1
|
Johnsen LK, Larsen KM, Fuglsang SA, Ver Loren van Themaat AH, Baaré WFC, Madsen KS, Madsen KH, Hemager N, Andreassen AK, Veddum L, Greve AN, Nejad AB, Burton BK, Gregersen M, Eichele H, Lund TE, Bliksted V, Thorup AAE, Mors O, Plessen KJ, Nordentoft M, Siebner HR. Executive Control and Associated Brain Activity in Children With Familial High-Risk of Schizophrenia or Bipolar Disorder: A Danish Register-based Study. Schizophr Bull 2024; 50:567-578. [PMID: 37756493 PMCID: PMC11059809 DOI: 10.1093/schbul/sbad134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
BACKGROUND AND HYPOTHESES Impaired executive control is a potential prognostic and endophenotypic marker of schizophrenia (SZ) and bipolar disorder (BP). Assessing children with familial high-risk (FHR) of SZ or BP enables characterization of early risk markers and we hypothesize that they express impaired executive control as well as aberrant brain activation compared to population-based control (PBC) children. STUDY DESIGN Using a flanker task, we examined executive control together with functional magnetic resonance imaging (fMRI) in 11- to 12-year-old children with FHR of SZ (FHR-SZ) or FHR of BP (FHR-BP) and PBC children as part of a register-based, prospective cohort-study; The Danish High Risk and Resilience study-VIA 11. STUDY RESULTS We included 85 (44% female) FHR-SZ, 63 (52% female) FHR-BP and 98 (50% female) PBC in the analyses. Executive control effects, caused by the spatial visuomotor conflict, showed no differences between groups. Bayesian ANOVA of reaction time (RT) variability, quantified by the coefficient of variation (CVRT), revealed a group effect with similarly higher CVRT in FHR-BP and FHR-SZ compared to PBC (BF10 = 6.82). The fMRI analyses revealed no evidence for between-group differences in task-related brain activation. Post hoc analyses excluding children with psychiatric illness yielded same results. CONCLUSION FHR-SZ and FHR-BP at age 11-12 show intact ability to resolve a spatial visuomotor conflict and neural efficacy. The increased variability in RT may reflect difficulties in maintaining sustained attention. Since variability in RT was independent of existing psychiatric illness, it may reflect a potential endophenotypic marker of risk.
Collapse
Affiliation(s)
- Line Korsgaard Johnsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services CPH, Copenhagen, Denmark
| | - Kit Melissa Larsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services CPH, Copenhagen, Denmark
| | - Søren Asp Fuglsang
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
| | - Anna Hester Ver Loren van Themaat
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services CPH, Copenhagen, Denmark
| | - William Frans Christiaan Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
| | - Kathrine Skak Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Radiography, Department of Technology, University College Copenhagen, Copenhagen, Denmark
| | - Kristoffer Hougaard Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark
| | - Nicoline Hemager
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services CPH, Copenhagen, Denmark
- Copenhagen Research Center for Mental Health, CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte, Mental Health Services, Capital Region, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Anna Krogh Andreassen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark
- The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Lotte Veddum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark
- The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Aja Neergaard Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark
- The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Ayna Baladi Nejad
- Medical and Science, Clinical Drug Development, Novo Nordisk A/S, Greater Copenhagen area, Denmark
| | - Birgitte Klee Burton
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital, Psychiatry Region Zealand, Roskilde, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services CPH, Copenhagen, Denmark
| | - Maja Gregersen
- Copenhagen Research Center for Mental Health, CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte, Mental Health Services, Capital Region, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Heike Eichele
- Division of Psychiatry, Regional Resource Centre for Autism, ADHD and Tourette syndrome Western Norway, Haukeland University Hospital, Bergen, Norway
| | - Torben E Lund
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
| | - Vibeke Bliksted
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark
- The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Amalie Elgaard Thorup
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services CPH, Copenhagen, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark
- The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Kerstin Jessica Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, The University Hospital of Lausanne (CHUV) and University of Lausanne, Lausanne, Switzerland
- Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services CPH, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Merete Nordentoft
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Research Center for Mental Health, CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte, Mental Health Services, Capital Region, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| |
Collapse
|
2
|
Sunaga M, Takei Y, Kato Y, Tagawa M, Suto T, Hironaga N, Sakurai N, Fukuda M. The Characteristics of Power Spectral Density in Bipolar Disorder at the Resting State. Clin EEG Neurosci 2023; 54:574-583. [PMID: 34677105 DOI: 10.1177/15500594211050487] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bipolar disorder (BD) is a common psychiatric disorder, but its pathophysiology is not fully elucidated. The current study focused on its electrophysiological characteristics, especially power spectral density (PSD). Resting state with eyes opened magnetoencephalography data were collected from 21 patients with BD and 22 healthy controls. The whole brain's PSD was calculated from source reconstructed waveforms at each frequency band (delta: 1-3 Hz, theta: 4-7 Hz, alpha: 8-12 Hz, low beta: 13-19 Hz, high beta: 20-29 Hz, and gamma: 30-80 Hz). We compared PSD values on the marked vertices at each frequency band between healthy and patient groups using a Mann-Whitney rank test to examine the relationship between significantly different PSD and clinical measures. The PSD in patients with BD was significantly decreased in lower frequency bands, mainly in the default mode network (DMN) areas (bilateral medial prefrontal cortex, bilateral precuneus, left inferior parietal lobe, and right temporal cortex in the alpha band) and salience network areas (SAL; left anterior insula [AI] at the delta band, anterior cingulate cortex at the theta band, and right AI at the alpha band). No significant differences in PSD were observed at low beta and high beta. PSD was not correlated with age or other clinical scales. Altered PSDs of the DMN and SAL were observed in the delta, theta, and alpha bands. These alterations contribute to the vulnerability of BD through the disturbance of self-referential mental activity and switching between the default mode and frontoparietal networks.
Collapse
Affiliation(s)
- Masakazu Sunaga
- Gunma Prefectural Psychiatric Medical Center, Isesaki, Japan
| | - Yuichi Takei
- Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yutaka Kato
- Gunma University Graduate School of Medicine, Maebashi, Japan
- Tsutsuji Mental Hospital, Tatebayashi, Japan
| | - Minami Tagawa
- Gunma Prefectural Psychiatric Medical Center, Isesaki, Japan
- Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tomohiro Suto
- Gunma Prefectural Psychiatric Medical Center, Isesaki, Japan
| | | | - Noriko Sakurai
- Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masato Fukuda
- Gunma University Graduate School of Medicine, Maebashi, Japan
| |
Collapse
|
3
|
Verdolini N, Moreno-Ortega M, Salgado-Pineda P, Monté G, de Aragón AM, Dompablo M, McKenna PJ, Salvador R, Palomo T, Pomarol-Clotet E, Rodriguez-Jimenez R. Failure of deactivation in bipolar disorder during performance of an fMRI adapted version of the Stroop task. J Affect Disord 2023; 329:307-314. [PMID: 36863465 DOI: 10.1016/j.jad.2023.02.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/04/2023]
Abstract
INTRODUCTION Few studies have examined the functional brain correlates of the performance of the Stroop task in bipolar disorder (BD). It is also not known whether it is associated with failure of de-activation in the default mode network, as has been found in studies using other tasks. METHODS Twenty-four BD patients and 48 age, sex and educationally estimated intellectual quotient (IQ) matched healthy subjects (HS) underwent a functional MRI during performance of the counting Stroop task. Task-related activations (incongruent versus congruent condition) and de-activations (incongruent versus fixation) were examined using whole-brain, voxel-based methodology. RESULTS Both the BD patients and the HS showed activation in a cluster encompassing the left dorsolateral and ventrolateral prefrontal cortex and the rostral anterior cingulate cortex and supplementary motor area, with no differences between them. The BD patients, however, showed significant failure of de-activation in the medial frontal cortex and the posterior cingulate cortex/precuneus. CONCLUSIONS The failure to find activation differences between BD patients and controls suggests that the 'regulative' component of cognitive control remains intact in the disorder, at least outside episodes of illness. The failure of de-activation found adds to evidence documenting trait-like default mode network dysfunction in the disorder.
Collapse
Affiliation(s)
- Norma Verdolini
- FIDMAG Germanes Hospitalàries Research Foundation, c/Dr. Pujades 38, 08830, Sant Boi de Llobregat, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036 Barcelona, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain
| | - Marta Moreno-Ortega
- CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute/Columbia University Medical Center, New York, USA
| | - Pilar Salgado-Pineda
- FIDMAG Germanes Hospitalàries Research Foundation, c/Dr. Pujades 38, 08830, Sant Boi de Llobregat, Barcelona, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain
| | - Gemma Monté
- FIDMAG Germanes Hospitalàries Research Foundation, c/Dr. Pujades 38, 08830, Sant Boi de Llobregat, Barcelona, Spain
| | - Ana Martínez de Aragón
- Department of Radiology, Hospital Universitario 12 de Octubre, Avda. De Córdoba s/n, 28041 Madrid, Spain
| | - Mónica Dompablo
- CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Cardenal Cisneros, Centro de Enseñanza Superior adscrito a la Universidad Complutense de Madrid, Spain
| | - Peter J McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, c/Dr. Pujades 38, 08830, Sant Boi de Llobregat, Barcelona, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, c/Dr. Pujades 38, 08830, Sant Boi de Llobregat, Barcelona, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain
| | - Tomás Palomo
- CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, c/Dr. Pujades 38, 08830, Sant Boi de Llobregat, Barcelona, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain.
| | - Roberto Rodriguez-Jimenez
- CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain
| |
Collapse
|
4
|
Abstract
This article reviews the literature on the relationship between sleep deficiency and unipolar and bipolar depression, anxiety disorders, and posttraumatic stress disorder. We consider the evidence for sleep as a contributory causal factor in the development of psychiatric disorders, as well as sleep as an influential factor related to the outcome and recurrence of psychopathology. A case for sleep deficiency being an important treatment target when sleep and psychiatric disorders are comorbid is also made. Our recommendation is that sleep deficiency is recognized as a means to positively impact the development and course of psychopathology and, as such, is routinely assessed and treated in clinical practice.
Collapse
|
5
|
Zhu Z, Zhao Y, Wen K, Li Q, Pan N, Fu S, Li F, Radua J, Vieta E, Kemp GJ, Biswa BB, Gong Q. Cortical thickness abnormalities in patients with bipolar disorder: A systematic review and meta-analysis. J Affect Disord 2022; 300:209-218. [PMID: 34971699 DOI: 10.1016/j.jad.2021.12.080] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/10/2021] [Accepted: 12/19/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND An increasing number of neuroimaging studies report alterations of cortical thickness (CT) related to the neuropathology of bipolar disorder (BD). We provide here a whole-brain vertex-wise meta-analysis, which may help improve the spatial precision of these identifications. METHODS A comprehensive meta-analysis was performed to investigate the differences in CT between patients with BD and healthy controls (HCs) by using a newly developed mask for CT analysis in seed-based d mapping (SDM) meta-analytic software. We used meta-regression to explore the effects of demographics and clinical characteristics on CT. This meta-review was conducted in accordance with PRISMA guideline. RESULTS We identified 21 studies meeting criteria for the systematic review, of which 11 were eligible for meta-analysis. The meta-analysis comprising 649 BD patients and 818 HCs showed significant cortical thinning in the left insula extending to left Rolandic operculum and Heschl gyrus, the orbital part of left inferior frontal gyrus (IFG), the medial part of left superior frontal gyrus (SFG) as well as bilateral anterior cingulate cortex (ACC) in BD. In meta-regression analyses, mean patient age was negatively correlated with reduced CT in the left insula. LIMITATIONS All enrolled studies were cross-sectional; we could not explore the potential effects of medication and mood states due to the limited data. CONCLUSIONS Our results suggest that BD patients have significantly thinner frontoinsular cortex than HCs, and the results may be helpful in revealing specific neuroimaging biomarkers of BD patients.
Collapse
Affiliation(s)
- Ziyu Zhu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Youjin Zhao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan, China
| | - Keren Wen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qian Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shiqin Fu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan, China
| | - Joaquim Radua
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan, China; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain; Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, Northern Ireland United Kingdom
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain; Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Bharat B Biswa
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA; The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China.
| |
Collapse
|
6
|
Chen Q, Zhao J, Gu H, Li X. Inhibitory Control of Emotional Interference in Deaf Children: Evidence From Event-Related Potentials and Event-Related Spectral Perturbation Analysis. Front Psychiatry 2022; 13:897595. [PMID: 35815005 PMCID: PMC9263210 DOI: 10.3389/fpsyt.2022.897595] [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] [Received: 03/16/2022] [Accepted: 05/26/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Impairment of interference control ability may reflect a more general deficit in executive functioning, and lead to an increase in internal-externalized problems such as impulsivity, which has been reported in deaf children. However, few researches have examined the neural mechanism of this impairment. METHODS This study applied the electroencephalogram (EEG) technique to investigate the interference control ability in 31 deaf children and 28 hearing controls with emotional face-word stroop task. RESULTS Results from behavioral task showed that deaf children exhibited lower accuracy compared to hearing controls. As for EEG analysis, reduced activation of ERP components in N1 and enhanced activation of ERP components in N450 have been found in deaf children. Besides, incongruent condition elicited larger N450 than congruent condition. Furthermore, for brain oscillation, alpha band (600-800 ms) revealed a reduced desynchronization in deaf children, while theta band (200-400 ms) revealed an enhanced synchronization in deaf children and incongruent condition, which were in line with ERP components. CONCLUSION The present findings seem to indicate that the deficit during emotional interference control ability among deaf children might be due to the impaired attention allocation ability and emotional cognitive monitoring function during emotional conflict detection process. Consequently, reduced N1 and enhanced N450 might be due to early attention impairment causing more effort of deaf children later in emotional cognitive monitoring.
