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Moebus L, Quirin M, Ehrlenspiel F. Cerebral Asymmetry in Bipolar Disorders: A Scoping Review. Biol Psychol 2023; 179:108551. [PMID: 37059217 DOI: 10.1016/j.biopsycho.2023.108551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/23/2023] [Accepted: 04/01/2023] [Indexed: 04/16/2023]
Abstract
Current brain stimulation protocols for patients with bipolar disorders propose brain stimulation according to a model of opposing cerebral dominance in mania and bipolar depression by stimulating the right or left dorsolateral prefrontal cortex during manic or depressive episodes, respectively. However, there is very little observational, rather than interventional, research on such opposing cerebral dominance. In fact, this is the first scoping review that summarizes resting-state and task- related functional cerebral asymmetries measured with brain imaging techniques in manic and depressive symptoms or episodes in patients with formal bipolar disorder diagnoses. In a three-step search process MEDLINE, Scopus, APA PsycInfo, Web of Science Core Collection, and BIOSIS Previews databases as well as reference lists of eligible studies were searched. Data from these studies were extracted with a charting table. Ten resting-state EEG and task-related fMRI studies met inclusion criteria. In line with brain stimulation protocols, mania relates to cerebral dominance in regions of the left frontal lobe, such as the left dorsolateral prefrontal cortex and dorsal anterior cingulate cortex. Bipolar depression relates to cerebral dominance in regions of the right frontal and temporal lobe, such as the right dorsolateral prefrontal cortex, orbitofrontal cortex and temporal pole. More observational research on cerebral asymmetries in mania and bipolar depression can advance brain stimulation protocols and potentially inform standard treatment protocols.
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Affiliation(s)
- Lukas Moebus
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany.
| | - Markus Quirin
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; Department of Psychology, PFH Private University of Applied Sciences, 37073 Göttingen, Germany.
| | - Felix Ehrlenspiel
- Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany.
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2
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Tu PC, Li CT, Lin WC, Chen MH, Su TP, Bai YM. Structural and functional correlates of serum soluble IL-6 receptor level in patients with bipolar disorder. J Affect Disord 2017; 219:172-177. [PMID: 28558364 DOI: 10.1016/j.jad.2017.04.036] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 04/13/2017] [Accepted: 04/20/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Inflammation is reported to play a crucial role in the pathogenesis of bipolar disorder (BD). Higher serum levels of soluble interleukin-6 receptor (sIL-6R), which forms a ligand-receptor complex with the potent proinflammatory cytokine IL-6, have been consistently observed in patients with BD. However, the effect of sIL-6R on neural structure and function remains unclear. This study investigated the association between serum sIL-6R levels and the structural and functional connectivity (FC) of the brain in patients with BD. METHODS Seventy-four stable patients with BD-I or BD-II were enrolled from the outpatient clinic. Structural and resting functional MRI and clinical evaluations were performed in all participants, and serum sIL-6R levels were measured. We used an automated surface-based method (FreeSurfer) to measure cortical thickness and a seed-based FC analysis to derive the FC map of the medial prefrontal cortex (mPFC), a key region implicated in the fronto-limbic disconnection hypothesis of BD. Brain-wise regression analyses of cortical thickness and FC mapping on IL-6 levels were performed using a general linear model. RESULTS Higher sIL-6R levels were associated with a thinner cortex in the right middle temporal gyrus. Furthermore, higher sIL-6R levels were associated with increased FC between the mPFC and amygdala, pallidum, putamen, and insula and decreased FC between the mPFC and subgenual anterior cingulate cortex and frontal pole. CONCLUSION The results evidence that higher serum inflammatory marker levels are associated with a severer deficit in structural and connectivity abnormalities implicated in BD.
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Affiliation(s)
- Pei-Chi Tu
- Department of Medical Research, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Li J, Wang Z, Hwang J, Zhao B, Yang X, Xin S, Wang Y, Jiang H, Shi P, Zhang Y, Wang X, Lang C, Park J, Bao T, Kong J. Anatomical brain difference of subthreshold depression in young and middle-aged individuals. Neuroimage Clin 2017; 14:546-551. [PMID: 28331801 PMCID: PMC5345971 DOI: 10.1016/j.nicl.2017.02.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 02/27/2017] [Accepted: 02/27/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Subthreshold depression (StD) is associated with substantial functional impairments due to depressive symptoms that do not fully meet the diagnosis of major depressive disorder (MDD). Its high incidence in the general population and debilitating symptoms has recently put it at the forefront of mood disorder research. AIM In this study we investigated common volumetric brain changes in both young and middle-aged StD patients. METHODS Two cohorts of StD patients, young and middle-aged, (n = 57) and matched controls (n = 76) underwent voxel-based morphometry (VBM). RESULTS VBM analysis found that: 1) compared with healthy controls, StD patients showed decreased gray matter volume (GMV) in the bilateral globus pallidus and precentral gyrus, as well as increased GMV in the left thalamus and right rostral anterior cingulate cortex/medial prefrontal cortex; 2) there is a significant association between Center for Epidemiological Studies Depression Scale scores and the bilateral globus pallidus (negative) and left thalamus (positive); 3) there is no interaction between age (young vs. middle-age) and group (StD vs. controls). CONCLUSIONS Our findings indicate significant VBM brain changes in both young and middle-aged individuals with StD. Individuals with StD, regardless of age, may share common neural characteristics.
