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Kirsch DE, Tretyak V, Le V, Huffman A, Fromme K, Strakowski SM, Lippard ET. Alcohol Use and Prefrontal Cortex Volume Trajectories in Young Adults with Mood Disorders and Associated Clinical Outcomes. Behav Sci (Basel) 2022; 12:57. [PMID: 35323376 PMCID: PMC8945008 DOI: 10.3390/bs12030057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/05/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Alcohol use in the course of mood disorders is associated with worse clinical outcomes. The mechanisms by which alcohol use alters the course of illness are unclear but may relate to prefrontal cortical (PFC) sensitivity to alcohol. We investigated associations between alcohol use and PFC structural trajectories in young adults with a mood disorder compared to typically developing peers. (2) Methods: 41 young adults (24 with a mood disorder, agemean = 21 ± 2 years) completed clinical evaluations, assessment of alcohol use, and two structural MRI scans approximately one year apart. Freesurfer was used to segment PFC regions of interest (ROIs) (anterior cingulate, orbitofrontal cortex, and frontal pole). Effects of group, alcohol use, time, and interactions among these variables on PFC ROIs at baseline and follow-up were modeled. Associations were examined between alcohol use and longitudinal changes in PFC ROIs with prospective mood. (3) Results: Greater alcohol use was prospectively associated with decreased frontal pole volume in participants with a mood disorder, but not typically developing comparison participants (time-by-group-by-alcohol interaction; p = 0.007); however, this interaction became a statistical trend in a sensitivity analysis excluding one outlier in terms of alcohol use. Greater alcohol use and a decrease in frontal pole volume related to longer duration of major depression during follow-up (p’s < 0.05). (4) Conclusion: Preliminary findings support more research on alcohol use, PFC trajectories, and depression recurrence in young adults with a mood disorder including individuals with heavier drinking patterns.
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Affiliation(s)
- Dylan E. Kirsch
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX 78712, USA; (V.T.); (V.L.); (A.H.); (S.M.S.)
- Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX 78712, USA;
- Institute for Neuroscience, University of Texas, Austin, TX 78712, USA
| | - Valeria Tretyak
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX 78712, USA; (V.T.); (V.L.); (A.H.); (S.M.S.)
- Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX 78712, USA;
- Department of Psychology, University of Texas, Austin, TX 78712, USA
| | - Vanessa Le
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX 78712, USA; (V.T.); (V.L.); (A.H.); (S.M.S.)
| | - Ansley Huffman
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX 78712, USA; (V.T.); (V.L.); (A.H.); (S.M.S.)
| | - Kim Fromme
- Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX 78712, USA;
- Department of Psychology, University of Texas, Austin, TX 78712, USA
| | - Stephen M. Strakowski
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX 78712, USA; (V.T.); (V.L.); (A.H.); (S.M.S.)
- Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX 78712, USA;
- Institute for Neuroscience, University of Texas, Austin, TX 78712, USA
- Department of Psychology, University of Texas, Austin, TX 78712, USA
| | - Elizabeth T.C. Lippard
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX 78712, USA; (V.T.); (V.L.); (A.H.); (S.M.S.)
- Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX 78712, USA;
- Institute for Neuroscience, University of Texas, Austin, TX 78712, USA
- Department of Psychology, University of Texas, Austin, TX 78712, USA
- Institute of Early Life Adversity Research, University of Texas, Austin, TX 78712, USA
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Mazumder AH, Barnett J, Isometsä ET, Lindberg N, Torniainen-Holm M, Lähteenvuo M, Lahdensuo K, Kerkelä M, Ahola-Olli A, Hietala J, Kampman O, Kieseppä T, Jukuri T, Häkkinen K, Cederlöf E, Haaki W, Kajanne R, Wegelius A, Männynsalo T, Niemi-Pynttäri J, Suokas K, Lönnqvist J, Tiihonen J, Paunio T, Vainio SJ, Palotie A, Niemelä S, Suvisaari J, Veijola J. Reaction Time and Visual Memory in Connection to Alcohol Use in Persons with Bipolar Disorder. Brain Sci 2021; 11:brainsci11091154. [PMID: 34573174 PMCID: PMC8467646 DOI: 10.3390/brainsci11091154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to explore the association of cognition with hazardous drinking and alcohol-related disorder in persons with bipolar disorder (BD). The study population included 1268 persons from Finland with bipolar disorder. Alcohol use was assessed through hazardous drinking and alcohol-related disorder including alcohol use disorder (AUD). Hazardous drinking was screened with the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) screening tool. Alcohol-related disorder diagnoses were obtained from the national registrar data. Participants performed two computerized tasks from the Cambridge Automated Neuropsychological Test Battery (CANTAB) on A tablet computer: the 5-choice serial reaction time task, or reaction time (RT) test and the Paired Associative Learning (PAL) test. Depressive symptoms were assessed with the Mental Health Inventory with five items (MHI-5). However, no assessment of current manic symptoms was available. Association between RT-test and alcohol use was analyzed with log-linear regression, and eβ with 95% confidence intervals (CI) are reported. PAL first trial memory score was analyzed with linear regression, and β with 95% CI are reported. PAL total errors adjusted was analyzed with logistic regression and odds ratios (OR) with 95% CI are reported. After adjustment of age, education, housing status and depression, hazardous drinking was associated with lower median and less variable RT in females while AUD was associated with a poorer PAL test performance in terms of the total errors adjusted scores in females. Our findings of positive associations between alcohol use and cognition in persons with bipolar disorder are difficult to explain because of the methodological flaw of not being able to separately assess only participants in euthymic phase.
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Affiliation(s)
- Atiqul Haq Mazumder
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Correspondence:
| | - Jennifer Barnett
- Cambridge Cognition, University of Cambridge, Cambridge CB25 9TU, UK;
| | - Erkki Tapio Isometsä
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Department of Psychiatry, University of Helsinki, 00014 Helsinki, Finland;
| | - Nina Lindberg
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
| | - Minna Torniainen-Holm
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
| | - Markku Lähteenvuo
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Kaisla Lahdensuo
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
| | - Martta Kerkelä
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
| | - Ari Ahola-Olli
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
- Department of Psychiatry, Turku University Hospital, 20521 Turku, Finland
| | - Olli Kampman
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland;
- Department of Psychiatry, Pirkanmaa Hospital District, 33521 Tampere, Finland
| | - Tuula Kieseppä
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
| | - Tuomas Jukuri
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Katja Häkkinen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Erik Cederlöf
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
| | - Willehard Haaki
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
| | - Risto Kajanne
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Asko Wegelius
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Teemu Männynsalo
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Jussi Niemi-Pynttäri
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Kimmo Suokas
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland;
| | - Jouko Lönnqvist
- Department of Psychiatry, University of Helsinki, 00014 Helsinki, Finland;
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
| | - Jari Tiihonen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Department of Clinical Neuroscience, Karolinska Institute, 17177 Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, 11364 Stockholm, Sweden
| | - Tiina Paunio
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Seppo Juhani Vainio
- Infotech Oulu, University of Oulu, 90014 Oulu, Finland;
- Northern Finland Biobank Borealis, Oulu University Hospital, 90220 Oulu, Finland
- Faculty of Biochemistry and Molecular Medicine, University of Oulu, 90014 Oulu, Finland
- Kvantum Institute, University of Oulu, 90014 Oulu, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
- Stanley Center for Psychiatric Research, The Broad Institute of MIT (Massachusetts Institute of Technology) and Harvard, Cambridge, MA 02142, USA
- Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
- Department of Psychiatry, Turku University Hospital, 20521 Turku, Finland
| | - Jaana Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Department of Psychiatry, Oulu University Hospital, 90220 Oulu, Finland
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Tretyak V, Kirsch DE, Radpour S, Weber WA, Fromme K, Strakowski SM, Lippard ET. Subjective response to alcohol: Associated alcohol use and orbitofrontal gray matter volume in bipolar disorder. J Affect Disord 2021; 279:671-679. [PMID: 33190118 PMCID: PMC7812664 DOI: 10.1016/j.jad.2020.10.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/13/2020] [Accepted: 10/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Alcohol use disorders (AUDs) are highly prevalent in bipolar disorder, however the developmental etiology of this comorbidity remains unknown. Structural differences in the orbitofrontal cortex (OFC) have been linked to problematic drinking in bipolar disorder and typically developing youth, with evidence implicating variations in OFC in differential subjective response to alcohol in typical development. METHODS Subjective response to alcohol, recent alcohol use, impulsivity, and variation in OFC gray matter volume were investigated in 48 emerging adults (24 with bipolar disorder, 24 typically developing). On average 1.5 years later, drinking patterns were reassessed and relations between subjective response and changes in alcohol use were explored. RESULTS Groups did not differ in baseline alcohol use or subjective response. At baseline, decreased subjective response to alcohol was associated with increased alcohol use in both groups. Lower gray matter volume in medial OFC in bipolar disorder was associated with increased subjective response to alcohol, whereas lower gray matter volume in OFC in typically developing participants was associated with decreased subjective response to alcohol. Increase in alcohol use (baseline to follow-up) was associated with increased baseline subjective response to alcohol in bipolar disorder, and decreased baseline subjective response in the typically developing group. LIMITATIONS Preliminary study with a small sample size. CONCLUSION Underlying OFC biology may contribute to differences in alcohol sensitivity in bipolar disorder which may also relate to prospective changes in alcohol use patterns. Future studies are needed to examine how these factors prospectively relate to development of AUDs in bipolar disorder.
