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Yates JR. Aberrant glutamatergic systems underlying impulsive behaviors: Insights from clinical and preclinical research. Prog Neuropsychopharmacol Biol Psychiatry 2024; 135:111107. [PMID: 39098647 DOI: 10.1016/j.pnpbp.2024.111107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 07/07/2024] [Accepted: 07/24/2024] [Indexed: 08/06/2024]
Abstract
Impulsivity is a broad construct that often refers to one of several distinct behaviors and can be measured with self-report questionnaires and behavioral paradigms. Several psychiatric conditions are characterized by one or more forms of impulsive behavior, most notably the impulsive/hyperactive subtype of attention-deficit/hyperactivity disorder (ADHD), mood disorders, and substance use disorders. Monoaminergic neurotransmitters are known to mediate impulsive behaviors and are implicated in various psychiatric conditions. However, growing evidence suggests that glutamate, the major excitatory neurotransmitter of the mammalian brain, regulates important functions that become dysregulated in conditions like ADHD. The purpose of the current review is to discuss clinical and preclinical evidence linking glutamate to separate aspects of impulsivity, specifically motor impulsivity, impulsive choice, and affective impulsivity. Hyperactive glutamatergic activity in the corticostriatal and the cerebro-cerebellar pathways are major determinants of motor impulsivity. Conversely, hypoactive glutamatergic activity in frontal cortical areas and hippocampus and hyperactive glutamatergic activity in anterior cingulate cortex and nucleus accumbens mediate impulsive choice. Affective impulsivity is controlled by similar glutamatergic dysfunction observed for motor impulsivity, except a hyperactive limbic system is also involved. Loss of glutamate homeostasis in prefrontal and nucleus accumbens may contribute to motor impulsivity/affective impulsivity and impulsive choice, respectively. These results are important as they can lead to novel treatments for those with a condition characterized by increased impulsivity that are resistant to conventional treatments.
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Affiliation(s)
- Justin R Yates
- Department of Psychological Science, Northern Kentucky University, 1 Nunn Drive, Highland Heights, KY 41099, USA.
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Cong E, Zhong Y, Wu M, Chen H, Cai Y, Ling Z, Wang Y, Wen H, Hu Y, Zhang H, Li Y, Liu X, Zhong P, Lai W, Xu Y, Wu Y. Hippocampal subfield morphology from first episodes of bipolar disorder type II and major depressive disorder in a drug naïve Chinese cohort. Front Psychiatry 2024; 15:1438144. [PMID: 39119073 PMCID: PMC11306163 DOI: 10.3389/fpsyt.2024.1438144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 07/05/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Symptoms during the onset of major depressive disorder [MDD] and bipolar disorder type II [BD-II] are similar. The difference of hippocampus subregion could be a biological marker to distinguish MDD from BD-II. Methods We recruited 61 drug-naïve patients with a first-episode MDD and BD-II episode and 30 healthy controls (HC) to participate in a magnetic resonance imaging [MRI] study. We built a general linear model (one-way analysis of covariance) with 22 hippocampal subfields and two total hippocampal volumes as dependent variables, and the diagnosis of MDD, BD-II, and HC as independent variables. We performed pair-wise comparisons of hippocampal subfield volumes between MDD and HC, BD-II and MDD, BD-II and HC with post hoc for primary analysis. Results We identified three regions that differed significantly in size between patients and controls. The left hippocampal fissure, the hippocampal-amygdaloid transition area (HATA), and the right subiculum body were all significantly larger in patients with MDD compared with the HC. In the onset of first-episode of MDD, the hippocampal volume increased significantly, especially on the left side comparing to HC. However, we found differences between MDD and BD-II were not statistically significant. The volume of the left HATA and right subiculum body in BD-II was larger. Conclusions The sample size of this study is relatively small, as it is a cross-sectional comparative study. In both MDD and BD-II groups, the volume of more left subregions appeared to increase. The left subregions were severely injured in the development of depressive disorder.
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Affiliation(s)
- Enzhao Cong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yingyan Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengyue Wu
- X-LANCE Lab, Department of Computer Science and Engineering, MoE Key Lab of Artificial Intelligence, AI Institute Shanghai Jiao Tong University, Shanghai, China
| | - Haiying Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiyun Cai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Ling
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yao Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huifeng Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaohua Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pingfang Zhong
- Affective Disorder Department, Lincang Psychiatric Hospital, Lincang, China
| | - Weijie Lai
- Psychiatric Department, Zhangzhou Fukang Hospital, Zhangzhou, China
| | - Yifeng Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kennedy E, Liebel SW, Lindsey HM, Vadlamani S, Lei PW, Adamson MM, Alda M, Alonso-Lana S, Anderson TJ, Arango C, Asarnow RF, Avram M, Ayesa-Arriola R, Babikian T, Banaj N, Bird LJ, Borgwardt S, Brodtmann A, Brosch K, Caeyenberghs K, Calhoun VD, Chiaravalloti ND, Cifu DX, Crespo-Facorro B, Dalrymple-Alford JC, Dams-O’Connor K, Dannlowski U, Darby D, Davenport N, DeLuca J, Diaz-Caneja CM, Disner SG, Dobryakova E, Ehrlich S, Esopenko C, Ferrarelli F, Frank LE, Franz CE, Fuentes-Claramonte P, Genova H, Giza CC, Goltermann J, Grotegerd D, Gruber M, Gutierrez-Zotes A, Ha M, Haavik J, Hinkin C, Hoskinson KR, Hubl D, Irimia A, Jansen A, Kaess M, Kang X, Kenney K, Keřková B, Khlif MS, Kim M, Kindler J, Kircher T, Knížková K, Kolskår KK, Krch D, Kremen WS, Kuhn T, Kumari V, Kwon J, Langella R, Laskowitz S, Lee J, Lengenfelder J, Liou-Johnson V, Lippa SM, Løvstad M, Lundervold AJ, Marotta C, Marquardt CA, Mattos P, Mayeli A, McDonald CR, Meinert S, Melzer TR, Merchán-Naranjo J, Michel C, Morey RA, Mwangi B, Myall DJ, Nenadić I, Newsome MR, Nunes A, O’Brien T, Oertel V, Ollinger J, Olsen A, Ortiz García de la Foz V, Ozmen M, Pardoe H, Parent M, Piras F, Piras F, Pomarol-Clotet E, Repple J, Richard G, Rodriguez J, Rodriguez M, Rootes-Murdy K, Rowland J, Ryan NP, Salvador R, Sanders AM, Schmidt A, Soares JC, Spalleta G, Španiel F, Sponheim SR, Stasenko A, Stein F, Straube B, Thames A, Thomas-Odenthal F, Thomopoulos SI, Tone EB, Torres I, Troyanskaya M, Turner JA, Ulrichsen KM, Umpierrez G, Vecchio D, Vilella E, Vivash L, Walker WC, Werden E, Westlye LT, Wild K, Wroblewski A, Wu MJ, Wylie GR, Yatham LN, Zunta-Soares GB, Thompson PM, Pugh MJ, Tate DF, Hillary FG, Wilde EA, Dennis EL. Verbal Learning and Memory Deficits across Neurological and Neuropsychiatric Disorders: Insights from an ENIGMA Mega Analysis. Brain Sci 2024; 14:669. [PMID: 39061410 PMCID: PMC11274572 DOI: 10.3390/brainsci14070669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 06/20/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024] Open
Abstract
Deficits in memory performance have been linked to a wide range of neurological and neuropsychiatric conditions. While many studies have assessed the memory impacts of individual conditions, this study considers a broader perspective by evaluating how memory recall is differentially associated with nine common neuropsychiatric conditions using data drawn from 55 international studies, aggregating 15,883 unique participants aged 15-90. The effects of dementia, mild cognitive impairment, Parkinson's disease, traumatic brain injury, stroke, depression, attention-deficit/hyperactivity disorder (ADHD), schizophrenia, and bipolar disorder on immediate, short-, and long-delay verbal learning and memory (VLM) scores were estimated relative to matched healthy individuals. Random forest models identified age, years of education, and site as important VLM covariates. A Bayesian harmonization approach was used to isolate and remove site effects. Regression estimated the adjusted association of each clinical group with VLM scores. Memory deficits were strongly associated with dementia and schizophrenia (p < 0.001), while neither depression nor ADHD showed consistent associations with VLM scores (p > 0.05). Differences associated with clinical conditions were larger for longer delayed recall duration items. By comparing VLM across clinical conditions, this study provides a foundation for enhanced diagnostic precision and offers new insights into disease management of comorbid disorders.
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Affiliation(s)
- Eamonn Kennedy
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- Division of Epidemiology, University of Utah, Salt Lake City, UT 84108, USA;
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Spencer W. Liebel
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Hannah M. Lindsey
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Shashank Vadlamani
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
| | - Pui-Wa Lei
- Department of Educational Psychology, Counseling, and Special Education, Pennsylvania State University, University Park, PA 16802, USA;
| | - Maheen M. Adamson
- WRIISC-WOMEN & Rehabilitation Department, VA Palo Alto, Palo Alto, CA 94304, USA (X.K.); (V.L.-J.)
- Neurosurgery, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada; (M.A.); (A.N.)
| | - Silvia Alonso-Lana
- FIDMAG Research Foundation, 08025 Barcelona, Spain; (S.A.-L.); (P.F.-C.); (E.P.-C.); (R.S.)
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, 08022 Barcelona, Spain
| | - Tim J. Anderson
- Department of Medicine, University of Otago, Christchurch 8011, New Zealand; (T.J.A.); (J.C.D.-A.); (T.R.M.)
- New Zealand Brain Research Institute, Christchurch 8011, New Zealand;
- Department of Neurology, Te Whatu Ora–Health New Zealand Waitaha Canterbury, Christchurch 8011, New Zealand
| | - Celso Arango
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, 28040 Madrid, Spain; (C.M.D.-C.); (J.M.-N.)
| | - Robert F. Asarnow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; (R.F.A.); (T.B.); (C.H.); (T.K.); (A.T.)
- Brain Research Institute, University of California Los Angeles, Los Angeles, CA 90095, USA
- Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Mihai Avram
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany; (M.A.); (S.B.)
| | - Rosa Ayesa-Arriola
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), School of Medicine, University of Cantabria, 39008 Santander, Spain;
| | - Talin Babikian
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; (R.F.A.); (T.B.); (C.H.); (T.K.); (A.T.)
- UCLA Steve Tisch BrainSPORT Program, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (N.B.); (R.L.); (F.P.); (F.P.); (G.S.); (D.V.)
| | - Laura J. Bird
- School of Clinical Sciences, Monash University, Clayton, VIC 3800, Australia;
| | - Stefan Borgwardt
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, 23562 Lübeck, Germany; (M.A.); (S.B.)
- Center of Brain, Behaviour and Metabolism (CBBM), University of Lübeck, 23562 Lübeck, Germany
| | - Amy Brodtmann
- Cognitive Health Initiative, School of Translational Medicine, Monash University, Melbourne, VIC 3800, Australia;
- Department of Medicine, Royal Melbourne Hospital, Melbourne, VIC 3050, Australia;
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Burwood, VIC 3125, Australia;
| | - Vince D. Calhoun
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory University, Atlanta, GA 30322, USA; (V.D.C.); (K.R.-M.)
| | - Nancy D. Chiaravalloti
- Centers for Neuropsychology, Neuroscience & Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ 07936, USA;
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
| | - David X. Cifu
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD 20892, USA;
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
- Department of Psychiatry, Virgen del Rocio University Hospital, School of Medicine, University of Seville, IBIS, 41013 Seville, Spain
| | - John C. Dalrymple-Alford
- Department of Medicine, University of Otago, Christchurch 8011, New Zealand; (T.J.A.); (J.C.D.-A.); (T.R.M.)
- New Zealand Brain Research Institute, Christchurch 8011, New Zealand;
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch 8041, New Zealand
| | - Kristen Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (C.E.)
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany; (U.D.); (J.G.); (D.G.); (M.G.); (S.M.); (J.R.)
| | - David Darby
- Department of Neuroscience, Monash University, Melbourne, VIC 3800, Australia; (D.D.); (C.M.); (L.V.)
- Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia; (H.P.); (E.W.)
| | - Nicholas Davenport
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (N.D.); (S.G.D.); (C.A.M.); (S.R.S.)
- Minneapolis VA Health Care System, Minneapolis, MN 55417, USA
| | - John DeLuca
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
- Kessler Foundation, East Hanover, NJ 07936, USA
| | - Covadonga M. Diaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, 28040 Madrid, Spain; (C.M.D.-C.); (J.M.-N.)
| | - Seth G. Disner
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (N.D.); (S.G.D.); (C.A.M.); (S.R.S.)
- Minneapolis VA Health Care System, Minneapolis, MN 55417, USA
| | - Ekaterina Dobryakova
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ 07936, USA
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany;
- Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (C.E.)
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA; (F.F.); (A.M.)
| | - Lea E. Frank
- Department of Psychology, University of Oregon, Eugene, OR 97403, USA
| | - Carol E. Franz
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA; (C.E.F.); (W.S.K.); (J.R.); (A.S.)
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
| | - Paola Fuentes-Claramonte
- FIDMAG Research Foundation, 08025 Barcelona, Spain; (S.A.-L.); (P.F.-C.); (E.P.-C.); (R.S.)
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
| | - Helen Genova
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
- Center for Autism Research, Kessler Foundation, East Hanover, NJ 07936, USA
| | - Christopher C. Giza
- UCLA Steve Tisch BrainSPORT Program, University of California Los Angeles, Los Angeles, CA 90095, USA;
- Department of Pediatrics, Division of Neurology, UCLA Mattel Children’s Hospital, Los Angeles, CA 90095, USA
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany; (U.D.); (J.G.); (D.G.); (M.G.); (S.M.); (J.R.)
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany; (U.D.); (J.G.); (D.G.); (M.G.); (S.M.); (J.R.)
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany; (U.D.); (J.G.); (D.G.); (M.G.); (S.M.); (J.R.)
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany
| | - Alfonso Gutierrez-Zotes
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
- Hospital Universitari Institut Pere Mata, 43007 Tarragona, Spain
- Institut d’Investiació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, 43007 Tarragona, Spain
| | - Minji Ha
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 08826, Republic of Korea; (M.H.); (J.K.); (J.L.)
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, 5007 Bergen, Norway;
- Division of Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway
| | - Charles Hinkin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; (R.F.A.); (T.B.); (C.H.); (T.K.); (A.T.)
| | - Kristen R. Hoskinson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA;
- Section of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Daniela Hubl
- Translational Research Centre, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland;
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA;
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
- Department of Quantitative & Computational Biology, Dornsife College of Arts & Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (M.K.); (J.K.); (C.M.)
- Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, 69120 Heidelberg, Germany
| | - Xiaojian Kang
- WRIISC-WOMEN & Rehabilitation Department, VA Palo Alto, Palo Alto, CA 94304, USA (X.K.); (V.L.-J.)
| | - Kimbra Kenney
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA;
| | - Barbora Keřková
- National Institute of Mental Health, 250 67 Klecany, Czech Republic; (B.K.); (K.K.); (M.R.); (F.Š.)
| | - Mohamed Salah Khlif
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia;
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea;
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (M.K.); (J.K.); (C.M.)
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - Karolina Knížková
- National Institute of Mental Health, 250 67 Klecany, Czech Republic; (B.K.); (K.K.); (M.R.); (F.Š.)
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital, 128 00 Prague, Czech Republic
| | - Knut K. Kolskår
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; (K.K.K.); (G.R.); (A.-M.S.); (K.M.U.); (L.T.W.)
- Department of Psychology, University of Oslo, 0373 Oslo, Norway;
- Department of Research, Sunnaas Rehabilitation Hospital, 1450 Nesodden, Norway
| | - Denise Krch
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ 07936, USA
| | - William S. Kremen
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA; (C.E.F.); (W.S.K.); (J.R.); (A.S.)
