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Janiri D, Simonetti A, Luciano M, Montanari S, Bernardi E, Carrà G, Fiorillo A, Sani G. Type of cycle, temperament and childhood trauma are associated with lithium response in patients with bipolar disorders. Int J Bipolar Disord 2024; 12:10. [PMID: 38563884 PMCID: PMC10987409 DOI: 10.1186/s40345-024-00331-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Lithium stands as the gold standard in treating bipolar disorders (BD). Despite numerous clinical factors being associated with a favorable response to lithium, comprehensive studies examining the collective influence of clinical variables alongside psychopathological dimensions are lacking. Our study aims to enhance comprehension of lithium response in individuals with BD by integrating clinical variables with psychopathological traits and early adverse events. METHODS We assessed 201 patients with BD for clinical characteristics, childhood trauma, temperament traits, impulsivity, and aggression. Lithium response was evaluated using the gold standard Alda scale, and predictors of lithium response were estimated through a multivariate model. RESULTS On the total sample, 61 (30.3%) patients were lithium responders according to the Alda scale. Comparatively, lithium responders, in contrast to non-responders, demonstrated a higher prevalence of the mania-depression-interval (MDI) cycle, a more frequent diagnosis of BD type I, and reported an earlier age of onset. They also exhibited less lifetime substance abuse, emotional, physical, and sexual abuse, while scoring higher on hyperthymic and irritable temperament scales. In multivariate analyses, only the MDI cycle (OR,3.47; 95%CI,1.61-7.50) hyperthymic (OR,1.20; 95%CI,1.02-1.41) and irritable temperament (OR,1.28; 95%CI,1.08-1.52) persisted as significant predictors of a positive response to lithium treatment, while emotional (OR,0.87; 95%CI,0.76-0.98) and physical abuse (OR,0.83; 95%CI,0.70-0.98) were predictors of non-response. CONCLUSIONS In evaluating lithium response in BD, our study highlights the importance of considering clinical variables alongside temperament and childhood adversities. The assessment of hyperthymic and irritable temperament, emotional and physical abuse together with the type of cycle is of particular importance. Furthermore, our findings underscore the significance of systematically assessing the type of cycle in patients with BD through the use of life charts.
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Affiliation(s)
- Delfina Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
- Department of Neurosciences, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Alessio Simonetti
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Silvia Montanari
- Department of Neurosciences, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Evelina Bernardi
- Department of Neurosciences, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Division of Psychiatry, University College London, London, UK
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neurosciences, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
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2
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Squarcina L, Lucini Paioni S, Bellani M, Rossetti MG, Houenou J, Polosan M, Phillips ML, Wessa M, Brambilla P. White matter integrity in bipolar disorder investigated with diffusion tensor magnetic resonance imaging and fractal geometry. J Affect Disord 2024; 345:200-207. [PMID: 37863367 DOI: 10.1016/j.jad.2023.10.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/14/2023] [Accepted: 10/15/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Growing evidence suggests the presence of white matter (WM) alterations in bipolar disorder (BD). In this study we aimed to investigate the state of WM structures, in terms of tissue integrity and morphological complexity, in BD patients compared to healthy controls (HC), in an attempt to better elucidate the microstructural changes associated with BD. METHODS We collected a dataset of 399 Diffusion Tensor Magnetic Resonance Imaging (167 BD and 232 healthy controls) images, acquired at five different sites, which was processed with Tract-Based Spatial Statistics (TBSS) and fractal analysis. RESULTS The TBSS analysis demonstrated significantly lower FA values in the BD group. Diffusion abnormalities were primarily located in the temporo-parietal network. The Fractal Dimension (FD) analysis did not reveal consistent significant differences in the morphological complexity of WM structures between the groups. When the FD values of patients were considered individually, it is possible to notice some localized significant deviations from the healthy population. LIMITATIONS DTI sequences have not been harmonized before acquisition, samples' sizes are heterogeneous. CONCLUSIONS This study, by applying both TBSS and FD analyses, allows to evaluate diffusion and structural alterations of WM at the same time. The evaluation of WM integrity from these two different perspectives could be useful to better understand the pathophysiological and morphological changes underpinning bipolar disorder.
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Affiliation(s)
- Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Susanna Lucini Paioni
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Marcella Bellani
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - Maria Gloria Rossetti
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy; UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy
| | - Josselin Houenou
- APHP, Mondor Univ Hospitals, DMU IMPACT, INSERM U955, Translational NeuroPsychiatry Team, UPEC, Créteil, France & NeuroSpin, UNIACT Lab, PsyBrain Team, CEA Saclay, Gif-sur-Yvette, France
| | - Mircea Polosan
- Univ. Grenoble-Alpes, Grenoble Institut Neurosciences, Inserm U1216, CHU Grenoble Alpes, France
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America
| | - Michèle Wessa
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy.
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3
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Macoveanu J, Damgaard V, Ysbæk-Nielsen AT, Frangou S, Yatham LN, Chakrabarty T, Stougaard ME, Knudsen GM, Vinberg M, Kessing LV, Kjærstad HL, Miskowiak KW. Early longitudinal changes in brain structure and cognitive functioning in remitted patients with recently diagnosed bipolar disorder. J Affect Disord 2023; 339:153-161. [PMID: 37442440 DOI: 10.1016/j.jad.2023.07.026] [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: 02/03/2023] [Revised: 06/08/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Patients with bipolar disorder (BD) who are presenting with cognitive impairment and associated structural brain abnormalities have generally a poorer clinical outcome. This study aims to map the early longitudinal trajectories in brain structure and cognition in patients with recently diagnosed BD. METHODS Fully or partially remitted patients with a recent diagnosis of BD and matched healthy controls (HC) underwent structural MRI and neuropsychological testing at baseline (BD n = 97; HC n = 66) and again following an average of 16 (range 6-27) months (BD n = 50; HC n = 38). We investigated the differential trajectories in BD vs. HC in cortical gray matter volume and thickness, total cerebral white matter, hippocampal and amygdala volumes, estimated brain age, and cognitive functioning using linear mixed models. Within patients, we further investigated whether brain structural abnormalities detected at baseline were associated with subsequent mood episodes. RESULTS Compared to HC, patients showed a decline in total white matter volume over time and they had a larger amygdala volume, both at baseline and at follow-up time. Patients further showed lower cognitive performance at both times of investigation with no significant change over time. There were no differences between patients and HC in cortical gray matter volume or thickness, hippocampal volume, or brain-aging patterns. CONCLUSIONS Cognitive impairment and amygdala enlargement may represent stable markers of BD early in the course of illness, whereas subtle white matter decline may result from illness progression.
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Affiliation(s)
- Julian Macoveanu
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark.
| | - Viktoria Damgaard
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Denmark
| | - Alexander Tobias Ysbæk-Nielsen
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Denmark
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lakshmi N Yatham
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Canada
| | - Trisha Chakrabarty
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Canada
| | - Marie Eschau Stougaard
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Maj Vinberg
- Department of Clinical Medicine, University of Copenhagen, Denmark; Psychiatric Research Unit, Psychiatric Centre North Zealand, Hillerød, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Hanne Lie Kjærstad
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Denmark
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Huth F, Tozzi L, Marxen M, Riedel P, Bröckel K, Martini J, Berndt C, Sauer C, Vogelbacher C, Jansen A, Kircher T, Falkenberg I, Thomas-Odenthal F, Lambert M, Kraft V, Leicht G, Mulert C, Fallgatter AJ, Ethofer T, Rau A, Leopold K, Bechdolf A, Reif A, Matura S, Biere S, Bermpohl F, Fiebig J, Stamm T, Correll CU, Juckel G, Flasbeck V, Ritter P, Bauer M, Pfennig A, Mikolas P. Machine Learning Prediction of Estimated Risk for Bipolar Disorders Using Hippocampal Subfield and Amygdala Nuclei Volumes. Brain Sci 2023; 13:870. [PMID: 37371350 DOI: 10.3390/brainsci13060870] [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: 04/27/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
The pathophysiology of bipolar disorder (BD) remains mostly unclear. Yet, a valid biomarker is necessary to improve upon the early detection of this serious disorder. Patients with manifest BD display reduced volumes of the hippocampal subfields and amygdala nuclei. In this pre-registered analysis, we used structural MRI (n = 271, 7 sites) to compare volumes of hippocampus, amygdala and their subfields/nuclei between help-seeking subjects divided into risk groups for BD as estimated by BPSS-P, BARS and EPIbipolar. We performed between-group comparisons using linear mixed effects models for all three risk assessment tools. Additionally, we aimed to differentiate the risk groups using a linear support vector machine. We found no significant volume differences between the risk groups for all limbic structures during the main analysis. However, the SVM could still classify subjects at risk according to BPSS-P criteria with a balanced accuracy of 66.90% (95% CI 59.2-74.6) for 10-fold cross-validation and 61.9% (95% CI 52.0-71.9) for leave-one-site-out. Structural alterations of the hippocampus and amygdala may not be as pronounced in young people at risk; nonetheless, machine learning can predict the estimated risk for BD above chance. This suggests that neural changes may not merely be a consequence of BD and may have prognostic clinical value.