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Affiliation(s)
- Valeria Tretyak
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA,Department of Psychology, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA
| | - Dylan E. Kirsch
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA,Institute for Neuroscience, University of Texas, Austin, TX, USA
| | - Sepeadeh Radpour
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA
| | - Wade A. Weber
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA
| | - Kim Fromme
- Department of Psychology, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA
| | - Stephen M. Strakowski
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA,Department of Psychology, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA,Institute for Neuroscience, University of Texas, Austin, TX, USA
| | - Elizabeth T.C. Lippard
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA,Department of Psychology, University of Texas, Austin, TX, USA,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA,Institute for Neuroscience, University of Texas, Austin, TX, USA,Institute of Early Life Adversity Research, University of Texas, Austin, TX, USA
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Wang X, Luo Q, Tian F, Cheng B, Qiu L, Wang S, He M, Wang H, Duan M, Jia Z. Brain grey-matter volume alteration in adult patients with bipolar disorder under different conditions: a voxel-based meta-analysis. J Psychiatry Neurosci 2019; 44:89-101. [PMID: 30354038 PMCID: PMC6397036 DOI: 10.1503/jpn.180002] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The literature on grey-matter volume alterations in bipolar disorder is heterogeneous in its findings. METHODS Using effect-size differential mapping, we conducted a meta-analysis of grey-matter volume alterations in patients with bipolar disorder compared with healthy controls. RESULTS We analyzed data from 50 studies that included 1843 patients with bipolar disorder and 2289 controls. Findings revealed lower grey-matter volumes in the bilateral superior frontal gyri, left anterior cingulate cortex and right insula in patients with bipolar disorder and in patients with bipolar disorder type I. Patients with bipolar disorder in the euthymic and depressive phases had spatially distinct regions of altered grey-matter volume. Meta-regression revealed that the proportion of female patients with bipolar disorder or bipolar disorder type I was negatively correlated with regional grey-matter alteration in the right insula; the proportion of patients with bipolar disorder or bipolar disorder type I taking lithium was positively correlated with regional grey-matter alterations in the left anterior cingulate/paracingulate gyri; and the proportion of patients taking antipsychotic medications was negatively correlated with alterations in the anterior cingulate/paracingulate gyri. LIMITATIONS This study was cross-sectional; analysis techniques, patient characteristics and clinical variables in the included studies were heterogeneous. CONCLUSION Structural grey-matter abnormalities in patients with bipolar disorder and bipolar disorder type I were mainly in the prefrontal cortex and insula. Patients' mood state might affect grey-matter alterations. Abnormalities in regional grey-matter volume could be correlated with patients' specific demographic and clinical features.
