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Is processing speed a valid neurocognitive endophenotype in bipolar disorder? Evidence from a longitudinal, family study. J Psychiatr Res 2021; 141:241-247. [PMID: 34256275 DOI: 10.1016/j.jpsychires.2021.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/30/2021] [Accepted: 07/05/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Substantial evidence supports the existence of neurocognitive endophenotypes in bipolar disorder (BD), but very few longitudinal studies have included unaffected relatives. In a 5-year, follow-up, family study, we have recently suggested that deficits in manual motor speed and visual memory could be endophenotype candidates for BD. We aimed to explore whether this also applies to processing speed. METHODS A sample of 348 individuals, including 163 BD patients, 65 unaffected first-degree relatives (BD-Rel) and 120 genetically unrelated healthy controls (HC), was assessed with the Digit Symbol Substitution Test (DSST) on two occasions over a 2-year period (T1, T2). DSST values were controlled for age, years of education, occupational status, and subsyndromic mood symptoms. Differences between groups were evaluated with ANCOVAs. RESULTS At T1 BD performed significantly worse than HC (p < 0.001; Cohen's d = 1.38) and BD-Rel (p < 0.001; Cohen's d = 0.82). BD-Rel showed an intermediate performance with significant differences with HC (p < 0.01; Cohen's d = 0.50). Similarly, at T2 BD performed significantly worse than HC (p < 0.001; Cohen's d = 1.44) and BD-Rel (p < 0.01; Cohen's d = 0.51). BD-Rel performance was intermediate and significantly lower than that of HC (p < 0.01; Cohen's d = 0.97). A Repeated Measures ANOVA revealed no significant between-group differences in performance over time (p > 0.05). CONCLUSIONS The results of this longitudinal, family study suggest that impaired processing speed may represent a suitable cognitive endophenotype for BD. Further research on the field is required to confirm these preliminary findings.
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6
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Tang L, Liu J, Zhu Y, Duan J, Chen Y, Wei Y, Gong X, Wang F, Tang Y. ANK3 Gene Polymorphism Rs10994336 Influences Executive Functions by Modulating Methylation in Patients With Bipolar Disorder. Front Neurosci 2021; 15:682873. [PMID: 34421516 PMCID: PMC8371237 DOI: 10.3389/fnins.2021.682873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/31/2021] [Indexed: 01/11/2023] Open
Abstract
Background: A large body of evidence suggests that epigenetic modification including DNA methylation plays a critical role in BD's pathogenesis while the identification of methylation quantitative trait loci (meQTLs) shed light on the interpretation of the function of genetic variants in non-coding regions. The intronic single nucleotide polymorphism (SNP) rs10994336 within the ANK3 has emerged as one of the most replicated risk variants for bipolar disorder (BD) in genome-wide association studies. Whether rs10994336 functions as a meQTL to mediate the association between genotype and phenotype remains unclear. Method: A total of 154 patients with BD and 181 healthy controls (HC) were recruited. The genotypes of rs10994336 and methylation levels of CpG sites within ANK3 were tested. Executive functions were assessed using a computerized version of the Wisconsin Card Sorting Test (WCST). Results: Bipolar disorder patients with the risk-T allele of rs10994336 scored lower on tests of executive function compared to homozygous CC carriers, after controlling for age, gender, and education level. No significant difference was found in HC individuals. The risk-T allele is associated with a lower methylation level of CpG site cg02172182 in HC after multiple corrections and replicated in the BD group in the same direction. Further mediation analysis revealed that the cg02172182 methylation significantly mediated the association between the polymorphism rs10994336 and PE index of WCST in patients with BD. Conclusion: Our study suggests that BD-related genetic variant rs10994336 in ANK3 impacts executive functions by modulating ANK3 methylation, supporting the theory that methylation acts as a mediator between genotype and phenotype.
