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Lei D, Li W, Tallman MJ, Strakowski SM, DelBello MP, Rodrigo Patino L, Fleck DE, Lui S, Gong Q, Sweeney JA, Strawn JR, Nery FG, Welge JA, Rummelhoff E, Adler CM. Changes in the structural brain connectome over the course of a nonrandomized clinical trial for acute mania. Neuropsychopharmacology 2022; 47:1961-1968. [PMID: 35585125 PMCID: PMC9485114 DOI: 10.1038/s41386-022-01328-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/17/2022] [Accepted: 04/11/2022] [Indexed: 02/05/2023]
Abstract
Disrupted topological organization of brain functional networks has been widely reported in bipolar disorder. However, the potential clinical implications of structural connectome abnormalities have not been systematically investigated. The present study included 109 unmedicated subjects with acute mania who were assigned to 8 weeks of treatment with quetiapine or lithium and 60 healthy controls. High resolution 3D-T1 weighted magnetic resonance images (MRI) were collected from both groups at baseline, week 1 and week 8. Brain networks were constructed based on the similarity of morphological features across brain regions and analyzed using graph theory approaches. At baseline, individuals with bipolar disorder illness showed significantly lower clustering coefficient (Cp) (p = 0.012) and normalized characteristic path length (λ) (p = 0.004) compared to healthy individuals, as well as differences in nodal centralities across multiple brain regions. No baseline or post-treatment differences were identified between drug treatment conditions, so change after treatment were considered in the combined treatment groups. Relative to healthy individuals, differences in Cp, λ and cingulate gyrus nodal centrality were significantly reduced with treatment; changes in these parameters correlated with changes in Young Mania Rating Scale scores. Baseline structural connectome matrices significantly differentiated responder and non-responder groups at 8 weeks with 74% accuracy. Global and nodal network alterations evident at baseline were normalized with treatment and these changes associated with symptomatic improvement. Further, baseline structural connectome matrices predicted treatment response. These findings suggest that structural connectome abnormalities are clinically significant and may be useful for predicting clinical outcome of treatment and tracking drug effects on brain anatomy in bipolar disorder. CLINICAL TRIALS REGISTRATION Name: Functional and Neurochemical Brain Changes in First-episode Bipolar Mania Following Successful Treatment with Lithium or Quetiapine. URL: https://clinicaltrials.gov/ . REGISTRATION NUMBER NCT00609193. Name: Neurofunctional and Neurochemical Markers of Treatment Response in Bipolar Disorder. URL: https://clinicaltrials.gov/ . REGISTRATION NUMBER NCT00608075.
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Affiliation(s)
- Du Lei
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, 45219, OH, USA.
| | - Wenbin Li
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, 45219, OH, USA
- Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, P.R. China
- Department of the Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, P.R. China
| | - Maxwell J Tallman
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, 45219, OH, USA
| | - Stephen M Strakowski
- Department of Psychiatry & Behavioral Sciences, Dell Medical School of The University of Texas at Austin, Austin, 78712, TX, USA
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, 45219, OH, USA
| | - L Rodrigo Patino
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, 45219, OH, USA
| | - David E Fleck
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, 45219, OH, USA
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, P.R. China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, P.R. China
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, 45219, OH, USA
- Huaxi MR Research Center (HMRRC), Department of Radiology, The Center for Medical Imaging, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, P.R. China
| | - Jeffrey R Strawn
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, 45219, OH, USA
| | - Fabiano G Nery
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, 45219, OH, USA
| | - Jeffrey A Welge
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, 45219, OH, USA
| | - Emily Rummelhoff
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, 45219, OH, USA
| | - Caleb M Adler
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, 45219, OH, USA
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Zhang L, Wu H, Zhang A, Bai T, Ji GJ, Tian Y, Wang K. Aberrant brain network topology in the frontoparietal-limbic circuit in bipolar disorder: a graph-theory study. Eur Arch Psychiatry Clin Neurosci 2021; 271:1379-1391. [PMID: 33386961 DOI: 10.1007/s00406-020-01219-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/02/2020] [Indexed: 12/21/2022]
Abstract
Characterizing the properties of brain networks across mood states seen in bipolar disorder (BP) can provide a deeper insight into the mechanisms involved in this type of affective disorder. In this study, graph theoretical methods were used to examine global, modular and nodal brain network topology in the resting state using functional magnetic resonance imaging data acquired from 95 participants, including those with bipolar depression (BPD; n = 30) and bipolar mania (BPM; n = 39) and healthy control (HC) subjects (n = 26). The threshold value of the individual subjects' connectivity matrix varied from 0.15 to 0.30 with steps of 0.01. We found that: (1) at the global level, BP patients showed a significantly increased global efficiency and synchronization and a decreased path length; (2) at the nodal level, BP patients showed impaired nodal parameters, predominantly within the frontoparietal and limbic sub-network; (3) at the module level, BP patients were characterized by denser FCs (edges) between Module III (the front-parietal system) and Module V (limbic/paralimbic systems); (4) at the nodal level, the BPD and BPM groups showed state-specific differences in the orbital part of the left superior-frontal gyrus, right putamen, right parahippocampal gyrus and left fusiform gyrus. These results revealed abnormalities in topological organization in the whole brain, especially in the frontoparietal-limbic circuit in both BPD and BPM. These deficits may reflect the pathophysiological processes occurring in BP. In addition, state-specific regional nodal alterations in BP could potentially provide biomarkers of conversion across different mood states.