Collapse
Affiliation(s)
- Qiong Chen
- Shaanxi Provincial Key Research Center for Children Mental and Behavioral Health, School of Psychology, Shaanxi Normal University, Xi'an, China.,Institute of Behavior and Psychology, School of Psychology, Henan University, Kaifeng, China
| | - Junfeng Zhao
- Institute of Behavior and Psychology, School of Psychology, Henan University, Kaifeng, China
| | - Huang Gu
- Institute of Behavior and Psychology, School of Psychology, Henan University, Kaifeng, China
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, United States
| |
Collapse
|
7
|
Woo Y, Kang W, Kang Y, Kim A, Han KM, Tae WS, Ham BJ. Cortical Thickness and Surface Area Abnormalities in Bipolar I and II Disorders. Psychiatry Investig 2021; 18:850-863. [PMID: 34500506 PMCID: PMC8473857 DOI: 10.30773/pi.2021.0074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/11/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Although bipolar II disorder (BD II) is not simply a mitigated form of bipolar I disorder (BD I), their neurobiological differences have not been elucidated. The present study aimed to explore cortical thickness (CT) and surface area (SA) in patients with BD I and BD II and healthy controls (HCs) to investigate the shared and unique neurobiological mechanisms of BD subtypes. METHODS We enrolled 30 and 44 patients with BD I and BD II, respectively, and 100 HCs. We evaluated CT and SA using FreeSurfer and estimated differences in CT and SA among the three groups (BD I vs. BD II vs. HC). We adjusted for age, sex, educational level, and intracranial volume as confounding factors. RESULTS We found widespread cortical thinning in the bilateral frontal, temporal, and occipital regions; cingulate gyrus; and insula in patients with BD. Alterations in SA, including increased SA of the pars triangularis and decreased SA of the insula, were noted in patients with BD. Overall, we found BD II patients demonstrated decreased SA in the right long insula compared to BD I patients. CONCLUSION Our results suggest that decreased SA in the right long insula is crucial for differentiating BD subtypes.
Collapse
Affiliation(s)
- Yoonmi Woo
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Wooyoung Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youbin Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Aram Kim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo-Suk Tae
- Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
8
|
Van Meter AR, Perez-Rodriguez MM, Braga RJ, Shanahan M, Hanna L, Malhotra AK, Burdick KE. Pramipexole to Improve Cognition in Bipolar Disorder: A Randomized Controlled Trial. J Clin Psychopharmacol 2021; 41:421-427. [PMID: 33956703 PMCID: PMC8238822 DOI: 10.1097/jcp.0000000000001407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/24/2021] [Accepted: 02/24/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Adults with bipolar disorder (BD) often experience neurocognitive impairment that negatively impacts functioning and quality of life. Previous trials have found that dopamine agonist agents improve cognition in healthy volunteers and that adults with BD who have stable mood and mild cognitive deficits may also benefit. We hypothesized that pramipexole, a dopamine agonist, would improve neurocognitive function in patients with BD. METHODS We recruited 60 adults (aged 18-65 years) with a diagnosis of BD I or II for an 8-week, double-blind, placebo-controlled trial (NCT02397837). All had stable mood and clinically significant neurocognitive impairment at baseline. Participants were randomized to receive pramipexole (n = 31) or a placebo (n = 29), dose was initiated at 0.125 mg 2 times a day and increased to a target of 4.5 mg/d. RESULTS At trial end, the primary outcome, MATRICS Consensus Cognitive Battery composite score, had not improved more in the pramipexole group (mean [SD] = 1.15 [5.4]) than in the placebo group (mean [SD] = 4.12 [5.2], Cohen's d = 0.56, P = 0.049), and mixed models, controlling for symptoms, showed no association between treatment group and MATRICS Consensus Cognitive Battery scores. No serious adverse events were reported. CONCLUSIONS These results suggest that pramipexole is not an efficacious cognitive enhancement agent in BD, even in a sample enriched for characteristics that were associated with a beneficial response in prior work. There are distinct cognitive subgroups among adults with BD and may be related differences in neurobiology that affect response to pramipexole. Additional research to better understand the onset and nature of the cognitive deficits in people with BD will be an important step toward a more personalized approach to treatment.
Collapse
Affiliation(s)
- Anna R. Van Meter
- From the Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks
- Feinstein Institutes for Medical Research, Institute for Behavioral Science, Manhasset
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead
| | | | - Raphael J. Braga
- From the Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead
| | - Megan Shanahan
- Brigham and Women's Hospital, Mood and Psychosis Research Program, Boston
| | - Lauren Hanna
- From the Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead
| | - Anil K. Malhotra
- From the Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks
- Feinstein Institutes for Medical Research, Institute for Behavioral Science, Manhasset
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead
| | - Katherine E. Burdick
- Brigham and Women's Hospital, Mood and Psychosis Research Program, Boston
- Department of Psychiatry, Harvard Medical School, Cambridge, MA
| |
Collapse
|
9
|
Neuroprogression as an Illness Trajectory in Bipolar Disorder: A Selective Review of the Current Literature. Brain Sci 2021; 11:brainsci11020276. [PMID: 33672401 PMCID: PMC7926350 DOI: 10.3390/brainsci11020276] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/01/2021] [Accepted: 02/15/2021] [Indexed: 01/29/2023] Open
Abstract
Bipolar disorder (BD) is a chronic and disabling psychiatric condition that is linked to significant disability and psychosocial impairment. Although current neuropsychological, molecular, and neuroimaging evidence support the existence of neuroprogression and its effects on the course and outcome of this condition, whether and to what extent neuroprogressive changes may impact the illness trajectory is still poorly understood. Thus, this selective review was aimed toward comprehensively and critically investigating the link between BD and neurodegeneration based on the currently available evidence. According to the most relevant findings of the present review, most of the existing neuropsychological, neuroimaging, and molecular evidence demonstrates the existence of neuroprogression, at least in a subgroup of BD patients. These studies mainly focused on the most relevant effects of neuroprogression on the course and outcome of BD. The main implications of this assumption are discussed in light of specific shortcomings/limitations, such as the inability to carry out a meta-analysis, the inclusion of studies with small sample sizes, retrospective study designs, and different longitudinal investigations at various time points.
Collapse
|
10
|
Mariani R, Di Trani M, Negri A, Tambelli R. Linguistic analysis of autobiographical narratives in unipolar and bipolar mood disorders in light of multiple code theory. J Affect Disord 2020; 273:24-31. [PMID: 32421609 DOI: 10.1016/j.jad.2020.03.170] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/21/2020] [Accepted: 03/29/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Discriminating bipolar disorder (BD) from unipolar disorder (UD) is crucial in diagnosing mood disorders. Neurophysiological studies have identified different correlates of emotional regulation in BD and UD. According to the Multiple Code Theory, bodily modifications relate to linguistic styles, as highlighted by studies on the language of depression. Our purpose is to verify the existence in the Italian language of linguistic features of depression differentiating BD from UD to provide tools for clinicians to use beyond self-report measures. METHODS The sample included 20 BD, 20 UD (all diagnosed using DSM-5), and 20 Control Group (CG) participants. Participants completed the Profile of Mood States (POMS) and an audio-recorded Relationship Anecdotes Paradigm Interview, transcribed and analyzed by the Discourse Attributes Analysis Program for Referential Process Linguistic Measures. RESULTS One-way ANOVAs confirmed that specific linguistic features characterized BD, UD and CG. The use of Sensory-Somatic words was significantly different in the groups: higher in BD, intermediate in UD, and lower in CG. Individuals with BD produced higher scores on the Referential Activity Intensity Index and the use of singular pronoun "I". Negative Affect, as well as several POMS subscales, distinguished UD and BD from CG. LIMITATIONS Narrow sample size, use of a single self-report instrument and treatment effects on measures in the clinical groups are limitations of the study. CONCLUSION Individuals with UD and BD appear to use sensory-somatic language in predictably different patterns from each other and from the non-clinical population. Observation and assessment of linguistic features could improve diagnostic accuracy.
Collapse
Affiliation(s)
- R Mariani
- Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy.
| | - M Di Trani
- Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy
| | - A Negri
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - R Tambelli
- Department of Dynamic and Clinical Psychology, Sapienza University, Rome, Italy
| |
Collapse
|
11
|
Wang Y, Gao Y, Tang S, Lu L, Zhang L, Bu X, Li H, Hu X, Hu X, Jiang P, Jia Z, Gong Q, Sweeney JA, Huang X. Large-scale network dysfunction in the acute state compared to the remitted state of bipolar disorder: A meta-analysis of resting-state functional connectivity. EBioMedicine 2020; 54:102742. [PMID: 32259712 PMCID: PMC7136605 DOI: 10.1016/j.ebiom.2020.102742] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/28/2020] [Accepted: 03/16/2020] [Indexed: 02/08/2023] Open
Abstract
Background Bipolar disorder (BD) is a mental disorder characterized by mood fluctuations between an acute episodic state of either mania or depression and a clinically remitted state. Dysfunction of large-scale intrinsic brain networks has been demonstrated in this disorder, but it remains unknown whether those network alterations are related to different states. Methods In the present study, we performed a meta-analysis of whole-brain seed-based resting-state functional connectivity (rsFC) studies in BD patients to compare the intrinsic function of brain networks between episodic and remitted states. Thirty-nine seed-based voxel-wise rsFC datasets from thirty publications (1047 BD patients vs 1081 controls) were included in the meta-analysis. Seeds were categorized into networks by their locations within a priori functional networks. Seed-based d mapping analysis of between-state effects identified brain systems in which different states were associated with increased connectivity or decreased connectivity within and between each seed network. Findings We found that BD patients presented decreased connectivity within the affective network (AN) in acute episodes but not in the remitted state of the illness. Similar decreased connectivity within the default-mode network (DMN) was also found in the acute state, but it was replaced by increased connectivity in the remitted state. In addition, different patterns of between-network dysconnectivity were observed between the acute and remitted states. Interpretation This study is the first to identify different patterns of intrinsic function in large-scale brain networks between the acute and remitted states of BD through meta-analysis. The findings suggest that a shift in network function between the acute and remitted states may be related to distinct emotional and cognitive dysfunctions in BD, which may have important implications for identifying clinically relevant biomarkers to guide alternative treatment strategies for BD patients during active episodes or remission. Funding This study was supported by grants from the National Natural Science Foundation of China (81171488, 81671669 and 81820108018) and by a Sichuan Provincial Youth Grant (2017JQ0001).
Collapse
Affiliation(s)
- Yanlin Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Shi Tang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Lu Lu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xuan Bu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xiaoxiao Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Ping Jiang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Zhiyun Jia
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China.
| |
Collapse
|
12
|
Nabulsi L, McPhilemy G, Kilmartin L, Whittaker JR, Martyn FM, Hallahan B, McDonald C, Murphy K, Cannon DM. Frontolimbic, Frontoparietal, and Default Mode Involvement in Functional Dysconnectivity in Psychotic Bipolar Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:140-151. [PMID: 31926904 PMCID: PMC7613114 DOI: 10.1016/j.bpsc.2019.10.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Functional abnormalities, mostly involving functionally specialized subsystems, have been associated with disorders of emotion regulation such as bipolar disorder (BD). Understanding how independent functional subsystems integrate globally and how they relate with anatomical cortical and subcortical networks is key to understanding how the human brain's architecture constrains functional interactions and underpins abnormalities of mood and emotion, particularly in BD. METHODS Resting-state functional magnetic resonance time series were averaged to obtain individual functional connectivity matrices (using AFNI software); individual structural connectivity matrices were derived using deterministic non-tensor-based tractography (using ExploreDTI, version 4.8.6), weighted by streamline count and fractional anisotropy. Structural and functional nodes were defined using a subject-specific cortico-subcortical mapping (using Desikan-Killiany Atlas, FreeSurfer, version 5.3). Whole-brain connectivity alongside a permutation-based statistical approach and structure-function coupling were employed to investigate topological variance in individuals with predominantly euthymic BD relative to psychiatrically healthy control subjects. RESULTS Patients with BD (n = 41) exhibited decreased (synchronous) connectivity in a subnetwork encompassing frontolimbic and posterior-occipital functional connections (T > 3, p = .048), alongside increased (antisynchronous) connectivity within a frontotemporal subnetwork (T > 3, p = .014); all relative to control subjects (n = 56). Preserved whole-brain functional connectivity and comparable structure-function coupling among whole-brain and edge-class connections were observed in patients with BD relative to control subjects. CONCLUSIONS This study presents a functional map of BD dysconnectivity that differentially involves communication within nodes belonging to functionally specialized subsystems-default mode, frontoparietal, and frontolimbic systems; these changes do not extend to be detected globally and may be necessary to maintain a remitted clinical state of BD. Preserved structure-function coupling in BD despite evidence of regional anatomical and functional deficits suggests a dynamic interplay between structural and functional subnetworks.