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Affiliation(s)
- Jing Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijng, China
| | - Zengjian Wang
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, MA, USA
| | - JiWon Hwang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijng, China
| | - Bingcong Zhao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijng, China
| | - Xinjing Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijng, China
| | - Suicheng Xin
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijng, China
| | - Yu Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijng, China
| | - Huili Jiang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijng, China
| | - Peng Shi
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijng, China
| | - Ye Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijng, China
- Dongfang Hospital, The Second Clinic College of Beijing University of Chinese Medicine, Beijing, China
| | - Xu Wang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Courtney Lang
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, MA, USA
| | - Joel Park
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, MA, USA
| | - Tuya Bao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijng, China
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, MA, USA
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4
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Atagun MI, Balaban OD, Lordoglu DY, Evren EC. Lithium and Valproate May Affect Motor and Sensory Speed in Patients with Bipolar Disorder. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20130304010158] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Murat Ilhan Atagun
- Yildirim Beyazit University, Faculty of Medicine, Department of Psychiatry, Ankara - Turkey
| | - Ozlem Devrim Balaban
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul - Turkey
| | - Dilek Yesilbas Lordoglu
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul - Turkey
| | - Ekrem Cuneyt Evren
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Alcohol and Drug Research, Treatment and Training Center (AMATEM), Istanbul - Turkey
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5
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Altinay MI, Hulvershorn LA, Karne H, Beall EB, Anand A. Differential Resting-State Functional Connectivity of Striatal Subregions in Bipolar Depression and Hypomania. Brain Connect 2016. [PMID: 26824737 DOI: 10.1089/brain.2015.0396.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Bipolar disorder (BP) is characterized by periods of depression (BPD) and (hypo)mania (BPM), but the underlying state-related brain circuit abnormalities are not fully understood. Striatal functional activation and connectivity abnormalities have been noted in BP, but consistent findings have not been reported. To further elucidate striatal abnormalities in different BP states, this study investigated differences in resting-state functional connectivity of six striatal subregions in BPD, BPM, and healthy control (HC) subjects. Ninety medication-free subjects (30 BPD, 30 BPM, and 30 HC), closely matched for age and gender, were scanned using 3T functional magnetic resonance imaging (fMRI) acquired at resting state. Correlations of low-frequency blood oxygen level dependent signal fluctuations for six previously described striatal subregions were used to obtain connectivity maps of each subregion. Using a factorial design, main effects for differences between groups were obtained and post hoc pairwise group comparisons performed. BPD showed increased connectivity of the dorsal caudal putamen with somatosensory areas such as the insula and temporal gyrus. BPM group showed unique increased connectivity between left dorsal caudate and midbrain regions, as well as increased connectivity between ventral striatum inferior and thalamus. In addition, both BPD and BPM exhibited widespread functional connectivity abnormalities between striatal subregions and frontal cortices, limbic regions, and midbrain structures. In summary, BPD exhibited connectivity abnormalities of associative and somatosensory subregions of the putamen, while BPM exhibited connectivity abnormalities of associative and limbic caudate. Most other striatal subregion connectivity abnormalities were common to both groups and may be trait related.
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Affiliation(s)
- Murat I Altinay
- 1 Center for Behavioral Health , Cleveland Clinic, Cleveland, Ohio
| | - Leslie A Hulvershorn
- 1 Center for Behavioral Health , Cleveland Clinic, Cleveland, Ohio.,2 Department of Psychiatry, Indiana University School of Medicine , Indianapolis, Indiana
| | - Harish Karne
- 1 Center for Behavioral Health , Cleveland Clinic, Cleveland, Ohio.,2 Department of Psychiatry, Indiana University School of Medicine , Indianapolis, Indiana
| | - Erik B Beall
- 3 Imaging Institute, Cleveland Clinic , Cleveland, Ohio
| | - Amit Anand
- 1 Center for Behavioral Health , Cleveland Clinic, Cleveland, Ohio.,2 Department of Psychiatry, Indiana University School of Medicine , Indianapolis, Indiana
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6
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Altinay MI, Hulvershorn LA, Karne H, Beall EB, Anand A. Differential Resting-State Functional Connectivity of Striatal Subregions in Bipolar Depression and Hypomania. Brain Connect 2016; 6:255-65. [PMID: 26824737 DOI: 10.1089/brain.2015.0396] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Bipolar disorder (BP) is characterized by periods of depression (BPD) and (hypo)mania (BPM), but the underlying state-related brain circuit abnormalities are not fully understood. Striatal functional activation and connectivity abnormalities have been noted in BP, but consistent findings have not been reported. To further elucidate striatal abnormalities in different BP states, this study investigated differences in resting-state functional connectivity of six striatal subregions in BPD, BPM, and healthy control (HC) subjects. Ninety medication-free subjects (30 BPD, 30 BPM, and 30 HC), closely matched for age and gender, were scanned using 3T functional magnetic resonance imaging (fMRI) acquired at resting state. Correlations of low-frequency blood oxygen level dependent signal fluctuations for six previously described striatal subregions were used to obtain connectivity maps of each subregion. Using a factorial design, main effects for differences between groups were obtained and post hoc pairwise group comparisons performed. BPD showed increased connectivity of the dorsal caudal putamen with somatosensory areas such as the insula and temporal gyrus. BPM group showed unique increased connectivity between left dorsal caudate and midbrain regions, as well as increased connectivity between ventral striatum inferior and thalamus. In addition, both BPD and BPM exhibited widespread functional connectivity abnormalities between striatal subregions and frontal cortices, limbic regions, and midbrain structures. In summary, BPD exhibited connectivity abnormalities of associative and somatosensory subregions of the putamen, while BPM exhibited connectivity abnormalities of associative and limbic caudate. Most other striatal subregion connectivity abnormalities were common to both groups and may be trait related.
