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Guo Y, Liu Y, Zhang T, Ruan J, Liu S, Ren Z. Intrinsic disruption of white matter microarchitecture in major depressive disorder: A voxel-based meta analysis of diffusion tensor imaging. J Affect Disord 2024; 363:161-173. [PMID: 39032713 DOI: 10.1016/j.jad.2024.07.050] [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: 12/12/2023] [Revised: 06/17/2024] [Accepted: 07/12/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Major depressive disorder (MDD) is a prevalent and disabling mood disorder, thought to be linked with brain white matter (WM) alterations. Prior diffusion tensor imaging (DTI) studies have reported inconsistent changes in fractional anisotropy (FA) across different brain regions in MDD patients. However, none of these studies utilized raw t-map data for WM meta-analysis in MDD. Our study aims to address this gap by conducting a whole-brain-based meta-analysis of FA in MDD using Seed-based d mapping via permutation of subject images (SDM-PSI), combining reported peak coordinates and raw statistical parametric maps. OBJECTIVES Following PRISMA guidelines, we performed a systematic search and meta-analysis to compare FA in MDD patients with healthy controls (HC). Our goal was to identify WM abnormalities in MDD, using SDM, which could shed light on the disorder's pathogenesis. RESULTS The meta-analysis included 39 studies with 3696 participants (2094 with MDD, 1602HC). It revealed that MDD patients, in comparison to HC, have lower FA in the corpus callosum (CC) and anterior thalamic projections (ATP). Subgroup analyses indicated that the CC is a more stable pathogenic factor in MDD. Meta-regression analyses showed no linear correlation between the mean age, percentage of female patients, duration of depression, and FA abnormalities. This suggests that WM impairments in interhemispheric connections and anterior thalamocortical circuits are significant in the pathogenesis of MDD.
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Affiliation(s)
- Yunxiao Guo
- Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), School of Psychology, Central China Normal University, Wuhan, China; Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
| | - Yinong Liu
- Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), School of Psychology, Central China Normal University, Wuhan, China; Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
| | - Tao Zhang
- Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), School of Psychology, Central China Normal University, Wuhan, China; Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
| | - Jun Ruan
- Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), School of Psychology, Central China Normal University, Wuhan, China; Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
| | - Sijun Liu
- Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), School of Psychology, Central China Normal University, Wuhan, China; Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
| | - Zhihong Ren
- Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), School of Psychology, Central China Normal University, Wuhan, China; Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China.
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Cao P, Li Y, Dong Y, Tang Y, Xu G, Si Q, Chen C, Yao Y, Li R, Sui Y. Different structural connectivity patterns in the subregions of the thalamus, hippocampus, and cingulate cortex between schizophrenia and psychotic bipolar disorder. J Affect Disord 2024; 363:269-281. [PMID: 39053628 DOI: 10.1016/j.jad.2024.07.077] [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: 03/14/2024] [Revised: 06/25/2024] [Accepted: 07/14/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE Schizophrenia (SCZ) and psychotic bipolar disorder (PBD) are two major psychotic disorders with similar symptoms and tight associations on the psychopathological level, posing a clinical challenge for their differentiation. This study aimed to investigate and compare the structural connectivity patterns of the limbic system between SCZ and PBD, and to identify specific regional disruptions associated with psychiatric symptoms. METHODS Using sMRI data from 146 SCZ, 160 PBD, and 145 healthy control (HC) participants, we employed a data-driven approach to segment the hippocampus, thalamus, hypothalamus, amygdala, and cingulate cortex into subregions. We then investigated the structural connectivity patterns between these subregions at the global and nodal levels. Additionally, we assessed psychotic symptoms by utilizing the subscales of the Brief Psychiatric Rating Scale (BPRS) to examine correlations between symptom severity and network metrics between groups. RESULTS Patients with SCZ and PBD had decreased global efficiency (Eglob) (SCZ: adjusted P<0.001; PBD: adjusted P = 0.003), local efficiency (Eloc) (SCZ and PBD: adjusted P<0.001), and clustering coefficient (Cp) (SCZ and PBD: adjusted P<0.001), and increased path length (Lp) (SCZ: adjusted P<0.001; PBD: adjusted P = 0.004) compared to HC. Patients with SCZ showed more pronounced decreases in Eglob (adjusted P<0.001), Eloc (adjusted P<0.001), and Cp (adjusted P = 0.029), and increased Lp (adjusted P = 0.024) compared to patients with PBD. The most notable structural disruptions were observed in the hippocampus and thalamus, which correlated with different psychotic symptoms, respectively. CONCLUSION This study provides evidence of distinct structural connectivity disruptions in the limbic system of patients with SCZ and PBD. These findings might contribute to our understanding of the neuropathological basis for distinguishing SCZ and PBD.
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Affiliation(s)
- Peiyu Cao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing 210000, Jiangsu, China
| | - Yuting Li
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing 210000, Jiangsu, China; Huzhou Third People's Hospital, Huzhou 313000, Zhejiang, China
| | - Yingbo Dong
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing 210000, Jiangsu, China
| | - Yilin Tang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing 210000, Jiangsu, China
| | - Guoxin Xu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing 210000, Jiangsu, China
| | - Qi Si
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing 210000, Jiangsu, China; Huai'an No. 3 People's Hospital, Huai'an 223001, Jiangsu, China
| | - Congxin Chen
- Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210000, Jiangsu, China
| | - Ye Yao
- Nanjing Medical University, Nanjing 210000, Jiangsu, China
| | - Runda Li
- Vanderbilt University, Nashville 37240, TN, USA
| | - Yuxiu Sui
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing 210000, Jiangsu, China.
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Zhang Q, Ding H. Meta-analysis of resting-state fMRI in cervical spondylosis patients using AES-SDM. Front Neurol 2024; 15:1439939. [PMID: 39381074 PMCID: PMC11460301 DOI: 10.3389/fneur.2024.1439939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 08/21/2024] [Indexed: 10/10/2024] Open
Abstract
Background Resting-state functional magnetic resonance imaging (rs-fMRI) reveals diverse neural activity patterns in cervical spondylosis (CS) patients. However, the reported results are inconsistent. Therefore, our objective was to conduct a meta-analysis to synthesize the findings from existing rs-fMRI studies and identify consistent patterns of neural brain activity alterations in patients with CS. Materials and methods A systematic search was conducted across PubMed, Web of Knowledge, Embase, Google Scholar, and CNKI for rs-fMRI studies that compared CS patients with healthy controls (HCs), up to January 28, 2024. Significant cluster coordinates were extracted for comprehensive analysis. Results We included 16 studies involving 554 CS patients and 488 HCs. CS patients demonstrated decreased brain function in the right superior temporal gyrus and left postcentral gyrus, and increased function in the left superior frontal gyrus. Jackknife sensitivity analysis validated the robustness of these findings, and Egger's test confirmed the absence of significant publication bias (p > 0.05). Meta-regression showed no significant impact of age or disease duration differences on the results. Conclusion This meta-analysis confirms consistent alterations in specific brain regions in CS patients, highlighting the potential of rs-fMRI to refine diagnostic and therapeutic strategies. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42024496263.
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Affiliation(s)
- Qin Zhang
- Guizhou Second People’s Hospital, Guiyang, Guizhou, China
- Guizhou Provincial People’s Hospital, Guiyang, Guizhou Province, China
| | - Hui Ding
- Guizhou Second People’s Hospital, Guiyang, Guizhou, China
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Deng LR, Harmata GIS, Barsotti EJ, Williams AJ, Christensen GE, Voss MW, Saleem A, Rivera-Dompenciel AM, Richards JG, Sathyaputri L, Mani M, Abdolmotalleby H, Fiedorowicz JG, Xu J, Shaffer JJ, Wemmie JA, Magnotta VA. Machine learning with multiple modalities of brain magnetic resonance imaging data to identify the presence of bipolar disorder. J Affect Disord 2024:S0165-0327(24)01510-6. [PMID: 39278469 DOI: 10.1016/j.jad.2024.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 09/03/2024] [Accepted: 09/08/2024] [Indexed: 09/18/2024]
Abstract
BACKGROUND Bipolar disorder (BD) is a chronic psychiatric mood disorder that is solely diagnosed based on clinical symptoms. These symptoms often overlap with other psychiatric disorders. Efforts to use machine learning (ML) to create predictive models for BD based on data from brain imaging are expanding but have often been limited using only a single modality and the exclusion of the cerebellum, which may be relevant in BD. METHODS In this study, we sought to improve ML classification of BD by combining information from structural, functional, and diffusion-weighted imaging. Participants (108 BD I, 78 control) with BD type I and matched controls were recruited into an imaging study. This dataset was randomly divided into training and testing sets. For each of the three modalities, a separate ML model was selected, trained, and then used to generate a prediction of the class of each test subject. Majority voting was used to combine results from the three models to make a final prediction of whether a subject had BD. An independent replication sample was used to evaluate the ability of the ML classification to generalize to data collected at other sites. RESULTS Combining the three machine learning models through majority voting resulted in an accuracy of 89.5 % for classification of the test subjects as being in the BD or control group. Bootstrapping resulted in a 95 % confidence interval of 78.9 %-97.4 % for test accuracy. Performance was reduced when only using 2 of the 3 modalities. Analysis of feature importance revealed that the cerebellum and nodes of the emotional control network were among the most important regions for classification. The machine learning model performed at chance on the independent replication sample. CONCLUSION BD I could be identified with high accuracy in our relatively small sample by combining structural, functional, and diffusion-weighted imaging data within a single site but not generalize well to an independent replication sample. Future studies using harmonized imaging protocols may facilitate generalization of ML models.
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Affiliation(s)
- Lubin R Deng
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Gail I S Harmata
- Department of Radiology, University of Iowa, Iowa City, IA, USA; Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | | | | | - Gary E Christensen
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IA, USA
| | - Michelle W Voss
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Arshaq Saleem
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | | | | | | | - Merry Mani
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | | | | | - Jia Xu
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | - Joseph J Shaffer
- Department of Biosciences, Kansas City University, Kansas City, MO, USA
| | - John A Wemmie
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA; Department of Veterans Affairs Medical Center, 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.
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Mamah D, Patel A, Chen S, Wang Y, Wang Q. Diffusion Basis Spectrum Imaging of White Matter in Schizophrenia and Bipolar Disorder. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.07.602402. [PMID: 39005300 PMCID: PMC11245098 DOI: 10.1101/2024.07.07.602402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Background Multiple studies point to the role of neuroinflammation in the pathophysiology of schizophrenia (SCZ), however, there have been few in vivo tools for imaging brain inflammation. Diffusion basis spectrum imaging (DBSI) is an advanced diffusion-based MRI method developed to quantitatively assess microstructural alternations relating to neuroinflammation, axonal fiber, and other white matter (WM) pathologies. Methods We acquired one-hour-long high-directional diffusion MRI data from young control (CON, n = 27), schizophrenia (SCZ, n = 21), and bipolar disorder (BPD, n = 21) participants aged 18-30. We applied Tract-based Spatial Statistics (TBSS) to allow whole-brain WM analyses and compare DBSI-derived isotropic and anisotropic diffusion measures between groups. Clinical relationships of DBSI metrics with clinical symptoms were assessed across SCZ and control participants. Results In SCZ participants, we found a generalized increase in DBSI-derived cellularity (a putative marker of neuroinflammation), a decrease in restricted fiber fraction (a putative marker of apparent axonal density), and an increase in extra-axonal water (a putative marker of vasogenic edema) across several WM tracts. There were only minimal WM abnormalities noted in BPD, mainly in regions of the corpus callosum (increase in DTI-derived RD and extra-axonal water). DBSI metrics showed significant partial correlations with psychosis and mood symptoms across groups. Conclusion Our findings suggest that SCZ involves generalized white matter neuroinflammation, decreased fiber density, and demyelination, which is not seen in bipolar disorder. Larger studies are needed to identify medication-related effects. DBSI metrics could help identify high-risk groups requiring early interventions to prevent the onset of psychosis and improve outcomes.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Aakash Patel
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - ShingShiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Yong Wang
- Departments of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
- Department of Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
- Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, Missouri
- Mechanical Engineering and Materials Science, Washington University School of Medicine, St. Louis, Missouri
| | - Qing Wang
- Department of Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
- Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, Missouri
- Mechanical Engineering and Materials Science, Washington University School of Medicine, St. Louis, Missouri
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6
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Thiel K, Lemke H, Winter A, Flinkenflügel K, Waltemate L, Bonnekoh L, Grotegerd D, Dohm K, Hahn T, Förster K, Kanske P, Repple J, Opel N, Redlich R, David F, Forstner AJ, Stein F, Brosch K, Thomas-Odenthal F, Usemann P, Teutenberg L, Straube B, Alexander N, Jamalabadi H, Jansen A, Witt SH, Andlauer TFM, Pfennig A, Bauer M, Nenadić I, Kircher T, Meinert S, Dannlowski U. White and gray matter alterations in bipolar I and bipolar II disorder subtypes compared with healthy controls - exploring associations with disease course and polygenic risk. Neuropsychopharmacology 2024; 49:814-823. [PMID: 38332015 PMCID: PMC10948847 DOI: 10.1038/s41386-024-01812-7] [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] [Received: 10/19/2023] [Revised: 12/28/2023] [Accepted: 01/21/2024] [Indexed: 02/10/2024]
Abstract
Patients with bipolar disorder (BD) show alterations in both gray matter volume (GMV) and white matter (WM) integrity compared with healthy controls (HC). However, it remains unclear whether the phenotypically distinct BD subtypes (BD-I and BD-II) also exhibit brain structural differences. This study investigated GMV and WM differences between HC, BD-I, and BD-II, along with clinical and genetic associations. N = 73 BD-I, n = 63 BD-II patients and n = 136 matched HC were included. Using voxel-based morphometry and tract-based spatial statistics, main effects of group in GMV and fractional anisotropy (FA) were analyzed. Associations between clinical and genetic features and GMV or FA were calculated using regression models. For FA but not GMV, we found significant differences between groups. BD-I patients showed lower FA compared with BD-II patients (ptfce-FWE = 0.006), primarily in the anterior corpus callosum. Compared with HC, BD-I patients exhibited lower FA in widespread clusters (ptfce-FWE < 0.001), including almost all major projection, association, and commissural fiber tracts. BD-II patients also demonstrated lower FA compared with HC, although less pronounced (ptfce-FWE = 0.049). The results remained unchanged after controlling for clinical and genetic features, for which no independent associations with FA or GMV emerged. Our findings suggest that, at a neurobiological level, BD subtypes may reflect distinct degrees of disease expression, with increasing WM microstructure disruption from BD-II to BD-I. This differential magnitude of microstructural alterations was not clearly linked to clinical and genetic variables. These findings should be considered when discussing the classification of BD subtypes within the spectrum of affective disorders.