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Affiliation(s)
- Li Zhang
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Huiling Wu
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Aiguo Zhang
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Tongjian Bai
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
| | - Gong-Jun Ji
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China
- Department of Medical Psychology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
- Department of Medical Psychology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China.
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China.
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China.
- Department of Medical Psychology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
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Wei W, Yi X, Ruan J, Duan X, Luo H. The efficacy of repetitive transcranial magnetic stimulation on emotional processing in apathetic patients with Parkinson's disease: A Placebo-controlled ERP study. J Affect Disord 2021; 282:776-785. [PMID: 33601718 DOI: 10.1016/j.jad.2020.12.099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/21/2020] [Accepted: 12/24/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Few studies have examined the effect of rTMS on impaired emotional processing in apathetic Parkinson's disease (PD) patients, which impelled us to use a combination of repetitive transcranial magnetic stimulation (rTMS) with event-related potentials (ERPs) to gain insight into the underlying mechanisms. METHODS Apathetic and non-apathetic patients diagnosed with PD performed a facial emotion categorization task, and ERP data were collected before and after HF-rTMS or sham stimulation over the right dorsolateral prefrontal cortex (DLPFC). We observed the behavioural results and early components of P100 and N170. RESULTS After rTMS, accuracy (ACC) was higher for negative expressions, and reaction times (RTs) were shorter for all expressions in both apathetic and non-apathetic patients. P100 amplitudes significantly increased except for negative expressions in the right hemisphere, and hemisphere lateralization was reversed in apathetic patients. P100 amplitudes increased for all expressions bilaterally in non-apathetic patients. N170 amplitudes in apathetic patients increased, and hemisphere lateralization was normalized. Neither the apathetic sham group nor the non-apathetic cohort of patients showed changes in P100 or N170 lateralization. LIMITATIONS The effects of rTMS on PD patients relative to normal subjects should be compared and observed over a long period of time. CONCLUSIONS HF-rTMS over the right DLPFC is beneficial for emotional processing in both apathetic and non-apathetic PD patients but shows different sensitivities. The effect of rTMS on emotional processing impairments in apathetic PD patients is profound. Treatment with rTMS may be an important, novel nonpharmaceutical approach for apathy in PD patients.
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Affiliation(s)
- Wei Wei
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Xingyang Yi
- Department of Neurology, People's Hospital of Deyang City, Deyang 618000, Sichuan, China
| | - Jianghai Ruan
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Xiaodong Duan
- Department of Rehabilitation Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
| | - Hua Luo
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
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Jabbi M, Weber W, Welge J, Nery F, Tallman M, Gable A, Fleck DE, Lippard ETC, DelBello M, Adler C, Strakowski SM. Frontolimbic brain volume abnormalities in bipolar disorder with suicide attempts. Psychiatry Res 2020; 294:113516. [PMID: 33160217 DOI: 10.1016/j.psychres.2020.113516] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 10/17/2020] [Indexed: 11/24/2022]
Abstract
Over 2.3 million people in the United States live with bipolar disorder. Sixty percent of those with a bipolar disorder diagnosis attempt suicide at least once in their lifetime and up to 19% die by suicide. However, the neurobiology of suicide attempts in bipolar disorder remains unclear. We studied the gray matter volume (GMV) of 81 participants with a bipolar-I diagnosis (age-range: 14-34 years old) and 40 healthy participants (age-range 14.7-32 years old) to compare their neuroanatomy and histories of suicide attempt. In the bipolar group, 42 were manic with ages ranging from 14-30.6 years, and 39 were depressed with ages ranging from 14-34.3 years). Twenty three bipolar participants had a suicide attempt history, and 58 had no suicide attempt history. All participants completed behavioral/diagnostic assessments and MRI. We focused on a predefined frontolimbic circuitry in bipolar disorder versus controls to first identify diagnostic GMV correlates and to specifically identify GMV correlates for suicide attempt history. We found reduced GMV in bipolar diagnosis versus controls in the subgenual cingulate and dorsolateral prefrontal cortices. Our observed regional GMV reductions were associated with histories of suicide attempts and measures of individual variations in current suicidal ideation at the time of scanning.