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Affiliation(s)
- Murat I Altinay
- 1 Center for Behavioral Health , Cleveland Clinic, Cleveland, Ohio
| | - Leslie A Hulvershorn
- 1 Center for Behavioral Health , Cleveland Clinic, Cleveland, Ohio.,2 Department of Psychiatry, Indiana University School of Medicine , Indianapolis, Indiana
| | - Harish Karne
- 1 Center for Behavioral Health , Cleveland Clinic, Cleveland, Ohio.,2 Department of Psychiatry, Indiana University School of Medicine , Indianapolis, Indiana
| | - Erik B Beall
- 3 Imaging Institute, Cleveland Clinic , Cleveland, Ohio
| | - Amit Anand
- 1 Center for Behavioral Health , Cleveland Clinic, Cleveland, Ohio.,2 Department of Psychiatry, Indiana University School of Medicine , Indianapolis, Indiana
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7
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Andreescu C, Mennin D, Tudorascu D, Sheu LK, Walker S, Banihashemi L, Aizenstein H. The many faces of anxiety-neurobiological correlates of anxiety phenotypes. Psychiatry Res 2015; 234:96-105. [PMID: 26347412 PMCID: PMC4651749 DOI: 10.1016/j.pscychresns.2015.08.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 02/25/2015] [Accepted: 08/27/2015] [Indexed: 01/13/2023]
Abstract
Anxiety is an all-inclusive concept incorporating somatic symptoms (palpitations, dizziness, dyspnea), emotional and cognitive elements (negative affect, fear, worry, rumination) and behavioral components (e.g., avoidance). The aim of this study was to examine the specific neural correlates associated with anxiety phenotypes (worry, rumination, somatic anxiety) and negative affect (neuroticism). Twenty-nine anxious participants and 30 healthy controls were included in the study. We analyzed seed-based intrinsic connectivity and used correlation maps in a multivariable regression model to describe the specific effect of each anxiety phenotype independently of the effects of age and the other measures of anxiety. Worry severity was uniquely correlated with increased intrinsic connectivity between right anterior insula (RAI) and the precuneus. Global and somatic anxiety were associated with the limbic and paralimbic structures (increased connectivity between the amygdala, PVN, and hippocampus), while neuroticism was correlated with increased connectivity between limbic and prefrontal structures. Rumination severity did not correlate significantly with any measures of functional connectivity once we controlled for other clinical measures of anxiety. Measures of worry, global anxiety, somatic anxiety, and neuroticism have distinct 'neural signatures'. These results advocate for a fine-grain approach when analyzing the neural substrates of clinical samples with various anxiety disorders.
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Affiliation(s)
- Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811, O'Hara Street, Pittsburgh, PA 15213, United States.
| | - Douglas Mennin
- Department of Psychology, Hunter College, City University of New York
| | - Dana Tudorascu
- Department of Psychiatry, University of Pittsburgh School of Medicine,Department of Internal Medicine, University of Pittsburgh School of Medicine,Biostatistics Department, University of Pittsburgh School of Medicine
| | - Lei K Sheu
- Department of Psychology, University of Pittsburgh
| | - Sarah Walker
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Layla Banihashemi
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Howard Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine,Bioengineering Department, University of Pittsburgh
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8
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Frontal lobe hypoactivation in medication-free adults with bipolar II depression during response inhibition. Psychiatry Res 2015; 231:202-9. [PMID: 25555505 DOI: 10.1016/j.pscychresns.2014.11.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 10/29/2014] [Accepted: 11/06/2014] [Indexed: 12/23/2022]
Abstract
In executive function, specifically in response inhibition, numerous studies support the essential role for the inferior frontal cortex (IFC). Hypoactivation of the IFC during response-inhibition tasks has been found consistently in subjects with bipolar disorder during manic and euthymic states. The aim of this study was to examine whether reduced IFC activation also exists in unmedicated subjects with bipolar disorder during the depressed phase of the disorder. Participants comprised 19 medication-free bipolar II (BP II) depressed patients and 20 healthy control subjects who underwent functional magnetic resonance imaging (fMRI) while performing a Go/NoGo response-inhibition task. Whole-brain analyses were conducted to assess activation differences within and between groups. The BP II depressed group, compared with the control group, showed significantly reduced activation in right frontal regions, including the IFC (Brodmann's area (BA) 47), middle frontal gyrus (BA 10), as well as other frontal and temporal regions. IFC hypoactivation may be a persistent deficit in subjects with bipolar disorder in both acute mood states as well as euthymia, thus representing a trait feature of bipolar disorder.
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Rey G, Desseilles M, Favre S, Dayer A, Piguet C, Aubry JM, Vuilleumier P. Modulation of brain response to emotional conflict as a function of current mood in bipolar disorder: preliminary findings from a follow-up state-based fMRI study. Psychiatry Res 2014; 223:84-93. [PMID: 24862389 DOI: 10.1016/j.pscychresns.2014.04.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 03/21/2014] [Accepted: 04/28/2014] [Indexed: 12/26/2022]
Abstract
We used functional magnetic resonance imaging (fMRI) to examine affective control longitudinally in a group of patients with bipolar disorder (BD). Participants comprised 12 BD patients who underwent repeated fMRI scans in euthymic (n=11), depressed (n=9), or hypomanic (n=9) states, and were compared with 12 age-matched healthy controls. During fMRI, participants performed an emotional face-word interference task with either low or high attentional demands. Relative to healthy controls, patients showed decreased activation of the cognitive control network normally associated with conflict processing, more severely during hypomania than during depression, but regardless of level of task demand in both cases. During euthymia, a decreased response to conflict was observed only during the high load condition. Additionally, unlike healthy participants, patients exhibited deactivation in several key areas in response to emotion-conflict trials - including the rostral anterior cingulate cortex during euthymia, the hippocampus during depression, and the posterior cingulate cortex during hypomania. Our results indicate that the ability of BD patients to recruit control networks when processing affective conflict, and the abnormal suppression of activity in distinct components of the default mode network, may depend on their current clinical state and attentional demand.