Collapse
Affiliation(s)
- Leila Nabulsi
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland.
| | - Genevieve McPhilemy
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Liam Kilmartin
- College of Engineering and Informatics, National University of Ireland Galway, Galway, Ireland
| | - Joseph R Whittaker
- Cardiff University Brain Research Imaging Centre, Cardiff, United Kingdom
| | - Fiona M Martyn
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Brian Hallahan
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Colm McDonald
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland
| | - Kevin Murphy
- Cardiff University Brain Research Imaging Centre, Cardiff, United Kingdom
| | - Dara M Cannon
- Centre for Neuroimaging and Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland
| |
Collapse
|
13
|
Xu C, Chen J, Cui Z, Wen R, Han H, Jin L, Wan G, Wei Z, Peng Z. Abnormal Anhedonia as a Potential Endophenotype in Obsessive-Compulsive Disorder. Neuropsychiatr Dis Treat 2020; 16:3001-3010. [PMID: 33324061 PMCID: PMC7733443 DOI: 10.2147/ndt.s268148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/02/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is often accompanied by cognitive, particularly executive function, impairments. Recently, anhedonia has emerged as an apparently important symptom of OCD reflecting altered emotion regulation. These two aspects are often comorbid in OCD. However, little is known about whether anhedonia may be a trait marker for OCD. METHODS To verify the role of executive function and evaluate the role of anhedonia in OCD and its relationship with OCD symptoms, we recruited 60 OCD patients, 30 unaffected first-degree relatives (FDRs), and 60 healthy controls (HCs). Participants completed psychometric testing to assess depression, anxiety, and anhedonia symptoms, as well as two cognitive tests to assess executive function, namely the Wisconsin Card Sorting Test (WCST) and the Stroop Color-Word Test (SCWT). RESULTS Compared to HCs, OCD patients and FDRs had significantly lower anticipatory and consummatory pleasure scores. The severity of anticipatory anhedonia correlated positively with obsessive-compulsive symptoms (r = 0.253, p = 0.009), even after controlling for depression and anxiety symptoms. Compared to HCs, OCD patients and FDRs made more errors and achieved fewer categories in the WCST. For all three SWCT components, OCD patients and FDRs took more time to name colors than HCs, but the three groups had similar numbers of errors. CONCLUSION This family-based study showed dampened pleasure together with cognitive dysfunction in OCD patients. The similar consummatory pleasure findings between OCD and FDR groups suggest anhedonia may be considered as a candidate OCD endophenotype.
Collapse
Affiliation(s)
- Chuanyong Xu
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Jierong Chen
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Zitian Cui
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Rongzhen Wen
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Hongying Han
- Department of Psychiatry, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Lili Jin
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Guobin Wan
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Zhen Wei
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Ziwen Peng
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| |
Collapse
|
14
|
Uscinska M, Polla Mattiot A, Bellino S. Treatment-Induced Brain Plasticity in Psychiatric Disorders. Behav Neurosci 2019. [DOI: 10.5772/intechopen.85448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
15
|
Delvecchio G, Ciappolino V, Perlini C, Barillari M, Ruggeri M, Altamura AC, Bellani M, Brambilla P. Cingulate abnormalities in bipolar disorder relate to gender and outcome: a region-based morphometry study [corrected]. Eur Arch Psychiatry Clin Neurosci 2019; 269:777-784. [PMID: 29594394 DOI: 10.1007/s00406-018-0887-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 03/16/2018] [Indexed: 12/22/2022]
Abstract
Structural magnetic resonance imaging (MRI) studies reported gray matter (GM) loss in bipolar disorder (BD) in cingulate cortices, key regions subserving emotional regulation and cognitive functions in humans. The aim of this study was to further explore cingulate GM volumes in a sizeable group of BD patients with respect to healthy controls, particularly investigating the impact of gender and clinical variables. 39 BD patients (mean Age = 48.6 ± 9.7, 15 males and 24 females) and 39 demographically matched healthy subjects (mean Age = 47.9 ± 9.1, 15 males and 24 females) underwent a 1.5T MRI scan. GM volumes within the cingulate cortex were manually detected, including anterior and posterior regions. BD patients had decreased left anterior cingulate volumes compared with healthy controls (F = 6.7, p = 0.01). Additionally, a significant gender effect was observed, with male patients showing reduced left anterior cingulate cortex (ACC) volumes compared to healthy controls (F = 5.1, p = 0.03). Furthermore, a significant inverse correlation between right ACC volumes and number of hospitalizations were found in the whole group of BD patients (r = - 0.51, p = 0.04) and in male BD patients (r = - 0.88, p = 0.04). Finally, no statistically significant correlations were observed in female BD patients. Our findings further confirm the putative role of the ACC in the pathophysiology of BD. Interestingly, this study also suggested the presence of gender-specific GM volume reductions in ACC in BD, which may also be associated to poor outcome.
Collapse
Affiliation(s)
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
| | - Cinzia Perlini
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy
| | - Marco Barillari
- Section of Radiology, Department of Neurological and Movement Sciences, University Hospital of Verona, Verona, Italy
| | - Mirella Ruggeri
- Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy.,Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - A Carlo Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
| | - Marcella Bellani
- Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy.,Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy. .,Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA.
| |
Collapse
|
16
|
Kato T. Current understanding of bipolar disorder: Toward integration of biological basis and treatment strategies. Psychiatry Clin Neurosci 2019; 73:526-540. [PMID: 31021488 DOI: 10.1111/pcn.12852] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 04/19/2019] [Accepted: 04/22/2019] [Indexed: 12/18/2022]
Abstract
Biological studies of bipolar disorder initially focused on the mechanism of action for antidepressants and antipsychotic drugs, and the roles of monoamines (e.g., serotonin, dopamine) have been extensively studied. Thereafter, based on the mechanism of action of lithium, intracellular signal transduction systems, including inositol metabolism and intracellular calcium signaling, have drawn attention. Involvement of intracellular calcium signaling has been supported by genetics and cellular studies. Elucidation of the neural circuits affected by calcium signaling abnormalities is critical, and our previous study suggested a role of the paraventricular thalamic nucleus. The genetic vulnerability of mitochondria causes calcium dysregulation and results in the hyperexcitability of serotonergic neurons, which are suggested to be susceptible to oxidative stress. Efficacy of anticonvulsants, animal studies of candidate genes, and studies using induced pluripotent stem cell-derived neurons have suggested a relation between bipolar disorder and the hyperexcitability of neurons. Recent genetic findings suggest the roles of polyunsaturated acids. At the systems level, social rhythm therapy targets circadian rhythm abnormalities, and cognitive behavioral therapy may target emotion/cognition (E/C) imbalance. In the future, pharmacological and psychosocial treatments may be combined and optimized based on the biological basis of each patient, which will realize individualized treatment.
Collapse
Affiliation(s)
- Tadafumi Kato
- Laboratory for Molecular Dynamics of Mental Disorders, RIKEN Center for Brain Science, Wako, Japan
| |
Collapse
|
17
|
Cattarinussi G, Di Giorgio A, Wolf RC, Balestrieri M, Sambataro F. Neural signatures of the risk for bipolar disorder: A meta-analysis of structural and functional neuroimaging studies. Bipolar Disord 2019; 21:215-227. [PMID: 30444299 DOI: 10.1111/bdi.12720] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Widespread functional and structural alterations in the brain have been extensively reported in unaffected relatives (RELs) of patients with bipolar disorder (BD) who are at genetic risk for BD. A sufficiently powered meta-analysis of structural (sMRI) and functional magnetic resonance imaging (fMRI) alterations in RELs is still lacking. METHODS Functional and structural magnetic resonance imaging studies investigating RELs and healthy controls (HCs) published by July 2017 were included in the meta-analyses. Study procedures were conducted in accordance with the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Random-effects coordinate-based meta-analyses were performed across all the studies per imaging modality using Seed-based d Mapping (SDM). For fMRI studies, meta-analyses were calculated for each task type. For sMRI studies, regional volumetric changes-analyses were estimated using R. Finally, multimodal meta-analyses of structural and functional abnormalities were performed. RESULTS Sixty-nine imaging studies (2195 RELs and 3169 HCs) were included in the meta-analyses. RELs showed hyperactivation in the fronto-striatal regions as well as parietal hypoactivation during cognition. Also, activation was increased in the amygdala during emotional processing and in the orbitofrontal cortex during reward, respectively. Frontal and superior temporal cortex were hypertrophic in RELs. The right inferior frontal gyrus (rIFG) showed both increased activation during cognitive tasks and greater volume in RELs. CONCLUSIONS Our findings demonstrate that increased brain volume and activation are present in RELs and may represent intermediate phenotypes for the disorder. Furthermore, some neural changes including increased rIFG volume may be associated with the resilience to BD.
Collapse
Affiliation(s)
| | | | - Robert Christian Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | | | - Fabio Sambataro
- Department of Medicine (DAME), University of Udine, Udine, Italy
| |
Collapse
|
18
|
Abstract
Neuropsychiatric illnesses including mood disorders are accompanied by cognitive impairment, which impairs work capacity and quality of life. However, there is a lack of treatment options that would lead to solid and lasting improvement of cognition. This is partially due to the absence of valid and reliable neurocircuitry-based biomarkers for pro-cognitive effects. This systematic review therefore examined the most consistent neural underpinnings of cognitive impairment and cognitive improvement in unipolar and bipolar disorders. We identified 100 studies of the neuronal underpinnings of working memory and executive skills, learning and memory, attention, and implicit learning and 9 studies of the neuronal basis for cognitive improvements. Impairments across several cognitive domains were consistently accompanied by abnormal activity in dorsal prefrontal (PFC) cognitive control regions-with the direction of this activity depending on patients' performance levels-and failure to suppress default mode network (DMN) activity. Candidate cognition treatments seemed to enhance task-related dorsal PFC and temporo-parietal activity when performance increases were observed, and to reduce their activity when performance levels were unchanged. These treatments also attenuated DMN hyper-activity. In contrast, nonspecific cognitive improvement following symptom reduction was typically accompanied by decreased limbic reactivity and reversal of pre-treatment fronto-parietal hyper-activity. Together, the findings highlight some common neural correlates of cognitive impairments and cognitive improvements. Based on this evidence, studies are warranted to examine the reliability and predictive validity of target engagement in the identified neurocircuitries as a biomarker model of pro-cognitive effects.
Collapse
|
19
|
Perry A, Roberts G, Mitchell PB, Breakspear M. Connectomics of bipolar disorder: a critical review, and evidence for dynamic instabilities within interoceptive networks. Mol Psychiatry 2019; 24:1296-1318. [PMID: 30279458 PMCID: PMC6756092 DOI: 10.1038/s41380-018-0267-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/14/2018] [Accepted: 09/07/2018] [Indexed: 12/31/2022]
Abstract
The notion that specific cognitive and emotional processes arise from functionally distinct brain regions has lately shifted toward a connectivity-based approach that emphasizes the role of network-mediated integration across regions. The clinical neurosciences have likewise shifted from a predominantly lesion-based approach to a connectomic paradigm-framing disorders as diverse as stroke, schizophrenia (SCZ), and dementia as "dysconnection syndromes". Here we position bipolar disorder (BD) within this paradigm. We first summarise the disruptions in structural, functional and effective connectivity that have been documented in BD. Not surprisingly, these disturbances show a preferential impact on circuits that support emotional processes, cognitive control and executive functions. Those at high risk (HR) for BD also show patterns of connectivity that differ from both matched control populations and those with BD, and which may thus speak to neurobiological markers of both risk and resilience. We highlight research fields that aim to link brain network disturbances to the phenotype of BD, including the study of large-scale brain dynamics, the principles of network stability and control, and the study of interoception (the perception of physiological states). Together, these findings suggest that the affective dysregulation of BD arises from dynamic instabilities in interoceptive circuits which subsequently impact on fear circuitry and cognitive control systems. We describe the resulting disturbance as a "psychosis of interoception".