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Affiliation(s)
- Mbemba Jabbi
- Department of Psychiatry, Dell Medical School, the University of Texas at Austin; The Mulva Clinic for the Neurosciences, Dell Medical School, the University of Texas at Austin; Institute of Neuroscience, the University of Texas at Austin; Department of Psychology, the University of Texas at Austin.
| | - Wade Weber
- Department of Psychiatry, Dell Medical School, the University of Texas at Austin; The Mulva Clinic for the Neurosciences, Dell Medical School, the University of Texas at Austin
| | - Jeffrey Welge
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Fabiano Nery
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Maxwell Tallman
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Austin Gable
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH
| | - David E Fleck
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Elizabeth T C Lippard
- Department of Psychiatry, Dell Medical School, the University of Texas at Austin; The Mulva Clinic for the Neurosciences, Dell Medical School, the University of Texas at Austin; Institute of Neuroscience, the University of Texas at Austin; Department of Psychology, the University of Texas at Austin
| | - Melissa DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Caleb Adler
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Stephen M Strakowski
- Department of Psychiatry, Dell Medical School, the University of Texas at Austin; The Mulva Clinic for the Neurosciences, Dell Medical School, the University of Texas at Austin; Department of Psychology, the University of Texas at Austin.
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Tian S, Zhang S, Mo Z, Chattun MR, Wang Q, Wang L, Zhu R, Shao J, Wang X, Yao Z, Si T, Lu Q. Antidepressants normalize brain flexibility associated with multi-dimensional symptoms in major depressive patients. Prog Neuropsychopharmacol Biol Psychiatry 2020; 100:109866. [PMID: 31972187 DOI: 10.1016/j.pnpbp.2020.109866] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/06/2020] [Accepted: 01/15/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The fundamental pathophysiology of major depressive disorder (MDD) could be characterized by functional brain networks which tightly and dynamically connect into groups as communities, making the flexible brain possible to external multifarious demands. We aim to scrutinize what brain dynamics go awry in MDD and antidepressants effects on multi-dimensional symptoms. METHODS Thirty-five patients and thirty-five controls underwent resting-state functional magnetic resonance imaging (MRI). Patients were scanned before and after 8 or 12 weeks of pharmacotherapy. Group independent component analysis decomposed resting-state images to instinct networks and networks' integrated flexibility was calculated. Network flexibility between patients at baseline and after therapy were compared. RESULTS All patients completed the clinical trial and MRI scans. Following antidepressants treatment, we found significant normalization of reduced network flexibility in default mode network (DMN) and cognitive control network (CCN) of MDD patients. Selectively significant correlations between network flexibility and multi-dimensional symptoms such as anxiety/somatization and hysteresis factor were also found. CONCLUSIONS "Hypoflexible" CCN may involve in anxiety syndrome. Low flexibility in DMN may be indicative of hysteresis. These suggest an important pathophysiology of depressive manifestation of MDD. The antidepressant-induced normalization of the "hypoflexibility" suggests a selective pathway through which antidepressants may alleviate symptoms in depression.
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Affiliation(s)
- Shui Tian
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China
| | - Siqi Zhang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China
| | - Zhaoqi Mo
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China
| | - Mohammad Ridwan Chattun
- Department of Psychiatry,the Affiliated Nanjing Brain Hospital of Nanjing Medical University,Nanjing 210029, China
| | - Qiang Wang
- Nanjing Brain Hospital, Medical School of Nanjing University,Nanjing 210093, China
| | - Li Wang
- Peking University Institute of Mental Health & Sixth Hospital, Beijing 100191, China; National Clinical Research Center for Mental Disorder & The Key Laboratory of Mental Health, Ministry of Health, Ministry of Health (Peking University), Beijing 100191, China
| | - Rongxin Zhu
- Department of Psychiatry,the Affiliated Nanjing Brain Hospital of Nanjing Medical University,Nanjing 210029, China
| | - Junneng Shao
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China
| | - Xinyi Wang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China
| | - Zhijian Yao
- Department of Psychiatry,the Affiliated Nanjing Brain Hospital of Nanjing Medical University,Nanjing 210029, China; Nanjing Brain Hospital, Medical School of Nanjing University,Nanjing 210093, China.
| | - Tianmei Si
- Peking University Institute of Mental Health & Sixth Hospital, Beijing 100191, China; National Clinical Research Center for Mental Disorder & The Key Laboratory of Mental Health, Ministry of Health, Ministry of Health (Peking University), Beijing 100191, China.