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Affiliation(s)
- Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Kira Flinkenflügel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lena Waltemate
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Translational Psychotherapy, Institute of Psychology, University of Göttingen, Göttingen, Germany
| | - Linda Bonnekoh
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Förster
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
- Department of Psychology, University of Halle, Halle, Germany
- Center for Intervention and Research on adaptive and maladaptive brain circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Halle, Germany
| | - Friederike David
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Florian Thomas-Odenthal
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Paula Usemann
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Lea Teutenberg
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Nina Alexander
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Hamidreza Jamalabadi
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
- Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Stephanie H Witt
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Till F M Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, TU Dresden University of Technology, Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, TU Dresden University of Technology, Dresden, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute of Translational Neuroscience, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.
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Escelsior A, Inuggi A, Sterlini B, Bovio A, Marenco G, Bode J, Favilla L, Tardito S, Altosole T, Pereira da Silva B, Fenoglio D, Filaci G, Amore M, Serafini G. T-cell immunophenotype correlations with cortical thickness and white matter microstructure in bipolar disorder. J Affect Disord 2024; 348:179-190. [PMID: 38154587 DOI: 10.1016/j.jad.2023.12.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/20/2023] [Accepted: 12/23/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Inflammation and immunological alterations, such as T-cell and cytokine changes, are implicated in bipolar disorder (BD), with some evidence linking them to brain structural changes (e.g., cortical thickness (CT), gray matter (GM) volume and white matter (WM) microstructure). However, the connection between specific peripheral cell types, such as T-cells, and neuroimaging in BD remains scarcely investigated. AIMS OF THE STUDY This study aims to explore the link between T-cell immunophenotype and neuroradiological findings in BD. METHODS Our study investigated 43 type I BD subjects (22 depressive, 21 manic) and 26 healthy controls (HC), analyzing T lymphocyte immunophenotype and employing neuroimaging to assess CT for GM and fractional anisotropy (FA) for WM. RESULTS In lymphocyte populations, BD patients exhibited elevated CD4+ and CD4+ central memory (TCM) cells frequencies, but lower CD8+ effector memory (TEM) and terminal effector memory (TTEM) cells. Neuroimaging analysis revealed reduced CT in multiple brain regions in BD patients; and significant negative correlations between CD4 + TCM levels and CT of precuneus and fusiform gyrus. Tract-based spatial statistics (TBSS) analysis showed widespread alteration in WM microstructure in BD patients, with negative and positive correlations respectively between FA and radial diffusivity (RD) and CD4 + TCM. Additionally, positive and negative correlations were found respectively between FA and RD and the CD8 + TEM and CD8 + TTEM subsets. CONCLUSIONS Our research revealed distinct T lymphocyte changes and brain structure alterations in BD, underscoring possible immune-brain interactions, warranting further study and therapeutic exploration.
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Affiliation(s)
- Andrea Escelsior
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
| | - Alberto Inuggi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
| | - Bruno Sterlini
- Department of Experimental Medicine, University of Genoa, Genoa, Italy; Center for Synaptic Neuroscience and Technology, Istituto Italiano di Tecnologia, Genoa, Italy.
| | - Anna Bovio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Giacomo Marenco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Juxhin Bode
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Luca Favilla
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Samuele Tardito
- Center for Cancer & Immunology Research, Children's National Hospital, 111 Michigan Ave NW (5th floor), Washington, DC 20010, United States of America.
| | | | - Beatriz Pereira da Silva
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Daniela Fenoglio
- Centre of Excellence for Biomedical Research and Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; Biotherapy Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy.
| | - Gilberto Filaci
- Centre of Excellence for Biomedical Research and Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy; Biotherapy Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy.
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
| | - Gianluca Serafini
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
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Mamah D, Chen S, Shimony JS, Harms MP. Tract-based analyses of white matter in schizophrenia, bipolar disorder, aging, and dementia using high spatial and directional resolution diffusion imaging: a pilot study. Front Psychiatry 2024; 15:1240502. [PMID: 38362028 PMCID: PMC10867155 DOI: 10.3389/fpsyt.2024.1240502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction Structural brain connectivity abnormalities have been associated with several psychiatric disorders. Schizophrenia (SCZ) is a chronic disabling disorder associated with accelerated aging and increased risk of dementia, though brain findings in the disorder have rarely been directly compared to those that occur with aging. Methods We used an automated approach to reconstruct key white matter tracts and assessed tract integrity in five participant groups. We acquired one-hour-long high-directional diffusion MRI data from young control (CON, n =28), bipolar disorder (BPD, n =21), and SCZ (n =22) participants aged 18-30, and healthy elderly (ELD, n =15) and dementia (DEM, n =9) participants. Volume, fractional (FA), radial diffusivity (RD) and axial diffusivity (AD) of seven key white matter tracts (anterior thalamic radiation, ATR; dorsal and ventral cingulum bundle, CBD and CBV; corticospinal tract, CST; and the three superior longitudinal fasciculi: SLF-1, SLF-2 and SLF-3) were analyzed with TRACULA. Group comparisons in tract metrics were performed using multivariate and univariate analyses. Clinical relationships of tract metrics with recent and chronic symptoms were assessed in SCZ and BPD participants. Results A MANOVA showed group differences in FA (λ=0.5; p=0.0002) and RD (λ=0.35; p<0.0001) across the seven tracts, but no significant differences in tract AD and volume. Post-hoc analyses indicated lower tract FA and higher RD in ELD and DEM groups compared to CON, BPD and SCZ groups. Lower FA and higher RD in SCZ compared to CON did not meet statistical significance. In SCZ participants, a significant negative correlation was found between chronic psychosis severity and FA in the SLF-1 (r= -0.45; p=0.035), SLF-2 (r= -0.49; p=0.02) and SLF-3 (r= -0.44; p=0.042). Discussion Our results indicate impaired white matter tract integrity in elderly populations consistent with myelin damage. Impaired tract integrity in SCZ is most prominent in patients with advanced illness.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - ShingShiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Joshua S. Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Michael P. Harms
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
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9
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Squarcina L, Lucini Paioni S, Bellani M, Rossetti MG, Houenou J, Polosan M, Phillips ML, Wessa M, Brambilla P. White matter integrity in bipolar disorder investigated with diffusion tensor magnetic resonance imaging and fractal geometry. J Affect Disord 2024; 345:200-207. [PMID: 37863367 DOI: 10.1016/j.jad.2023.10.095] [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: 09/05/2022] [Revised: 09/14/2023] [Accepted: 10/15/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Growing evidence suggests the presence of white matter (WM) alterations in bipolar disorder (BD). In this study we aimed to investigate the state of WM structures, in terms of tissue integrity and morphological complexity, in BD patients compared to healthy controls (HC), in an attempt to better elucidate the microstructural changes associated with BD. METHODS We collected a dataset of 399 Diffusion Tensor Magnetic Resonance Imaging (167 BD and 232 healthy controls) images, acquired at five different sites, which was processed with Tract-Based Spatial Statistics (TBSS) and fractal analysis. RESULTS The TBSS analysis demonstrated significantly lower FA values in the BD group. Diffusion abnormalities were primarily located in the temporo-parietal network. The Fractal Dimension (FD) analysis did not reveal consistent significant differences in the morphological complexity of WM structures between the groups. When the FD values of patients were considered individually, it is possible to notice some localized significant deviations from the healthy population. LIMITATIONS DTI sequences have not been harmonized before acquisition, samples' sizes are heterogeneous. CONCLUSIONS This study, by applying both TBSS and FD analyses, allows to evaluate diffusion and structural alterations of WM at the same time. The evaluation of WM integrity from these two different perspectives could be useful to better understand the pathophysiological and morphological changes underpinning bipolar disorder.
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Affiliation(s)
- Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Susanna Lucini Paioni
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Marcella Bellani
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - Maria Gloria Rossetti
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy; UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy
| | - Josselin Houenou
- APHP, Mondor Univ Hospitals, DMU IMPACT, INSERM U955, Translational NeuroPsychiatry Team, UPEC, Créteil, France & NeuroSpin, UNIACT Lab, PsyBrain Team, CEA Saclay, Gif-sur-Yvette, France
| | - Mircea Polosan
- Univ. Grenoble-Alpes, Grenoble Institut Neurosciences, Inserm U1216, CHU Grenoble Alpes, France
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America
| | - Michèle Wessa
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy.
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10
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Caruana GF, Carruthers SP, Berk M, Rossell SL, Van Rheenen TE. To what extent does white matter map to cognition in bipolar disorder? A systematic review of the evidence. Prog Neuropsychopharmacol Biol Psychiatry 2024; 128:110868. [PMID: 37797735 DOI: 10.1016/j.pnpbp.2023.110868] [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: 08/17/2023] [Revised: 09/19/2023] [Accepted: 10/01/2023] [Indexed: 10/07/2023]
Abstract
Cognitive impairment is a prominent feature of bipolar disorder (BD), however the neural substrates underpinning it remain unclear. Several studies have explored white matter as a correlate of cognitive functioning in BD cohorts, but mixed results and varied methodologies from one to another make inferences about this relationship difficult to draw. Here we sought to systematically synthesise the findings of these studies to more clearly explicate the nature and extent of relationships between white matter and cognition in BD and determine best practice methodologies and areas for future research in this area. Using PRISMA guidelines, we identified and systematically reviewed 37 relevant studies, all of which were cross-sectional by design. There was substantial methodological heterogeneity and variability in the clinical presentations of BD cohorts encapsulated within the studies we reviewed, which complicated our synthesis of the findings. Nonetheless, there was some evidence that cognition is related to both white matter macrostructure and microstructure in people with BD. In particular, multiple microstructural studies consistently reported that higher fractional anisotropy, both globally and in the corpus callosum, associated with better complex attention skills and executive functioning. However, several reports did not identify any associations at all, and in general, associations between WM and cognition tended to only be evident in studies utilising larger samples and post-hoc selection of WM regions of interest. Further research with increased statistical power and standardised methods are required moving forward.
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Affiliation(s)
- Georgia F Caruana
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria 3053, Australia
| | - Sean P Carruthers
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Victoria 3122, Australia
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong 3220, Australia; Centre for Youth Mental Health and Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Victoria 3052, Australia; Barwon Health, University Hospital Geelong, Victoria 3220, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Victoria 3052, Australia
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Victoria 3122, Australia; St Vincent's Mental Health, St Vincent's Hospital, VIC, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria 3053, Australia; Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Victoria 3122, Australia; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong 3220, Australia.
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11
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Singh A, Pandey HR, Arya A, Agarwal V, Shree R, Kumar U. Altered white matter integrity in euthymic children with bipolar disorder: A tract-based spatial statistical analysis of diffusion tensor imaging. J Affect Disord 2023; 340:820-827. [PMID: 37597779 DOI: 10.1016/j.jad.2023.08.066] [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: 03/28/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 08/21/2023]
Abstract
Pediatric Bipolar Disorder (BD) is a serious mental illness that affects children and adolescents, characterized by episodes of mania, depression, and mixed episodes. Recent studies have suggested that abnormalities in the white matter (WM) may be a contributing factor. The neuropathogenesis of BD in children is not well-described, and research in this area is limited. Euthymic phase is a period in which clinical symptoms are present but not severe enough to significantly impact mood and daily behavior. In order to better understand the WM changes associated with BD in children, this study utilized Diffusion Tensor Imaging (DTI), to investigate alterations in WM microstructure. 20 confirmed euthymic BD children (aged 7-16) and 20 typically developing children were included in the study. DTI scans were obtained using a 3 T Magnetom Skyra and were analyzed using tract-based spatial statistics (TBSS) to examine changes in fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD). Results showed that compared to the healthy control group, the euthymic BD group exhibited increased FA, AD, RD, and MD values in several brain regions, including the thalamus, precentral corticospinal tract, and superior longitudinal fasciculus. Conversely, decreased values were observed in the body of the corpus callosum and inferior fronto-occipital fasciculus. These findings suggest that alterations in WM microstructure are a hallmark of pediatric bipolar disorder. These findings provide important insights into the brain changes associated with pediatric bipolar disorder and open the door for new avenues of research.
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Affiliation(s)
- Anshita Singh
- Centre of Bio-Medical Research, Sanjay Gandhi Postgraduate Institute of Medical Sciences Campus, Lucknow, India; Department of Information Technology, Babasaheb Bhimrao Ambedkar University, Lucknow, India
| | - Himanshu R Pandey
- Centre of Bio-Medical Research, Sanjay Gandhi Postgraduate Institute of Medical Sciences Campus, Lucknow, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Amit Arya
- Department of Psychiatry, King George Medical University, Lucknow, India
| | - Vivek Agarwal
- Department of Psychiatry, King George Medical University, Lucknow, India
| | - Raj Shree
- Department of Information Technology, Babasaheb Bhimrao Ambedkar University, Lucknow, India
| | - Uttam Kumar
- Centre of Bio-Medical Research, Sanjay Gandhi Postgraduate Institute of Medical Sciences Campus, Lucknow, India.