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Affiliation(s)
- Gwladys Rey
- Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva, 1 rue Michel Servet, 1211 Geneva, Switzerland.
| | - Martin Desseilles
- Department of Mental Health and Psychiatry, Division of Psychiatric Specialties, Mood Disorder Program, Geneva University Hospitals, Geneva, Switzerland; Cyclotron Research Center, University of Liège, Liège, Belgium
| | - Sophie Favre
- Department of Mental Health and Psychiatry, Division of Psychiatric Specialties, Mood Disorder Program, Geneva University Hospitals, Geneva, Switzerland
| | - Alexandre Dayer
- Department of Mental Health and Psychiatry, Division of Psychiatric Specialties, Mood Disorder Program, Geneva University Hospitals, Geneva, Switzerland
| | - Camille Piguet
- Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva, 1 rue Michel Servet, 1211 Geneva, Switzerland
| | - Jean-Michel Aubry
- Department of Mental Health and Psychiatry, Division of Psychiatric Specialties, Mood Disorder Program, Geneva University Hospitals, Geneva, Switzerland
| | - Patrik Vuilleumier
- Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva, 1 rue Michel Servet, 1211 Geneva, Switzerland; Department of Neurology, Geneva University Hospitals, Geneva, Switzerland
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Kuiper S, McLean L, Malhi GS. To BD or not to BD: functional neuroimaging and the boundaries of bipolarity. Expert Rev Neurother 2014; 13:75-86; quiz 87. [DOI: 10.1586/ern.12.126] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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11
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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
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12
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Liberg B, Adler M, Jonsson T, Landén M, Rahm C, Wahlund LO, Kristoffersen-Wiberg M, Wahlund B. The neural correlates of self-paced finger tapping in bipolar depression with motor retardation. Acta Neuropsychiatr 2013; 25:43-51. [PMID: 26953073 DOI: 10.1111/j.1601-5215.2012.00659.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Motor retardation is a characteristic feature of bipolar depression, and is also a core feature of Parkinson's disease. Within the framework of the functional deafferentiation theory in Parkinson's disease, we hypothesised that motor retardation in bipolar depression is mediated by disrupted subcortical activation, leading to decreased activation of cortical motor areas during finger tapping. METHODS We used functional magnetic resonance imaging to investigate neural activity during self-paced finger tapping to elucidate whether brain regions that mediate preparation, control and execution of movement are activated differently in subjects with bipolar depression (n = 9) compared to healthy controls (n = 12). RESULTS An uncorrected whole-brain analysis revealed significant group differences in dorsolateral and ventromedial prefrontal cortex. Corrected analyses showed non-significant differences in patients compared to controls: decreased and less widespread activation of the left putamen and left pallidum; increased activity in the left thalamus and supplementary motor area; decreased activation in the left lateral pre- and primary motor cortices; absence of activation in the pre-supplementary motor area; activation of the bilateral rostral cingulate motor area. CONCLUSION Both movement preparation and execution may be affected in motor retardation, and the activity in the whole left-side motor circuit is altered during self-initiated motor performance in bipolar depression.
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Affiliation(s)
- Benny Liberg
- 1 Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Mats Adler
- 1 Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Jonsson
- 2 Department of Diagnostic Medical Physics, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Mikael Landén
- 1 Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Christoffer Rahm
- 1 Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Lars-Olof Wahlund
- 4 Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Kristoffersen-Wiberg
- 5 Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Björn Wahlund
- 1 Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
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13
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Adleman NE, Fromm SJ, Razdan V, Kayser R, Dickstein DP, Brotman MA, Pine DS, Leibenluft E. Cross-sectional and longitudinal abnormalities in brain structure in children with severe mood dysregulation or bipolar disorder. J Child Psychol Psychiatry 2012; 53:1149-56. [PMID: 22650379 PMCID: PMC3472043 DOI: 10.1111/j.1469-7610.2012.02568.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is debate as to whether chronic irritability (operationalized as severe mood dysregulation, SMD) is a developmental form of bipolar disorder (BD). Although structural brain abnormalities in BD have been demonstrated, no study compares neuroanatomy among SMD, BD, and healthy volunteers (HV) either cross-sectionally or over time. Furthermore, the developmental trajectories of structural abnormalities in BD or SMD are unknown. This study provides such data in BD, SMD, and HV. METHODS An optimized, modulated voxel-based morphometry (VBM) analysis was conducted on structural MRI scans from 201 children (78 SMD, 55 BD, and 68 HV). In addition, 92 children (31 SMD, 34 BD, and 27 HV) were rescanned after 2 years (mean interval 1.99 ± 0.94 years), to compare time-related changes among the three groups. RESULTS Cross-sectionally, the groups differed in gray matter (GM) volume in presupplementary motor area (pre-SMA), dorsolateral prefrontal cortex (DLPFC), insula, and globus pallidus. The cortical differences were driven mainly by increased GM volume in HV compared with BD and SMD. In globus pallidus, there was increased GM in BD compared with HV and SMD. Longitudinally, group-by-time interactions were evident in two clusters in the superior/inferior parietal lobule (R SPL/IPL) and in the precuneus. In both clusters, the interactions were driven by an abnormal increase in volume in BD. CONCLUSIONS Cross-sectionally, both BD and SMD are associated with structural abnormalities in frontal cortex, insula, and basal ganglia. Although some of these deficits overlap (insula and DLPFC), others differentiate SMD and BD (pre-SMA and globus pallidus). Abnormal developmental trajectories in lateral parietal cortex and precuneus are present in, and unique to, BD. Because of the high proportion of co-occurring ADHD in the SMD subjects, we could not separate effects of ADHD from those of SMD, and future research including a nonirritable ADHD group must address this issue.
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Affiliation(s)
- Nancy E Adleman
- National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA.