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Affiliation(s)
- Fabian Huth
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01062 Dresden, Germany
| | - Leonardo Tozzi
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Michael Marxen
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01062 Dresden, Germany
| | - Philipp Riedel
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01062 Dresden, Germany
| | - Kyra Bröckel
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01062 Dresden, Germany
| | - Julia Martini
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01062 Dresden, Germany
| | - Christina Berndt
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01062 Dresden, Germany
| | - Cathrin Sauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01062 Dresden, Germany
| | - Christoph Vogelbacher
- Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, 35037 Marburg, Germany
- Translational Clinical Psychology, Philipps-University Marburg, 35037 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and University Giessen, 35039 Marburg, Germany
| | - Andreas Jansen
- Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, 35037 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and University Giessen, 35039 Marburg, Germany
- Department of Psychiatry and Psychotherapy, University of Marburg, 35037 Marburg, Germany
| | - Tilo Kircher
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and University Giessen, 35039 Marburg, Germany
- Department of Psychiatry and Psychotherapy, University of Marburg, 35037 Marburg, Germany
| | - Irina Falkenberg
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and University Giessen, 35039 Marburg, Germany
- Department of Psychiatry and Psychotherapy, University of Marburg, 35037 Marburg, Germany
| | - Florian Thomas-Odenthal
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and University Giessen, 35039 Marburg, Germany
- Department of Psychiatry and Psychotherapy, University of Marburg, 35037 Marburg, Germany
| | - Martin Lambert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Vivien Kraft
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Gregor Leicht
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Christoph Mulert
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and University Giessen, 35039 Marburg, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
- Centre for Psychiatry, Justus-Liebig University Giessen, 35390 Gießen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry, Tuebingen Center for Mental Health, University of Tuebingen, 72074 Tuebingen, Germany
| | - Thomas Ethofer
- Department of Psychiatry, Tuebingen Center for Mental Health, University of Tuebingen, 72074 Tuebingen, Germany
| | - Anne Rau
- Department of Psychiatry, Tuebingen Center for Mental Health, University of Tuebingen, 72074 Tuebingen, Germany
| | - Karolina Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, 10117 Berlin, Germany
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, 10117 Berlin, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, 60323 Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, 60323 Frankfurt, Germany
| | - Silvia Biere
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, University Hospital, 60323 Frankfurt, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité University Medicine, 10117 Berlin, Germany
| | - Jana Fiebig
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité University Medicine, 10117 Berlin, Germany
| | - Thomas Stamm
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité University Medicine, 10117 Berlin, Germany
- Department of Clinical Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
- Department of Psychiatry, Northwell Health, The Zucker Hillside Hospital, Glen Oaks, New York, NY 11004, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA
| | - Georg Juckel
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr-University, 44791 Bochum, Germany
| | - Vera Flasbeck
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr-University, 44791 Bochum, Germany
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01062 Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01062 Dresden, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01062 Dresden, Germany
| | - Pavol Mikolas
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, 01062 Dresden, Germany
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Stumper A, Alloy LB. Associations Between Pubertal Stage and Depression: A Systematic Review of the Literature. Child Psychiatry Hum Dev 2023; 54:312-339. [PMID: 34529199 DOI: 10.1007/s10578-021-01244-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 11/26/2022]
Abstract
The current article systematically reviews the literature and provides results from 36 studies testing the relation between pubertal stage and depression, as well as moderators and mediators of this relation. Results indicate that there is a significant relation between advancing pubertal stage and depression among girls, and this effect is strongest among White girls. Among boys, risk for depression does not increase with pubertal stage. Importantly, gonadal development appears to be driving the pubertal stage effect. Increasing hormone concentrations, shared environmental stressors, and body esteem appear to be mechanisms of this relation; increases in nonshared environmental stressors (negative life events, peer victimization) moderate the relation between pubertal stage and depression. Inconsistencies in findings across studies can be explained by methodological differences. Future work on this topic should control for age, examine differences by sex, and utilize within-person analyses to evaluate the effect of pubertal stage on depression over time.
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Affiliation(s)
- Allison Stumper
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St, Philadelphia, PA, 19122, USA.
| | - Lauren B Alloy
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St, Philadelphia, PA, 19122, USA
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6
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Sun D, Zhang R, Ma X, Sultana MS, Jiao L, Li M, Yang Y, Li M, Liu Q, Li Z. The association between childhood trauma and the age of onset in drug-free bipolar depression. Psychiatry Res 2022; 310:114469. [PMID: 35231875 DOI: 10.1016/j.psychres.2022.114469] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 02/14/2022] [Accepted: 02/19/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed to investigate the relationship between childhood trauma and clinical correlates in bipolar depression. METHODS A total of 61 bipolar depression patients were enrolled and assessed based on the Childhood Trauma Questionnaire-Short Form (CTQ-SF), Patient Health Questionaire-15 (PHQ-15), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) systems. RESULTS The age of onset in bipolar depression patients with either trauma or abuse or neglect was significantly lower than in patients without these factors. There were statistically significant negative correlations between the age of onset and the number of different trauma types in bipolar depression patients. Multiple variable regression showed a significant association between the number of trauma types and the age of onset. Furthermore, there was a significant negative correlation between the age of onset with CTQ-SF total score (CTS), emotional abuse score and emotional neglect score, and physical neglect score. However, multiple variable regression analysis revealed that there was a significant association between emotional abuse score and the age of onset of bipolar depression patients. CONCLUSION Our results suggest that childhood trauma may be associated with physical symptoms and the age of onset in bipolar depression patients.
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Affiliation(s)
- Daliang Sun
- Department of Psychiatry, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Ran Zhang
- Department of Psychiatry, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | | | - Mst Sadia Sultana
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Lianfa Jiao
- Department of Xinzhuang Town Health Center, Jinnan District, Tianjin, China
| | - Meijuan Li
- Department of Psychiatry, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Yuan Yang
- Department of Psychiatry, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Min Li
- Department of Psychiatry, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Qinghe Liu
- Department of Psychiatry, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
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7
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Simonetti A, Saxena K, Koukopoulos AE, Janiri D, Lijffijt M, Swann AC, Kotzalidis GD, Sani G. Amygdala structure and function in paediatric bipolar disorder and high-risk youth: A systematic review of magnetic resonance imaging findings. World J Biol Psychiatry 2022; 23:103-126. [PMID: 34165050 DOI: 10.1080/15622975.2021.1935317] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Converging evidence from structural and functional magnetic resonance imaging (MRI) studies points to amygdala alteration as crucial in the development of paediatric bipolar disorder (pBP). The high number of recent studies prompted us to comprehensively evaluate findings. We aimed to systematically review structural and functional MRI studies investigating the amygdala in patients with pBP and in youth at high-risk (HR) for developing pBP. METHODS We searched PubMed from any time to 25 September 2020 using: 'amygdala AND (MRI OR magnetic resonance imaging) AND bipolar AND (pediatr* OR child OR children OR childhood OR adolescent OR adolescents OR adolescence OR young OR familial OR at-risk OR sibling* OR offspring OR high risk)'. In this review, we adhered to the PRISMA statement. RESULTS Amygdala hyperactivity to emotional stimuli is the most commonly reported finding in youth with pBP and HR compared to healthy peers (HC), whereas findings from structural MRI studies are inconsistent. CONCLUSIONS Hyperactivation of the amygdala might be an endophenotype of pBP.