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12
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Nabulsi L, Chandio BQ, McPhilemy G, Martyn FM, Roberts G, Hallahan B, Dannlowski U, Kircher T, Haarman B, Mitchell P, McDonald C, Cannon DM, Andreassen OA, Ching CRK, Thompson PM. Multi-Site Statistical Mapping of Along-Tract Microstructural Abnormalities in Bipolar Disorder with Diffusion MRI Tractometry. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.17.553762. [PMID: 37662230 PMCID: PMC10473593 DOI: 10.1101/2023.08.17.553762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Investigating alterations in brain circuitry associated with bipolar disorder (BD) may offer a valuable approach to discover brain biomarkers for genetic and interventional studies of the disorder and related mental illnesses. Some diffusion MRI studies report evidence of microstructural abnormalities in white matter regions of interest, but we lack a fine-scale spatial mapping of brain microstructural differences along tracts in BD. We also lack large-scale studies that integrate tractometry data from multiple sites, as larger datasets can greatly enhance power to detect subtle effects and assess whether effects replicate across larger international datasets. In this multisite diffusion MRI study, we used BUndle ANalytics (BUAN, Chandio 2020), a recently developed analytic approach for tractography, to extract, map, and visualize profiles of microstructural abnormalities on 3D models of fiber tracts in 148 participants with BD and 259 healthy controls from 6 independent scan sites. Modeling site differences as random effects, we investigated along-tract white matter (WM) microstructural differences between diagnostic groups. QQ plots showed that group differences were gradually enhanced as more sites were added. Using the BUAN pipeline, BD was associated with lower mean fractional anisotropy (FA) in fronto-limbic, interhemispheric, and posterior pathways; higher FA was also noted in posterior bundles, relative to controls. By integrating tractography and anatomical information, BUAN effectively captures unique effects along white matter (WM) tracts, providing valuable insights into anatomical variations that may assist in the classification of diseases.
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Affiliation(s)
- Leila Nabulsi
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, CA 90292, USA
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, H91 TK33 Galway, Ireland
| | - Bramsh Q Chandio
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, CA 90292, USA
| | - Genevieve McPhilemy
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, H91 TK33 Galway, Ireland
| | - Fiona M Martyn
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, H91 TK33 Galway, Ireland
| | - Gloria Roberts
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Brian Hallahan
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, H91 TK33 Galway, Ireland
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Benno Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Philip Mitchell
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, H91 TK33 Galway, Ireland
| | - Dara M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, H91 TK33 Galway, Ireland
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christopher R K Ching
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, CA 90292, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, CA 90292, USA
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13
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Thiel K, Meinert S, Winter A, Lemke H, Waltemate L, Breuer F, Gruber M, Leenings R, Wüste L, Rüb K, Pfarr JK, Stein F, Brosch K, Meller T, Ringwald KG, Nenadić I, Krug A, Repple J, Opel N, Koch K, Leehr EJ, Bauer J, Grotegerd D, Hahn T, Kircher T, Dannlowski U. Reduced fractional anisotropy in bipolar disorder v. major depressive disorder independent of current symptoms. Psychol Med 2023; 53:4592-4602. [PMID: 35833369 PMCID: PMC10388324 DOI: 10.1017/s0033291722001490] [Citation(s) in RCA: 3] [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: 02/21/2022] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Patients with bipolar disorder (BD) show reduced fractional anisotropy (FA) compared to patients with major depressive disorder (MDD). Little is known about whether these differences are mood state-independent or influenced by acute symptom severity. Therefore, the aim of this study was (1) to replicate abnormalities in white matter microstructure in BD v. MDD and (2) to investigate whether these vary across depressed, euthymic, and manic mood. METHODS In this cross-sectional diffusion tensor imaging study, n = 136 patients with BD were compared to age- and sex-matched MDD patients and healthy controls (HC) (n = 136 each). Differences in FA were investigated using tract-based spatial statistics. Using interaction models, the influence of acute symptom severity and mood state on the differences between patient groups were tested. RESULTS Analyses revealed a main effect of diagnosis on FA across all three groups (ptfce-FWE = 0.003). BD patients showed reduced FA compared to both MDD (ptfce-FWE = 0.005) and HC (ptfce-FWE < 0.001) in large bilateral clusters. These consisted of several white matter tracts previously described in the literature, including commissural, association, and projection tracts. There were no significant interaction effects between diagnosis and symptom severity or mood state (all ptfce-FWE > 0.704). CONCLUSIONS Results indicated that the difference between BD and MDD was independent of depressive and manic symptom severity and mood state. Disruptions in white matter microstructure in BD might be a trait effect of the disorder. The potential of FA values to be used as a biomarker to differentiate BD from MDD should be further addressed in future studies using longitudinal designs.
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Affiliation(s)
- Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute of Translational Neuroscience, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lena Waltemate
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Fabian Breuer
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ramona Leenings
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lucia Wüste
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Kathrin Rüb
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | | | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Kai Gustav Ringwald
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Koch
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Elisabeth J. Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jochen Bauer
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
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14
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Nabulsi L, Chandio BQ, Dhinagar N, Laltoo E, McPhilemy G, Martyn FM, Hallahan B, McDonald C, Thompson PM, Cannon DM. Along-Tract Statistical Mapping of Microstructural Abnormalities in Bipolar Disorder: A Pilot Study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-7. [PMID: 38083303 DOI: 10.1109/embc40787.2023.10339964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Investigating brain circuitry involved in bipolar disorder (BD) is key to discovering brain biomarkers for genetic and interventional studies of the disorder. Even so, prior research has not provided a fine-scale spatial mapping of brain microstructural differences in BD. In this pilot diffusion MRI dataset, we used BUndle ANalytics (BUAN)-a recently developed analytic approach for tractography-to extract, map, and visualize the profile of microstructural abnormalities on a 3D model of fiber tracts in people with BD (N=38) and healthy controls (N=49), and investigate along-tract white matter (WM) microstructural differences between these groups. Using the BUAN pipeline, BD was associated with lower mean fractional anisotropy (FA) in fronto-limbic and interhemispheric pathways and higher mean FA in posterior bundles relative to controls.Clinical Relevance- BUAN combines tractography and anatomical information to capture distinct along-tract effects on WM microstructure that may aid in classifying diseases based on anatomical differences.
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15
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Yang J, Tao H, Sun F, Fan Z, Yang J, Liu Z, Xue Z, Chen X. The anatomical networks based on probabilistic structurally connectivity in bipolar disorder across mania, depression, and euthymic states. J Affect Disord 2023; 329:42-49. [PMID: 36842653 DOI: 10.1016/j.jad.2023.02.109] [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: 04/10/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUNDS There have pieces of evidence of the distinct aberrant functional network topology profile in bipolar disorder (BD) across mania, depression, and euthymic episodes. However, the underlying anatomical network topology pattern in BD across different episodes is unclear. METHODS We calculated the whole-brain probabilistic structurally connectivity across 143 subjects (72 with BD [34 depression; 13 mania; 25 euthymic] and 53 healthy controls), and used graph theory to examine the trait- and state-related topology alterations of the structural connectome in BD. The correlation analysis was further conducted to explore the relationship between detected network measures and clinical symptoms. RESULTS There no omnibus alteration of any global network metrics were observed across all diagnostic groups. In the regional network metrics level, bipolar depression showed increased clustering coefficient in the right lingual gyrus compared with all other groups, and the increased clustering coefficient in the right lingual gyrus positively correlated with depression, anxiety, and illness burden symptoms but negatively correlated with mania symptoms; manic and euthymic patients showed decreased clustering coefficient in the left inferior occipital gyrus compared with HCs. LIMITATIONS The moderate sample size of all patient groups (especially for subjects with mania) might have contributed to the negative findings of the trait feature in this study. CONCLUSIONS We demonstrated the altered regional connectivity pattern in the occipital lobe of the bipolar depression and mania episode, especially the lingual gyrus. The association of the clustering coefficient in the lingual gyrus with clinical symptoms helps monitor the state of BD.
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Affiliation(s)
- Jie Yang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Haojuan Tao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Fuping Sun
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Zebin Fan
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jun Yang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Zhening Liu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Zhimin Xue
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xudong Chen
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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16
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Nabulsi L, Chandio BQ, Dhinagar N, Laltoo E, McPhilemy G, Martyn FM, Hallahan B, McDonald C, Thompson PM, Cannon DM. Along-Tract Statistical Mapping of Microstructural Abnormalities in Bipolar Disorder: A Pilot Study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.07.531585. [PMID: 36945403 PMCID: PMC10028925 DOI: 10.1101/2023.03.07.531585] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Investigating brain circuitry involved in bipolar disorder (BD) is key to discovering brain biomarkers for genetic and interventional studies of the disorder. Even so, prior research has not provided a fine-scale spatial mapping of brain microstructural differences in BD. In this pilot diffusion MRI dataset, we used BUndle ANalytics (BUAN), a recently developed analytic approach for tractography, to extract, map, and visualize the profile of microstructural abnormalities on a 3D model of fiber tracts in people with BD (N=38) and healthy controls (N=49), and investigate along-tract white matter (WM) microstructural differences between these groups. Using the BUAN pipeline, BD was associated with lower mean Fractional Anisotropy (FA) in fronto-limbic and interhemispheric pathways and higher mean FA in posterior bundles relative to controls. BUAN combines tractography and anatomical information to capture distinct along-tract effects on WM microstructure that may aid in classifying diseases based on anatomical differences.
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Affiliation(s)
- Leila Nabulsi
- Imaging Genetics Center, Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, 90292 USA
| | - Bramsh Q Chandio
- Imaging Genetics Center, Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, 90292 USA
| | - Nikhil Dhinagar
- Imaging Genetics Center, Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, 90292 USA
| | - Emily Laltoo
- Imaging Genetics Center, Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, 90292 USA
| | - Genevieve McPhilemy
- Clinical Neuroimaging Lab, Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, University of Galway, Galway, Ireland
| | - Fiona M Martyn
- Clinical Neuroimaging Lab, Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, University of Galway, Galway, Ireland
| | - Brian Hallahan
- Clinical Neuroimaging Lab, Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, University of Galway, Galway, Ireland
| | - Colm McDonald
- Clinical Neuroimaging Lab, Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, University of Galway, Galway, Ireland
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, 90292 USA
| | - Dara M Cannon
- Clinical Neuroimaging Lab, Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, University of Galway, Galway, Ireland
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17
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Tseng HH, Hsu CF, Lu TH, Yang YK, Chen PS, Lin PT, Chang YPE, Weng JC. Disrupted white matter network of brain structural connectomes in bipolar disorder patients revealed by q-ball imaging. J Affect Disord 2023; 330:239-244. [PMID: 36870453 DOI: 10.1016/j.jad.2023.02.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Structural and functional brain changes have been found to be associated with altered emotion and cognition in patients with bipolar disorder (BD). Widespread microstructural white matter abnormalities have been observed using traditional structural imaging in BD. q-Ball imaging (QBI) and graph theoretical analysis (GTA) improve the specificity and sensitivity and high accuracy of fiber tracking. We applied QBI and GTA to investigate and compare the structural connectivity alterations and network alterations in patients with and without BD. METHODS Sixty-two patients with BD and 62 healthy controls (HCs) completed a MR scan. We evaluated the group differences in generalized fractional anisotropy (GFA) and normalized quantitative anisotropy (NQA) values by voxel-based statistical analysis with QBI. We also evaluated the group differences in topological parameters of GTA and subnetwork interconnections in network-based statistical analysis (NBS). RESULTS The QBI indices in the BD group were significantly lower than those in the HC group in the corpus callosum, cingulate gyrus, and caudate. The GTA indices indicated that the BD group demonstrated less global integration and higher local segregation than the HC group, but they retained small-world properties. NBS evaluation showed that the majority of the more connected subnetworks in BD occurred in thalamo-temporal/parietal connectivity. CONCLUSION Our findings supported white matter integrity with network alterations in BD.
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Affiliation(s)
- Huai-Hsuan Tseng
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Fen Hsu
- Division of Clinical Psychology, Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Tsung-Hua Lu
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Po See Chen
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Pei-Ti Lin
- Department of Medical Imaging and Radiological Sciences and Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Peng Eve Chang
- Department of Counseling and Clinical Psychology, Columbia University, New York City, NY, USA
| | - Jun-Cheng Weng
- Department of Medical Imaging and Radiological Sciences and Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan; Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan.
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18
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Tao Q, Dang J, Niu X, Gao X, Zhang M, Yang Z, Xu Y, Yu M, Cheng J, Han S, Zhang Y. White matter microstructural abnormalities and gray matter volume alterations in obsessive-compulsive disorder: A coordinate-based meta-analysis. J Affect Disord 2023; 320:751-761. [PMID: 36174788 DOI: 10.1016/j.jad.2022.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/10/2022] [Accepted: 09/15/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE A comprehensive meta-analysis using correlated coordinate data to explore abnormalities in white matter (WM) microarchitecture and changes in gray matter volume (GMV) in patients with obsessive-compulsive disorder (OCD). METHODS We reviewed 23 reported studies of diffusion tensor imaging (DTI) in OCD patients. The differences in WM fractional anisotropy (FA) between OCD patients and healthy controls (HCs) were investigated using tract-based spatial statistics (TBSS) and voxel-based analysis (VBA), respectively, and the results of the two methods were compared. In addition, we will explore changes in OCD GMV by analyzing studies (n = 21) using the voxel-based morphometry (VBM) approach and comparing the difference between adults and adolescents. RESULTS In the pooled meta-analysis, WM study results presented that compared with HCs, OCD patients had higher FA in right lenticular nucleus (putamen), and lower FA in corpus callosum (CC), left insula, right cerebellum (hemispheric lobule), right gyrus rectal and left inferior parietal gyri. However, in subgroup analysis, there was a significant difference in FA changes between TBSS and VBA in OCD patients compared with HCs. In addition, we found that the GMV of OCD patients was significantly increased in left striatum and left precentral gyrus, and significantly decreased in right inferior frontal gyrus triangular part, right superior temporal gyrus and right hippocampus. Compared with adolescents, adult patients have increased GMV in left lenticular nucleus putamen. CONCLUSION The meta-analysis showed that OCD patients had abnormal WM microarchitecture and altered GMV. These changes may be closely related to the pathophysiological mechanism of the disease.