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Blond BN, Fredericks CA, Blumberg HP. Functional neuroanatomy of bipolar disorder: structure, function, and connectivity in an amygdala-anterior paralimbic neural system. Bipolar Disord 2012; 14:340-55. [PMID: 22631619 PMCID: PMC3880745 DOI: 10.1111/j.1399-5618.2012.01015.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES In past decades, neuroimaging research in bipolar disorder has demonstrated a convergence of findings in an amygdala-anterior paralimbic cortex neural system. This paper reviews behavioral neurology literature that first suggested a central role for this neural system in the disorder and the neuroimaging evidence that supports it. METHODS Relevant articles are reviewed to provide an amygdala-anterior paralimbic cortex neural system model of bipolar disorder, including articles from the fields of behavioral neurology and neuroanatomy, and neuroimaging. RESULTS The literature is highly supportive of key roles for the amygdala, anterior paralimbic cortices, and connections among these structures in the emotional dysregulation of bipolar disorder. The functions subserved by their more widely distributed connection sites suggest that broader system dysfunction could account for the range of functions-from neurovegetative to cognitive-disrupted in the disorder. Abnormalities in some components of this neural system are apparent by adolescence, while others, such as those in rostral prefrontal regions, appear to progress over adolescence and young adulthood, suggesting a neurodevelopmental model of the disorder. However, some findings conflict, which may reflect the small sample sizes of some studies, and clinical heterogeneity and methodological differences across studies. CONCLUSIONS Consistent with models derived from early behavioral neurology studies, neuroimaging studies support a central role for an amygdala-anterior paralimbic neural system in bipolar disorder, and implicate abnormalities in the development of this system in the disorder. This system will be an important focus of future studies on the developmental pathophysiology, detection, treatment, and prevention of the disorder.
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Affiliation(s)
- Benjamin N Blond
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Carolyn A Fredericks
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA,Department of Diagnostic Radiology, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA,The Child Study Center, Yale School of Medicine, New Haven, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA,Research Enhancement Award Program Depression Center, Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
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15
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Bora E, Fornito A, Yücel M, Pantelis C. The effects of gender on grey matter abnormalities in major psychoses: a comparative voxelwise meta-analysis of schizophrenia and bipolar disorder. Psychol Med 2012; 42:295-307. [PMID: 21835091 DOI: 10.1017/s0033291711001450] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Recent evidence from genetic and familial studies revitalized the debate concerning the validity of the distinction between schizophrenia and bipolar disorder. Comparing brain imaging findings is an important avenue to examine similarities and differences and, therefore, the validity of the distinction between these conditions. However, in contrast to bipolar disorder, most patient samples in studies of schizophrenia are predominantly male. This a limiting factor for comparing schizophrenia and bipolar disorder since male gender is associated with more severe neurodevelopmental abnormalities, negative symptoms and cognitive deficits in schizophrenia. METHOD We used a coordinate-based meta-analysis technique to compare grey matter (GM) abnormalities in male-dominated schizophrenia, gender-balanced schizophrenia and bipolar disorder samples based on published voxel-based morphometry (VBM) studies. In total, 72 English-language, peer reviewed articles published prior to January 2011 were included. All reports used VBM for comparing schizophrenia or bipolar disorder with controls and reported whole-brain analyses in standard stereotactic space. RESULTS GM reductions were more extensive in male-dominated schizophrenia compared to gender-balanced bipolar disorder and schizophrenia. In gender-balanced samples, GM reductions were less severe. Compared to controls, GM reductions were restricted to dorsal anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex in schizophrenia and ACC and bilateral fronto-insular cortex in bipolar disorder. CONCLUSIONS When gender is controlled, GM abnormalities in bipolar disorder and schizophrenia are mostly restricted to regions that have a role in emotional and cognitive aspects of salience respectively. Dorsomedial and dorsolateral prefrontal cortex were the only regions that showed greater GM reductions in schizophrenia compared to bipolar disorder.
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Affiliation(s)
- E Bora
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
| | - A Fornito
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
| | - M Yücel
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia
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16
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Piacentini S, Versaci R, Romito L, Ferré F, Albanese A. Behavioral and personality features in patients with lateralized Parkinson's disease. Eur J Neurol 2010; 18:772-7. [PMID: 21159067 DOI: 10.1111/j.1468-1331.2010.03279.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dopamine neurotransmission plays a key role in several brain activities, including motor, cognitive, and behavioral functions. Parkinson's disease (PD) typically begins with asymmetrical motor features related to asymmetrical dopamine denervation. This study was designed to examine whether distinct cognitive, behavioral, and personality features are related to this asymmetry. METHODS Fifty-six patients with mild PD and lateralized motor features were grouped according to dominant side of motor features and evaluated using a neuropsychological assessment focused on attention and executive functions, impulse control disorders, and personality inventory. RESULTS There were no differences in neuropsychological functions between patients with right and left lateralized PD, but differences occurred in personality features. Patients with motor impairment predominant on the left-hand side had prevalence of hypomania and conversion profile. CONCLUSIONS This study suggests that side dominance of dopaminergic denervation may be related to personality features in patients with PD that could influence behavioral aspects.
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Affiliation(s)
- S Piacentini
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.
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17
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Abstract
OBJECTIVES A large and diverse literature has implicated abnormalities of striatal structure and function in both unipolar and bipolar disorder. Recent functional imaging studies have greatly expanded this body of research. The aim of this review is to provide a comprehensive and critical appraisal of the relevant literature. METHODS A total of 331 relevant articles were reviewed to develop an integrated overview of striatal function in mood disorders. RESULTS There is compelling evidence from multiple studies that functional abnormalities of the striatum and greater corticostriatal circuitry exist in at least some forms of affective illness. The literature does not yet provide data to determine whether these aberrations represent primary pathology or they contribute directly to symptom expression. Finally, there is considerable evidence that bipolar disorder may be associated with striatal hyperactivity and some suggestion that unipolar illness may be associated with hypoactivation. CONCLUSIONS Additional research investigating striatal function in affective disorders will be critical to the development of comprehensive models of the neurobiology of these conditions.
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Affiliation(s)
- William R Marchand
- Department of Veterans Affairs, VISN 19 MIRECC, 5500 Foothill, Salt Lake City, UT 84148, USA.