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Affiliation(s)
- Lili Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Juan Liu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yue Zhu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jia Duan
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yifan Chen
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yange Wei
- Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Xiaohong Gong
- State Key Laboratory of Genetic Engineering and Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai, China
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
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7
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Zeighami R, Raeisolhagh A, Ranjbaran M. Effect of Home Nursing Care on the Severity of Symptoms in Patients With Bipolar I Disorder: A Randomized Clinical Trial. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2021. [DOI: 10.1177/1084822320969122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bipolar I disorder is a common, chronic, and recurrent disease in which improper and inadequate follow-up of patients after discharge leads to increased hospitalization. This study aimed at investigating the effect of home nursing care on the severity of symptoms of bipolar I disorder. This clinical trial was performed on 90 patients admitted to 22 Bahman Qazvin Hospital in 2019. The available sampling was done using random allocation of six blocks in experimental and control groups. In the experimental group, after leaving the hospital, the intervention was performed for 3 months in the form of two telephone calls and one face-to-face meeting per month. Data were collected using a demographic questionnaire, the Yang scale questionnaire, and entered into the SPSS-24 software. Statistical tests such as Mann-Whitney u test, Fisher, independent T-test, paired T-test, chi-square, and ANCOVA were used at the significance level of p < .05. The severity of the disease before the intervention in the experimental and control groups were (93/9 ± 25/32) and (04/11 ± 86/28), respectively, showing no statistically significant difference ( p = .146). However, after the intervention, the mean severity of the disease in the experimental and control groups were (17/5 ± 38/13) and (79/12 ± 21/33), respectively, showing a statistically significant difference ( p < .05). According to the results, the home nursing care for patients leads to a reduction in the severity of symptoms and a reduction in the rate of re-hospitalization of patients.
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Affiliation(s)
| | | | - Mehdi Ranjbaran
- School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
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Liang Y, Jiang X, Zhu W, Shen Y, Xue F, Li Y, Chen Z. Disturbances of Dynamic Function in Patients With Bipolar Disorder I and Its Relationship With Executive-Function Deficit. Front Psychiatry 2020; 11:537981. [PMID: 33192653 PMCID: PMC7542231 DOI: 10.3389/fpsyt.2020.537981] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 09/02/2020] [Indexed: 01/20/2023] Open
Abstract
Abnormity in brain regional function and inter-regional cooperation have been linked with the dysfunction during cognitive and emotional processing in bipolar disorder (BD) patients. Recent evidences have suggested that brain function is not static but temporal dynamic. In present study, we aimed to characterize the temporal dynamics of regional function and inter-regional cooperation in BD and its relationship with executive dysfunction, an important deficit in BD. Resting-state functional MRI was performed in patients with bipolar I disorder (BDI) (n = 18) and healthy controls (HCs, n = 19). We first assessed local-function temporal variety with dynamic amplitude of low-frequency fluctuation (dALFF). Region with significant inter-groups difference in dALFF was chosen as a seed to calculate inter-regions connective temporal variety with dynamic functional connectivity (dFC). The executive function was measured by Verbal Fluency Test (VFT). The relationship between executive function and brain dynamics were examined. Compared with HC, the BDI group showed decreased dALFF (less temporal variability) in the posterior cingulate cortex (PCC) and decreased dFC between PCC and medial prefrontal cortex (mPFC). The PCC-mPFC dFC was positively associated with VFT in BDI patients, but not in HC. These findings implicated the reduced temporal variability in local region and inter-regions cooperation in BDI, which may be a neural substrate of executive-function deficit in BDI.