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Affiliation(s)
- Qiuying Tao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China; Engineering Technology Research Center for Detection and application of Brain Function of Henan Province, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China
| | - Jinghan Dang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China; Engineering Technology Research Center for Detection and application of Brain Function of Henan Province, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China
| | - Xiaoyu Niu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China; Engineering Technology Research Center for Detection and application of Brain Function of Henan Province, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China
| | - Xinyu Gao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China; Engineering Technology Research Center for Detection and application of Brain Function of Henan Province, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China
| | - Mengzhe Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China; Engineering Technology Research Center for Detection and application of Brain Function of Henan Province, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China
| | - Zhengui Yang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China; Engineering Technology Research Center for Detection and application of Brain Function of Henan Province, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China
| | - Yinhuan Xu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China; Engineering Technology Research Center for Detection and application of Brain Function of Henan Province, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China
| | - Miaomiao Yu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China; Engineering Technology Research Center for Detection and application of Brain Function of Henan Province, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China; Engineering Technology Research Center for Detection and application of Brain Function of Henan Province, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China.
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China; Engineering Technology Research Center for Detection and application of Brain Function of Henan Province, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China.
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China; Engineering Technology Research Center for Detection and application of Brain Function of Henan Province, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China
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Zou Y, Grigorian A, Kennedy KG, Zai CC, Shao S, Kennedy JL, Andreazza AC, Ameis SH, Heyn C, Maclntosh BJ, Goldstein BI. Differential association of antioxidative defense genes with white matter integrity in youth bipolar disorder. Transl Psychiatry 2022; 12:504. [PMID: 36476443 PMCID: PMC9729619 DOI: 10.1038/s41398-022-02261-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 11/03/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Oxidative stress is associated with white matter diffusion metrics in adults with bipolar disorder (BD). We examined the association of single-nucleotide polymorphisms in the oxidative stress system, superoxide dismutase-2 (SOD2) rs4880 and glutathione peroxidase-3 (GPX3) rs3792797 with fractional anisotropy (FA) and radial diffusivity (RD) in youth with BD. Participants included 104 youth (age 17.5 ± 1.7 years; 58 BD, 46 healthy controls). Saliva samples were obtained for genotyping, and diffusion tensor imaging was acquired. Voxel-wise whole-brain white matter diffusion analyses controlled for age, sex, and race. There were significant diagnosis-by-SOD2 rs4880 interaction effects for FA and RD in major white matter tracts. Within BD, the group with two copies of the G-allele (GG) showed lower FA and higher RD than A-allele carriers. Whereas within the control group, the GG group showed higher FA and lower RD than A-allele carriers. Additionally, FA was higher and RD was lower within the control GG group compared to the BD GG group. No significant findings were observed for GPX3 rs3793797. The current study revealed that, within matter tracts known to differ in BD, associations of SOD2 rs4880 GG genotype with both FA and RD differed between BD vs healthy control youth. The SOD2 enzyme encoded by the G-allele, has higher antioxidant capacity than the enzyme encoded by the A-allele. We speculate that the current findings of lower FA and higher RD of the BD GG group compared to the other groups reflects attenuation of the salutary antioxidant effects of GG genotype on white matter integrity in youth with BD, in part due to predisposition to oxidative stress. Future studies incorporating other genetic markers and oxidative stress biomarkers are warranted.
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Affiliation(s)
- Yi Zou
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Anahit Grigorian
- grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Kody G. Kennedy
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Clement C. Zai
- grid.155956.b0000 0000 8793 5925Psychiatric Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Suyi Shao
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - James L. Kennedy
- grid.155956.b0000 0000 8793 5925Psychiatric Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Ana C. Andreazza
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Stephanie H. Ameis
- grid.155956.b0000 0000 8793 5925Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Department of Psychiatry, The Hospital for Sick Children, Toronto, ON Canada
| | - Chinthaka Heyn
- grid.413104.30000 0000 9743 1587Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON Canada
| | - Bradley J. Maclntosh
- grid.17063.330000 0001 2157 2938Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Medical Biophysics, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada
| | - Benjamin I. Goldstein
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
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20
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Investigation of endophenotype potential of decreased fractional anisotropy in pediatric bipolar disorder patients and unrelated offspring of bipolar disorder patients. CNS Spectr 2022; 27:709-715. [PMID: 34044907 DOI: 10.1017/s1092852921000584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Bipolar disorder (BD) is a severe psychiatric disorder associated with structural and functional brain abnormalities, some of which have been found in unaffected relatives as well. In this study, we examined the potential role of decreased fractional anisotropy (FA) as a BD endophenotype, in adolescents at high risk for BD. METHODS We included 15 offspring of patients with BD, 16 pediatric BD patients, and 16 matched controls. Diffusion weighted scans were obtained on a 3T scanner using an echo-planar sequence. Scans were segmented using FreeSurfer. RESULTS Our results showed significantly decreased FA in six brain areas of offspring group; left superior temporal gyrus (LSTG; P < .0001), left transverse temporal gyrus (LTTG; P = .002), left banks of the superior temporal sulcus (LBSTS; P = .002), left anterior cingulum (LAC; P = .003), right temporal pole (RTP; P = .004) and left frontal pole (LFP; P = .017). On analysis, LSTG, LAC, and RTP demonstrated a potential to be an endophenotype when comparing all three groups. FA values in three regions, LBSTS, LTTG, and LFP were increased only in controls. CONCLUSION Our findings point at decreased FA as a possible endophenotype for BD, as they were found in children of patients with BD. Most of these areas were previously found to have morphological and functional changes in adult and pediatric BD, and are thought to play important roles in affected domains of functioning. Prospective follow up studies should be performed to detect reliability of decreased FA as an endophenotype and effects of treatment on FA.
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21
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Ikeda N, Yamada S, Yasuda K, Uenishi S, Tamaki A, Ishida T, Tabata M, Tsuji T, Kimoto S, Takahashi S. Structural connectivity between the hippocampus and cortical/subcortical area relates to cognitive impairment in schizophrenia but not in mood disorders. J Neuropsychol 2022. [DOI: 10.1111/jnp.12298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 08/10/2022] [Accepted: 09/11/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Natsuko Ikeda
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
- Department of Psychiatry Wakayama Prefectural Mental Health Care Center Wakayama Japan
| | - Shinichi Yamada
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
| | - Kasumi Yasuda
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
| | - Shinya Uenishi
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
- Department of Psychiatry Hidaka Hospital Gobo Japan
| | - Atsushi Tamaki
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
- Department of Psychiatry Hidaka Hospital Gobo Japan
| | - Takuya Ishida
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
| | - Michiyo Tabata
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
| | - Tomikimi Tsuji
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
| | - Sohei Kimoto
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
| | - Shun Takahashi
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
- Clinical Research and Education Center Asakayama General Hospital Sakai Japan
- Graduate School of Rehabilitation Science Osaka Metropolitan University Habikino Japan
- Department of Psychiatry Osaka University Graduate School of Medicine Suita Japan
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22
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Lorkiewicz P, Waszkiewicz N. Is SARS-CoV-2 a Risk Factor of Bipolar Disorder?-A Narrative Review. J Clin Med 2022; 11:6060. [PMID: 36294388 PMCID: PMC9604904 DOI: 10.3390/jcm11206060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
For 2.5 years we have been facing the coronavirus disease (COVID-19) and its health, social and economic effects. One of its known consequences is the development of neuropsychiatric diseases such as anxiety and depression. However, reports of manic episodes related to COVID-19 have emerged. Mania is an integral part of the debilitating illness-bipolar disorder (BD). Due to its devastating effects, it is therefore important to establish whether SARS-CoV-2 infection is a causative agent of this severe mental disorder. In this narrative review, we discuss the similarities between the disorders caused by SARS-CoV-2 and those found in patients with BD, and we also try to answer the question of whether SARS-CoV-2 infection may be a risk factor for the development of this affective disorder. Our observation shows that disorders in COVID-19 showing the greatest similarity to those in BD are cytokine disorders, tryptophan metabolism, sleep disorders and structural changes in the central nervous system (CNS). These changes, especially intensified in severe infections, may be a trigger for the development of BD in particularly vulnerable people, e.g., with family history, or cause an acute episode in patients with a pre-existing BD.
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Affiliation(s)
- Piotr Lorkiewicz
- Department of Psychiatry, Medical University of Bialystok, Wołodyjowskiego 2, 15-272 Białystok, Poland
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Rajashekar N, Blumberg HP, Villa LM. Neuroimaging Studies of Brain Structure in Older Adults with Bipolar Disorder: A Review. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2022; 7:e220006. [PMID: 36092855 PMCID: PMC9453888 DOI: 10.20900/jpbs.20220006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Bipolar disorder (BD) is a common mood disorder that can have severe consequences during later life, including suffering and impairment due to mood and cognitive symptoms, elevated risk for dementia and an especially high risk for suicide. Greater understanding of the brain circuitry differences involved in older adults with BD (OABD) in later life and their relationship to aging processes is required to improve outcomes of OABD. The current literature on gray and white matter findings, from high resolution structural and diffusion-weighted magnetic resonance imaging (MRI) studies, has shown that BD in younger age groups is associated with gray matter reductions within cortical and subcortical brain regions that subserve emotion processing and regulation, as well as reduced structural integrity of white matter tracts connecting these brain regions. While fewer neuroimaging studies have focused on OABD, it does appear that many of the structural brain differences found in younger samples are present in OABD. There is also initial suggestion that there are additional brain differences, for at least a subset of OABD, that may result from more pronounced gray and white matter declines with age that may contribute to adverse outcomes. Preclinical and clinical data supporting neuro-plastic and -protective effects of mood-stabilizing medications, suggest that treatments may reverse and/or prevent the progression of brain changes thereby reducing symptoms. Future neuroimaging research implementing longitudinal designs, and large-scale, multi-site initiatives with detailed clinical and treatment data, holds promise for reducing suffering, cognitive dysfunction and suicide in OABD.
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Affiliation(s)
- Niroop Rajashekar
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA
- Child Study Center, Yale School of Medicine, New Haven, CT 06519, USA
| | - Luca M. Villa
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
- Department of Psychiatry, University of Oxford, Oxford, OX37JX, UK
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Gray and white matter abnormality in patients with T2DM-related cognitive dysfunction: a systemic review and meta-analysis. Nutr Diabetes 2022; 12:39. [PMID: 35970833 PMCID: PMC9378704 DOI: 10.1038/s41387-022-00214-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 07/05/2022] [Accepted: 07/15/2022] [Indexed: 12/03/2022] Open
Abstract
Aims/hypothesis Brain structure abnormality in patients with type 2 diabetes mellitus (T2DM)-related cognitive dysfunction (T2DM-CD) has been reported for decades in magnetic resonance imaging (MRI) studies. However, the reliable results were still unclear. This study aimed to make a systemic review and meta-analysis to find the significant and consistent gray matter (GM) and white matter (WM) alterations in patients with T2DM-CD by comparing with the healthy controls (HCs). Methods Published studies were systemically searched from PubMed, MEDLINE, Cochrane Library and Web of Science databases updated to November 14, 2021. Studies reporting abnormal GM or WM between patients with T2DM-CD and HCs were selected, and their significant peak coordinates (x, y, z) and effect sizes (z-score or t-value) were extracted to perform a voxel-based meta-analysis by anisotropic effect size-signed differential mapping (AES-SDM) 5.15 software. Results Total 15 studies and 16 datasets (1550 participants) from 7531 results were involved in this study. Compared to HCs, patients with T2DM-CD showed significant and consistent decreased GM in right superior frontal gyrus, medial orbital (PFCventmed. R, BA 11), left superior temporal gyrus (STG. L, BA 48), and right calcarine fissure / surrounding cortex (CAL. R, BA 17), as well as decreased fractional anisotropy (FA) in right inferior network, inferior fronto-occipital fasciculus (IFOF. R), right inferior network, longitudinal fasciculus (ILF. R), and undefined area (32, −60, −42) of cerebellum. Meta-regression showed the positive relationship between decreased GM in PFCventmed.R and MoCA score, the positive relationship between decreased GM in STG.L and BMI, as well as the positive relationship between the decreased FA in IFOF.R and age or BMI. Conclusions/interpretation T2DM impairs the cognitive function by affecting the specific brain structures. GM atrophy in PFCventmed. R (BA 11), STG. L (BA 48), and CAL. R (BA 17), as well as WM injury in IFOF. R, ILF. R, and undefined area (32, −60, −42) of cerebellum. And those brain regions may be valuable targets for future researches. Age, BMI, and MoCA score have a potential influence on the altered GM or WM in T2DM-CD.
