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Gencheva TM, Valkov BV, Kandilarova SS, Maes MHJ, Stoyanov DS. Diagnostic value of structural, functional and effective connectivity in bipolar disorder. Acta Psychiatr Scand 2024. [PMID: 39137928 DOI: 10.1111/acps.13742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 08/15/2024]
Abstract
INTRODUCTION The aim of this systematic review is to assess the functional magnetic resonance imaging (fMRI) studies of bipolar disorder (BD) patients that characterize differences in terms of structural, functional, and effective connectivity between the patients with BD, patients with other psychiatric disorders and healthy controls as possible biomarkers for diagnosing the disorder using neuroimaging. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), guidelines a systematic search for recent (since 2015) original studies on connectivity in bipolar disorder was conducted in PUBMED and SCOPUS. RESULTS A total of 60 studies were included in this systematic review: 20 of the structural connectivity, 33 of the functional connectivity, and only 7 of the studies focused on effective connectivity complied with the inclusion and exclusion criteria. DISCUSSION Despite the great heterogeneity in the findings, there are several trends that emerge. In structural connectivity studies, the main abnormalities in bipolar disorder patients were in the frontal gyrus, anterior, as well as posterior cingulate cortex and differences in emotion and reward-related networks. Cerebellum (vermis) to cerebrum functional connectivity was found to be the most common finding in BD. Moreover, prefrontal cortex and amygdala connectivity as part of the rich-club hubs were often reported to be disrupted. The most common findings based on effective connectivity were alterations in salience network, default mode network and executive control network. Although more studies with larger sample sizes are needed to ascertain altered brain connectivity as diagnostic biomarker, there is a perspective that the method could be used as a single marker of diagnosis in the future, and the process of adoption could be accelerated by using approaches such as semiunsupervised machine learning.
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Affiliation(s)
| | - Bozhidar V Valkov
- Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Sevdalina S Kandilarova
- Department of Psychiatry and Medical Psychology, and Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria
- Research and Innovation Program for the Development of MU - PLOVDIV - (SRIPD-MUP), Creation of a Network of Research Higher Schools, National Plan For Recovery and Sustainability, European Union - NextGenerationEU, Plovdiv, Bulgaria
| | - Michael H J Maes
- Department of Psychiatry and Medical Psychology, and Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Research and Innovation Program for the Development of MU - PLOVDIV - (SRIPD-MUP), Creation of a Network of Research Higher Schools, National Plan For Recovery and Sustainability, European Union - NextGenerationEU, Plovdiv, Bulgaria
| | - Drozdstoy S Stoyanov
- Department of Psychiatry and Medical Psychology, and Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria
- Research and Innovation Program for the Development of MU - PLOVDIV - (SRIPD-MUP), Creation of a Network of Research Higher Schools, National Plan For Recovery and Sustainability, European Union - NextGenerationEU, Plovdiv, Bulgaria
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Pérez-Ramos A, Romero-López-Alberca C, Hidalgo-Figueroa M, Berrocoso E, Pérez-Revuelta JI. A systematic review of the biomarkers associated with cognition and mood state in bipolar disorder. Int J Bipolar Disord 2024; 12:18. [PMID: 38758506 PMCID: PMC11101403 DOI: 10.1186/s40345-024-00340-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a severe psychiatric disorder characterized by changes in mood that alternate between (hypo) mania or depression and mixed states, often associated with functional impairment and cognitive dysfunction. But little is known about biomarkers that contribute to the development and sustainment of cognitive deficits. The aim of this study was to review the association between neurocognition and biomarkers across different mood states. METHOD Search databases were Web of Science, Scopus and PubMed. A systematic review was carried out following the PRISMA guidelines. Risk of bias was assessed with the Newcastle-Ottawa Scale. Studies were selected that focused on the correlation between neuroimaging, physiological, genetic or peripheral biomarkers and cognition in at least two phases of BD: depression, (hypo)mania, euthymia or mixed. PROSPERO Registration No.: CRD42023410782. RESULTS A total of 1824 references were screened, identifying 1023 published articles, of which 336 were considered eligible. Only 16 provided information on the association between biomarkers and cognition in the different affective states of BD. The included studies found: (i) Differences in levels of total cholesterol and C reactive protein depending on mood state; (ii) There is no association found between cognition and peripheral biomarkers; (iii) Neuroimaging biomarkers highlighted hypoactivation of frontal areas as distinctive of acute state of BD; (iv) A deactivation failure has been reported in the ventromedial prefrontal cortex (vmPFC), potentially serving as a trait marker of BD. CONCLUSION Only a few recent articles have investigated biomarker-cognition associations in BD mood phases. Our findings underline that there appear to be central regions involved in BD that are observed in all mood states. However, there appear to be underlying mechanisms of cognitive dysfunction that may vary across different mood states in BD. This review highlights the importance of standardizing the data and the assessment of cognition, as well as the need for biomarkers to help prevent acute symptomatic phases of the disease, and the associated functional and cognitive impairment.
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Affiliation(s)
- Anaid Pérez-Ramos
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, Faculty of Medicine, University of Cadiz, Cadiz, Spain
| | - Cristina Romero-López-Alberca
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain.
- Personality, Evaluation and Psychological Treatment Area, Department of Psychology, University of Cadiz, Cadiz, Spain.
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain.
| | - Maria Hidalgo-Figueroa
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Psychobiology Area, Department of Psychology, University of Cadiz, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain
| | - Esther Berrocoso
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, Faculty of Medicine, University of Cadiz, Cadiz, Spain
| | - Jose I Pérez-Revuelta
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Clinical Management of Mental Health Unit, University Hospital of Jerez, Andalusian Health Service, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain
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Wu YK, Su YA, Li L, Zhu LL, Li K, Li JT, Mitchell PB, Yan CG, Si TM. Brain functional changes across mood states in bipolar disorder: from a large-scale network perspective. Psychol Med 2024; 54:763-774. [PMID: 38084586 DOI: 10.1017/s0033291723002453] [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] [Indexed: 03/05/2024]
Abstract
BACKGROUND Exploring the neural basis related to different mood states is a critical issue for understanding the pathophysiology underlying mood switching in bipolar disorder (BD), but research has been scarce and inconsistent. METHODS Resting-state functional magnetic resonance imaging data were acquired from 162 patients with BD: 33 (hypo)manic, 64 euthymic, and 65 depressive, and 80 healthy controls (HCs). The differences of large-scale brain network functional connectivity (FC) between the four groups were compared and correlated with clinical characteristics. To validate the generalizability of our findings, we recruited a small longitudinal independent sample of BD patients (n = 11). In addition, we examined topological nodal properties across four groups as exploratory analysis. RESULTS A specific strengthened pattern of network FC, predominantly involving the default mode network (DMN), was observed in (hypo)manic patients when compared with HCs and bipolar patients in other mood states. Longitudinal observation revealed an increase in several network FCs in patients during (hypo)manic episode. Both samples evidenced an increase in the FC between the DMN and ventral attention network, and between the DMN and limbic network (LN) related to (hypo)mania. The altered network connections were correlated with mania severity and positive affect. Bipolar depressive patients exhibited decreased FC within the LN compared with HCs. The exploratory analysis also revealed an increase in degree in (hypo)manic patients. CONCLUSIONS Our findings identify a distributed pattern of large-scale network disturbances in the unique context of (hypo)mania and thus provide new evidence for our understanding of the neural mechanism of BD.
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Affiliation(s)
- Yan-Kun Wu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yun-Ai Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Le Li
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Center for Cognitive Science of Language, Beijing Language and Culture University, Beijing, China
| | - Lin-Lin Zhu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Ke Li
- PLA Strategic Support Force Characteristic Medical Center, Beijing, China
| | - Ji-Tao Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - Chao-Gan Yan
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Tian-Mei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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Wu Y, Su YA, Zhu L, Li J, Si T. Advances in functional MRI research in bipolar disorder: from the perspective of mood states. Gen Psychiatr 2024; 37:e101398. [PMID: 38292862 PMCID: PMC10826570 DOI: 10.1136/gpsych-2023-101398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/20/2023] [Indexed: 02/01/2024] Open
Abstract
Bipolar disorder is characterised by recurrent and alternating episodes of mania/hypomania and depression. Current breakthroughs in functional MRI techniques have uncovered the functional neuroanatomy of bipolar disorder. However, the pathophysiology underlying mood instability, mood switching and the development of extreme mood states is less well understood. This review presents a comprehensive overview of current evidence from functional MRI studies from the perspective of mood states. We first summarise the disrupted brain activation patterns and functional connectivity that have been reported in bipolar disorder, irrespective of the mood state. We next focus on research that solely included patients in a single mood state for a better understanding of the pathophysiology of bipolar disorder and research comparing patients with different mood states to dissect mood state-related effects. Finally, we briefly summarise current theoretical models and conclude this review by proposing potential avenues for future research. A comprehensive understanding of the pathophysiology with consideration of mood states could not only deepen our understanding of how acute mood episodes develop at a neurophysiological level but could also facilitate the identification of biological targets for personalised treatment and the development of new interventions for bipolar disorder.
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Affiliation(s)
- Yankun Wu
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yun-Ai Su
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Linlin Zhu
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jitao Li
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Tianmei Si
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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Li D, Hao J, Hao J, Cui X, Niu Y, Xiang J, Wang B. Enhanced Dynamic Laterality Based on Functional Subnetworks in Patients with Bipolar Disorder. Brain Sci 2023; 13:1646. [PMID: 38137094 PMCID: PMC10741828 DOI: 10.3390/brainsci13121646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 12/24/2023] Open
Abstract
An ocean of studies have pointed to abnormal brain laterality changes in patients with bipolar disorder (BD). Determining the altered brain lateralization will help us to explore the pathogenesis of BD. Our study will fill the gap in the study of the dynamic changes of brain laterality in BD patients and thus provide new insights into BD research. In this work, we used fMRI data from 48 BD patients and 48 normal controls (NC). We constructed the dynamic laterality time series by extracting the dynamic laterality index (DLI) at each sliding window. We then used k-means clustering to partition the laterality states and the Arenas-Fernandez-Gomez (AFG) community detection algorithm to determine the number of states. We characterized subjects' laterality characteristics using the mean laterality index (MLI) and laterality fluctuation (LF). Compared with NC, in all windows and state 1, BD patients showed higher MLI in the attention network (AN) of the right hemisphere, and AN in the left hemisphere showed more frequent laterality fluctuations. AN in the left hemisphere of BD patients showed higher MLI in all windows and state 3 compared to NC. In addition, in the AN of the right hemisphere in state 1, higher MLI in BD patients was significantly associated with patient symptoms. Our study provides new insights into the understanding of BD neuropathology in terms of brain dynamic laterality.
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Affiliation(s)
- Dandan Li
- College of Computer Science and Technology, Taiyuan University of Technology, Jinzhong 030600, China; (J.H.)
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Niu M, Guo H, Zhang Z, Fu Y. Abnormal temporal variability of rich-club organization in three major psychiatric conditions. Front Psychiatry 2023; 14:1226143. [PMID: 37720902 PMCID: PMC10500439 DOI: 10.3389/fpsyt.2023.1226143] [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: 05/20/2023] [Accepted: 08/07/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Convergent evidence has demonstrated a shared rich-club reorganization across multiple major psychiatric conditions. However, previous studies assessing altered functional couplings between rich-club regions have typically focused on the mean time series from entire functional magnetic resonance imaging (fMRI) scanning session, neglecting their time-varying properties. Methods In this study, we aim to explore the common and/or unique alterations in the temporal variability of rich-club organization among schizophrenia (SZ), bipolar disorder (BD), and attention deficit/hyperactivity disorder (ADHD). We employed a temporal rich-club (TRC) approach to quantitatively assess the propensity of well-connected nodes to form simultaneous and stable structures in a temporal network derived from resting-state fMRI data of 156 patients with major psychiatric disorders (SZ/BD/ADHD = 71/45/40) and 172 healthy controls. We executed the TRC workflow at both whole-brain and subnetwork scales across varying network sparsity, sliding window strategies, lengths and steps of sliding windows, and durations of TRC coefficients. Results The SZ and BD groups displayed significantly decreased TRC coefficients compared to corresponding HC groups at the whole-brain scale and in most subnetworks. In contrast, the ADHD group exhibited reduced TRC coefficients in longer durations, as opposed to shorter durations, which markedly differs from the SZ and BD groups. These findings reveal both transdiagnostic and illness-specific patterns in temporal variability of rich-club organization across SZ, BD, and ADHD. Discussion TRC may serve as an effective metric for detecting brain network disruptions in particular states, offering novel insights and potential biomarkers into the neurobiological basis underpinning the behavioral and cognitive deficits observed in these disorders.