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Affiliation(s)
- Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Department of Psychiatry, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.,Centro Lucio Bini, Rome, Italy
| | - Kirti Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA
| | - Alexia E Koukopoulos
- Centro Lucio Bini, Rome, Italy.,Azienda Ospedaliera Universitaria Policlinico Umberto I, Sapienza School of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Delfina Janiri
- Centro Lucio Bini, Rome, Italy.,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Marijn Lijffijt
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Alan C Swann
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Georgios D Kotzalidis
- Centro Lucio Bini, Rome, Italy.,NESMOS Department, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.,Institute of Psychiatry, Università Cattolica del Sacro Cuore, Roma, Italy
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8
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McLachlan J, Mehdikhani M, Larham B, Centifanti LCM. Borderline Personality Traits and Emotion Regulation Strategies in Adolescents: The Role of Implicit Theories. Child Psychiatry Hum Dev 2022; 53:899-907. [PMID: 33914216 PMCID: PMC9470600 DOI: 10.1007/s10578-021-01169-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 01/12/2023]
Abstract
Borderline Personality Disorder (BPD) is associated with emotion dysregulation. The emotion regulation strategies people adopt may depend on one's belief about emotion as either fixed or changeable (termed "implicit theory"). We test this experimentally by modifying beliefs about emotions using virtual reality (VR). A sample of 29 adolescents (ages 14-17 years) were recruited from two adolescent inpatient units for an uncontrolled pilot trial of a new brief intervention. We measured BPD traits, beliefs about emotion, treatment preference, cognitive reappraisal and rumination, before the VR game and 14-31 days later. Adolescents with higher levels of BPD traits endorsed fixed beliefs of emotion and reported higher levels of rumination and lower levels of cognitive reappraisal. After a one-time message delivered via VR, adolescents evidenced an increase in belief that their emotions were changeable. These findings suggest beliefs about emotions may have an important role in interventions for adolescents with BPD traits.
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Affiliation(s)
- Jane McLachlan
- Department of Clinical Psychology, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK. .,Liverpool Heart and Chest NHS Foundation Trust, Thomas Drive, Liverpool, L14 3PE, UK.
| | - Mani Mehdikhani
- Salford Primary Care Psychological Therapy Service, Greater Manchester Mental Health Trust, St James House, Pendleton Way, Salford, M6 5FW UK
| | - Beth Larham
- FRESH CAMHS (Liverpool), Alder Hey Children’s NHS Foundation Hospital, Catkin Building, Alder Road, Liverpool, L12 2AP UK
| | - Luna C. Muñoz Centifanti
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool, L69 3GB UK
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9
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Stewart SL, Van Dyke JN, Poss JW. Examining the Mental Health Presentations of Treatment-Seeking Transgender and Gender Nonconforming (TGNC) Youth. Child Psychiatry Hum Dev 2021; 54:826-836. [PMID: 34860314 PMCID: PMC10140107 DOI: 10.1007/s10578-021-01289-1] [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] [Accepted: 11/21/2021] [Indexed: 12/14/2022]
Abstract
Recent research suggests that transgender and/or gender nonconforming (TGNC) youth present with heightened levels of mental health problems compared to peers. This study seeks to examine the mental health needs of a large sample of treatment-seeking TGNC youth by comparing them to cisgender males and females. Participants were 94,804 children and youth ages 4-18 years (M = 12.1, SD = 3.72) who completed the interRAI Child and Youth Mental Health Instrument (ChYMH) or Screener (ChYMH-S) at participating mental health agencies in the Ontario, Canada. Overall, the mental health presentations of TGNC youth were similar to cisgender females but at higher acuity levels. TGNC youth showed significantly higher levels of anxiety, depression, social disengagement, positive symptoms, risk of suicide/self-harm, and were more likely to report experiencing emotional abuse, past suicide attempts, and a less strong, supportive family relationship than cisgender females and males. Clinical implications of these findings are discussed.
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Affiliation(s)
- Shannon L Stewart
- Faculty of Education, University of Western Ontario, 1137 Western Rd, London, ON, N6G 1G7, Canada
| | - Jocelyn N Van Dyke
- Faculty of Education, University of Western Ontario, 1137 Western Rd, London, ON, N6G 1G7, Canada.
| | - Jeffrey W Poss
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G5, Canada
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10
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Lithium effects on Hippocampus volumes in patients with bipolar disorder. J Affect Disord 2021; 294:521-526. [PMID: 34330048 DOI: 10.1016/j.jad.2021.07.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/11/2021] [Accepted: 07/11/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Lithium is one of the most effective medications for bipolar disorder episode prevention, but its mechanism of action is still largely unknown. The hippocampus is a subcortical cerebral structure involved in the formation of emotional responses, cognition and various primitive functions, altered during affective episodes. Deviations in the anatomy or physiology of the hippocampus would partially explain the symptomatology of bipolar subjects, and restoration may reflect treatment response. METHODS In this mini review, we summarize the studies which have investigated the effect of lithium intake on the volume of hippocampus, measured using magnetic resonance imaging (MRI). We performed a bibliographic search on PubMed, using the terms terms "hippocampus", "lithium", "bipolar disorder", "volume" and "MRI". Only original studies were considered. RESULTS Thirteen studies met the inclusion criteria. Nine studies demonstrated increased total hippocampal volume or hippocampal subfield volumes in BD patients on lithium treatment (Li BD) compared to those not taking lithium (non-Li BD), while four failed to show significant differences between groups. When healthy controls were compared to either the Li subjects or the non-Li ones, the findings were more heterogeneous. LIMITATIONS Heterogeneity in the methodology and definition of groups limits the comparison of study results. CONCLUSIONS Lithium may be associated with increased hippocampal volume in BD, potentially due to its putative neurotrophic action, but further research is needed better define the morphological alterations of hippocampus in BD and the longitudinal effects of lithium in the short and long-term.
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11
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Gray matter volume covariance networks are associated with altered emotional processing in bipolar disorder: a source-based morphometry study. Brain Imaging Behav 2021; 16:738-747. [PMID: 34546520 PMCID: PMC9010334 DOI: 10.1007/s11682-021-00541-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/26/2022]
Abstract
Widespread regional gray matter volume (GMV) alterations have been reported in bipolar disorder (BD). Structural networks, which are thought to better reflect the complex multivariate organization of the brain, and their clinical and psychological function have not been investigated yet in BD. 24 patients with BD type-I (BD-I), and 30 with BD type-II (BD-II), and 45 controls underwent MRI scan. Voxel-based morphometry and source-based morphometry (SBM) were performed to extract structural covariation patterns of GMV. SBM components associated with morphometric differences were compared among diagnoses. Executive function and emotional processing correlated with morphometric characteristics. Compared to controls, BD-I showed reduced GMV in the temporo-insular-parieto-occipital cortex and in the culmen. An SBM component spanning the prefrontal-temporal-occipital network exhibited significantly lower GMV in BD-I compared to controls, but not between the other groups. The structural network covariance in BD-I was associated with the number of previous manic episodes and with worse executive performance. Compared to BD-II, BD-I showed a loss of GMV in the temporal-occipital regions, and this was correlated with impaired emotional processing. Altered prefrontal-temporal-occipital network structure could reflect a neural signature associated with visuospatial processing and problem-solving impairments as well as emotional processing and illness severity in BD-I.
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12
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Simonetti A, Kurian S, Saxena J, Verrico CD, Restaino A, Di Nicola M, Soares JC, Sani G, Saxena K. Cortical Correlates of Impulsive Aggressive Behavior in Pediatric Bipolar Disorder. Front Psychiatry 2021; 12:674707. [PMID: 34366914 PMCID: PMC8333699 DOI: 10.3389/fpsyt.2021.674707] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/15/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Impulsive aggression represents a frequent characteristic of pediatric bipolar disorder (PBD). Cortical alterations associated with impulsive aggression and its multiple facets have not been investigated yet in youth with bipolar disorder. Aim: To investigate the relationship between cortical thickness and facets of impulsive aggression in youth with PBD. Materials and Methods: Twenty-three youth with PBD and 23 healthy controls (HC) were administered the aggression questionnaire (AQ) and underwent 3T magnetic resonance imaging scan. Cortical thickness was assessed with FreeSurfer. Canonical correlation analyses were used to investigate the relationship between AQ total and subscale scores and cortical thickness in youth with PBD. Results: Youth with PBD had increased scores in the subscales of AQ-anger and AQ-hostility and cortical thinning in in areas belonging to the affective network (AN), frontoparietal network (FPN) and cingulo-opercular network (CON), i.e., right rostral anterior cingulate, right caudal anterior cingulate, right lateral orbitofrontal, right medial orbitofrontal, left and right inferior parietal, left posterior cingulate, left and right supramarginal left lingual cortices. Greater thickness in these networks positively correlated with the AQ-hostility subscale and negatively correlated with AQ-anger subscale. Conclusions: The opposite patterns observed between areas belonging to AN, FPN, CON, and the two facets of IA, namely anger and hostility, corroborate clinical findings supporting the different nature of these two constructs.