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
| | - Taylor Kuhn
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; (R.F.A.); (T.B.); (C.H.); (T.K.); (A.T.)
| | - Veena Kumari
- Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK;
| | - Junsoo Kwon
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 08826, Republic of Korea; (M.H.); (J.K.); (J.L.)
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea;
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Roberto Langella
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (N.B.); (R.L.); (F.P.); (F.P.); (G.S.); (D.V.)
| | - Sarah Laskowitz
- Brain Imaging and Analysis Center, Duke University, Durham, NC 27710, USA; (S.L.); (R.A.M.)
| | - Jungha Lee
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 08826, Republic of Korea; (M.H.); (J.K.); (J.L.)
| | - Jean Lengenfelder
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
- Center for Traumatic Brain Injury, Kessler Foundation, East Hanover, NJ 07936, USA
| | - Victoria Liou-Johnson
- WRIISC-WOMEN & Rehabilitation Department, VA Palo Alto, Palo Alto, CA 94304, USA (X.K.); (V.L.-J.)
| | - Sara M. Lippa
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA; (S.M.L.); (J.O.)
- Department of Neuroscience, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Marianne Løvstad
- Department of Psychology, University of Oslo, 0373 Oslo, Norway;
- Department of Research, Sunnaas Rehabilitation Hospital, 1450 Nesodden, Norway
| | - Astri J. Lundervold
- Department of Biological and Medical Psychology, University of Bergen, 5007 Bergen, Norway;
| | - Cassandra Marotta
- Department of Neuroscience, Monash University, Melbourne, VIC 3800, Australia; (D.D.); (C.M.); (L.V.)
- Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia
| | - Craig A. Marquardt
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (N.D.); (S.G.D.); (C.A.M.); (S.R.S.)
- Minneapolis VA Health Care System, Minneapolis, MN 55417, USA
| | - Paulo Mattos
- Institute D’Or for Research and Education (IDOR), São Paulo 04501-000, Brazil;
| | - Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA; (F.F.); (A.M.)
| | - Carrie R. McDonald
- Department of Radiation Medicine and Applied Sciences and Psychiatry, University of California San Diego, La Jolla, CA 92093, USA;
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA 92093, USA
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany; (U.D.); (J.G.); (D.G.); (M.G.); (S.M.); (J.R.)
- Institute for Translational Neuroscience, University of Münster, 48149 Münster, Germany
| | - Tracy R. Melzer
- Department of Medicine, University of Otago, Christchurch 8011, New Zealand; (T.J.A.); (J.C.D.-A.); (T.R.M.)
- New Zealand Brain Research Institute, Christchurch 8011, New Zealand;
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch 8041, New Zealand
| | - Jessica Merchán-Naranjo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, 28040 Madrid, Spain; (C.M.D.-C.); (J.M.-N.)
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland; (M.K.); (J.K.); (C.M.)
| | - Rajendra A. Morey
- Brain Imaging and Analysis Center, Duke University, Durham, NC 27710, USA; (S.L.); (R.A.M.)
- VISN 6 MIRECC, Durham VA, Durham, NC 27705, USA
| | - Benson Mwangi
- Center of Excellence on Mood Disorders, Louis A Faillace, MD Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (B.M.); (J.C.S.); (M.-J.W.); (G.B.Z.-S.)
| | - Daniel J. Myall
- New Zealand Brain Research Institute, Christchurch 8011, New Zealand;
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - Mary R. Newsome
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Abraham Nunes
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada; (M.A.); (A.N.)
- Faculty of Computer Science, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Terence O’Brien
- Department of Medicine, Royal Melbourne Hospital, Melbourne, VIC 3050, Australia;
- Department of Neuroscience, The School of Translational Medicine, Alfred Health, Monash University, Melbourne VIC 3004, Australia
| | - Viola Oertel
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt University, 60590 Frankfurt, Germany;
| | - John Ollinger
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA; (S.M.L.); (J.O.)
| | - Alexander Olsen
- Department of Psychology, Norwegian University of Science and Technology, 7491 Trondheim, Norway;
- Department of Physical Medicine and Rehabilitation, St Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
- NorHEAD—Norwegian Centre for Headache Research, 7491 Trondheim, Norway
| | - Victor Ortiz García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), School of Medicine, University of Cantabria, 39008 Santander, Spain;
| | - Mustafa Ozmen
- Division of Epidemiology, University of Utah, Salt Lake City, UT 84108, USA;
- Department of Electrical and Electronics Engineering, Antalya Bilim University, 07190 Antalya, Turkey
| | - Heath Pardoe
- The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia; (H.P.); (E.W.)
| | - Marise Parent
- Neuroscience Institute & Department of Psychology, Georgia State University, Atlanta, GA 30303, USA;
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (N.B.); (R.L.); (F.P.); (F.P.); (G.S.); (D.V.)
| | - Federica Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (N.B.); (R.L.); (F.P.); (F.P.); (G.S.); (D.V.)
| | - Edith Pomarol-Clotet
- FIDMAG Research Foundation, 08025 Barcelona, Spain; (S.A.-L.); (P.F.-C.); (E.P.-C.); (R.S.)
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany; (U.D.); (J.G.); (D.G.); (M.G.); (S.M.); (J.R.)
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany
| | - Geneviève Richard
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; (K.K.K.); (G.R.); (A.-M.S.); (K.M.U.); (L.T.W.)
| | - Jonathan Rodriguez
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA; (C.E.F.); (W.S.K.); (J.R.); (A.S.)
| | - Mabel Rodriguez
- National Institute of Mental Health, 250 67 Klecany, Czech Republic; (B.K.); (K.K.); (M.R.); (F.Š.)
| | - Kelly Rootes-Murdy
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory University, Atlanta, GA 30322, USA; (V.D.C.); (K.R.-M.)
| | - Jared Rowland
- WG (Bill) Hefner VA Medical Center, Salisbury, NC 28144, USA;
- Department of Neurobiology & Anatomy, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MA-MIRECC), Durham, NC 27705, USA
| | - Nicholas P. Ryan
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC 3220, Australia;
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Raymond Salvador
- FIDMAG Research Foundation, 08025 Barcelona, Spain; (S.A.-L.); (P.F.-C.); (E.P.-C.); (R.S.)
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
| | - Anne-Marthe Sanders
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; (K.K.K.); (G.R.); (A.-M.S.); (K.M.U.); (L.T.W.)
- Department of Psychology, University of Oslo, 0373 Oslo, Norway;
- Department of Research, Sunnaas Rehabilitation Hospital, 1450 Nesodden, Norway
| | - Andre Schmidt
- Department of Psychiatry (UPK), University of Basel, 4002 Basel, Switzerland;
| | - Jair C. Soares
- Center of Excellence on Mood Disorders, Louis A Faillace, MD Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (B.M.); (J.C.S.); (M.-J.W.); (G.B.Z.-S.)
| | - Gianfranco Spalleta
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (N.B.); (R.L.); (F.P.); (F.P.); (G.S.); (D.V.)
| | - Filip Španiel
- National Institute of Mental Health, 250 67 Klecany, Czech Republic; (B.K.); (K.K.); (M.R.); (F.Š.)
- 3rd Faculty of Medicine, Charles University, 100 00 Prague, Czech Republic
| | - Scott R. Sponheim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (N.D.); (S.G.D.); (C.A.M.); (S.R.S.)
- Minneapolis VA Health Care System, Minneapolis, MN 55417, USA
| | - Alena Stasenko
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA; (C.E.F.); (W.S.K.); (J.R.); (A.S.)
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA 92093, USA
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - April Thames
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; (R.F.A.); (T.B.); (C.H.); (T.K.); (A.T.)
| | - Florian Thomas-Odenthal
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - Sophia I. Thomopoulos
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA 90292, USA; (S.I.T.); (P.M.T.)
| | - Erin B. Tone
- Department of Psychology, Georgia State University, Atlanta, GA 30303, USA;
| | - Ivan Torres
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (I.T.); (L.N.Y.)
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC V5Z 1M9, Canada
| | - Maya Troyanskaya
- Michael E DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA;
- H Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jessica A. Turner
- Psychiatry and Behavioral Health, Ohio State Wexner Medical Center, Columbus, OH 43210, USA;
| | - Kristine M. Ulrichsen
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; (K.K.K.); (G.R.); (A.-M.S.); (K.M.U.); (L.T.W.)
- Department of Psychology, University of Oslo, 0373 Oslo, Norway;
- Department of Research, Sunnaas Rehabilitation Hospital, 1450 Nesodden, Norway
| | - Guillermo Umpierrez
- Division of Endocrinology, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, 00179 Rome, Italy; (N.B.); (R.L.); (F.P.); (F.P.); (G.S.); (D.V.)
| | - Elisabet Vilella
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain; (C.A.); (R.A.-A.); (B.C.-F.); (A.G.-Z.); (E.V.)
- Hospital Universitari Institut Pere Mata, 43007 Tarragona, Spain
- Institut d’Investiació Sanitària Pere Virgili-CERCA, Universitat Rovira i Virgili, 43007 Tarragona, Spain
| | - Lucy Vivash
- Department of Neuroscience, Monash University, Melbourne, VIC 3800, Australia; (D.D.); (C.M.); (L.V.)
- Department of Neurology, Alfred Health, Melbourne, VIC 3004, Australia
| | - William C. Walker
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23298, USA;
- Richmond Veterans Affairs (VA) Medical Center, Central Virginia VA Health Care System, Richmond, VA 23249, USA
| | - Emilio Werden
- The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia; (H.P.); (E.W.)
| | - Lars T. Westlye
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway; (K.K.K.); (G.R.); (A.-M.S.); (K.M.U.); (L.T.W.)
- Department of Psychology, University of Oslo, 0373 Oslo, Norway;
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, 0372 Oslo, Norway
| | - Krista Wild
- Department of Psychology, Phoenix VA Health Care System, Phoenix, AZ 85012, USA;
| | - Adrian Wroblewski
- Department of Psychiatry and Psychotherapy, University of Marburg, 35032 Marburg, Germany; (K.B.); (A.J.); (T.K.); (I.N.); (F.S.); (B.S.); (F.T.-O.); (A.W.)
| | - Mon-Ju Wu
- Center of Excellence on Mood Disorders, Louis A Faillace, MD Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (B.M.); (J.C.S.); (M.-J.W.); (G.B.Z.-S.)
| | - Glenn R. Wylie
- Department of Physical Medicine & Rehabilitation, Rutgers, New Jersey Medical School, Newark, NJ 07103, USA; (J.D.); (E.D.); (H.G.); (D.K.); (J.L.); (G.R.W.)
- Rocco Ortenzio Neuroimaging Center, Kessler Foundation, East Hanover, NJ 07936, USA
| | - Lakshmi N. Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (I.T.); (L.N.Y.)
| | - Giovana B. Zunta-Soares
- Center of Excellence on Mood Disorders, Louis A Faillace, MD Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (B.M.); (J.C.S.); (M.-J.W.); (G.B.Z.-S.)
| | - Paul M. Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA 90292, USA; (S.I.T.); (P.M.T.)
- Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology, University of Southern California, Los Angeles, CA 90089, USA
| | - Mary Jo Pugh
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- Division of Epidemiology, University of Utah, Salt Lake City, UT 84108, USA;
| | - David F. Tate
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Frank G. Hillary
- Department of Psychology, Penn State University, State College, PA 16801, USA;
- Department of Neurology, Hershey Medical Center, State College, PA 16801, USA
- Social Life and Engineering Science Imaging Center, Penn State University, State College, PA 16801, USA
| | - Elisabeth A. Wilde
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Emily L. Dennis
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (E.K.); (S.W.L.); (H.M.L.); (S.V.); (M.R.N.); (M.J.P.); (D.F.T.); (E.A.W.)
- George E Wahlen Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
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Zhang H, Chen J, Fang Y. Functional Alterations in Patients with Bipolar Disorder and Their Unaffected First-Degree Relatives: Insight from Genetic, Epidemiological, and Neuroimaging Data. Neuropsychiatr Dis Treat 2023; 19:2797-2806. [PMID: 38111594 PMCID: PMC10726715 DOI: 10.2147/ndt.s427617] [Citation(s) in RCA: 1] [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: 06/26/2023] [Accepted: 11/30/2023] [Indexed: 12/20/2023] Open
Abstract
Bipolar disorder (BD) profoundly affects cognitive and psychosocial functioning, leading to a significant illness burden on patients and their families. Genetic factors are predominant in the onset of bipolar disorder and functional impairments. This disorder exhibits a strong family aggregation, with heritability estimates reaching up to 80%. Individuals with BD often experience impaired functioning, especially in significant areas such as physical performance, sleep, cognition, interpersonal interactions, socioeconomic status, family and marital relationships, work and school performance, well-being, and life expectancy. However, patients with different subtypes exhibit significant heterogeneity in social functioning, cognition, and creativity levels. There are notable differences in psychosocial and cognitive function in their unaffected first-degree relatives (UFR) who do not suffer but may carry susceptibility genes compared to healthy control (HC) without a family history. The observations indicate common genetic structures between BD patients and their UFR, which results in varying degrees of functional abnormalities. Therefore, this article mainly provides evidence on cognition, creativity, and psychosocial functioning in patients with BD and their UFR to provide a more comprehensive understanding of this critical topic in the field of BD. By integrating various findings, including clinical data and neuroimaging studies, our article aims to provide insights and valuable information for a deeper exploration of the pathogenesis of BD and the development of more targeted therapeutic strategies in the future.
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Affiliation(s)
- Haonan Zhang
- Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Jun Chen
- Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, People’s Republic of China
| | - Yiru Fang
- Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, People’s Republic of China
- Department of Psychiatry & Affective Disorders Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, People’s Republic of China
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Sato K, Matsui M, Ono Y, Miyagishi Y, Tsubomoto M, Naito N, Kikuchi M. The relationship between cognitive reserve focused on leisure experiences and cognitive functions in bipolar patients. Heliyon 2023; 9:e21661. [PMID: 38027814 PMCID: PMC10661430 DOI: 10.1016/j.heliyon.2023.e21661] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/01/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Bipolar disorder (BP) is characterized by cognitive decline. Individual differences exist in maintaining cognitive function due to daily physical activity and sleep. We examined the relationship between leisure experiences as proxies for cognitive reserve (CR) and cognitive function in patients with bipolar disorder after adjusting for daily physical activity and sleep. The CR of patients with BP (n = 24) and healthy study controls (HC) (n = 24) was assessed using premorbid IQ, years of education, and leisure activity history. Performance-based neuropsychological tests were performed to evaluate cognitive function. A self-reported scale was used to assess resilience. Physical activity and sleep were measured using an activity meter. Verbal fluency, story memory, and verbal memory were significantly positively correlated with the kinds of leisure experiences in patients with BP. A hierarchical regression analysis accounting for confounding factors showed that verbal fluency and memory were associated with the kinds of leisure experiences. Neither years of education nor resilience were significantly associated with neuropsychological scores. Various leisure experiences in patients with BP are associated with higher language-related cognitive functioning. Engaging in various leisure experiences may affect higher cognitive functions related to language.