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Affiliation(s)
- Meng Niu
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, China
- Intelligent Imaging Medical Engineering Research Center of Gansu Province, Lanzhou, China
- Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou, China
| | - Hanning Guo
- Institute of Neuroscience and Medicine, Medical Imaging Physics (INM-4), Forschungszentrum Jülich, Jülich, Germany
| | - Zhe Zhang
- School of Physics, Hangzhou Normal University, Hangzhou, China
- Institute of Brain Science, Hangzhou Normal University, Hangzhou, China
| | - Yu Fu
- College of Information Science & Electronic Engineering, Zhejiang University, Hangzhou, China
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Greene AS, Horien C, Barson D, Scheinost D, Constable RT. Why is everyone talking about brain state? Trends Neurosci 2023; 46:508-524. [PMID: 37164869 PMCID: PMC10330476 DOI: 10.1016/j.tins.2023.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/17/2023] [Accepted: 04/07/2023] [Indexed: 05/12/2023]
Abstract
The rapid and coordinated propagation of neural activity across the brain provides the foundation for complex behavior and cognition. Technical advances across neuroscience subfields have advanced understanding of these dynamics, but points of convergence are often obscured by semantic differences, creating silos of subfield-specific findings. In this review we describe how a parsimonious conceptualization of brain state as the fundamental building block of whole-brain activity offers a common framework to relate findings across scales and species. We present examples of the diverse techniques commonly used to study brain states associated with physiology and higher-order cognitive processes, and discuss how integration across them will enable a more comprehensive and mechanistic characterization of the neural dynamics that are crucial to survival but are disrupted in disease.
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Affiliation(s)
- Abigail S Greene
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06520, USA; MD/PhD program, Yale School of Medicine, New Haven, CT 06520, USA.
| | - Corey Horien
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06520, USA; MD/PhD program, Yale School of Medicine, New Haven, CT 06520, USA.
| | - Daniel Barson
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06520, USA; MD/PhD program, Yale School of Medicine, New Haven, CT 06520, USA; Department of Neuroscience, Yale School of Medicine, New Haven, CT 06520, USA.
| | - Dustin Scheinost
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06520, USA; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06520, USA; Department of Biomedical Engineering, Yale School of Engineering and Applied Science, New Haven, CT 06520, USA; Department of Statistics and Data Science, Yale University, New Haven, CT 06511, USA; Child Study Center, Yale School of Medicine, New Haven, CT 06520, USA
| | - R Todd Constable
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06520, USA; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06520, USA; Department of Biomedical Engineering, Yale School of Engineering and Applied Science, New Haven, CT 06520, USA; Department of Neurosurgery, Yale School of Medicine, New Haven, CT 06520, USA
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Luna LP, Sousa MB, Passinho JS, Nardi AE, Oertel V, Veras AB, Alves GS. Resting-state fMRI functional connectivity and clinical correlates in Afro-descendants with schizophrenia and bipolar disorder. Psychiatry Res Neuroimaging 2023; 331:111628. [PMID: 36924740 DOI: 10.1016/j.pscychresns.2023.111628] [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: 06/16/2022] [Revised: 02/12/2023] [Accepted: 03/07/2023] [Indexed: 03/18/2023]
Abstract
Schizophrenia (SCZ) and bipolar disorder (BD) exhibited altered activation in several brain areas, including the prefrontal and temporal cortex; however, a less explored topic is how brain connectivity and functional disturbances occur in non-Caucasian samples of SCZ and BD. Individuals with SCZ (n=20), BD (n=21), and healthy controls (HC, n=21) from indigenous and African ethnicity were submitted to clinical screening and functional assessments. Mood, compulsive and psychotic symptoms were also correlated to network dysfunction in each group. Two distinct networks' subcomponents demonstrated significant lower global efficiency (GE) in SCZ versus HC, corresponding to left posterior dorsal attention and medial left ventral attention (VA) networks. Lower GE was found in BD versus controls in four subcomponents, including the left medial and right VA. Higher compulsion scores correlated in BD with lower GE in the left VA, whereas increased report of alcohol abuse was associated with higher GE in left default mode network. Although preliminary, differences in the activation of specific networks, notably the left hemisphere, in SCZ versus controls, and lower activation in VA areas, in BD versus controls. Results highlight default mode and salient network as relevant for the emotional processing of SCZ and BD of indigenous and black ethnicity. Abstract: schizophrenia, bipolar disorder, functional neuroimaging, ethnicity, default network.
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Affiliation(s)
- Licia P Luna
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD, USA
| | | | - Jhule S Passinho
- Neuropsychology Laboratory, CEUMA University, São Luís, Maranhão, Brazil
| | - Antônio E Nardi
- Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Viola Oertel
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Frankfurt Goethe University, Germany
| | - André Barciela Veras
- Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Translational Research Group on Mental Health (GPTranSMe), Dom Bosco Catholic University, Campo Grande, Mato Grosso do Sul, Brazil
| | - Gilberto Sousa Alves
- Post-Graduation in Psychiatry and Mental Health (PROPSAM), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Translational Psychiatry Research Group, Federal University of Maranhão, São Luís, Maranhão, Brazil.
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Shamabadi A, Karimi H, Cattarinussi G, Moghaddam HS, Akhondzadeh S, Sambataro F, Schiena G, Delvecchio G. Neuroimaging Correlates of Treatment Response to Transcranial Magnetic Stimulation in Bipolar Depression: A Systematic Review. Brain Sci 2023; 13:brainsci13050801. [PMID: 37239273 DOI: 10.3390/brainsci13050801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) has become a promising strategy for bipolar disorder (BD). This study reviews neuroimaging findings, indicating functional, structural, and metabolic brain changes associated with TMS in BD. Web of Science, Embase, Medline, and Google Scholar were searched without any restrictions for studies investigating neuroimaging biomarkers, through structural magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), functional MRI (fMRI), magnetic resonance spectroscopy (MRS), positron emission tomography (PET), and single photon emission computed tomography (SPECT), in association with response to TMS in patients with BD. Eleven studies were included (fMRI = 4, MRI = 1, PET = 3, SPECT = 2, and MRS = 1). Important fMRI predictors of response to repetitive TMS (rTMS) included higher connectivity of emotion regulation and executive control regions. Prominent MRI predictors included lower ventromedial prefrontal cortex connectivity and lower superior frontal and caudal middle frontal volumes. SPECT studies found hypoconnectivity of the uncus/parahippocampal cortex and right thalamus in non-responders. The post-rTMS changes using fMRI mostly showed increased connectivity among the areas neighboring the coil. Increased blood perfusion was reported post-rTMS in PET and SPECT studies. Treatment response comparison between unipolar depression and BD revealed almost equal responses. Neuroimaging evidence suggests various correlates of response to rTMS in BD, which needs to be further replicated in future studies.
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Affiliation(s)
- Ahmad Shamabadi
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran M9HV+R6Q, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran P94V+8MF, Iran
| | - Hanie Karimi
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran M9HV+R6Q, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran P94V+8MF, Iran
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, 35131 Padua, Italy
| | - Hossein Sanjari Moghaddam
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran M9HV+R6Q, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran M9HV+R6Q, Iran
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, 35131 Padua, Italy
| | - Giandomenico Schiena
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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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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11
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Zeng J, Zhang Y, Xiang Y, Liang S, Xue C, Zhang J, Ran Y, Cao M, Huang F, Huang S, Deng W, Li T. Optimizing multi-domain hematologic biomarkers and clinical features for the differential diagnosis of unipolar depression and bipolar depression. NPJ MENTAL HEALTH RESEARCH 2023; 2:4. [PMID: 38609642 PMCID: PMC10955811 DOI: 10.1038/s44184-023-00024-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/01/2023] [Indexed: 04/14/2024]
Abstract
There is a lack of objective features for the differential diagnosis of unipolar and bipolar depression, especially those that are readily available in practical settings. We investigated whether clinical features of disease course, biomarkers from complete blood count, and blood biochemical markers could accurately classify unipolar and bipolar depression using machine learning methods. This retrospective study included 1160 eligible patients (918 with unipolar depression and 242 with bipolar depression). Patient data were randomly split into training (85%) and open test (15%) sets 1000 times, and the average performance was reported. XGBoost achieved the optimal open-test performance using selected biomarkers and clinical features-AUC 0.889, sensitivity 0.831, specificity 0.839, and accuracy 0.863. The importance of features for differential diagnosis was measured using SHapley Additive exPlanations (SHAP) values. The most informative features include (1) clinical features of disease duration and age of onset, (2) biochemical markers of albumin, low density lipoprotein (LDL), and potassium, and (3) complete blood count-derived biomarkers of white blood cell count (WBC), platelet-to-lymphocyte ratio (PLR), and monocytes (MONO). Overall, onset features and hematologic biomarkers appear to be reliable information that can be readily obtained in clinical settings to facilitate the differential diagnosis of unipolar and bipolar depression.
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Affiliation(s)
- Jinkun Zeng
- Hangzhou Seventh People's Hospital, Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yaoyun Zhang
- Alibaba Damo Academy, 969 West Wen Yi Road, Yu Hang District, Hangzhou, Zhejiang, China
| | - Yutao Xiang
- Center for Cognition and Brain Sciences, Unit of Psychiatry, Institute of Translational Medicine, University of Macau, Macao, China
| | - Sugai Liang
- Hangzhou Seventh People's Hospital, Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chuang Xue
- Hangzhou Seventh People's Hospital, Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Junhang Zhang
- Hangzhou Seventh People's Hospital, Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ya Ran
- West China Hospital, Sichuan University, Sichuan, China
| | - Minne Cao
- Hangzhou Seventh People's Hospital, Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Fei Huang
- Alibaba Damo Academy, 969 West Wen Yi Road, Yu Hang District, Hangzhou, Zhejiang, China
| | - Songfang Huang
- Alibaba Damo Academy, 969 West Wen Yi Road, Yu Hang District, Hangzhou, Zhejiang, China
| | - Wei Deng
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, 1369 West Wenyi Road, 311121, Hangzhou, China.
| | - Tao Li
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, 1369 West Wenyi Road, 311121, Hangzhou, China.
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, 310058, Hangzhou, China.
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12
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Fan F, Wang Z, Fan H, Shi J, Guo H, Yang F, Tan S, Tan Y. Functional disconnection between subsystems of the default mode network in bipolar disorder. J Affect Disord 2023; 325:22-28. [PMID: 36623564 DOI: 10.1016/j.jad.2023.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/09/2023]
Affiliation(s)
- Fengmei Fan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Zhiren Wang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China.
| | - Hongzhen Fan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Jing Shi
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Hua Guo
- Zhumadian Psychiatry Hospital Henan Province, China
| | - Fude Yang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Shuping Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China.
| | - Yunlong Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
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13
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Saleem A, Harmata G, Jain S, Voss MW, Fiedorowicz JG, Williams A, Shaffer JJ, Richards JG, Barsotti EJ, Sathyaputri L, Schmitz SL, Christensen GE, Long JD, Xu J, Wemmie JA, Magnotta VA. Functional Connectivity of the Cerebellar Vermis in Bipolar Disorder and Associations with Mood. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.02.526878. [PMID: 36778335 PMCID: PMC9915674 DOI: 10.1101/2023.02.02.526878] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Purpose Studies of the neural underpinnings of bipolar type I disorder have focused on the emotional control network. However, there is also growing evidence for cerebellar involvement, including abnormal structure, function, and metabolism. Here, we sought to assess functional connectivity of the cerebellum with the cerebrum in bipolar disorder and to assess whether any effects might depend on mood. Methods This cross-sectional study enrolled 128 participants with bipolar type I disorder and 83 control comparison participants who completed a 3T MRI scan, which included anatomical imaging as well as resting state BOLD imaging. Functional connectivity of the cerebellar vermis to all other brain regions was assessed. Based on quality control metrics of the fMRI data, 109 participants with bipolar disorder and 79 controls were used to in the statistical analysis comparing connectivity of the vermis as well as associations with mood. Potential impacts of medications were also explored. Results Functional connectivity of the cerebellar vermis in bipolar disorder was found to differ significantly between brain regions known to be involved in the control of emotion, motor function, and language. While connections with emotion and motor control areas were significantly stronger in bipolar disorder, connection to a region associated language production was significantly weaker. In the participants with bipolar disorder, ratings of depression and mania were inversely associated with vermis functional connectivity. No effect of medications on these connections were observed. Conclusion Together the findings suggest cerebellum may play a compensatory role in bipolar disorder and when it can no longer fulfill this role, depression and mania develop. The proximity of the cerebellar vermis to the skull may make this region a potential target for treatment with transcranial magnetic stimulation.
