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Baset A, Huang F. Shedding light on subiculum's role in human brain disorders. Brain Res Bull 2024; 214:110993. [PMID: 38825254 DOI: 10.1016/j.brainresbull.2024.110993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/17/2024] [Accepted: 05/30/2024] [Indexed: 06/04/2024]
Abstract
Subiculum is a pivotal output component of the hippocampal formation, a structure often overlooked in neuroscientific research. Here, this review aims to explore the role of the subiculum in various brain disorders, shedding light on its significance within the functional-neuroanatomical perspective on neurological diseases. The subiculum's involvement in multiple brain disorders was thoroughly examined. In Alzheimer's disease, subiculum alterations precede cognitive decline, while in epilepsy, the subiculum plays a critical role in seizure initiation. Stress involves the subiculum's impact on the hypothalamic-pituitary-adrenocortical axis. Moreover, the subiculum exhibits structural and functional changes in anxiety, schizophrenia, and Parkinson's disease, contributing to cognitive deficits. Bipolar disorder is linked to subiculum structural abnormalities, while autism spectrum disorder reveals an alteration of inward deformation in the subiculum. Lastly, frontotemporal dementia shows volumetric differences in the subiculum, emphasizing its contribution to the disorder's complexity. Taken together, this review consolidates existing knowledge on the subiculum's role in brain disorders, and may facilitate future research, diagnostic strategies, and therapeutic interventions for various neurological conditions.
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Affiliation(s)
- Abdul Baset
- Department of Neuroscience, City University of Hong Kong, Hong Kong Special Administrative Region of China; Centre for Regenerative Medicine and Health, Hong Kong Institute of Science & Innovation, Chinese Academy of Sciences, Hong Kong Special Administrative Region of China
| | - Fengwen Huang
- Department of Neuroscience, City University of Hong Kong, Hong Kong Special Administrative Region of China; Centre for Regenerative Medicine and Health, Hong Kong Institute of Science & Innovation, Chinese Academy of Sciences, Hong Kong Special Administrative Region of China.
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Li W, Li Q, Zhang P, Liu H, Ye Z. Interaction between childhood trauma experience and TPH2 rs7305115 gene polymorphism in brain gray matter volume. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2023; 19:22. [PMID: 38093326 PMCID: PMC10720107 DOI: 10.1186/s12993-023-00224-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Childhood trauma is one of the most extensively studied and well-supported environmental risk factors for the development of mental health problems. The human tryptophan hydroxylase 2 (TPH2) gene is one of the most promising candidate genes in numerous psychiatric disorders. However, it is now widely acknowledged that neither genetic variation nor environmental exposure alone can fully explain all the phenotypic variance observed in psychiatric disorders. Therefore, it is necessary to consider the interaction between the two factors in psychiatric research. METHODS We enrolled a sizable nonclinical cohort of 786 young, healthy adults who underwent structural MRI scans and completed genotyping, the Childhood Trauma Questionnaire (CTQ) and behavioural scores. We identified the interaction between childhood trauma and the TPH2 rs7305115 gene polymorphism in the gray matter volume (GMV) of specific brain subregions and the behaviour in our sample using a multiple linear regression framework. We utilized mediation effect analysis to identify environment /gene-brain-behaviour relationships. RESULTS We found that childhood trauma and TPH2 rs7305115 interacted in both behaviour and the GMV of brain subregions. Our findings indicated that the GMV of the right posterior parietal thalamus served as a significant mediator supporting relationship between childhood trauma (measured by CTQ score) and anxiety scores in our study population, and the process was partly modulated by the TPH2 rs7305115 gene polymorphism. Moreover, we found only a main effect of childhood trauma in the GMV of the right parahippocampal gyrus area, supporting the relationship between childhood trauma and anxiety scores as a significant mediator. CONCLUSIONS Our findings suggest that early-life trauma may have a specific and long-term structural effect on brain GMV, potentially leading to altered cognitive and emotional processes involving the parahippocampal gyrus and thalamus that may also be modulated by the TPH2 gene polymorphism. This finding highlights the importance of considering genetic factors when examining the impact of early-life experiences on brain structure and function. Gene‒environment studies can be regarded as a powerful objective supplement for targeted therapy, early diagnosis and treatment evaluation in the future.
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Affiliation(s)
- Wei Li
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, 300060, China
| | - Qian Li
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, 300060, China
| | - Peng Zhang
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, 300060, China
| | - Huaigui Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
| | - Zhaoxiang Ye
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Huanhuxi Road, Hexi District, Tianjin, 300060, China.
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Atwood B, Yassin W, Chan SY, Hall MH. Subfield-specific longitudinal changes of hippocampal volumes in patients with early-stage bipolar disorder. Bipolar Disord 2023; 25:301-311. [PMID: 36855850 PMCID: PMC10330583 DOI: 10.1111/bdi.13315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND The hippocampus is a heterogeneous structure composed of biologically and functionally distinct subfields. Hippocampal aberrations are proposed to play a fundamental role in the etiology of psychotic symptoms. Bipolar disorder (BPD) has substantial overlap in symptomatology and genetic liability with schizophrenia (SZ), and reduced hippocampal volumes, particularly at the chronic illness stages, are documented in both disorders. Studies of hippocampal subfields in the early stage of BPD are limited and cross-sectional findings to date report no reduction in hippocampal volumes. To our knowledge, there have been no longitudinal studies of BPD evaluating hippocampal volumes in the early phase of illness. We investigated the longitudinal changes in hippocampal regions and subfields in BPD mainly and in early stage of psychosis (ESP) patients more broadly and compared them to those in controls (HC). METHODS Baseline clinical and structural MRI data were acquired from 88 BPD, from a total of 143 ESP patients, and 74 HCs. Of those, 66 participants (23 HC, 43 patients) completed a 12-month follow-up visit. The hippocampus regions and subfields were segmented using Freesurfer automated pipeline. RESULTS We found general baseline deficits in hippocampal volumes among BPD and ESP cohorts. Both cohorts displayed significant increases in the anterior hippocampal region and dentate gyrus compared with controls. Additionally, antipsychotic medications were positively correlated with the posterior region at baseline. CONCLUSION These findings highlight brain plasticity in BPD and in ESP patients providing evidence that deviations in hippocampal volumes are adaptive responses to atypical signaling rather than progressive degeneration.
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Affiliation(s)
- Bruce Atwood
- Psychosis Neurobiology Laboratory, McLean Hospital, Belmont, MA, USA
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Belmont, MA, USA
| | - Walid Yassin
- Psychosis Neurobiology Laboratory, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Shi Yu Chan
- Psychosis Neurobiology Laboratory, McLean Hospital, Belmont, MA, USA
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Belmont, MA, USA
| | - Mei-Hua Hall
- Psychosis Neurobiology Laboratory, McLean Hospital, Belmont, MA, USA
- Schizophrenia and Bipolar Disorders Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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The Association of the Oral Microbiota with the Effects of Acid Stress Induced by an Increase of Brain Lactate in Schizophrenia Patients. Biomedicines 2023; 11:biomedicines11020240. [PMID: 36830777 PMCID: PMC9953675 DOI: 10.3390/biomedicines11020240] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/28/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
The altered cerebral energy metabolism central to schizophrenia can be linked to lactate accumulation. Lactic acid is produced by gastrointestinal bacteria, among others, and readily crosses the blood-brain barrier, leading to the brain acidity. This study aimed to examine the association of the oral microbiota with the effects of acid stress induced by an increase of brain lactate in schizophrenia patients. The study included patients with a diagnosis of acute polyphasic psychotic disorder meeting criteria for schizophrenia at 3-month follow-up. Results: Individuals with a significantly higher total score on the Positive and Negative Syndrome Scale had statistically significantly lower lactate concentrations compared to those with a lower total score and higher brain lactate. We observed a positive correlation between Actinomyces and lactate levels in the anterior cingulate cap and a negative correlation between bacteria associated with lactate metabolism and some clinical assessment scales. Conclusions: Shifts in the oral microbiota in favour of lactate-utilising bacterial genera may represent a compensatory mechanism in response to increased lactate production in the brain. Assessment of neuronal function mediated by ALA-LAC-dependent NMDA regulatory mechanisms may, thus, support new therapies for schizophrenia, for which acidosis has become a differentiating feature of individuals with schizophrenia endophenotypes.
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Twait EL, Blom K, Koek HL, Zwartbol MHT, Ghaznawi R, Hendrikse J, Gerritsen L, Geerlings MI. Psychosocial factors and hippocampal subfields: The Medea-7T study. Hum Brain Mapp 2022; 44:1964-1984. [PMID: 36583397 PMCID: PMC9980899 DOI: 10.1002/hbm.26185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/21/2022] [Accepted: 12/05/2022] [Indexed: 12/31/2022] Open
Abstract
Specific subfields within the hippocampus have shown vulnerability to chronic stress, highlighting the importance of looking regionally within the hippocampus to understand the role of psychosocial factors in the development of neurodegenerative diseases. A systematic review on psychosocial factors and hippocampal subfield volumes was performed and showed inconsistent results, highlighting the need for future studies to explore this relationship. The current study aimed to explore the association of psychosocial factors with hippocampal (subfield) volumes, using high-field 7T MRI. Data were from the Memory Depression and Aging (Medea)-7T study, which included 333 participants without dementia. Hippocampal subfields were automatically segmented from T2-weighted images using ASHS software. Generalized linear models accounting for correlated outcomes were used to assess the association between subfields (i.e., entorhinal cortex, subiculum, Cornu Ammonis [CA]1, CA2, CA3, dentate gyrus, and tail) and each psychosocial factor (i.e., depressive symptoms, anxiety symptoms, childhood maltreatment, recent stressful life events, and social support), adjusted for age, sex, and intracranial volume. Neither depression nor anxiety was associated with specific hippocampal (subfield) volumes. A trend for lower total hippocampal volume was found in those reporting childhood maltreatment, and a trend for higher total hippocampal volume was found in those who experienced a recent stressful life event. Among subfields, low social support was associated with lower volume in the CA3 (B = -0.43, 95% CI: -0.72; -0.15). This study suggests possible differential effects among hippocampal (subfield) volumes and psychosocial factors.