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Affiliation(s)
- Yan Liang
- Department of Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou, China
- Mental Health Center, Zhejiang University, School of Medicine, Hangzhou, China
| | - Xiaoying Jiang
- Department of Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou, China
- Mental Health Center, Zhejiang University, School of Medicine, Hangzhou, China
| | - Wenjing Zhu
- Department of Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou, China
- Mental Health Center, Zhejiang University, School of Medicine, Hangzhou, China
| | - Yonghui Shen
- Department of Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou, China
- Mental Health Center, Zhejiang University, School of Medicine, Hangzhou, China
| | - Fengfeng Xue
- Department of Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou, China
- Mental Health Center, Zhejiang University, School of Medicine, Hangzhou, China
| | - Yi Li
- Department of Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou, China
- Mental Health Center, Zhejiang University, School of Medicine, Hangzhou, China
| | - Zhiyu Chen
- Department of Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou, China
- Mental Health Center, Zhejiang University, School of Medicine, Hangzhou, China
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9
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Kjærstad HL, Mistarz N, Coello K, Stanislaus S, Melbye SA, Harmer CJ, Vinberg M, Miskowiak K, Kessing LV. Aberrant cognition in newly diagnosed patients with bipolar disorder and their unaffected relatives. Psychol Med 2020; 50:1808-1819. [PMID: 31456531 DOI: 10.1017/s0033291719001867] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Patients with bipolar disorder (BD) experience persistent impairments in both affective and non-affective cognitive function, which is associated with a worse course of illness and poor functional outcomes. Nevertheless, the temporal progression of cognitive dysfunction in BD remains unclear and the identification of objective endophenotypes can inform the aetiology of BD. METHODS The present study is a cross-sectional investigation of cognitive baseline data from the longitudinal Bipolar Illness Onset-study. One hundred seventy-two remitted patients newly diagnosed with BD, 52 of their unaffected relatives (UR), and 110 healthy controls (HC) were compared on a large battery of behavioural cognitive tasks tapping into non-affective (i.e. neurocognitive) and affective (i.e. emotion processing and regulation) cognition. RESULTS Relative to HCs, patients with BD exhibited global neurocognitive deficits (ps < 0.001), as well as aberrant emotion processing and regulation (ps ⩽ 0.011); including decreased emotional reactivity to positive social scenarios, impaired ability to down-regulate positive emotion, as well as a specific deficit in the ability to recognise surprised facial expressions. Their URs also showed a trend towards difficulties identifying surprised faces (p = 0.075). No other differences in cognitive function were found for URs compared to HCs. CONCLUSIONS Neurocognitive deficits and impairments within emotion processing and regulation may be illness-related deficits of BD that present after illness-onset, whereas processing of emotional faces may represent an early risk marker of BD. However, longitudinal studies are needed to examine the association between cognitive impairments and illness progression in BD.
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Affiliation(s)
- Hanne Lie Kjærstad
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Nicolaj Mistarz
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Klara Coello
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Sharleny Stanislaus
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Sigurd Arne Melbye
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Catherine J Harmer
- Department of Psychiatry, University of Oxford, Oxford, UK and
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Maj Vinberg
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kamilla Miskowiak
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Correa-Ghisays P, Sánchez-Ortí JV, Ayesa-Arriola R, Setién-Suero E, Balanzá-Martínez V, Selva-Vera G, Ruiz-Ruiz JC, Vila-Francés J, Martinez-Aran A, Vivas-Lalinde J, Conforte-Molina C, San-Martín C, Martínez-Pérez C, Fuentes-Durá I, Crespo-Facorro B, Tabarés-Seisdedos R. Visual memory dysfunction as a neurocognitive endophenotype in bipolar disorder patients and their unaffected relatives. Evidence from a 5-year follow-up Valencia study. J Affect Disord 2019; 257:31-37. [PMID: 31299402 DOI: 10.1016/j.jad.2019.06.059] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/26/2019] [Accepted: 06/30/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Scarce research has focused on Visual Memory (VM) deficits as a possible neurocognitive endophenotype of bipolar disorder (BD). The main aim of this longitudinal, family study with healthy controls was to explore whether VM dysfunction represents a neurocognitive endophenotype of BD. METHODS Assessment of VM by Rey-Osterrieth Complex Figure Test (ROCF) was carried out on a sample of 317 subjects, including 140 patients with BD, 60 unaffected first-degree relatives (BD-Rel), and 117 genetically-unrelated healthy controls (HC), on three occasions over a 5-year period (T1, T2, and T3). BD-Rel group scores were analyzed only at T1 and T2. RESULTS Performance of BD patients was significantly worse than the HC group (p < 0.01). Performance of BD-Rel was also significantly different from HC scores at T1 (p < 0.01) and T2 (p = 0.05), and showed an intermediate profile between the BD and HC groups. Only among BD patients, there were significant differences according to sex, with females performing worse than males (p = 0.03). Regarding other variables, education represented significant differences only in average scores of BD-Rel group (p = 0.01). LIMITATIONS Important attrition in BD-Rel group over time was detected, which precluded analysis at T3. CONCLUSIONS BD patients show significant deficits in VM that remain stable over time, even after controlling sociodemographic and clinical variables. Unaffected relatives also show stable deficits in VM. Accordingly, the deficit in VM could be considered a potential endophenotype of BD, which in turn may be useful as a predictor of the evolution of the disease. Further studies are needed to confirm these findings.