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Affiliation(s)
- Kuniko Sato
- Laboratory of Clinical Cognitive Neuroscience, Graduate School of Medical Science, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan
| | - Mie Matsui
- Laboratory of Clinical Cognitive Neuroscience, Graduate School of Medical Science, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan
- Laboratory of Clinical Cognitive Neuroscience, Institute of Liberal Arts and Science, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan
| | - Yasuki Ono
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, 1 Bunkyocyo, Hirosaki, Aomori 036-8224, Japan
| | - Yoshiaki Miyagishi
- Department of Psychiatry and Behavioral Science, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
| | - Makoto Tsubomoto
- Department of Psychiatry and Behavioral Science, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
| | - Nobushige Naito
- Department of Psychiatry and Behavioral Science, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
| | - Mitsuru Kikuchi
- Department of Psychiatry and Behavioral Science, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan
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Zhong S, Chen P, Lai S, Zhang Y, Chen G, He J, Pan Y, Tang G, Wang Y, Jia Y. Hippocampal Dynamic Functional Connectivity, HPA Axis Activity, and Personality Trait in Bipolar Disorder with Suicidal Attempt. Neuroendocrinology 2023; 114:179-191. [PMID: 37729896 DOI: 10.1159/000534033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION Suicide in bipolar disorder (BD) is a multifaceted behavior, involving specific neuroendocrine and psychological mechanisms. According to previous studies, we hypothesized that suicidal BD patients may exhibit impaired dynamic functional connectivity (dFC) variability of hippocampal subregions and hypothalamic-pituitary-adrenal (HPA) axis activity, which may be associated with suicide-related personality traits. The objective of our study was to clarify this. METHODS Resting-state functional magnetic resonance imaging data were obtained from 79 patients with BD, 39 with suicidal attempt (SA), and 40 without SA, and 35 healthy controls (HCs). The activity of the HPA axis was assessed by measuring morning plasma adrenocorticotropic hormone (ACTH) and cortisol (CORT) levels. All participants underwent personality assessment using Minnesota Multiphasic Personality Inventory-2 (MMPI-2). RESULTS BD patients with SA exhibited increased dFC variability between the right caudal hippocampus and the left superior temporal gyrus (STG) when compared with non-SA BD patients and HCs. BD with SA also showed significantly lower ACTH levels in comparison with HCs, which was positively correlated with increased dFC variability between the right caudal hippocampus and the left STG. BD with SA had significantly higher scores of Hypochondriasis, Depression, and Schizophrenia than non-SA BD. Additionally, multivariable regression analysis revealed the interaction of ACTH × dFC variability between the right caudal hippocampus and the left STG independently predicted MMPI-2 score (depression evaluation) in suicidal BD patients. CONCLUSION These results suggested that suicidal BD exhibited increased dFC variability of hippocampal-temporal cortex and less HPA axis hyperactivity, which may affect their personality traits.
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Affiliation(s)
- Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China,
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Youling Pan
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou, China
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7
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Degraff Z, Souza GS, Santos NA, Shoshina II, Felisberti FM, Fernandes TP, Sigurdsson G. Brain atrophy and cognitive decline in bipolar disorder: Influence of medication use, symptomatology and illness duration. J Psychiatr Res 2023; 163:421-429. [PMID: 37276646 DOI: 10.1016/j.jpsychires.2023.05.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/02/2023] [Accepted: 05/25/2023] [Indexed: 06/07/2023]
Abstract
Bipolar disorder (BPD) is a chronic condition characterized by recurrent episodes of mania and depression. To date, the association of biological and psychopathological processes in BPD has not been extensively studied on a cognitive and cortical basis at the same time. We investigated whether brain atrophy (in prefrontal, temporal and occipital cortices) was associated with cognitive, biological and clinical processes in patients with BPD and healthy controls (HCs). A total of 104 participants (56 with BPD) completed tasks that measured attention, memory, information processing speed, inhibitory control, visuospatial working memory and cognitive flexibility. In addition, structural brain scans were obtained using high-resolution MRI. Outcomes of the measurements were examined using robust multiple mediation analyses. BPD patients showed greater cortical atrophy across all regions of interest when compared to HCs, linked to cognitive decline. BPD patients had slower reaction times and markedly increased errors of commission on the tasks. The outcomes were significantly influenced by medication use, symptomatology and illness duration. The findings showcase the complexity of brain structures and networks as well as the physiological mechanisms underlying diverse BPD symptomatology and endophenotypes. These differences were pronounced in patients with BPD, motivating further investigations of pathophysiological mechanisms involved in brain atrophy and cognitive decline.
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Affiliation(s)
- Zeke Degraff
- Svenskagier Neurologie, Stockholm, Sweden; Institute of Neurology, Belgium.
| | | | | | | | | | - Thiago P Fernandes
- Federal University of Para, Para, Brazil; Federal University of Paraiba, Paraiba, Brazil
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8
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Förster K, Grotegerd D, Dohm K, Lemke H, Enneking V, Meinert S, Redlich R, Heindel W, Bauer J, Kugel H, Suslow T, Ohrmann P, Carballedo A, O'Keane V, Fagan A, Doolin K, McCarthy H, Kanske P, Frodl T, Dannlowski U. Association of hospitalization with structural brain alterations in patients with affective disorders over nine years. Transl Psychiatry 2023; 13:170. [PMID: 37202406 DOI: 10.1038/s41398-023-02452-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/20/2023] Open
Abstract
Repeated hospitalizations are a characteristic of severe disease courses in patients with affective disorders (PAD). To elucidate how a hospitalization during a nine-year follow-up in PAD affects brain structure, a longitudinal case-control study (mean [SD] follow-up period 8.98 [2.20] years) was conducted using structural neuroimaging. We investigated PAD (N = 38) and healthy controls (N = 37) at two sites (University of Münster, Germany, Trinity College Dublin, Ireland). PAD were divided into two groups based on the experience of in-patient psychiatric treatment during follow-up. Since the Dublin-patients were outpatients at baseline, the re-hospitalization analysis was limited to the Münster site (N = 52). Voxel-based morphometry was employed to examine hippocampus, insula, dorsolateral prefrontal cortex and whole-brain gray matter in two models: (1) group (patients/controls)×time (baseline/follow-up) interaction; (2) group (hospitalized patients/not-hospitalized patients/controls)×time interaction. Patients lost significantly more whole-brain gray matter volume of superior temporal gyrus and temporal pole compared to HC (pFWE = 0.008). Patients hospitalized during follow-up lost significantly more insular volume than healthy controls (pFWE = 0.025) and more volume in their hippocampus compared to not-hospitalized patients (pFWE = 0.023), while patients without re-hospitalization did not differ from controls. These effects of hospitalization remained stable in a smaller sample excluding patients with bipolar disorder. PAD show gray matter volume decline in temporo-limbic regions over nine years. A hospitalization during follow-up comes with intensified gray matter volume decline in the insula and hippocampus. Since hospitalizations are a correlate of severity, this finding corroborates and extends the hypothesis that a severe course of disease has detrimental long-term effects on temporo-limbic brain structure in PAD.
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Affiliation(s)
- Katharina Förster
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychology, University of Halle, Halle, Germany
| | - Walter Heindel
- Department of Radiology, University of Münster and University Hospital Münster, Münster, Germany
| | - Jochen Bauer
- Department of Radiology, University of Münster and University Hospital Münster, Münster, Germany
| | - Harald Kugel
- Department of Radiology, University of Münster and University Hospital Münster, Münster, Germany
| | - Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | | | - Angela Carballedo
- Department of Psychiatry & Trinity College Institute of Neuroscience, University Dublin, Dublin, Ireland
| | - Veronica O'Keane
- Department of Psychiatry & Trinity College Institute of Neuroscience, University Dublin, Dublin, Ireland
| | - Andrew Fagan
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Kelly Doolin
- Department of Psychiatry & Trinity College Institute of Neuroscience, University Dublin, Dublin, Ireland
| | - Hazel McCarthy
- Department of Psychiatry & Trinity College Institute of Neuroscience, University Dublin, Dublin, Ireland
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Thomas Frodl
- Department of Psychiatry & Trinity College Institute of Neuroscience, University Dublin, Dublin, Ireland
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, RWTH University Aachen, Aachen, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.
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9
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Grewal S, McKinlay S, Kapczinski F, Pfaffenseller B, Wollenhaupt-Aguiar B. Biomarkers of neuroprogression and late staging in bipolar disorder:
A systematic review. Aust N Z J Psychiatry 2023; 57:328-343. [PMID: 35403455 PMCID: PMC9950598 DOI: 10.1177/00048674221091731] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Bipolar disorder may undertake a progressive course in a subset of patients, and research efforts have been made to understand the biological basis underlying this process. This systematic review examined the literature available on biological markers associated with illness progression in bipolar disorder. METHODS Peer-reviewed articles were assessed using Embase, PsycINFO and PubMed, as well as from external sources. After initial screening, a total of 871 citations from databases and other sources were identified. Participants with a diagnosis of bipolar disorder were included in our systematic review; however, studies with participants younger than 15 or older than 65 were excluded. All studies were assessed using the Newcastle-Ottawa Scale assessment tool, and data pertaining to the results were extracted into tabular form using Google Sheets and Google Documents. The systematic review was registered on PROSPERO international prospective register of systematic reviews (ID Number: CRD42020154305). RESULTS A total of 35 studies were included in the systematic review. Increased ventricular size and reduction of grey matter volume were the most common brain changes associated with illness progression in bipolar disorder. Among the several biomarkers evaluated in this systematic review, findings also indicate a role of peripheral inflammatory markers in this process. DISCUSSION The studies evaluating the biological basis of the illness progression in bipolar disorder are still scarce and heterogeneous. However, current evidence supports the notion of neuroprogression, the pathophysiological process related to progressive brain changes associated with clinical progression in patients with bipolar disorder. The increase in peripheral inflammatory biomarkers and the neuroanatomical changes in bipolar disorder suggest progressive systemic and structural brain alterations, respectively.
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Affiliation(s)
- Sonya Grewal
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Stuart McKinlay
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Flávio Kapczinski
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada,Mood Disorders Program, St. Joseph’s
Healthcare Hamilton, Hamilton, ON, Canada,Instituto Nacional de Ciência e
Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil,Department of Psychiatry, Universidade
Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Bianca Pfaffenseller
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada,Mood Disorders Program, St. Joseph’s
Healthcare Hamilton, Hamilton, ON, Canada
| | - Bianca Wollenhaupt-Aguiar
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada,Mood Disorders Program, St. Joseph’s
Healthcare Hamilton, Hamilton, ON, Canada,Bianca Wollenhaupt de Aguiar, Department of
Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th
Street, Suite G116, Hamilton, ON L8N 3K7, Canada.
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10
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Simjanoski M, McIntyre A, Kapczinski F, Cardoso TDA. Cognitive impairment in bipolar disorder in comparison to mild cognitive impairment and dementia: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2023; 44. [PMID: 34374270 PMCID: PMC10039729 DOI: 10.47626/2237-6089-2021-0300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/09/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To conduct a systematic review to describe cognitive abilities in bipolar disorder (BD) in comparison to cognitive abilities in mild cognitive impairment (MCI) and dementia. METHODS A literature search was performed with no year or language restrictions. The search yielded 1,461 articles, with 1,261 remaining after removal of duplicates, five of which were suitable for the systematic review: two for the comparison between BD and MCI and three comparing BD and dementia. RESULTS Analyses from our systematic review showed that euthymic individuals with BD present impairments in cognitive domains such as attention and executive functioning, motor skills, conceptual thinking, and visuo-spatial abilities that are equally severe as or more severe than the impairments observed in individuals with MCI. In contrast, studies comparing BD and dementia indicated that Alzheimer's disease (AD) dementia and behavioral variant frontotemporal dementia (bvFTD) both showed greater cognitive deficits than BD during euthymia, whereas BD during a mood episode demonstrated higher cognitive impairments than bvFTD. CONCLUSION Findings from our systematic review suggest that cognitive impairments in euthymic BD fall into a range between the impairments seen in MCI and those seen in dementia. More studies are needed to analyze these comparisons, while also focusing on comparing different clinical stages of BD with MCI and dementia to analyze the progression of the clinical course and cognitive dysfunction in BD.
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Affiliation(s)
- Mario Simjanoski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Aidan McIntyre
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Flavio Kapczinski
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Taiane de Azevedo Cardoso
- Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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11
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Liebing S, Dalkner N, Ischebeck A, Bengesser SA, Birner A, Fellendorf FT, Lenger M, Maget A, Kroisenbrunner H, Häussl A, Platzer M, Queissner R, Schönthaler EMD, Stross T, Tmava-Berisha A, Reininghaus EZ. A one-year view on the association of metabolic syndrome and cognitive function in bipolar disorder - Preliminary data. J Affect Disord 2023; 323:251-256. [PMID: 36435403 DOI: 10.1016/j.jad.2022.11.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 11/16/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Individuals with bipolar disorder have a high prevalence of metabolic syndrome and an increased risk for cognitive deficits. The aim of this longitudinal study was to investigate the trajectory of cognitive decline in dependence of metabolic syndrome over a one-year interval. METHODS 52 well-diagnosed individuals with bipolar disorder, euthymic at baseline and follow-up (n = 17 with metabolic syndrome vs. n = 35 without metabolic syndrome) were investigated with a comprehensive neurocognitive test battery (Trail Making Test A/B, Digit Symbol Test, California Verbal Leaning Test, or the Verbal Learning and Memory Test respectively) twice within the interval of one year. RESULTS Patients with bipolar disorder and additional metabolic syndrome performed significantly worse in the domain of psychomotor and processing speed/attention than patients without metabolic syndrome at test point one. No deteriorating effects of metabolic syndrome on the cognitive domain scores and overall cognitive performance were found at the one-year follow up. However, no cognitive decline could be reported in both groups. LIMITATIONS Time interval, small sample size and selection of metabolic syndrome affected patients were the major limitations of this study. CONCLUSION There was no association of metabolic syndrome on the one-year trajectory of cognitive function in bipolar disorder. Future studies should expand the observation period and investigate larger samples.
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Affiliation(s)
- S Liebing
- Institute of Psychology, University of Graz, Austria
| | - N Dalkner
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria.
| | - A Ischebeck
- Institute of Psychology, University of Graz, Austria
| | - S A Bengesser
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | - A Birner
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | - F T Fellendorf
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | - M Lenger
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | - A Maget
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | | | - A Häussl
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | - M Platzer
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | - R Queissner
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | - E M D Schönthaler
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | - T Stross
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | - A Tmava-Berisha
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | - E Z Reininghaus
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
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12
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Gupta R, Sood M, Sharma U, Bhargava R, Jagannathan NR, Chadda RK. Neurochemical correlates of cognitive functions in euthymic patients with bipolar disorder: 1H-MRS study. Asian J Psychiatr 2022; 78:103273. [PMID: 36270047 DOI: 10.1016/j.ajp.2022.103273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES We assessed and correlated neurochemical levels and cognitive functions in left dorsolateral prefrontal cortex (DLPFC) and left hippocampus in euthymic patients with bipolar disorder and compared these with healthy controls METHODOLOGY: Twenty-five right-handed euthymic patients (HAM-D score < 7, and YMRS score < 7) with bipolar disorder and 20 age and gender matched controls were compared for neurometabolites (n-acetylaspartate - tNAA, choline - Cho, creatinine - Cr, myoinositol - Ins, and glutamine/glutamate - Glu/Gln) measured in left DLPFC and left hippocampus using single voxel magnetic resonance spectroscopy (MRS) and cognitive functions assessed using trail making test (TMT - A and B), wisconsin card sorting test (WCST), and wechsler memory scale (WMS-III Indian adaptation). RESULTS The two groups were comparable on socio-demographic variables. tNAA levels in DLPFC and hippocampus, and glutamate levels in hippocampus were found to be significantly lower and Inositol and glutamine levels in hippocampus were found to be significantly higher in patients as compared to controls. Patients performed significantly poorly as compared to controls on TMT A & B, all subscales of WMS - III, 5 subscales of WCST, including perseverative responses and errors. The tNAA and glutamate levels in left DLPFC in patients correlated with scores on TMT A & B, and several subscales of WCST and WMS-III. tNAA concentration in left hippocampus in patients correlated with scores on subscales of WMS-III. CONCLUSION Neurochemical dysfunction in select brain areas directly correlates with impairment in cognitive functions seen in patients with bipolar disorder in euthymic phase.