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Affiliation(s)
- Emma L. Twait
- Department of Epidemiology, Julius Center for Health Sciences and Primary CareUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Kim Blom
- Department of Epidemiology, Julius Center for Health Sciences and Primary CareUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Huiberdina L. Koek
- Department of GeriatricsUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Maarten H. T. Zwartbol
- Department of RadiologyUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Rashid Ghaznawi
- Department of RadiologyUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Jeroen Hendrikse
- Department of RadiologyUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Lotte Gerritsen
- Department of PsychologyUtrecht UniversityUtrechtThe Netherlands
| | - Mirjam I. Geerlings
- Department of Epidemiology, Julius Center for Health Sciences and Primary CareUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands,Department of General PracticeAmsterdam UMC, Location University of AmsterdamAmsterdamThe Netherlands,Amsterdam Public Health, Aging & Later life, and Personalized MedicineAmsterdamThe Netherlands,Amsterdam Neuroscience, Neurodegeneration, and Mood, Anxiety, Psychosis, Stress, and SleepAmsterdamThe Netherlands
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Brain gyrification in bipolar disorder: a systematic review of neuroimaging studies. Brain Imaging Behav 2022; 16:2768-2784. [PMID: 36042153 DOI: 10.1007/s11682-022-00713-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 11/02/2022]
Abstract
Bipolar disorder (BD) is a severe mental illness with a strong genetic component. Genetic variations have been involved in the risk of this disorder, including those mediating brain function and neurodevelopment. Early neurodevelopment and neuroprogression processes could be reflected in brain gyrification patterns and help optimize the prediction and diagnosis of such disorders that is often delayed. Previous neuroimaging studies using this measure in patients with bipolar disorder revealed controversial results. This systematic review aimed to summarize available neuroimaging investigations on gyrification in BD compared to healthy controls (HC) and/or other psychiatric groups. Fourteen studies including 733 patients with BD, 585 patients with schizophrenia (SCZ), 90 with schizoaffective disorder (SZA), and 1380 healthy subjects were identified. Overall, a heterogeneous pattern of gyrification emerged between patients with BD and HC. Interestingly, increased gyrification or no differences were also observed in patients with BD compared to those with the schizophrenia-spectrum disorders. Furthermore, relatives of patients with BD showed lower or no differences in gyrification compared to healthy subjects without a family history of affective illness. Differences in the design and in methodological approaches could have contributed to the heterogeneity of the findings. The current review supports an altered brain gyrification pattern that underlies the pathophysiology of BD spanning large anatomical and functional neural networks, associated with altered cognitive functioning, difficulties in processing and affective regulation, and clinical symptoms. Longitudinal studies are needed to test different bipolar phenotypes and pharmacological effects on gyrification.
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Thapaliya K, Staines D, Marshall-Gradisnik S, Su J, Barnden L. Volumetric differences in hippocampal subfields and associations with clinical measures in myalgic encephalomyelitis/chronic fatigue syndrome. J Neurosci Res 2022; 100:1476-1486. [PMID: 35355311 PMCID: PMC9321967 DOI: 10.1002/jnr.25048] [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: 11/23/2021] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 12/02/2022]
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients suffer from a cognitive and memory dysfunction. Because the hippocampus plays a key role in both cognition and memory, we tested for volumetric differences in the subfields of the hippocampus in ME/CFS. We estimated hippocampal subfield volumes for 25 ME/CFS patients who met Fukuda criteria only (ME/CFSFukuda), 18 ME/CFS patients who met the stricter ICC criteria (ME/CFSICC), and 25 healthy controls (HC). Group comparisons with HC detected extensive differences in subfield volumes in ME/CFSICC but not in ME/CFSFukuda. ME/CFSICC patients had significantly larger volume in the left subiculum head (p < 0.001), left presubiculum head (p = 0.0020), and left fimbria (p = 0.004). Correlations of hippocampus subfield volumes with clinical measures were stronger in ME/CFSICC than in ME/CFSFukuda patients. In ME/CFSFukuda patients, we detected positive correlations between fatigue and hippocampus subfield volumes and a negative correlation between sleep disturbance score and the right CA1 body volume. In ME/CFSICC patients, we detected a strong negative relationship between fatigue and left hippocampus tail volume. Strong negative relationships were also detected between pain and SF36 physical scores and two hippocampal subfield volumes (left: GC‐ML‐DG head and CA4 head). Our study demonstrated that volumetric differences in hippocampal subfields have strong statistical inference for patients meeting the ME/CFSICC case definition and confirms hippocampal involvement in the cognitive and memory problems of ME/CFSICC patients.
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Affiliation(s)
- Kiran Thapaliya
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - Donald Staines
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Sonya Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Jiasheng Su
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Leighton Barnden
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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Abstract
Early-life adverse events or childhood adversities (CAs) are stressors and harmful experiences severely impacting on a child's wellbeing and development. Examples of CAs include parental neglect, emotional and physical abuse and bullying. Even though the prevalence of CAs and their psychological effects in both healthy and psychiatric populations is established, only a paucity of studies have investigated the neurobiological firms associated with CAs in bipolar disorder (BD). In particular, the exact neural mechanisms and trajectories of biopsychosocial models integrating both environmental and genetic effects are still debated. Considering the potential impact of CAs on BD, including its clinical manifestations, we reviewed existing literature discussing the association between CAs and brain alterations in BD patients. Results showed that CAs are associated with volume alterations of several grey matter regions including the hippocampus, thalamus, amygdala and frontal cortex. A handful of studies suggest the presence of alterations in the corpus callosum and the pre-fronto-limbic connectivity at rest. Alterations in these regions of the brain of patients with BD are possibly due to the effect of stress produced by CAs, being hippocampus part of the hypothalamus-pituitary-adrenal axis and thalamus together with amygdala filtering sensory information and regulating emotional responses. However, results are mixed possibly due to the heterogeneity of methods and study design. Future neuroimaging studies disentangling between different types of CAs or differentiating between BD sub-types are needed in order to understand the link between CAs and BD.
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Wang H, Luo W, Huang W, Xiang H, Chen S, Lin W, Chen C, Zhang Y, Huang S, Wang Y, Liu P. How sleep duration mediated childhood trauma and Internet addiction of the vocational college population in urban areas of south China. Front Psychiatry 2022; 13:1088172. [PMID: 36713913 PMCID: PMC9880202 DOI: 10.3389/fpsyt.2022.1088172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Internet Addiction is positively associated with a range of psychological risk factors such as childhood trauma and sleep disorders. However, it remains unclear if sleep duration mediates the association between childhood trauma and Internet addiction. METHODS We enrolled 14,263 students from Shenzhen Polytechnic College, China. Sleep duration, Internet addiction and childhood maltreatment were assessed in these students by self-report measures, Internet Addiction Test (IAT) and Childhood Trauma Questionnaire (CTQ), respectively. With bootstrap approach and path analysis, the mediating role of sleep duration in the association between childhood trauma and Internet addiction was analysed. RESULTS The Internet-addicted group exhibited a higher level of the emotional abuse (EA) score, physical abuse (PA) score, sexual abuse (SA) score, a lower level of emotional neglect (EN) score and sleep duration compared with the control group (all p < 0.001). The CTQ total score and subscores showed a positive correlation with IAT scores both for males (r = 0.199, p < 0.001 for the total score, r = 0.356, p < 0.001 for EA, r = 0.270, p < 0.001 for PA, r = 0.249, p < 0.001 for SA, and r = 0.132, p < 0.001 for PN) and females (r = 0.127, p < 0.001 for the total score, r = 0.335, p < 0.001 for EA, r = 0.187, p < 0.001 for PA, r = 0.189, p < 0.001 for SA, and r = 0.065, p < 0.001 for PN). The CTQ subcores were negatively related to sleep duration both for males (r = -0.177, p < 0.001 for EA, r = -0.180, p < 0.001 for PA and r = 0.182, p < 0.001 for SA) and females (r = -0.137, p < 0.001 for EA, r = -0.105, p < 0.001 for PA, and r = -0.182, p < 0.001 for SA) and sleep duration was negatively correlated with IAT scores both in males (r = -0.120, p < 0.001) and females (r = -0.108, p < 0.001). Further, the path analysis suggested that EA and SA mediated significantly to the Internet addiction when all types of childhood trauma were examined in one model (both p < 0.001). CONCLUSION In the current study, a great proportion of students met criteria for Internet addiction. Sleep duration mediated a significant proportion of the indirect effect between EA/SA and Internet addiction. The findings may help with prevention and intervention of Internet addiction in the future. The limitation of this study was that it was a cross-sectional study and not controlling for other mental disorders. Future large-scale longitudinal studies will be needed to further clarify the relationship between childhood abuse and Internet addiction and the mediation role of sleep duration.