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18
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Marchand WR. Cortico-basal ganglia circuitry: a review of key research and implications for functional connectivity studies of mood and anxiety disorders. Brain Struct Funct 2010; 215:73-96. [PMID: 20938681 DOI: 10.1007/s00429-010-0280-y] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 09/22/2010] [Indexed: 11/25/2022]
Abstract
There is considerable evidence that dysfunction of the cortico-basal ganglia circuits may be associated with several mood and anxiety disorders. However, it is unclear whether circuit abnormalities contribute directly either to the neurobiology of these conditions or to the manifestation of symptoms. Understanding the role of these pathways in psychiatric illness has been limited by an incomplete characterization of normal function. In recent years, studies using animal models and human functional imaging have greatly expanded the literature describing normal cortico-basal ganglia circuit function. In this paper, recent key studies of circuit function using human and animal models are reviewed and integrated with findings from other studies conducted over the previous decades. The literature suggests several hypotheses of cortico-basal ganglia circuitry function in mood and anxiety disorders that warrant further exploration. Hypotheses are proposed herein based upon the cortico-basal ganglia mechanisms of: (1) feedforward and feedback control, (2) circuit integration and (3) emotional control. These are presented as models of circuit function, which may be particularly relevant to future investigations using neuroimaging and functional connectivity analyses.
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Affiliation(s)
- William R Marchand
- George E. Wahlen Department of Veterans Affairs Medical Center, VHASLCHCS 151, 500 Foothill, Salt Lake City, UT 84148, USA.
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19
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Singh MK, Chang KD, Mazaika P, Garrett A, Adleman N, Kelley R, Howe M, Reiss A. Neural correlates of response inhibition in pediatric bipolar disorder. J Child Adolesc Psychopharmacol 2010; 20:15-24. [PMID: 20166792 PMCID: PMC2835388 DOI: 10.1089/cap.2009.0004] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Pediatric bipolar disorder is characterized by core deficits in mood and executive function and commonly co-occurs with attention-deficit/hyperactivity disorder (ADHD). We aimed to examine response inhibition in this population, as an element of executive function, which, if aberrant, may interfere with learning and information processing. METHODS Children (9-18 years) with bipolar I or II disorder (BD, n = 26) and age, gender, and intelligence quotient (IQ) comparable healthy children (HC, n = 22) without any psychopathology were given a standardized Go/NoGo computerized task measuring response inhibition. A whole-brain functional magnetic resonance imaging (MRI) group analysis was performed using statistical parametric mapping software (SPM2) for comparing NoGo to Go epochs. RESULTS There were no statistically significant group differences between groups in age, gender, or ethnicity. The BD group had high rates of co-morbid disorders, including 81% with ADHD, 62% with oppositional defiant disorder (ODD), and 46% with anxiety disorders. This BD group had fewer correct responses on Go (84% vs. 96%, T[46] = 3.35, p = 0.002) and overall (85% vs. 94%, T[46] = 4.12, p = 0.0002) trials as compared to the HC group. However, there were no statistically significant group differences in response inhibition on NoGo trials (p = 0.11). In the NoGo-Go contrast, the BD group showed increased neural activation in the right dorsolateral prefrontal cortex (DLPFC) compared to HC (T[46] = 4.21, p < 0.001). CONCLUSIONS During accurate NoGo but impaired Go trial performance, children with BD showed increased right DLPFC activation versus controls, suggesting increased recruitment of executive control regions for accurate response inhibition. Studies relating these results to mood regulation in pediatric BD are warranted.
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Affiliation(s)
- Manpreet K. Singh
- Pediatric Bipolar Disorders Program, Stanford University School of Medicine, Stanford, California.,Center for Interdisciplinary Brain Sciences Research, Stanford University School of Medicine, Stanford, California
| | - Kiki D. Chang
- Pediatric Bipolar Disorders Program, Stanford University School of Medicine, Stanford, California
| | - Paul Mazaika
- Center for Interdisciplinary Brain Sciences Research, Stanford University School of Medicine, Stanford, California
| | - Amy Garrett
- Center for Interdisciplinary Brain Sciences Research, Stanford University School of Medicine, Stanford, California
| | - Nancy Adleman
- Center for Interdisciplinary Brain Sciences Research, Stanford University School of Medicine, Stanford, California
| | - Ryan Kelley
- Center for Interdisciplinary Brain Sciences Research, Stanford University School of Medicine, Stanford, California
| | - Meghan Howe
- Pediatric Bipolar Disorders Program, Stanford University School of Medicine, Stanford, California
| | - Allan Reiss
- Center for Interdisciplinary Brain Sciences Research, Stanford University School of Medicine, Stanford, California
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20
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Abstract
Functional neuroimaging techniques have been important research tools in the study of bipolar disorder (BPD). These methods provide measures of regional brain functioning that reflect the mental state at the time of scanning and have helped to elucidate both state and trait features of BPD. This chapter will review converging functional neuroimaging evidence implicating state and trait dysfunction in a ventral prefrontal cortex-amygdala neural system in BPD. Emerging evidence that suggests a developmental progression in dysfunction in this neural system over the course of adolescence will be considered. Finally, new research approaches that have begun to reveal the contribution of specific genetic mechanisms to regional dysfunction in the disorder, potential salutary effects of medications, and structure-function relationships will be discussed.
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21
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Abstract
Bipolar disorder (BPD) is increasingly recognized as a neuropathological disorder characterized by reductions in grey matter (GM) volume, as measured by magnetic resonance imaging (MRI) and neuronal and postmortem glial cell changes. Here, we use an anatomical framework to discuss the neurobiology of BPD, focusing on individual components of the "visceromotor network" that regulates bodily homeostasis along with neurophysiological and neuroendocrine responses to stress. MRI-defined reductions in GM volume, combined with neuronal changes, are observed in the perigenual anterior cingulate cortex (ACC) of individuals with BPD, while postmortem glial cell loss is also a characteristic of Brodmann's Area 9. Both postmortem neuronal loss and reduced GM volume have been reported in the amygdala and hippocampus. These structural changes to components of the visceromotor network are associated with increased regional cerebral blood flow (rCBF) or blood oxygenated level-dependent (BOLD) activity in response to affective or rewarding stimuli, raising the possibility that the BPD-associated structural changes are secondary to a glutamate-driven excitotoxic process.