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Affiliation(s)
- Rishi Gupta
- Dept. of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta Sood
- Dept. of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Uma Sharma
- Dept. of Nuclear Magnetic Resonance, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Bhargava
- Dept. of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - N R Jagannathan
- Dept. of Nuclear Magnetic Resonance, All India Institute of Medical Sciences, New Delhi, India
| | - R K Chadda
- Dept. of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
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13
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Ikeda N, Yamada S, Yasuda K, Uenishi S, Tamaki A, Ishida T, Tabata M, Tsuji T, Kimoto S, Takahashi S. Structural connectivity between the hippocampus and cortical/subcortical area relates to cognitive impairment in schizophrenia but not in mood disorders. J Neuropsychol 2022. [DOI: 10.1111/jnp.12298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 08/10/2022] [Accepted: 09/11/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Natsuko Ikeda
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
- Department of Psychiatry Wakayama Prefectural Mental Health Care Center Wakayama Japan
| | - Shinichi Yamada
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
| | - Kasumi Yasuda
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
| | - Shinya Uenishi
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
- Department of Psychiatry Hidaka Hospital Gobo Japan
| | - Atsushi Tamaki
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
- Department of Psychiatry Hidaka Hospital Gobo Japan
| | - Takuya Ishida
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
| | - Michiyo Tabata
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
| | - Tomikimi Tsuji
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
| | - Sohei Kimoto
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
| | - Shun Takahashi
- Department of Neuropsychiatry Wakayama Medical University Wakayama Japan
- Clinical Research and Education Center Asakayama General Hospital Sakai Japan
- Graduate School of Rehabilitation Science Osaka Metropolitan University Habikino Japan
- Department of Psychiatry Osaka University Graduate School of Medicine Suita Japan
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14
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Miyazaki Y, Niino M, Takahashi E, Nomura T, Naganuma R, Amino I, Akimoto S, Minami N, Kikuchi S. Stages of brain volume loss and performance in the Brief International Cognitive Assessment for Multiple Sclerosis. Mult Scler Relat Disord 2022; 67:104183. [PMID: 36116381 DOI: 10.1016/j.msard.2022.104183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/28/2022] [Accepted: 09/11/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cognitive dysfunction occurs in a substantial proportion of patients with multiple sclerosis (MS), negatively affects their daily activities, and is associated with poor prognosis. Cognitive dysfunction in MS can extend across multiple cognitive domains, depending on the patterns and extent of the brain regions affected. Therefore, a combination of tests, including the Brief International Cognitive Assessment for MS (BICAMS), that assess different aspects of cognition is recommended to capture the full picture of cognitive impairment in each patient. However, the temporal relationships between the progression of the MS brain pathology and the performances in different cognitive tests remain unclear. METHODS Global and regional brain volume data were obtained based on T1-weighted magnetic resonance imaging from 61 patients with MS, and hierarchical cluster analysis was performed using these brain volume data. Cognitive function was assessed using the three subcomponents of the BICAMS: the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test Second Edition (CVLT2), and Brief Visuospatial Memory Test-Revised (BVMTR). Clinical characteristics, patterns of regional brain volume loss, and cognitive test scores were compared among clusters. RESULTS Cluster analysis of the global and regional brain volume data classified patients into three clusters (Clusters 1, 2, and 3) in order of decreasing global brain volume. A comparison of the clinical profiles of the patients suggested that those in Clusters 1, 2, and 3 are in the early, intermediate, and advanced stages of MS, respectively. Pair-wise analysis of regional brain volume among the three clusters suggested brain regions where volume loss starts early and continues throughout the disease course, occurs preferentially at the early phase, or evolves relatively slowly. SDMT scores differed significantly among the three clusters, with a decrease from Clusters 1 to 3. BVMTR scores also declined in this order, whereas the CVLT2 was significantly impaired only in Cluster 3. CONCLUSION Our results suggest that SDMT performance declines in conjunction with brain volume loss throughout the disease course of MS. Performance in the BVMTR also declines in line with the brain volume loss, but impairment in the CVLT2 becomes particularly apparent at the late phase of MS.
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Affiliation(s)
- Yusei Miyazaki
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan.
| | - Masaaki Niino
- Departments of Clinical Research, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Eri Takahashi
- Departments of Clinical Research, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Taichi Nomura
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Ryoji Naganuma
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Itaru Amino
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Sachiko Akimoto
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Naoya Minami
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
| | - Seiji Kikuchi
- Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo 063-0005, Japan
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15
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Madireddy S, Madireddy S. Therapeutic Interventions to Mitigate Mitochondrial Dysfunction and Oxidative Stress–Induced Damage in Patients with Bipolar Disorder. Int J Mol Sci 2022; 23:ijms23031844. [PMID: 35163764 PMCID: PMC8836876 DOI: 10.3390/ijms23031844] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/26/2021] [Accepted: 12/30/2021] [Indexed: 01/10/2023] Open
Abstract
Bipolar disorder (BD) is characterized by mood changes, including recurrent manic, hypomanic, and depressive episodes, which may involve mixed symptoms. Despite the progress in neurobiological research, the pathophysiology of BD has not been extensively described to date. Progress in the understanding of the neurobiology driving BD could help facilitate the discovery of therapeutic targets and biomarkers for its early detection. Oxidative stress (OS), which damages biomolecules and causes mitochondrial and dopamine system dysfunctions, is a persistent finding in patients with BD. Inflammation and immune dysfunction might also play a role in BD pathophysiology. Specific nutrient supplements (nutraceuticals) may target neurobiological pathways suggested to be perturbed in BD, such as inflammation, mitochondrial dysfunction, and OS. Consequently, nutraceuticals may be used in the adjunctive treatment of BD. This paper summarizes the possible roles of OS, mitochondrial dysfunction, and immune system dysregulation in the onset of BD. It then discusses OS-mitigating strategies that may serve as therapeutic interventions for BD. It also analyzes the relationship between diet and BD as well as the use of nutritional interventions in the treatment of BD. In addition, it addresses the use of lithium therapy; novel antipsychotic agents, including clozapine, olanzapine, risperidone, cariprazine, and quetiapine; and anti-inflammatory agents to treat BD. Furthermore, it reviews the efficacy of the most used therapies for BD, such as cognitive–behavioral therapy, bright light therapy, imagery-focused cognitive therapy, and electroconvulsive therapy. A better understanding of the roles of OS, mitochondrial dysfunction, and inflammation in the pathogenesis of bipolar disorder, along with a stronger elucidation of the therapeutic functions of antioxidants, antipsychotics, anti-inflammatory agents, lithium therapy, and light therapies, may lead to improved strategies for the treatment and prevention of bipolar disorder.
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Affiliation(s)
- Sahithi Madireddy
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Correspondence:
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16
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Ryan MC, Hong LE, Hatch KS, Gao S, Chen S, Haerian K, Wang J, Goldwaser EL, Du X, Adhikari BM, Bruce H, Hare S, Kvarta MD, Jahanshad N, Nichols TE, Thompson PM, Kochunov P. The additive impact of cardio-metabolic disorders and psychiatric illnesses on accelerated brain aging. Hum Brain Mapp 2022; 43:1997-2010. [PMID: 35112422 PMCID: PMC8933252 DOI: 10.1002/hbm.25769] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 11/28/2021] [Accepted: 12/28/2021] [Indexed: 12/24/2022] Open
Abstract
Severe mental illnesses (SMI) including major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia spectrum disorder (SSD) elevate accelerated brain aging risks. Cardio‐metabolic disorders (CMD) are common comorbidities in SMI and negatively impact brain health. We validated a linear quantile regression index (QRI) approach against the machine learning “BrainAge” index in an independent SSD cohort (N = 206). We tested the direct and additive effects of SMI and CMD effects on accelerated brain aging in the N = 1,618 (604 M/1,014 F, average age = 63.53 ± 7.38) subjects with SMI and N = 11,849 (5,719 M/6,130 F; 64.42 ± 7.38) controls from the UK Biobank. Subjects were subdivided based on diagnostic status: SMI+/CMD+ (N = 665), SMI+/CMD− (N = 964), SMI−/CMD+ (N = 3,765), SMI−/CMD− (N = 8,083). SMI (F = 40.47, p = 2.06 × 10−10) and CMD (F = 24.69, p = 6.82 × 10−7) significantly, independently impacted whole‐brain QRI in SMI+. SSD had the largest effect (Cohen’s d = 1.42) then BD (d = 0.55), and MDD (d = 0.15). Hypertension had a significant effect on SMI+ (d = 0.19) and SMI− (d = 0.14). SMI effects were direct, independent of MD, and remained significant after correcting for effects of antipsychotic medications. Whole‐brain QRI was significantly (p < 10−16) associated with the volume of white matter hyperintensities (WMH). However, WMH did not show significant association with SMI and was driven by CMD, chiefly hypertension (p < 10−16). We used a simple and robust index, QRI, the demonstrate additive effect of SMI and CMD on accelerated brain aging. We showed a greater effect of psychiatric illnesses on QRI compared to cardio‐metabolic illness. Our findings suggest that subjects with SMI should be among the targets for interventions to protect against age‐related cognitive decline.
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Affiliation(s)
- Meghann C Ryan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kathryn S Hatch
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Si Gao
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Division of Biostatistics and Bioinformatics, Department of Public Health and Epidemiology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Krystl Haerian
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA
| | - Jingtao Wang
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Eric L Goldwaser
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Xiaoming Du
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Bhim M Adhikari
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Heather Bruce
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Stephanie Hare
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Mark D Kvarta
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Thomas E Nichols
- Nuffield Department of Population Health of the University of Oxford, Oxford, UK
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
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17
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Digiovanni A, Ajdinaj P, Russo M, Sensi SL, Onofrj M, Thomas A. Bipolar spectrum disorders in neurologic disorders. Front Psychiatry 2022; 13:1046471. [PMID: 36620667 PMCID: PMC9811836 DOI: 10.3389/fpsyt.2022.1046471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Psychiatric symptoms frequently predate or complicate neurological disorders, such as neurodegenerative diseases. Symptoms of bipolar spectrum disorders (BSD), like mood, behavioral, and psychotic alterations, are known to occur - individually or as a syndromic cluster - in Parkinson's disease and in the behavioral variant of frontotemporal dementia (FTD). Nonetheless, due to shared pathophysiological mechanisms, or genetic predisposition, several other neurological disorders show significant, yet neglected, clinical and biological overlaps with BSD like neuroinflammation, ion channel dysfunctions, neurotransmission imbalance, or neurodegeneration. BSD pathophysiology is still largely unclear, but large-scale network dysfunctions are known to participate in the onset of mood disorders and psychotic symptoms. Thus, functional alterations can unleash BSD symptoms years before the evidence of an organic disease of the central nervous system. The aim of our narrative review was to illustrate the numerous intersections between BSD and neurological disorders from a clinical-biological point of view and the underlying predisposing factors, to guide future diagnostic and therapeutical research in the field.
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Affiliation(s)
- Anna Digiovanni
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Paola Ajdinaj
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Astrid Thomas
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
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18
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Kupka R, Duffy A, Scott J, Almeida J, Balanzá‐Martínez V, Birmaher B, Bond DJ, Brietzke E, Chendo I, Frey BN, Grande I, Hafeman D, Hajek T, Hillegers M, Kauer‐Sant’Anna M, Mansur RB, van der Markt A, Post R, Tohen M, Tremain H, Vazquez G, Vieta E, Yatham LN, Berk M, Alda M, Kapczinski F. Consensus on nomenclature for clinical staging models in bipolar disorder: A narrative review from the International Society for Bipolar Disorders (ISBD) Staging Task Force. Bipolar Disord 2021; 23:659-678. [PMID: 34174130 PMCID: PMC9290926 DOI: 10.1111/bdi.13105] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Clinical staging is widely used in medicine to map disease progression, inform prognosis, and guide treatment decisions; in psychiatry, however, staging remains a hypothetical construct. To facilitate future research in bipolar disorders (BD), a well-defined nomenclature is needed, especially since diagnosis is often imprecise with blurred boundaries, and a full understanding of pathophysiology is lacking. METHODS Under the auspices of the International Society of Bipolar Disorders, a Task Force of international experts was convened to review, discuss, and integrate findings from the scientific literature relevant to the development of a consensus staging model and standardize a terminology that could be used to advance future research including staging of BD and related disorders. RESULTS Consensus opinion and areas of uncertainty or difference were identified in regard to terms referring to staging as it may apply to BD, to at-risk status and subthreshold stages, and to various clinical stages of BD as it is currently diagnosed. CONCLUSION The use of a standardized nomenclature about the clinical stages of BD will facilitate communication about research on clinical and pathological components of this heterogeneous group of disorders. The concepts presented are based on current evidence, but the template provided allows for further refinements as etiological advances come to light.
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Affiliation(s)
- Ralph Kupka
- Department of PsychiatryAmsterdam Public Mental Health Research InsituteAmsterdam UMCVrije UniversiteitAmsterdamThe Netherlands
| | - Anne Duffy
- Department of PsychiatryDivision of Student Mental HealthQueen's UniversityCote Sharp Student Wellness CentreKingstonONCanada,Department of PsychiatryUniversity of OxfordOxfordUK
| | - Jan Scott
- Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneUK,Brain and Mind CentreThe University of SydneySydneyNSWAustralia
| | - Jorge Almeida
- Department of Psychiatry and Behavior SciencesDell Medical SchoolUniversity of Texas at AustinAustinTXUSA
| | - Vicent Balanzá‐Martínez
- Teaching Unit of Psychiatry and Psychological MedicineDepartment of MedicineUniversity of ValenciaCIBERSAMValenciaSpain
| | | | - David J. Bond
- Department of Psychiatry and Behavioral SciencesUniversity of Minnesota Medical SchoolMinneapolisMNUSA
| | - Elisa Brietzke
- Department of PsychiatryQueen's University School of MedicineKingstonONCanada,Centre for Neuroscience StudiesQueen’s UniversityKingstonONCanada
| | - Ines Chendo
- Psychiatry DepartmentDepartment of NeurosciencesHospital Santa MariaLisbonPortugal,Clínica Universitária de PsiquiatriaFaculty of MedicineUniversity of LisbonLisbonPortugal
| | - Benicio N. Frey
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada,Mood Disorders Program and Women's Health Concerns ClinicSt. Joseph's Healthcare HamiltonHamiltonONCanada
| | - Iria Grande
- Barcelona Bipolar Disorders and Depressive UnitHospital ClinicInstitute of NeurosciencesUniversity of BarcelonaIDIBAPSCIBERSAMBarcelonaSpain
| | - Danella Hafeman
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Tomas Hajek
- Department of PsychiatryDalhousie UniversityHalifaxNSCanada
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical Center‐Sophia Children’s HospitalRotterdamThe Netherlands
| | - Marcia Kauer‐Sant’Anna
- Department of PsychiatryFaculty of MedicineUniversidade Federal do Rio Grande do Sul (UFRGSHospital de Clínicas de Porto Alegre (HCPAPorto AlegreBrazil
| | - Rodrigo B. Mansur
- Mood Disorders Psychopharmacology UnitUniversity Health NetworkTorontoONCanada,Department of PsychiatryUniversity of TorontoTorontoONCanada
| | - Afra van der Markt
- Department of PsychiatryAmsterdam Public Mental Health Research InsituteAmsterdam UMCVrije UniversiteitAmsterdamThe Netherlands
| | - Robert Post
- George Washington University School of MedicineWashingtonDCUSA,Bipolar Collaborative NetworkBethesdaMDUSA
| | - Mauricio Tohen
- Department of Psychiatry and Behavioral SciencesUniversity of New Mexico Health Sciences CenterAlbuquerqueNMUSA
| | - Hailey Tremain
- Centre for Mental HealthFaculty of Health Arts and DesignSwinburne UniversityMelbourneVicAustralia,OrygenThe National Centre of Excellence in Youth Mental HealthParkvilleVicAustralia
| | | | - Eduard Vieta
- Hospital ClinicInstitute of NeuroscienceUniversity of BarcelonaIDIBAPSCIBERSAMBarcelonaSpain
| | - Lakshmi N. Yatham
- Department of PsychiatryUniversity of British ColumbiaVancouverBCCanada
| | - Michael Berk
- IMPACT – the Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineBarwon HealthDeakin UniversityGeelongVicAustralia,OrygenThe National Centre of Excellence in Youth Mental HealthCentre for Youth Mental HealthFlorey Institute for Neuroscience and Mental HealthDepartment of PsychiatryThe University of MelbourneMelbourneVicAustralia
| | - Martin Alda
- Department of PsychiatryMood Disorders ClinicDalhousie UniversityHalifaxNCCanada
| | - Flávio Kapczinski
- St. Joseph’s Healthcare Hamilton McMaster UniversityHamiltonONCanada,Universidade Federal do Rio Grande do SulUFRGSPorto AlegreBrazil
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19
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Neuroprogression as an Illness Trajectory in Bipolar Disorder: A Selective Review of the Current Literature. Brain Sci 2021; 11:brainsci11020276. [PMID: 33672401 PMCID: PMC7926350 DOI: 10.3390/brainsci11020276] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/01/2021] [Accepted: 02/15/2021] [Indexed: 01/29/2023] Open
Abstract
Bipolar disorder (BD) is a chronic and disabling psychiatric condition that is linked to significant disability and psychosocial impairment. Although current neuropsychological, molecular, and neuroimaging evidence support the existence of neuroprogression and its effects on the course and outcome of this condition, whether and to what extent neuroprogressive changes may impact the illness trajectory is still poorly understood. Thus, this selective review was aimed toward comprehensively and critically investigating the link between BD and neurodegeneration based on the currently available evidence. According to the most relevant findings of the present review, most of the existing neuropsychological, neuroimaging, and molecular evidence demonstrates the existence of neuroprogression, at least in a subgroup of BD patients. These studies mainly focused on the most relevant effects of neuroprogression on the course and outcome of BD. The main implications of this assumption are discussed in light of specific shortcomings/limitations, such as the inability to carry out a meta-analysis, the inclusion of studies with small sample sizes, retrospective study designs, and different longitudinal investigations at various time points.