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Affiliation(s)
- Arshaq Saleem
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Gail Harmata
- Department of Radiology, University of Iowa, Iowa City, IA, 52242
| | - Shivangi Jain
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Michelle W. Voss
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Jess G. Fiedorowicz
- The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa Brain & Mind Research Institute, Ottawa ON Canada K1H 8L6
| | - Aislinn Williams
- Department of Psychiatry, University of Iowa, Iowa City, IA, 52242
| | | | | | | | - Leela Sathyaputri
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Samantha L. Schmitz
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Gary E. Christensen
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IA, 52242,Department of Radiation Oncology, University of Iowa, Iowa City, IA, 52242
| | - Jeffrey D. Long
- Department of Psychiatry, University of Iowa, Iowa City, IA, 52242,Department of Biostatistics, University of Iowa, Iowa City, IA, 52242
| | - Jia Xu
- Department of Radiology, University of Iowa, Iowa City, IA, 52242
| | - John A. Wemmie
- Department of Psychiatry, University of Iowa, Iowa City, IA, 52242,Veterans Affairs Medical Center, Iowa City, Iowa, USA,Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, Iowa, USA,Department of Neurosurgery, University of Iowa, Iowa City, IA, 52242
| | - Vincent A. Magnotta
- Department of Radiology, University of Iowa, Iowa City, IA, 52242,Department of Psychiatry, University of Iowa, Iowa City, IA, 52242,Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242
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14
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Gamma band VMPFC-PreCG.L connection variation after the onset of negative emotional stimuli can predict mania in depressive patients. J Psychiatr Res 2023; 158:165-171. [PMID: 36586215 DOI: 10.1016/j.jpsychires.2022.12.026] [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: 03/27/2022] [Revised: 11/27/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Because of the similar clinical symptoms, it is difficult to distinguish unipolar disorder (UD) from bipolar disorder (BD) in the depressive episode using the available clinical features, especially for those who meet the diagnostic criteria of UD, however, experience the manic episode during the follow-up (tBD). METHODS Magnetoencephalography recordings during a sad expression recognition task were obtained from 81 patients (27 BD, 24 tBD, 30 UD) and 26 healthy controls (HCs). Source analysis was applied to localize 64 regions of interest in the low gamma band (30-50 Hz). Regional functional connections (FCs) were constructed respectively within three time periods (early: 0-200 ms, middle: 200-400 ms, and post: 400-600 ms). The network-based statistic method was used to explore the abnormal connection patterns in tBD compared to UD and HC. BD was applied to explore whether such abnormality is still significant between every two groups of BD, tBD, UD, and HC. RESULTS The VMPFC-PreCG.L connection was found to be a significantly different connection between tBD and UD in the early time period and between tBD and BD in the middle time period. Furthermore, the middle/early time period ratio of FC value of VMPFC-PreCG.L connection was negatively correlated with the bipolarity index in tBD. CONCLUSIONS The VMPFC-PreCG.L connection in different time periods after the onset of sad facial stimuli may be a potential biomarker to distinguish the different states of BD. The FC ratio of VMPFC-PreCG.L connection may predict whether patients with depressive episodes subsequently develop mania.
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15
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Interleukin-6-white matter network differences explained the susceptibility to depression after stressful life events. J Affect Disord 2022; 305:122-132. [PMID: 35271870 DOI: 10.1016/j.jad.2022.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Stressful life events (SLEs) are well-established proximal predictors of the onset of depression. However, the fundamental causes of interindividual differences in depression outcomes are poorly understood. This study addressed this depression susceptibility mechanism using a well-powered sample of adults living in China. METHODS Healthy participants with SLEs (n = 185; mean = 47.51 years, 49.73% female), drawn from a longitudinal study on the development of depression, underwent diffusion tensor imaging, interleukin-6 (IL-6) level measurement, and trimonthly standardized clinical and scale evaluations within a two-year period. RESULTS Receiver operating characteristic analyses indicated that reduced feeder connection and HIP.R nodal efficiency improved the predictive accuracy of post-SLEs depression (ORfeeder = 0.623, AUC = 0.869, P < 0.001; ORHIP = 0.459, AUC = 0.855, P < 0.001). The successfully established path analysis model confirmed the significant partial effect of SLEs-IL-6-white matter (WM) network differences-depression (onset and severity) (x2/8 = 1.453, goodness-of-fit [GFI] = 0.935, standard root-mean-square error of approximation [SRMR] = 0.024). Females, individuals with lower exercise frequency (EF) or annual household income (AHI) were more likely to have higher IL-6 level after SLEs (βint-female⁎SLEs = -0.420, P < 0.001; βint-exercise⁎SLEs = -0.412, P < 0.001; βint-income⁎SLEs = -0.302, P = 0.005). LIMITATIONS The sample size was restricted due to the limited incidence rate and prospective follow-up design. CONCLUSIONS Our results suggested that among healthy adults after SLEs, those who exhibited abnormal IL-6-WM differences were susceptible to developing depression. Females, lower AHI or EF might account for an increased risk of developing these abnormal IL-6-WM differences.
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16
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Tracing the psychopathology of bipolar disorder to the functional architecture of intrinsic brain activity and its neurotransmitter modulation: a three-dimensional model. Mol Psychiatry 2022; 27:793-802. [PMID: 33414499 DOI: 10.1038/s41380-020-00982-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/22/2020] [Accepted: 12/01/2020] [Indexed: 12/17/2022]
Abstract
Bipolar disorder (BD) shows complex alterations in psychomotor, affective, and thought dimensions, as described by Kraepelin in his fundamental model of manic-depressive illness. In turn, the expression of behavioral/phenomenological dimensions is traceable to intrinsic brain activity. We reported a data overview on intrinsic brain functioning and its changes in BD. Accordingly, we proposed a three-dimensional model of the relationship between brain functioning and behavioral/phenomenological patterns, along with its application to BD. In this model, intrinsic brain activity is organized in distinct units in accordance to connectivity patterns and related setting of input/output processing, underlying the different behavioral/phenomenological dimensions. An external unit (mainly involving the sensorimotor network) is connected with the external environment and sets the exteroceptive input/somatomotor output processing, underlying the psychomotor dimension. An internal unit (mainly involving the salience network) is connected to the internal/body environment and sets the interoceptive input/visceromotor output processing, underlying the affective dimension. Finally, an associative unit (mainly involving the default-mode network) is not connected with the environment and sets the processing of associative inputs/outputs, underlying the thought dimension. In each unit, neurotransmitter signaling couples the subcortical-cortical loop, which modulates the network activity levels, in turn setting input/output processing and related expression levels of the behavioral/phenomenological dimension. Different combinations in neurotransmitter signaling favor network balancing into distinct functional brain states, which manifest in different combinations of excitation or inhibition in psychomotricity, affectivity, and thought, resulting in the manic, depressive, and mixed states of BD. Our working model might provide a coherent framework for tracing the complex BD psychopathology to core functional brain alterations.
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17
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Chan SY, Brady RO, Lewandowski KE, Higgins A, Öngür D, Hall MH. Dynamic and progressive changes in thalamic functional connectivity over the first five years of psychosis. Mol Psychiatry 2022; 27:1177-1183. [PMID: 34697450 PMCID: PMC9035477 DOI: 10.1038/s41380-021-01319-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 09/09/2021] [Accepted: 09/24/2021] [Indexed: 11/09/2022]
Abstract
The early stage of psychosis (ESP) is a critical period where effective intervention has the most favorable impact on outcomes. Thalamic connectivity abnormalities have been consistently found in psychosis, and are associated with clinical symptoms and cognitive deficits. However, most studies consider ESP patients as a homogeneous population and fail to take the duration of illness into account. In this study, we aimed to capture the progression of thalamic connectivity changes over the first five years of psychosis. Resting-state functional MRI scans were collected from 156 ESP patients (44 with longitudinal data) and 82 healthy controls (24 with longitudinal data). We first performed a case-control analysis comparing thalamic connectivity with 13 networks in the cortex and cerebellum. Next, we modelled the shape (flat, linear, curvilinear) of thalamic connectivity trajectories by comparing flexible non-linear versus linear models. We then tested the significance of the duration of illness and diagnosis in trajectories that changed over time. Connectivity changed over the ESP period between the thalamus and default mode network (DMN) and fronto-parietal network (FPN) nodes in both the cortex and cerebellum. Three models followed a curvilinear trajectory (early increase followed by a subsequent decrease), while thalamo-cerebellar FPN connectivity followed a linear trajectory of steady reductions over time, indicating different rates of change. Finally, diagnosis significantly predicted thalamic connectivity. Thalamo-cortical and thalamo-cerebellar connectivity change in a dynamic fashion during the ESP period. A better understanding of these changes may provide insights into the compensatory and progressive changes in functional connectivity in the early stages of illness.
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Affiliation(s)
- Shi Yu Chan
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA, USA.
- Psychosis Neurobiology Laboratory, McLean Hospital, Belmont, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Roscoe O Brady
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, USA
| | - Kathryn E Lewandowski
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Amy Higgins
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA, USA
- Psychosis Neurobiology Laboratory, McLean Hospital, Belmont, MA, USA
| | - Dost Öngür
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA, USA
- Psychosis Neurobiology Laboratory, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Mei-Hua Hall
- Schizophrenia and Bipolar Disorder Research Program, McLean Hospital, Belmont, MA, USA
- Psychosis Neurobiology Laboratory, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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18
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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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Marino M, Romeo Z, Angrilli A, Semenzato I, Favaro A, Magnolfi G, Padovan GB, Mantini D, Spironelli C. Default mode network shows alterations for low-frequency fMRI fluctuations in euthymic bipolar disorder. J Psychiatr Res 2021; 144:59-65. [PMID: 34600288 DOI: 10.1016/j.jpsychires.2021.09.051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/13/2021] [Accepted: 09/23/2021] [Indexed: 11/18/2022]
Abstract
Bipolar disorder (BD) is a psychiatric condition causing acute dysfunctional mood states and emotion regulation. Specific neuropsychological features are often present also among patients in euthymic phase, who do not show clear psychotic symptoms, and for whom the characterization from functional magnetic resonance imaging (fMRI) is very limited. This study aims at identifying the neural and behavioral correlates of the default mode network (DMN) using the fractional amplitude of low frequency fluctuations (fALFF). Eighteen euthymic BD patients (10 females; age = 54.50 ± 11.38 years) and sixteen healthy controls (HC) (8 females; age = 51.16 ± 11.44 years) underwent a 1.5T fMRI scan at rest. The DMN was extracted through independent component analysis. Then, DMN time series was used to compute the fALFF, which was correlated with clinical scales. From the between-group comparison, no significant differences emerged in correspondence to regions belonging to the DMN. For fALFF analysis, we reported significant increase of low-frequency fluctuations for lower frequencies, and decreases for higher frequencies compared to HC. Correlations with clinical scales showed that an increase in higher frequency spectral content was associated with lower levels of mania and higher levels of anxious symptoms, while an increase in lower frequencies was linked to lower depressive symptoms. Starting from our findings on the DMN in euthymic BD patients, we suggest that the fALFF derived from network time series represents a viable approach to investigate the behavioral correlates of resting state networks, and the pathophysiological mechanisms of different psychiatric conditions.
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Affiliation(s)
- Marco Marino
- Department of Movement Sciences, Research Center for Motor Control and Neuroplasticity, KU, Leuven, Belgium; IRCCS San Camillo Hospital, Venice, Italy.
| | - Zaira Romeo
- Department of General Psychology, University of Padova, Italy
| | - Alessandro Angrilli
- Department of General Psychology, University of Padova, Italy; Padova Neuroscience Center, University of Padova, Italy
| | | | - Angela Favaro
- Padova Neuroscience Center, University of Padova, Italy; Psychiatric Clinic, Neuroscience Department, University of Padova, Italy
| | - Gianna Magnolfi
- Psychiatric Clinic, Neuroscience Department, University of Padova, Italy
| | - Giordano Bruno Padovan
- Psychiatric Clinic, Neuroscience Department, University of Padova, Italy; Unit of Penitentiary Medicine, ULSS6, Padova, Italy
| | - Dante Mantini
- Department of Movement Sciences, Research Center for Motor Control and Neuroplasticity, KU, Leuven, Belgium; IRCCS San Camillo Hospital, Venice, Italy
| | - Chiara Spironelli
- Department of General Psychology, University of Padova, Italy; Padova Neuroscience Center, University of Padova, Italy.
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20
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Hwang M, Roh YS, Talero J, Cohen BM, Baker JT, Brady RO, Öngür D, Shinn AK. Auditory hallucinations across the psychosis spectrum: Evidence of dysconnectivity involving cerebellar and temporal lobe regions. Neuroimage Clin 2021; 32:102893. [PMID: 34911197 PMCID: PMC8636859 DOI: 10.1016/j.nicl.2021.102893] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/29/2021] [Accepted: 11/19/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Auditory hallucinations (AH) are typically associated with schizophrenia (SZ), but they are also prevalent in bipolar disorder (BD). Despite the large body of research on the neural correlates of AH in SZ, the pathophysiology underlying AH remains unclear. Few studies have examined the neural substrates associated with propensity for AH in BD. Investigating AH across the psychosis spectrum has the potential to inform about the neural signature associated with the trait of AH, irrespective of psychiatric diagnosis. METHODS We compared resting state functional magnetic resonance imaging data in psychosis patients with (n = 90 AH; 68 SZ, 22 BD) and without (n = 55 NAH; 16 SZ, 39 BD) lifetime AH. We performed region of interest (ROI)-to-ROI functional connectivity (FC) analysis using 91 cortical, 15 subcortical, and 26 cerebellar atlas-defined regions. The primary aim was to identify FC differences between patients with and without lifetime AH. We secondarily examined differences between AH and NAH within each diagnosis. RESULTS Compared to the NAH group, patients with AH showed higher FC between cerebellum and frontal (left precentral gyrus), temporal [right middle temporal gyrus (MTG), left inferior temporal gyrus (ITG), left temporal fusiform gyrus)], parietal (bilateral superior parietal lobules), and subcortical (left accumbens, left palldium) brain areas. AH also showed lower FC between temporal lobe regions (between right ITG and right MTG and bilateral superior temporal gyri) relative to NAH. CONCLUSIONS Our findings suggest that dysconnectivity involving the cerebellum and temporal lobe regions may be common neurofunctional elements associated with AH propensity across the psychosis spectrum. We also found dysconnectivity patterns that were unique to lifetime AH within SZ or bipolar psychosis, suggesting both common and distinct mechanisms underlying AH pathophysiology in these disorders.