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Affiliation(s)
- Xiuli Wang
- From the Department of Psychiatry, the Fourth People’s Hospital of Chengdu, Chengdu, China (Duan, He, H. Wang, S. Wang, X. Wang); the Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China (Luo, Jia); the Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China (Tian, Jia); the Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China (Cheng); and the Department of Radiology, the Second People’s Hospital of Yibin, Yibin, China (Qiu)
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Stoychev KR. Neuroimaging Studies in Patients With Mental Disorder and Co-occurring Substance Use Disorder: Summary of Findings. Front Psychiatry 2019; 10:702. [PMID: 31708805 PMCID: PMC6819501 DOI: 10.3389/fpsyt.2019.00702] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/30/2019] [Indexed: 11/21/2022] Open
Abstract
Introduction: More than half of psychiatric patients have comorbid substance use disorder (dual diagnosis) and this rate, confirmed by many epidemiological studies, is substantially higher compared to general population. Combined operation of self-medication mechanisms, common etiological factors, and mutually causative influences most likely accounts for comorbidity, which, despite its clinical prevalence, remains underrepresented in psychiatric research, especially in terms of neuroimaging. The current paper attempts to review and discuss all existing methodologically sustainable structural and functional neuroimaging studies in comorbid subjects published in the last 20 years. Methods: Performing a systematic PubMed/MEDLINE, Web of Science, and Cochrane databases search with predefined key-words and selection criteria, 43 structural and functional neuroimaging studies were analyzed. Results: Although markedly inconsistent and confounded by a variety of sources, available data suggest that structural brain changes are slightly more pronounced, yet not qualitatively different in comorbid patients compared to non-comorbid ones. In schizophrenia (SZ) patients, somewhat greater gray matter reduction is seen in cingulate cortex, dorsolateral prefrontal and frontotemporal cortex, limbic structures (hippocampus), and basal ganglia (striatum). The magnitude of structural changes is positively correlated to duration and severity of substance use, but it is important to note that at least in the beginning of the disease, dual diagnosis subjects tend to show less brain abnormalities and better cognitive functioning than pure SZ ones suggesting lower preexisting neuropathological burden. When analysing neuroimaging findings in SZ and bipolar disorder subjects, dorsolateral prefrontal, cingular, and insular cortex emerge as common affected areas in both groups which might indicate a shared endophenotypic (i.e., transdiagnostic) disruption of brain networks involved in executive functioning, emotional processing, and social cognition, rendering affected individuals susceptible to both mental disorder and substance misuse. In patients with anxiety disorders and substance misuse, a common neuroimaging finding is reduced volume of limbic structures (n. accumbens, hippocampus and amygdala). Whether this is a neuropathological marker of common predisposition to specific behavioral symptoms and drug addiction or a result from neuroadaptation changes secondary to substance misuse is unknown. Future neuroimaging studies with larger samples, longitudinal design, and genetic subtyping are warranted to enhance current knowledge on comorbidity.
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Lippard ETC, Mazure CM, Johnston JAY, Spencer L, Weathers J, Pittman B, Wang F, Blumberg HP. Brain circuitry associated with the development of substance use in bipolar disorder and preliminary evidence for sexual dimorphism in adolescents. J Neurosci Res 2017; 95:777-791. [PMID: 27870392 DOI: 10.1002/jnr.23901] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 07/29/2016] [Accepted: 08/05/2016] [Indexed: 02/06/2023]
Abstract
Substance use disorders and mood disorders are highly comorbid and confer a high risk for adverse outcomes. However, data are limited on the neurodevelopmental basis of this comorbidity. Substance use initiation typically occurs during adolescence, and sex-specific developmental mechanisms are implicated. In this preliminary study, we review the literature and investigate regional gray matter volume (GMV) associated with subsequent substance use problems in adolescents with bipolar disorder (BD) and explore these associations for females and males. Thirty adolescents with DSM-IV-diagnosed BD and minimal alcohol/substance exposure completed baseline structural magnetic resonance imaging scans. At follow-up (on average 6 years post baseline), subjects were administered the CRAFFT interview and categorized into those scoring at high ( ≥ 2: CRAFFTHIGH ) vs. low ( < 2: CRAFFTLOW ) risk for alcohol/substance problems. Lower GMV in prefrontal, insular, and temporopolar cortices were observed at baseline among adolescents with BD reporting subsequent alcohol and cannabis use compared to adolescents with BD who did not (P < 0.005, clusters ≥ 20 voxels). Lower dorsolateral prefrontal GMV was associated with future substance use in both females and males. In females, lower orbitofrontal and insula GMV was associated with future substance use, while in males, lower rostral prefrontal GMV was associated with future use. Lower orbitofrontal, insular, and temporopolar GMV was observed in those who transitioned to smoking tobacco. Findings indicate that GMV development is associated with risk for future substance use problems in adolescents with BD, with results implicating GMV development in regions subserving emotional regulation in females and regions subserving executive processes and attention in males. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Elizabeth T C Lippard