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20
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Ott CV, Knorr U, Jespersen A, Obenhausen K, Røen I, Purdon SE, Kessing LV, Miskowiak KW. Norms for the Screen for Cognitive Impairment in Psychiatry and cognitive trajectories in bipolar disorder. J Affect Disord 2021; 281:33-40. [PMID: 33285390 DOI: 10.1016/j.jad.2020.11.119] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/19/2020] [Accepted: 11/26/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The International Society for Bipolar Disorders Targeting Cognition Task Force recommends screening for and monitoring of cognitive impairments in patients with bipolar disorder (BD) with the Screen for Cognitive Impairment in Psychiatry (SCIP). The study aimed to provide the first demographically adjusted norms and change norms for the SCIP and to compare the cognitive trajectory over one year in remitted BD patients with normative cognitive change. METHODS Patients with fully or partially remitted BD and healthy controls (HC) were assessed with the SCIP at baseline and at a one-year follow-up. Regression-based models were used to determine demographically adjusted norms and change norms. Using the change models, predicted follow-up scores were calculated for BD and HC, and independent t-tests were used to compare deviations of the observed from the predicted follow-up scores for BD vs. HC to assess differences in cognitive trajectories. RESULTS Baseline data were collected for n=273 HC and n=218 BD, and follow-up data for n=139 HC and n=74 BD. Baseline norm models included age, sex and years of education, while change models included baseline SCIP scores and age. Patients with follow-up data showed selective impairments within verbal learning and recall at baseline. They followed the normative cognitive trajectories for all cognitive domains but verbal learning. LIMITATIONS Cognition was assessed with a screening tool. CONCLUSIONS We recommend implementing demographically adjusted norms and change norms for the SCIP in clinical and research settings. Change norms seem sensitive to subtle and selective cognitive decline over one year in remitted BD.
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Affiliation(s)
- Caroline V Ott
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ulla Knorr
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Andreas Jespersen
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kia Obenhausen
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Isabella Røen
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Scot E Purdon
- Alberta Hospital Edmonton and the Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Lars V Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kamilla W Miskowiak
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
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21
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Wollenhaupt-Aguiar B, Kapczinski F, Pfaffenseller B. Biological Pathways Associated with Neuroprogression in Bipolar Disorder. Brain Sci 2021; 11:brainsci11020228. [PMID: 33673277 PMCID: PMC7918818 DOI: 10.3390/brainsci11020228] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 02/06/2023] Open
Abstract
There is evidence suggesting clinical progression in a subset of patients with bipolar disorder (BD). This progression is associated with worse clinical outcomes and biological changes. Molecular pathways and biological markers of clinical progression have been identified and may explain the progressive changes associated with this disorder. The biological basis for clinical progression in BD is called neuroprogression. We propose that the following intertwined pathways provide the biological basis of neuroprogression: inflammation, oxidative stress, impaired calcium signaling, endoplasmic reticulum and mitochondrial dysfunction, and impaired neuroplasticity and cellular resilience. The nonlinear interaction of these pathways may worsen clinical outcomes, cognition, and functioning. Understanding neuroprogression in BD is crucial for identifying novel therapeutic targets, preventing illness progression, and ultimately promoting better outcomes.
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Affiliation(s)
- Bianca Wollenhaupt-Aguiar
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON L8N 3K7, Canada; (B.W.-A.); (F.K.)
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON L8N 3K7, Canada; (B.W.-A.); (F.K.)
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada
- Neuroscience Graduate Program, McMaster University, Hamilton, ON L8S 4L8, Canada
- Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-003, Brazil
| | - Bianca Pfaffenseller
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON L8N 3K7, Canada; (B.W.-A.); (F.K.)
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada
- Correspondence:
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22
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Zhang Y, Zhu D, Zhang P, Li W, Qin W, Liu F, Xu J, Xu Q, Wang J, Ye Z, Yu C. Neural mechanisms of AVPR1A RS3-RS1 haplotypes that impact verbal learning and memory. Neuroimage 2020; 222:117283. [PMID: 32828928 DOI: 10.1016/j.neuroimage.2020.117283] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/27/2020] [Accepted: 08/15/2020] [Indexed: 12/16/2022] Open
Abstract
Converging evidence from both human and animal studies has highlighted the pervasive role of the neuropeptide arginine vasopressin (AVP), which is mediated by arginine vasopressin receptor 1A (AVPR1A), in both social and nonsocial learning and memory. However, the effect of genetic variants in AVPR1A on verbal learning and memory is unknown. The hippocampus is a heterogeneous structure that consists of several anatomically and functionally distinct subfields, and it is the principal target structure for the memory-enhancing effect of AVP. We tested the hypothesis that genetic variants in the RS3 and RS1 repeat polymorphisms may influence verbal learning and memory performance evaluated by the California Verbal Learning Test-II (CVLT-II) by modulating the gray matter volume (GMV) and resting-state functional connectivity (rsFC) of whole hippocampus and its subfields in a large cohort of young healthy subjects (n = 1001). Using a short/long classification scheme for the repeat length of RS3 and RS1, we found that the individuals carrying more short alleles of RS3-RS1 haplotypes had poorer learning and memory performance compared to that of those carrying more long alleles. We also revealed that individuals carrying more short alleles exhibited a significantly smaller GMV in the left cornu ammonis (CA)2/3 and weaker rsFC of the left CA2/3-bilateral thalamic (primarily in medial prefrontal subfields) compared to those carrying more long alleles. Furthermore, multiple mediation analysis confirmed that these two hippocampal imaging measures jointly and fully mediated the relationship between the genetic variants in AVPR1A RS3-RS1 haplotypes and the individual differences in verbal learning and memory performance. Our results suggest that genetic variants in AVPR1A RS3-RS1 haplotypes may affect verbal learning and memory performance in part by modulating the left hippocampal CA2/3 structure and its rsFC with the thalamus.
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Affiliation(s)
- Yan Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin 300052, China
| | - Dan Zhu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin 300052, China
| | - Peng Zhang
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin 300060, China
| | - Wei Li
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin 300060, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin 300052, China
| | - Feng 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
| | - Jiayuan Xu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin 300052, China
| | - Qiang Xu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin 300052, China
| | - Junping Wang
- 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, Huanhuxi Road, Hexi District, Tianjin 300060, China.
| | - Chunshui Yu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin 300052, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China.
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23
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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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Li C, Palka JM, Brown ES. Cognitive impairment in individuals with bipolar disorder with and without comorbid alcohol and/or cocaine use disorders. J Affect Disord 2020; 272:355-362. [PMID: 32553378 PMCID: PMC7305419 DOI: 10.1016/j.jad.2020.03.179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 02/27/2020] [Accepted: 03/29/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Bipolar disorder (BD) frequently co-occurs with substance use disorders (SUDs), and both are associated with cognitive impairment. This study compares cognition between individuals with BD with and without current alcohol use disorder (AUD), cocaine use disorder (CUD), or both, as these disorders may be linked with additive cognitive impairment. METHODS Baseline data were analyzed from five clinical studies of individuals with the aforementioned disorders (N = 373). Participants were grouped as follows: BD-only, BD + AUD, BD + CUD, or BD + AUD + CUD. Cognition was assessed with the Rey Auditory Verbal Learning Test (RAVLT) (verbal learning and memory) and Stroop Color Word Test (executive function). Multiple linear regression models determined if SUD diagnosis, among other demographic and clinical variables, predicted each cognitive test's T-score. Regression equations were used to compute each group's mean T-scores. RESULTS All groups demonstrated below-average mean T-scores on all tests, with no significant between-group score differences. RAVLT total T-scores were lower than Stroop color-word T-scores within all groups (non-overlapping 95% confidence intervals). Higher daily cocaine use predicted higher Stroop T-scores (p < 0.01) and RAVLT delayed recall T-scores (p < 0.05). No other non-demographic variable, including AUD/CUD group status, predicted cognitive performance. LIMITATIONS A full cognitive battery and some relevant variables (e.g. BD lifetime illness course) were not available. Many participants (42.1%) had additional SUDs. CONCLUSIONS BD with and without AUD/CUD was found to be associated with greater deficits in verbal learning and memory than in executive function. Addressing these impaired domains in dually-diagnosed patients may improve treatment and functional outcomes.
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Affiliation(s)
- Chengxi Li
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd. MC 8849, Dallas, TX 75390-8849, USA
| | - Jayme M Palka
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd. MC 8849, Dallas, TX 75390-8849, USA
| | - E Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd. MC 8849, Dallas, TX 75390-8849, USA.
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25
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Chen J, Tan J, Greenshaw AJ, Sawalha J, Liu Y, Zhang X, Zou W, Cheng X, Deng W, Zhang Y, Cui L, Liu C, Sun J, Cheng X, Wu Q, Li S, Mai S, Lan X, Chen Y, Cai Y, Zheng C, Cheng D, Zhang B, Yang C, Li X, Li X, Ye B, Yousefnezhad M, Zhang Y, Zhao L, Soares JC, Zhang X, Li T, Cao B, Cao L. CACNB2 rs11013860 polymorphism correlates of prefrontal cortex thickness in bipolar patients with first-episode mania. J Affect Disord 2020; 268:82-87. [PMID: 32158010 DOI: 10.1016/j.jad.2020.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/28/2020] [Accepted: 02/01/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The β2 subunit of the voltage-gated l-type calcium channel gene(CACNB2) rs11013860 polymorphism is a putative genetic susceptibility marker for bipolar disorder (BD). However, the neural effects of CACNB2 rs11013860 in BD are largely unknown. METHODS Forty-six bipolar patients with first-episode mania and eighty-three healthy controls (HC) were genotyped for CACNB2 rs11013860 and were scanned with a 3.0 Tesla structural magnetic resonance imaging system to measure cortical thickness of prefrontal cortex (PFC) components (superior frontal cortex, orbitofrontal cortex, middle and inferior frontal gyri). RESULTS Cortical thickness was thinner in patients on all PFC measurements compared to HC (p < 0.050). Moreover, we found a significant interaction between CACNB2 genotype and diagnosis for the right superior frontal cortical thickness (F = 8.190, p = 0.040). Bonferroni corrected post-hoc tests revealed that, in CACNB2 A-allele carriers, patients displayed thinner superior frontal thickness compared to HC (p < 0.001). In patients, CACNB2 A-allele carriers also exhibited reduced superior frontal thickness compared to CACNB2 CC-allele carriers (p = 0.016). LIMITATIONS Lithium treatment may influence our results, and the sample size in our study is relatively small. CONCLUSIONS Our results suggest that the CACNB2 rs11013860 might impact PFC thickness in patients with first-episode mania. These findings provide evidence to support CACNB2 rs11013860 involvement in the emotion-processing neural circuitry abnormality in the early stage of BD, which will ultimately contribute to revealing the link between the variation in calcium channel genes and the neuropathological mechanism of BD.
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Affiliation(s)
- Jianshan Chen
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Jiuwei Tan
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Andrew J Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Jeff Sawalha
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Yang Liu
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Xiaofei Zhang
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Wenjin Zou
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Xiaofang Cheng
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Wenhao Deng
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Yizhi Zhang
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China; General Hospital of Southern Theater Command, Guangzhou, Guangdong, PR China
| | - Liqian Cui
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Chuihong Liu
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Jiaqi Sun
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Xiongchao Cheng
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China; Nanning Fifth People's Hospital, Nanning, Guangxi Zhuang autonomous region, PR China
| | - Qiuxia Wu
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Suyi Li
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Siming Mai
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Xiaofeng Lan
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Yingmei Chen
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Yinglian Cai
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Chaodun Zheng
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Daomeng Cheng
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Bin Zhang
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Chanjuan Yang
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Xuan Li
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | - Xinmin Li
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Biyu Ye
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China
| | | | - Yamin Zhang
- The Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Liansheng Zhao
- The Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Xiangyang Zhang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, PR China
| | - Tao Li
- The Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Bo Cao
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China; Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.
| | - Liping Cao
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou HuiAi Hospital, Guangzhou, Guangdong, PR China.
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26
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Fries GR, Zamzow MJ, Andrews T, Pink O, Scaini G, Quevedo J. Accelerated aging in bipolar disorder: A comprehensive review of molecular findings and their clinical implications. Neurosci Biobehav Rev 2020; 112:107-116. [DOI: 10.1016/j.neubiorev.2020.01.035] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/11/2020] [Accepted: 01/29/2020] [Indexed: 01/08/2023]
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Tremain H, Fletcher K, Murray G. Number of episodes in bipolar disorder: The case for more thoughtful conceptualization and measurement. Bipolar Disord 2020; 22:231-244. [PMID: 31730294 DOI: 10.1111/bdi.12872] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Number of mood episodes (NoE) may be an important prognostic indicator in bipolar disorder, with implications for treatment. However, NoE has been conceptualized and measured inconsistently throughout the literature. This review examines the construct of NoE in bipolar disorder, with the aim of enhancing its conceptualization and measurement. METHODS A critical evaluation of literatures on important correlates of NoE, conceptually and phenomenologically overlapping features, and previous studies considering and measuring this construct was undertaken. RESULTS The literature indicates that despite frequent use, NoE has been inconsistently defined and measured. Multiple studies have linked NoE with important clinical factors, including relapse, functioning, cognitive impairment and the effectiveness of both pharmacological and psychosocial interventions, yet conclusions are limited by its inconsistent treatment. Additionally, it seems evident that that NoE may best be treated as a fuzzy construct (rather than precise figure), with yet to be defined overlaps with clinical variables such as age at onset and severity. Attempts to measure this construct have varied in comprehensiveness and structure. CONCLUSIONS The NoE construct may have important implications for individuals with bipolar disorders. However, more consistent and systematic definition and assessment of NoE is required to advance this literature and clarify its role. Recommendations aimed at advancing the conceptualization and the measurement of NoE are provided. Conceptualization may be advanced by considering and exploring relationships between NoE and factors with which it overlaps, while measurement may best be improved with increased consistency and balancing accuracy with feasibility.