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Affiliation(s)
- Melissa Hwang
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA
| | - Youkyung S Roh
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA
| | - Jessica Talero
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA
| | - Bruce M Cohen
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Program for Neuropsychiatric Research, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Justin T Baker
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Roscoe O Brady
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Dost Öngür
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Ann K Shinn
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.
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21
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Hilland E, Johannessen C, Jonassen R, Alnæs D, Jørgensen KN, Barth C, Andreou D, Nerland S, Wortinger LA, Smelror RE, Wedervang-Resell K, Bohman H, Lundberg M, Westlye LT, Andreassen OA, Jönsson EG, Agartz I. Aberrant default mode connectivity in adolescents with early-onset psychosis: A resting state fMRI study. Neuroimage Clin 2021; 33:102881. [PMID: 34883402 PMCID: PMC8662331 DOI: 10.1016/j.nicl.2021.102881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 12/14/2022]
Abstract
Abnormal default mode network (DMN) connectivity has been found in schizophrenia and other psychotic disorders. However, there are limited studies on early onset psychosis (EOP), and their results show lack of agreement. Here, we investigated within-network DMN connectivity in EOP compared to healthy controls (HC), and its relationship to clinical characteristics. A sample of 68 adolescent patients with EOP (mean age 16.53 ± 1.12 [SD] years, females 66%) and 95 HC (mean age 16.24 ± 1.50 [SD], females 60%) from two Scandinavian cohorts underwent resting state functional magnetic resonance imaging (rsfMRI). A group independent component analysis (ICA) was performed to identify the DMN across all participants. Dual regression was used to estimate spatial maps reflecting each participant's DMN network, which were compared between EOP and HC using voxel-wise general linear models and permutation-based analyses. Subgroup analyses were performed within the patient group, to explore associations between diagnostic subcategories and current use of psychotropic medication in relation to connectivity strength. The analysis revealed significantly reduced DMN connectivity in EOP compared to HC in the posterior cingulate cortex, precuneus, fusiform cortex, putamen, pallidum, amygdala, and insula. The subgroup analysis in the EOP group showed strongest deviations for affective psychosis, followed by other psychotic disorders and schizophrenia. There was no association between DMN connectivity strength and the current use of psychotropic medication. In conclusion, the findings demonstrate weaker DMN connectivity in adolescent patients with EOP compared to healthy peers, and differential effects across diagnostic subcategories, which may inform our understanding of underlying disease mechanisms in EOP.
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Affiliation(s)
- Eva Hilland
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Faculty of Health Sciences, Oslo Metropolitan University, Norway.
| | - Cecilie Johannessen
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Rune Jonassen
- Faculty of Health Sciences, Oslo Metropolitan University, Norway
| | - Dag Alnæs
- Bjørknes College, Oslo, Norway; Norwegian Centre for Mental Disorders Research NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kjetil N Jørgensen
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Claudia Barth
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Dimitrios Andreou
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Stener Nerland
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Laura A Wortinger
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Runar E Smelror
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Kirsten Wedervang-Resell
- Norwegian Centre for Mental Disorders Research NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Hannes Bohman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden; Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Mathias Lundberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden; Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Lars T Westlye
- Norwegian Centre for Mental Disorders Research NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Mental Disorders Research NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Erik G Jönsson
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
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22
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Piguet C, Karahanoğlu FI, Saccaro LF, Van De Ville D, Vuilleumier P. Mood disorders disrupt the functional dynamics, not spatial organization of brain resting state networks. Neuroimage Clin 2021; 32:102833. [PMID: 34619652 PMCID: PMC8498469 DOI: 10.1016/j.nicl.2021.102833] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/10/2021] [Accepted: 09/19/2021] [Indexed: 12/24/2022]
Abstract
Spontaneous fluctuations in the blood oxygenation level dependent signal measured through resting-state functional magnetic resonance imaging have been corroborated to aggregate into multiple functional networks. Abnormal resting brain activity is observed in mood disorder patients, however with inconsistent results. How do such alterations relate to clinical symptoms; e.g., level of depression and rumination tendencies? Here we recovered spatially and temporally overlapping functional networks from 31 mood disorder patients and healthy controls during rest, by applying novel methods that identify transient changes in spontaneous brain activity. Our unique approach disentangles the dynamic engagement of resting-state networks unconstrained by the slow hemodynamic response. This time-varying characterization provides moment-to-moment information about functional networks in terms of their durations and dynamic coupling, and offers novel evidence for selective contributionsto particular clinical symptoms. Patients showed increased duration of default-mode network (DMN), increased duration and occurrence of posterior DMN as well as insula- and amygdala-centered networks, but decreased occurrence of visual and anterior salience networks. Coupling between limbic (insula and amygdala) networks was also reduced. Depression level modulated DMN duration, whereas intrusive thoughts correlated with occurrence of insula and posterior DMN. Anatomical network organization was similar to controls. In sum, altered brain dynamics in mood disorder patients appear to mediate distinct clinical dimensions including increased self-processing, and decreased attention to external world.
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Affiliation(s)
- Camille Piguet
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland
| | - Fikret Işık Karahanoğlu
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, USA
- Department of Radiology, Harvard Medical School, MA, USA
| | | | - Dimitri Van De Ville
- Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Switzerland
- Institute of Bioengineering, School of Engineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Patrik Vuilleumier
- Swiss Center for Affective Sciences, Campus Biotech, Geneva, Switzerland
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23
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Li S, Teng Z, Qiu Y, Pan P, Wu C, Jin K, Wang L, Chen J, Tang H, Xiang H, De Leon SA, Huang J, Guo W, Wang B, Wu H. Dissociation Pattern in Default-Mode Network Homogeneity in Drug-Naive Bipolar Disorder. Front Psychiatry 2021; 12:699292. [PMID: 34434127 PMCID: PMC8380964 DOI: 10.3389/fpsyt.2021.699292] [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: 04/23/2021] [Accepted: 07/13/2021] [Indexed: 11/20/2022] Open
Abstract
Default mode network (DMN) plays a key role in the pathophysiology of in bipolar disorder (BD). However, the homogeneity of this network in BD is still poorly understood. This study aimed to investigate abnormalities in the NH of the DMN at rest and the correlation between the NH of DMN and clinical variables in patients with BD. Forty drug-naive patients with BD and thirty-seven healthy control subjects participated in the study. Network homogeneity (NH) and independent component analysis (ICA) methods were used for data analysis. Support vector machines (SVM) method was used to analyze NH in different brain regions. Compared with healthy controls, significantly increased NH in the left superior medial prefrontal cortex (MPFC) and decreased NH in the right posterior cingulate cortex (PCC) and bilateral precuneus were found in patients with BD. NH in the right PCC was positively correlated with the verbal fluency test and verbal function total scores. NH in the left superior MPFC was negatively correlated with triglyceride (TG). NH in the right PCC was positively correlated with TG but negatively correlated with high-density lipoprotein cholesterol (HDL-C). NH in the bilateral precuneus was positively correlated with cholesterol and low-density lipoprotein cholesterol (LDL-C). In addition, NH in the left superior MPFC showed high sensitivity (80.00%), specificity (71.43%), and accuracy (75.61%) in the SVM results. These findings contribute new evidence of the participation of the altered NH of the DMN in the pathophysiology of BD.
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Affiliation(s)
- Sujuan Li
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ziwei Teng
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yan Qiu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Pan Pan
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chujun Wu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Kun Jin
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lu Wang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jindong Chen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hui Tang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hui Xiang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Sara Arenas De Leon
- Department of Biochemistry and Molecular Biology, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Jing Huang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenbin Guo
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Bolun Wang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Haishan Wu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
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24
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Broeders TAA, Schoonheim MM, Vink M, Douw L, Geurts JJG, van Leeuwen JMC, Vinkers CH. Dorsal attention network centrality increases during recovery from acute stress exposure. NEUROIMAGE-CLINICAL 2021; 31:102721. [PMID: 34134017 PMCID: PMC8214139 DOI: 10.1016/j.nicl.2021.102721] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/19/2021] [Accepted: 06/04/2021] [Indexed: 12/17/2022]
Abstract
Stress is a major risk factor for the development of almost all psychiatric disorders. In addition to the acute stress response, an efficient recovery in the aftermath of stress is important for optimal resilience. Increased stress vulnerability across psychiatric disorders may therefore be related to altered trajectories during the recovery phase following stress. Such recovery trajectories can be quantified by changes in functional brain networks. This study therefore evaluated longitudinal functional network changes related to stress in healthy individuals (N = 80), individuals at risk for psychiatric disorders (healthy siblings of schizophrenia patients) (N = 39), and euthymic bipolar I disorder (BD) patients (N = 36). Network changes were evaluated before and at 20 and 90 min after onset of an experimental acute stress task (Trier Social Stress Test) or a control condition. Whole-brain functional networks were analyzed using eigenvector centrality as a proxy for network importance, centrality change over time was related to the acute stress response and recovery for each group. In healthy individuals, centrality of the dorsal attention network (DAN; p = 0.007) changed over time in relation to stress. More specifically, DAN centrality increased during the recovery phase after acute stress exposure (p = 0.020), while no DAN centrality change was observed during the initial stress response (p = 0.626). Such increasing DAN centrality during stress recovery was also found in healthy siblings (p = 0.016), but not in BD patients (p = 0.554). This study highlights that temporally complex and precise changes in network configuration are vital to understand the response to and recovery from stress.
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Affiliation(s)
- T A A Broeders
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - M M Schoonheim
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M Vink
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Experimental, Utrecht University, Utrecht, The Netherlands; Department Developmental Psychology, Utrecht University, Utrecht, The Netherlands
| | - L Douw
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J J G Geurts
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J M C van Leeuwen
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - C H Vinkers
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
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25
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Xiao Q, Wu Z, Jiao Q, Zhong Y, Zhang Y, Lu G. Children with euthymic bipolar disorder during an emotional go/nogo task: Insights into the neural circuits of cognitive-emotional regulation. J Affect Disord 2021; 282:669-676. [PMID: 33445090 DOI: 10.1016/j.jad.2020.12.157] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/30/2020] [Accepted: 12/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pediatric bipolar disorder (PBD), manifested by alternating episodes of depression and mania, is more likely to relapse than adult BD and develop into chronic BD. Although it can be asymptomatic during the remission of PBD, subtle changes in the brain neural response can still exist. Abnormal activities in the neural circuits of cognitive-emotional regulation have been found in adult BD patients using fMRI. However, few fMRI studies focus on emotional regulation on cognitive function in euthymic PBD, especially during an emotional go/nogo task. Therefore, this study aims to compare differences in the activities of both emotional and cognitive circuits between euthymic BD children and healthy controls. METHODS 18 euthymic PBD and 17 healthy subjects from 12 to 17 years of age were enrolled in our study. Simultaneous neural activity was recorded during the overall task and the effect of emotional factors on task performances was assessed. RESULTS There were no significant differences in behavioral performances between the PBD group and the control group. During a task with emotional versus neutral distractors, euthymic PBD patients showed increased activities in the DLPFC, inferior parietal lobule, superior/middle frontal gyrus, superior/middle temporal gyrus, insula, posterior cingulate gyrus and posterior cerebellum lobe relative to healthy controls. The insula and DLPFC activities in response to emotional versus neutral distractors were positively associated with the differences in false response errors. CONCLUSIONS This study confirms the enhanced neural activities in euthymic PBD during a task with emotional versus control distractors. These brain regions supporting the cognitive and emotional dysregulation of PBD mainly coincide with the salience and executive control networks. As neural responses are more sensitive than behavioral manifestations in euthymic PBD, our findings will inspire more clinical studies to unveil the characteristic neuromechanism of PBD.
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Affiliation(s)
- Qian Xiao
- Mental Health Centre of Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Zhou Wu
- School of Psychology, Nanjing Normal University, Nanjing 210097, China
| | - Qing Jiao
- Department of Radiology, Taishan Medical University, Taian 271016, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing 210097, China.
| | - Yun Zhang
- Medical Department, Northwest Minzu University, Lanzhou 730030, China.
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
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26
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Heyman-Kantor R, Rizk M, Sublette ME, Rubin-Falcone H, Fard YY, Burke AK, Oquendo MA, Sullivan GM, Milak MS, Zanderigo F, Mann JJ, Miller JM. Examining the relationship between gray matter volume and a continuous measure of bipolarity in unmedicated unipolar and bipolar depression. J Affect Disord 2021; 280:105-113. [PMID: 33207282 DOI: 10.1016/j.jad.2020.10.071] [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: 05/11/2020] [Revised: 09/10/2020] [Accepted: 10/31/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND It has been argued that unipolar major depressive disorder (MDD) and bipolar disorder (BD) exist on a continuous spectrum, given their overlapping symptomatology and genetic diatheses. The Bipolarity Index (BI) is a scale that considers bipolarity as a continuous construct and was developed to assess confidence in bipolar diagnosis. Here we investigated whether BI scores correlate with gray matter volume (GMV) in a sample of unmedicated unipolar and bipolar depressed individuals. METHODS 158 subjects (139 with MDD, 19 with BD) in a major depressive episode at time of scan were assigned BI scores. T1-weighted Magnetic Resonance Imaging scans were obtained and processed with Voxel-Based Morphometry using SPM12 (CAT12 toolbox) to assess GMV. Regression was performed at the voxel level to identify clusters of voxels whose GMV was associated with BI score, (p<0.001, family-wise error-corrected cluster-level p<0.05), with age, sex and total intracranial volume as covariates. RESULTS GMV was inversely correlated with BI score in four clusters located in left lateral occipital cortex, bilateral angular gyri and right frontal pole. Clusters were no longer significant after controlling for diagnosis. GMV was not correlated with BI score within the MDD cohort alone. LIMITATIONS Incomplete clinical data required use of a modified BI scale. CONCLUSION BI scores were inversely correlated with GMV in unmedicated subjects with MDD and BD, but these correlations appeared driven by categorical diagnosis. Future work will examine other imaging modalities and focus on elements of the BI scale most likely to be related to brain structure and function.