Collapse
Affiliation(s)
- Alistair Perry
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. .,Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin/London, Germany. .,Center for Lifespan Psychology, Max Planck Institute for Human Development, Lentzeallee 94, 14195, Berlin, Germany.
| | - Gloria Roberts
- 0000 0004 4902 0432grid.1005.4School of Psychiatry, University of New South Wales, Randwick, NSW Australia ,grid.415193.bBlack Dog Institute, Prince of Wales Hospital, Randwick, NSW Australia
| | - Philip B. Mitchell
- 0000 0004 4902 0432grid.1005.4School of Psychiatry, University of New South Wales, Randwick, NSW Australia ,grid.415193.bBlack Dog Institute, Prince of Wales Hospital, Randwick, NSW Australia
| | - Michael Breakspear
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. .,Metro North Mental Health Service, Brisbane, QLD, Australia.
| |
Collapse
|
20
|
King JB, Anderson JS, Yurgelun-Todd DA, Subramaniam P, Ehrler MR, Lopez-Larson MP. Decreased anterior cingulate activation in a motor task in youths with bipolar disorder. J Child Psychol Psychiatry 2018; 59:900-907. [PMID: 29451300 PMCID: PMC6041159 DOI: 10.1111/jcpp.12875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Bipolar disorder (BP) is characterized by abnormal shifts in mood between episodes of mania and severe depression, both of which have been linked with psychomotor disturbances. This study compares brain activation patterns in motor networks between euthymic youths with BP and healthy controls (HC) during the completion of a simple motor task. METHODS Thirty-five youths with BP and 35 HC (aged 10-19) completed a self-paced sequential bilateral finger-tapping task, consisting of a 4-minute scan block with alternating 20-second periods of either the tapping task (six blocks) or rest (six blocks), while undergoing functional magnetic resonance imaging. Clinical and behavioral symptoms were assessed using the Child Behavior Checklist (CBCL). A between-group whole-brain analysis compared activation pattern differences while controlling for effects of age and sex. Clusters meeting whole-brain false discovery rate (FDR) correction (qFDR < .05) were considered statistically significant. Post hoc analyses evaluating comorbid attention-deficit/hyperactivity disorder (ADHD) in the BP group were also conducted. RESULTS Significantly decreased activation was found in the anterior cingulate cortex (ACC) in youths with BP compared to HC. Furthermore, ACC activation was negatively correlated with CBCL mood dysregulation profile scores in the BP group. No significant differences in functional activation patterns were found between youths with BP and comorbid ADHD and those with only BP. CONCLUSIONS These findings suggest a potential common mechanism of impaired ACC modulation between emotion dysregulation and motor processing in youths with BP.
Collapse
Affiliation(s)
- Jace B. King
- Department of Radiology, University of Utah, Salt Lake City, UT, USA,Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA,Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA,Correspondence: Jace B. King, University of Utah, Imaging and Neurosciences Center, 729 Arapeen Drive, Salt Lake City, UT, 84108, USA; Phone: 801-585-9667;
| | - Jeffrey S. Anderson
- Department of Radiology, University of Utah, Salt Lake City, UT, USA,Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA,School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Deborah A. Yurgelun-Todd
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA,Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA,School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Punitha Subramaniam
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA,Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA
| | | | - Melissa P. Lopez-Larson
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA,School of Medicine, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
21
|
Larrivee D, Echarte L. Contemplative Meditation and Neuroscience: Prospects for Mental Health. JOURNAL OF RELIGION AND HEALTH 2018; 57:960-978. [PMID: 28819790 DOI: 10.1007/s10943-017-0475-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Numerous studies show that personal spirituality developed through prayer positively influences mental health. Phenomenological and neuroscientific studies of mindfulness, an Eastern meditative prayer form, reveal significant health benefits now yielding important insights useful for guiding treatment of psychological disorders. By contrast, and despite its practice for millennia, Christian meditation is largely unrepresented in studies of clinical efficacy. Resemblances between mindfulness and disciplinary acts in Christian meditation taken from the ancient Greek practice of askesis suggest that Christian meditation will prove similarly beneficial; furthermore, psychological and neuroscientific studies suggest that its retention of a dialogical and transcendent praxis will additionally benefit social and existential psychotherapy. This paper thus argues that study of contemplative meditation for its therapeutic potential is warranted.
Collapse
Affiliation(s)
- Denis Larrivee
- Neiswanger Bioethics Institute, Loyola University Chicago, Chicago, IL, USA.
- , 1032 W. Sheridan Rd, Chicago, IL, 60660, USA.
| | - Luis Echarte
- Institute of Ethics and Culture, School of Medicine, University of Navarra, Pamplona, Spain
| |
Collapse
|
22
|
Soehner AM, Goldstein TR, Gratzmiller SM, Phillips ML, Franzen PL. Cognitive control under stressful conditions in transitional age youth with bipolar disorder: Diagnostic and sleep-related differences in fronto-limbic activation patterns. Bipolar Disord 2018; 20:238-247. [PMID: 29441653 PMCID: PMC6002960 DOI: 10.1111/bdi.12583] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 10/09/2017] [Accepted: 10/21/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Adults with bipolar disorder (BD) display aberrant activation in fronto-limbic neural circuitry during cognitive control. However, fronto-limbic response to cognitive control, and factors destabilizing this circuitry, remain under-studied during the transition from adolescence to young adulthood in BD. Sleep patterns are disturbed in BD, undergo change in adolescence, and support brain function. Among transitional age youth, BD diagnosis and sleep (duration and variability) were tested as predictors of fronto-limbic response to a stressful cognitive control task. METHODS Two groups of youth (13-22 years old) participated: 15 with BD type I, II or not otherwise specified (NOS) [BD; age 18.1 ± 2.7 years (mean ± standard deviation, SD); 17 female] and 25 healthy controls [CTL; age 19.4 ± 2.7 years (mean ± SD); 17 female]. Sleep was monitored with actigraphy for at least 1 week prior to an adaptive multi-source interference functional magnetic resonance imaging (fMRI) paradigm (a Stroop-like cognitive interference task). Group status and sleep duration (average and intra-individual variability) were examined as predictors of activation in response to incongruent>congruent trials within the bilateral amygdala, anterior cingulate (ACC), ventrolateral prefrontal and dorsolateral prefrontal cortical regions of interest. RESULTS The BD group displayed greater right amygdala activation than the CTL group. Average sleep duration and rostroventral ACC (rvACC) activity were negatively associated in the CTL group, but exhibited a quadratic relationship in the BD group such that short and long sleep were related to greater rvACC activation. Sleep duration variability and dorsal ACC activity were negatively associated in the BD group, and unrelated in the CTL group. Findings remained significant after controlling for age, sex, and mood symptoms. CONCLUSIONS Subjects with BD displayed a hyper-limbic response during cognitive control, and sleep was a source of variability in ACC engagement. Stabilizing sleep may be one avenue for improving cognitive control in BD.
Collapse
Affiliation(s)
- Adriane M. Soehner
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tina R. Goldstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sarah M. Gratzmiller
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mary L. Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Peter L. Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| |
Collapse
|
23
|
Shaffer JJ, Johnson CP, Long JD, Fiedorowicz JG, Christensen GE, Wemmie JA, Magnotta VA. Relationship altered between functional T1ρ and BOLD signals in bipolar disorder. Brain Behav 2017; 7:e00802. [PMID: 29075562 PMCID: PMC5651386 DOI: 10.1002/brb3.802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 07/06/2017] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Functional neuroimaging typically relies on the blood-oxygen-level-dependent (BOLD) contrast, which is sensitive to the influx of oxygenated blood following neuronal activity. A new method, functional T1 relaxation in the rotating frame (fT1ρ) is thought to reflect changes in local brain metabolism, likely pH, and may more directly measure neuronal activity. These two methods were applied to study activation of the visual cortex in participants with bipolar disorder as compared to controls. METHODS Thirty-nine participants with bipolar disorder and 32 healthy controls underwent functional neuroimaging during a flashing checkerboard paradigm. Functional images were acquired in alternating blocks of BOLD and fT1ρ. Linear mixed-effect models were used to examine the relationship between these two functional imaging modalities and to test whether that relationship was altered in bipolar disorder. RESULTS BOLD and fT1ρ signal were strongly related in visual and cerebellar areas during the task in controls. The relationship between these two measures was reduced in bipolar disorder within the visual areas, cerebellum, striatum, and thalamus. CONCLUSIONS These results support a distinct mechanisms underlying BOLD and fT1ρ signals. The weakened relationship between these imaging modalities may provide a novel tool for measuring pathology in bipolar disorder and other psychiatric illnesses.
Collapse
Affiliation(s)
| | | | - Jeffrey D Long
- Department of Psychiatry University of Iowa Iowa City IA USA.,Department of Biostatistics University of Iowa Iowa City IA USA
| | - Jess G Fiedorowicz
- Department of Psychiatry University of Iowa Iowa City IA USA.,Department of Epidemiology University of Iowa Iowa City IA USA.,Department of Internal Medicine University of Iowa Iowa City IA USA
| | - Gary E Christensen
- Department of Electrical and Computer Engineering University of Iowa Iowa City IA USA.,Department of Radiation Oncology University of Iowa Iowa City IA USA
| | - John A Wemmie
- Department of Psychiatry University of Iowa Iowa City IA USA.,Department of Veterans Affairs Medical Center Iowa City IA USA.,Department of Molecular Physiology and Biophysics University of Iowa Iowa City IA USA.,Department of Neurosurgery University of Iowa Iowa City IA USA.,Iowa Neuroscience Institute University of Iowa Iowa City IA USA
| | - Vincent A Magnotta
- Department of Radiology University of Iowa Iowa City IA USA.,Department of Psychiatry University of Iowa Iowa City IA USA.,Department of Biomedical Engineering University of Iowa Iowa City IA USA
| |
Collapse
|
24
|
Corréard N, Consoloni JL, Raust A, Etain B, Guillot R, Job S, Loftus J, Médecin I, Bougerol T, Polosan M, Fredembach B, Gard S, M’Bailara K, Kahn JP, Roux P, Homassel AS, Carminati M, Matos L, Olié E, Bellivier F, Courtet P, Henry C, Leboyer M, Azorin JM, Belzeaux R. Neuropsychological functioning, age, and medication adherence in bipolar disorder. PLoS One 2017; 12:e0184313. [PMID: 28873468 PMCID: PMC5584797 DOI: 10.1371/journal.pone.0184313] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 08/22/2017] [Indexed: 12/19/2022] Open
Abstract
Objectives Poor adherence to medication is frequent in bipolar disorder (BD) and has been associated with several factors. To date, the relationship between low adherence and neuropsychological functioning in BD is still unclear. As age and neuropsychological functioning might have opposing influences on adherence, our aim was to investigate this link with a particular focus on the effect of age. Methods In a cross-sectional study, we included 353 patients divided into two age-groups (16–46; 47–71) from a French cohort diagnosed with BD (type I, II, NOS) and strictly euthymic. All patients had a standardized clinical and neuropsychological assessment and were categorized as high (n = 186) or low (n = 167) adherent based on their score from the Medication Adherence Rating Scale. Clinical information was collected based on a standardized interview and clinical validated scales. Neuropsychological performances were evaluated with an established standardized neuropsychological battery for bipolar disorder patients. After univariate analysis, neuropsychological and clinical predictors of low adherence were included in two age-specific stepwise multiple logistic regressions. Results A smaller number of hospitalizations (OR = 0.846, p = 0.012), a shorter illness duration (OR = 0.937, p = 0.003) and higher adverse effects (OR = 1.082, p<0.001) were associated with a greater risk of low adherence in the younger patients. In the older patients, low adherence was also predicted by a smaller number of hospitalizations (OR = 0.727, p = 0.008) and higher adverse effects (OR = 1.124, p = 0.005). Interestingly poor inhibition performance was also a significant predictor of low adherence in older patients (OR = 0.924, p = 0.030). Conclusions We found an age-specific relationship between cognitive functioning and adherence in patients with BD. Poor inhibition performances predicted low adherence in older patients only. Our results highlight the need to provide age-adapted therapeutic interventions to improve adherence in patients with BD.