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Affiliation(s)
- Hailey Tremain
- Faculty of Health Arts and Design, Centre for Mental Health, Swinburne University, Melbourne, Australia
| | - Kathryn Fletcher
- Faculty of Health Arts and Design, Centre for Mental Health, Swinburne University, Melbourne, Australia
| | - Greg Murray
- Faculty of Health Arts and Design, Centre for Mental Health, Swinburne University, Melbourne, Australia
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28
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Van Rheenen TE, Lewandowski KE, Bauer IE, Kapczinski F, Miskowiak K, Burdick KE, Balanzá-Martínez V. Current understandings of the trajectory and emerging correlates of cognitive impairment in bipolar disorder: An overview of evidence. Bipolar Disord 2020; 22:13-27. [PMID: 31408230 DOI: 10.1111/bdi.12821] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Cognitive dysfunction affects a significant proportion of people with bipolar disorder (BD), but the cause, trajectory and correlates of such dysfunction remains unclear. Increased understanding of these factors is required to progress treatment development for this symptom dimension. METHODS This paper provides a critical overview of the literature concerning the trajectories and emerging correlates of cognitive functioning in BD. It is a narrative review in which we provide a qualitative synthesis of current evidence concerning clinical, molecular, neural and lifestyle correlates of cognitive impairment in BD across the lifespan (in premorbid, prodromal, early onset, post-onset, elderly cohorts). RESULTS There is emerging evidence of empirical links between cognitive impairment and an increased inflammatory state, brain structural abnormalities and reduced neuroprotection in BD. However, evidence regarding the progressive nature of cognitive impairment is mixed, since consensus between different cross-sectional data is lacking and does not align to the outcomes of the limited longitudinal studies available. Increased recognition of cognitive heterogeneity in BD may help to explain some inconsistencies in the extant literature. CONCLUSIONS Large, longitudinally focussed studies of cognition and its covariation alongside biological and lifestyle factors are required to better define cognitive trajectories in BD, and eventually pave the way for the application of a precision medicine approach for individual patients in clinical practice.
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Affiliation(s)
- Tamsyn E Van Rheenen
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia.,Faculty of Health, Arts and Design, School of Health Sciences, Centre for Mental Health, Swinburne University, Melbourne, Australia
| | - Kathryn E Lewandowski
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Isabelle E Bauer
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioral Neurosciences, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada.,Department of Psychiatry, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Kamilla Miskowiak
- Neurocognition and Emotion in Affective Disorders Group, Copenhagen Affective Disorder Research Centre, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Katherine E Burdick
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA.,James J Peters VA Medical Center, Bronx, NY, USA
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
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29
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A clinical staging model for bipolar disorder: longitudinal approach. Transl Psychiatry 2020; 10:45. [PMID: 32066710 PMCID: PMC7026435 DOI: 10.1038/s41398-020-0718-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/18/2019] [Accepted: 01/02/2020] [Indexed: 12/21/2022] Open
Abstract
Bipolar disorder (BD) has been identified as a life-course illness with different clinical manifestations from an at-risk to a late stage, supporting the assumption that it would benefit from a staging model. In a previous study, we used a clustering approach to stratify 224 patients with a diagnosis of BD into five clusters based on clinical characteristics, functioning, cognition, general health, and health-related quality of life. This study was design to test the construct validity of our previously developed k-means clustering model and to confirm its longitudinal validity over a span of 3 years. Of the 224 patients included at baseline who were used to develop our model, 129 (57.6%) reached the 3-year follow-up. All life domains except mental health-related quality of life (QoL) showed significant worsening in stages (p < 0.001), suggesting construct validity. Furthermore, as patients progressed through stages, functional decline (p < 0.001) and more complex treatment patterns (p = 0.002) were observed. As expected, at 3 years, the majority of patients remained at the same stage (49.6%), or progressed (20.9%) or regressed (23.3%) one stage. Furthermore, 85% of patients who stayed euthymic during that period remained at the same stage or regressed to previous stages, supporting its longitudinal validity. For that reason, this study provides evidence of the construct and longitudinal validity of an empirically developed, comprehensive staging model for patients with BD. Thus, it may help clinicians and researchers to better understand the disorder and, at the same time, to design more accurate and personalized treatment plans.
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30
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Overlapping mechanisms linking insulin resistance with cognition and neuroprogression in bipolar disorder. Neurosci Biobehav Rev 2020; 111:125-134. [PMID: 31978440 DOI: 10.1016/j.neubiorev.2020.01.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 12/26/2022]
Abstract
Cognitive impairment is highly prevalent in the progression of both diabetes mellitus and bipolar disorder. The relationship between insulin resistance in diabetes and the risk of developing major neurocognitive disorders such as Alzheimer's disease has been well described. Insulin resistance and the associated metabolic deficiencies lead to biochemical alteration which hasten neurodegeneration and subsequent cognitive impairment. For bipolar disorder, some patients experience a cyclical, yet progressive course of illness. These patients are also more likely to have medical comorbidities such as cardiovascular disease and diabetes, and insulin resistance in particular may precede the neuroprogressive course. Diabetes and bipolar disorder share epidemiological, biochemical, and structural signatures, as well as cognitive impairment within similar domains, suggesting a common mechanism between the two conditions. Here we describe the association between insulin resistance and cognitive changes in bipolar disorder, as well as potential implications for therapeutic modulation of neuroprogression.
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31
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Barichello T, Giridharan VV, Bhatti G, Sayana P, Doifode T, Macedo D, Quevedo J. Inflammation as a Mechanism of Bipolar Disorder Neuroprogression. Curr Top Behav Neurosci 2020; 48:215-237. [PMID: 33040314 DOI: 10.1007/7854_2020_173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Bipolar disorder (BD) is a severe, debilitating psychiatric condition with onset in adolescence or young adulthood and often follows a relapsing and remitting course throughout life. The concept of neuroprogression in BD refers to the progressive path with an identifiable trajectory that takes place with recurrent mood episodes, which eventually leads to cognitive, functional, and clinical deterioration in the course of BD. Understanding the biological basis of neuroprogression helps to explain the subset of BD patients who experience worsening of their disorder over time. Additionally, the study of the neurobiological mechanisms underpinning neuroprogression will help BD staging based on systems biology. Replicated epidemiological studies have suggested inflammatory mechanisms as primary contributors to the neuroprogression of mood disorders. It is known that dysregulated inflammatory/immune pathways are often associated with BD pathophysiology. Hence, in this chapter, we focus on the evidence for the involvement of inflammation and immune regulated pathways in the neurobiological consequences of BD neuroprogression. Herein we put forth the evidence of immune markers from autoimmune disorders, chronic infections, and gut-brain axis that lead to BD neuroprogression. Further, we highlighted the peripheral and central inflammatory components measured along with BD progression.
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Affiliation(s)
- Tatiana Barichello
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA. .,Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil. .,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.
| | - Vijayasree Vayalanellore Giridharan
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Gursimrat Bhatti
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Pavani Sayana
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Tejaswini Doifode
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Danielle Macedo
- Neuropsychopharmacology Laboratory, Drug Research, and Development Center, Faculty of Medicine, Universidade Federal do Ceará, Fortaleza, CE, Brazil.,National Institute for Translational Medicine (INCT-TM, CNPq), Ribeirao Preto, Brazil
| | - Joao Quevedo
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.,Laboratory of Neurosciences, Graduate Program in Health Sciences, University of Southern Santa Catarina-UNESC, Criciúma, SC, Brazil.,Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
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32
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Fijtman A, Bücker J, Strange BA, Martins DS, Passos IC, Hasse-Sousa M, Lima FM, Kapczinski F, Yatham L, Kauer-Sant'Anna M. Emotional memory in bipolar disorder: Impact of multiple episodes and childhood trauma. J Affect Disord 2020; 260:206-213. [PMID: 31505398 DOI: 10.1016/j.jad.2019.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/07/2019] [Accepted: 09/01/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Emotional memory is a critical amygdala-dependent cognitive function characterized by enhanced memory for emotional events coupled with retrograde amnesia. Our study aims to assess the influence of bipolar disorder (BD), trauma, and the number of mood episodes on emotional memory. METHODS 53 subjects (33 euthymic patients with BD and 20 healthy controls) answered a clinical assessment, childhood trauma questionnaire (CTQ), and an emotional memory test composed of lists of nouns, including neutral words, one emotional (E), one preceding (E-1) and one following word (E + 1). We assessed for the influence of type, position, diagnosis, trauma, and number of mood episodes in word recall using generalized estimating equations. RESULTS Controlling for neutral words, BD had a higher recall for E-1 (p = 0.038) and a trend for a higher recall of E (p = 0.055). There was no difference between patients with and without trauma. Patients with BD who suffered multiple mood episodes had a higher recall of E compared to patients with fewer episodes (p = 0.016). LIMITATIONS Cross-sectional design and small sample size. CONCLUSION Our results indicate dysfunction in emotional memory in patients with BD, particularly after multiple mood episodes. While we expected an impaired emotional memory, patients with BD showed an increased recall for emotional stimuli and events preceding them. Childhood trauma does not seem to interfere with emotional memory changes in patients with BD. Emotional memory enhancement seems to be a promising marker of progression in BD.
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Affiliation(s)
- Adam Fijtman
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
| | - Joana Bücker
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Bryan A Strange
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, Spain
| | - Dayane Santos Martins
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Mathias Hasse-Sousa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavia Moreira Lima
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavio Kapczinski
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Neuroscience Graduate Program, McMaster University, 100 West Fifth Street, Hamilton, ON, Canada
| | - Lakshmi Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Márcia Kauer-Sant'Anna
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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33
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Structural and Functional Brain Correlates of Neuroprogression in Bipolar Disorder. Curr Top Behav Neurosci 2020; 48:197-213. [PMID: 33040317 DOI: 10.1007/7854_2020_177] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Neuroprogression is associated with structural and functional brain changes that occur in parallel with cognitive and functioning impairments. There is substantial evidence showing early white matter changes, as well as trajectory-related gray matter alterations. Several structures, including prefrontal, parietal, temporal cortex, and limbic structures, seem to be altered over the course of bipolar disorder, especially associated with the number of episodes and length of the disease. An important limitation is that most of the studies used either a cross-sectional design or a short follow-up period, which may be insufficient to identify all neuroprogressive changes over time. In addition, the heterogeneity of patients with bipolar disorder is another challenge to determine which subjects will have a more pernicious trajectory. Larger studies and the use of new techniques, such as machine learning, may help to enable more discoveries and evidence on the role of neuroprogression in BD.
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34
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Lundberg M, Millischer V, Backlund L, Martinsson L, Stenvinkel P, Sellgren CM, Lavebratt C, Schalling M. Lithium and the Interplay Between Telomeres and Mitochondria in Bipolar Disorder. Front Psychiatry 2020; 11:586083. [PMID: 33132941 PMCID: PMC7553080 DOI: 10.3389/fpsyt.2020.586083] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/31/2020] [Indexed: 01/06/2023] Open
Abstract
Bipolar disorder is a severe psychiatric disorder which affects more than 1% of the world's population and is a leading cause of disability among young people. For the past 50 years, lithium has been the drug of choice for maintenance treatment of bipolar disorder due to its potent ability to prevent both manic and depressive episodes as well as suicide. However, though lithium has been associated with a multitude of effects within different cellular pathways and biological systems, its specific mechanism of action in stabilizing mood remains largely elusive. Mitochondrial dysfunction and telomere shortening have been implicated in both the pathophysiology of bipolar disorder and as targets of lithium treatment. Interestingly, it has in recent years become clear that these phenomena are intimately linked, partly through reactive oxygen species signaling and the subcellular translocation and non-canonical actions of telomerase reverse transcriptase. In this review, we integrate the current understanding of mitochondrial dysfunction, oxidative stress and telomere shortening in bipolar disorder with documented effects of lithium. Moreover, we propose that lithium's mechanism of action is intimately connected with the interdependent regulation of mitochondrial bioenergetics and telomere maintenance.
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Affiliation(s)
- Martin Lundberg
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Vincent Millischer
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Lena Backlund
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Lina Martinsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden
| | - Peter Stenvinkel
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Carl M Sellgren
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
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Nascimento C, Nunes VP, Diehl Rodriguez R, Takada L, Suemoto CK, Grinberg LT, Nitrini R, Lafer B. A review on shared clinical and molecular mechanisms between bipolar disorder and frontotemporal dementia. Prog Neuropsychopharmacol Biol Psychiatry 2019; 93:269-283. [PMID: 31014945 PMCID: PMC6994228 DOI: 10.1016/j.pnpbp.2019.04.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 04/15/2019] [Accepted: 04/18/2019] [Indexed: 12/12/2022]
Abstract
Mental disorders are highly prevalent and important causes of medical burden worldwide. Co-occurrence of neurological and psychiatric symptoms are observed among mental disorders, representing a challenge for their differential diagnosis. Psychiatrists and neurologists have faced challenges in diagnosing old adults presenting behavioral changes. This is the case for early frontotemporal dementia (FTD) and bipolar disorder. In its initial stages, FTD is characterized by behavioral or language disturbances in the absence of cognitive symptoms. Consequently, patients with the behavioral subtype of FTD (bv-FTD) can be initially misdiagnosed as having a psychiatric disorder, typically major depression disorder (MDD) or bipolar disorder (BD). Bipolar disorder is associated with a higher risk of dementia in older adults and with cognitive impairment, with a subset of patients presents a neuroprogressive pattern during the disease course. No mendelian mutations were identified in BD, whereas three major genetic causes of FTD have been identified. Clinical similarities between BD and bv-FTD raise the question whether common molecular pathways might explain shared clinical symptoms. Here, we reviewed existing data on clinical and molecular similarities between BD and FTD to propose biological pathways that can be further investigated as common or specific markers of BD and FTD.
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Affiliation(s)
- Camila Nascimento
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
| | - Villela Paula Nunes
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
| | - Roberta Diehl Rodriguez
- Behavioral and Cognitive Neurology Unit, Department of Neurology and LIM 22, University of São Paulo, São Paulo 05403-900, Brazil
| | - Leonel Takada
- Behavioral and Cognitive Neurology Unit, Department of Neurology, University of São Paulo, São Paulo 05403-900, Brazil
| | - Cláudia Kimie Suemoto
- Division of Geriatrics, LIM-22, University of São Paulo Medical School, São Paulo 01246-90, Brazil
| | - Lea Tenenholz Grinberg
- Department of Pathology, LIM-22, University of São Paulo Medical School, São Paulo 01246-90, Brazil; Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143-120, USA.
| | - Ricardo Nitrini
- Behavioral and Cognitive Neurology Unit, Department of Neurology, University of São Paulo, São Paulo 05403-900, Brazil
| | - Beny Lafer
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
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Sánchez-Morla EM, López-Villarreal A, Jiménez-López E, Aparicio AI, Martínez-Vizcaíno V, Roberto RJ, Vieta E, Santos JL. Impact of number of episodes on neurocognitive trajectory in bipolar disorder patients: a 5-year follow-up study. Psychol Med 2019; 49:1299-1307. [PMID: 30043716 DOI: 10.1017/s0033291718001885] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND The neurocognitive trajectory in bipolar disorder (BD) is variable, with controversial findings, and most evidence come from cross-sectional studies. We aimed to examine the course of neurocognitive functioning in a sample of euthymic BD patients in comparison with a control group during a 5-year follow-up. METHODS Ninety-nine euthymic bipolar patients and 40 healthy controls were assessed using a comprehensive neurocognitive battery (six neurocognitive domains) at baseline (T1) and then at 5-year follow-up (T2) in a longitudinal study. RESULTS No evidence of a progression in neurocognitive dysfunction was found either in cognitive composite index or in any of the neurocognitive domains for the whole cohort. However, there was a negative correlation between number of manic episodes and hospitalisations due to manic episodes and change in neurocognitive composite index (NCI) during the follow-up. Moreover, patients with higher number of manic and hypomanic episodes have a greater decrease in NCI, working memory and visual memory. History of psychotic symptoms was not related to the trajectory of neurocognitive impairment. CONCLUSIONS Our results suggest that, although the progression of cognitive decline is not a general rule in BD, BD patients who have a greater number of manic or hypomanic episodes may constitute a subgroup characterised by the progression of neurocognitive impairment. Prevention of manic and hypomanic episodes could have a positive impact on the trajectory of cognitive function.