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Affiliation(s)
- Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” Istituto di Ricovero e Cura a Carattere Scientific (IRCCS), Rome, Italy
| | - Sherin Kurian
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Department of Psychiatry, Texas Children's Hospital, Houston, TX, United States
| | - Johanna Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Department of Psychiatry, Texas Children's Hospital, Houston, TX, United States
| | - Christopher D. Verrico
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Antonio Restaino
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” Istituto di Ricovero e Cura a Carattere Scientific (IRCCS), Rome, Italy
| | - Jair C. Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, United States
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” Istituto di Ricovero e Cura a Carattere Scientific (IRCCS), Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Kirti Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Department of Psychiatry, Texas Children's Hospital, Houston, TX, United States
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13
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Simonetti A, Kurian S, Saxena J, Verrico CD, Soares JC, Sani G, Saxena K. Cognitive correlates of impulsive aggression in youth with pediatric bipolar disorder and bipolar offspring. J Affect Disord 2021; 287:387-396. [PMID: 33838473 DOI: 10.1016/j.jad.2021.03.044] [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: 01/30/2021] [Revised: 03/13/2021] [Accepted: 03/17/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Youth with bipolar disorder (BD) and offspring of individuals with BD (BD-OFF) are characterized by higher levels of impulsive and overt aggression. The cognitive basis underlying these aggressive behaviors are not clarified in this population. The aim of this study was to investigate the relationship between cognitive alterations and aggressive behavior in youth with BD and BD-OFF. METHODS Forty-two youth with BD, 17 BD-OFF and 57 healthy controls (HCs) were administered the Modified Overt Aggression Scale (MOAS), the Cambridge Neuropsychological Test Automated Battery (CANTAB), the Young Mania Rating Scale (YMRS) and the Children's Depression Rating Scale (CDRS). Multiple linear regression analyses were performed in the three groups separately. In each group, tests scores from the CANTAB were predictors. MOAS subscale scores and MOAS total scores were dependent variables. Results are corrected for age, IQ and mood state. RESULTS Both youth with BD and BD-OFF showed positive correlations between impairment in executive functions and levels of verbal aggression. In youth with BD, altered processing of either positive and negative stimuli positively correlated with MOAS total scores, whereas in BD-OFF, such relationship was negative. CONCLUSIONS Impulsive aggressive behaviors in youth with BD arise from a combination of altered affective processing and executive dysfunction. The negative relationship between affective processing and aggression in BD-OFF suggested the presence of possible mechanisms of resilience in this population.
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Affiliation(s)
- Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Neuroscience, Section of Psychiatry; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Italy; Centro Lucio Bini, Rome, Italy.
| | - Sherin Kurian
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA.
| | - Johanna Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA.
| | - Christopher D Verrico
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA.
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Kirti Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA.
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14
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Piras F, Vecchio D, Kurth F, Piras F, Banaj N, Ciullo V, Luders E, Spalletta G. Corpus callosum morphology in major mental disorders: a magnetic resonance imaging study. Brain Commun 2021; 3:fcab100. [PMID: 34095833 PMCID: PMC8172496 DOI: 10.1093/braincomms/fcab100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 03/02/2021] [Accepted: 03/16/2021] [Indexed: 11/14/2022] Open
Abstract
Mental disorders diagnosis is based on specific clinical criteria. However, clinical studies found similarities and overlapping phenomenology across a variety of disorders, which suggests a common neurobiological substrate. Thus, there is a need to measure disease-related neuroanatomical similarities and differences across conditions. While structural alterations of the corpus callosum have been investigated in obsessive-compulsive disorder, schizophrenia, major depressive disorder and bipolar disorder, no study has addressed callosal aberrations in all diseases in a single study. Moreover, results from pairwise comparisons (patients vs. controls) show some inconsistencies, possibly related to the parcellation methods to divide the corpus callosum into subregions. The main aim of the present paper was to uncover highly localized callosal characteristics for each condition (i.e. obsessive-compulsive disorder, schizophrenia, major depressive disorder and bipolar disorder) as compared either to healthy control subjects or to each other. For this purpose, we did not rely on any sub-callosal parcellation method, but applied a well-validated approach measuring callosal thickness at 100 equidistant locations along the whole midline of the corpus callosum. One hundred and twenty patients (30 in each disorder) as well as 30 controls were recruited for the study. All groups were closely matched for age and gender, and the analyses were performed controlling for the impact of antipsychotic treatment and illness duration. There was a significant main effect of group along the whole callosal surface. Pairwise post hoc comparisons revealed that, compared to controls, patients with obsessive-compulsive disorder had the thinnest corpora callosa with significant effects almost on the entire callosal structure. Patients with schizophrenia also showed thinner corpora callosa than controls but effects were confined to the isthmus and the anterior part of the splenium. No significant differences were found in both major depressive disorder and bipolar disorder patients compared to controls. When comparing the disease groups to each other, the corpus callosum was thinner in obsessive-compulsive disorder patients than in any other group. The effect was evident across the entire corpus callosum, with the exception of the posterior body. Altogether, our study suggests that the corpus callosum is highly changed in obsessive-compulsive disorder, selectively changed in schizophrenia and not changed in bipolar disorder and major depressive disorder. These results shed light on callosal similarities and differences among mental disorders providing valuable insights regarding the involvement of the major brain commissural fibre tract in the pathophysiology of each specific mental illness.
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Affiliation(s)
- Fabrizio Piras
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
| | - Florian Kurth
- School of Psychology, University of Auckland, Auckland, Private Bag 92019, New Zealand
| | - Federica Piras
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
| | - Valentina Ciullo
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
| | - Eileen Luders
- School of Psychology, University of Auckland, Auckland, Private Bag 92019, New Zealand.,Laboratory of Neuro Imaging, School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, 00179 Rome, Italy.,Menninger Department of Psychiatry and Behavioral Sciences, Division of Neuropsychiatry, Baylor College of Medicine, Houston, TX 77030, USA
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15
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Hozer F, Sarrazin S, Laidi C, Favre P, Pauling M, Cannon D, McDonald C, Emsell L, Mangin JF, Duchesnay E, Bellani M, Brambilla P, Wessa M, Linke J, Polosan M, Versace A, Phillips ML, Delavest M, Bellivier F, Hamdani N, d'Albis MA, Leboyer M, Houenou J. Lithium prevents grey matter atrophy in patients with bipolar disorder: an international multicenter study. Psychol Med 2021; 51:1201-1210. [PMID: 31983348 DOI: 10.1017/s0033291719004112] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Lithium (Li) is the gold standard treatment for bipolar disorder (BD). However, its mechanisms of action remain unknown but include neurotrophic effects. We here investigated the influence of Li on cortical and local grey matter (GM) volumes in a large international sample of patients with BD and healthy controls (HC). METHODS We analyzed high-resolution T1-weighted structural magnetic resonance imaging scans of 271 patients with BD type I (120 undergoing Li) and 316 HC. Cortical and local GM volumes were compared using voxel-wise approaches with voxel-based morphometry and SIENAX using FSL. We used multiple linear regression models to test the influence of Li on cortical and local GM volumes, taking into account potential confounding factors such as a history of alcohol misuse. RESULTS Patients taking Li had greater cortical GM volume than patients without. Patients undergoing Li had greater regional GM volumes in the right middle frontal gyrus, the right anterior cingulate gyrus, and the left fusiform gyrus in comparison with patients not taking Li. CONCLUSIONS Our results in a large multicentric sample support the hypothesis that Li could exert neurotrophic and neuroprotective effects limiting pathological GM atrophy in key brain regions associated with BD.