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Affiliation(s)
- He Wang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Weijun Luo
- Department of Traditional Chinese Medicine, People's Hospital of Longhua, Shenzhen, Guangdong, China
| | - Weikang Huang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Haishan Xiang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Siqi Chen
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Wei Lin
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Caiyun Chen
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical UniversityGuangzhou, Guangdong, China
| | - Yingjie Zhang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical UniversityGuangzhou, Guangdong, China
| | - Shengbing Huang
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yueyun Wang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Peiyi Liu
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
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Murphy F, Nasa A, Cullinane D, Raajakesary K, Gazzaz A, Sooknarine V, Haines M, Roman E, Kelly L, O'Neill A, Cannon M, Roddy DW. Childhood Trauma, the HPA Axis and Psychiatric Illnesses: A Targeted Literature Synthesis. Front Psychiatry 2022; 13:748372. [PMID: 35599780 PMCID: PMC9120425 DOI: 10.3389/fpsyt.2022.748372] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Studies of early life stress (ELS) demonstrate the long-lasting effects of acute and chronic stress on developmental trajectories. Such experiences can become biologically consolidated, creating individual vulnerability to psychological and psychiatric issues later in life. The hippocampus, amygdala, and the medial prefrontal cortex are all important limbic structures involved in the processes that undermine mental health. Hyperarousal of the sympathetic nervous system with sustained allostatic load along the Hypothalamic Pituitary Adrenal (HPA) axis and its connections has been theorized as the basis for adult psychopathology following early childhood trauma. In this review we synthesize current understandings and hypotheses concerning the neurobiological link between childhood trauma, the HPA axis, and adult psychiatric illness. We examine the mechanisms at play in the brain of the developing child and discuss how adverse environmental stimuli may become biologically incorporated into the structure and function of the adult brain via a discussion of the neurosequential model of development, sensitive periods and plasticity. The HPA connections and brain areas implicated in ELS and psychopathology are also explored. In a targeted review of HPA activation in mood and psychotic disorders, cortisol is generally elevated across mood and psychotic disorders. However, in bipolar disorder and psychosis patients with previous early life stress, blunted cortisol responses are found to awakening, psychological stressors and physiological manipulation compared to patients without previous early life stress. These attenuated responses occur in bipolar and psychosis patients on a background of increased cortisol turnover. Although cortisol measures are generally raised in depression, the evidence for a different HPA activation profile in those with early life stress is inconclusive. Further research is needed to explore the stress responses commonalities between bipolar disorder and psychosis in those patients with early life stress.
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Affiliation(s)
- Felim Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Anurag Nasa
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | | | - Kesidha Raajakesary
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Areej Gazzaz
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Vitallia Sooknarine
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Madeline Haines
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Elena Roman
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Linda Kelly
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Aisling O'Neill
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Darren William Roddy
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
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Janiri D, Moccia L, Dattoli L, Pepe M, Molinaro M, De Martin V, Chieffo D, Di Nicola M, Fiorillo A, Janiri L, Sani G. Emotional dysregulation mediates the impact of childhood trauma on psychological distress: First Italian data during the early phase of COVID-19 outbreak. Aust N Z J Psychiatry 2021; 55:1071-1078. [PMID: 33715469 DOI: 10.1177/0004867421998802] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic represents an unprecedented traumatic stressor to mental health. Psychological distress is considered a reliable proxy for psychopathology and can be negatively influenced by childhood trauma through sensitization effects. Emotion dysregulation has been proposed as a potential mediator of this mechanism. We aimed to test this hypothesis in a national Italian sample assessed in the early phase of the coronavirus disease 2019 outbreak. METHODS We investigated the relationship between psychological distress and childhood trauma in 500 healthy participants assessed through a survey-based study, after the coronavirus disease 2019 pandemic lockdown in Italy. Levels of psychological distress and history of childhood trauma were obtained using the Kessler-10 (K10) and the Childhood Trauma Questionnaire, respectively. We used bootstrapped mediation analysis to test the mediator role of emotional dysregulation, measured through the Difficulties in Emotion Regulation Scale, on the effect of childhood trauma on psychological distress. RESULTS In total, 190 (38%) reported psychological distress related to the coronavirus disease 2019 outbreak. Individuals with psychological distress experienced more childhood trauma, specifically emotional abuse (F = 23.51, df = 1, p < 0.001) and neglect (F = 10.98, df = 1, p = 0.001). After modelling the effect of emotional dysregulation, the impact of childhood trauma on coronavirus disease 2019-related psychological distress resulted in indirect effects and mediated by deficits in emotion regulation mechanisms (bootstrapped lower level of confidence interval = 0.345, upper level of confidence interval = 0.598). CONCLUSION Childhood trauma is associated with increased vulnerability to the stressful effect of the coronavirus disease 2019 outbreak. Our data suggest that emotional dysregulation may represent a dimension mediating the impact of childhood trauma on coronavirus disease 2019-related psychological distress and may be considered as specific target for interventions aiming at empowering resilience.
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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
| | - Lorenzo Moccia
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luigi Dattoli
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Pepe
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marzia Molinaro
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valentina De Martin
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Chieffo
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Di Nicola
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania 'L. Vanvitelli', Naples, Italy
| | - Luigi Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
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12
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Lewis-de los Angeles WW, Liu RT. History of Depression, Elevated Body Mass Index, and Waist-to-Height Ratio in Preadolescent Children. Psychosom Med 2021; 83:1075-1081. [PMID: 34267084 PMCID: PMC8578339 DOI: 10.1097/psy.0000000000000982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to evaluate whether a history of depression or self-injurious thoughts and behaviors predict elevated body mass index (BMI) and elevated waist-to-height ratio in preadolescents. METHODS Baseline data were evaluated from a large, nationally representative cohort study of 9- and 10-year-old children (unweighted n = 11,875), the Adolescent Brain and Cognitive Development study. RESULTS In the weighted sample, 10.6% of children had a history of depression, 7.0% had engaged in nonsuicidal self-injury, 13.1% had experienced suicidal ideation in their lifetime, and 1.1% had a history of attempted suicide. Among the children, 34.1% had an elevated BMI in the overweight or obese range and 31.9% had a waist-to-height ratio >0.5. In multivariate analyses, history of depression was associated with elevated BMI and waist-to-height ratio. Furthermore, interactions with sex were found; girls with a history of depression were more likely to have an elevated BMI (odds ratio = 1.47, 95% confidence interval = 1.24-1.74) and elevated waist-to-height ratio (odds ratio = 1.48, 95% confidence interval = 1.18-1.86) than girls without a history of depression, but no differences were observed between boys with and without a history of depression. Self-injurious thoughts and behaviors were not associated with elevated BMI or elevated waist-to-height. CONCLUSIONS In this study, 9- and 10-year-old girls with a history of depression were more likely to have an elevated BMI and elevated waist-to-height ratio than girls with no history of depression. These results provide important clinical context in caring for preadolescents with a history of depression.
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Affiliation(s)
- William W. Lewis-de los Angeles
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Pediatrics, Emma Pendleton Bradley Hospital, Riverside, Rhode Island
| | - Richard T. Liu
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
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13
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De Looze C, Feeney JC, Scarlett S, Hirst R, Knight SP, Carey D, Meaney JF, Kenny RA. Sleep duration, sleep problems and perceived stress are associated with hippocampal subfield volumes in later life: Findings from The Irish Longitudinal Study on Ageing (TILDA). Sleep 2021; 45:6374891. [PMID: 34558630 DOI: 10.1093/sleep/zsab241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/15/2021] [Indexed: 02/07/2023] Open
Abstract
STUDY OBJECTIVES This study examines the cross-sectional and two-year follow-up relationships between sleep and stress and total hippocampal volume and hippocampal subfield volumes among older adults. METHODS 417 adults (aged 68.8±7.3; 54% women) from the Irish Longitudinal Study on Ageing completed an interview, a questionnaire and multiparametric brain MRI. The relationships between self-reported sleep duration, sleep problems, perceived stress and total hippocampal volume were examined by using ordinary least squares regressions. Linear mixed-effects models were used to investigate the relationships between sleep duration, sleep problems, perceived stress, changes in these measures over two-years and hippocampal subfield volumes. RESULTS No cross-sectional and follow-up associations between sleep and total hippocampal volume and between stress and total hippocampal volume were found. By contrast, Long sleep (≥9-10 hours / night) was associated with smaller volumes of molecular layer, hippocampal tail, presubiculum and subiculum. The co-occurrence of Short sleep (≤6 hours) and perceived stress was associated with smaller cornu ammonis 1, molecular layer, subiculum and tail. Sleep problems independently and in conjunction with higher stress, and increase in sleep problems over 2 years were associated with smaller volumes of these same subfields. CONCLUSION Our study highlights the importance of concurrently assessing sub-optimal sleep and stress for phenotyping individuals at risk of hippocampal subfield atrophy.