Collapse
Affiliation(s)
- Nadia Corréard
- Department of Psychiatry, AP-HM, Marseille, France
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
| | - Julia-Lou Consoloni
- Department of Psychiatry, AP-HM, Marseille, France
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- CRN2M-UMR7286, Aix-Marseille University, CNRS, Marseille, France
| | - Aurélie Raust
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- AP-HP, Academic Hospital Henri Mondor, Psychiatric and Addictology pole, Créteil, France
| | - Bruno Etain
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- AP-HP, Fernand Widal Hospital, Department of Addictology-Toxicology-Psychiatry and University Paris-7, Paris, France
| | - Romain Guillot
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry and Clinical Psychology, Psychotherapeutic Centre of Nancy, Laxou, France
| | - Sophie Job
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry and Clinical Psychology, Psychotherapeutic Centre of Nancy, Laxou, France
| | - Joséphine Loftus
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry, Princess-Grace Hospital, Monaco, Monaco
| | - Isabelle Médecin
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry, Princess-Grace Hospital, Monaco, Monaco
| | - Thierry Bougerol
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry, Academic Hospital of Grenoble, Grenoble, France
| | - Mircea Polosan
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry, Academic Hospital of Grenoble, Grenoble, France
- U1216 INSERM-UGA – Brain stimulation and Systems neuroscience, Grenoble Institute of Neurosciences, La Tronche, France
| | - Benjamin Fredembach
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry, Academic Hospital of Grenoble, Grenoble, France
| | - Sébastien Gard
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Charles-Perrens Hospital, Department of clinical and academic Psychiatry, Bordeaux, France
| | - Katia M’Bailara
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Charles-Perrens Hospital, Department of clinical and academic Psychiatry, Bordeaux, France
- University of Bordeaux, Laboratory of psychology, Bordeaux, France
| | - Jean-Pierre Kahn
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry and Clinical Psychology, Psychotherapeutic Centre of Nancy, Laxou, France
- French Addictovigilance network (CEIP-A) CHRU of Nancy, Nancy, France
- University of Lorraine, Nancy, France
| | - Paul Roux
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry for adults, Academic Hospital of Versailles, UFR of Health Sciences Simone Veil, University of Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Anne-Sophie Homassel
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- Department of Psychiatry for adults, Academic Hospital of Versailles, UFR of Health Sciences Simone Veil, University of Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Mathilde Carminati
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- AP-HP, Fernand Widal Hospital, Department of Addictology-Toxicology-Psychiatry and University Paris-7, Paris, France
| | - Lucile Matos
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- CHRU Lapeyronie, Department of Emergency Psychiatry and Post-Acute Care, Montpellier, France
| | - Emilie Olié
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- CHRU Lapeyronie, Department of Emergency Psychiatry and Post-Acute Care, Montpellier, France
- Inserm, U1061, University of Montpellier, Montpellier, France
| | - Frank Bellivier
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- AP-HP, Fernand Widal Hospital, Department of Addictology-Toxicology-Psychiatry and University Paris-7, Paris, France
| | - Philippe Courtet
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- CHRU Lapeyronie, Department of Emergency Psychiatry and Post-Acute Care, Montpellier, France
- Inserm, U1061, University of Montpellier, Montpellier, France
| | - Chantal Henry
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- AP-HP, Academic Hospital Henri Mondor, Psychiatric and Addictology pole, Créteil, France
- Inserm, U955, Translational Psychiatry, Mondor Institute, Créteil, France
| | - Marion Leboyer
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- AP-HP, Academic Hospital Henri Mondor, Psychiatric and Addictology pole, Créteil, France
- Inserm, U955, Translational Psychiatry, Mondor Institute, Créteil, France
| | - Jean-Michel Azorin
- Department of Psychiatry, AP-HM, Marseille, France
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- CNRS, UMR 7289, Institute of Neurosciences Timone, Marseille, France
| | - Raoul Belzeaux
- Department of Psychiatry, AP-HM, Marseille, France
- FondaMental foundation, Foundation of scientific cooperation, Créteil, France
- CRN2M-UMR7286, Aix-Marseille University, CNRS, Marseille, France
- * E-mail:
| | | |
Collapse
|
25
|
Duarte DGG, Neves MDCL, Albuquerque MR, Turecki G, Ding Y, de Souza-Duran FL, Busatto G, Correa H. Structural brain abnormalities in patients with type I bipolar disorder and suicidal behavior. Psychiatry Res Neuroimaging 2017; 265:9-17. [PMID: 28494347 DOI: 10.1016/j.pscychresns.2017.04.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 04/24/2017] [Accepted: 04/28/2017] [Indexed: 12/20/2022]
Abstract
Some studies have identified brain morphological changes in the frontolimbic network (FLN) in bipolar subjects who attempt suicide (SA). The present study investigated neuroanatomical abnormalities in the FLN to find a possible neural signature for suicidal behavior in patients with bipolar disorder type I (BD-I). We used voxel-based morphometry to compare euthymic patients with BD-I who had attempted suicide (n=20), who had not attempted suicide (n=19) and healthy controls (HCs) (n=20). We also assessed the highest medical lethality of their previous SA. Compared to the participants who had not attempted suicide, the patients with BD-I who had attempted suicide exhibited significantly increased gray matter volume (GMV) in the right rostral anterior cingulate cortex (ACC), which was more pronounced and extended further to the left ACC in the high-lethality subgroup (p<0.05, with family-wise error (FWE) correction for multiple comparisons using small-volume correction). GMV in the insula and orbitofrontal cortex was also related to suicide lethality (p<0.05, FWE-corrected). The current findings suggest that morphological changes in the FLN could be a signature of previous etiopathogenic processes affecting regions related to suicidality and its severity in BD-I patients.
Collapse
Affiliation(s)
- Dante G G Duarte
- Mental Health Department, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil.
| | - Maila de Castro L Neves
- Mental Health Department, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil.
| | | | - Gustavo Turecki
- McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Montreal, Canada.
| | - Yang Ding
- McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Montreal, Canada.
| | - Fabio Luis de Souza-Duran
- Laboratory of Neuroimaging in Psychiatry (LIM-21), Research in Applied Neuroscience, Support Care of the University of São Paulo (NAPNA-USP), São Paulo, Brazil.
| | - Geraldo Busatto
- Laboratory of Neuroimaging in Psychiatry (LIM-21), Research in Applied Neuroscience, Support Care of the University of São Paulo (NAPNA-USP), São Paulo, Brazil.
| | - Humberto Correa
- Mental Health Department, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil.
| |
Collapse
|
26
|
Gruber SA, Dahlgren MK, Sagar KA, Gonenc A, Norris L, Cohen BM, Ongur D, Lewandowski KE. Decreased Cingulate Cortex activation during cognitive control processing in bipolar disorder. J Affect Disord 2017; 213:86-95. [PMID: 28199893 DOI: 10.1016/j.jad.2017.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/05/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cognitive deficits are well-documented in patients with bipolar disorder (BPD) and may impact the efficacy of psychotherapy. Cognitive control, a form of executive functioning, is often used therapeutically to shift patients' thoughts and behaviors from automatic, maladaptive responses to adaptive coping strategies. This study examined cognitive control processing in patients with BPD using the Multi-Source Interference Task (MSIT). METHOD Twenty-nine patients diagnosed with BPD and 21 healthy control (HC) subjects completed the MSIT with concurrent functional magnetic resonance imaging (fMRI). RESULTS Patients with BPD generally performed worse on the MSIT relative to HC participants; the BPD group had significantly lower performance accuracy and made more omission errors. Further, fMRI analyses revealed differential patterns of activation between the groups during the MSIT. Region of interest (ROI) analyses revealed that relative to HC participants, patients with BPD activated significantly fewer voxels within the cingulate cortex (CC) and more voxels within prefrontal cortex (PFC), although the PFC findings did not survive more stringent significance thresholds. LIMITATIONS Patients and HCs were not matched for age, sex, and premorbid verbal IQ, however, these variables were controlled for statistically. Medication usage in the BPD group may have possibly impacted the results. Given a priori hypotheses, ROI analyses were utilized. CONCLUSIONS Decreased CC activation and increased PFC activation may be associated with impaired cognitive control, demonstrated by BPD patients when completing the MSIT. Identifying the neural mechanisms which underlie key cognitive abnormalities in BPD may aid in clarifying the pathophysiology of this disorder and inform selection of potential targets for cognition remediation in BPD.
Collapse
Affiliation(s)
- Staci A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States.
| | - M Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychology, Tufts University, Medford, MA 02155, United States
| | - Kelly A Sagar
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States
| | - Lesley Norris
- Schizophrenia and Bipolar Disorders Research Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
| | - Bruce M Cohen
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States; Program for Neuropsychiatric Research, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
| | - Dost Ongur
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States; Schizophrenia and Bipolar Disorders Research Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Program for Neuropsychiatric Research, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
| | - Kathryn E Lewandowski
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, United States; Schizophrenia and Bipolar Disorders Research Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
| |
Collapse
|
27
|
Laidi C, Houenou J. Brain functional effects of psychopharmacological treatments in bipolar disorder. Eur Neuropsychopharmacol 2016; 26:1695-1740. [PMID: 27617780 DOI: 10.1016/j.euroneuro.2016.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 06/06/2016] [Accepted: 06/18/2016] [Indexed: 12/29/2022]
Abstract
Functional magnetic resonance imaging (fMRI) studies have contributed to the understanding of bipolar disorder. However the effect of medication on brain activation remains poorly understood. We conducted an extensive literature review on PubMed and ScienceDirect to investigate the influence of medication in fMRI studies, including both longitudinal and cross-sectional studies, which aimed at assessing this influence. Although we reported all reviewed studies, we gave greater emphasis to studies with the most robust methodology. One hundred and forty studies matched our inclusion criteria and forty-seven studies demonstrated an effect of pharmacological treatment on fMRI blood oxygen level dependent (BOLD) signal in adults and children with bipolar disorder. Out of these studies, nineteen were longitudinal. Most of cross-sectional studies suffered from methodological bias, due to post-hoc analyses performed on a limited number of patients and did not find any effect of medication. However, both longitudinal and cross-sectional studies showing an impact of treatment tend to suggest that medication prescribed to patients with bipolar disorder mostly influenced brain activation in prefrontal regions, when measured by tasks involving emotional regulation and processing as well as non-emotional cognitive tasks. FMRI promises to elucidate potential new biomarkers in bipolar disorder and could be used to evaluate the effect of new therapeutic compounds. Further research is needed to disentangle the effect of medication and the influence of the changes in mood state on brain activation in patients with bipolar disorder.
Collapse
Affiliation(s)
- Charles Laidi
- APHP, Mondor University Hospitals, DHU PePsy, Psychiatry Department, Créteil, France; INSERM, U955, IMRB, Translational Psychiatry, Créteil, France; Faculté de médecine de Créteil, Université Paris Est Créteil (UPEC), France; Fondation FondaMental, Créteil, France; UNIACT Lab, Psychiatry Team, NeuroSpin, I2BM, CEA Saclay, Gif Sur Yvette, Cedex, France.
| | - Josselin Houenou
- APHP, Mondor University Hospitals, DHU PePsy, Psychiatry Department, Créteil, France; INSERM, U955, IMRB, Translational Psychiatry, Créteil, France; Faculté de médecine de Créteil, Université Paris Est Créteil (UPEC), France; Fondation FondaMental, Créteil, France; UNIACT Lab, Psychiatry Team, NeuroSpin, I2BM, CEA Saclay, Gif Sur Yvette, Cedex, France
| |
Collapse
|
28
|
Rive MM, Koeter MWJ, Veltman DJ, Schene AH, Ruhé HG. Visuospatial planning in unmedicated major depressive disorder and bipolar disorder: distinct and common neural correlates. Psychol Med 2016; 46:2313-2328. [PMID: 27198937 DOI: 10.1017/s0033291716000933] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cognitive impairments are an important feature of both remitted and depressed major depressive disorder (MDD) and bipolar disorder (BD). In particular, deficits in executive functioning may hamper everyday functioning. Identifying the neural substrates of impaired executive functioning would improve our understanding of the pathophysiology underlying these disorders, and may eventually aid in discriminating between MDD and BD, which is often difficult during depression and remission. To date, mostly medicated MDD and BD subjects have been investigated, which may have influenced results. Therefore, we investigated executive functioning in medication-free depressed and remitted MDD and BD subjects. METHOD We used the Tower of London (ToL) visuospatial planning task to assess behavioural performance and blood oxygen-level dependent responses in 35 healthy controls, 21 remitted MDD, 23 remitted BD, 19 depressed MDD and nine depressed BD subjects. RESULTS Visuospatial planning per se was associated with increased frontostriatal activity in depressed BD compared to depressed MDD. In addition, post-hoc analyses indicated that visuospatial planning load was associated with increased parietal activity in depressed compared to remitted subjects, and BD compared to MDD subjects. Task performance did not significantly differ between groups. CONCLUSIONS More severely affected, medication-free mood disorder patients require greater parietal activity to perform in visuospatial planning, which may be compensatory to maintain relatively normal performance. State-dependent frontostriatal hyperactivity during planning may be a specific BD characteristic, providing clues for further characterization of differential pathophysiology in MDD v. BD. This could potentially provide a biomarker to aid in the differentiation of these disorders.
Collapse
Affiliation(s)
- M M Rive
- Program for Mood Disorders,Department of Psychiatry,Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands
| | - M W J Koeter
- Program for Mood Disorders,Department of Psychiatry,Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands
| | - D J Veltman
- Department of Psychiatry,VU University medical center,Amsterdam,The Netherlands
| | - A H Schene
- Program for Mood Disorders,Department of Psychiatry,Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands
| | - H G Ruhé
- Program for Mood Disorders,Department of Psychiatry,Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands
| |
Collapse
|
29
|
Russo M, Mahon K, Shanahan M, Ramjas E, Solon C, Purcell SM, Burdick KE. The relationship between sleep quality and neurocognition in bipolar disorder. J Affect Disord 2015; 187:156-62. [PMID: 26339925 PMCID: PMC4598049 DOI: 10.1016/j.jad.2015.08.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 06/15/2015] [Accepted: 08/04/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUNDS Sleep and circadian rhythm disruptions are prominent, trait-like features of bipolar disorder (BD) which precede the onset of mood episodes. Neurocognitive impairments also characterize BD not only during acute phases of the illness but also during remission. Although the relationship between these two debilitating aspects of the illness might seem intuitive, very little is known about their relationship. We examined the association between sleep dysfunction and neurocognition in BD. METHODS In a sample of 117 BD patients (mean age=45.0±10.7; 59.0% (n=69) male), neurocognitive functioning was assessed using the MATRICS Consensus Cognitive Battery (MCCB). Sleep quality data were collected using the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). Partial Pearson correlations tested for a relationship between sleep and neurocognition. Path analyses were conducted to examine the hypothesized direct influence of sleep disruption on neurocognition. RESULTS Higher levels of sleep disruptions were associated with a more severe clinical presentation and poorer performance in social cognition, visual learning and working memory. Social cognition and working memory were directly (negatively) predicted by sleep disruptions. LIMITATIONS The study was limited by a relatively small sample size and the lack of behavioral and biological objectives measure of activity/rest cycles. CONCLUSIONS Our study suggests that in patients with BD, sleep disruptions have a detrimental effect on general level of psychopathology and contribute directly to impaired cognitive functioning in the domains of social cognition and working memory. More research using objective measurement of sleep should be pursued to support these data and to further investigate the causal relationship between these disabling aspects of the illness.