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China.
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Yu Z, Qin J, Xiong X, Xu F, Wang J, Hou F, Yang A. Abnormal topology of brain functional networks in unipolar depression and bipolar disorder using optimal graph thresholding. Prog Neuropsychopharmacol Biol Psychiatry 2020; 96:109758. [PMID: 31493423 DOI: 10.1016/j.pnpbp.2019.109758] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/09/2019] [Accepted: 09/03/2019] [Indexed: 12/27/2022]
Abstract
Two popular debilitating illness, unipolar depression (UD) and bipolar disorder (BD), have the similar symptoms and tight association on the psychopathological level, leading to a clinical challenge to distinguish them. In order to figure out the underlying common and different mechanism of both mood disorders, resting-state functional magnetic resonance imaging (rs-fMRI) data derived from 36 UD patients, 42 BD patients (specially type I, BD-I) and 45 healthy controls (HC) were analyzed retrospectively in this study. Functional brain networks were firstly constructed on both group and individual levels with a density 0.2, which was determined by a network thresholding approach based on modular similarity. Then we investigated the alterations of modular structure and other topological properties of the functional brain network, including global network characteristics and nodal network measures. The results demonstrated that the functional brain networks of UD and BD-I groups preserved the modularity and small-worldness property. However, compared with HC, reduced number of modules was observed in both patients' groups with shared alterations occurring in hippocampus, para hippocampal gyrus, amygdala and superior parietal gyrus and distinct changes of modular composition mainly in the caudate regions of basal ganglia. Additionally, for the network characteristics, compared to HC, significantly decreased global efficiency and small-worldness were observed in BD-I. For the nodal metrics, significant decrease of local efficiency was found in several regions in both UD and BD-I, while a UD-specified increase of participant coefficient was found in the right paracentral lobule and the right thalamus. These findings may contribute to throw light on the neuropathological mechanisms underlying the two disorders and further help to explore objective biomarkers for the correct diagnosis of UD and BD.
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Affiliation(s)
- Zhinan Yu
- Key Laboratory of Biomedical Functional Materials, School of Science, China Pharmaceutical University, Nanjing 210009, China
| | - Jiaolong Qin
- Key Laboratory of Intelligent Perception and Systems for High-Dimensional Information of Ministry of Education, School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Xinyuan Xiong
- School of Software Institute, Nanjing University, Nanjing 210093, China
| | - Fengguo Xu
- Key Laboratory of Drug Quality Control & Pharmacovigilance, China Pharmaceutical University, Nanjing 210009, China
| | - Jun Wang
- School of Geographic and Biologic Information, Nanjing University of Posts and Telecommunications, Nanjing 210003, China
| | - Fengzhen Hou
- Key Laboratory of Biomedical Functional Materials, School of Science, China Pharmaceutical University, Nanjing 210009, China.
| | - Albert Yang
- Division of Interdisciplinary Medicine and Biotechnology, Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
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Emotional Processing Impairments in Apathetic Patients with Parkinson's Disease: An ERP Study in Early Time Windows. PARKINSON'S DISEASE 2019; 2019:1309245. [PMID: 31143435 PMCID: PMC6501166 DOI: 10.1155/2019/1309245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 03/21/2019] [Indexed: 11/17/2022]
Abstract
We investigated emotional processing in apathetic patients with Parkinson's disease (PD) by observing components of event-related potentials (ERPs) in early time windows. Forty PD patients and 21 healthy controls (HCs) were enrolled. The Starkstein Apathy Scale (SAS) was used to divide the PD patients into apathetic and nonapathetic groups. Cognitive function was evaluated by the forward and backward Digit Span tests, Trail Making Test (TMT), and Word Fluency Test. The participants were required to recognize positive, neutral, and negative emotional faces and engage in an emotion categorization task while EEG was recorded. The time to completion for the TMT (Part A and Part B) from highest to lowest was in the order of apathetic group > nonapathetic group > HC group. Compared with the nonapathetic and HC groups, in the apathetic group, P100 amplitudes were smaller for positive expressions in the right hemisphere and latencies were longer for positive expressions in the left hemisphere, while latencies were longer for neutral expressions bilaterally. Compared with the nonapathetic group, in the apathetic group, N170 amplitudes were attenuated and latencies were delayed for neutral and negative expressions in the right hemisphere. A trend towards larger N170 amplitudes in the right hemisphere than in the left was observed in the nonapathetic and HC groups, but this difference was not significant in the apathetic group. In the apathetic group, bilateral P100 amplitudes elicited by negative expressions were negatively correlated with SAS scores, and SAS scores were positively correlated with Part B of the TMT. N170 amplitudes elicited by negative expressions in the right hemisphere were negatively correlated with SAS in the apathetic group and with Part B of TMT in both PD groups. Our findings suggested that emotional processing was impaired in apathetic PD patients and that the right hemisphere was more sensitive to reflecting this impairment in the early time windows of ERPs.