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22
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Bluhm R, Williamson P, Lanius R, Théberge J, Densmore M, Bartha R, Neufeld R, Osuch E. Resting state default-mode network connectivity in early depression using a seed region-of-interest analysis: decreased connectivity with caudate nucleus. Psychiatry Clin Neurosci 2009; 63:754-61. [PMID: 20021629 DOI: 10.1111/j.1440-1819.2009.02030.x] [Citation(s) in RCA: 223] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Reports on resting brain activity in healthy controls have described a default-mode network (DMN) and important differences in DMN connectivity have emerged for several psychiatric conditions. No study to date, however, has investigated resting-state DMN in relatively early depression before years of medication treatment. The objective of the present study was, therefore, to investigate the DMN in patients seeking help from specialized mental health services for the first time for symptoms of depression. METHODS Fourteen depressed subjects and 15 matched controls were scanned using 4-T functional magnetic resonance imaging while resting with eyes closed. All but one subject was medication free. A precuneus/posterior cingulate cortex (P/PCC) seed-region connectivity analysis was used to identify the DMN and compare study groups in regions of relevance to depression. RESULTS The P/PCC analysis identified the DMN well in both study groups, consistent with prior literature. Direct comparison showed significantly reduced correlation between the P/PCC and the bilateral caudate in depression compared with controls and no areas of increased connectivity in the depressed group. CONCLUSIONS The present study is the first to investigate resting-state DMN in the early stages of treatment-seeking for depression. Depressed subjects had decreased connectivity between the P/PCC and the bilateral caudate, regions known to be involved in motivation and reward processing. Deficits in DMN connectivity with the caudate may be an early manifestation of major depressive disorder.
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Affiliation(s)
- Robyn Bluhm
- Department of Psychiatry, University of Western Ontario, Ontario N6A 3H8, Canada
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23
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Gos T, Krell D, Bielau H, Steiner J, Trübner K, Brisch R, Bernstein HG, Jankowski Z, Bogerts B. Demonstration of disturbed activity of external globus pallidus projecting neurons in depressed patients by the AgNOR staining method. J Affect Disord 2009; 119:149-55. [PMID: 19344956 DOI: 10.1016/j.jad.2009.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Revised: 03/08/2009] [Accepted: 03/11/2009] [Indexed: 01/19/2023]
Abstract
BACKGROUND The external globus pallidus (EGP) is thought to play the most important integrating and conveying role in the striatopallidal system involved in the transfer from motivation to action. The aim to find a morphological biomarker of disturbed EGP activity in depression was approached by the karyometric analysis of large projecting neurons. METHODS The study was performed on paraffin-embedded brains from 19 depressed patients from both the major depressive disorder (MDD) and the bipolar disorder (BD) diagnostic groups encompassing 10 suicides and from 24 controls. The karyometric parameters of EGP neurons bilaterally were evaluated by argyrophilic nucleolar organiser (AgNOR) silver staining method. RESULTS A significantly decreased AgNOR area was found in the left EGP neurons in depressed patients compared to controls. The distinctness of the diagnostic groups and suicidal vs non-suicidal patients was not shown in the statistical comparisons. The AgNOR parameter which was decreased correlated positively with the mean dose of benzodiazepines in non-suicidal patients. LIMITATIONS A major limitation of this study is the relatively small number of cases. A further limitation is given by the lack of data on drug exposure across the whole lifespan of patients. CONCLUSION The results suggest disturbed, most likely decreased, activity of the left EGP projecting neurons in depressed patients, a disturbed activity that should hypothetically be counteracted by the applied pharmacotherapy in non-suicidal patients.
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Affiliation(s)
- Tomasz Gos
- Institute of Forensic Medicine, Medical University of Gdańsk, Poland.
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24
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Arnone D, Cavanagh J, Gerber D, Lawrie SM, Ebmeier KP, McIntosh AM. Magnetic resonance imaging studies in bipolar disorder and schizophrenia: meta-analysis. Br J Psychiatry 2009; 195:194-201. [PMID: 19721106 DOI: 10.1192/bjp.bp.108.059717] [Citation(s) in RCA: 315] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Several magnetic resonance imaging (MRI) studies have identified structural abnormalities in association with bipolar disorder. The literature is, however, heterogeneous and there is remaining uncertainty about which brain areas are pivotal to the pathogenesis of the condition. AIMS To identify, appraise and summarise volumetric MRI studies of brain regions comparing bipolar disorder with an unrelated control group and individuals with schizophrenia. METHOD A systematic review and random-effects meta-analysis was carried out to identify key areas of structural abnormality in bipolar disorder and whether the pattern of affected areas separated bipolar disorder from schizophrenia. Significant heterogeneity was explored using meta-regression. RESULTS Participants with bipolar disorder are characterised by whole brain and prefrontal lobe volume reductions, and also by increases in the volume of the globus pallidus and lateral ventricles. In comparison with schizophrenia, bipolar disorder is associated with smaller lateral ventricular volume and enlarged amygdala volume. Heterogeneity was widespread and could be partly explained by clinical variables and year of publication, but generally not by differences in image acquisition. CONCLUSIONS There appear to be robust changes in brain volume in bipolar disorder compared with healthy volunteers, although most changes do not seem to be diagnostically specific. Age and duration of illness appear to be key issues in determining the magnitude of observed effect sizes.
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Affiliation(s)
- Danilo Arnone
- Neuroscience and Psychiatry Unit, University of Manchester, Manchester M13 9PT, UK.