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Affiliation(s)
- Patricia Correa-Ghisays
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Faculty of Psychology, University of Valencia, Valencia, Spain; INCLIVA Health Research Institute, Valencia, Spain; TMAP Unidad de evaluación en autonomía personal, dependencia y trastornos mentales graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vicent Sánchez-Ortí
- Faculty of Psychology, University of Valencia, Valencia, Spain; TMAP Unidad de evaluación en autonomía personal, dependencia y trastornos mentales graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Rosa Ayesa-Arriola
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; University Hospital Marqués de Valdecilla. Department of Psychiatry, IDIVAL, Santander, Spain; Department of Psychiatry, IDIVAL, School of Medicine, Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain
| | - Esther Setién-Suero
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; University Hospital Marqués de Valdecilla. Department of Psychiatry, IDIVAL, Santander, Spain; Department of Psychiatry, IDIVAL, School of Medicine, Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain
| | - Vicent Balanzá-Martínez
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; TMAP Unidad de evaluación en autonomía personal, dependencia y trastornos mentales graves, Department of Medicine, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Gabriel Selva-Vera
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; INCLIVA Health Research Institute, Valencia, Spain; TMAP Unidad de evaluación en autonomía personal, dependencia y trastornos mentales graves, Department of Medicine, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | | | - Joan Vila-Francés
- IDAL - Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | - Anabel Martinez-Aran
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Bipolar Disorders Unit, Neurosciences Institute, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Catalonia, Spain
| | | | | | - Constanza San-Martín
- TMAP Unidad de evaluación en autonomía personal, dependencia y trastornos mentales graves, Department of Medicine, University of Valencia, Valencia, Spain; Departament of Physioterapiy, University of Valencia, Valencia, Spain
| | | | | | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Spain
| | - Rafael Tabarés-Seisdedos
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; INCLIVA Health Research Institute, Valencia, Spain; TMAP Unidad de evaluación en autonomía personal, dependencia y trastornos mentales graves, Department of Medicine, University of Valencia, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain.
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11
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Zhong S, Wang Y, Lai S, Liu T, Liao X, Chen G, Jia Y. Associations between executive function impairment and biochemical abnormalities in bipolar disorder with suicidal ideation. J Affect Disord 2018; 241:282-290. [PMID: 30142586 DOI: 10.1016/j.jad.2018.08.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/03/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Executive dysfunction and biochemical abnormalities using proton magnetic resonance spectroscopy (1H-MRS) have been reported in bipolar disorder (BD). Much less is known about the information from BD with suicidal ideation (SI). This study aimed to assess alterations of execution function and biochemical metabolism in BD with SI, in BD without SI, and in healthy controls. The associations between execution function and biochemical metabolism in the two BD patient groups were also been studied. METHODS 92 patients with bipolar disorder during a depressive episode (50 with current SI, and 42 without SI), as well as, 43 healthy controls were recruited in our study. Executive function was assessed by Wisconsin Card Sorting Test (WCST). Bilateral metabolite levels of prefrontal cortex (PFC), anterior cingulated cortex (ACC), lenticular nucleus (LN) of basal ganglia and thalamus were obtained by 1H-MRS at 3.0 T, then determined the ratios of N-acetyl aspartate (NAA), choline-containing compounds (Cho), myo-inositol (mI) to creatine (Cr). RESULTS Number of categories completed (CC) in BD with SI was significantly less than healthy controls. NAA/Cr ratios of left PFC in the two BD patient groups (with or without SI) were significantly lower than healthy controls, and NAA/Cr ratios of left thalamus were significantly higher than healthy controls. Moreover, NAA/Cr ratio of right LN in BD without SI was higher than BD with SI and healthy controls. For BD with SI, NAA/Cr ratio of left thalamus was negatively correlated with number of CC. CONCLUSIONS These results suggested that BD with or without SI may have abnormal NAA metabolism, and NAA/Cr ratio of right LN may distinguish SI from the BD patients. Further, BD with SI may have executive function impairment, which may be associated with the abnormal NAA metabolism in the left thalamus.