Collapse
Affiliation(s)
- Manuela Russo
- Icahn School of Medicine at Mount Sinai; Departments of Psychiatry and Neuroscience
| | - Katie Mahon
- Icahn School of Medicine at Mount Sinai; Departments of Psychiatry and Neuroscience
| | - Megan Shanahan
- Icahn School of Medicine at Mount Sinai; Departments of Psychiatry and Neuroscience
| | - Elizabeth Ramjas
- Icahn School of Medicine at Mount Sinai; Departments of Psychiatry and Neuroscience
| | - Carly Solon
- Icahn School of Medicine at Mount Sinai; Departments of Psychiatry and Neuroscience
| | - Shaun M Purcell
- Icahn School of Medicine at Mount Sinai; Departments of Psychiatry and Neuroscience
| | - Katherine E Burdick
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, United States; James J Peters VA Medical Center Bronx, NY, United States.
| |
Collapse
|
30
|
Hölzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U. How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 6:537-59. [PMID: 26168376 DOI: 10.1177/1745691611419671] [Citation(s) in RCA: 1175] [Impact Index Per Article: 130.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Cultivation of mindfulness, the nonjudgmental awareness of experiences in the present moment, produces beneficial effects on well-being and ameliorates psychiatric and stress-related symptoms. Mindfulness meditation has therefore increasingly been incorporated into psychotherapeutic interventions. Although the number of publications in the field has sharply increased over the last two decades, there is a paucity of theoretical reviews that integrate the existing literature into a comprehensive theoretical framework. In this article, we explore several components through which mindfulness meditation exerts its effects: (a) attention regulation, (b) body awareness, (c) emotion regulation (including reappraisal and exposure, extinction, and reconsolidation), and (d) change in perspective on the self. Recent empirical research, including practitioners' self-reports and experimental data, provides evidence supporting these mechanisms. Functional and structural neuroimaging studies have begun to explore the neuroscientific processes underlying these components. Evidence suggests that mindfulness practice is associated with neuroplastic changes in the anterior cingulate cortex, insula, temporo-parietal junction, fronto-limbic network, and default mode network structures. The authors suggest that the mechanisms described here work synergistically, establishing a process of enhanced self-regulation. Differentiating between these components seems useful to guide future basic research and to specifically target areas of development in the treatment of psychological disorders.
Collapse
Affiliation(s)
- Britta K Hölzel
- Bender Institute of Neuroimaging, Justus Liebig-University, Giessen, Germany Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Sara W Lazar
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Tim Gard
- Bender Institute of Neuroimaging, Justus Liebig-University, Giessen, Germany Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - David R Vago
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Ulrich Ott
- Bender Institute of Neuroimaging, Justus Liebig-University, Giessen, Germany
| |
Collapse
|
31
|
Disturbed cortico-amygdalar functional connectivity as pathophysiological correlate of working memory deficits in bipolar affective disorder. Eur Arch Psychiatry Clin Neurosci 2015; 265:303-11. [PMID: 25119145 DOI: 10.1007/s00406-014-0517-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Accepted: 07/23/2014] [Indexed: 01/06/2023]
Abstract
Patients suffering from bipolar affective disorder show deficits in working memory functions. In a previous functional magnetic resonance imaging study, we observed an abnormal hyperactivity of the amygdala in bipolar patients during articulatory rehearsal in verbal working memory. In the present study, we investigated the dynamic neurofunctional interactions between the right amygdala and the brain systems that underlie verbal working memory in both bipolar patients and healthy controls. In total, 18 euthymic bipolar patients and 18 healthy controls performed a modified version of the Sternberg item-recognition (working memory) task. We used the psychophysiological interaction approach in order to assess functional connectivity between the right amygdala and the brain regions involved in verbal working memory. In healthy subjects, we found significant negative functional interactions between the right amygdala and multiple cortical brain areas involved in verbal working memory. In comparison with the healthy control subjects, bipolar patients exhibited significantly reduced functional interactions of the right amygdala particularly with the right-hemispheric, i.e., ipsilateral, cortical regions supporting verbal working memory. Together with our previous finding of amygdala hyperactivity in bipolar patients during verbal rehearsal, the present results suggest that a disturbed right-hemispheric "cognitive-emotional" interaction between the amygdala and cortical brain regions underlying working memory may be responsible for amygdala hyperactivation and affects verbal working memory (deficits) in bipolar patients.
Collapse
|
32
|
Morsel AM, Morrens M, Temmerman A, Sabbe B, de Bruijn ERA. Electrophysiological (EEG) evidence for reduced performance monitoring in euthymic bipolar disorder. Bipolar Disord 2014; 16:820-9. [PMID: 25219677 DOI: 10.1111/bdi.12256] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 05/16/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Apart from mood episodes, many cognitive deficits are present in bipolar disorder (BD). Performance monitoring is an important aspect of executive functioning and involves continuous monitoring of behavior and making subsequent changes when an error is made. On a neurophysiological level, the error-related negativity (ERN), an event-related brain potential (ERP) generated in the anterior cingulate cortex (ACC), reflects this process of performance monitoring. Abnormal ERN amplitudes have been observed in many major psychiatric disorders. However, despite conflicting evidence regarding the role of the ACC in BD, no studies to date have investigated performance monitoring as reflected in the ERN in BD. METHODS Sixteen patients with BD in a euthymic state and 14 matched healthy controls performed a speeded two-choice reaction-time paradigm (Flankers Task) while electroencephalogram (EEG) measures were obtained. Behavioral and ERP measurements were analyzed for the two groups. RESULTS The patients with BD, although euthymic, scored higher on depressive symptoms than healthy controls. While no behavioral group differences were found, patients with BD displayed lower ERN amplitudes than healthy controls when controlling for effects of residual mood. CONCLUSIONS The lower ERN amplitudes in the BD group reflect reduced performance monitoring and extend current knowledge of executive functioning in BD. Importantly, these findings go a long way to resolving the contradictory results regarding ACC involvement in BD by showing that taking into account residual mood may greatly influence error-related ACC activations and is critically important in understanding cognitive deficits in BD.
Collapse
Affiliation(s)
- Anne M Morsel
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp
| | | | | | | | | |
Collapse
|
33
|
fMRI evidence for abnormal resting-state functional connectivity in euthymic bipolar patients. J Affect Disord 2014; 165:182-9. [PMID: 24882198 DOI: 10.1016/j.jad.2014.04.054] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND Neural substrates of bipolar disorder (BD) have frequently been characterized by dysregulation of fronto-limbic networks that may persist during euthymic periods. Only a few studies have investigated euthymic bipolar patients (BP) functional connectivity at rest. The current study aims to assess resting-state functional connectivity in euthymic BP in order to identify trait abnormalities responsible for enduring mood dysregulation in these patients. METHODS Medial prefrontal cortex (mPFC) functional connectivity was investigated in 20 euthymic BP and 20 healthy subjects (HS). The functional connectivity maps were compared across groups using a between-group random effect analysis. Additional region of interest (ROI) analysis focused on mPFC-amygdala functional connectivity as well as correlations between the clinical features in euthymic BP was also conducted. RESULTS A significant difference between euthymic BP and HS was observed in terms of connectivity between the mPFC and the right dorsolateral prefrontal cortex (dlPFC). A significant negative correlation between the activity of these regions was found in HS but not in euthymic BP. In addition, euthymic BP showed greater connectivity between mPFC and right amygdala compared to HS, which was also correlated with the duration of the disease. LIMITATIONS The BP group was heterogeneous with respect to the bipolarity subtype and the medication. The robustness of results could be improved with an increased sample size. CONCLUSIONS Compared to HS, the euthymic BP showed abnormal decoupling (decreased functional connectivity) activity between mPFC-dlPFC and hyperconnectivity (increased functional connectivity) and between mPFC and amygdala. These abnormalities could underlie the pathophysiology of BD, and may deteriorate further in accordance with disease duration.
Collapse
|
34
|
Howells FM, Laurie Rauch HG, Ives-Deliperi VL, Horn NR, Stein DJ. Mindfulness based cognitive therapy may improve emotional processing in bipolar disorder: pilot ERP and HRV study. Metab Brain Dis 2014; 29:367-75. [PMID: 24311196 DOI: 10.1007/s11011-013-9462-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 11/21/2013] [Indexed: 01/07/2023]
Abstract
Emotional processing in bipolar disorder (BD) is impaired. We aimed to measure the effects of mindfulness based cognitive-behavioral therapy (MBCT) in BD on emotional processing, as measured by event related potentials (ERP) and by heart rate variability (HRV). ERP and HRV were recorded during the completion of a visual matching task, which included object matching, affect matching, and affect labeling. Individuals with BD (n = 12) were compared with controls (n = 9) to obtain baseline data prior to the individuals with BD undergoing an 8-week MBCT intervention. ERP and HRV recording was repeated after the MBCT intervention in BD. Participants with BD had exaggerated ERP N170 amplitude and increased HRV HF peak compared to controls, particularly during the affect matching condition. After an 8-week MBCT intervention, participants with BD showed attenuation of ERP N170 amplitude and reduced HRV HF peak. Our findings support findings from the literature emphasizing that emotional processing in BD is altered, and suggesting that MBCT may improve emotional processing in BD.
Collapse
Affiliation(s)
- Fleur M Howells
- Department of Psychiatry, Faculty of Health Sciences, University of Cape Town, Observatory, 7925, South Africa,
| | | | | | | | | |
Collapse
|
35
|
Minzenberg MJ, Gomes GC, Yoon JH, Swaab TY, Carter CS. Disrupted action monitoring in recent-onset psychosis patients with schizophrenia and bipolar disorder. Psychiatry Res 2014; 221:114-21. [PMID: 24314907 PMCID: PMC4019327 DOI: 10.1016/j.pscychresns.2013.11.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 10/18/2013] [Accepted: 11/09/2013] [Indexed: 10/26/2022]
Abstract
Schizophrenia patients experience cognitive control disturbances, manifest in altered neural signatures during action monitoring. It remains unclear whether error- and conflict-monitoring disturbances co-occur, and whether they are observed in recent-onset psychosis patients with schizophrenia or bipolar disorder. We tested electrophysiological measures of action monitoring in these patients. Seventy-three schizophrenia patients (SZ), 26 bipolar disorder type I patients (BP), each within one year of psychosis onset, and 54 healthy control subjects (HC) underwent EEG during Stroop task performance. In the trial-averaged EEG at three midline scalp electrodes, the error-related negativity (ERN), error positivity (Pe) and conflict-related N450 were measured. Compared to HC (1) SZ exhibited an attenuated ERN and N450, and Pe unchanged and (2) BP exhibited an attenuated ERN but normal Pe and N450. Between patient groups, SZ showed an attenuated N450; ERN and Pe were not significantly different. A small (n=10) SZ subgroup that was not receiving antipsychotic medication showed normal ERPs. Altered error- and conflict-monitoring occur together in the first-episode schizophrenia patients, and these measures are comparable in patients with the first-episode bipolar disorder. Antipsychotic medication may be associated with altered measures of error-monitoring in schizophrenia.
Collapse
Affiliation(s)
- Michael J. Minzenberg
- Department of Psychiatry, University of California, San Francisco School of Medicine, San Francisco, CA,Please address correspondence to: Michael J. Minzenberg, MD, Outpatient Mental Health, 116C, San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121, PH (415) 221-4810, x6554,
| | - Glenn C. Gomes
- Department of Psychiatry, University of California, Davis School of Medicine, Sacramento, CA
| | - Jong H. Yoon
- Department of Psychiatry, University of California, Davis School of Medicine, Sacramento, CA
| | - Tamara Y. Swaab
- Department of Psychology, University of California, Davis, CA
| | - Cameron S. Carter
- Department of Psychiatry, University of California, Davis School of Medicine, Sacramento, CA
| |
Collapse
|
36
|
Abstract
From a neurobiological perspective there is no such thing as bipolar disorder. Rather, it is almost certainly the case that many somewhat similar, but subtly different, pathological conditions produce a disease state that we currently diagnose as bipolarity. This heterogeneity - reflected in the lack of synergy between our current diagnostic schema and our rapidly advancing scientific understanding of the condition - limits attempts to articulate an integrated perspective on bipolar disorder. However, despite these challenges, scientific findings in recent years are beginning to offer a provisional "unified field theory" of the disease. This theory sees bipolar disorder as a suite of related neurodevelopmental conditions with interconnected functional abnormalities that often appear early in life and worsen over time. In addition to accelerated loss of volume in brain areas known to be essential for mood regulation and cognitive function, consistent findings have emerged at a cellular level, providing evidence that bipolar disorder is reliably associated with dysregulation of glial-neuronal interactions. Among these glial elements are microglia - the brain's primary immune elements, which appear to be overactive in the context of bipolarity. Multiple studies now indicate that inflammation is also increased in the periphery of the body in both the depressive and manic phases of the illness, with at least some return to normality in the euthymic state. These findings are consistent with changes in the hypothalamic-pituitary-adrenal axis, which are known to drive inflammatory activation. In summary, the very fact that no single gene, pathway, or brain abnormality is likely to ever account for the condition is itself an extremely important first step in better articulating an integrated perspective on both its ontological status and pathogenesis. Whether this perspective will translate into the discovery of innumerable more homogeneous forms of bipolarity is one of the great questions facing the field and one that is likely to have profound treatment implications, given that fact that such a discovery would greatly increase our ability to individualize - and by extension, enhance - treatment.