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Affiliation(s)
| | | | | | | | | | | | - Eduard Vieta
- CIBERSAM (Biomedical Research Networking Centre in Mental Health),Spain
| | - José-Luis Santos
- CIBERSAM (Biomedical Research Networking Centre in Mental Health),Spain
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Huang MH, Cheng CM, Huang KL, Hsu JW, Bai YM, Su TP, Li CT, Tsai SJ, Lin WC, Chen TJ, Chen MH. Bipolar disorder and risk of Parkinson disease: A nationwide longitudinal study. Neurology 2019; 92:e2735-e2742. [PMID: 31118242 DOI: 10.1212/wnl.0000000000007649] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/01/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the risk of Parkinson disease (PD) among patients with bipolar disorder (BD). METHODS Using the Taiwan National Health Insurance Research Database, we examined 56,340 patients with BD and 225,360 age- and sex-matched controls between 2001 and 2009 and followed them to the end of 2011. Individuals who developed PD during the follow-up period were identified. RESULTS Patients with BD had a higher incidence of PD (0.7% vs 0.1%, p < 0.001) during the follow-up period than the controls. A Cox regression analysis with adjustments for demographic data and medical comorbid conditions revealed that patients with BD were more likely to develop PD (hazard ratio [HR] 6.78, 95% confidence interval [CI] 5.74-8.02) than the control group. Sensitivity analyses after exclusion of the first year (HR 5.82, 95% CI 4.89-6.93) or first 3 years (HR 4.42; 95% CI 3.63-5.37) of observation showed consistent findings. Moreover, a high frequency of psychiatric admission for manic/mixed and depressive episodes was associated with an increased risk of developing PD. CONCLUSION Patients with BD had a higher incidence of PD during the follow-up period than the control group. Manic/mixed and depressive episodes were associated with an elevated likelihood of developing PD. Further studies are necessary to investigate the underlying pathophysiology between BD and PD.
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Affiliation(s)
- Mao-Hsuan Huang
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Chih-Ming Cheng
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan.
| | - Kai-Lin Huang
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Ju-Wei Hsu
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Ya-Mei Bai
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Tung-Ping Su
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Cheng-Ta Li
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Shih-Jen Tsai
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Wei-Chen Lin
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Tzeng-Ji Chen
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Mu-Hong Chen
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan.
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38
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Kauer-Sant'Anna M, Frey BN, Fijtman A, Loredo-Souza AC, Dargél AA, Pfaffenseller B, Wollenhaupt-Aguiar B, Gazalle FK, Colpo GD, Passos IC, Bücker J, Walz JC, Jansen K, Ceresér M, Bürke Bridi KP, Dos Santos Sória L, Kunz M, Pinho M, Kapczinski NS, Goi PD, Magalhães PV, Reckziegel R, Burque RK, de Azevedo Cardoso T, Kapczinski F. Adjunctive tianeptine treatment for bipolar disorder: A 24-week randomized, placebo-controlled, maintenance trial. J Psychopharmacol 2019; 33:502-510. [PMID: 30835152 DOI: 10.1177/0269881119826602] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the efficacy and tolerability of tianeptine as an adjunctive maintenance treatment for bipolar depression. METHODS This is a multicenter double-blind randomized placebo-controlled maintenance trial of adjunctive tianeptine 37.5 mg/day. Participants ( n=161) had a Montgomery-Asberg Depression Rating Scale ⩾12 at entry. After eight weeks of open-label tianeptine treatment, those who responded to tianeptine ( n=69) were randomized to adjunctive tianeptine ( n=36) or placebo ( n=33) in addition to usual treatment. Kaplan-Meier estimates and the Mantel-Cox log-rank test were used to evaluate differences in time to intervention for a mood episode between the tianeptine and placebo groups. We also assessed overall functioning, biological rhythms, quality of life, rates of manic switch and serum brain-derived neurotrophic factor levels. RESULTS There were no differences between adjunctive tianeptine or placebo regarding time to intervention or depression scores in the 24-week double-blind controlled phase. Patients in the tianeptine group showed better performance in the letter-number sequencing subtest from the Wechsler Adult Intelligence Scale at the endpoint ( p=0.014). Tianeptine was well tolerated and not associated with higher risk for manic switch compared to placebo. CONCLUSION Tianeptine was not more effective than placebo in the maintenance treatment of bipolar depression. There is preliminary evidence suggesting a pro-cognitive effect of tianeptine in working memory compared to placebo.
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Affiliation(s)
- Márcia Kauer-Sant'Anna
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,2 Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Benicio N Frey
- 3 Women's Health Concerns Clinic, St Joseph's Healthcare, Hamilton, ON, Canada.,4 Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Adam Fijtman
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,2 Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Ana C Loredo-Souza
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Aroldo A Dargél
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Bianca Pfaffenseller
- 4 Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Bianca Wollenhaupt-Aguiar
- 4 Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Fernando K Gazalle
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriela D Colpo
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ives C Passos
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,2 Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Joana Bücker
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Júlio C Walz
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Karen Jansen
- 6 Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Mendes Ceresér
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,2 Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Kelen P Bürke Bridi
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Lisiane Dos Santos Sória
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maurício Kunz
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,2 Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Michele Pinho
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Natália S Kapczinski
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,2 Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Pedro D Goi
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,5 Department of Internal Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Pedro Vs Magalhães
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,2 Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Ramiro Reckziegel
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Renan K Burque
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Taiane de Azevedo Cardoso
- 4 Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Flávio Kapczinski
- 1 Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,2 Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,4 Mood Disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Fateh AA, Long Z, Duan X, Cui Q, Pang Y, Farooq MU, Nan X, Chen Y, Sheng W, Tang Q, Chen H. Hippocampal functional connectivity-based discrimination between bipolar and major depressive disorders. Psychiatry Res Neuroimaging 2019; 284:53-60. [PMID: 30684896 DOI: 10.1016/j.pscychresns.2019.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 01/11/2019] [Accepted: 01/11/2019] [Indexed: 01/14/2023]
Abstract
Despite the impressive advancements in the neuropathology of mood disorders, patients with bipolar disorder (BD) are often misdiagnosed on the initial presentation with major depressive disorder (MDD). With supporting evidence from neuroimaging studies, the abnormal functional connectivity (FC) of the hippocampus has been associated with various mood disorders, including BD and MDD. However, the features of the hippocampal FC underlying MDD and BD have not been directly compared. This study aims to investigate the hippocampal resting-state FC (rsFC) analyses to distinguish these two clinical conditions. Resting-state functional magnetic resonance imaging (fMRI) data was collected from a sample group of 30 patients with BD, 29 patients with MDD and 30 healthy controls (HCs). One-way ANOVA was employed to assess the potential differences of the hippocampus FC across all subjects. BD patients exhibited increased FC of the bilateral anterior/posterior hippocampus with lingual gyrus and inferior frontal gyrus (IFG) relative to patients MDD patients. In comparison with HCs, patients with BD and MDD had an increased FC between the right anterior hippocampus and lingual gyrus and a decreased FC between the right posterior hippocampus and right IFG. The results revealed a distinct hippocampal FC in MDD patients compared with that observed in BD patients. These findings may assist investigators in attempting to distinguish mood disorders by using fMRI data.
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Affiliation(s)
- Ahmed Ameen Fateh
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiliang Long
- Sleep and Neuroimaging Center, Faculty of Psychology, Southwest University, Chongqing, China
| | - Xujun Duan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Cui
- School of Political Science and Public Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Yajing Pang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Muhammad Umar Farooq
- Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, China
| | - Xiaoyu Nan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China; School of Political Science and Public Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuyan Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qin Tang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China.
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Tsai SY, Gildengers AG, Hsu JL, Chung KH, Chen PH, Huang YJ. Inflammation associated with volume reduction in the gray matter and hippocampus of older patients with bipolar disorder. J Affect Disord 2019; 244:60-66. [PMID: 30317016 DOI: 10.1016/j.jad.2018.10.093] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/22/2018] [Accepted: 10/05/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Bipolar disorder (BD) and aging appear to be associated with inflammatory activation. Inflammatory processes might affect hippocampal function, neurogenesis, and gray matter loss. This study investigated the relationship between BD-specific brain regions and the total gray matter volume, peripheral inflammatory markers, and clinical features in older patients with BD. METHODS We recruited euthymic patients with bipolar I disorder aged ≥50 years to undergo whole-brain magnetic resonance imaging. Each brain region was divided by an individual's total intracranial volume to obtain that brain region's volume in percentage relative to the total intracranial volume. We measured the plasma levels of soluble tumor necrosis factor receptor-1 (sTNF-R1), soluble interleukin (IL)-2 receptor (sIL-2R), sIL-6R, IL-1β, and IL-1 receptor antagonist when patients were euthymic. Clinical data were obtained by reviewing available medical records and interviewing patients along with their reliable others. RESULTS There were 32 patients with a mean age of 61.2 ± 8.3 years and a mean age at illness onset of 33.4 ± 13.8 years in this study. Stepwise regression showed that the right hippocampal volume was negatively associated with the levels of sIL-2R and sTNF-R1. The left hippocampal volume were negatively associated with the sIL-2R level and body mass index. The total gray matter volume had an inverse relationship with sTNF-R1 and IL-1β levels. The duration of bipolar illness, lithium treatment, and antipsychotic use were not associated with hippocampal and total gray matter volumes. CONCLUSIONS It is suggested that persistent inflammation is associated with reduction of hippocampal and gray matter volumes in older patients with BD. This phenomenon is supported by increases in sTNF-R1, sIL-2R, and IL-1β levels. Neuroinflammation due to aging, obesity, and BD pathophysiology may play a role in BD neuroprogression across the life span.
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Affiliation(s)
- Shang-Ying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Ariel G Gildengers
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jung-Lung Hsu
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Kuo-Hsuan Chung
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Pao-Huan Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Jui Huang
- Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
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de la Fuente-Tomas L, Arranz B, Safont G, Sierra P, Sanchez-Autet M, Garcia-Blanco A, Garcia-Portilla MP. Classification of patients with bipolar disorder using k-means clustering. PLoS One 2019; 14:e0210314. [PMID: 30673717 PMCID: PMC6343877 DOI: 10.1371/journal.pone.0210314] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 11/20/2018] [Indexed: 12/28/2022] Open
Abstract
Introduction Bipolar disorder (BD) is a heterogeneous disorder needing personalized and shared decisions. We aimed to empirically develop a cluster-based classification that allocates patients according to their severity for helping clinicians in these processes. Methods Naturalistic, cross-sectional, multicenter study. We included 224 subjects with BD (DSM-IV-TR) under outpatient treatment from 4 sites in Spain. We obtained information on socio-demography, clinical course, psychopathology, cognition, functioning, vital signs, anthropometry and lab analysis. Statistical analysis: k-means clustering, comparisons of between-group variables, and expert criteria. Results and discussion We obtained 12 profilers from 5 life domains that classified patients in five clusters. The profilers were: Number of hospitalizations and of suicide attempts, comorbid personality disorder, body mass index, metabolic syndrome, the number of comorbid physical illnesses, cognitive functioning, being permanently disabled due to BD, global and leisure time functioning, and patients’ perception of their functioning and mental health. We obtained preliminary evidence on the construct validity of the classification: (1) all the profilers behaved correctly, significantly increasing in severity as the severity of the clusters increased, and (2) more severe clusters needed more complex pharmacological treatment. Conclusions We propose a new, easy-to-use, cluster-based severity classification for BD that may help clinicians in the processes of personalized medicine and shared decision-making.
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Affiliation(s)
- Lorena de la Fuente-Tomas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Fondos FEDER, Madrid, Spain
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
| | - Belen Arranz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Fondos FEDER, Madrid, Spain
- Parc Sanitari Sant Joan de Deu and University of Barcelona, Barcelona, Spain
| | - Gemma Safont
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Fondos FEDER, Madrid, Spain
- University Hospital Mutua Terrassa and University of Barcelona, Barcelona, Spain
| | - Pilar Sierra
- La Fe University and Polytechnic Hospital and University of Valencia, Valencia, Spain
| | | | - Ana Garcia-Blanco
- La Fe University and Polytechnic Hospital and University of Valencia, Valencia, Spain
| | - Maria P. Garcia-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Fondos FEDER, Madrid, Spain
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- * E-mail:
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Hørlyck LD, Macoveanu J, Vinberg M, Kessing LV, Siebner HR, Miskowiak KW. The BDNF Val66Met Polymorphism Has No Effect on Encoding-Related Hippocampal Response But Influences Recall in Remitted Patients With Bipolar Disorder. Front Psychiatry 2019; 10:845. [PMID: 31866880 PMCID: PMC6908505 DOI: 10.3389/fpsyt.2019.00845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/24/2019] [Indexed: 01/20/2023] Open
Abstract
Background: Cognitive impairments in bipolar disorder (BD) such as memory deficits are associated with poor functional outcomes and it has been suggested that the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism contributes to individual variability in memory function in BD. The current study investigated the relationship between the BDNF Val66Met polymorphism, neural activity during a picture-encoding task, and subsequent memory recall. Methods: A total of 70 patients with BD grouped according to genotype [ValVal or Met carriers (MetVal/MetMet)] underwent fMRI while performing a picture-encoding task. Memory for the encoded pictures was tested with a subsequent free recall memory task. Results: There was no difference between the ValVal homozygotes and Met carriers in the involvement of hypothesized memory encoding regions i.e. hippocampus and dorsal prefrontal cortex (dPFC). However, an exploratory whole-brain analysis showed greater encoding-related lateral occipital cortex activity in Met carriers. Behaviorally, Met carriers also showed better free recall of the encoded pictures. Conclusions: We found no effect of the BDNF genotype on encoding-related hippocampal and dPFC activity in BD, although Met carriers showed superior memory performance after the scan, which could be related to more efficient perceptual processing during encoding.
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Affiliation(s)
- Lone Diana Hørlyck
- Neurocognition and Emotion in Affective Disorders (NEAD) Group, Copenhagen Affective Disorder Research Centre (CADIC), Copenhagen Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Julian Macoveanu
- Neurocognition and Emotion in Affective Disorders (NEAD) Group, Copenhagen Affective Disorder Research Centre (CADIC), Copenhagen Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Maj Vinberg
- CADIC, Copenhagen Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lars Vedel Kessing
- CADIC, Copenhagen Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Neurocognition and Emotion in Affective Disorders (NEAD) Group, Copenhagen Affective Disorder Research Centre (CADIC), Copenhagen Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Kovács Z, D'Agostino DP, Diamond D, Kindy MS, Rogers C, Ari C. Therapeutic Potential of Exogenous Ketone Supplement Induced Ketosis in the Treatment of Psychiatric Disorders: Review of Current Literature. Front Psychiatry 2019; 10:363. [PMID: 31178772 PMCID: PMC6543248 DOI: 10.3389/fpsyt.2019.00363] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 05/10/2019] [Indexed: 12/16/2022] Open
Abstract
Globally, psychiatric disorders, such as anxiety disorder, bipolar disorder, schizophrenia, depression, autism spectrum disorder, and attention-deficit/hyperactivity disorder (ADHD) are becoming more prevalent. Although the exact pathological alterations are not yet clear, recent studies have demonstrated that widespread changes of very complex metabolic pathways may partially underlie the pathophysiology of many psychiatric diseases. Thus, more attention should be directed to metabolic-based therapeutic interventions in the treatment of psychiatric disorders. Emerging evidence from numerous studies suggests that administration of exogenous ketone supplements, such as ketone salts or ketone esters, generates rapid and sustained nutritional ketosis and metabolic changes, which may evoke potential therapeutic effects in cases of central nervous system (CNS) disorders, including psychiatric diseases. Therefore, the aim of this review is to summarize the current information on ketone supplementation as a potential therapeutic tool for psychiatric disorders. Ketone supplementation elevates blood levels of the ketone bodies: D-β-hydroxybutyrate (βHB), acetoacetate (AcAc), and acetone. These compounds, either directly or indirectly, beneficially affect the mitochondria, glycolysis, neurotransmitter levels, activity of free fatty acid receptor 3 (FFAR3), hydroxycarboxylic acid receptor 2 (HCAR2), and histone deacetylase, as well as functioning of NOD-like receptor pyrin domain 3 (NLRP3) inflammasome and mitochondrial uncoupling protein (UCP) expression. The result of downstream cellular and molecular changes is a reduction in the pathophysiology associated with various psychiatric disorders. We conclude that supplement-induced nutritional ketosis leads to metabolic changes and improvements, for example, in mitochondrial function and inflammatory processes, and suggest that development of specific adjunctive ketogenic protocols for psychiatric diseases should be actively pursued.