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Affiliation(s)
- Céline De Looze
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Joanne C Feeney
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Siobhan Scarlett
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Rebecca Hirst
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Silvin P Knight
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Daniel Carey
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - James F Meaney
- The National Centre for Advanced Medical Imaging (CAMI), St. James's Hospital, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland.,Mercer's Institute for Successful Ageing (MISA), St James's Hospital, Dublin, Ireland
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14
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Papadopoulos A, Seguin D, Correa S, Duerden EG. Peer victimization and the association with hippocampal development and working memory in children with ADHD and typically-developing children. Sci Rep 2021; 11:16411. [PMID: 34385508 PMCID: PMC8360960 DOI: 10.1038/s41598-021-95582-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/21/2021] [Indexed: 11/18/2022] Open
Abstract
The symptoms of hyperactivity-impulsivity and inattention displayed by children with ADHD put them at risk of experiencing peer victimization. Hippocampal maturation, may reduce a child's vulnerability to the experience of peer victimization, as it has been associated with decreased ADHD symptomatology. Working memory is an important executive function in the formation and maintenance of social relationships, which is often impaired in ADHD. We aimed to evaluate the relationship between problem behaviours, peer victimization, hippocampal morphology, and working memory in children with and without ADHD. 218 typically-developing participants (50.5% male) and 232 participants diagnosed with ADHD (77.6% male) were recruited. The ADHD group was subdivided into inattentive (ADHD-I) or combined (ADHD-C) types. The Child Behavior Checklist measured problem behaviours and peer victimization. Children underwent Magnetic Resonance Imaging (MRI). Hippocampal subfield volumes were obtained using FreeSurfer. The Wechsler Intelligence Scale for Children-fifth edition measured working memory (WM). The ADHD-C group displayed significantly higher levels of problem behaviours and peer victimization (all, p < 0.001), compared to the other groups. Left Cornu Ammonis 3 (CA3) volume was a positive predictor of peer victimization (all, p < 0.013). Left CA3 volume was a positive predictor of WM and left Cornu Ammonis 4 (CA4) volume negatively predicted WM (all, p < 0.025). A cluster analysis revealed that children displaying symptoms of hyperactivity-impulsivity are the most at risk for peer victimization. Interventions focusing on minimizing peer victimization may aid in mitigating adverse downstream effects, and assist in promoting brain health and cognitive function.
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Affiliation(s)
- Alissa Papadopoulos
- Applied Psychology, Faculty of Education, Western University, 1137 Western Rd, London, ON, N6G 1G7, Canada
| | - Diane Seguin
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Susana Correa
- Applied Psychology, Faculty of Education, Western University, 1137 Western Rd, London, ON, N6G 1G7, Canada
| | - Emma G Duerden
- Applied Psychology, Faculty of Education, Western University, 1137 Western Rd, London, ON, N6G 1G7, Canada.
- Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Canada.
- Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Canada.
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15
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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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16
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Bio DS, Moreno RA, Garcia-Otaduy MC, Nery F, Lafer B, Soeiro-de-Souza MG. Altered brain creatine cycle metabolites in bipolar I disorder with childhood abuse: A 1H magnetic resonance spectroscopy study. Prog Neuropsychopharmacol Biol Psychiatry 2021; 109:110233. [PMID: 33387596 DOI: 10.1016/j.pnpbp.2020.110233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/09/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Childhood abuse (CA) is a risk factor for a number of psychiatric disorders and has been associated with higher risk of developing bipolar disorders (BD). CA in BD has been associated with more severe clinical outcomes, but the neurobiological explanation for this is unknown. Few studies have explored in vivo measurement of brain metabolites using proton magnetic resonance spectroscopy (1H-MRS) in CA and no studies have investigated the association of CA severity with brain neurometabolites in BD. OBJECTIVE To investigate whether CA severity is associated with changes in anterior cingulate cortex (ACC) neurometabolite profile in BD and HC subjects. METHODS Fifty-nine BD I euthymic patients and fifty-nine HC subjects were assessed using the Childhood Trauma Questionnaire (CTQ) and underwent a 3-Tesla 1H-MRS scan. Severity of childhood abuse (physical, sexual and emotional) and its association with levels of brain metabolites was analyzed within each group. RESULTS BD patients had higher total scores on the CTQ and higher severity rates of sexual and physical abuse compared to HC subjects. Greater severity of physical and sexual abuse was associated with increased ACC PCr level and lower Cr/PCr ratio in the BD group only. CONCLUSION Sexual and physical abuse in BD patients, but not in HC subjects, appeared to be associated with creatine metabolism in the ACC, which can influence neuronal mitochondrial energy production. Further studies should investigate whether this is the mechanism underlying the association between CA and worse clinical outcomes in BD.
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Affiliation(s)
- Danielle Soares Bio
- Mood Disorders Unit (PROGRUDA), Department of Psychiatry, School of Medicine, University of São Paulo, Brazil
| | - Ricardo Alberto Moreno
- Mood Disorders Unit (PROGRUDA), Department of Psychiatry, School of Medicine, University of São Paulo, Brazil
| | | | - Fabiano Nery
- University of Cincinnati Medical Center, United States
| | - Beny Lafer
- Bipolar Disorders Program (PROMAN), Department of Psychiatry, School of Medicine, University of São Paulo, Brazil
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17
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Hansen N, Singh A, Bartels C, Brosseron F, Buerger K, Cetindag AC, Dobisch L, Dechent P, Ertl-Wagner BB, Fliessbach K, Haynes JD, Heneka MT, Janowitz D, Kilimann I, Laske C, Metzger CD, Munk MH, Peters O, Priller J, Roy N, Scheffler K, Schneider A, Spottke A, Spruth EJ, Teipel S, Tscheuschler M, Vukovich R, Wiltfang J, Duezel E, Jessen F, Goya-Maldonado R. Hippocampal and Hippocampal-Subfield Volumes From Early-Onset Major Depression and Bipolar Disorder to Cognitive Decline. Front Aging Neurosci 2021; 13:626974. [PMID: 33967736 PMCID: PMC8097178 DOI: 10.3389/fnagi.2021.626974] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/10/2021] [Indexed: 12/04/2022] Open
Abstract
Background: The hippocampus and its subfields (HippSub) are reported to be diminished in patients with Alzheimer's disease (AD), bipolar disorder (BD), and major depressive disorder (MDD). We examined these groups vs healthy controls (HC) to reveal HippSub alterations between diseases. Methods: We segmented 3T-MRI T2-weighted hippocampal images of 67 HC, 58 BD, and MDD patients from the AFFDIS study and 137 patients from the DELCODE study assessing cognitive decline, including subjective cognitive decline (SCD), amnestic mild cognitive impairment (aMCI), and AD, via Free Surfer 6.0 to compare volumes across groups. Results: Groups differed significantly in several HippSub volumes, particularly between patients with AD and mood disorders. In comparison to HC, significant lower volumes appear in aMCI and AD groups in specific subfields. Smaller volumes in the left presubiculum are detected in aMCI and AD patients, differing from the BD group. A significant linear regression is seen between left hippocampus volume and duration since the first depressive episode. Conclusions: HippSub volume alterations were observed in AD, but not in early-onset MDD and BD, reinforcing the notion of different neural mechanisms in hippocampal degeneration. Moreover, duration since the first depressive episode was a relevant factor explaining the lower left hippocampal volumes present in groups.
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Affiliation(s)
- Niels Hansen
- Department of Psychiatry and Psychotherapy, Göttingen, Germany.,Laboratory of Systems Neuroscience and Imaging in Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - Aditya Singh
- Department of Psychiatry and Psychotherapy, Göttingen, Germany.,Laboratory of Systems Neuroscience and Imaging in Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, Göttingen, Germany
| | - Frederic Brosseron
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany.,Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Arda C Cetindag
- Berlin Institute of Health, Institute of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Peter Dechent
- MR-Research in Neurology and Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - Birgit B Ertl-Wagner
- Institute for Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - John D Haynes
- Bernstein Center for Computational Neuroscience, Charité-Universitätsmedizin, Berlin, Germany
| | - Michael T Heneka
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Section for Dementia Research, Hertie Institute for Clinical Brain Research, Tübingen, Germany.,Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Coraline D Metzger
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - Matthias H Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Section for Dementia Research, Hertie Institute for Clinical Brain Research, Tübingen, Germany.,Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Oliver Peters
- Berlin Institute of Health, Institute of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Klaus Scheffler
- Department for Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Neurology, University of Bonn, Bonn, Germany
| | - Eike J Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Maike Tscheuschler
- Department of Psychiatry and Psychotherapy, University of Cologne, Medical Faculty, Cologne, Germany
| | - Ruth Vukovich
- Department of Psychiatry and Psychotherapy, Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.,Neurosciences and Signaling Group, Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Emrah Duezel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Cologne, Medical Faculty, Cologne, Germany.,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Köln, Germany
| | - Roberto Goya-Maldonado
- Department of Psychiatry and Psychotherapy, Göttingen, Germany.,Laboratory of Systems Neuroscience and Imaging in Psychiatry, University Medical Center Göttingen, Göttingen, Germany
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18
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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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19
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DNA Methylation and Allelic Polymorphism at the Dopamine Transporter Promoter Affect Internalizing and Externalizing Symptoms in Preschoolers. Child Psychiatry Hum Dev 2021; 52:281-290. [PMID: 32462358 DOI: 10.1007/s10578-020-01009-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The role of the dopamine transporter (DAT) in the onset and maintenance of emotional-behavioral difficulties is recognized in adults, adolescents and school-age children, whereas few studies in this field have focused on preschoolers. The study recruited 2-year old children (N = 152) in the general population assessing the possible effect of DAT methylation and allelic polymorphism on internalizing and externalizing symptoms, also exploring whether epigenetic and genetic variability interact. Our results showed that DAT methylation is significantly associated with all the dimensions of children's emotional/behavioral functioning in children carrying 10/10-3/3-8/10 polymorphisms but not in children carrying 9/10-9/9 allele repeats. Understanding the influence of genetic/epigenetic factors on maladaptive emotional/behavioral outcomes in young children, can be of great help in programming effective prevention and intervention plans and can be a valid aid to alleviate psychopathological symptoms before they crystalize into more severe clinical conditions in later life.