Collapse
Affiliation(s)
- Vladimir Maletic
- Department of Neuropsychiatry and Behavioral Sciences, University of South Carolina School of Medicine , Columbia, SC , USA
| | - Charles Raison
- Department of Psychiatry, University of Arizona , Tucson, AZ , USA ; Norton School of Family and Consumer Sciences, College of Agriculture and Life Sciences, University of Arizona , Tucson, AZ , USA
| |
Collapse
|
37
|
Hajek T, Alda M, Hajek E, Ivanoff J. Functional neuroanatomy of response inhibition in bipolar disorders--combined voxel based and cognitive performance meta-analysis. J Psychiatr Res 2013; 47:1955-66. [PMID: 24070910 DOI: 10.1016/j.jpsychires.2013.08.015] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 08/20/2013] [Accepted: 08/26/2013] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Impaired response inhibition underlies symptoms and altered functioning in patients with bipolar disorders (BD). The interpretation of fMRI studies requires an accurate estimation of neurocognitive performance, for which individual studies are typically underpowered. Thus, we performed the first combined meta-analysis of fMRI activations and neurocognitive performance in studies investigating response inhibition in BD. METHODS We used signed differential mapping to combine anatomical coordinates of activation and standardized differences between means to evaluate neurocognitive performance in 30 fMRI studies of response inhibition comparing controls (n = 667) and patients with BD (n = 635). RESULTS Relative to controls, BD patients underactivated the right inferior frontal gyrus (rIFG) regardless of current mood state and behavioral performance. Unique to euthymia were cortical hyperactivations (left superior temporal, right middle frontal gyri) combined with subcortical hypoactivations (basal ganglia), whereas unique to mania were subcortical hyperactivations (bilateral basal ganglia), combined with cortical hypoactivations (right inferior and medial frontal gyri). The fMRI changes in euthymia were associated with normal cognitive performance, whereas manic patients committed more errors during response inhibition. CONCLUSIONS The rIFG hypoactivations were congruent with a BD trait, which may underlie the impaired response inhibition in mania. Euthymic BD subjects may compensate for the rIFG hypoactivations by hyperactivations of adjacent cortical areas, yielding comparable performance in inhibitory functions and suggesting possibilities for neuromodulation treatment of these cognitive impairments. The reversal of the activation pattern between mania and euthymia has implications for monitoring of treatment response and identification of imminent relapse.
Collapse
Affiliation(s)
- Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, Canada; Prague Psychiatric Centre, Department of Psychiatry and Medical Psychology, 3rd School of Medicine, Charles University, Prague, Czech Republic.
| | | | | | | |
Collapse
|
38
|
Malhi GS, Tanious M, Fritz K, Coulston CM, Bargh DM, Phan KL, Calhoun V, Das P. Differential engagement of the fronto-limbic network during emotion processing distinguishes bipolar and borderline personality disorder. Mol Psychiatry 2013; 18:1247-8. [PMID: 23439484 PMCID: PMC4429860 DOI: 10.1038/mp.2013.22] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- G S Malhi
- 1] CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Sydney, NSW, Australia [2] Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia [3] Advanced Research and Clinical Highfield Imaging (ARCHI), University of Sydney, Sydney, NSW, Australia
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Welander-Vatn A, Jensen J, Otnaess MK, Agartz I, Server A, Melle I, Andreassen OA. The neural correlates of cognitive control in bipolar I disorder: An fMRI study of medial frontal cortex activation during a Go/No-go task. Neurosci Lett 2013; 549:51-6. [DOI: 10.1016/j.neulet.2013.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 06/04/2013] [Accepted: 06/06/2013] [Indexed: 02/09/2023]
|
40
|
Patino LR, Adler CM, Mills NP, Strakowski SM, Fleck DE, Welge JA, DelBello MP. Conflict monitoring and adaptation in individuals at familial risk for developing bipolar disorder. Bipolar Disord 2013; 15:264-71. [PMID: 23528067 PMCID: PMC3644328 DOI: 10.1111/bdi.12059] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 01/08/2013] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To examine conflict monitoring and conflict-driven adaptation in individuals at familial risk for developing bipolar disorder. METHODS We recruited 24 adolescents who had a parent with bipolar disorder and 23 adolescents with healthy parents. Participants completed an arrow version of the Eriksen Flanker Task that included trials with three levels of conflict: neutral, congruent, and incongruent flanks. Differences in performance were explored based upon the level of conflict in the current and previous trials. RESULTS Individuals at risk for developing bipolar disorder performed more slowly than youth with healthy parents in all trials. Analyses evaluating sequential effects revealed that at-risk subjects responded more slowly than youth of healthy parents for all trial types when preceded by an incongruent trial, for incongruent trials preceded by congruent trials, and for neutral and congruent trials when preceded by neutral trials. In contrast to the comparison group, at-risk adolescents failed to display a response time advantage for incongruent trials preceded by an incongruent trial. When removing subjects with attention-deficit hyperactivity disorder (ADHD), differences between groups in response time fell below significant level, but a difference in sequence modulation remained significant. Subjects at risk for bipolar disorder also displayed greater intra-subject response time variability for incongruent and congruent trials compared with the comparison adolescents. No differences in response accuracy were observed between groups. CONCLUSIONS Adolescents at risk for developing bipolar disorder displayed specific deficits in cognitive flexibility, which might be useful as a potential marker related to the development of bipolar disorder.
Collapse
Affiliation(s)
- Luis R. Patino
- Division of Bipolar Disorders Research, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA,Instituto Nacional de Psiquiatría Dr. Ramón de la Fuente, Mexico City, Mexico
| | - Caleb M. Adler
- Division of Bipolar Disorders Research, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA,Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati OH, USA
| | - Neil P. Mills
- Division of Bipolar Disorders Research, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stephen M. Strakowski
- Division of Bipolar Disorders Research, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA,Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati OH, USA
| | - David E. Fleck
- Division of Bipolar Disorders Research, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA,Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati OH, USA
| | - Jeffrey A. Welge
- Division of Bipolar Disorders Research, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Melissa P. DelBello
- Division of Bipolar Disorders Research, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| |
Collapse
|
41
|
Lim CS, Baldessarini RJ, Vieta E, Yucel M, Bora E, Sim K. Longitudinal neuroimaging and neuropsychological changes in bipolar disorder patients: Review of the evidence. Neurosci Biobehav Rev 2013; 37:418-35. [PMID: 23318228 DOI: 10.1016/j.neubiorev.2013.01.003] [Citation(s) in RCA: 165] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 12/23/2012] [Accepted: 01/03/2013] [Indexed: 01/23/2023]
Affiliation(s)
- Chin Siang Lim
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | | | | | | | | | | |
Collapse
|
42
|
Li CT, Hsieh JC, Wang SJ, Yang BH, Bai YM, Lin WC, Lan CC, Su TP. Differential relations between fronto-limbic metabolism and executive function in patients with remitted bipolar I and bipolar II disorder. Bipolar Disord 2012; 14:831-42. [PMID: 23167933 DOI: 10.1111/bdi.12017] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the relationship between resting brain glucose metabolism and cognitive profiles in patients with remitted bipolar I disorder (BD-I) and bipolar II disorder (BD-II). We hypothesized that BD-I patients (compared to BD-II patients) would perform worse on tests of cognitive function because of abnormal metabolism in the prefrontal cortex and other mood-related brain areas. METHODS Thirty-four patients with remitted bipolar disorder (BD) (BD-I = 17, BD-II = 17) under treatment and 17 well-matched healthy controls received both fluorodeoxyglucose ((18) F-FDG) positron emission tomography (PET) and neuropsychological tests of attention, memory, and executive function. RESULTS Clinical features in patients with BD-I and BD-II were comparable. Executive function, as indicated by performance on the Wisconsin Card Sorting Test, was significantly worse (i.e., higher percentage of errors, lower percentage of conceptual level responses, and fewer categories completed) in BD-I patients than in BD-II patients and healthy subjects. No difference in attention and memory tests was found among these three groups. Brain PET analysis showed that BD-I patients (compared to BD-II patients) had significantly lower glucose uptake in the bilateral anterior cingulum, insula, striatum, and part of the prefrontal cortex, and higher glucose uptake in the left parahippocampus. Further analyses revealed significant correlations between poor executive function and abnormal glucose uptake in other brain areas in BD-I patients. CONCLUSIONS There are neurobiological differences between subtypes of BD. BD-I is associated with more impaired fronto-limbic circuitry, which might account for reduced executive function in BD-I patients during remission.
Collapse
Affiliation(s)
- Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Pattanayak RD, Sagar R, Mehta M. Neuropsychological performance in euthymic Indian patients with bipolar disorder type I: correlation between quality of life and global functioning. Psychiatry Clin Neurosci 2012; 66:553-63. [PMID: 23252921 DOI: 10.1111/j.1440-1819.2012.02400.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 02/02/2012] [Accepted: 02/05/2012] [Indexed: 01/03/2023]
Abstract
AIM This study aims to assess the neuropsychological performance, quality of life (QoL) and global functioning in euthymic patients and healthy controls. It also explores the hypothesis that poorer cognitive performance will adversely influence the QoL of patients with bipolar disorder. METHODS We carried out a cross-sectional assessment of 30 euthymic patients with bipolar disorder type I and compared them to a healthy control group. All the participants were evaluated for IQ, sustained attention, information processing speed, executive functions and memory using the Verbal Adult Intelligence Scale, the Trail Making Test A & B, the Stroop Color and Word Test, the N-Back test and Postgraduate Institute Memory Scale. Patients were also rated on World Health Organization QoL (BREF, Hindi version) and Global Assessment of Functioning. RESULTS The patient and control group were comparable in age, sex distribution, education, and verbal IQ. Compared to controls, the patients performed poorly on tests for sustained attention, information processing speed, cognitive flexibility, delayed recall and verbal retention. Patients had significantly lower scores in psychological and social domains of QoL as well as global functioning. The test for sustained attention, executive functions and verbal retention showed a significant correlation to QoL domains. On stepwise multiple regression, cognitive flexibility and set shifting (Trail Making Test Part B) could significantly predict the psychological and social QoL domains, explaining 17% and 32% of the variance, respectively. CONCLUSION Patients with bipolar disorder display cognitive impairments in the euthymic period, which appears to adversely affect their QoL and overall functioning.
Collapse
|
44
|
Overlapping prefrontal systems involved in cognitive and emotional processing in euthymic bipolar disorder and following sleep deprivation: a review of functional neuroimaging studies. Clin Psychol Rev 2012; 32:650-63. [PMID: 22926687 DOI: 10.1016/j.cpr.2012.07.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 07/11/2012] [Accepted: 07/30/2012] [Indexed: 12/11/2022]
Abstract
Prefrontal cortex (PFC) mediated cognitive and emotional processing deficits in bipolar disorder lead to functional limitations even during periods of mood stability. Alterations of sleep and circadian functioning are well-documented in bipolar disorder, but there is little research directly examining the mechanistic role of sleep and/or circadian rhythms in the observed cognitive and emotional processing deficits. We systematically review the cognitive and emotional processing deficits reliant upon PFC functioning of euthymic patients with bipolar disorder and in healthy individuals deprived of sleep. The evidence from two parallel lines of investigation suggests that sleep and circadian rhythms may be involved in the cognitive and emotional processing deficits seen in bipolar disorder through overlapping neurobiological systems. We discuss current models of bipolar highlighting the PFC-limbic connections and discuss inclusion of sleep-related mechanisms. Sleep and circadian dysfunction is a core feature of bipolar disorder and models of neurobiological abnormalities should incorporate chronobiological measures. Further research into the role of sleep and circadian rhythms in cognition and emotional processing in bipolar disorder is warranted.
