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Zhu T, Simonetti A, Ouyang M, Kurian S, Saxena J, Soares JC, Saxena K, Huang H. Disrupted white matter microstructure correlates with impulsivity in children and adolescents with bipolar disorder. J Psychiatr Res 2023; 158:71-80. [PMID: 36577236 PMCID: PMC9898209 DOI: 10.1016/j.jpsychires.2022.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/29/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
Altered white matter (WM) microstructure likely occurs in children with bipolar disorder (BD) with impulsivity representing one of the core features. However, altered WM microstructures and their age-related trendlines in children with BD and those at high-risk of developing BD, as well as correlations of WM microstructures with impulsivity, have been poorly investigated. In this study, diffusion MRI, cognitive, and impulsivity assessments were obtained from children/adolescents diagnosed with BD, offspring of individuals with BD (high-risk BD) and age-matched healthy controls. A novel atlas-based WM skeleton measurement approach was used to quantify WM microstructural integrity with all diffusion-tensor-imaging (DTI) metrics including fractional anisotropy, axial, mean and radial diffusivity to survey entire WM tracts and ameliorate partial volume effects. Among all DTI-derived metric measures, radial diffusivity quantifying WM myelination was found significantly higher primarily in corpus callosum and in the corona radiata in children with BD compared to controls. Distinguished from age-related progressively decreasing diffusivities and increasing fractional anisotropy in healthy controls, flattened age-related trendlines were found in BD group, and intermediate developmental rates were observed in high-risk group. Larger radial diffusivity in the corpus callosum and corona radiata significantly correlated with shorter response times to affective words that indicate higher impulsivity in the BD group, whereas no such correlation was found in the healthy control group. This work corroborates the progressive nature of pediatric BD and suggests that WM microstructural disruption involved in affective regulation and sensitive to impulsivity may serve as a biomarker of pediatric BD progression.
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Affiliation(s)
- Tianjia Zhu
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, USA
| | - Alessio Simonetti
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Minhui Ouyang
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sherin Kurian
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Johanna Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Jair C Soares
- Department of Psychiatry, McGovern Medical School at UTHealth, Houston, TX, USA
| | - Kirti Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
| | - Hao Huang
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Simonetti A, Lijffijt M, Kurian S, Saxena J, Janiri D, Mazza M, Carriero G, Moccia L, Mwangi B, Swann AC, Soares JC. Neuroanatomical Correlates of the Late Positive Potential in Youth with Pediatric Bipolar Disorder. Curr Neuropharmacol 2023; 21:1617-1630. [PMID: 37056060 PMCID: PMC10472816 DOI: 10.2174/1570159x21666230413104536] [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: 05/13/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND The late positive potential (LPP) could be a marker of emotion dysregulation in youth with pediatric bipolar disorder (PBD). However, the neuroanatomical correlates of the LPP are still not clarified. OBJECTIVE To provide cortical and deep gray matter correlates of the LPP in youth, specifically, youth with PBD. METHODS Twenty-four 7 to 17 years-old children with PBD and 28 healthy controls (HC) underwent cortical thickness and deep gray matter volumes measurements through magnetic resonance imaging and LPP measurement elicited by passively viewing emotional faces through electroencephalography. T-tests compared group differences in LPP, cortical thickness, and deep gray matter volumes. Linear regressions tested the relationship between LPP amplitude and cortical thickness/deep gray matter volumes. RESULTS PBD had a more pronounced LPP amplitude for happy faces and a thinner cortex in prefrontal areas than HC. While considering both groups, a higher LPP amplitude was associated with a thicker cortex across occipital and frontal lobes, and with a smaller right globus pallidus volume. In addition, a higher LPP amplitude for happy faces was associated with smaller left caudate and left globus pallidus volumes across both groups. Finally, the LPP amplitude correlated negatively with right precentral gyrus thickness across youth with PBD, but positively across HC. CONCLUSION Neural correlates of LPP in youth included fronto-occipital areas that have been associated also with emotion processing and control. The opposite relationship between BPD and HC of LPP amplitude and right precentral gyrus thickness might explain the inefficacy of the emotional control system in PBD.
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Affiliation(s)
- Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
- Department of Neuroscience, Section of Psychiatry; Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Marijn Lijffijt
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
- Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA
| | - Sherin Kurian
- Department of Psychiatry, Texas Children’s Hospital, Houston, TX, 77030, USA
| | - Johanna Saxena
- Department of Psychiatry, Texas Children’s Hospital, Houston, TX, 77030, USA
| | - Delfina Janiri
- Department of Neuroscience, Section of Psychiatry; Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Marianna Mazza
- Department of Neuroscience, Section of Psychiatry; Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Giulio Carriero
- Department of Neuroscience, Section of Psychiatry; Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Lorenzo Moccia
- Department of Neuroscience, Section of Psychiatry; Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, 77030, USA
| | - Alan C. Swann
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
- Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA
| | - Jair C. Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, 77030, USA
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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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