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20
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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: 4] [Impact Index Per Article: 1.3] [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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21
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Li L, Pan N, Zhang L, Lui S, Huang X, Xu X, Wang S, Lei D, Li L, Kemp GJ, Gong Q. Hippocampal subfield alterations in pediatric patients with post-traumatic stress disorder. Soc Cogn Affect Neurosci 2021; 16:334-344. [PMID: 33315100 PMCID: PMC7943370 DOI: 10.1093/scan/nsaa162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/15/2020] [Accepted: 12/14/2020] [Indexed: 02/05/2023] Open
Abstract
The hippocampus, a key structure with distinct subfield functions, is strongly implicated in the pathophysiology of post-traumatic stress disorder (PTSD); however, few studies of hippocampus subfields in PTSD have focused on pediatric patients. We therefore investigated the hippocampal subfield volume using an automated segmentation method and explored the subfield-centered functional connectivity aberrations related to the anatomical changes, in a homogenous population of traumatized children with and without PTSD. To investigate the potential diagnostic value in individual patients, we used a machine learning approach to identify features with significant discriminative power for diagnosis of PTSD using random forest classifiers. Compared to controls, we found significant mean volume reductions of 8.4% and 9.7% in the right presubiculum and hippocampal tail in patients, respectively. These two subfields' volumes were the most significant contributors to group discrimination, with a mean classification accuracy of 69% and a specificity of 81%. These anatomical alterations, along with the altered functional connectivity between (pre)subiculum and inferior frontal gyrus, may underlie deficits in fear circuitry leading to dysfunction of fear extinction and episodic memory, causally important in post-traumatic symptoms such as hypervigilance and re-experience. For the first time, we suggest that hippocampal subfield volumes might be useful in discriminating traumatized children with and without PTSD.
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Affiliation(s)
- Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xin Xu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Du Lei
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha 410008, China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L693BX, UK
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, China
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22
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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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23
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Sämann PG, Iglesias JE, Gutman B, Grotegerd D, Leenings R, Flint C, Dannlowski U, Clarke‐Rubright EK, Morey RA, Erp TG, Whelan CD, Han LKM, Velzen LS, Cao B, Augustinack JC, Thompson PM, Jahanshad N, Schmaal L. FreeSurfer
‐based segmentation of hippocampal subfields: A review of methods and applications, with a novel quality control procedure for
ENIGMA
studies and other collaborative efforts. Hum Brain Mapp 2020; 43:207-233. [PMID: 33368865 PMCID: PMC8805696 DOI: 10.1002/hbm.25326] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/26/2020] [Accepted: 12/13/2020] [Indexed: 12/11/2022] Open
Abstract
Structural hippocampal abnormalities are common in many neurological and psychiatric disorders, and variation in hippocampal measures is related to cognitive performance and other complex phenotypes such as stress sensitivity. Hippocampal subregions are increasingly studied, as automated algorithms have become available for mapping and volume quantification. In the context of the Enhancing Neuro Imaging Genetics through Meta Analysis Consortium, several Disease Working Groups are using the FreeSurfer software to analyze hippocampal subregion (subfield) volumes in patients with neurological and psychiatric conditions along with data from matched controls. In this overview, we explain the algorithm's principles, summarize measurement reliability studies, and demonstrate two additional aspects (subfield autocorrelation and volume/reliability correlation) with illustrative data. We then explain the rationale for a standardized hippocampal subfield segmentation quality control (QC) procedure for improved pipeline harmonization. To guide researchers to make optimal use of the algorithm, we discuss how global size and age effects can be modeled, how QC steps can be incorporated and how subfields may be aggregated into composite volumes. This discussion is based on a synopsis of 162 published neuroimaging studies (01/2013–12/2019) that applied the FreeSurfer hippocampal subfield segmentation in a broad range of domains including cognition and healthy aging, brain development and neurodegeneration, affective disorders, psychosis, stress regulation, neurotoxicity, epilepsy, inflammatory disease, childhood adversity and posttraumatic stress disorder, and candidate and whole genome (epi‐)genetics. Finally, we highlight points where FreeSurfer‐based hippocampal subfield studies may be optimized.
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Affiliation(s)
| | - Juan Eugenio Iglesias
- Centre for Medical Image Computing University College London London UK
- The Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology Massachusetts General Hospital/Harvard Medical School Boston Massachusetts US
- Computer Science and AI Laboratory (CSAIL), Massachusetts Institute of Technology (MIT) Cambridge Massachusetts US
| | - Boris Gutman
- Department of Biomedical Engineering Illinois Institute of Technology Chicago USA
| | | | - Ramona Leenings
- Department of Psychiatry University of Münster Münster Germany
| | - Claas Flint
- Department of Psychiatry University of Münster Münster Germany
- Department of Mathematics and Computer Science University of Münster Germany
| | - Udo Dannlowski
- Department of Psychiatry University of Münster Münster Germany
| | - Emily K. Clarke‐Rubright
- Brain Imaging and Analysis Center, Duke University Durham North Carolina USA
- VISN 6 MIRECC, Durham VA Durham North Carolina USA
| | - Rajendra A. Morey
- Brain Imaging and Analysis Center, Duke University Durham North Carolina USA
- VISN 6 MIRECC, Durham VA Durham North Carolina USA
| | - Theo G.M. Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior University of California Irvine California USA
- Center for the Neurobiology of Learning and Memory University of California Irvine Irvine California USA
| | - Christopher D. Whelan
- Imaging Genetics Center Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California Los Angeles California USA
| | - Laura K. M. Han
- Department of Psychiatry Amsterdam University Medical Centers, Vrije Universiteit and GGZ inGeest, Amsterdam Neuroscience Amsterdam The Netherlands
| | - Laura S. Velzen
- Orygen Parkville Australia
- Centre for Youth Mental Health The University of Melbourne Melbourne Australia
| | - Bo Cao
- Department of Psychiatry, Faculty of Medicine & Dentistry University of Alberta Edmonton Canada
| | - Jean C. Augustinack
- The Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology Massachusetts General Hospital/Harvard Medical School Boston Massachusetts US
| | - Paul M. Thompson
- Imaging Genetics Center Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California Los Angeles California USA
| | - Neda Jahanshad
- Imaging Genetics Center Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California Los Angeles California USA
| | - Lianne Schmaal
- Orygen Parkville Australia
- Centre for Youth Mental Health The University of Melbourne Melbourne Australia
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24
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Quidé Y, Tozzi L, Corcoran M, Cannon DM, Dauvermann MR. The Impact of Childhood Trauma on Developing Bipolar Disorder: Current Understanding and Ensuring Continued Progress. Neuropsychiatr Dis Treat 2020; 16:3095-3115. [PMID: 33364762 PMCID: PMC7751794 DOI: 10.2147/ndt.s285540] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/18/2020] [Indexed: 12/12/2022] Open
Abstract
Childhood trauma (CT) has been repeatedly linked to earlier onset and greater severity of bipolar disorder (BD) in adulthood. However, such knowledge is mostly based on retrospective and cross-sectional studies in adults with BD. The first objective of this selective review is to characterize the short-term effects of CT in the development of BD by focusing on studies in young people. The second objective is to describe the longer-term consequences of CT by considering studies with adult participants. This review first outlines the most prominent hypotheses linking CT exposure and the onset of BD. Then, it summarizes the psychological and biological risk factors implicated in the development of BD, followed by a discussion of original studies that investigated the role of CT in young people with early-onset BD, youths at increased risk of developing BD, or young people with BD with a focus on subclinical and clinical outcome measures. The review considers additional biological and psychological factors associated with a negative impact of CT on the long-term course of BD in later adulthood. Finally, we discuss how the integration of information of CT can improve ongoing early identification of BD and mitigate severe clinical expression in later adulthood.
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Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Leonardo Tozzi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Mark Corcoran
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Dara M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Maria R Dauvermann
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
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25
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Menculini G, Balducci PM, Attademo L, Bernardini F, Moretti P, Tortorella A. Environmental Risk Factors for Bipolar Disorders and High-Risk States in Adolescence: A Systematic Review. ACTA ACUST UNITED AC 2020; 56:medicina56120689. [PMID: 33322430 PMCID: PMC7763529 DOI: 10.3390/medicina56120689] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/29/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022]
Abstract
Background and objectives: A deeper comprehension of the role that environmental risk factors play in the development of adolescent Bipolar Disorder (BD), as well as in the evolution of high-risk states for BD, may entangle further prevention and treatment advances. The present systematic review is aimed at critically summarizing evidence about the role that environmental risk factors play in the development of BD in adolescence and their interaction with BD high-risk states. Materials and Methods: MEDLINE/Pubmed, Scopus and Web of Science datasets were systematically searched until 4 September 2020. Original studies that reported information about the role of environmental risk factors in the development of BD during adolescence, or assessing their influence on the development of psychopathology in high-risk states for BD, were considered for inclusion. Two blind researchers performed title/abstract, full-text screening, and hand-screening of relevant references. The risk of bias was assessed by means of the Newcastle-Ottawa Scale. Results: Fourteen studies were included in the review. Negative stressful life events, particularly sexual and physical abuse, but also emotional mistreatment, were associated with more severe psychopathology in adolescents with BD, as well as with higher risk for developing mood disorders in BD offspring. Similar findings were detected for familial environment-related features, such as parental rejection and low perceived care, while no univocal results were found when analyzing familial functioning. Conclusions: The present systematic review confirmed the relevant role that environmental risk factors, particularly negative stressful live events and family-related features, play in the development of BD psychopathology during adolescence. Future studies are expected to clarify possible further environmental factors that may be implicated in the development of BD during youth that may serve as target of prevention and early treatment strategies.