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Affiliation(s)
- Reuben Heyman-Kantor
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
| | - Mina Rizk
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute; Department of Psychiatry, Columbia University
| | - M Elizabeth Sublette
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute; Department of Psychiatry, Columbia University
| | | | | | - Ainsley K Burke
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute; Department of Psychiatry, Columbia University
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | | | - Matthew S Milak
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute; Department of Psychiatry, Columbia University
| | - Francesca Zanderigo
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute; Department of Psychiatry, Columbia University
| | - J John Mann
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute; Department of Psychiatry, Columbia University
| | - Jeffrey M Miller
- Molecular Imaging and Neuropathology Area, New York State Psychiatric Institute; Department of Psychiatry, Columbia University.
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27
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Reviewing applications of structural and functional MRI for bipolar disorder. Jpn J Radiol 2021; 39:414-423. [PMID: 33389525 DOI: 10.1007/s11604-020-01074-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/19/2020] [Indexed: 02/07/2023]
Abstract
Bipolar disorders (BDs) represent one of the leading causes of disability and morbidity globally. The use of functional magnetic resonance imaging (fMRI) is being increasingly studied as a tool to improve the diagnosis and treatment of BDs. While morphological biomarkers can be identified through the use of structural magnetic resonance imaging (sMRI), recent studies have demonstrated that varying degrees of both structural and functional impairments indicate differing bipolar subtypes. Within fMRI, resting-state fMRI has specifically drawn increased interest for its capability to detect different neuronal activation patterns compared to task-based fMRI. This study aims to review recently published literature regarding the use of fMRI to investigate structural-functional relationships in BD diagnosis and specifically resting-state fMRI to provide an opinion on fMRI's modern clinical application. All sources in this literature review were collected through searches on both PubMed and Google Scholar databases for terms such as 'resting-state fMRI' and 'functional neuroimaging biomarkers of bipolar disorder'. While there are promising results supporting the use of fMRI for improving differential accuracy and establishing clinically relevant biomarkers, additional evidence will be required before fMRI is considered a dependable component of the overall BD diagnostic process.
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28
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Tee MMK, Au CH. A Systematic Review and Meta-Analysis of Randomized Sham-Controlled Trials of Repetitive Transcranial Magnetic Stimulation for Bipolar Disorder. Psychiatr Q 2020; 91:1225-1247. [PMID: 32860557 DOI: 10.1007/s11126-020-09822-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is effective in treating unipolar depression. However, the efficacy of rTMS in bipolar disorder (BD) is unclear. This meta-analysis aimed to examine the efficacy and tolerability of rTMS for both depressive and manic phases in BD. METHODS MEDLINE, EMBASE, PsycINFO, CENTRAL databases were searched for controlled trials on treatment of BD with rTMS. Primary outcomes included changes in depression or mania scores, response and remission rates. Secondary outcomes included quality of life and functioning assessment. We used random-effects model, Hedge's g, risk differences (RDs) and the number needed to treat (NNT). RESULTS Eleven randomized sham-controlled studies were included, with a total of 345 patients with BD (bipolar depression = 257, mania = 86, mixed affective = 2). Trials of rTMS in bipolar depression (N = 8) demonstrated small but significant improvement in depression scores [standardized mean difference = 0.302, p < 0.05], compared to control group. Furthermore, rTMS brought a higher remission rate than sham-controls [RD = 0.104 ± 0.044, p < 0.05, NNT = 10; and a trend of greater response rate [RD = 0.074 ± 0.039, p = 0.06]. Results were inconclusive for effect of rTMS in mania. In both depressive and manic groups, no serious adverse events were reported. Risk of treatment-emergent mania appeared low. LIMITATIONS There was limited number of eligible primary studies, with variable randomization procedures. CONCLUSION rTMS appears safe and effective in treating bipolar depression. More stringent RCTs are necessary for concrete conclusion about efficacy in mania.
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Affiliation(s)
- Maggie M K Tee
- Department of Psychiatry, Kwai Chung Hospital, 3-15 Kwai Chung Hospital Road, Hong Kong, China.
| | - C H Au
- Department of Psychiatry, Queen Mary Hospital, Hong Kong, China
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Fan Z, Yang J, Zeng C, Xi C, Wu G, Guo S, Xue Z, Liu Z, Tao H. Bipolar Mood State Reflected in Functional Connectivity of the Hate Circuit: A Resting-State Functional Magnetic Resonance Imaging Study. Front Psychiatry 2020; 11:556126. [PMID: 33192670 PMCID: PMC7652934 DOI: 10.3389/fpsyt.2020.556126] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/28/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Previous studies suggested bipolar disorder caused an aberrant alteration in the insular, putamen, and left superior frontal gyrus, which are the main components of the hate circuit. However, the relationship between the hate circuit and the pathophysiologic substrate underlying different phases of bipolar disorder remain unclear. In this study, we aimed to identify group differences of resting-state functional connectivity within the hate circuit in healthy controls (HCs) and bipolar patients in different mood states. METHODS Resting-state functional magnetic resonance imaging of the brain were acquired from 54 HCs and 81 patients with bipolar disorder including 20 with bipolar mania (BM), 35 with bipolar depression (BD), and 26 with bipolar euthymia (BE). We selected bilateral insula (L.INS and R.INS), bilateral putamen (L.PUT and R.PUT), and left superior frontal gyrus (L.SFGd) as seed regions, and conducted the seed-based functional connectivity analysis to identify group differences of connectivity strength within the hate circuit. Spearman correlations were performed to evaluate the relationship between the hate circuit and manic/depressive symptoms. RESULTS Significant group differences of connectivity strength within the hate circuit were found in links of the R.INS-L.SFGd, R.PUT-L.SFGd, and L.INS- R.PUT after false discovery rate was corrected. The BM group showed an opposite hate circuit pattern to BD, BE, and HCs. The BD group showed decreased hate circuit connectivity in the L.INS-R.PUT compared with the BE group. No significant difference was detected among BD, BE, and HCs. Furthermore, functional connectivity of the R.INS-L.SFGd and R.PUT-L.SFGd were positively correlated with manic symptoms, while the L.INS- R.PUT was negatively correlated with depressive symptoms. CONCLUSIONS Our preliminary findings suggest that altered functional connectivity of the hate circuit in different mood phases may be related to state markers and underpin the neuropathological basis of bipolar disorder.
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Affiliation(s)
- Zebin Fan
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Jie Yang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Can Zeng
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Chang Xi
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Guowei Wu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Shuixia Guo
- Mathematics and Computer Science College, Hunan Normal University, Changsha, China
| | - Zhimin Xue
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Zhening Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Haojuan Tao
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
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30
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Cotovio G, Talmasov D, Barahona-Corrêa JB, Hsu J, Senova S, Ribeiro R, Soussand L, Velosa A, Silva VCE, Rost N, Wu O, Cohen AL, Oliveira-Maia AJ, Fox MD. Mapping mania symptoms based on focal brain damage. J Clin Invest 2020; 130:5209-5222. [PMID: 32831292 PMCID: PMC7524493 DOI: 10.1172/jci136096] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUNDAlthough mania is characteristic of bipolar disorder, it can also occur following focal brain damage. Such cases may provide unique insight into brain regions responsible for mania symptoms and identify therapeutic targets.METHODSLesion locations associated with mania were identified using a systematic literature search (n = 41) and mapped onto a common brain atlas. The network of brain regions functionally connected to each lesion location was computed using normative human connectome data (resting-state functional MRI, n = 1000) and contrasted with those obtained from lesion locations not associated with mania (n = 79). Reproducibility was assessed using independent cohorts of mania lesions derived from clinical chart review (n = 15) and of control lesions (n = 490). Results were compared with brain stimulation sites previously reported to induce or relieve mania symptoms.RESULTSLesion locations associated with mania were heterogeneous and no single brain region was lesioned in all, or even most, cases. However, these lesion locations showed a unique pattern of functional connectivity to the right orbitofrontal cortex, right inferior temporal gyrus, and right frontal pole. This connectivity profile was reproducible across independent lesion cohorts and aligned with the effects of therapeutic brain stimulation on mania symptoms.CONCLUSIONBrain lesions associated with mania are characterized by a specific pattern of brain connectivity that lends insight into localization of mania symptoms and potential therapeutic targets.FUNDINGFundação para a Ciência e Tecnologia (FCT), Harvard Medical School DuPont-Warren Fellowship, Portuguese national funds from FCT and Fundo Europeu de Desenvolvimento Regional, Child Neurology Foundation Shields Research, Sidney R. Baer, Jr. Foundation, Nancy Lurie Marks Foundation, Mather's Foundation, and the NIH.
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Affiliation(s)
- Gonçalo Cotovio
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal
- Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
- NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Daniel Talmasov
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, New York University School of Medicine, New York, New York, USA
| | - J. Bernardo Barahona-Corrêa
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal
- Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
- NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Joey Hsu
- Berenson-Allen Center for Non-Invasive Brain Stimulation and
- Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Suhan Senova
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal
- Neurosurgery Department and
- PePsy Department, Groupe Henri-Mondor Albert-Chenevier, Assistance Publique-Hôpitaux de Paris (APHP), Créteil, France
- Equipe 14, U955 INSERM, Institut Mondor de Recherche Biomedicale and
- Faculté de Médecine, Université Paris Est, Créteil, France
| | - Ricardo Ribeiro
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Louis Soussand
- Berenson-Allen Center for Non-Invasive Brain Stimulation and
- Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Ana Velosa
- Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Vera Cruz e Silva
- Department of Neuroradiology, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Natalia Rost
- J. Philip Kistler Stroke Research Center, Department of Neurology and
| | - Ona Wu
- Athinoula A. Martinos Centre for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital
| | - Alexander L. Cohen
- Berenson-Allen Center for Non-Invasive Brain Stimulation and
- Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Boston Children’s Hospital, and
| | - Albino J. Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal
- Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
- NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Michael D. Fox
- Berenson-Allen Center for Non-Invasive Brain Stimulation and
- Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Athinoula A. Martinos Centre for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Center for Brain Circuit Therapeutics, Department of Neurology, Department of Psychiatry, Department of Neurosurgery, and Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Stange JP, Jenkins LM, Pocius S, Kreutzer K, Bessette KL, DelDonno SR, Kling LR, Bhaumik R, Welsh RC, Keilp JG, Phan KL, Langenecker SA. Using resting-state intrinsic network connectivity to identify suicide risk in mood disorders. Psychol Med 2020; 50:2324-2334. [PMID: 31597581 PMCID: PMC7368462 DOI: 10.1017/s0033291719002356] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Little is known about the neural substrates of suicide risk in mood disorders. Improving the identification of biomarkers of suicide risk, as indicated by a history of suicide-related behavior (SB), could lead to more targeted treatments to reduce risk. METHODS Participants were 18 young adults with a mood disorder with a history of SB (as indicated by endorsing a past suicide attempt), 60 with a mood disorder with a history of suicidal ideation (SI) but not SB, 52 with a mood disorder with no history of SI or SB (MD), and 82 healthy comparison participants (HC). Resting-state functional connectivity within and between intrinsic neural networks, including cognitive control network (CCN), salience and emotion network (SEN), and default mode network (DMN), was compared between groups. RESULTS Several fronto-parietal regions (k > 57, p < 0.005) were identified in which individuals with SB demonstrated distinct patterns of connectivity within (in the CCN) and across networks (CCN-SEN and CCN-DMN). Connectivity with some of these same regions also distinguished the SB group when participants were re-scanned after 1-4 months. Extracted data defined SB group membership with good accuracy, sensitivity, and specificity (79-88%). CONCLUSIONS These results suggest that individuals with a history of SB in the context of mood disorders may show reliably distinct patterns of intrinsic network connectivity, even when compared to those with mood disorders without SB. Resting-state fMRI is a promising tool for identifying subtypes of patients with mood disorders who may be at risk for suicidal behavior.
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Affiliation(s)
| | | | | | | | | | | | | | - Runa Bhaumik
- University of Illinois at Chicago, Chicago, IL, USA
| | | | | | - K. Luan Phan
- University of Illinois at Chicago, Chicago, IL, USA
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Abstract
Since its discovery in 1997, the default mode network (DMN) and its components have been extensively studied in both healthy individuals and psychiatric patients. Several studies have investigated possible DMN alterations in specific mental conditions such as bipolar disorder (BD). In this review, we describe current evidence from resting-state functional magnetic resonance imaging studies with the aim to understand possible changes in the functioning of the DMN in BD. Overall, several types of analyses including seed-based and independent component have been conducted on heterogeneous groups of patients highlighting different results. Despite the differences, findings seem to indicate that BD is associated with alterations in both frontal and posterior DMN structures, mainly in the prefrontal, posterior cingulate and inferior parietal cortices. We conclude this review by suggesting possible future research directions.