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25
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Chen X, Fan X, Song X, Gardner M, Du F, Öngür D. White Matter Metabolite Relaxation and Diffusion Abnormalities in First-Episode Psychosis: A Longitudinal Study. Schizophr Bull 2022; 48:712-720. [PMID: 34999898 PMCID: PMC9077413 DOI: 10.1093/schbul/sbab149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Microstructural abnormalities in the white matter (WM) are implicated in the pathophysiology of psychosis. In vivo magnetic resonance spectroscopy (MRS) can probe the brain's intracellular microenvironment through the measurement of transverse relaxation and diffusion of neurometabolites and possibly provide cell-specific information. In our previous studies, we observed differential metabolite signal abnormalities in first episode and chronic stages of psychosis. In the present work, longitudinal data were presented for the first time on white matter cell-type specific abnormalities using a combination of diffusion tensor spectroscopy (DTS), T2 MRS, and diffusion tensor imaging (DTI) from a group of 25 first episode psychosis patients and nine matched controls scanned at baseline and one and two years of follow-up. We observed significantly reduced choline ADC in the year 1 of follow-up (0.194 µm2/ms) compared to baseline (0.229 µm2/ms), followed by a significant increase in NAA ADC in the year 2 follow-up (0.258 µm2/ms) from baseline (0.222 µm2/ms) and year 1 follow-up (0.217 µm2/ms). In contrast, NAA T2 relaxation, reflecting a related but different aspect of microenvironment from diffusion, was reduced at year 1 follow-up (257 ms) compared to baseline (278 ms). These abnormalities were observed in the absence of any abnormalities in water relaxation and diffusion at any timepoint. These findings indicate that abnormalities are seen in in glial-enriched (choline) signals in early stages of psychosis, followed by the subsequent emergence of neuronal-enriched (NAA) diffusion abnormalities, all in the absence of nonspecific water signal abnormalities.
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Affiliation(s)
- Xi Chen
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
- McLean Imaging Center, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Xiaoying Fan
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
- McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Xiaopeng Song
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
- McLean Imaging Center, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Margaret Gardner
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
- McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Fei Du
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
- McLean Imaging Center, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Dost Öngür
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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26
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Haddad HW, Boardman E, Williams B, Mouhaffel R, Kaye AM, Kaye AD. Combination Olanzapine and Samidorphan for the Management of Schizophrenia and Bipolar 1 Disorder in Adults: A Narrative Review. Health Psychol Res 2022; 10:34224. [DOI: 10.52965/001c.34224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/12/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
| | | | | | | | - Adam M. Kaye
- Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific
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27
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Bi B, Che D, Bai Y. Neural network of bipolar disorder: Toward integration of neuroimaging and neurocircuit-based treatment strategies. Transl Psychiatry 2022; 12:143. [PMID: 35383150 PMCID: PMC8983759 DOI: 10.1038/s41398-022-01917-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 01/23/2023] Open
Abstract
Bipolar disorder (BD) is a complex psychiatric disorder characterized by dysfunctions in three domains including emotional processing, cognitive processing, and psychomotor dimensions. However, the neural underpinnings underlying these clinical profiles are not well understood. Based on the reported data, we hypothesized that (i) the core neuropathology in BD is damage in fronto-limbic network, which is associated with emotional dysfunction; (ii) changes in intrinsic brain network, such as sensorimotor network, salience network, default-mode network, central executive network are associated with impaired cognition function; and (iii) beyond the dopaminergic-driven basal ganglia-thalamo-cortical motor circuit modulated by other neurotransmitter systems, such as serotonin (subcortical-cortical modulation), the sensorimotor network and related motor function modulated by other non-motor networks such as the default-mode network are involved in psychomotor function. In this review, we propose a neurocircuit-based clinical characteristics and taxonomy to guide the treatment of BD. We draw on findings from neuropsychological and neuroimaging studies in BD and link variations in these clinical profiles to underlying neurocircuit dysfunctions. We consider pharmacological, psychotherapy, and neuromodulatory treatments that could target those specific neurocircuit dysfunctions in BD. Finally, it is suggested that the methods of testing the neurocircuit-based taxonomy and important limitations to this approach should be considered in future.
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Affiliation(s)
- Bo Bi
- Department of Clinical Psychology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China.
| | - Dongfang Che
- grid.452787.b0000 0004 1806 5224Neurosurgery department, Shenzhen Children’s Hospital, Shenzhen, China
| | - Yuyin Bai
- grid.12981.330000 0001 2360 039XDepartment of Clinical Psychology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
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28
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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.
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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.
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29
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El Nagar Z, El Shahawi HH, Effat SM, El Sheikh MM, Adel A, Ibrahim YA, Aufa OM. Single episode brief psychotic disorder versus bipolar disorder: A diffusion tensor imaging and executive functions study. Schizophr Res Cogn 2022; 27:100214. [PMID: 34557386 PMCID: PMC8446778 DOI: 10.1016/j.scog.2021.100214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/21/2021] [Accepted: 08/23/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite fast progress in neuroscientific approaches, the neurobiological continuum links psychotic spectrum, and affective disorder is obscure. White matter WM abnormalities found utilizing Diffusion Tensor Imaging (DTI) showing impaired communication in both disorders have been consistently demonstrated; however, direct comparisons of findings between them are scarce. This study aims to study WM abnormalities in single episode bipolar I disorder, and single episode brief psychotic disorder related to healthy control with the association of executive function. METHODS A cross-sectional case-control study was used to assess 60 subjects divided into 20 patients with single episode bipolar I disorder, 20 individuals with single episode brief psychotic disorder (both groups of patients were in remission), and 20 healthy controls. The present study examined the superior longitudinal fasciculus (SLF), and cingulum bundle fractional anisotropy (FA) determined from DTI images symmetrically and connected these results with cognitive functions as assessed by the trail making test (TMT) and Wisconsin card sorting test (WCST). RESULTS DTI data indicated that the psychotic group had a significant decrease in FA of the right SLF (p-value less than 0.001), left SLF (p-value less than 0.001), and left cingulum (p-value less than 0.001) than the bipolar I group. In terms of executive functioning, the psychotic group performed significantly worse than the bipolar I group on the TMT part B (p-value less than 0.001), the WCST (number of classifications fulfilled) (p-value less than 0.001), and perseverative errors (p-value less than 0.001). CONCLUSION Even after clinical remission, individuals with single episode brief psychotic disorder had more pronounced white matter impairments and executive function deficiencies than individuals with single episode bipolar I disorder.
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Affiliation(s)
- Zeinab El Nagar
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba H. El Shahawi
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Safeya M. Effat
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mona M. El Sheikh
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Adel
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Yosra A. Ibrahim
- Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ola M. Aufa
- Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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30
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Valdés-Tovar M, Rodríguez-Ramírez AM, Rodríguez-Cárdenas L, Sotelo-Ramírez CE, Camarena B, Sanabrais-Jiménez MA, Solís-Chagoyán H, Argueta J, López-Riquelme GO. Insights into myelin dysfunction in schizophrenia and bipolar disorder. World J Psychiatry 2022; 12:264-285. [PMID: 35317338 PMCID: PMC8900585 DOI: 10.5498/wjp.v12.i2.264] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/10/2021] [Accepted: 01/17/2022] [Indexed: 02/06/2023] Open
Abstract
Schizophrenia and bipolar disorder are disabling psychiatric disorders with a worldwide prevalence of approximately 1%. Both disorders present chronic and deteriorating prognoses that impose a large burden, not only on patients but also on society and health systems. These mental illnesses share several clinical and neurobiological traits; of these traits, oligodendroglial dysfunction and alterations to white matter (WM) tracts could underlie the disconnection between brain regions related to their symptomatic domains. WM is mainly composed of heavily myelinated axons and glial cells. Myelin internodes are discrete axon-wrapping membrane sheaths formed by oligodendrocyte processes. Myelin ensheathment allows fast and efficient conduction of nerve impulses through the nodes of Ranvier, improving the overall function of neuronal circuits. Rapid and precisely synchronized nerve impulse conduction through fibers that connect distant brain structures is crucial for higher-level functions, such as cognition, memory, mood, and language. Several cellular and subcellular anomalies related to myelin and oligodendrocytes have been found in postmortem samples from patients with schizophrenia or bipolar disorder, and neuroimaging techniques have revealed consistent alterations at the macroscale connectomic level in both disorders. In this work, evidence regarding these multilevel alterations in oligodendrocytes and myelinated tracts is discussed, and the involvement of proteins in key functions of the oligodendroglial lineage, such as oligodendrogenesis and myelination, is highlighted. The molecular components of the axo-myelin unit could be important targets for novel therapeutic approaches to schizophrenia and bipolar disorder.
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Affiliation(s)
- Marcela Valdés-Tovar
- Departamento de Farmacogenética, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | | | - Leslye Rodríguez-Cárdenas
- Departamento de Farmacogenética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Carlo E Sotelo-Ramírez
- Departamento de Farmacogenética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
- Doctorado en Biología Experimental, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City 09340, Mexico
| | - Beatriz Camarena
- Departamento de Farmacogenética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | | | - Héctor Solís-Chagoyán
- Laboratorio de Neurofarmacología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Jesús Argueta
- Doctorado en Biología Experimental, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City 09340, Mexico
- Laboratorio de Neurofarmacología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Germán Octavio López-Riquelme
- Laboratorio de Socioneurobiología, Centro de Investigación en Ciencias Cognitivas, Universidad del Estado de Morelos, Cuernavaca 62209, Morelos, Mexico
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31
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Chen M, Chen G, Tian H, Dou G, Fang T, Cai Z, Cheng L, Chen S, Chen C, Ping J, Lin X, Chen C, Zhu J, Zhao F, Liu C, Yue W, Song X, Zhuo C. Brain Neural Activity Patterns in an Animal Model of Antidepressant-Induced Manic Episodes. Front Behav Neurosci 2022; 15:771975. [PMID: 35250499 PMCID: PMC8889145 DOI: 10.3389/fnbeh.2021.771975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background: In the treatment of patients with bipolar disorder (BP), antidepressant-induced mania is usually observed. The rate of phase switching (from depressive to manic) in these patients exceeds 22%. The exploration of brain activity patterns during an antidepressant-induced manic phase may aid the development of strategies to reduce the phase-switching rate. The use of a murine model to explore brain activity patterns in depressive and manic phases can help us to understandthe pathological features of BP. The novel object recognition preference ratio is used to assess cognitive ability in such models. Objective: To investigate brain Ca2+ activity and behavioral expression in the depressive and manic phases in the same murine model, to aid understanding of brain activity patterns in phase switching in BP. Methods: In vivo two-photon imaging was used to observe brain activity alterations in a murine model in which induce depressive-like and manic-like behaviors were induced sequentially. The immobility time was used to assess depressive-like symptoms and the total distance traveled was used to assess manic-like symptoms. Results: In vivo two-photon imaging revealed significantly reduced brain Ca2+ activity in temporal cortex pyramidal neurons in the depressive phase in mice exposed to chronic unpredictable mild stress compared with naïve controls. The brain Ca2+ activity correlated negatively with the novel object recognition preference ratio within the immobility time. Significantly increased brain Ca2+ activity was observed in the ketamine-induced manic phase. However, this activity did not correlate with the total distance traveled. The novel object recognition preference ratio correlated negatively with the total distance traveled in the manic phase.
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Affiliation(s)
- Min Chen
- Micro-imaging Center of Psychiatric Disorder, Institute of Mental Health, Jining Medical University, Jining, China
| | - Guangdong Chen
- Center of Psychiatric Animal Model, Institute of Mental Health, Wenzhou Seventh Peoples Hospital, Wenzhou, China
- Department of Psychiatry Medical Center, Wenzhou Seventh Peoples Hospital, Wenzhou, China
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Hongjun Tian
- Key Laboratory of Real Time Tracing of Brain Circuits in Psychiatry and Neurology (RTBNP_Lab), Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
| | - Guangqian Dou
- Key Laboratory of Real Time Tracing of Brain Circuits in Psychiatry and Neurology (RTBNP_Lab), Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
| | - Tao Fang
- Key Laboratory of Real Time Tracing of Brain Circuits in Psychiatry and Neurology (RTBNP_Lab), Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
| | - Ziyao Cai
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Langlang Cheng
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Suling Chen
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Ce Chen
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Jing Ping
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Xiaodong Lin
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Chunmian Chen
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Jingjing Zhu
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Feifei Zhao
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Chuanxin Liu
- Micro-imaging Center of Psychiatric Disorder, Institute of Mental Health, Jining Medical University, Jining, China
| | - Weihua Yue
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- *Correspondence: Chuanjun Zhuo Weihua Yue Xueqin Song
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Chuanjun Zhuo Weihua Yue Xueqin Song
| | - Chuanjun Zhuo
- Key Laboratory of Real Time Tracing of Brain Circuits in Psychiatry and Neurology (RTBNP_Lab), Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Chuanjun Zhuo Weihua Yue Xueqin Song
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32
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Kieseppä T, Mäntylä R, Luoma K, Rikandi E, Jylhä P, Isometsä E. White Matter Hyperintensities after Five-Year Follow-Up and a Cross-Sectional FA Decrease in Bipolar I and Major Depressive Patients. Neuropsychobiology 2022; 81:39-50. [PMID: 34130283 DOI: 10.1159/000516234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/30/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION An increase in brain white matter hyperintensities (WMHs) and a decrease in white matter fractional anisotrophy (FA) have been detected in bipolar I (BPI), II (BPII), and major depressive disorder (MDD) patients. Their relationship, and differences in diagnostic groups are obscure. Longitudinal studies are rare. OBJECTIVE After 5-year follow-up, we evaluated WMHs in BPI, BPII, and MDD patients as compared with controls, and studied the effects of clinical variables. We also explored the associations of clinical variables with cross-sectional whole brain FA. METHODS Eight BPI, 8 BPII, 6 MDD patients, and 19 controls participated in magnetic resonance imaging at baseline and follow-up. Diffusion weighted imaging was included at follow-up. WMHs were rated by the Coffey scale, and a tract-based spatial statistics method was used for diffusion data. The general linear model, ANOVA, Fisher's exact, Wilcoxon sign, and Kruskal-Wallis tests were used for statistical analyses. RESULTS Periventricular WMHs were increased in BPI patients (p = 0.047) and associated with the duration of disorder and lifetime occurrence of substance use disorder (p = 0.018). FA decrease was found in the corpus callosum of BPI patients (p < 0.01). MDD patients showed FA decrease in the right cerebellar middle peduncle (RCMP) (p < 0.01). In BPI patients, the duration of disorder associated with FA increase in RCMP (p < 0.05). No FA decrease was detected in patients with WMHs as compared with those without. CONCLUSIONS Preceding illness burden associated modestly with WMHs, and FA increase in RCMP in BPI patients. MDD patients had FA decrease in RCMP. No association with FA decrease and WMHs was found.