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Affiliation(s)
- Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital, Jinan University, No. 613 West Huangpu Avenue Tianhe District, Guangzhou 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital, Jinan University, No. 613 West Huangpu Avenue Tianhe District, Guangzhou 510630, China
| | - Tao Liu
- Department of Psychiatry, First Affiliated Hospital, Jinan University, No. 613 West Huangpu Avenue Tianhe District, Guangzhou 510630, China
| | - Xiaoxiao Liao
- Department of Psychiatry, First Affiliated Hospital, Jinan University, No. 613 West Huangpu Avenue Tianhe District, Guangzhou 510630, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital, Jinan University, No. 613 West Huangpu Avenue Tianhe District, Guangzhou 510630, China.
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Miskowiak KW, Kjærstad HL, Meluken I, Petersen JZ, Maciel BR, Köhler CA, Vinberg M, Kessing LV, Carvalho AF. The search for neuroimaging and cognitive endophenotypes: A critical systematic review of studies involving unaffected first-degree relatives of individuals with bipolar disorder. Neurosci Biobehav Rev 2017; 73:1-22. [DOI: 10.1016/j.neubiorev.2016.12.011] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 10/05/2016] [Accepted: 12/09/2016] [Indexed: 12/16/2022]
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Özerdem A, Ceylan D, Can G. Neurobiology of Risk for Bipolar Disorder. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2016; 3:315-329. [PMID: 27867834 PMCID: PMC5093194 DOI: 10.1007/s40501-016-0093-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Bipolar disorder (BD) is a chronic mental illness which follows a relapsing and remitting course and requires lifetime treatment. The lack of biological markers for BD is a major difficulty in clinical practice. Exploring multiple endophenotypes to fit in multivariate genetic models for BD is an important element in the process of finding tools to facilitate early diagnosis, early intervention, prevention of new episodes, and follow-up of treatment response in BD. Reviewing of studies on neuroimaging, neurocognition, and biochemical parameters in populations with high genetic risk for the illness can yield an integrative perspective on the neurobiology of risk for BD. The most up-to-date data reveals consistent deficits in executive function, response inhibition, verbal memory/learning, verbal fluency, and processing speed in risk groups for BD. Functional magnetic resonance imaging (fMRI) studies report alterations in the activity of the inferior frontal gyrus, medial prefrontal cortex, and limbic areas, particularly in the amygdala in unaffected first-degree relatives (FDR) of BD compared to healthy controls. Risk groups for BD also present altered immune and neurochemical modulation. Despite inconsistencies, accumulating data reveals cognitive and imaging markers for risk and to a less extent resilience of BD. Findings on neural modulation markers are preliminary and require further studies. Although the knowledge on the neurobiology of risk for BD has been inadequate to provide benefits for clinical practice, further studies on structural and functional changes in the brain, neurocognitive functioning, and neurochemical modulation have a potential to reveal biomarkers for risk and resilience for BD. Multimodal, multicenter, population-based studies with large sample size allowing for homogeneous subgroup analyses will immensely contribute to the elucidation of biological markers for risk for BD in an integrative model.
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Affiliation(s)
- Ayşegül Özerdem
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Deniz Ceylan
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
- Department of Psychiatry, Gümüşhane State Hospital, Gümüşhane, Turkey
| | - Güneş Can
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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