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Affiliation(s)
- Zsolt Kovács
- Savaria Department of Biology, ELTE Eötvös Loránd University, Savaria University Centre, Szombathely, Hungary
| | - Dominic P D'Agostino
- Department of Molecular Pharmacology and Physiology, Laboratory of Metabolic Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States.,Institute for Human and Machine Cognition, Ocala, FL, United States
| | - David Diamond
- Department of Molecular Pharmacology and Physiology, Laboratory of Metabolic Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States.,Department of Psychology, Hyperbaric Neuroscience Research Laboratory, University of South Florida, Tampa, FL, United States
| | - Mark S Kindy
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, United States.,James A. Haley VA Medical Center, Tampa, FL, United States.,Shriners Hospital for Children, Tampa, FL, United States
| | - Christopher Rogers
- Department of Molecular Pharmacology and Physiology, Laboratory of Metabolic Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Csilla Ari
- Department of Psychology, Hyperbaric Neuroscience Research Laboratory, University of South Florida, Tampa, FL, United States
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de la Fuente-Tomas L, Sánchez-Autet M, García-Álvarez L, González-Blanco L, Velasco Á, Sáiz Martínez PA, Garcia-Portilla MP, Bobes J. Clinical staging in severe mental disorders; bipolar disorder, depression and schizophrenia. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2018; 12:106-115. [PMID: 30314812 DOI: 10.1016/j.rpsm.2018.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 07/02/2018] [Accepted: 08/02/2018] [Indexed: 01/08/2023]
Abstract
Clinical staging is a diagnostic tool used in other medical specialties, which has resulted from the combination of a categorical and dimensional approach. In the last 2decades, the usefulness of its application in the field of psychiatry has been suggested, mainly as a tool for diagnostic help, and therapeutic and prognostic orientation. In this paper we review the clinical staging models that have been proposed to date for bipolar disorder, depression and schizophrenia. A literature search was performed in PubMed and Medline databases. A total of 15 studies were selected according to inclusion and exclusion criteria. Models were grouped according to the type of disorder for which staging was proposed (bipolar disorder: 4, depression: 5, schizophrenia: 6), and their characteristics were described. As a conclusion, we identify the need to empirically validate these models to demonstrate that staging is a useful tool for clinical practice.
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Affiliation(s)
- Lorena de la Fuente-Tomas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM G-05); Departamento de Psiquiatría, Universidad de Oviedo; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España
| | - Mónica Sánchez-Autet
- Hospital Universitario Mutua Terrassa, Universidad de Barcelona, Terrasa, España
| | - Leticia García-Álvarez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM G-05); Departamento de Psiquiatría, Universidad de Oviedo; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España
| | - Leticia González-Blanco
- Servicio de Salud del Principado de Asturias (SESPA), Departamento de Psiquiatría, Universidad de Oviedo; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España
| | - Ángela Velasco
- Departamento de Psiquiatría, Universidad de Oviedo, Oviedo, España
| | - Pilar A Sáiz Martínez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM G-05); Departamento de Psiquiatría, Universidad de Oviedo; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España
| | - María P Garcia-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM G-05); Departamento de Psiquiatría, Universidad de Oviedo; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España.
| | - Julio Bobes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM G-05); Departamento de Psiquiatría, Universidad de Oviedo; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España
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45
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Sartori JM, Reckziegel R, Passos IC, Czepielewski LS, Fijtman A, Sodré LA, Massuda R, Goi PD, Vianna-Sulzbach M, Cardoso TDA, Kapczinski F, Mwangi B, Gama CS. Volumetric brain magnetic resonance imaging predicts functioning in bipolar disorder: A machine learning approach. J Psychiatr Res 2018; 103:237-243. [PMID: 29894922 DOI: 10.1016/j.jpsychires.2018.05.023] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/30/2018] [Accepted: 05/24/2018] [Indexed: 12/14/2022]
Abstract
Neuroimaging studies have been steadily explored in Bipolar Disorder (BD) in the last decades. Neuroanatomical changes tend to be more pronounced in patients with repeated episodes. Although the role of such changes in cognition and memory is well established, daily-life functioning impairments bulge among the consequences of the proposed progression. The objective of this study was to analyze MRI volumetric modifications in BD and healthy controls (HC) as possible predictors of daily-life functioning through a machine learning approach. Ninety-four participants (35 DSM-IV BD type I and 59 HC) underwent clinical and functioning assessments, and structural MRI. Functioning was assessed using the Functioning Assessment Short Test (FAST). The machine learning analysis was used to identify possible candidates of regional brain volumes that could predict functioning status, through a support vector regression algorithm. Patients with BD and HC did not differ in age, education and marital status. There were significant differences between groups in gender, BMI, FAST score, and employment status. There was significant correlation between observed and predicted FAST score for patients with BD, but not for controls. According to the model, the brain structures volumes that could predict FAST scores were: left superior frontal cortex, left rostral medial frontal cortex, right white matter total volume and right lateral ventricle volume. The machine learning approach demonstrated that brain volume changes in MRI were predictors of FAST score in patients with BD and could identify specific brain areas related to functioning impairment.
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Affiliation(s)
- Juliana M Sartori
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Ramiro Reckziegel
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Leticia S Czepielewski
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Adam Fijtman
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Leonardo A Sodré
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Raffael Massuda
- Departamento de Psiquiatria, Universidade Federal do Paraná, Rua Padre Camargo, 280 - 6º andar, 80060-240, Curitiba, Brazil
| | - Pedro D Goi
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Miréia Vianna-Sulzbach
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Taiane de Azevedo Cardoso
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Flávio Kapczinski
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil; Department of Psychiatry and Behavioural Neurosciences, McMaster University, West 5th Campus, Administration - B3, 100 West 5th, Hamilton, ON L8N 3K7, Canada
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center, Houston, 1941 East Road, Houston, TX 77054, USA
| | - Clarissa S Gama
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil.
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Tannous J, Amaral-Silva H, Cao B, Wu MJ, Zunta-Soares GB, Kazimi I, Zeni C, Mwangi B, Soares JC. Hippocampal subfield volumes in children and adolescents with mood disorders. J Psychiatr Res 2018; 101:57-62. [PMID: 29550609 DOI: 10.1016/j.jpsychires.2018.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/01/2018] [Accepted: 03/09/2018] [Indexed: 01/04/2023]
Abstract
The hippocampus has been implicated in various mood disorders, with global volume deficits consistently found in patient populations. The hippocampus, however, consists of anatomically distinct subfields, and examination of specific subfield differences may elucidate the possible molecular mechanisms behind psychiatric pathologies. Indeed, adult studies have reported smaller hippocampal subfield volumes in regions within the cornu ammonis (CA1 and CA4), dentate gyrus (DG), and hippocampal tails in both patients with Major Depressive Disorder (MDD) and Bipolar Disorder (BD) compared to healthy controls. Subfield differences in pediatric patients with mood disorders, on the other hand, have not been extensively investigated. In the current study, magnetic resonance imaging scans were acquired for 141 children and adolescents between the ages of eight and eighteen (57 with BD, 30 with MDD, and 54 healthy controls). An automated segmentation method was then used to assess differences in hippocampal subfield volumes. Children and adolescents with BD were found to have significantly smaller volumes in the right CA1, CA4, and right subiculum, as well as the bilateral granule cell layer (GCL), molecular layer (ML), and hippocampal tails. The volume of the right subiculum in BD patients was also found to be negatively correlated with illness duration. Overall, the findings from this cross-sectional study provide evidence for specific hippocampal subfield volume differences in children and adolescents with BD compared to healthy controls and suggest progressive reductions with increased illness duration.
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Affiliation(s)
- Jonika Tannous
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA.
| | - Henrique Amaral-Silva
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
| | - Bo Cao
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
| | - Mon-Ju Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
| | - Giovana B Zunta-Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
| | - Iram Kazimi
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
| | - Cristian Zeni
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
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Cao B, Luo Q, Fu Y, Du L, Qiu T, Yang X, Chen X, Chen Q, Soares JC, Cho RY, Zhang XY, Qiu H. Predicting individual responses to the electroconvulsive therapy with hippocampal subfield volumes in major depression disorder. Sci Rep 2018; 8:5434. [PMID: 29615675 PMCID: PMC5882798 DOI: 10.1038/s41598-018-23685-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/15/2018] [Indexed: 12/12/2022] Open
Abstract
Electroconvulsive therapy (ECT) is one of the most effective treatments for major depression disorder (MDD). ECT can induce neurogenesis and synaptogenesis in hippocampus, which contains distinct subfields, e.g., the cornu ammonis (CA) subfields, a granule cell layer (GCL), a molecular layer (ML), and the subiculum. It is unclear which subfields are affected by ECT and whether we predict the future treatment response to ECT by using volumetric information of hippocampal subfields at baseline? In this study, 24 patients with severe MDD received the ECT and their structural brain images were acquired with magnetic resonance imaging before and after ECT. A state-of-the-art hippocampal segmentation algorithm from Freesurfer 6.0 was used. We found that ECT induced volume increases in CA subfields, GCL, ML and subiculum. We applied a machine learning algorithm to the hippocampal subfield volumes at baseline and were able to predict the change in depressive symptoms (r = 0.81; within remitters, r = 0.93). Receiver operating characteristic analysis also showed robust prediction of remission with an area under the curve of 0.90. Our findings provide evidence for particular hippocampal subfields having specific roles in the response to ECT. We also provide an analytic approach for generating predictions about clinical outcomes for ECT in MDD.
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Affiliation(s)
- Bo Cao
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, United States
| | - Qinghua Luo
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Yixiao Fu
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Lian Du
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Tian Qiu
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Xiangying Yang
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Xiaolu Chen
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Qibin Chen
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, United States
| | - Raymond Y Cho
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, United States
| | - Xiang Yang Zhang
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, United States
| | - Haitang Qiu
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China.
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48
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Shi J, Guo H, Fan F, Fan H, An H, Wang Z, Tan S, Yang F, Tan Y. Sex differences of hippocampal structure in bipolar disorder. Psychiatry Res Neuroimaging 2018; 273:35-41. [PMID: 29329741 DOI: 10.1016/j.pscychresns.2017.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 11/17/2017] [Accepted: 11/17/2017] [Indexed: 12/16/2022]
Abstract
Although differential patterns in clinical characteristics have been consistently noted between male and female patients with bipolar disorder (BD), the effect of sex on the hippocampal structure remains unclear. To address this, the present study investigated the effects of BD and sex on the hippocampal structure, and the relationship between the hippocampal structure and cognitive performance. Morphometric and neurocognitive analyses were performed in 91 subjects (patients with BD: male/female = 33/19; normal controls: male/female = 22/17). Patients had significantly decreased left parahippocampal gyrus area and left/right hippocampal volume compared to normal controls. Within the BD group only, female patients presented with smaller right hippocampal volume than males. In the Spatial Span (SS) test (used to assess working memory capacity) and the Maze test (used to evaluate the ability to anticipate), patients demonstrated decreased performance compared to normal controls, with a significant main effect of sex. Left parahippocampal gyrus area and right hippocampal volume were positively correlated with SS and Maze in patients; moreover, right hippocampal volume predicted 17.4% of SS performance variance. These results suggest that there may be a difference between male and female patients with regard to right hippocampal volume, and that female patients may need more attention than males.
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Affiliation(s)
- Jing Shi
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Hua Guo
- The Psychiatric Hospital of Zhumadian, Zhumadian City, Henan Province, China
| | - Fengmei Fan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Hongzhen Fan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Huimei An
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Zhiren Wang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China.
| | - Shuping Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China.
| | - Fude Yang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yunlong Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
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49
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Vieta E, Berk M, Schulze TG, Carvalho AF, Suppes T, Calabrese JR, Gao K, Miskowiak KW, Grande I. Bipolar disorders. Nat Rev Dis Primers 2018. [PMID: 29516993 DOI: 10.1038/nrdp.2018.8] [Citation(s) in RCA: 433] [Impact Index Per Article: 72.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Bipolar disorders are chronic and recurrent disorders that affect >1% of the global population. Bipolar disorders are leading causes of disability in young people as they can lead to cognitive and functional impairment and increased mortality, particularly from suicide and cardiovascular disease. Psychiatric and nonpsychiatric medical comorbidities are common in patients and might also contribute to increased mortality. Bipolar disorders are some of the most heritable psychiatric disorders, although a model with gene-environment interactions is believed to best explain the aetiology. Early and accurate diagnosis is difficult in clinical practice as the onset of bipolar disorder is commonly characterized by nonspecific symptoms, mood lability or a depressive episode, which can be similar in presentation to unipolar depression. Moreover, patients and their families do not always understand the significance of their symptoms, especially with hypomanic or manic symptoms. As specific biomarkers for bipolar disorders are not yet available, careful clinical assessment remains the cornerstone of diagnosis. The detection of hypomanic symptoms and longtudinal clinical assessment are crucial to differentiate a bipolar disorder from other conditions. Optimal early treatment of patients with evidence-based medication (typically mood stabilizers and antipsychotics) and psychosocial strategies is necessary.
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Affiliation(s)
- Eduard Vieta
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health and the Centre for Youth Mental Health, Parkville, Victoria, Australia.,The Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University Göttingen, Göttingen, Germany.,Human Genetics Branch, National Institute of Mental Health, NIH, Bethesda, MD, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.,Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - André F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction & Mental Health (CAMH), Toronto, Ontario, Canada
| | - Trisha Suppes
- Bipolar and Depression Research Program, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA.,Bipolar and Depression Research Program, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Joseph R Calabrese
- Mood and Anxiety Clinic, The Mood Disorders Program, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,University Hospital Cleveland Medical Center, Cleveland, OH, USA
| | - Keming Gao
- Mood and Anxiety Clinic, The Mood Disorders Program, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,University Hospital Cleveland Medical Center, Cleveland, OH, USA
| | - Kamilla W Miskowiak
- Copenhagen Affective Disorder Research Centre, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Iria Grande
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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50
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Pinto JV, Passos IC, Librenza-Garcia D, Marcon G, Schneider MA, Conte JH, Abreu da Silva JP, Lima LP, Quincozes-Santos A, Kauer-Sant’Anna M, Kapczinski F. Neuron-glia Interaction as a Possible Pathophysiological Mechanism of Bipolar Disorder. Curr Neuropharmacol 2018; 16:519-532. [PMID: 28847296 PMCID: PMC5997869 DOI: 10.2174/1570159x15666170828170921] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 07/26/2017] [Accepted: 08/24/2017] [Indexed: 12/15/2022] Open
Abstract
Accumulating evidence has shown the importance of glial cells in the neurobiology of bipolar disorder. Activated microglia and inflammatory cytokines have been pointed out as potential biomarkers of bipolar disorder. Indeed, recent studies have shown that bipolar disorder involves microglial activation in the hippocampus and alterations in peripheral cytokines, suggesting a potential link between neuroinflammation and peripheral toxicity. These abnormalities may also be the biological underpinnings of outcomes related to neuroprogression, such as cognitive impairment and brain changes. Additionally, astrocytes may have a role in the progression of bipolar disorder, as these cells amplify inflammatory response and maintain glutamate homeostasis, preventing excitotoxicity. The present review aims to discuss neuron-glia interactions and their role in the pathophysiology and treatment of bipolar disorder.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Flávio Kapczinski
- Address correspondence to this author at the Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton-ON, Canada; Tel: +55 512 101 8845; E-mails: ,
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