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Affiliation(s)
- Franz Hozer
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Issy-les-Moulineaux, France
- Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
| | - Samuel Sarrazin
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
| | - Charles Laidi
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Pauline Favre
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
| | - Melissa Pauling
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Dara Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), NCBES Galway Neuroscience Centre, National University of Ireland Galway, H91 TK33Galway, Ireland
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), NCBES Galway Neuroscience Centre, National University of Ireland Galway, H91 TK33Galway, Ireland
| | - Louise Emsell
- Translational MRI, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium
- Department of Old Age Psychiatry, University Psychiatry Centre, KU Leuven, Leuven, Belgium
| | | | - Edouard Duchesnay
- UNATI Lab, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
| | - Marcella Bellani
- UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona (AOUI), Verona, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Grand Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Michele Wessa
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Julia Linke
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Mircea Polosan
- Grenoble Alpes University, Grenoble Institute of Neuroscience, INSERM U1216, Hôpital Grenoble Alpes, Grenoble, France
| | - Amelia Versace
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mary L Phillips
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Marine Delavest
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Lariboisière-Fernand Widal, INSERM U705 CNRS UMR 8206, Paris, France
- Paris Diderot University, Paris, France
| | - Frank Bellivier
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Lariboisière-Fernand Widal, INSERM U705 CNRS UMR 8206, Paris, France
- Paris Diderot University, Paris, France
| | - Nora Hamdani
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Marc-Antoine d'Albis
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Marion Leboyer
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
- Faculté de Médecine de Créteil, Université Paris Est Créteil, Créteil, France
| | - Josselin Houenou
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
- Faculté de Médecine de Créteil, Université Paris Est Créteil, Créteil, France
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16
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Janiri D, Kotzalidis GD, di Luzio M, Giuseppin G, Simonetti A, Janiri L, Sani G. Genetic neuroimaging of bipolar disorder: a systematic 2017-2020 update. Psychiatr Genet 2021; 31:50-64. [PMID: 33492063 DOI: 10.1097/ypg.0000000000000274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
There is evidence of genetic polymorphism influences on brain structure and function, genetic risk in bipolar disorder (BD), and neuroimaging correlates of BD. How genetic influences related to BD could be reflected on brain changes in BD has been efficiently reviewed in a 2017 systematic review. We aimed to confirm and extend these findings through a Preferred Reporting Items for Systematic reviews and Meta-Analyses-based systematic review. Our study allowed us to conclude that there is no replicated finding in the timeframe considered. We were also unable to further confirm prior results of the BDNF gene polymorphisms to affect brain structure and function in BD. The most consistent finding is an influence of the CACNA1C rs1006737 polymorphism in brain connectivity and grey matter structure and function. There was a tendency of undersized studies to obtain positive results and large, genome-wide polygenic risk studies to find negative results in BD. The neuroimaging genetics in BD field is rapidly expanding.
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Affiliation(s)
- Delfina Janiri
- Department of Neurology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Department of Psychiatry and Neurology, Sapienza University of Rome
| | - Georgios D Kotzalidis
- NESMOS Department, Sant'Andrea University Hospital, School of Medicine and Psychology, Sapienza University
| | - Michelangelo di Luzio
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Giuseppin
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessio Simonetti
- Department of Psychiatry and Neurology, Sapienza University of Rome
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Luigi Janiri
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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17
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Janiri D, Conte E, De Luca I, Simone MV, Moccia L, Simonetti A, Mazza M, Marconi E, Monti L, Chieffo DPR, Kotzalidis G, Janiri L, Sani G. Not Only Mania or Depression: Mixed States/Mixed Features in Paediatric Bipolar Disorders. Brain Sci 2021; 11:brainsci11040434. [PMID: 33805270 PMCID: PMC8065627 DOI: 10.3390/brainsci11040434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/15/2021] [Accepted: 03/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background: early onset is frequent in Bipolar Disorders (BDs), and it is characterised by the occurrence of mixed states (or mixed features). In this systematic review, we aimed to confirm and extend these observations by providing the prevalence rates of mixed states/features and data on associated clinical, pharmacological and psychopathological features. Methods: following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched from inception to 9 February 2021 for all studies investigating mixed states/mixed features in paediatric BD. Data were independently extracted by multiple observers. The prevalence rates of mixed states/features for each study were calculated. Results: eleven studies were included in our review, involving a total patient population of 1365 individuals. Overall, of the patients with paediatric age BD, 55.2% had mixed states/features (95% CI 40.1–70.3). Children with mixed states/features presented with high rates of comorbidities, in particular, with Attention Deficit Hyperactivity Disorder (ADHD). Evidences regarding the psychopathology and treatment response of mixed states/features are currently insufficient. Conclusions: our findings suggested that mixed states/features are extremely frequent in children and adolescents with BD and are characterised by high levels of comorbidity. Future investigations should focus on the relationship between mixed states/features and psychopathological dimensions as well as on the response to pharmacological treatment.
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Affiliation(s)
- Delfina Janiri
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
- Department of Psychiatry and Neurology, Sapienza University of Rome, 00168 Rome, Italy
| | - Eliana Conte
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
- Eating Disorders Treatment Unit, Casa di Cura Villa Armonia Nuova, 00100 Rome, Italy
| | - Ilaria De Luca
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
| | - Maria Velia Simone
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
| | - Lorenzo Moccia
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
| | - Alessio Simonetti
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
| | - Marianna Mazza
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
| | - Elisa Marconi
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00100 Rome, Italy
| | - Laura Monti
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
| | | | - Georgios Kotzalidis
- NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy;
| | - Luigi Janiri
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00100 Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00100 Rome, Italy; (D.J.); (E.C.); (I.D.L.); (M.V.S.); (L.M.); (A.S.); (M.M.); (E.M.); (L.M.); (L.J.)
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00100 Rome, Italy
- Correspondence: ; Tel.: +39-063355896764; Fax: +39-063051343
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18
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Barth C, Nerland S, de Lange AMG, Wortinger LA, Hilland E, Andreassen OA, Jørgensen KN, Agartz I. In Vivo Amygdala Nuclei Volumes in Schizophrenia and Bipolar Disorders. Schizophr Bull 2021; 47:1431-1441. [PMID: 33479754 PMCID: PMC8379533 DOI: 10.1093/schbul/sbaa192] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abnormalities in amygdala volume are well-established in schizophrenia and commonly reported in bipolar disorders. However, the specificity of volumetric differences in individual amygdala nuclei is largely unknown. Patients with schizophrenia disorders (SCZ, N = 452, mean age 30.7 ± 9.2 [SD] years, females 44.4%), bipolar disorders (BP, N = 316, 33.7 ± 11.4, 58.5%), and healthy controls (N = 753, 34.1 ± 9.1, 40.9%) underwent T1-weighted magnetic resonance imaging. Total amygdala, nuclei, and intracranial volume (ICV) were estimated with Freesurfer (v6.0.0). Analysis of covariance and multiple linear regression models, adjusting for age, age2, ICV, and sex, were fitted to examine diagnostic group and subgroup differences in volume, respectively. Bilateral total amygdala and all nuclei volumes, except the medial and central nuclei, were significantly smaller in patients relative to controls. The largest effect sizes were found for the basal nucleus, accessory basal nucleus, and cortico-amygdaloid transition area (partial η2 > 0.02). The diagnostic subgroup analysis showed that reductions in amygdala nuclei volume were most widespread in schizophrenia, with the lateral, cortical, paralaminar, and central nuclei being solely reduced in this disorder. The right accessory basal nucleus was marginally smaller in SCZ relative to BP (t = 2.32, P = .05). Our study is the first to demonstrate distinct patterns of amygdala nuclei volume reductions in a well-powered sample of patients with schizophrenia and bipolar disorders. Volume differences in the basolateral complex (lateral, basal, and accessory basal nuclei), an integral part of the threat processing circuitry, were most prominent in schizophrenia.