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Affiliation(s)
- Tuula Kieseppä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Finnish Institute for Health and Welfare, Public Health and Welfare, Mental Health, Helsinki, Finland
| | - Riitta Mäntylä
- Department of Radiology, HUS Medical Imaging Center, Hyvinkää Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katariina Luoma
- Department of Radiology, HUS Medical Imaging Center, Meilahti Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eva Rikandi
- Finnish Institute for Health and Welfare, Public Health and Welfare, Mental Health, Helsinki, Finland.,Department of Neuroscience and Biomedical Engineering, and Advanced Magnetic Imaging Center, Aalto NeuroImaging, Aalto University School of Science, Espoo, Finland.,Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Pekka Jylhä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Finnish Institute for Health and Welfare, Public Health and Welfare, Mental Health, Helsinki, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Finnish Institute for Health and Welfare, Public Health and Welfare, Mental Health, Helsinki, Finland
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Machine learning approaches for prediction of bipolar disorder based on biological, clinical and neuropsychological markers: a systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 135:104552. [PMID: 35120970 DOI: 10.1016/j.neubiorev.2022.104552] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 01/11/2022] [Accepted: 01/30/2022] [Indexed: 01/10/2023]
Abstract
Applying machine learning (ML) to objective markers may overcome prognosis uncertainty due to the subjective nature of the diagnosis of bipolar disorder (BD). This PRISMA-compliant meta-analysis provides new systematic evidence of the BD classification accuracy reached by different markers and ML algorithms. We focused on neuroimaging, electrophysiological techniques, peripheral biomarkers, genetic data, neuropsychological or clinical measures, and multimodal approaches. PubMed, Embase and Scopus were searched through 3rd December 2020. Meta-analyses were performed using random-effect models. Overall, 81 studies were included in this systematic review and 65 in the meta-analysis (11,336 participants, 3,903 BD). The overall pooled classification accuracy was 0.77 (95%CI[0.75;0.80]). Despite subgroup analyses for diagnostic comparison group, psychiatric disorders, marker, ML algorithm, and validation procedure were not significant, linear discriminant analysis significantly outperformed support vector machine for peripheral biomarkers (p=0.03). Sample size was inversely related to accuracy. Evidence of publication bias was detected. Ultimately, although ML reached a high accuracy in differentiating BD from other psychiatric disorders, best practices in methodology are needed for the advancement of future studies.
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34
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Digiovanni A, Ajdinaj P, Russo M, Sensi SL, Onofrj M, Thomas A. Bipolar spectrum disorders in neurologic disorders. Front Psychiatry 2022; 13:1046471. [PMID: 36620667 PMCID: PMC9811836 DOI: 10.3389/fpsyt.2022.1046471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Psychiatric symptoms frequently predate or complicate neurological disorders, such as neurodegenerative diseases. Symptoms of bipolar spectrum disorders (BSD), like mood, behavioral, and psychotic alterations, are known to occur - individually or as a syndromic cluster - in Parkinson's disease and in the behavioral variant of frontotemporal dementia (FTD). Nonetheless, due to shared pathophysiological mechanisms, or genetic predisposition, several other neurological disorders show significant, yet neglected, clinical and biological overlaps with BSD like neuroinflammation, ion channel dysfunctions, neurotransmission imbalance, or neurodegeneration. BSD pathophysiology is still largely unclear, but large-scale network dysfunctions are known to participate in the onset of mood disorders and psychotic symptoms. Thus, functional alterations can unleash BSD symptoms years before the evidence of an organic disease of the central nervous system. The aim of our narrative review was to illustrate the numerous intersections between BSD and neurological disorders from a clinical-biological point of view and the underlying predisposing factors, to guide future diagnostic and therapeutical research in the field.
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Affiliation(s)
- Anna Digiovanni
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Paola Ajdinaj
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Astrid Thomas
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
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A unified model of the pathophysiology of bipolar disorder. Mol Psychiatry 2022; 27:202-211. [PMID: 33859358 DOI: 10.1038/s41380-021-01091-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/17/2021] [Accepted: 03/29/2021] [Indexed: 02/02/2023]
Abstract
This work provides an overview of the most consistent alterations in bipolar disorder (BD), attempting to unify them in an internally coherent working model of the pathophysiology of BD. Data on immune-inflammatory changes, structural brain abnormalities (in gray and white matter), and functional brain alterations (from neurotransmitter signaling to intrinsic brain activity) in BD were reviewed. Based on the reported data, (1) we hypothesized that the core pathological alteration in BD is a damage of the limbic network that results in alterations of neurotransmitter signaling. Although heterogeneous conditions can lead to such damage, we supposed that the main pathophysiological mechanism is traceable to an immune/inflammatory-mediated alteration of white matter involving the limbic network connections, which destabilizes the neurotransmitter signaling, such as dopamine and serotonin signaling. Then, (2) we suggested that changes in such neurotransmitter signaling (potentially triggered by heterogeneous stressors onto a structurally-damaged limbic network) lead to phasic (and often recurrent) reconfigurations of intrinsic brain activity, from abnormal subcortical-cortical coupling to changes in network activity. We suggested that the resulting dysbalance between networks, such as sensorimotor networks, salience network, and default-mode network, clinically manifest in combined alterations of psychomotricity, affectivity, and thought during the manic and depressive phases of BD. Finally, (3) we supposed that an additional contribution of gray matter alterations and related cognitive deterioration characterize a clinical-biological subgroup of BD. This model may provide a general framework for integrating the current data on BD and suggests novel specific hypotheses, prompting for a better understanding of the pathophysiology of BD.
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Espanhol JCL, Vieira-Coelho MA. Effects of lithium use on the white matter of patients with bipolar disorder - a systematic review. Nord J Psychiatry 2022; 76:1-11. [PMID: 33969798 DOI: 10.1080/08039488.2021.1921264] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Several studies revealed changes in the microstructure of white matter in bipolar disorder patients. Lithium has been reported as having neuroprotective effects. However, its effect on the white matter remains unclear. This systematic review aims to identify the existing clinical evidence of lithium's effect on the white matter from bipolar disorder patients. METHODS PRISMA guidelines were followed for a systematic literature review to assess the effect of lithium on the white matter of patients with bipolar disorder. From a total of 204 studies screened, 16 were included in the final systematic review. The quality assessment of the included records was assessed by the Newcastle-Ottawa scale. RESULTS Most studies included (13 out of 16) evaluated diffusion tensor imaging measures to assess white matter integrity. Of these, eleven reported a positive effect of lithium on the integrity of white matter of bipolar disorder patients. Two reported no effect. Two studies evaluated white matter volume. The first reported that lithium attenuates the reduction of white matter volume over time, and the second reported significantly smaller white matter volume in non-lithium-using patients. The last evaluated ventricular brain ratio and reported that patients treated with lithium did not have a significantly greater ventricular size than their normal control counterparts. CONCLUSIONS Lithium appears to positively influence the evolution of the white matter abnormalities described in bipolar disorder patients. Should this information be confirmed in future research, and given its important mood stabilizer effect, it could further reinforce the use of lithium in the treatment of bipolar disorder.
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Affiliation(s)
- José Carlos L Espanhol
- Department of Biomedicine - Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Porto, Alameda Professor Hernani Monteiro, Porto, Portugal
| | - Maria A Vieira-Coelho
- Department of Biomedicine - Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Porto, Alameda Professor Hernani Monteiro, Porto, Portugal.,Department of Psychiatry and Mental Health, São João University Hospital Centre, Alameda Professor Hernani Monteiro, Porto, Portugal.,MedInUP-Center for Drug Discovery and Innovative Medicines, University of Porto, Porto, Portugal
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Calcium imaging reveals depressive- and manic-phase-specific brain neural activity patterns in a murine model of bipolar disorder: a pilot study. Transl Psychiatry 2021; 11:619. [PMID: 34876553 PMCID: PMC8651770 DOI: 10.1038/s41398-021-01750-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/18/2021] [Accepted: 11/29/2021] [Indexed: 12/25/2022] Open
Abstract
Brain pathological features during manic/hypomanic and depressive episodes in the same patients with bipolar disorder (BPD) have not been described precisely. The study aimed to investigate depressive and manic-phase-specific brain neural activity patterns of BPD in the same murine model to provide information guiding investigation of the mechanism of phase switching and tailored prevention and treatment for patients with BPD. In vivo two-photon imaging was used to observe brain activity alterations in the depressive and manic phases in the same murine model of BPD. Two-photon imaging showed significantly reduced Ca2+ activity in temporal cortex pyramidal neurons in the depression phase in mice exposed to chronic unpredictable mild stress (CUMS), but not in the manic phase in mice exposed to CUMS and ketamine. Total integrated calcium values correlated significantly with immobility times. Brain Ca2+ hypoactivity was observed in the depression and manic phases in the same mice exposed to CUMS and ketamine relative to naïve controls. The novel object recognition preference ratio correlated negatively with the immobility time in the depression phase and the total distance traveled in the manic phase. With recognition of its limitations, this study revealed brain neural activity impairment indicating that intrinsic emotional network disturbance is a mechanism of BPD and that brain neural activity is associated with cognitive impairment in the depressive and manic phases of this disorder. These findings are consistent with those from macro-imaging studies of patients with BPD. The observed correlation of brain neural activity with the severity of depressive, but not manic, symptoms need to be investigated further.
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Differentiating white matter measures that protect against vs. predispose to bipolar disorder and other psychopathology in at-risk youth. Neuropsychopharmacology 2021; 46:2207-2216. [PMID: 34285367 PMCID: PMC8505429 DOI: 10.1038/s41386-021-01088-1] [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: 02/19/2021] [Revised: 06/17/2021] [Accepted: 06/24/2021] [Indexed: 12/02/2022]
Abstract
Bipolar disorder (BD) is highly heritable. Identifying objective biomarkers reflecting pathophysiological processes predisposing to, versus protecting against BD, can help identify BD risk in offspring of BD parents. We recruited 21 BD participants with a first-degree relative with BD, 25 offspring of BD parents, 27 offspring of comparison parents with non-BD psychiatric disorders, and 32 healthy offspring of healthy parents. In at-risk groups, 23 had non-BD diagnoses and 29, no Axis-I diagnoses(healthy). Five at-risk offspring who developed BD post scan(Converters) were included. Diffusion imaging(dMRI) analysis with tract segmentation identified between-group differences in the microstructure of prefrontal tracts supporting emotional regulation relevant to BD: forceps minor, anterior thalamic radiation(ATR), cingulum bundle(CB), and uncinate fasciculus(UF). BD participants showed lower fractional anisotropy (FA) in the right CB (anterior portion) than other groups (q < 0.05); and in bilateral ATR (posterior portion) versus at-risk groups (q < 0.001). Healthy, but not non-BD, at-risk participants showed significantly higher FA in bilateral ATR clusters than healthy controls (qs < 0.05). At-risk groups showed higher FA in these clusters than BD participants (qs < 0.05). Non-BD versus healthy at-risk participants, and Converters versus offspring of BD parents, showed lower FA in the right ATR cluster (qs < 0.05). Low anterior right CB FA in BD participants versus other groups might result from having BD. High bilateral ATR FA in at-risk groups, and in healthy at-risk participants, versus healthy controls might protect against BD/other psychiatric disorders. Absence of elevated right ATR FA in non-BD versus healthy at-risk participants, and in Converters versus non-converter offspring of BD parents, might lower protection against BD in at-risk groups.
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Zhou C, Dong M, Duan W, Lin H, Wang S, Wang Y, Zhang Y, Shi J, Liu S, Cheng Y, Xu X, Xu J. White matter microstructure alterations in systemic lupus erythematosus: A preliminary coordinate-based meta-analysis of diffusion tensor imaging studies. Lupus 2021; 30:1973-1982. [PMID: 34652991 DOI: 10.1177/09612033211045062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Systemic lupus erythematosus is often accompanied with neuropsychiatric symptoms. Neuroimaging evidence indicated that microstructural white matter (WM) abnormalities play role in the neuropathological mechanism. Diffusion tensor imaging (DTI) studies allows the assessment of the microstructural integrity of WM tracts, but existing findings were inconsistent. This present study aimed to conduct a coordinate-based meta-analysis (CBMA) to identify statistical consensus of DTI studies in SLE. METHODS Relevant studies that reported the differences of fractional anisotropy (FA) between SLE patients and healthy controls (HC) were searched systematically. Only studies reported the results in Talairach or Montreal Neurological Institute (MNI) coordinates were included. The anisotropic effect size version of signed differential mapping (AES-SDM) was applied to detect WM alterations in SLE. RESULTS Totally, five studies with seven datasets which included 126 patients and 161 HC were identified. The pooled meta-analysis demonstrated that SLE patients exhibited significant FA reduction in the left striatum and bilateral inferior network, mainly comprised the corpus callosum (CC), bilateral inferior fronto-occipital fasciculus (IFOF), bilateral anterior thalamic projections, bilateral superior longitudinal fasciculus (SLF), left inferior longitudinal fasciculus (ILF), and left insula. No region with higher FA was identified. CONCLUSIONS Disorders of the immune system might lead to subtle WM microstructural alterations in SLE, which might be related with cognitive deficits or emotional distress symptoms. This provides a better understanding of the pathological mechanism of microstructural brain abnormalities in SLE.
