Minor Physical Anomalies in Bipolar Disorder

Face-brain correlates as potential sex-specific biomarkers for schizophrenia and bipolar disorder

Given the shared ectodermal origin and integrated development of the face and the brain, facial biomarkers emerge as potential candidates to assess vulnerability for disorders in which neurodevelopment is compromised, such as schizophrenia (SZ) and bipolar disorder (BD). The sample comprised 188 individuals (67 SZ patients, 46 BD patients and 75 healthy controls (HC)). Using a landmark-based approach on 3D facial reconstructions, we quantified global and local facial shape differences between SZ/BD patients and HC using geometric morphometrics. We also assessed correlations between facial and brain cortical measures. All analyses were performed separately by sex. Diagnosis explained 4.1 % - 5.9 % of global facial shape variance in males and females with SZ, and 4.5 % - 4.1 % in BD. Regarding local facial shape, we detected 43.2 % of significantly different distances in males and 47.4 % in females with SZ as compared to HC, whereas in BD the percentages decreased to 35.8 % and 26.8 %, respectively. We detected that brain area and volume significantly explained 2.2 % and 2 % of facial shape variance in the male SZ - HC sample. Our results support facial shape as a neurodevelopmental marker for SZ and BD and reveal sex-specific pathophysiological mechanisms modulating the interplay between the brain and the face.

Minor physical anomalies in bipolar disorder in comparison to healthy controls and schizophrenia: A systematic review and meta-analysis

Minor physical anomalies (MPAs) are markers of abnormalities in early foetal development and are well established findings in schizophrenia. It has been suggested that neurodevelopmental abnormalities might play a role not only in schizophrenia but also in bipolar disorder (BD). Therefore, according to neurodevelopmental theory of BD, one might expect increased prevalence of MPAs in BD. A meta-analysis of 11 studies was conducted to quantitatively review MPAs in BD in comparison to schizophrenia and healthy controls. The current meta-analysis compared MPA scores of 584 BD patients and 723 healthy controls, and 401 BD and 612 schizophrenia patients. Patients with BD had significantly higher MPA scores than healthy controls (g=0.47, CI=0.28-0.67). This was true both for craniofacial (g=0.57, CI=0.34-0.79) and periphery (g=0.46, CI=0.18-0.73) MPAs. BD was associated with a less severe increase in MPA score compared to schizophrenia, however, between-group difference was small (g=0.19, CI=0.05-0.33). The outcome of this meta-analysis suggests that BD is associated with medium effect size increase in MPAs which is only minimally less severe than schizophrenia. This finding supports the hypothesis that early developmental insult in brain development plays a role not only in schizophrenia but also BD. Studies investigating clinical, neurocognitive, neuroanatomical and other biological correlates of MPAs in BD might helpful in characterizing subtype (s) of BD that is associated with pronounced deviations in brain development.

Increased Prevalence of Minor Physical Anomalies Among the Healthy First-Degree Relatives of Bipolar I Patients - Results With the Méhes Scale

Minor physical anomalies are somatic markers of aberrant neurodevelopment, so the higher prevalence of these signs among the relatives of bipolar I patients can confirm minor physical anomalies as endophenotypes. The aim of the study was to evaluate the prevalence of minor physical anomalies in first-degree healthy relatives of patients with bipolar I disorder compared to normal control subjects. Using a list of 57 minor physical anomalies (the Méhes Scale), 20 first-degree unaffected relatives of patients with the diagnosis of bipolar I disorder and as a comparison 20 matched normal control subjects were examined. Minor physical anomalies were more common in the ear, head, mouth and trunk regions among the relatives of bipolar I patients compared to normal controls. By the differentiation of minor malformations and phenogenetic variants, we have found that both minor malformations and phenogenetic variants were more common among the relatives of bipolar I patients compared to the control group, while individual analyses showed, that one minor malformation (sole crease) and one phenogenetic variant (high arched palate) were more prevalent in the relative group. This is the first report in literature on the increased prevalence of minor physical anomalies among the first-degree unaffected relatives of bipolar I patients. The study support the concept, that minor physical anomalies can be endophenotypic markers of bipolar I affective disorder.

Minor Physical Anomalies in Bipolar Disorder-A Meta-Analysis

Introduction: Minor physical anomalies (MPAs) may reflect basic neurobiological features underlying bipolar disorders (BPD), as they are sensitive physical indicators of morphogenetic failure of the brain. Despite several researches about the presence of MPAs in BPD, the results are still controversial. Objectives: The aim of the present meta-analysis was to assess the standardized weighted mean effect sizes of MPAs in BPD and to examine if MPAs may be found predominantly in the head and/or facial regions in BPD patients compared to controls (HC). Methods: Four studies, involving 155 patients with BPD, and 187 HC, were involved in the analysis after searching the literature. For the investigation of MPAs in the peripheral (MPA-P) and in the head and facial regions (MPA-CF), two studies involving 121 BPD patients, and 133 HC passed the inclusion criteria. Results: The number of the MPAs in the BPD group was significantly higher compared to HC. Another important finding of the present study is that BPD patients' MPA-P scores do not significantly differ from those of the HC. In contrast, BPD patients' MPA-CF scores were found to be significantly higher compared to HC subjects. It is important to note that there was a low number of eligible publications included, which caused higher heterogeneity. Conclusions: Low quality of evidence suggests that MPAs are more common in patients with BPD than in HC and the higher rate of MPAs is found predominantly in the head and facial regions.