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8
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Frequently Recurrent Takotsubo Syndrome in COPD. Case Rep Cardiol 2019; 2019:6706935. [PMID: 30729044 PMCID: PMC6343172 DOI: 10.1155/2019/6706935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 12/04/2018] [Accepted: 12/06/2018] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular disease is common among patients with chronic obstructive pulmonary disease (COPD). Takotsubo syndrome (TTS) is a transient cardiac disorder that, in its typical form, involves left ventricular dysfunction with apical ballooning and mimics acute coronary syndrome (ACS). “Bronchogenic TTS” has been proposed as a specific form of TTS (during severe acute dyspnea in asthma or COPD) with atypical presentation. Recurrent TTS in COPD seems to be exceptionally rare since only a handful of clinical cases have previously been reported in the literature. Here, we present a unique case of a frequently recurrent TTS during COPD exacerbation in a 70-year-old woman, with at least 4 different episodes of TTS within 5 years. This case report exemplifies the difficulties of the diagnosis of TTS at the onset of acute COPD exacerbation. Potential pathophysiological mechanisms and therapeutic strategies are also briefly discussed.
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Strakowski SM, Fleck DE, Welge J, Eliassen JC, Norris M, Durling M, Komoroski RA, Chu WJ, Weber W, Dudley JA, Blom TJ, Stover A, Klein C, Strawn JR, DelBello MP, Lee JH, Adler CM. fMRI brain activation changes following treatment of a first bipolar manic episode. Bipolar Disord 2016; 18:490-501. [PMID: 27647671 PMCID: PMC5951160 DOI: 10.1111/bdi.12426] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/19/2016] [Accepted: 07/22/2016] [Indexed: 01/16/2023]
Abstract
OBJECTIVES We tested the hypothesis that, with treatment, functional magnetic resonance imaging (fMRI) regional brain activation in first-episode mania would normalize - i.e., that differences from healthy subjects would diminish over time, and would be associated with clinical remission status, potentially identifying neuroanatomic treatment response markers. METHODS Forty-two participants with bipolar I disorder were recruited during their first manic episode, pseudo-randomized to open-label lithium or quetiapine, and followed for 8 weeks. fMRI scans were obtained at baseline and then after 1 and 8 weeks of treatment, while participants performed a continuous performance task with emotional distracters. Healthy participants received fMRI scans at these same intervals. Specific region-of-interest (ROI) activations within prefrontal emotional networks were assessed as potential measures of treatment response. RESULTS ROI data were reduced using exploratory factor analysis, which identified five factors that were organizationally consistent with functional anatomic models of human emotion modulation. Half of the participants with bipolar disorder achieved remission by Week 8 and were contrasted with the other half that did not. Analyses demonstrated that, in the bipolar disorder group in general, treatment led to decreases in activation across brain regions toward healthy subject values. However, differences in activation changes were observed between subjects with bipolar disorder who did or did not achieve remission in subcortical and amygdala factors. CONCLUSIONS These findings provide evidence for potential neuroanatomic treatment response markers in first-episode bipolar disorder.
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Affiliation(s)
- Stephen M Strakowski
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA. .,Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
| | - David E Fleck
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jeffrey Welge
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - James C Eliassen
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Matthew Norris
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Michelle Durling
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Richard A Komoroski
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Wen-Jang Chu
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Wade Weber
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jonathan A Dudley
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Thomas J Blom
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Amanda Stover
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Christina Klein
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jeffrey R Strawn
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jing-Huei Lee
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Caleb M Adler
- Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH
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