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Affiliation(s)
- Cong Zhou
- School of Mental Health, 74496Jining Medical University, Jining, China
| | - Man Dong
- School of Mental Health, 74496Jining Medical University, Jining, China
| | - Weiwei Duan
- School of Mental Health, 74496Jining Medical University, Jining, China
| | - Hao Lin
- School of Mental Health, 74496Jining Medical University, Jining, China
| | - Shuting Wang
- School of Mental Health, 74496Jining Medical University, Jining, China
| | - Yuxin Wang
- School of Mental Health, 74496Jining Medical University, Jining, China
| | - Yujia Zhang
- School of Mental Health, 74496Jining Medical University, Jining, China
| | - Jiameng Shi
- School of Mental Health, 74496Jining Medical University, Jining, China
| | - Shirui Liu
- School of Mental Health, 74496Jining Medical University, Jining, China
| | - Yuqi Cheng
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jian Xu
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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40
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Nabulsi L, McPhilemy G, O'Donoghue S, Cannon DM, Kilmartin L, O'Hora D, Sarrazin S, Poupon C, D'Albis MA, Versace A, Delavest M, Linke J, Wessa M, Phillips ML, Houenou J, McDonald C. Aberrant Subnetwork and Hub Dysconnectivity in Adult Bipolar Disorder: A Multicenter Graph Theory Analysis. Cereb Cortex 2021; 32:2254-2264. [PMID: 34607352 DOI: 10.1093/cercor/bhab356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 11/14/2022] Open
Abstract
Neuroimaging evidence implicates structural network-level abnormalities in bipolar disorder (BD); however, there remain conflicting results in the current literature hampered by sample size limitations and clinical heterogeneity. Here, we set out to perform a multisite graph theory analysis to assess the extent of neuroanatomical dysconnectivity in a large representative study of individuals with BD. This cross-sectional multicenter international study assessed structural and diffusion-weighted magnetic resonance imaging data obtained from 109 subjects with BD type 1 and 103 psychiatrically healthy volunteers. Whole-brain metrics, permutation-based statistics, and connectivity of highly connected nodes were used to compare network-level connectivity patterns in individuals with BD compared with controls. The BD group displayed longer characteristic path length, a weakly connected left frontotemporal network, and increased rich-club dysconnectivity compared with healthy controls. Our multisite findings implicate emotion and reward networks dysconnectivity in bipolar illness and may guide larger scale global efforts in understanding how human brain architecture impacts mood regulation in BD.
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Affiliation(s)
- Leila Nabulsi
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Lab, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, Galway H91 TK33, Ireland.,Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA 90292, USA
| | - Genevieve McPhilemy
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Lab, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - Stefani O'Donoghue
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Lab, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - Dara M Cannon
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Lab, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - Liam Kilmartin
- College of Engineering and Informatics, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - Denis O'Hora
- School of Psychology, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - Samuel Sarrazin
- APHP, Hôpitaux Universitaires Mondor, Pôle de psychiatrie, DHU PePsy, INSERM U955, Equipe 15, Faculté de medicine de Créteil, Université Paris Est, Créteil, France.,NeuroSpin, CEA Saclay, Gif-Sur-Yvette, France
| | | | - Marc-Antoine D'Albis
- APHP, Hôpitaux Universitaires Mondor, Pôle de psychiatrie, DHU PePsy, INSERM U955, Equipe 15, Faculté de medicine de Créteil, Université Paris Est, Créteil, France.,NeuroSpin, CEA Saclay, Gif-Sur-Yvette, France
| | - Amelia Versace
- Department of Psychiatry, Pittsburgh University Medicine School, Pittsburgh, PA, USA.,Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, PA, USA
| | - Marine Delavest
- APHP, GH Fernand Widal-Lariboisière, Service de psychiatrie, Paris, France
| | - Julia Linke
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University Mainz, Wallstraße 3, Mainz 55122, Germany
| | - Michèle Wessa
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University Mainz, Wallstraße 3, Mainz 55122, Germany
| | - Mary L Phillips
- Department of Psychiatry, Pittsburgh University Medicine School, Pittsburgh, PA, USA.,Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, PA, USA
| | - Josselin Houenou
- APHP, Hôpitaux Universitaires Mondor, Pôle de psychiatrie, DHU PePsy, INSERM U955, Equipe 15, Faculté de medicine de Créteil, Université Paris Est, Créteil, France.,NeuroSpin, CEA Saclay, Gif-Sur-Yvette, France
| | - Colm McDonald
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Lab, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, Galway H91 TK33, Ireland
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41
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Cruz-Sanabria F, Reyes PA, Triviño-Martínez C, García-García M, Carmassi C, Pardo R, Matallana DL. Exploring Signatures of Neurodegeneration in Early-Onset Older-Age Bipolar Disorder and Behavioral Variant Frontotemporal Dementia. Front Neurol 2021; 12:713388. [PMID: 34539558 PMCID: PMC8446277 DOI: 10.3389/fneur.2021.713388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/28/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Older-age bipolar disorder (OABD) may involve neurocognitive decline and behavioral disturbances that could share features with the behavioral variant of frontotemporal dementia (bvFTD), making the differential diagnosis difficult in cases of suspected dementia. Objective: To compare the neuropsychological profile, brain morphometry, and structural connectivity patterns between patients diagnosed with bvFTD, patients classified as OABD with an early onset of the disease (EO-OABD), and healthy controls (HC). Methods: bvFTD patients (n = 25, age: 66 ± 7, female: 64%, disease duration: 6 ± 4 years), EO-OABD patients (n = 17, age: 65 ± 9, female: 71%, disease duration: 38 ± 8 years), and HC (n = 28, age: 62 ± 7, female: 64%) were evaluated through neuropsychological tests concerning attention, memory, executive function, praxis, and language. Brain morphometry was analyzed through surface-based morphometry (SBM), while structural brain connectivity was assessed through diffusion tensor imaging (DTI). Results: Both bvFTD and EO-OABD patients showed lower performance in neuropsychological tests of attention, verbal fluency, working memory, verbal memory, and praxis than HC. Comparisons between EO-OABD and bvFTD showed differences limited to cognitive flexibility delayed recall and intrusion errors in the memory test. SBM analysis demonstrated that several frontal, temporal, and parietal regions were altered in both bvFTD and EO-OABD compared to HC. In contrast, comparisons between bvFTD and EO-OABD evidenced differences exclusively in the right temporal pole and the left entorhinal cortex. DTI analysis showed alterations in association and projection fibers in both EO-OABD and bvFTD patients compared to HC. Commissural fibers were found to be particularly affected in EO-OABD. The middle cerebellar peduncle and the pontine crossing tract were exclusively altered in bvFTD. There were no significant differences in DTI analysis between EO-OABD and bvFTD. Discussion: EO-OABD and bvFTD may share an overlap in cognitive, brain morphometry, and structural connectivity profiles that could reflect common underlying mechanisms, even though the etiology of each disease can be different and multifactorial.
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Affiliation(s)
- Francy Cruz-Sanabria
- Department of Translational Research, New Surgical, and Medical Technologies, University of Pisa, Pisa, Italy
- Neurosciences Research Group, Institute of Genetics, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Pablo Alexander Reyes
- Ph.D. Program in Neuroscience, Department of Psychiatry, Pontificia Universidad Javeriana, Bogotá, Colombia
- Radiology Department, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Cristian Triviño-Martínez
- Psychiatry Department, School of Medicine, Aging Institute, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Milena García-García
- Ph.D. Program in Neuroscience, Department of Psychiatry, Pontificia Universidad Javeriana, Bogotá, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Rodrigo Pardo
- Neurosciences Research Group, Institute of Genetics, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Diana L. Matallana
- Ph.D. Program in Neuroscience, Department of Psychiatry, Pontificia Universidad Javeriana, Bogotá, Colombia
- Psychiatry Department, School of Medicine, Aging Institute, Pontificia Universidad Javeriana, Bogotá, Colombia
- Mental Health Department, Hospital Universitario Fundación Santa Fe, Bogotá, Colombia
- Memory and Cognition Clinic, Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
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42
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Ochoa ELM. Lithium as a Neuroprotective Agent for Bipolar Disorder: An Overview. Cell Mol Neurobiol 2021; 42:85-97. [PMID: 34357564 DOI: 10.1007/s10571-021-01129-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/14/2021] [Indexed: 11/28/2022]
Abstract
Lithium (Li+) is a first option treatment for adult acute episodes of Bipolar Disorder (BD) and for the prophylaxis of new depressed or manic episodes. It is also the preferred choice as maintenance treatment. Numerous studies have shown morphological abnormalities in the brains of BD patients, suggesting that this highly heritable disorder may exhibit progressive and deleterious changes in brain structure. Since treatment with Li+ ameliorates these abnormalities, it has been postulated that Li+ is a neuroprotective agent in the same way atypical antipsychotics are neuroprotective in patients diagnosed with schizophrenia spectrum disorders. Li+'s neuroprotective properties are related to its modulation of nerve growth factors, inflammation, mitochondrial function, oxidative stress, and programmed cell death mechanisms such as autophagy and apoptosis. Notwithstanding, it is not known whether Li+-induced neuroprotection is related to the inhibition of its putative molecular targets in a BD episode: the enzymes inositol-monophosphatase, (IMPase), glycogen-synthase-kinase 3β (GSK3), and Protein kinase C (PKC). Furthermore, it is uncertain whether these neuroprotective mechanisms are correlated with Li+'s clinical efficacy in maintaining mood stability. It is expected that in a nearby future, precision medicine approaches will improve diagnosis and expand treatment options. This will certainly contribute to ameliorating the medical and economic burden created by this devastating mood disorder.
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Affiliation(s)
- Enrique L M Ochoa
- Department of Psychiatry and Behavioral Sciences, Volunteer Clinical Faculty, University of California at Davis, 2230 Stockton Boulevard, Sacramento, CA, 95817, USA.
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43
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Soeiro-de-Souza MG, Scotti-Muzzi E, Fernandes F, De Sousa RT, Leite CC, Otaduy MC, Machado-Vieira R. Anterior cingulate cortex neuro-metabolic changes underlying lithium-induced euthymia in bipolar depression: A longitudinal 1H-MRS study. Eur Neuropsychopharmacol 2021; 49:93-100. [PMID: 33882433 DOI: 10.1016/j.euroneuro.2021.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 12/02/2020] [Accepted: 03/23/2021] [Indexed: 12/30/2022]
Abstract
The diagnosis and treatment of bipolar depression (BDep) poses complex clinical challenges for psychiatry. Proton magnetic resonance spectroscopy (1H-MRS) is a useful imaging tool for investigating in vivo levels of brain neuro-metabolites, critical to understanding the process of mood dysregulation in Bipolar Disorder. Few studies have evaluated longitudinal clinical outcomes in BDep associated with 1H-MRS metabolic changes. This study aimed to longitudinally assess brain 1H-MRS metabolites in the anterior cingulate cortex (ACC) correlated with improvement in depression (from BDep to euthymia) after lithium treatment in BDep patients versus matched healthy controls (HC). Twenty-eight medication-free BDep patients and 28 HC, matched for age and gender, were included in this study. All subjects were submitted to a 3-Tesla brain 1H-MRS scan in the ACC using a single-voxel (8cm3) PRESS sequence at baseline. At follow-up (6 weeks), 14 BDep patients repeated the exam in euthymia. Patients with current BDep had higher baseline Myo-inositol/Cr (mI/Cr) and Choline/Cr (Cho/Cr) compared to HC. After six weeks, mI/Cr or Cho/Cr levels in subjects that achieved euthymia no longer differed to levels in HC, while high Cho/Cr levels persisted in non-responders . Elevated ACC mI/Cr and Cho/Cr in BDep might indicate increased abnormal membrane phospholipid metabolism and phosphatidylinositol (PI) cycle activity. Return of mI/Cr and Cho/Cr to normal levels after lithium-induced euthymia suggests a critical regulatory effect of lithium targeting the PI cycle involved in mood regulation.
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Affiliation(s)
- M G Soeiro-de-Souza
- Department and Institute of Psychiatry, School of Medicine, University of Sao Paulo, Brazil.
| | - E Scotti-Muzzi
- Department and Institute of Psychiatry, School of Medicine, University of Sao Paulo, Brazil
| | - F Fernandes
- Department and Institute of Psychiatry, School of Medicine, University of Sao Paulo, Brazil
| | - R T De Sousa
- Department and Institute of Psychiatry, School of Medicine, University of Sao Paulo, Brazil
| | - C C Leite
- Laboratory of Magnetic Resonance LIM44, Department and Institute of Radiology, University of São Paulo (InRad-FMUSP), Brazil
| | - M C Otaduy
- Laboratory of Magnetic Resonance LIM44, Department and Institute of Radiology, University of São Paulo (InRad-FMUSP), Brazil
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44
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Daoust J, Schaffer J, Zeighami Y, Dagher A, García-García I, Michaud A. White matter integrity differences in obesity: A meta-analysis of diffusion tensor imaging studies. Neurosci Biobehav Rev 2021; 129:133-141. [PMID: 34284063 DOI: 10.1016/j.neubiorev.2021.07.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 06/07/2021] [Accepted: 07/15/2021] [Indexed: 01/17/2023]
Abstract
Some Diffusion Tensor Imaging studies have shown a loss of white matter (WM) integrity linked to impaired cognitive function in obese individuals. However, inconsistent WM integrity changes have been reported. We aimed to identify which WM tracts show consistent changes with obesity. We conducted a systematic search to find studies examining the association between obesity-related measures and Fractional Anisotropy (FA) or Mean Diffusivity. We performed a meta-analysis with FA datasets using Anisotropic Effect Size-Signed Differential Mapping software. The meta-analysis showed that increased obesity measurements were related to reduced FA in the genu of the corpus callosum. We validated our findings using an independent sample from the Human Connectome Project dataset, which supports lower FA in this region in individuals with obesity compared to those with normal weight (p = 0.028). Our findings provide evidence that obesity is associated with reduced WM integrity in the genu of the corpus callosum, a tract linking frontal areas involved in executive function. Future studies are needed on the mechanisms linking obesity with loss of WM integrity.