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Russo D, Martino M, Magioncalda P, Inglese M, Amore M, Northoff G. Opposing Changes in the Functional Architecture of Large-Scale Networks in Bipolar Mania and Depression. Schizophr Bull 2020; 46:971-980. [PMID: 32047938 PMCID: PMC7342167 DOI: 10.1093/schbul/sbaa004] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Manic and depressive phases of bipolar disorder (BD) show opposite symptoms in psychomotor, thought, and affective dimensions. Neuronally, these may depend on distinct patterns of alterations in the functional architecture of brain intrinsic activity. Therefore, the study aimed to characterize the spatial and temporal changes of resting-state activity in mania and depression, by investigating the regional homogeneity (ReHo) and degree of centrality (DC), in different frequency bands. METHODS Using resting-state functional magnetic resonance imaging (fMRI), voxel-wise ReHo and DC were calculated-in the standard frequency band (SFB: 0.01-0.10 Hz), as well as in Slow5 (0.01-0.027 Hz) and Slow4 (0.027-0.073 Hz)-and compared between manic (n = 36), depressed (n = 43), euthymic (n = 29) patients, and healthy controls (n = 112). Finally, clinical correlations were investigated. RESULTS Mania was mainly characterized by decreased ReHo and DC in Slow4 in the medial prefrontal cortex (as part of the default-mode network [DMN]), which in turn correlated with manic symptomatology. Conversely, depression was mainly characterized by decreased ReHo in SFB in the primary sensory-motor cortex (as part of the sensorimotor network [SMN]), which in turn correlated with depressive symptomatology. CONCLUSIONS Our data show a functional reconfiguration of the spatiotemporal structure of intrinsic brain activity to occur in BD. Mania might be characterized by a predominance of sensorimotor over associative networks, possibly driven by a deficit of the DMN (reflecting in internal thought deficit). Conversely, depression might be characterized by a predominance of associative over sensorimotor networks, possibly driven by a deficit of the SMN (reflecting in psychomotor inhibition).
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Affiliation(s)
- Daniel Russo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy,Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Matteo Martino
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Paola Magioncalda
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy,Brain and Consciousness Research Center, Taipei Medical University – Shuang Ho Hospital, New Taipei City, Taiwan,Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan,To whom correspondence should be addressed; Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, No. 250 Wuxing Street, 11031 Taipei, Taiwan; tel: 00886-2-2736-1661-8601, fax: 00886-2-8732-5288, e-mail:
| | - Matilde Inglese
- Ospedale Policlinico San Martino IRCCS, Genoa, Italy,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Neurology, University of Genoa, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy,Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Georg Northoff
- University of Ottawa Brain and Mind Research Institute, and Mind Brain Imaging and Neuroethics Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada,Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China
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Dai W, Chen M, Duan W, Zhao L, Bolo NR, Tamminga C, Clementz BA, Pearlson GD, Alsop DC, Keshavan M. Abnormal perfusion fluctuation and perfusion connectivity in bipolar disorder measured by dynamic arterial spin labeling. Bipolar Disord 2020; 22:401-410. [PMID: 31630476 DOI: 10.1111/bdi.12856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES We sought to evaluate whether dynamic Arterial Spin Labeling (dASL), a novel quantitative technique robust to artifacts and noise that especially arise in inferior brain regions, could characterize neural substrates of BD pathology and symptoms. METHODS Forty-five subjects (19 BD patients, 26 controls) were imaged using a dASL sequence. Maps of average perfusion, perfusion fluctuation, and perfusion connectivity with anterior cingulate cortex (ACC) were derived. Patient symptoms were quantified along four symptom dimensions determined using factor analysis of the subjects from the Bipolar and Schizophrenia Network on Intermediate Phenotypes (BSNIP) study. Maps of the perfusion measures were compared between BD patients and controls and correlated with the symptom dimensions in the BD patients only by voxel-level and region-level analyses. RESULTS BD patients exhibited (i) significantly increased perfusion fluctuations in the left fusiform and inferior temporal regions (P = .020, voxel-level corrected) and marginally increased perfusion fluctuations in the right temporal pole and inferior temporal regions (P = .063, cluster-level corrected), (ii) significantly increased perfusion connectivity between ACC and the occipitoparietal cortex (P = .050, cluster-level corrected). In BD patients, positive symptoms were negatively associated with ACC perfusion connectivity to the right orbitofrontal and superior frontal regions (P = .002, cluster-level corrected) and right orbitofrontal and inferior frontal regions (P = .023, cluster-level corrected). CONCLUSION The abnormal perfusion fluctuations and connectivity alterations may underlie the mood fluctuations and cognitive and emotional dysregulation that characterize BD.
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Affiliation(s)
- Weiying Dai
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - Mingzhao Chen
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - Wenna Duan
- Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - Li Zhao
- Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, D.C, USA
| | - Nicolas R Bolo
- Psychiatry, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, USA
| | - Carol Tamminga
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Brett A Clementz
- Psychology and Neuroscience, University of Georgia, Athens, GA, USA
| | | | - David C Alsop
- Radiology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, USA
| | - Matcheri Keshavan
- Psychiatry, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, USA
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Painold A, Faber PL, Reininghaus EZ, Mörkl S, Holl AK, Achermann P, Saletu B, Saletu-Zyhlarz G, Anderer P, Dalkner N, Birner A, Bengesser S, Kapfhammer HP, Milz P. Reduced Brain Electric Activity and Functional Connectivity in Bipolar Euthymia: An sLORETA Source Localization Study. Clin EEG Neurosci 2020; 51:155-166. [PMID: 31845595 DOI: 10.1177/1550059419893472] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Bipolar disorder (BD) is a chronic illness with a relapsing and remitting time course. Relapses are manic or depressive in nature and intermitted by euthymic states. During euthymic states, patients lack the criteria for a manic or depressive diagnosis, but still suffer from impaired cognitive functioning as indicated by difficulties in executive and language-related processing. The present study investigated whether these deficits are reflected by altered intracortical activity in or functional connectivity between brain regions involved in these processes such as the prefrontal and the temporal cortices. Vigilance-controlled resting state EEG of 13 euthymic BD patients and 13 healthy age- and sex-matched controls was analyzed. Head-surface EEG was recomputed into intracortical current density values in 8 frequency bands using standardized low-resolution electromagnetic tomography. Intracortical current densities were averaged in 19 evenly distributed regions of interest (ROIs). Lagged coherences were computed between each pair of ROIs. Source activity and coherence measures between patients and controls were compared (paired t tests). Reductions in temporal cortex activity and in large-scale functional connectivity in patients compared to controls were observed. Activity reductions affected all 8 EEG frequency bands. Functional connectivity reductions affected the delta, theta, alpha-2, beta-2, and gamma band and involved but were not limited to prefrontal and temporal ROIs. The findings show reduced activation of the temporal cortex and reduced coordination between many brain regions in BD euthymia. These activation and connectivity changes may disturb the continuous frontotemporal information flow required for executive and language-related processing, which is impaired in euthymic BD patients.
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Affiliation(s)
- Annamaria Painold
- Department of Psychiatry and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Pascal L Faber
- Department of Psychiatry, Psychotherapy and Psychosomatics, The KEY Institute for Brain-Mind Research, University Hospital of Psychiatry, Zurich, Switzerland
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Sabrina Mörkl
- Department of Psychiatry and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Anna K Holl
- Department of Psychiatry and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Peter Achermann
- Department of Psychiatry, Psychotherapy and Psychosomatics, The KEY Institute for Brain-Mind Research, University Hospital of Psychiatry, Zurich, Switzerland
| | - Bernd Saletu
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Gerda Saletu-Zyhlarz
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Peter Anderer
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Armin Birner
- Department of Psychiatry and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Hans-Peter Kapfhammer
- Department of Psychiatry and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Patricia Milz
- Department of Psychiatry, Psychotherapy and Psychosomatics, The KEY Institute for Brain-Mind Research, University Hospital of Psychiatry, Zurich, Switzerland
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Wang Y, Gao Y, Tang S, Lu L, Zhang L, Bu X, Li H, Hu X, Hu X, Jiang P, Jia Z, Gong Q, Sweeney JA, Huang X. Large-scale network dysfunction in the acute state compared to the remitted state of bipolar disorder: A meta-analysis of resting-state functional connectivity. EBioMedicine 2020; 54:102742. [PMID: 32259712 PMCID: PMC7136605 DOI: 10.1016/j.ebiom.2020.102742] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/28/2020] [Accepted: 03/16/2020] [Indexed: 02/08/2023] Open
Abstract
Background Bipolar disorder (BD) is a mental disorder characterized by mood fluctuations between an acute episodic state of either mania or depression and a clinically remitted state. Dysfunction of large-scale intrinsic brain networks has been demonstrated in this disorder, but it remains unknown whether those network alterations are related to different states. Methods In the present study, we performed a meta-analysis of whole-brain seed-based resting-state functional connectivity (rsFC) studies in BD patients to compare the intrinsic function of brain networks between episodic and remitted states. Thirty-nine seed-based voxel-wise rsFC datasets from thirty publications (1047 BD patients vs 1081 controls) were included in the meta-analysis. Seeds were categorized into networks by their locations within a priori functional networks. Seed-based d mapping analysis of between-state effects identified brain systems in which different states were associated with increased connectivity or decreased connectivity within and between each seed network. Findings We found that BD patients presented decreased connectivity within the affective network (AN) in acute episodes but not in the remitted state of the illness. Similar decreased connectivity within the default-mode network (DMN) was also found in the acute state, but it was replaced by increased connectivity in the remitted state. In addition, different patterns of between-network dysconnectivity were observed between the acute and remitted states. Interpretation This study is the first to identify different patterns of intrinsic function in large-scale brain networks between the acute and remitted states of BD through meta-analysis. The findings suggest that a shift in network function between the acute and remitted states may be related to distinct emotional and cognitive dysfunctions in BD, which may have important implications for identifying clinically relevant biomarkers to guide alternative treatment strategies for BD patients during active episodes or remission. Funding This study was supported by grants from the National Natural Science Foundation of China (81171488, 81671669 and 81820108018) and by a Sichuan Provincial Youth Grant (2017JQ0001).
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Affiliation(s)
- Yanlin Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Shi Tang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Lu Lu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xuan Bu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xiaoxiao Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Ping Jiang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Zhiyun Jia
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China.
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Ilzarbe D, de la Serna E, Baeza I, Rosa M, Puig O, Calvo A, Masias M, Borras R, Pariente JC, Castro-Fornieles J, Sugranyes G. The relationship between performance in a theory of mind task and intrinsic functional connectivity in youth with early onset psychosis. Dev Cogn Neurosci 2019; 40:100726. [PMID: 31791005 PMCID: PMC6974903 DOI: 10.1016/j.dcn.2019.100726] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 09/06/2019] [Accepted: 11/03/2019] [Indexed: 12/15/2022] Open
Abstract
Psychotic disorders are characterized by theory of mind (ToM) impairment. Although ToM undergoes maturational changes throughout adolescence, there is a lack of studies examining ToM performance and its brain functional correlates in individuals with an early onset of psychosis (EOP; onset prior to age 18), and its relationship with age. Twenty-seven individuals with EOP were compared with 41 healthy volunteers using the "Reading-the-Mind-in-the-Eyes" Test, as a measure of ToM performance. A resting-state functional MRI scan was also acquired, in which the default mode network was used to identify areas relevant to ToM processing employing independent component analysis. Group effects revealed worse ToM performance and less intrinsic functional connectivity in the medial prefrontal cortex in EOP relative to healthy volunteers. Group by age interaction revealed age-positive associations in ToM task performance and in intrinsic connectivity in the medial prefrontal cortex in healthy volunteers, which were not present in EOP. Differences in ToM performance were partially mediated by intrinsic functional connectivity in the medial prefrontal cortex. Poorer ToM performance in EOP, coupled with less medial prefrontal cortex connectivity, could be associated with the impact of psychosis during a critical period of development of the social brain, limiting normative age-related maturation.
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Affiliation(s)
- Daniel Ilzarbe
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom
| | - Elena de la Serna
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Inmaculada Baeza
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Mireia Rosa
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Olga Puig
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Anna Calvo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mireia Masias
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Roger Borras
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Jose C Pariente
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Josefina Castro-Fornieles
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Gisela Sugranyes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain.
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Delvecchio G, Pigoni A, Bauer IE, Soares JC, Brambilla P. Disease-discordant twin structural MRI studies on affective disorders. Neurosci Biobehav Rev 2019; 108:459-471. [PMID: 31790709 DOI: 10.1016/j.neubiorev.2019.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/24/2019] [Accepted: 11/26/2019] [Indexed: 01/01/2023]
Abstract
Magnetic resonance imaging (MRI) studies have identified neural structures implicated in the pathophysiology of mood disorders, especially bipolar disorder (BD) and major depressive disorder (MDD). However, the role of genetic and environmental influences on such brain deficits is still unclear. In this context, the present review summarizes the current evidence from structural MRI and Diffusion Tensor Imaging (DTI) studies on twin samples concordant or discordant for BD or MDD, with the aim of clarifying the role of genetic and environmental risk factors on brain alterations. Although the results showed a complex interplay between gene and environment in affective disorders, the evidence seem to underline that both genetic and environmental risk factors have an impact on brain areas and vulnerability to MDD and BD. However, the precise mechanism of action and the interaction between these factors still needs to be unveiled. Therefore, future larger studies on concordant or discordant twins should be encouraged, because this population provides a unique opportunity to probe separately genetic and environmental markers of disease vulnerability.