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Affiliation(s)
- Claudia Barth
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway,To whom correspondence should be addressed; tel: +47 22 02 99 67, fax: +47 22 02 99 01, e-mail:
| | - Stener Nerland
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ann-Marie G de Lange
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Department of Psychiatry, University of Oxford, Oxford, UK,Department of Psychology, University of Oslo, Oslo, Norway
| | - Laura A Wortinger
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Eva Hilland
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kjetil N Jørgensen
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Section Vinderen, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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19
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Chronic lithium exposure attenuates ketamine-induced mania-like behavior and c-Fos expression in the forebrain of mice. Pharmacol Biochem Behav 2021; 202:173108. [PMID: 33450292 DOI: 10.1016/j.pbb.2021.173108] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/21/2020] [Accepted: 01/06/2021] [Indexed: 02/05/2023]
Abstract
Ketamine, a dissociative anaesthetic, has been used in the treatment of major depressive disorder (MDD) as a rapid acting antidepressant drug. Recent studies have shown that ketamine may increase the potential risk of treatment-induced mania in MDD patients. Lithium is a well-known mood stabilizer and has been widely used for the treatment of mania. It is not fully understood which forebrain regions are involved in ketamine- and lithium-induced expression of c-Fos. Therefore, our aim was to investigate the effect of chronic lithium treatment on mania-like behavior and c-Fos expression in the mouse forebrain activated by a single administration of ketamine. In the open field test, our results showed that ketamine significantly increased the total distance and total cumulative duration of movement in mice, while chronic lithium could attenuate these effects of ketamine. In addition, acute ketamine induced higher c-Fos expression in the lateral septal nucleus, hypothalamus, amygdala, and hippocampus of mice in the treatment group compared to those in the control group. However, chronic lithium inhibited the significant increase in c-Fos-immunoreactive neurons following acute ketamine administration in the dentate gyrus of the hippocampus, field CA1 of the hippocampus, dorsal subiculum, ventral subiculum, ventral subiculum, central amygdaloid nucleus and basolateral amygdaloid nucleus. In summary, our research shows that pretreatment with lithium moderates the effects of acute ketamine administration on mania-like behavior and c-Fos expression in the forebrain. These findings could be helpful in better understanding the episodes of mania related to ketamine treatment for MDD and bipolar disorder.
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20
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Athey TL, Ceritoglu C, Tward DJ, Kutten KS, DePaulo JR, Glazer K, Goes FS, Kelsoe JR, Mondimore F, Nievergelt CM, Rootes-Murdy K, Zandi PP, Ratnanather JT, Mahon PB. A 7 Tesla Amygdalar-Hippocampal Shape Analysis of Lithium Response in Bipolar Disorder. Front Psychiatry 2021; 12:614010. [PMID: 33664682 PMCID: PMC7920967 DOI: 10.3389/fpsyt.2021.614010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/19/2021] [Indexed: 11/15/2022] Open
Abstract
Research to discover clinically useful predictors of lithium response in patients with bipolar disorder has largely found them to be elusive. We demonstrate here that detailed neuroimaging may have the potential to fill this important gap in mood disorder therapeutics. Lithium treatment and bipolar disorder have both been shown to affect anatomy of the hippocampi and amygdalae but there is no consensus on the nature of their effects. We aimed to investigate structural surface anatomy changes in amygdala and hippocampus correlated with treatment response in bipolar disorder. Patients with bipolar disorder (N = 14) underwent lithium treatment, were classified by response status at acute and long-term time points, and scanned with 7 Tesla structural MRI. Large Deformation Diffeomorphic Metric Mapping was applied to detect local differences in hippocampal and amygdalar anatomy between lithium responders and non-responders. Anatomy was also compared to 21 healthy comparison participants. A patch of the ventral surface of the left hippocampus was found to be significantly atrophied in non-responders as compared to responders at the acute time point and was associated at a trend-level with long-term response status. We did not detect an association between response status and surface anatomy of the right hippocampus or amygdala. To the best of our knowledge, this is the first shape analysis of hippocampus and amygdala in bipolar disorder using 7 Tesla MRI. These results can inform future work investigating possible neuroimaging predictors of lithium response in bipolar disorder.
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Affiliation(s)
- Thomas L Athey
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States.,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States.,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Can Ceritoglu
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States
| | - Daniel J Tward
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States.,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States.,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Kwame S Kutten
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Kara Glazer
- Department of Occupational Therapy, Boston University, Boston, MA, United States
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - John R Kelsoe
- Department of Psychiatry, VA San Diego Healthcare System, La Jolla, CA, United States.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Francis Mondimore
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Kelly Rootes-Murdy
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - J Tilak Ratnanather
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States.,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States.,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Pamela B Mahon
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States.,Department of Psychiatry, Brigham & Women's Hospital, Boston, MA, United States.,Department of Psychiatry, Harvard School of Medicine, Boston, MA, United States
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21
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Janiri D, Petracca M, Moccia L, Tricoli L, Piano C, Bove F, Imbimbo I, Simonetti A, Di Nicola M, Sani G, Calabresi P, Bentivoglio AR. COVID-19 Pandemic and Psychiatric Symptoms: The Impact on Parkinson's Disease in the Elderly. Front Psychiatry 2020; 11:581144. [PMID: 33329124 PMCID: PMC7728715 DOI: 10.3389/fpsyt.2020.581144] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/28/2020] [Indexed: 12/14/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic represents a condition of increased vulnerability and frailty for elderly patients with Parkinson's disease (PD). Social isolation may worsen the burden of the disease and specifically exacerbate psychiatric symptoms, often comorbid with PD. This study aimed at identifying risk/protective factors associated with subjective worsening of psychiatric symptomatology during the COVID-19 outbreak in a sample of individuals with PD aged 65 years or older. Methods: Patients with PD routinely followed at the outpatient clinic of Gemelli University Hospital, Rome, were assessed for subjective worsening of psychiatric symptoms through a dedicated telephone survey, after Italy COVID-19 lockdown. Patients' medical records were reviewed to collect sociodemographic and clinical data, including lifetime psychiatric symptoms and pharmacological treatment. Results: Overall, 134 individuals were assessed and 101 (75.4%) reported lifetime psychiatric symptoms. Among those, 23 (22.8%) presented with subjective worsening of psychiatric symptomatology during the COVID-19 outbreak. In this group, the most frequent symptom was depression (82.6%), followed by insomnia (52.2%). Subjective worsening of neurological symptoms (Wald = 24.03, df = 1, p = 0.001) and lifetime irritability (Wald = 6.35, df = 1, p = 0.020), together with younger age (Wald = 5.06, df = 1, p = 0.038) and female sex (Wald = 9.07 df = 1, p = 0.007), resulted as specific risk factors for ingravescence of psychiatric presentation. Lifetime pre-existing delusions, having received antipsychotics, and not having received mood stabilizer were also associated with subjective worsening of psychiatric symptomatology due to the COVID-19 pandemic. Conclusions: Individuals with PD and lifetime history of psychiatric symptoms may be exposed to increased vulnerability to the stressful effect of COVID-19 outbreak. Interventions aimed at reducing irritability and mood instability might have an indirect effect on the health of patients with PD during the COVID-19 pandemic.
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Affiliation(s)
- Delfina Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy
| | - Martina Petracca
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Lorenzo Moccia
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Tricoli
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Carla Piano
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Bove
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Alessio Simonetti
- Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy
| | - Marco Di Nicola
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Calabresi
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Rita Bentivoglio
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy
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22
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Neuroanatomic and Functional Neuroimaging Findings. Curr Top Behav Neurosci 2020; 48:173-196. [PMID: 33040316 DOI: 10.1007/7854_2020_174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The search for brain morphology findings that could explain behavioral disorders has gone through a long path in the history of psychiatry. With the advance of brain imaging technology, studies have been able to identify brain morphology and neural circuits associated with the pathophysiology of mental illnesses, such as bipolar disorders (BD). Promising results have also shown the potential of neuroimaging findings in the identification of outcome predictors and response to treatment among patients with BD. In this chapter, we present brain imaging structural and functional findings associated with BD, as well as their hypothesized relationship with the pathophysiological aspects of that condition and their potential clinical applications.