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Affiliation(s)
- Giulia Menculini
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy; (G.M.); (P.M.B.); (P.M.)
| | - Pierfrancesco Maria Balducci
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy; (G.M.); (P.M.B.); (P.M.)
- CSM Terni, Department of Mental Health, AUSL Umbria 2, Via Bramante 40, 05100 Terni, Italy
| | - Luigi Attademo
- SPDC Potenza, Department of Mental Health, ASP Basilicata, Italian National Health Service, Via Petrone, 85100 Potenza, Italy;
| | - Francesco Bernardini
- Department of Mental Health, AsFO Friuli Occidentale, Via Vecchia Ceramica 1, 33170 Pordenone, Italy;
| | - Patrizia Moretti
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy; (G.M.); (P.M.B.); (P.M.)
| | - Alfonso Tortorella
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi 1, 06132 Perugia, Italy; (G.M.); (P.M.B.); (P.M.)
- Correspondence: ; Tel.: +39-(07)-5578-3194
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26
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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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Mazza M, Attanasio M, Pino MC, Masedu F, Tiberti S, Sarlo M, Valenti M. Moral Decision-Making, Stress, and Social Cognition in Frontline Workers vs. Population Groups During the COVID-19 Pandemic: An Explorative Study. Front Psychol 2020; 11:588159. [PMID: 33329249 PMCID: PMC7710972 DOI: 10.3389/fpsyg.2020.588159] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/28/2020] [Indexed: 12/13/2022] Open
Abstract
On March 9, 2020, Italy has gone into "lockdown" because of COVID-19 pandemic, with a national quarantine. All non-essential working activities and schools of all levels have been temporarily closed: consequently, the entire population have been forced to dramatically change their daily habits. The pandemic raised important psychological, moral, social, and economic issues. Our research focused on the moral decision-making of people during an emergency. This paper reports two studies. The aim of Study 1 was to evaluate moral decision-making, level of perceived stress, ability of mentalizing and empathy in university students and Italian workers. 224 front-line workers (FLW), 413 second-line workers (SLW), and 663 university students (US), during Italian Phase 1 of lockdown, completed an online questionnaire. The results of Study 1 showed that participants in the FLW group are more likely to choose utilitarian solutions and judge as morally acceptable actions finalized to saving lives of more people if this requires sacrificing a low number of individuals. At the same time, decision-making was experienced as less unpleasant and less arousing with respect to the other two groups, demonstrating a greater ability to keep emotional control under pressure. In Study 2, we compared the same variables used in Study 1, selecting two professional categories from the FLW group engaged in emergency during COVID-19, namely healthcare providers (n = 82) and public safety personnel (n = 117). Our results showed that healthcare providers were more stressed and emotionally involved than public safety personnel, with higher empathic concern and arousal in moral decision-making. We suggest it is essential providing immediate psychological support and monitoring physical and emotional well-being for workers in the front-line during emergencies like the COVID-19 pandemic, in order to prevent experiences of moral distress or mental health problems.
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Affiliation(s)
- Monica Mazza
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
- Regional Centre for Autism, Abruzzo Region Health System, L’Aquila, Italy
| | - Margherita Attanasio
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
- Regional Centre for Autism, Abruzzo Region Health System, L’Aquila, Italy
| | - Maria Chiara Pino
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
- Regional Centre for Autism, Abruzzo Region Health System, L’Aquila, Italy
| | - Francesco Masedu
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
| | - Sergio Tiberti
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
| | - Michela Sarlo
- Department of Communication Sciences, Humanities and International Studies, University of Urbino Carlo Bo, Urbino, Italy
| | - Marco Valenti
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
- Regional Centre for Autism, Abruzzo Region Health System, L’Aquila, Italy
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Chen YL, Tu PC, Huang TH, Bai YM, Su TP, Chen MH, Wu YT. Using Minimal-Redundant and Maximal-Relevant Whole-Brain Functional Connectivity to Classify Bipolar Disorder. Front Neurosci 2020; 14:563368. [PMID: 33192250 PMCID: PMC7641629 DOI: 10.3389/fnins.2020.563368] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/23/2020] [Indexed: 12/04/2022] Open
Abstract
Background A number of mental illness is often re-diagnosed to be bipolar disorder (BD). Furthermore, the prefronto-limbic-striatal regions seem to be associated with the main dysconnectivity of BD. Functional connectivity is potentially an appropriate objective neurobiological marker that can assist with BD diagnosis. Methods Health controls (HC; n = 173) and patients with BD who had been diagnosed by experienced physicians (n = 192) were separated into 10-folds, namely, a ninefold training set and a onefold testing set. The classification involved feature selection of the training set using minimum redundancy/maximum relevance. Support vector machine was used for training. The classification was repeated 10 times until each fold had been used as the testing set. Results The mean accuracy of the 10 testing sets was 76.25%, and the area under the curve was 0.840. The selected functional within-network/between-network connectivity was mainly in the subcortical/cerebellar regions and the frontoparietal network. Furthermore, similarity within the BD patients, calculated by the cosine distance between two functional connectivity matrices, was smaller than between groups before feature selection and greater than between groups after the feature selection. Limitations The major limitations were that all the BD patients were receiving medication and that no independent dataset was included. Conclusion Our approach effectively separates a relatively large group of BD patients from HCs. This was done by selecting functional connectivity, which was more similar within BD patients, and also seems to be related to the neuropathological factors associated with BD.
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Affiliation(s)
- Yen-Ling Chen
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan
| | - Tzu-Hsuan Huang
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Cheng-Hsin General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Te Wu
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming University, Taipei, Taiwan
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Li K, Zhang H, Wang B, Yang Y, Zhang M, Li W, Li X, Lv L, Zhao J, Zhang H. Hippocampal functional network: The mediating role between obsession and anxiety in adult patients with obsessive-compulsive disorder. World J Biol Psychiatry 2020; 21:685-695. [PMID: 32174208 DOI: 10.1080/15622975.2020.1733082] [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: 01/13/2023]
Abstract
OBJECTIVES Anxiety is a very common symptom and closely related to obsessive-compulsive symptoms in obsessive-compulsive disorder (OCD). However, the association between anxiety and obsessive-compulsive symptoms at the hippocampus network level remains unclear. METHODS This study enrolled 42 patients with OCD and 42 healthy controls (HCs), who underwent resting-state functional magnetic resonance imaging (fMRI) and clinical evaluation. Multiple linear regression analysis was performed to investigate the behavioural significance and interactive effects of obsessive-compulsive and anxiety symptoms on the hippocampus functional connectivity (HFC). The mediation analysis model was used to explore whether the hippocampus functional connectivity (FC) network indirectly mediated the relationship between obsessive-compulsive symptoms and anxiety. RESULTS Results showed that the FCs with the cerebellum, middle temporal gyrus (MTG) and anterior cingulate gyrus (ACG) were increased in the hippocampus FC network in patients with OCD compared with those in HCs. The regions of interactive effects between anxiety and obsession, which are mainly located in the prefrontal cortex and MTG, were positively correlated. The mediation effect is 0.018 between obsession and anxiety on the HFC networks in patients with OCD. CONCLUSIONS The FC between the hippocampus and MTG plays a key role in the relationship between anxiety and obsession.
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Affiliation(s)
- Kun Li
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China
| | - Haisan Zhang
- Department of Radiology, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China
| | - Bi Wang
- Department of Radiology, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China
| | - Yongfeng Yang
- Henan Key Lab of Biological Psychiatry, Xinxiang, P. R. China
| | - Meng Zhang
- School of Psychology, Xinxiang Medical University, Xinxiang, P. R. China
| | - Wenqiang Li
- Henan Key Lab of Biological Psychiatry, Xinxiang, P. R. China
| | - Xianrui Li
- School of Psychology, Xinxiang Medical University, Xinxiang, P. R. China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China.,Henan Key Lab of Biological Psychiatry, Xinxiang, P. R. China
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, P. R. China
| | - Hongxing Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China.,Henan Key Lab of Biological Psychiatry, Xinxiang, P. R. China.,School of Psychology, Xinxiang Medical University, Xinxiang, P. R. China
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30
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Li L, Reinhardt JD, Pennycott A, Li Y, Chen Q. Prevalence of and Risk Factors for Depression Among Older Persons 6 Months After the Lushan Earthquake in China: A Cross-Sectional Survey. Front Psychiatry 2020; 11:853. [PMID: 33132921 PMCID: PMC7549460 DOI: 10.3389/fpsyt.2020.00853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 08/05/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Older persons are particularly vulnerable to the impact of earthquakes and are more likely to suffer from depression. OBJECTIVES We aimed to estimate the prevalence of depression, to compare the prevalence between disaster-affected and non-disaster affected areas, and to explore additional risk factors for depression 6 months after the Lushan earthquake. DESIGN A cross-sectional study was conducted. SETTING A magnitude 7.0 earthquake occurred in Lushan County, Ya'an Prefecture, Sichuan Province, on April 20, 2013. In total, 196 people were killed, and 11,470 were injured over 5 days. PARTICIPANTS A multistage cluster sampling strategy was used. A total of 1,509 older persons (aged 60 or older) participated. METHODS The Geriatric Depression Scale-15, the University of California Los Angeles Loneliness scale, the Activities of Daily Living Scale, the Social Support Rating Scale, and the Family Apgar Index scale were used to evaluate symptoms of depression, loneliness, dependence with respect to activities of daily living, perceived social support, and family function, respectively. A generalized linear regression model and multiple logistic regression analysis were employed to identify risk factors for depression. RESULTS Using a cutoff score of 8, the prevalence of depression was 29.16% in the hardest-hit disaster area, 29.06% in the hard-hit disaster area, 31.61% in the moderately-hit disaster area, 17.94% in the remote non-disaster area, and 12.28% in the neighboring non-disaster area. The prevalence was significantly higher in the disaster areas than in the non-disaster areas. Risk factors for depression included an educational level of elementary school or lower, a greater number of chronic illnesses, feelings of loneliness, limitations in activities of daily living, family dysfunction, and low levels of social support. CONCLUSION Depression was highly prevalent in elderly survivors and was significantly more prevalent in disaster areas than in non-disaster areas. Psychological interventions and care should focus on older survivors.