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Affiliation(s)
- G Delvecchio
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy
| | - A Pigoni
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy
| | - I E Bauer
- Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - J C Soares
- Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - P Brambilla
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
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Novais F, Pestana LC, Loureiro S, Andrea M, Figueira ML, Pimentel J. Psychiatric disorders as predictors of epilepsy surgery outcome. Epilepsy Behav 2019; 100:106513. [PMID: 31639645 DOI: 10.1016/j.yebeh.2019.106513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 08/21/2019] [Accepted: 08/21/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Our aim was to determine if a history of a mental disorder predicts a worst neurological outcome for patients undergoing epilepsy surgery. METHODS We conducted an ambispective observational study including people with refractory epilepsy who underwent resective surgery. Demographic, psychiatric, and neurological data were collected, before and one year after surgery. Presurgical interviews included a psychiatric evaluation and the determination of prevalent and lifetime psychiatric diagnosis. The one-year postsurgical outcome was classified according to the Engel Outcome Scale. Predictors of postsurgical Engel class were determined using an ordered logistic regression model. RESULTS A lifetime history of any mental disorder was a significant predictor of a higher Engel Class (p = 0.017). CONCLUSION This study shows that psychiatric lifetime diagnoses are associated with worse surgical outcome and highlighted the importance of the inclusion of these diagnoses in the evaluation of the potential success of the surgery.
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Affiliation(s)
- Filipa Novais
- Department of Neurosciences and Mental Health, Psychiatry Department, Hospital de Santa Maria (CHULN), Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal.
| | - Luís Câmara Pestana
- Department of Neurosciences and Mental Health, Psychiatry Department, Hospital de Santa Maria (CHULN), Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Susana Loureiro
- Department of Neurosciences and Mental Health, Psychiatry Department, Hospital de Santa Maria (CHULN), Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Mafalda Andrea
- Department of Neurosciences and Mental Health, Psychiatry Department, Hospital de Santa Maria (CHULN), Portugal
| | - Maria Luísa Figueira
- Department of Neurosciences and Mental Health, Psychiatry Department, Hospital de Santa Maria (CHULN), Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - José Pimentel
- Department of Neurosciences and Mental Health, Neurology Department, Hospital de Santa Maria (CHULN), Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal
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Negoias S, Chen B, Iannilli E, Ning Y, Kitzler HH, Hummel T, Krüger S. Odor-related brain hyper-reactivity in euthymic bipolar disorder: An fMRI and ERP study. Psychiatry Res 2019; 278:218-227. [PMID: 31226548 DOI: 10.1016/j.psychres.2019.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
Abstract
Previous studies on olfactory function in patients with bipolar disorder (BD) are limited and contradictory. The current study aimed to comprehensively analyze the olfactory function of patients with euthymic BD using psychophysical, electrophysiological and neuroimaging techniques. Twenty-one patients with BD in remission and 20 healthy controls were tested with the "Sniffin' Sticks" olfactory test. Block-design fMRI data to a pleasant and an unpleasant stimulus were acquired while recording intensity and hedonic ratings. Olfactory event-related potentials (OERP) to the same stimuli were additionally recorded. Results show no differences between patients and healthy controls in terms of self-rated olfactory function and tested olfactory domains (odor threshold, discrimination or identification) (p>0.05). Compared to healthy controls, patients showed an increased fMRI activation in multiple cortical and subcortical regions as a response to olfactory stimulation, as well as larger amplitudes of OERPs regardless of the hedonic valence of the odor. All in all, patients with euthymic BD showed a stronger central responsiveness to odorous stimuli in fMRI and OERPs despite of normal psychophysical results, indicating the probable existence of an odor-related over-reactive brain network in the remission phase of BD.
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Affiliation(s)
- Simona Negoias
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany; Department of Otorhinolaryngology, Head and Neck Surgery, lnselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland
| | - Ben Chen
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany; Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
| | - Emilia Iannilli
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Yuping Ning
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Hagen H Kitzler
- Institute of Diagnostic and Interventional Neuroradiology, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Stephanie Krüger
- Teaching Hospital of the Charite - Universitätsmedizin Berlin, Center for Women's Mental Health, Vivantes Humboldt Klinik, Am Nordgraben 2, 13509, Berlin, Germany
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Lee I, Nielsen K, Nawaz U, Hall MH, Öngür D, Keshavan M, Brady R. Diverse pathophysiological processes converge on network disruption in mania. J Affect Disord 2019; 244:115-123. [PMID: 30340100 PMCID: PMC6785980 DOI: 10.1016/j.jad.2018.10.087] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/19/2018] [Accepted: 10/05/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Neuroimaging of psychiatric disease is challenged by the difficulty of establishing the causal role of neuroimaging abnormalities. Lesions that cause mania present a unique opportunity to understand how brain network disruption may cause mania in both lesions and in bipolar disorder. METHODS A literature search revealed 23 case reports with imaged lesions that caused mania in patients without history of bipolar disorder. We traced these lesions and examined resting-state functional Magnetic Resonance Imaging (rsfMRI) connectivity to these lesions and control lesions to find networks that would be disrupted specifically by mania-causing lesions. The results were then used as regions-of-interest to examine rsfMRI connectivity in patients with bipolar disorder (n = 16) who underwent imaging longitudinally across states of both mania and euthymia alongside a cohort of healthy participants scanned longitudinally. We then sought to replicate these results in independent cohorts of manic (n = 26) and euthymic (n = 21) participants with bipolar disorder. RESULTS Mania-inducing lesions overlap significantly in network connectivity. Mania-causing lesions selectively disrupt networks that include orbitofrontal cortex, dorsolateral prefrontal cortex, and temporal lobes. In bipolar disorder, the manic state was reflected in strong, significant, and specific disruption in network communication between these regions and regions implicated in bipolar pathophysiology: the amygdala and ventro-lateral prefrontal cortex. LIMITATIONS There was heterogeneity in the clinical characterization of mania causing lesions. CONCLUSIONS Lesions causing mania demonstrate shared and specific network disruptions. These disruptions are also observed in bipolar mania and suggest a convergence of multiple disorders on shared circuit dysfunction to cause mania.
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Affiliation(s)
- Ivy Lee
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kathryn Nielsen
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA,Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA
| | - Uzma Nawaz
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Mei-Hua Hall
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA
| | - Dost Öngür
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Roscoe Brady
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA.
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Chen G, Zhao L, Jia Y, Zhong S, Chen F, Luo X, Qiu S, Lai S, Qi Z, Huang L, Wang Y. Abnormal cerebellum-DMN regions connectivity in unmedicated bipolar II disorder. J Affect Disord 2019; 243:441-447. [PMID: 30273882 DOI: 10.1016/j.jad.2018.09.076] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 08/29/2018] [Accepted: 09/20/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Bipolar disorder (BD) is a common psychiatric disease. Previous studies have found abnormalities in structural and functional brain connectivity in BD patients. However, few studies have focused on the functional connectivity (FC) of the cerebellum and its sub-regions in patients with BD. The present study aimed to examine the FC of cerebellum-default mode network (DMN) regions in patients with BD II. METHOD Ninety patients with unmedicated BD II depression and 100 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging. We selected three pairs of subregions of the cerebellum that are DMN-related (the bilateral Crus I, Crus II, and lobule IX) as seed regions and calculated the whole brain FC for each subregion. RESULTS Compared with the HCs, the patients with BD II depression showed increased connectivity between the right Crus I and bilateral precuneus and decreased connectivity between the left Crus II and bilateral medial prefrontal cortex (mPFC) and between the left Crus II and right medial frontal gyrus (MFG). There was no significant difference in the whole FC of the left Crus I and bilateral lobule IX between the BD II depression group and the HCs group. LIMITATIONS This study was cross-sectional and did not examine data from euthymic BD patients. CONCLUSIONS The findings showed impaired FC of cerebellum-DMN regions in BD; partial FC between the Crus I and precuneus and the Crus II and prefrontal cortex suggests the importance of abnormal cerebellum-DMN regions FC in the pathophysiology of BD.
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Affiliation(s)
- Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Lianping Zhao
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Department of Radiology, Gansu Provincial Hospital, Gansu 730000, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Feng Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Xiaomei Luo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Shaojuan Qiu
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China.
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China.
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Vai B, Bertocchi C, Benedetti F. Cortico-limbic connectivity as a possible biomarker for bipolar disorder: where are we now? Expert Rev Neurother 2019; 19:159-172. [PMID: 30599797 DOI: 10.1080/14737175.2019.1562338] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The fronto-limbic network has been suggested as a key circuitry in the pathophysiology and maintenance of bipolar disorder. In the past decade, a disrupted connectivity within prefrontal-limbic structures was identified as a promising candidate biomarker for the disorder. Areas Covered: In this review, the authors examine current literature in terms of the structural, functional and effective connectivity in bipolar disorder, integrating recent findings of imaging genetics and machine learning. This paper profiles the current knowledge and identifies future perspectives to provide reliable and usable neuroimaging biomarkers for bipolar psychopathology in clinical practice. Expert Opinion: The replication and the translation of acquired knowledge into useful and usable tools represents one of the current greatest challenges in biomarker research applied to psychiatry.
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Affiliation(s)
- Benedetta Vai
- a Psychiatry & Clinical Psychobiology , Division of Neuroscience, Scientific Institute Ospedale San Raffaele , Milano , Italy.,b University Vita-Salute San Raffaele , Milano , Italy
| | - Carlotta Bertocchi
- a Psychiatry & Clinical Psychobiology , Division of Neuroscience, Scientific Institute Ospedale San Raffaele , Milano , Italy
| | - Francesco Benedetti
- a Psychiatry & Clinical Psychobiology , Division of Neuroscience, Scientific Institute Ospedale San Raffaele , Milano , Italy.,b University Vita-Salute San Raffaele , Milano , Italy
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Abnormal intrinsic cerebro-cerebellar functional connectivity in un-medicated patients with bipolar disorder and major depressive disorder. Psychopharmacology (Berl) 2018; 235:3187-3200. [PMID: 30206663 DOI: 10.1007/s00213-018-5021-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 08/29/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The cerebellum plays an important role in depression. Cerebro-cerebellar circuits have been found to show aberrance in bipolar disorder (BD) and major depressive disorder (MDD). However, whether the cerebro-cerebellar connectivity contributes equally to the pathologic mechanisms of BD and MDD remains unknown. METHODS We recruited 33 patients with MDD, 32 patients with BD, and 43 healthy controls (HC). We selected six seed regions (three per hemisphere) in the cerebrum, corresponding to the affective, cognitive control, and default mode networks, to establish cerebro-cerebellar functional connectivity maps. RESULTS Relative to the HC, both the BD and MDD patients exhibited weaker negative connectivity between the right subgenual anterior cingulate cortex and the cerebellar vermis IV_V (pBD = 0.03, pMDD = 0.001) and weaker positive connectivity between the left precuneus and the left cerebellar lobule IX (pBD = 0.043, pMDD = 0.000). Moreover, the MDD patients showed weaker positive connectivity in the left precuneus-left cerebellar lobule IX circuit than the BD patients (p = 0.049). In addition, the BD patients showed weaker positive connectivity in the right dorsolateral prefrontal cortex-left cerebellar lobule Crus Ι circuit compared to the HC (p = 0.002) or the MDD patients (p = 0.013). Receiver operating characteristic curves analyses showed that the altered cerebro-cerebellar connectivities could be used to distinguish the patients from the HC with relatively high accuracy. CONCLUSIONS Our findings suggested that differences in connectivity of cerebro-cerebellar circuits, which are involved in affective or cognitive functioning, significantly contributed to BD and MDD.
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Kazemi R, Rostami R, Khomami S, Baghdadi G, Rezaei M, Hata M, Aoki Y, Ishii R, Iwase M, Fitzgerald PB. Bilateral Transcranial Magnetic Stimulation on DLPFC Changes Resting State Networks and Cognitive Function in Patients With Bipolar Depression. Front Hum Neurosci 2018; 12:356. [PMID: 30233346 PMCID: PMC6135217 DOI: 10.3389/fnhum.2018.00356] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/20/2018] [Indexed: 01/13/2023] Open
Abstract
Introduction: Bipolar patients have abnormalities in cognitive functions and emotional processing. Two resting state networks (RSNs), the default mode network (DMN) and the sensorimotor network (SMN), play a decisive role in these two functions. Dorsolateral prefrontal cortex (DLPFC) is one of the main areas in the central executive network (CEN), which is linked to the activities of each of the two networks. Studies have found DLPFC abnormalities in both hemispheres of patients with bipolar depression. We hypothesized that the bilateral repetitive transcranial magnetic stimulation (rTMS) of DLPFC would produce changes in the activity of both the SMN and DMN as well as relevant cognitive function in patients with bipolar depression that responded to treatment. Methods: 20 patients with bipolar depression underwent 10 sessions of 1 Hz rTMS on right DLPFC with subsequent 10 Hz rTMS on left DLPFC. Changes in electroencephalography resting networks between pre and post rTMS were evaluated utilizing low-resolution electromagnetic tomography (eLORETA). Depression symptom was assessed using the Beck Depression Inventory (BDI-II) and cognitive function was assessed by Verbal Fluency Test (VFT), Rey Auditory Verbal Learning Test (RAVLT), Stroop Test, and Wisconsin Card Sorting Test (WCST). Results: Responders to rTMS showed significantly lower DMN activity at baseline and a significant decrease in SMN connectivity after treatment. Non-responders did not significantly differ from the control group at the baseline and they showed higher activity in the SMN, visual network, and visual perception network compared to control group following treatment. Bilateral rTMS resulted in significant changes in the executive functions, verbal memory, and depression symptoms. No significant changes were observed in selective attention and verbal fluency. Conclusion: Bilateral stimulation of DLPFC, as the main node of CEN, results in changes in the activity of the SMN and consequently improves verbal memory and executive functions in patients with bipolar depression.