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23
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Achalia R, Raju VB, Jacob A, Nahar A, Achalia G, Nagendra B, Kaginalkar V, Choudhary S, Venkatasubramanian G, Rao NP. Comparison of first-episode and multiple-episode bipolar disorder: A surface-based morphometry study. Psychiatry Res Neuroimaging 2020; 302:111110. [PMID: 32505904 DOI: 10.1016/j.pscychresns.2020.111110] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 01/17/2020] [Accepted: 02/14/2020] [Indexed: 01/09/2023]
Abstract
It is still unclear whether the structural abnormalities in Bipolar disorder (BD) are static or progressive. We aimed to compare differences in cortical thickness, surface area, and volume between patients with BD and healthy volunteers (HV) and to examine whether there are differences between patients who have had a single manic episode and those with multiple episodes. We recruited 30 patients with Type I BD and 30 age and sex matched HV. All participants underwent structural magnetic resonance imaging. Cortical volume, thickness, and surface area were measured using the QDEC tool from the Freesurfer software with age and intracranial volume as covariates. Study groups were comparable across age, sex distribution, and intracranial volume. Patients had significantly lower surface area in bilateral cuneus, right postcentral gyrus, and rostral middle frontal gyri; and lower cortical volume in the left middle temporal gyrus, right postcentral gyrus, and right cuneus. BD patients with multiple episodes had lower cortical measures while those with single episode had cortical measures comparable to HV. Findings indicate that the pathophysiological processes in BD are possibly progressive in nature. Our findings underscore the potential importance of early diagnosis and intervention in preventing deterioration and improving functional recovery.
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Affiliation(s)
| | - Vikas B Raju
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arpitha Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Abhinav Nahar
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Bhargavi Nagendra
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | | | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, India.
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24
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Ciftci E, Karacay R, Caglayan A, Altunay S, Ates N, Altintas MO, Doeppner TR, Yulug B, Kilic E. Neuroprotective effect of lithium in cold- induced traumatic brain injury in mice. Behav Brain Res 2020; 392:112719. [PMID: 32479849 DOI: 10.1016/j.bbr.2020.112719] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/20/2020] [Accepted: 05/18/2020] [Indexed: 11/17/2022]
Abstract
Apart from its well-established therapeutic activity on bipolar disorder and depression, lithium exerts neuroprotective activity upon neurodegenerative disorders, such as traumatic brain injury (TBI). However, the cellular signaling mechanisms mediating lithium's neuroprotective activity and long-term dose- and time-dependent effects on close and remote proximity are largely unknown. Herein, we tested prophylactic and acute effects of lithium (2 mmol/kg) after cold- induced TBI. In both conditions, treatments with lithium resulted in reduced infarct volume and apoptosis. Its acute treatment resulted in the increase of Akt, ERK-1/2 and GSK-3 α/β phosphoylations. Interestingly, its prophylactic treatment instead resulted in decreased phosphorylations of Akt, ERK-1/2, p38, JNK-1 moderately and GSK-3 α/β significantly. Then, we tested subacute (35-day follow-up) role of low (0.2 mmol/kg) and high dose (2 mmol/kg) lithium and revealed that high dose lithium group was the most mobile so the least depressed in the tail suspension test. Anxiety level was assessed by light-dark test, all groups' anxiety levels were decreased with time, but lithium had no effect on anxiety like behavior. When subacute effects of injury and drug treatment were evaluated on the defined brain regions, infarct volume was decreased in the high dose lithium group significantly. In contrast to other brain regions, hippocampal atrophies were observed in both lithium treatment groups, which were significant in the low dose lithium group in both hemispheres, which was associated with the reduced cell proliferation and neurogenesis. Our data demonstrate that lithium treatment protects neurons from TBI. However, long term particularly low-dose lithium causes hippocampal atrophy and decreased neurogenesis.
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Affiliation(s)
- Elvan Ciftci
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Physiology, Istanbul, Turkey
| | - Reyda Karacay
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Physiology, Istanbul, Turkey
| | - Aysun Caglayan
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Physiology, Istanbul, Turkey
| | - Serdar Altunay
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Physiology, Istanbul, Turkey
| | - Nilay Ates
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Pharmacology, Istanbul, Turkey
| | - Mehmet O Altintas
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Physiology, Istanbul, Turkey
| | - Thorsten R Doeppner
- University of Göttingen Medical School, Dept. of Neurology, Göttingen, Germany
| | - Burak Yulug
- Alanya Alaaddin Keykubat University, Faculty of Medicine, Dept. of Neurology, Antalya, Turkey
| | - Ertugrul Kilic
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Physiology, Istanbul, Turkey.
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25
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Janiri D, Kotzalidis GD, De Chiara L, Koukopoulos AE, Aas M, Sani G. The Ring of Fire: Childhood Trauma, Emotional Reactivity, and Mixed States in Mood Disorders. Psychiatr Clin North Am 2020; 43:69-82. [PMID: 32008689 DOI: 10.1016/j.psc.2019.10.007] [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: 02/07/2023]
Abstract
Childhood trauma (CT) is strongly associated with bipolar disorder, possibly through emotional hyperreactivity (EH). Mixed symptoms/states (MSs) are associated with increased illness severity. The authors tested through a systematic review the association between CT and MSs. The authors systematically looked for studies exploring associations between MSs and CT, CT and EH, and EH and MSs. Most literature agrees that MSs are associated with CT; the latter was found to be associated to EH, which is in turn associated with MSs. The literature supports an association between CT and later development of MSs, possibly mediated through EH.
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Affiliation(s)
- Delfina Janiri
- Sapienza School of Medicine and Psychology, Sant'Andrea University Hospital, UOC Psichiatria, Via di Grottarossa, 1035-1039, Rome 00189, Italy; ICAHN School of Medicine and Mount Sinai, New York, NY, USA; Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy
| | - Georgios D Kotzalidis
- Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy; School of Medicine and Psychology, NESMOS Department (Neuroscience, Mental Health and Sensory Organs) Sapienza University, Sant'Andrea Hospital, Via di Grottarossa 1035-1038, Rome 00189, Italy.
| | - Lavinia De Chiara
- Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy; School of Medicine and Psychology, NESMOS Department (Neuroscience, Mental Health and Sensory Organs) Sapienza University, Sant'Andrea Hospital, Via di Grottarossa 1035-1038, Rome 00189, Italy
| | - Alexia Emilia Koukopoulos
- Centro Lucio Bini, Via Crescenzio 42, Rome 00193, Italy; Department of Human Neurosciences, University of Rome "Sapienza", Viale dell'Università 30, Roma 00185, Italy
| | - Monica Aas
- NORMENT K.G Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo University Hospital, Bygg 49, Ullevål Sykehus, PO Box 4956, Nydalen, Oslo 0424, Norway
| | - Gabriele Sani
- Institute of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Psychiatry, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
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Xia Y, Ma D, Perich T, Hu J, Mitchell PB. Demographic and Clinical Differences Between Bipolar Disorder Patients With and Without Alcohol Use Disorders. Front Psychiatry 2020; 11:570574. [PMID: 33101085 PMCID: PMC7495181 DOI: 10.3389/fpsyt.2020.570574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/17/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) and alcohol use disorder (AUD) are two major independent causes of psychopathology in the general population. The prevalence of AUD in BD is high. Identifying the clinical and demographic features of patients with BD who may develop AUD could help with early identification and intervention. METHODS Data from 238 patients diagnosed with BD were gathered on alcohol use, social demographics, longitudinal course of BD, clinical features of the most severe lifetime manic and depressive episodes, comorbid physical diseases, anxiety disorders, and other substance use disorders. RESULTS We found that 74 of 238 BD patients had AUD (67 with alcohol dependence and 7 with alcohol abuse). Bivariate logistic regression analysis and multivariate logistic regression analysis found that the best predictors of AUD in patients with BD were being male (OR = 2.086, 95% CI = 1.094-3.979, p = 0.001), younger (OR = 0.965, 95% CI = 0.935-0.996, p = 0.026), and comorbidity with other unclassified substance dependence (OR = 10.817, 95% CI = 1.238-94.550, p = 0.031). CONCLUSIONS Male, younger current age, and having other substance use disorders were independently associated with AUD.