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Affiliation(s)
- Lan Li
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
- School of Nursing, Southwest Medical University, Luzhou, China
- The Hong Kong Polytechnic University Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jan D. Reinhardt
- The Hong Kong Polytechnic University Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Andrew Pennycott
- Sensory-Motor Systems Lab, Department of Health Science and Technology ETH Zürich, Zürich, Switzerland
| | - Ying Li
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Chen
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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31
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Janiri D. Neurobiological perspectives for the ACE model. Bipolar Disord 2020; 22:629-630. [PMID: 32297423 DOI: 10.1111/bdi.12913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Delfina Janiri
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.,Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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Janiri D, Simonetti A, Piras F, Ciullo V, Spalletta G, Sani G. Predominant polarity and hippocampal subfield volumes in Bipolar disorders. Bipolar Disord 2020; 22:490-497. [PMID: 31630469 DOI: 10.1111/bdi.12857] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Predominant polarity (PP) is a proposed course specifier for bipolar disorders (BD) based on patient lifetime mood episodes. Hippocampal subfield volumetric changes have been proposed as a neurobiological marker for BD and could be influenced by mood episodes. Our study aimed to test the hypothesis that patients with BD differ in hippocampal subfield volumes according to their PP. METHODS We assessed 172 outpatients, diagnosed with BD according to DSM-IV-TR criteria, and 150 healthy control (HC) participants. High-resolution magnetic resonance imaging was performed on all subjects and volumes of all hippocampal subfields were measured using FreeSurfer. RESULTS Patients with depressive PP (BD-DP) and with uncertain PP (BD-UP) but not with manic/hypomanic PP (BD-MP) showed a global reduction on all hippocampal subfield volumes with respect to HCs. When directly compared, BD-DP presented with smaller bilateral presubiculum/subiculum volumes than BD-MP. CONCLUSIONS Results support the potential utility of PP not only as a clinical but also as a neurobiological specifier of BD.
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Affiliation(s)
- Delfina Janiri
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Lucio Bini Center, Rome, Italy
| | - Alessio Simonetti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.,Lucio Bini Center, Rome, Italy.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Fabrizio Piras
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Valentina Ciullo
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Gianfranco Spalletta
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Gabriele Sani
- Lucio Bini Center, Rome, Italy.,NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.,Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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33
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Fries GR, Bauer IE, Scaini G, Valvassori SS, Walss-Bass C, Soares JC, Quevedo J. Accelerated hippocampal biological aging in bipolar disorder. Bipolar Disord 2020; 22:498-507. [PMID: 31746071 DOI: 10.1111/bdi.12876] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Evidence suggests accelerated aging mechanisms in bipolar disorder (BD), including DNA methylation (DNAm) aging in blood. However, it is unknown whether such mechanisms are also evident in the brain, in particular in association with other biological clocks. To investigate this, we interrogated genome-wide DNAm in postmortem hippocampus from 32 BD-I patients and 32 non-psychiatric controls group-matched for age and sex from the NIMH Human Brain Collection Core. METHODS DNAm age and epigenetic aging acceleration were estimated using the Horvath method. Telomere length (TL) and mitochondrial DNA (mtDNA) copy number were quantified by real-time PCR. Between-group differences were assessed by linear regression and univariate general linear models with age, sex, race, postmortem interval, tissue pH, smoking, and body mass index included as co-variates. RESULTS Groups did not differ for epigenetic aging acceleration when considering the entire sample. However, after splitting the sample by the median age, an epigenetic aging acceleration was detected in patients compared to controls among older subjects (P = .042). While TL did not differ between groups, a reduction in mtDNA copy number was observed in patients compared to controls (P = .047). In addition, significant correlations were observed between epigenetic aging acceleration and TL (r = -.337, P = .006), as well as between TL and mtDNA copy number (r = .274, P = .028). CONCLUSIONS Hippocampal aging may underlie neurocognitive dysfunctions observed in BD patients. Moreover, our results suggest a complex cross-talk between biological clocks in hippocampus that may underlie clinical manifestations of premature aging in BD.
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Affiliation(s)
- Gabriel R Fries
- Translational Psychiatry Program, Faillace Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Center for Precision Health, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Isabelle E Bauer
- Center of Excellence in Mood Disorders, Faillace Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Giselli Scaini
- Translational Psychiatry Program, Faillace Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Samira S Valvassori
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil
| | - Consuelo Walss-Bass
- Translational Psychiatry Program, Faillace Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Jair C Soares
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.,Center of Excellence in Mood Disorders, Faillace Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Joao Quevedo
- Translational Psychiatry Program, Faillace Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.,Center of Excellence in Mood Disorders, Faillace Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil
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Fuchshuber J, Unterrainer HF. Childhood Trauma, Personality, and Substance Use Disorder: The Development of a Neuropsychoanalytic Addiction Model. Front Psychiatry 2020; 11:531. [PMID: 32581894 PMCID: PMC7296119 DOI: 10.3389/fpsyt.2020.00531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/22/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND While traditional psychoanalysis has been criticized as insufficient for the treatment of substance use disorder (SUD), recent progress in the field of neuropsychoanalysis has generated new and promising hypotheses regarding its etiology. However, empirical research applying this framework has been sparse. AIM AND SCOPE The present overview aims at developing and empirically validating a neuroscientifically informed psychodynamic framework regarding the etiology of SUD. For this purpose, this review provides a concise overview of the most relevant historical and contemporary psychoanalytic theories on SUD etiology. Furthermore, the original research summarized in this paper consists of three studies investigating connections between childhood trauma, primary emotions, personality structure and attachment, as well as their relation to SUD development and treatment. CONCLUSIONS The results highlight the empirical validity of the neuropsychoanalytic approach towards SUD etiology. In particular, the findings underscore the conceptualization of SUD as a disorder related to dysfunctional attachment and affect regulation abilities especially linked to increased SADNESS and ANGER dispositions, which mediated the relationship between SUD and traumatic childhood relationships. Based on these findings, a refined model of SUD etiology is proposed, which should be tested in future studies.
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Affiliation(s)
- Jürgen Fuchshuber
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria
- University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Human Friedrich Unterrainer
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria
- University Clinic for Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
- Department of Religious Studies, University of Vienna, Vienna, Austria
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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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Abstract
The construct of mixed states is a robust clinical entity with a high variability of prevalence according to different diagnostic criteria. Despite the changes over the years, current official diagnostic criteria still have poor clinical usefulness. Premorbid characteristics with a potential high clinical importance such as temperament, personality, and emotional reactivity are understudied in patients with mixed states and excluded from the current nosologic systems. The authors provide an overview of current nosography and clinical pictures of mixed states and discuss the role of temperament, personality, and emotional reactivity in mixed states.