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25
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Bipolar and major depressive disorder: neuroimaging the developmental-degenerative divide. Neurosci Biobehav Rev 2009; 33:699-771. [PMID: 19428491 DOI: 10.1016/j.neubiorev.2009.01.004] [Citation(s) in RCA: 361] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Accepted: 01/14/2009] [Indexed: 01/30/2023]
Abstract
Both major depressive disorder and bipolar disorder are the subject of a voluminous imaging and genetics literature. Here, we attempt a comprehensive review of MRI and metabolic PET studies conducted to date on these two disorders, and interpret our findings from the perspective of developmental and degenerative models of illness. Elevated activity and volume loss of the hippocampus, orbital and ventral prefrontal cortex are recurrent themes in the literature. In contrast, dorsal aspects of the PFC tend to display hypometabolism. Ventriculomegaly and white matter hyperintensities are intimately associated with depression in elderly populations and likely have a vascular origin. Important confounding influences are medication, phenotypic and genetic heterogeneity, and technological limitations. We suggest that environmental stress and genetic risk variants interact with each other in a complex manner to alter neural circuitry and precipitate illness. Imaging genetic approaches hold out promise for advancing our understanding of affective illness.
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26
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Affiliation(s)
- Petra S Hüppi
- Department of Pediatrics, University of Geneva, Switzerland.
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27
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Marchand WR, Lee JN, Thatcher J, Thatcher GW, Jensen C, Starr J. A preliminary longitudinal fMRI study of frontal-subcortical circuits in bipolar disorder using a paced motor activation paradigm. J Affect Disord 2007; 103:237-41. [PMID: 17316821 DOI: 10.1016/j.jad.2007.01.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2006] [Revised: 12/01/2006] [Accepted: 01/04/2007] [Indexed: 11/24/2022]
Abstract
BACKGROUND Compelling evidence suggests abnormal functioning of frontal-subcortical (FSC) circuits in bipolar disorder, but it is unknown whether these are state or trait abnormalities. Longitudinal functional neuroimaging studies may help clarify this issue. However, studies to date have not determined which activation paradigms may be most useful for this purpose. A paced motor task has the potential to be more reliable than cognitive or emotional activation paradigms. METHODS To evaluate the utility of a paced motor activation task as a longitudinal probe of FSC function, we conducted fMRI scans of 10 subjects with bipolar I disorder when euthymic. We compared activation patterns to the same subjects who had been previously scanned during an episode of depression. RESULTS The paced motor task resulted in activation in the bilateral striatum which was consistent across mood states as well as greater activation among the subjects when euthymic in the right anterior cingulate and medial frontal gyrus. LIMITATIONS The study sample was small (10 subjects) which limits generalizability of findings. CONCLUSIONS To our knowledge, this is the first longitudinal study of bipolar illness utilizing a paced motor task. These findings suggest that a paced motor task is useful as a longitudinal probe of both state and trait function in bipolar disorder. Further, this study provides preliminary evidence that striatal functional abnormalities may represent a trait characteristic.
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28
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Marchand WR, Lee JN, Thatcher GW, Jensen C, Stewart D, Dilda V, Thatcher J, Creem-Regehr SH. A functional MRI study of a paced motor activation task to evaluate frontal-subcortical circuit function in bipolar depression. Psychiatry Res 2007; 155:221-30. [PMID: 17588725 DOI: 10.1016/j.pscychresns.2007.03.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2006] [Revised: 03/05/2007] [Accepted: 03/11/2007] [Indexed: 11/16/2022]
Abstract
The primary aim of this functional magnetic resonance imaging (fMRI) study was to test the utility of a paced motor activation task to evaluate frontal-subcortical (FSC) circuit function in bipolar depression. A secondary aim was to determine if utilizing both a motor and cognitive activation paradigm (Stroop) would provide information about the potential role of FSC dysfunction in the cognitive symptoms of bipolar depression. Analysis of the control group (n=15) alone revealed that the motor task activated FSC structures. Comparison of the control to bipolar group (n=14) revealed significant differences between the groups in striatum as well as cortical areas with FSC connections in response to the non-dominant-hand motor task. In response to the Stroop, there were significant differences between the groups in portions of the bilateral posterior cingulate and occipital cortex, but not in FSC structures. While these results must be considered preliminary, this work supports further studies of paced motor tasks to probe FSC function. Further, it suggests that the use of both a cognitive and motor task in the same study provides useful information about brain function. Finally, it supports the literature implicating FSC circuit abnormalities in bipolar disorder.
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Affiliation(s)
- William R Marchand
- VISN 19 MIRECC, George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah, USA.
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29
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Niculescu AB, Lulow LL, Ogden CA, Le-Niculescu H, Salomon DR, Schork NJ, Caligiuri MP, Lohr JB. PhenoChipping of psychotic disorders: a novel approach for deconstructing and quantitating psychiatric phenotypes. Am J Med Genet B Neuropsychiatr Genet 2006; 141B:653-62. [PMID: 16838358 DOI: 10.1002/ajmg.b.30404] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Psychiatric phenotypes as currently defined are primarily the result of clinical consensus criteria rather than empirical research. We propose, and present initial proof of principle for, a novel approach to characterizing psychiatric phenotypes. We have termed our approach PhenoChipping, by analogy with, and borrowing paradigms and tools from, gene expression microarray studies (GeneChipping). A massive parallel profiling of cognitive and affective state is done with a PhenoChip composed of a battery of existing and new quantitative psychiatric rating scales, as well as hand neuromotor measures. We present preliminary data from 104 subjects, 72 with psychotic disorders (bipolar disorder-41, schizophrenia-17, schizoaffective disorder-14), and 32 normal controls. Microarray data analysis software and visualization tools were used to investigate: 1. relationships between phenotypic items ("phenes"), including with objective motor measures, and 2. relationships between subjects. Our analyses revealed phenotypic overlap among, as well as phenotypic heterogeneity within, the three major psychotic disorders studied. This approach may be useful in helping us move beyond current diagnostic classifications, and suggests a combinatorial building-block (Lego-like) structure underlies psychiatric syndromes. The adaptation of microarray informatic tools for phenotypic analysis readily facilitates direct integration with gene expression profiling of lymphocytes in the same individuals, a strategy for molecular biomarker identification. Empirically derived clusterings of (endo)phenotypes and of patients will better serve genetic, pharmacological, and imaging research, as well as clinical practice.
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Affiliation(s)
- Alexander B Niculescu
- Laboratory of Neurophenomics, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
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