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Affiliation(s)
- Yan Xia
- Mental Health Institute, Harbin Medical University, Mental Health Centre, 1st Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Dongying Ma
- Department of Neurosurgery, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tania Perich
- School of Psychology, Western Sydney University, Sydney, NSW, Australia
| | - Jian Hu
- Mental Health Institute, Harbin Medical University, Mental Health Centre, 1st Affiliated Hospital of Harbin Medical University, Harbin, China
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Rodríguez-Ramírez AM, Meza-Urzúa F, Cedillo-Ríos V, Becerra-Palars C, Jiménez-Pavón J, Morales-Cedillo IP, Sanabrais-Jiménez MA, Hernández-Muñoz S, Camarena-Medellín B. CACNA1C Risk Variant and Mood Stabilizers Effects in the Prefrontal Cortical Thickness of Mexican Patients with Bipolar Disorder. Neuropsychiatr Dis Treat 2020; 16:1199-1206. [PMID: 32494139 PMCID: PMC7229798 DOI: 10.2147/ndt.s245911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/01/2020] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Bipolar disorder (BD) is a condition associated with structural alterations in the prefrontal cortex (PFC); some genetic variants and mood stabilizer medications like lithium or valproate are associated with these changes. CACNA1C is a gene involved in BD pathology and brain function; carriers of the A allele of rs1006737 are reported to have increased risk for BD and increased cortical thickness (CT) in the PFC compared to non-carriers. Lithium is also associated with increased CT in the PFC of BD subjects compared to the ones on valproate. The influence of these treatments and gene variants over the PFC structure of Mexican subjects has not been explored. Therefore, we evaluate the effects of mood stabilizers and risk A allele of CACNA1C rs1006737 on the prefrontal cortical thickness of Mexican BD patients treated with lithium or valproate. PATIENTS AND METHODS A cross-sectional study of 40 BD type I euthymic adult outpatients (20 treated with lithium and 20 with valproate) who underwent a 3T T1-weighted 3D brain scan and genotyping for CACNA1C risk allele rs1006737 was conducted. We performed a cortical thickness analysis of the dorsolateral and orbitofrontal regions of the prefrontal cortex with BrainVoyager 20.6. The effects of treatment and gene variants were analyzed with a two-way multivariate analysis of covariance. RESULTS There was no association of CACNA1C risk allele rs1006737 with CT measures of both PFCs nor significant interaction between the genetic variant and treatment. Mood stabilizers reported the main effect on the CT measures of the right PFC of our sample. Patients on treatment with lithium showed higher mean CT on the right orbitofrontal cortex. CONCLUSION We did not find any association between the prefrontal CT and CACNA1C risk A allele rs1006737 in BD Mexican patients treated with lithium or valproate. Our results suggest that mood stabilizers had the main effect in the CT of the right PFC.
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Affiliation(s)
| | - Fátima Meza-Urzúa
- Kinder und Jugend Psychiatrie, Klinikum Idar-Oberstein, Idar-Oberstein, Germany
| | - Valente Cedillo-Ríos
- Departamento de Imágenes Cerebrales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Claudia Becerra-Palars
- Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Joanna Jiménez-Pavón
- Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | | | | | - Sandra Hernández-Muñoz
- Departamento de Farmacogenética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Beatriz Camarena-Medellín
- Departamento de Farmacogenética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
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Personalized and precision medicine as informants for treatment management of bipolar disorder. Int Clin Psychopharmacol 2019; 34:189-205. [PMID: 30932919 DOI: 10.1097/yic.0000000000000260] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
DSM-5 diagnostic categories, defined by a set of psychopathological symptoms are heterogeneous conditions that may include different biological entities, with distinct etiopathogenesis, different courses and requiring different treatment management. For bipolar disorder the major evidences for this lack of validity are the long paths before a proper diagnosis, the inconsistence of treatment guidelines, the long phases of pharmacological adjustment and the low average of long-term treatment response rates. Personalized medicine for mental disorders aims to couple established clinical-pathological indexes with new molecular profiling to create diagnostic, prognostic and therapeutic strategies precisely tailored to each patient. Regarding bipolar disorder, the clinical history and presentation are still the most reliable markers in stratifying patients and guiding therapeutic management, despite the research goes to great lengths to develop new neuropsychological or biological markers that can reliably predict individual therapy effectiveness. We provide an overview of the advancements in personalized medicine in bipolar disorder, with particular attention to how psychopathology, age at onset, comorbidity, course and staging, genetic and epigenetic, imaging and biomarkers can influence treatment management and provide an integration to the conventional treatment guidelines. This approach may offer a new and rational path for the development of treatments for targeted subgroups of patients with bipolar disorder.
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Janiri D, Sani G, De Rossi P, Piras F, Banaj N, Ciullo V, Simonetti A, Arciniegas DB, Spalletta G. Hippocampal subfield volumes and childhood trauma in bipolar disorders. J Affect Disord 2019; 253:35-43. [PMID: 31022627 DOI: 10.1016/j.jad.2019.04.071] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 01/02/2019] [Accepted: 04/08/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Alterations in hippocampal structure and function are present in bipolar disorder (BD). Childhood trauma is associated with risk for BD, and the several subfields of the hippocampus are differentially sensitive to the effects of stressors of the sort associated with risk for BD. The current study therefore sought to test the hypothesis that childhood trauma may be differentially associated with abnormal hippocampal subfield volumes in BD. METHODS 104 participants with BD type I (BD-I, n = 56) or BD type II (BD-II, n = 48) and 81 healthy controls (HC) underwent high-resolution structural magnetic resonance neuroimaging. Hippocampal subfield volumes were determined using FreeSurfer. Childhood trauma was assessed with the Childhood Trauma Questionnaire (CTQ). RESULTS There were significant effects of diagnosis on intracranial volume corrected hippocampal subfield volumes bilaterally as well as a significant interaction between diagnosis and childhood trauma. Hippocampal volumes did not differ between the BD-I and BD-II subgroups but hippocampal volumes were smaller in both groups when compared to HC. There was a significant effect of childhood trauma on bilateral presubiculum volume as well as significant interactions between diagnosis and childhood trauma on bilateral CA1, presubiculum and subiculum volumes, the direction of which differed between individuals with BD (larger) and HC (smaller). LIMITATIONS Recall bias may influence the reliability of the retrospective assessment of childhood trauma experiences. CONCLUSIONS Childhood trauma demonstrates differential effects on hippocampal subfield volumes of BD and HC, particularly in hippocampal subfields involved in emotion regulation.
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Affiliation(s)
- Delfina Janiri
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Gabriele Sani
- Department of Neurosciences, Mental Health, and Sensory Organs, Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy; Centro Lucio Bini, Rome, Italy; Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Pietro De Rossi
- Department of Neurosciences, Mental Health, and Sensory Organs, Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy; Centro Lucio Bini, Rome, Italy; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Fabrizio Piras
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Nerisa Banaj
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Valentina Ciullo
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Alessio Simonetti
- Centro Lucio Bini, Rome, Italy; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - David B Arciniegas
- Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Behavioral Neurology Section, Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Gianfranco Spalletta
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy; Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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Han KM, Kim A, Kang W, Kang Y, Kang J, Won E, Tae WS, Ham BJ. Hippocampal subfield volumes in major depressive disorder and bipolar disorder. Eur Psychiatry 2019; 57:70-77. [PMID: 30721801 DOI: 10.1016/j.eurpsy.2019.01.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 01/19/2019] [Accepted: 01/21/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The hippocampus is not a uniform structure, but rather consists of multiple, functionally specialized subfields. Few studies have explored hippocampal subfield volume difference in the same sample of major depressive disorder (MDD) and bipolar disorder (BD) cases. We aimed to investigate the difference of hippocampal subfield volume between patents with MDD and BD and healthy controls (HCs). METHODS A total of 102 MDD and 55 BD patients and 135 HCs were recruited and underwent T1-weighted image. Hippocampal subfield volume was calculated by automated segmentation and volumetric procedures developed by Iglesias et al. and implemented in FreeSurfer. Volume differences between the groups were analyzed using the analysis of covariance and controlling for age, sex, and total intracranial cavity volume. RESULTS Patients with MDD had significantly reduced volumes in the bilateral cornu ammonis 1 (CA1), CA4, the granule cell layer (GCL), molecular layer (ML), whole hippocampus, the left CA2/3, and right presubiclum and subiculum. Patients with BD had significantly reduced volumes in the right CA1, GCL, and the whole hippocampus as compared to HCs. No significant volume differences were observed between the MDD and BD groups. Illness duration was negatively correlated with volumes of the left CA1, CA4, ML, presubiculum, subiculum, and the whole hippocampus in patients with BD. CONCLUSION We observed hippocampal subfield volume reductions in both MDD and BD, a finding which more prominent in MDD. The inverse correlation between BD illness duration and hippocampal subfield volume may evidence the neuroprogressive nature of BD.
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Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Aram Kim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Wooyoung Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youbin Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - June Kang
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Eunsoo Won
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo-Suk Tae
- Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea; Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea; Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea.
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