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Carmassi C, Bertelloni CA, Dell'Oste V, Foghi C, Diadema E, Cordone A, Pedrinelli V, Dell'Osso L. Post-traumatic stress burden in a sample of hospitalized patients with Bipolar Disorder: Which impact on clinical correlates and suicidal risk? J Affect Disord 2020; 262:267-272. [PMID: 31732278 DOI: 10.1016/j.jad.2019.10.044] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/05/2019] [Accepted: 10/28/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Increasing evidence suggests Bipolar Disorder (BD) to be frequently associated to a history of traumatic experiences and Post-traumatic Stress Disorder (PTSD), with consequent greater symptoms severity, number of hospitalizations and worsening in quality of life. The aim of the present study was to investigate the lifetime exposure to traumatic events and PTSD rates in-patients with BD and to analyze the relationships between PTSD symptoms, clinical characteristics and severity of the mood disorder. METHODS A consecutive sample of 212 in-patients with a DSM-5 diagnosis of BD was enrolled at the psychiatric unit of a major University hospital in Italy and assessed by the SCID-5 and MOOD Spectrum-Self Report lifetime version (MOODS-SR). Socio-demographic characteristics, clinical features, substance or alcohol abuse, history of suicide related behaviors were also collected. RESULTS Lifetime trauma exposure emerged in 72.3% subjects, with a DSM-5 PTSD diagnosis reported by 35.6%. Patients with PTSD showed more frequently a (hypo)manic episode at onset, alcohol or substance abuse, psychotic features, suicide behaviors, higher scores in almost all the MOODS-SR domains, compared to those without PTSD. LIMITATIONS Cross sectional study. Lack of data about the time since trauma exposure or PTSD onset. CONCLUSIONS Our findings show a history of multiple traumatic experiences in hospitalized patients with BD besides high rates of PTSD, with the co-occurrence of these conditions appearing to be related to a more severe BD. Detailed investigation of post-traumatic stress symptoms is recommended for the relevant implications on the choice of a tailored treatment and the prognosis assessment.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Carlo Antonio Bertelloni
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Claudia Foghi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Elisa Diadema
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Annalisa Cordone
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
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Janiri D, Kotzalidis GD, Giuseppin G, Molinaro M, Modica M, Montanari S, Terenzi B, Carfì A, Landi F, Sani G. Psychological Distress After Covid-19 Recovery: Reciprocal Effects With Temperament and Emotional Dysregulation. An Exploratory Study of Patients Over 60 Years of Age Assessed in a Post-acute Care Service. Front Psychiatry 2020; 11:590135. [PMID: 33304286 PMCID: PMC7693440 DOI: 10.3389/fpsyt.2020.590135] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/13/2020] [Indexed: 01/24/2023] Open
Abstract
To study the long-term psychological effects of Covid-19 disease, we recruited 61 patients older than 60 years of age and administered the Kessler questionnaire K10 to assess psychological distress and classify them according to mental health risk groups. Patients' affective temperaments were assessed with the 39-item form of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-A-39) and emotional dysregulation with the Difficulties in Emotion Regulation Scale (DERS). Patients were divided in two samples according to their scores on the K10, i.e., a high likelihood of psychological distress group (N = 18) and a low likelihood of psychological distress group (N = 43). The two groups differed on their gender composition, in that more women (N = 11) were in the former and more men in the latter (N = 29) (χ2 = 4.28; p = 0.039). The high likelihood of psychological distress group scored higher on the Cyclothymic (3.39 ± 3.45 vs. 0.93 ± 1.08, p < 0.001) and the Depressive (2.28 ± 2.82 vs. 0.65 ± 1.09, p = 0.01) affective temperaments of the TEMPS and on the lack of Impulse control (12.67 ± 4.04 vs. 9.63 ± 3.14, p = 0.003) and lack of Clarity (15.00 ± 5.56 vs. 9.85 ± 4.67, p = 0.004) scales of the DERS. Our results show that having had Covid-19 may be related with high likelihood for psychological distress in advanced-age people and this may in turn be associated with impaired emotional regulation and higher scores on depressive and cyclothymic temperaments.
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Affiliation(s)
- Delfina Janiri
- Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy.,Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Georgios D Kotzalidis
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Giulia Giuseppin
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marzia Molinaro
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Modica
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Silvia Montanari
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Beatrice Terenzi
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angelo Carfì
- Geriatrics Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesco Landi
- Geriatrics Department, 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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Janiri D, Sani G, Piras F, Simonetti A, Spalletta G. Understanding trauma-induced hippocampal subfield volume changes in the context of age and health. Response to Malhi et al. J Affect Disord 2020; 260:24-25. [PMID: 31493634 DOI: 10.1016/j.jad.2019.08.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 08/17/2019] [Indexed: 02/04/2023]
Abstract
It is important to integrate findings converging from different perspectives to better contextualize hippocampal subfield changes induced by childhood trauma (CT). Here we integrate Malhi's et al. model on this issue. Understanding the complex neurobiological mechanisms underpinning CT could address the multifaceted nature of resilience to traumatic life experiences that may cause different effects in health and disease.
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Affiliation(s)
- Delfina Janiri
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Gabriele Sani
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, Rome, Italy; Centro Lucio Bini, Rome, Italy; Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Fabrizio Piras
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Alessio Simonetti
- 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
| | - 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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Zaorska J, Kopera M, Trucco EM, Suszek H, Kobyliński P, Jakubczyk A. Childhood Trauma, Emotion Regulation, and Pain in Individuals With Alcohol Use Disorder. Front Psychiatry 2020; 11:554150. [PMID: 33192667 PMCID: PMC7661433 DOI: 10.3389/fpsyt.2020.554150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction: Several studies have confirmed that the experience of childhood trauma, poor emotion regulation, as well as the experience of physical pain may contribute to the development and poor treatment outcomes of alcohol use disorder (AUD). However, little is known about how the joint impact of these experiences may contribute to AUD. Objectives: To analyze associations between childhood trauma, emotion regulation, and pain in individuals with AUD. Methods: The study sample included 165 individuals diagnosed with AUD. The Childhood Trauma Questionnaire (CTQ) was used to investigate different types of trauma during childhood (physical, emotional, and sexual abuse and neglect), the Brief Symptom Inventory was used to assess anxiety symptoms, the Difficulties in Emotion Regulation Scale (DERS) was used to assess emotional dysregulation, and the Pain Resilience Scale and Pain Sensitivity Questionnaire were used to measure self-reported pain tolerance and sensitivity. Results: Childhood emotional abuse (CTQ subscale score) was positively associated with anxiety, anxiety was positively associated with emotional dysregulation, and emotional dysregulation was negatively associated with pain tolerance. Accordingly, there was support for a significant indirect negative association between childhood emotional abuse and pain tolerance. The serial mediation statistical procedure demonstrated that anxiety and emotional dysregulation mediated the effect of childhood emotional abuse on pain resilience among individuals with AUD. Conclusions: Targeting emotional dysregulation and physical pain that can result from childhood trauma may have particular therapeutic utility among individuals treated for AUD.
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Affiliation(s)
- Justyna Zaorska
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Elisa M Trucco
- Department of Psychology and the Center for Children and Families, Florida International University, Miami, FL, United States.,Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, United States
| | - Hubert Suszek
- Department of Psychology, University of Warsaw, Warsaw, Poland
| | - Paweł Kobyliński
- Laboratory of Interactive Technologies, National Information Processing Institute, Warsaw, Poland
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
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Simonetti A, Koukopoulos AE, Kotzalidis GD, Janiri D, De Chiara L, Janiri L, Sani G. Stabilization Beyond Mood: Stabilizing Patients With Bipolar Disorder in the Various Phases of Life. Front Psychiatry 2020; 11:247. [PMID: 32395107 PMCID: PMC7197486 DOI: 10.3389/fpsyt.2020.00247] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/13/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND There are different ways to define stabilization and currently, the main standpoint regards it as no-depression/no-mania. Furthermore, each person is physiologically different from childhood to adulthood, and in old age, thus the meaning of stabilization should take into account both growth and maturity. We aimed to review systematically studies focusing on mood stabilization in all phases of bipolar disorder (BD) and across all life phases, including pregnancy and the perinatal period, which is still a different phase in women's life cycles. METHODS We carried out a PubMed search focusing on studies of bipolar disorder treated with drugs and aimed at stabilization with the following search strategy stabiliz*[ti] OR stabilis*[ti] OR stable[ti] OR stability[ti]) AND mood[ti] AND bipolar. In conducting our review, we followed the PRISMA statement. Agreement on inclusion was reached by consensus of all authors through a Delphi rounds procedure. RESULTS The above search strategy produced 509 records on January 25, 2020. Of them, 58 fitted our inclusion criteria and were discussed. The eligible studies spanned from September 1983 to July 6, 2019. CONCLUSIONS No clear-cut indications could be drawn due to a number of limitations involving sample inconsistency and different methods of assessing mood stabilization. The evidence collected so far does not allow recommended treatments for Adolescents, pregnant or perinatal women, and aged patients. However, adults, not within these groups, better focused upon. For their manic/mixed phases, second generation antipsychotic drugs may be useful in the short-to-medium run, alone or combined with mood stabilizers (MSs). However, MSs, and especially lithium, continue to be pivotal in chronic treatment. Bipolar depression should rely on MSs, but an antidepressant may be added on and can prove to be helpful. However, there are concerns with the tendency of antidepressants to induce the opposite polarity or mood instability, rendering the need for concurrent MS prescription mandatory.
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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 Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.,Centro Lucio Bini, Rome, Italy
| | - 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
| | - Georgios D Kotzalidis
- Centro Lucio Bini, Rome, Italy.,NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Delfina Janiri
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.,Centro Lucio Bini, Rome, Italy
| | - Lavinia De Chiara
- Centro Lucio Bini, Rome, Italy.,NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Luigi Janiri
- Institute of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Psychiatry, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - 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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Malhi GS, Das P, Bell E, Mannie Z. Understanding trauma-induced hippocampal subfield volume changes in the context of age and health. J Affect Disord 2019; 257:150-151. [PMID: 31301616 DOI: 10.1016/j.jad.2019.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 07/04/2019] [Indexed: 12/17/2022]
Abstract
There is an urgent need to integrate the findings converging from different perspectives examining hippocampal volume changes both overall but in particular within its subfields in relation to childhood trauma and illness. We comment on a recent paper's findings and link these to our own research in an effort to provide impetus to this endeavor.
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Affiliation(s)
- Gin S Malhi
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia; Sydney Medical School Northern, University of Sydney, NSW, Australia; CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.
| | - Pritha Das
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia; Sydney Medical School Northern, University of Sydney, NSW, Australia; CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Erica Bell
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia; Sydney Medical School Northern, University of Sydney, NSW, Australia; CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Zola Mannie
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia; Sydney Medical School Northern, University of Sydney, NSW, Australia; CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia; NSW Health and Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
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