Collapse
|
45
|
Bertocci MA, Bebko GM, Mullin BC, Langenecker SA, Ladouceur CD, Almeida JRC, Phillips ML. Abnormal anterior cingulate cortical activity during emotional n-back task performance distinguishes bipolar from unipolar depressed females. Psychol Med 2012; 42:1417-1428. [PMID: 22099606 PMCID: PMC3601380 DOI: 10.1017/s003329171100242x] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Depression in the context of bipolar disorder (BDd) is often misdiagnosed as unipolar disorder depression (UDd) leading to poor clinical outcomes for many bipolar sufferers. We examined neural circuitry supporting emotion regulation in females with either BDd or UDd as a first stage toward identifying biomarkers that may differentiate BDd from UDd. METHOD Fifty-seven females aged 18-45 years participated in this study: 23 with UDd, 18 with bipolar disorder type I depression (BDId) and 16 healthy females. During 3-T functional magnetic resonance imaging (fMRI), the participants performed an emotional face n-back (EFNBACK) task, that is an n-back task with high (2-back) and low (0-back) memory load conditions flanked by two positive, negative or neutral face distracters. This paradigm examines executive control with emotional distracters-emotion regulation. RESULTS High memory load with neutral face distracters elicited greater bilateral and left dorsal anterior midcingulate cortex (dAMCC) activity in UDd than in healthy and BDId females respectively, and greater bilateral putamen activity in both depressed groups versus healthy females. High memory load with happy face distracters elicited greater left putamen activity in UDd than in healthy females. Psychotropic medication was associated with greater putamen activity to these contrasts in UDd females. CONCLUSIONS During high memory load with neutral face distracters, elevated dAMCC activity in UDd suggests abnormal recruitment of attentional control circuitry to maintain task performance, whereas elevated putamen activity unrelated to psychotropic medication in BDId females may suggest an attentional bias toward ambiguous neutral face distracters. Differential patterns of functional abnormalities in neural circuitry supporting attentional control during emotion regulation, especially in the dAMCC, is a promising neuroimaging measure to distinguish UDd from BDId in females.
Collapse
Affiliation(s)
- M A Bertocci
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | | | | | | | | | | | | |
Collapse
|
46
|
Townsend JD, Bookheimer SY, Foland-Ross LC, Moody TD, Eisenberger NI, Fischer JS, Cohen MS, Sugar CA, Altshuler LL. Deficits in inferior frontal cortex activation in euthymic bipolar disorder patients during a response inhibition task. Bipolar Disord 2012; 14:442-50. [PMID: 22631623 PMCID: PMC4412746 DOI: 10.1111/j.1399-5618.2012.01020.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The inferior frontal cortical-striatal network plays an integral role in response inhibition in normal populations. While inferior frontal cortex (IFC) impairment has been reported in mania, this study explored whether this dysfunction persists in euthymia. METHODS Functional magnetic resonance imaging (fMRI) activation was evaluated in 32 euthymic patients with bipolar I disorder and 30 healthy subjects while performing the Go/NoGo response inhibition task. Behavioral data were collected to evaluate accuracy and response time. Within-group and between-group comparisons of activation were conducted using whole-brain analyses to probe significant group differences in neural function. RESULTS Both groups activated bilateral IFC. However, between-group comparisons showed a significantly reduced activation in this brain region in euthymic patients with bipolar disorder compared to healthy subjects. Other frontal and basal ganglia regions involved in response inhibition were additionally significantly reduced in bipolar disorder patients, in both the medicated and the unmedicated subgroups. No areas of greater activation were observed in bipolar disorder patients versus healthy subjects. CONCLUSIONS Bipolar disorder patients, even during euthymia, have a persistent reduction in activation of brain regions involved in response inhibition, suggesting that reduced activation in the orbitofrontal cortex and striatum is not solely related to the state of mania. These findings may represent underlying trait abnormalities in bipolar disorder.
Collapse
Affiliation(s)
- Jennifer D Townsend
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Susan Y Bookheimer
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Lara C Foland-Ross
- Laboratory of NeuroImaging, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles,Department of Psychology, Stanford University, Stanford
| | - Teena D Moody
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles,Jane and Terry Semel Institute of Neuroscience and Human Behavior, School of Public Health, University of California, Los Angeles
| | - Naomi I Eisenberger
- Department of Psychology, School of Public Health, University of California, Los Angeles
| | - Jeffrey S Fischer
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Mark S Cohen
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Catherine A Sugar
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, School of Public Health, University of California, Los Angeles,Department of Biostatistics, School of Public Health, University of California, Los Angeles
| | - Lori L Altshuler
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles,Jane and Terry Semel Institute of Neuroscience and Human Behavior, School of Public Health, University of California, Los Angeles,Department of Psychiatry, VA Greater Los Angeles Healthcare System, West Los Angeles Healthcare Center, Los Angeles, CA, USA
| |
Collapse
|
47
|
Strakowski SM, Adler CM, Almeida J, Altshuler LL, Blumberg HP, Chang KD, DelBello MP, Frangou S, McIntosh A, Phillips ML, Sussman JE, Townsend JD. The functional neuroanatomy of bipolar disorder: a consensus model. Bipolar Disord 2012; 14:313-25. [PMID: 22631617 PMCID: PMC3874804 DOI: 10.1111/j.1399-5618.2012.01022.x] [Citation(s) in RCA: 349] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Functional neuroimaging methods have proliferated in recent years, such that functional magnetic resonance imaging, in particular, is now widely used to study bipolar disorder. However, discrepant findings are common. A workgroup was organized by the Department of Psychiatry, University of Cincinnati (Cincinnati, OH, USA) to develop a consensus functional neuroanatomic model of bipolar I disorder based upon the participants' work as well as that of others. METHODS Representatives from several leading bipolar disorder neuroimaging groups were organized to present an overview of their areas of expertise as well as focused reviews of existing data. The workgroup then developed a consensus model of the functional neuroanatomy of bipolar disorder based upon these data. RESULTS Among the participants, a general consensus emerged that bipolar I disorder arises from abnormalities in the structure and function of key emotional control networks in the human brain. Namely, disruption in early development (e.g., white matter connectivity and prefrontal pruning) within brain networks that modulate emotional behavior leads to decreased connectivity among ventral prefrontal networks and limbic brain regions, especially the amygdala. This developmental failure to establish healthy ventral prefrontal-limbic modulation underlies the onset of mania and ultimately, with progressive changes throughout these networks over time and with affective episodes, a bipolar course of illness. CONCLUSIONS This model provides a potential substrate to guide future investigations and areas needing additional focus are identified.
Collapse
Affiliation(s)
- Stephen M Strakowski
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0559, USA.
| | - Caleb M Adler
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jorge Almeida
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh PA
| | - Lori L Altshuler
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, The David Geffen School of Medicine, University of California at Los Angeles,Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Kiki D Chang
- Pediatric Bipolar Disorders Research Program, Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Sophia Frangou
- Section of Neurobiology of Psychosis, Department of Psychosis Studies, Institute of Psychiatry, King’s College, London
| | - Andrew McIntosh
- Division of Psychiatry, School of Molecular and Clinical Medicine, University of Edinburgh, Edinburgh
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh PA,Department of Psychological Medicine, Cardiff, UK
| | - Jessika E Sussman
- Division of Psychiatry, School of Molecular and Clinical Medicine, University of Edinburgh, Edinburgh
| | - Jennifer D Townsend
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, The David Geffen School of Medicine, University of California at Los Angeles
| |
Collapse
|
48
|
Strakowski SM, Adler CM, Almeida J, Altshuler LL, Blumberg HP, Chang KD, DelBello MP, Frangou S, McIntosh A, Phillips ML, Sussman JE, Townsend JD. The functional neuroanatomy of bipolar disorder: a consensus model. Bipolar Disord 2012. [PMID: 22631617 DOI: 10.1111/j.1399-5618.2012.01022.x.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Functional neuroimaging methods have proliferated in recent years, such that functional magnetic resonance imaging, in particular, is now widely used to study bipolar disorder. However, discrepant findings are common. A workgroup was organized by the Department of Psychiatry, University of Cincinnati (Cincinnati, OH, USA) to develop a consensus functional neuroanatomic model of bipolar I disorder based upon the participants' work as well as that of others. METHODS Representatives from several leading bipolar disorder neuroimaging groups were organized to present an overview of their areas of expertise as well as focused reviews of existing data. The workgroup then developed a consensus model of the functional neuroanatomy of bipolar disorder based upon these data. RESULTS Among the participants, a general consensus emerged that bipolar I disorder arises from abnormalities in the structure and function of key emotional control networks in the human brain. Namely, disruption in early development (e.g., white matter connectivity and prefrontal pruning) within brain networks that modulate emotional behavior leads to decreased connectivity among ventral prefrontal networks and limbic brain regions, especially the amygdala. This developmental failure to establish healthy ventral prefrontal-limbic modulation underlies the onset of mania and ultimately, with progressive changes throughout these networks over time and with affective episodes, a bipolar course of illness. CONCLUSIONS This model provides a potential substrate to guide future investigations and areas needing additional focus are identified.
Collapse
Affiliation(s)
- Stephen M Strakowski
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0559, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Mullin BC, Perlman SB, Versace A, de Almeida JRC, Labarbara EJ, Klein C, Ladouceur CD, Phillips ML. An fMRI study of attentional control in the context of emotional distracters in euthymic adults with bipolar disorder. Psychiatry Res 2012; 201:196-205. [PMID: 22510433 PMCID: PMC3361638 DOI: 10.1016/j.pscychresns.2011.09.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Revised: 08/08/2011] [Accepted: 09/02/2011] [Indexed: 11/23/2022]
Abstract
Inability to modulate attention away from emotional stimuli may be a key component of dysregulated emotion in bipolar disorder (BD). Previous studies of BD indicate abnormalities in neural circuitry underlying attentional control, yet few studies examined attentional control in the context of emotional distracters. We compared activity and connectivity in neural circuitry supporting attentional control and emotion processing among 22 individuals with BD type 1, currently remitted and euthymic, and 19 healthy controls. Participants performed an emotional n-back paradigm, comprising high and low attentional demand conditions, each with either emotional (happy, fearful), neutral or no face flanker distracters. During the high attentional control demand conditions without emotional distracters, BD individuals showed reduced activity relative to controls in dorsolateral prefrontal cortex, dorsal anterior cingulate cortex (dACC), and inferior parietal cortex. During the high attentional control demand conditions with fearful-face distracters, BD individuals showed greater activity than controls in these regions and amygdala and striatum. Relative to controls, BD individuals also showed abnormal patterns of effective connectivity between dACC and amygdala during high attentional control demand with emotional face distracters. Inter-episode bipolar disorder is characterized by abnormal recruitment of attentional control neural circuitry, especially in the context of emotionally distracting information.
Collapse
Affiliation(s)
- Benjamin C Mullin
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Burdick KE, Braga RJ, Nnadi CU, Shaya Y, Stearns WH, Malhotra AK. Placebo-controlled adjunctive trial of pramipexole in patients with bipolar disorder: targeting cognitive dysfunction. J Clin Psychiatry 2012; 73:103-12. [PMID: 22152405 PMCID: PMC4457389 DOI: 10.4088/jcp.11m07299] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 10/04/2011] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Patients with bipolar disorder suffer from significant cognitive impairment that contributes directly to functional disability, yet few studies have targeted these symptoms for treatment, and the optimal study design remains unclear. We evaluated the effects of the dopamine D₂/D₃ receptor agonist pramipexole on cognition in bipolar disorder. METHOD Fifty stable outpatients with DSM-IV-diagnosed bipolar I or bipolar II disorder enrolled in an 8-week, double-blind, randomized, placebo-controlled cognitive enhancement trial between July 2006 and April 2010. Patients completed neurocognitive testing at baseline and at week 8, and the primary outcome measures were change scores calculated for each of the 11 tasks. Symptoms and side effects were monitored weekly. RESULTS Forty-five patients completed the study (placebo, n = 24; pramipexole, n = 21), and groups were well matched on demographic and clinical features. Primary cognitive analyses indicated no compelling cognitive benefit of pramipexole versus placebo; however, secondary analyses highlight several important methodological issues for future trials and identify a subgroup of patients who might benefit more readily from cognitive enhancement strategies. This outcome suggests that the study design played a very important role in the results-implying a failed rather than altogether negative trial. Specifically, we found that even very subtle, subsyndromal mood symptoms at baseline had a significant influence on the degree of improvement due to active drug, with strictly euthymic patients faring best (multivariate analysis of variance, P = .03 in euthymic subgroup). In addition, the extent of baseline cognitive impairment also contributed to the likelihood of treatment response. Finally, concomitant medications may weaken, or in some cases enhance, response to cognitive treatment and should be accounted for in study design. CONCLUSIONS Although our results point toward a lack of clear effect of pramipexole on cognition in bipolar patients, our data revealed a potentially beneficial effect of pramipexole in a subgroup, providing some enthusiasm for pursuing this line of research in the future. Moreover, this study emphasizes the importance of rigorous subject selection for cognitive trials in bipolar illness. Future studies will be necessary to determine the possible clinical and functional implications of these results. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00597896.
Collapse
Affiliation(s)
| | - Raphael J Braga
- Zucker Hillside Hospital-North Shore Long Island Jewish Health System; Glen Oaks, NY 11004,Hofstra North Shore-LIJ School of Medicine at Hofstra University; Hempstead, NY 11549
| | - Charles U. Nnadi
- Harlem Hospital: Columbia University College of Physicians and Surgeons: New York, NY 10037
| | - Yaniv Shaya
- Zucker Hillside Hospital-North Shore Long Island Jewish Health System; Glen Oaks, NY 11004
| | - Walter H. Stearns
- Zucker Hillside Hospital-North Shore Long Island Jewish Health System; Glen Oaks, NY 11004
| | - Anil K. Malhotra
- Zucker Hillside Hospital-North Shore Long Island Jewish Health System; Glen Oaks, NY 11004,Hofstra North Shore-LIJ School of Medicine at Hofstra University; Hempstead, NY 11549,Feinstein Institute for Medical Research; Manhasset, NY 11030
| |
Collapse
|