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Affiliation(s)
- Reza Kazemi
- Cognitive Lab, Department of Psychology, University of Tehran, Tehran, Iran.,Atieh Clinical Neuroscience Center, Tehran, Iran
| | - Reza Rostami
- Department of Psychology, University of Tehran, Tehran, Iran
| | - Sanaz Khomami
- Cognitive Lab, Department of Psychology, University of Tehran, Tehran, Iran
| | - Golnaz Baghdadi
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Mehdi Rezaei
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Masahiro Hata
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasunori Aoki
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ryouhei Ishii
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Masao Iwase
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Paul B Fitzgerald
- Epworth Healthcare, Epworth Clinic Camberwell, Victoria Australia and Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University, Melbourne, VIC, Australia
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Morsel AM, Morrens M, Dhar M, Sabbe B. Systematic review of cognitive event related potentials in euthymic bipolar disorder. Clin Neurophysiol 2018; 129:1854-1865. [DOI: 10.1016/j.clinph.2018.05.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 04/25/2018] [Accepted: 05/16/2018] [Indexed: 01/04/2023]
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Syan SK, Smith M, Frey BN, Remtulla R, Kapczinski F, Hall GBC, Minuzzi L. Resting-state functional connectivity in individuals with bipolar disorder during clinical remission: a systematic review. J Psychiatry Neurosci 2018; 43:298-316. [PMID: 30125243 PMCID: PMC6158027 DOI: 10.1503/jpn.170175] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 12/21/2017] [Accepted: 01/19/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Bipolar disorder is chronic and debilitating. Studies investigating resting-state functional connectivity in individuals with bipolar disorder may help to inform neurobiological models of illness. METHODS We conducted a systematic review with the following goals: to summarize the literature on resting-state functional connectivity in bipolar disorder during clinical remission (euthymia) compared with healthy controls; to critically appraise the literature and research gaps; and to propose directions for future research. We searched PubMed/MEDLINE, Embase, PsycINFO, CINAHL and grey literature up to April 2017. RESULTS Twenty-three studies were included. The most consistent finding was the absence of differences in resting-state functional connectivity of the default mode network (DMN), frontoparietal network (FPN) and salience network (SN) between people with bipolar disorder and controls, using independent component analysis. However, 2 studies in people with bipolar disorder who were positive for psychosis history reported DMN hypoconnectivity. Studies using seed-based analysis largely reported aberrant resting-state functional connectivity with the amygdala, ventrolateral prefrontal cortex, cingulate cortex and medial prefrontal cortex in people with bipolar disorder compared with controls. Few studies used regional homogeneity or amplitude of low-frequency fluctuations. LIMITATIONS We found heterogeneity in the analysis methods used. CONCLUSION Stability of the DMN, FPN and SN may reflect a state of remission. Further, DMN hypoconnectivity may reflect a positive history of psychosis in patients with bipolar disorder compared with controls, highlighting a potentially different neural phenotype of psychosis in people with bipolar disorder. Resting-state functional connectivity changes between the amygdala, prefrontal cortex and cingulate cortex may reflect a neural correlate of subthreshold symptoms experienced in bipolar disorder euthymia, the trait-based pathophysiology of bipolar disorder and/or a compensatory mechanism to maintain a state of euthymia.
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Affiliation(s)
- Sabrina K Syan
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
| | - Mara Smith
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
| | - Benicio N Frey
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
| | - Raheem Remtulla
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
| | - Flavio Kapczinski
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
| | - Geoffrey B C Hall
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
| | - Luciano Minuzzi
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
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Yoon HK, Dev SI, Sutherland AN, Eyler LT. Disruptions in resting state functional connectivity in euthymic bipolar patients with insomnia symptoms. Psychiatry Res Neuroimaging 2018; 275:1-4. [PMID: 29572076 PMCID: PMC5899934 DOI: 10.1016/j.pscychresns.2018.03.005] [Citation(s) in RCA: 3] [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] [Received: 10/16/2017] [Revised: 02/07/2018] [Accepted: 03/02/2018] [Indexed: 11/22/2022]
Abstract
Insomnia is prevalent in bipolar disorder (BD) even during periods of euthymic mood. We compared resting state brain activity and cognitive function between euthymic BD with and without insomnia, and secondarily to healthy individuals. BD patients with insomnia symptoms showed a significantly lower functional connectivity within the task-positive network, compared to those without insomnia. They also showed significantly slower cognitive processing speed. These two features of BD with insomnia appeared relatively independent of each other. Preliminary findings suggest that exploration of the mechanisms of sleep disturbance in BD could lead to improved understanding and treatment of inattention in BD.
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Affiliation(s)
- Ho-Kyoung Yoon
- Department of Psychiatry, University of California, San Diego, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Sheena I Dev
- Department of Psychiatry, University of California, San Diego, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Ashley N Sutherland
- Department of Psychiatry, University of California, San Diego, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California, San Diego, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
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49
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Arefin TM, Mechling AE, Meirsman AC, Bienert T, Hübner NS, Lee HL, Ben Hamida S, Ehrlich A, Roquet D, Hennig J, von Elverfeldt D, Kieffer BL, Harsan LA. Remodeling of Sensorimotor Brain Connectivity in Gpr88-Deficient Mice. Brain Connect 2018; 7:526-540. [PMID: 28882062 DOI: 10.1089/brain.2017.0486] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Recent studies have demonstrated that orchestrated gene activity and expression support synchronous activity of brain networks. However, there is a paucity of information on the consequences of single gene function on overall brain functional organization and connectivity and how this translates at the behavioral level. In this study, we combined mouse mutagenesis with functional and structural magnetic resonance imaging (MRI) to determine whether targeted inactivation of a single gene would modify whole-brain connectivity in live animals. The targeted gene encodes GPR88 (G protein-coupled receptor 88), an orphan G protein-coupled receptor enriched in the striatum and previously linked to behavioral traits relevant to neuropsychiatric disorders. Connectivity analysis of Gpr88-deficient mice revealed extensive remodeling of intracortical and cortico-subcortical networks. Most prominent modifications were observed at the level of retrosplenial cortex connectivity, central to the default mode network (DMN) whose alteration is considered a hallmark of many psychiatric conditions. Next, somatosensory and motor cortical networks were most affected. These modifications directly relate to sensorimotor gating deficiency reported in mutant animals and also likely underlie their hyperactivity phenotype. Finally, we identified alterations within hippocampal and dorsal striatum functional connectivity, most relevant to a specific learning deficit that we previously reported in Gpr88-/- animals. In addition, amygdala connectivity with cortex and striatum was weakened, perhaps underlying the risk-taking behavior of these animals. This is the first evidence demonstrating that GPR88 activity shapes the mouse brain functional and structural connectome. The concordance between connectivity alterations and behavior deficits observed in Gpr88-deficient mice suggests a role for GPR88 in brain communication.
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Affiliation(s)
- Tanzil Mahmud Arefin
- 1 Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg, Germany .,2 Faculty of Biology, University of Freiburg , Freiburg, Germany .,3 Bernstein Center Freiburg, University of Freiburg , Freiburg, Germany .,4 Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine , New York, New York
| | - Anna E Mechling
- 1 Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg, Germany .,2 Faculty of Biology, University of Freiburg , Freiburg, Germany
| | - Aura Carole Meirsman
- 5 Département de Médecine Translationnelle et Neurogénétique, Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM U-964, CNRS UMR-7104, Université de Strasbourg , Illkirch-Graffenstaden, France .,6 Neuroscience Paris Seine, Institut de Biologie Paris Seine , CNRS UMR 8246/INSERM U1130/Université Pierre et Marie Currie, Paris, France
| | - Thomas Bienert
- 1 Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg, Germany
| | - Neele Saskia Hübner
- 1 Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg, Germany .,2 Faculty of Biology, University of Freiburg , Freiburg, Germany
| | - Hsu-Lei Lee
- 1 Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg, Germany
| | - Sami Ben Hamida
- 5 Département de Médecine Translationnelle et Neurogénétique, Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM U-964, CNRS UMR-7104, Université de Strasbourg , Illkirch-Graffenstaden, France .,7 Douglas Mental Health Institute, Department of Psychiatry, McGill University , Montreal, Quebec, Canada
| | - Aliza Ehrlich
- 5 Département de Médecine Translationnelle et Neurogénétique, Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM U-964, CNRS UMR-7104, Université de Strasbourg , Illkirch-Graffenstaden, France .,7 Douglas Mental Health Institute, Department of Psychiatry, McGill University , Montreal, Quebec, Canada
| | - Dan Roquet
- 8 Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS , Strasbourg, France
| | - Jürgen Hennig
- 1 Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg, Germany
| | - Dominik von Elverfeldt
- 1 Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg, Germany
| | - Brigitte Lina Kieffer
- 5 Département de Médecine Translationnelle et Neurogénétique, Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM U-964, CNRS UMR-7104, Université de Strasbourg , Illkirch-Graffenstaden, France .,7 Douglas Mental Health Institute, Department of Psychiatry, McGill University , Montreal, Quebec, Canada
| | - Laura-Adela Harsan
- 1 Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg, Germany .,8 Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS , Strasbourg, France .,9 Department of Biophysics and Nuclear Medicine, Faculty of Medicine, University Hospital Strasbourg , Strasbourg, France
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50
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Spuhler K, Bartlett E, Ding J, DeLorenzo C, Parsey R, Huang C. Diffusion Entropy: A Potential Neuroimaging Biomarker of Bipolar Disorder in the Temporal Pole. Synapse 2018; 72:10.1002/syn.22015. [PMID: 28960527 PMCID: PMC5823690 DOI: 10.1002/syn.22015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 09/23/2017] [Accepted: 09/25/2017] [Indexed: 12/25/2022]
Abstract
Despite much research, bipolar depression remains poorly understood, with no clinically useful biomarkers for its diagnosis. The paralimbic system has become a target for biomarker research, with paralimbic structural connectivity commonly reported to distinguish bipolar patients from controls in tractography-based diffusion MRI studies, despite inconsistent findings in voxel-based studies. The purpose of this analysis was to validate existing findings with traditional diffusion MRI metrics and investigate the utility of a novel diffusion MRI metric, entropy of diffusion, in the search for bipolar depression biomarkers. We performed group-level analysis on 9 un-medicated (6 medication-naïve; 3 medication-free for at least 33 days) bipolar patients in a major depressive episode and 9 matched healthy controls to compare: (1) average mean diffusivity (MD) and fractional anisotropy (FA) and; (2) MD and FA histogram entropy-a statistical measure of distribution homogeneity-in the amygdala, hippocampus, orbitofrontal cortex and temporal pole. We also conducted classification analyses with leave-one-out and separate testing dataset (N = 11) approaches. We did not observe statistically significant differences in average MD or FA between the groups in any region. However, in the temporal pole, we observed significantly lower MD entropy in bipolar patients; this finding suggests a regional difference in MD distributions in the absence of an average difference. This metric allowed us to accurately characterize bipolar patients from controls in leave-one-out (accuracy = 83%) and prediction (accuracy = 73%) analyses. This novel application of diffusion MRI yielded not only an interesting separation between bipolar patients and healthy controls, but also accurately classified bipolar patients from controls.
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Affiliation(s)
- Karl Spuhler
- Department of Biomedical Engineering, Stony Brook University. Biomedical Engineering, Stony Brook, NY, USA 11794
| | - Elizabeth Bartlett
- Department of Biomedical Engineering, Stony Brook University. Biomedical Engineering, Stony Brook, NY, USA 11794
| | - Jie Ding
- Department of Biomedical Engineering, Stony Brook University. Biomedical Engineering, Stony Brook, NY, USA 11794
| | - Christine DeLorenzo
- Department of Biomedical Engineering, Stony Brook University. Biomedical Engineering, Stony Brook, NY, USA 11794
- Department of Psychiatry, Stony Brook Medicine. 101 Nicolls Rd, Stony Brook, NY, USA 11794
| | - Ramin Parsey
- Department of Psychiatry, Stony Brook Medicine. 101 Nicolls Rd, Stony Brook, NY, USA 11794
| | - Chuan Huang
- Department of Biomedical Engineering, Stony Brook University. Biomedical Engineering, Stony Brook, NY, USA 11794
- Department of Psychiatry, Stony Brook Medicine. 101 Nicolls Rd, Stony Brook, NY, USA 11794
- Department of Radiology, Stony Brook Medicine. 101 Nicolls Rd, Stony Brook, NY, USA 11794
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