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Affiliation(s)
- Justine Daoust
- Research Center of the Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725 chemin Sainte-Foy, Québec, Québec, G1V 4G5, Canada; School of Nutrition, Université Laval, 2325 rue de l'Université, Québec, Québec, G1V 0A6, Canada
| | - Joelle Schaffer
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Québec, H3A 2B4, Canada
| | - Yashar Zeighami
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Québec, H3A 2B4, Canada
| | - Alain Dagher
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Québec, H3A 2B4, Canada
| | - Isabel García-García
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Gran Via de les Corts Catalanes, 585, 08007, Barcelona, Spain
| | - Andréanne Michaud
- Research Center of the Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725 chemin Sainte-Foy, Québec, Québec, G1V 4G5, Canada; School of Nutrition, Université Laval, 2325 rue de l'Université, Québec, Québec, G1V 0A6, Canada.
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45
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Lu F, Cui Q, He Z, Tang Q, Chen Y, Sheng W, Yang Y, Luo W, Yu Y, Chen J, Li D, Deng J, Hu S, Chen H. Superficial white-matter functional networks changes in bipolar disorder patients during depressive episodes. J Affect Disord 2021; 289:151-159. [PMID: 33984685 DOI: 10.1016/j.jad.2021.04.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/01/2021] [Accepted: 04/20/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Bipolar disorder is a common psychiatric disorder characterized by insufficient or ineffective connections associated with white-matter (WM) abnormalities. Previous studies have detected the structural attributes of WM using magnetic resonance imaging (MRI) or diffusion tensor imaging, however, they failed to disentangle the dysfunctional organization within the WM. METHODS This study aimed to uncover the WM functional connectivity (FC) in 45 bipolar disorder patients during depressive episodes (BDD) and 45 healthy controls based on resting-state functional MRI. Eight WM functional networks were identified by using a clustering analysis of voxel-based correlation profiles, which were further classified into superficial, middle and deep layers of networks. RESULTS Group comparisons on the FCs among 8 WM networks showed that the superficial tempofrontal network (TFN) in BDD patients had increased FC with the superficial cerebellar network (CN) and with the superficial pre/post-central network (PCN). Further, support vector regression prediction analysis results revealed that the increased FCs of CN-TFN and PCN-TFN could be served as features to predict the numbers of depressive episode in BDD patients. CONCLUSIONS The current study extended our knowledge about the impaired WM functional connections associated with emotional and sensory-motor perception processing in BDD, which may facilitate the interpretation of the pathophysiology mechanisms underlying BDD.
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Affiliation(s)
- Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Qian Cui
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China.
| | - Zongling He
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Qin Tang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Yuyan Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Yang Yang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Wei Luo
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Yue Yu
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Jiajia Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Di Li
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Jiaxin Deng
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Shan Hu
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China; MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 610054, P R China.
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Anterior cingulate cortex neurometabolites in bipolar disorder are influenced by mood state and medication: A meta-analysis of 1H-MRS studies. Eur Neuropsychopharmacol 2021; 47:62-73. [PMID: 33581932 DOI: 10.1016/j.euroneuro.2021.01.096] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 12/13/2022]
Abstract
The anterior cingulate cortex (ACC), a brain region that mediates affect and cognition by connecting the frontal cortex to limbic structures, has been consistently implicated in the neurobiology of Bipolar Disorder (BD). Proton magnetic resonance spectroscopy (1H-MRS) studies have extensively compared in vivo neurometabolite levels of BD patients and healthy controls (HC) in the ACC. However, these studies have not been analyzed in a systematic review or meta-analysis and nor has the influence of mood state and medication on neurometabolites been examined in this cortical region. A systematic review and a meta-analysis of 1H-MRS studies comparing ACC neurometabolite profiles of adult BD patients and HC subjects was conducted, retrieving 27 articles published between 2000 and 2018. Overall increased ACC levels of Glx [glutamine (Gln) + glutamate)/Creatine], Gln, choline (Cho) and Cho/Creatine were found in BD compared to HC. Bipolar depression was associated with higher Cho levels, while euthymia correlated with higher glutamine (Gln) and Cho. Mood stabilizers appeared to affect ACC Glu and Gln metabolites. Increased ACC Cho observed in euthymia, depression and in medication-free groups could be considered a trait marker in BD and attributed to increased cell membrane phospholipid turnover. Overall increased ACC Glx was associated with elevated Gln levels, particularly influenced by euthymia, but no abnormality in Glu was detected. Further 1H-MRS studies, on other voxels, should assess more homogeneous (mood state-specific), larger BD samples and account for medication status using more sensitive 1H-MRS techniques.
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Abstract
Objective: Previous studies have shown differences in the regional brain structure and function between patients with bipolar disorder (BD) and healthy subjects, but little is known about the structural connectivity between BD patients and healthy subjects. In this study, we evaluated the disease-related changes in regional structural connectivity derived from gray matter magnetic resonance imaging (MRI) scans. Methods: The subjects were 73 patients with BD and 80 healthy volunteers who underwent 3-Tesla MRI. Network metrics, such as the small world properties, were computed. We also performed rendering of the network metric images such as the degree, betweenness centrality, and clustering coefficient, on individual brain image. Then, we estimated the differences between them, and evaluate the relationships between the clinical symptoms and the network metrics in the patients with BD. Results: BD patients showed a lower clustering coefficient in the right parietal region and left occipital region, compared with healthy subjects. A weak negative correlation between Young mania rating scale and clustering coefficient was found in left anterior cingulate cortex. Conclusions: We found differences in gray matter structural connectivity between BD patients and healthy subjects by a similarity-based approach. These points may provide objective biological information as an adjunct to the clinical diagnosis of BD.
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Guglielmo R, Miskowiak KW, Hasler G. Evaluating endophenotypes for bipolar disorder. Int J Bipolar Disord 2021; 9:17. [PMID: 34046710 PMCID: PMC8160068 DOI: 10.1186/s40345-021-00220-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Phenotypic heterogeneity is a major impediment to the elucidation of the neurobiology and genetics of bipolar disorder. Endophenotype could help in reducing heterogeneity by defining biological traits that are more direct expressions of gene effects. The aim of this review is to examine the recent literature on clinical, epidemiological, neurobiological, and genetic findings and to select and evaluate candidate endophenotypes for bipolar disorder. Evaluating putative endophenotype could be helpful in better understanding the neurobiology of bipolar disorder by improving the definition of bipolar-related phenotypes in genetic studies. In this manner, research on endophenotypes could be useful to improve psychopathological diagnostics in the long-run by dissecting psychiatric macro phenotypes into biologically valid components. MAIN BODY The associations among the psychopathological and biological endophenotypes are discussed with respect to specificity, temporal stability, heritability, familiarity, and clinical and biological plausibility. Numerous findings regarding brain function, brain structure, neuropsychology and altered neurochemical pathways in patients with bipolar disorder and their relatives deserve further investigation. Overall, major findings suggest a developmental origin of this disorder as all the candidate endophenotypes that we have been able to select are present both in the early stages of the disorder as well as in subjects at risk. CONCLUSIONS Among the stronger candidate endophenotypes, we suggest circadian rhythm instability, dysmodulation of emotion and reward, altered neuroimmune state, attention and executive dysfunctions, anterior cingulate cortex thickness and early white matter abnormalities. In particular, early white matter abnormalities could be the result of a vulnerable brain on which new stressors are added in young adulthood which favours the onset of the disorder. Possible pathways that lead to a vulnerable brain are discussed starting from the data about molecular and imaging endophenotypes of bipolar disorder.
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Affiliation(s)
- Riccardo Guglielmo
- Psychiatry Research Unit, Fribourg Network for Mental Health (RFSM), University of Fribourg, Chemin du Cardinal-Journet 3, 1752, Villars-sur-Glâne, Switzerland.,Department of Neuroscience, Institute of Psychiatry, Catholic University Medical School, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Gregor Hasler
- Psychiatry Research Unit, Fribourg Network for Mental Health (RFSM), University of Fribourg, Chemin du Cardinal-Journet 3, 1752, Villars-sur-Glâne, Switzerland.
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Zhou C, Li J, Dong M, Ping L, Lin H, Wang Y, Wang S, Gao S, Yu G, Cheng Y, Xu X. Altered White Matter Microstructures in Type 2 Diabetes Mellitus: A Coordinate-Based Meta-Analysis of Diffusion Tensor Imaging Studies. Front Endocrinol (Lausanne) 2021; 12:658198. [PMID: 34012420 PMCID: PMC8127836 DOI: 10.3389/fendo.2021.658198] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/07/2021] [Indexed: 01/20/2023] Open
Abstract
Objective Type 2 diabetes mellitus (T2DM) is often accompanied by cognitive decline and depressive symptoms. Numerous diffusion tensor imaging (DTI) studies revealed microstructural white matter (WM) abnormalities in T2DM but the findings were inconsistent. The present study aimed to conduct a coordinate-based meta-analysis (CBMA) to identify statistical consensus of DTI studies in T2DM. Methods We performed a systematic search on relevant studies that reported fractional anisotropy (FA) differences between T2DM patients and healthy controls (HC). The anisotropic effect size seed-based d mapping (AES-SDM) approach was used to explore WM alterations in T2DM. A meta-regression was then used to analyze potential influences of sample characteristics on regional FA changes. Results A total of eight studies that comprised 245 patients and 200 HC, along with 52 coordinates were extracted. The meta-analysis identified FA reductions in three clusters including the left inferior network, the corpus callosum (CC), and the left olfactory cortex. Besides, FA in the CC was negatively correlated with body mass index (BMI) in the patients group. Conclusions T2DM could lead to subtle WM microstructural alterations, which might be associated with cognitive deficits or emotional distress symptoms. This provides a better understanding of the pathophysiology of neurodegeneration and complications in T2DM. Systematic Review Registration Registered at PROSPERO (http://www.crd.york.ac.uk/PROSPERO), registration number: CRD42020218737.
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Affiliation(s)
- Cong Zhou
- School of Mental Health, Jining Medical University, Jining, China
| | - Jie Li
- Department of Psychiatry, Jining Psychiatric Hospital, Jining, China
| | - Man Dong
- School of Mental Health, Jining Medical University, Jining, China
| | - Liangliang Ping
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Hao Lin
- School of Mental Health, Jining Medical University, Jining, China
| | - Yuxin Wang
- School of Mental Health, Jining Medical University, Jining, China
| | - Shuting Wang
- School of Mental Health, Jining Medical University, Jining, China
| | - Shuo Gao
- School of Mental Health, Jining Medical University, Jining, China
| | - Ge Yu
- School of Mental Health, Jining Medical University, Jining, China
| | - Yuqi Cheng
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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50
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Joseph B, Nandakumar AL, Ahmed AT, Gopal N, Murad MH, Frye MA, Tobin WO, Singh B. Prevalence of bipolar disorder in multiple sclerosis: a systematic review and meta-analysis. EVIDENCE-BASED MENTAL HEALTH 2021; 24:88-94. [PMID: 33328183 PMCID: PMC10231514 DOI: 10.1136/ebmental-2020-300207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/09/2020] [Accepted: 11/30/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic disabling, demyelinating disease of the central nervous system and is often associated with psychiatric comorbidities. Some studies suggest increased prevalence of bipolar disorder (BD) in MS. OBJECTIVE To conduct a systematic review and meta-analysis assessing the prevalence of BD in adults with MS. METHODS We registered this review with PROSPERO and searched electronic databases (Ovid MEDLINE, Central, Embase, PsycINFO and Scopus) for eligible studies from earliest inception to October 2020. Prevalence data of BD in adult patients with MS were extracted. Meta-analysis was conducted using random-effects model. FINDINGS Of the 802 articles that were screened, 23 studies enrolling a total of 68 796 patients were included in the systematic review and meta-analysis. The pooled prevalence rate of BD in patients with MS was 2.95% (95% CI 2.12% to 4.09%) with higher prevalence in the Americas versus Europe. The lifetime prevalence of BD was 8.4% in patients with MS. Subgroup analysis showed a higher prevalence of BD in MS in females (7.03%) than in males (5.64%), which did not reach statistical significance (p=0.53). CONCLUSIONS This meta-analysis suggests a high lifetime prevalence of BD in patients with MS. Patients with MS should be routinely screened for BD. Further assessment of bipolar comorbidity in MS through prospective studies may help in developing effective management strategies and may improve treatment outcomes in patients with MS.
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Affiliation(s)
- Boney Joseph
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Ahmed T Ahmed
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Clinical and Translational Science Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, Minnesota, USA
| | - Neethu Gopal
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - M Hassan Murad
- Evidence-Based Practice Research Program, Mayo Clinic, Rochester, Minnesota, USA
- Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - W Oliver Tobin
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Balwinder Singh
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
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