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Carolyn M Mazure
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Women's Health Research at Yale, Yale School of Medicine, New Haven, Connecticut
| | | | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Judah Weathers
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Fei Wang
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.,Women's Health Research at Yale, Yale School of Medicine, New Haven, Connecticut.,Child Study Center, Yale School of Medicine, New Haven, Connecticut
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Kollmann B, Scholz V, Linke J, Kirsch P, Wessa M. Reward anticipation revisited- evidence from an fMRI study in euthymic bipolar I patients and healthy first-degree relatives. J Affect Disord 2017; 219:178-186. [PMID: 28558365 DOI: 10.1016/j.jad.2017.04.044] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 03/01/2017] [Accepted: 04/23/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Symptomatic phases in bipolar disorder (BD) are hypothesized to result from a hypersensitive behavioral activation system (BAS) being sensitive to potential rewards. However, studies on the neuronal underpinnings of reward anticipation in BD are scarce with contradictory findings and possibly confounded by effects of dopaminergic medication, necessitating further research on dysfunctional motivation in BD. Moreover, its role as vulnerability marker for BD is unclear. METHODS Functional imaging was conducted in 16 euthymic BD-I patients free from dopaminergic medication and 19 healthy first-degree relatives using a monetary incentive delay task and compared to parallelized control groups. Further, reward proneness, using the BIS/BAS questionnaire, and its relationship to neural reward anticipation was investigated. RESULTS BD-I patients displayed greater anterior cingulate cortex (ACC) activity during reward anticipation and higher BIS total scores compared to controls, with a positive relationship between the two measures. There were no neural or self-report group differences between relatives and controls. LIMITATIONS Due to the experimental design, the role of the ACC during receipt of reward remains unknown, sample sizes were rather small, and patients were not naïve to dopaminergic drugs, making an exclusion of medication effects on findings impossible. CONCLUSIONS Our findings give new insights on reward anticipation in BD. BD-I patients rated themselves as more risk avoidant and showed larger recruitment of the ACC rather than ventral striatum compared to controls during reward anticipation, possibly to down-regulate hyperactive limbic reward regions. This activation seems to be a consequence of rather than a vulnerability marker for the disorder.
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Affiliation(s)
- Bianca Kollmann
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany; Emotion Regulation and Impulse Control Group, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Vanessa Scholz
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Julia Linke
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Peter Kirsch
- Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Michèle Wessa
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany.
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8
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Lange EH, Nerland S, Jørgensen KN, Mørch-Johnsen L, Nesvåg R, Hartberg CB, Haukvik UK, Osnes K, Melle I, Andreassen OA, Agartz I. Alcohol use is associated with thinner cerebral cortex and larger ventricles in schizophrenia, bipolar disorder and healthy controls. Psychol Med 2017; 47:655-668. [PMID: 27830632 DOI: 10.1017/s0033291716002920] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Excessive alcohol use is associated with brain damage but less is known about brain effects from moderate alcohol use. Previous findings indicate that patients with severe mental illness, particularly schizophrenia, are vulnerable to alcohol-related brain damage. We investigated the association between levels of alcohol consumption and cortical and subcortical brain structures in schizophrenia and bipolar disorder patients and healthy controls, and investigated for group differences for this association. METHOD 1.5 T structural magnetic resonance images were acquired of 609 alcohol-using participants (165 schizophrenia patients, 172 bipolar disorder patients, 272 healthy controls), mean (s.d.) age 34.2 (9.9) years, 52% men. Past year alcohol use was assessed with the Alcohol Use Disorder Identification Test - Consumption part (AUDIT-C). General linear models were used to investigate associations between AUDIT-C score and cortical thickness, surface area, and total brain and subcortical volumes. RESULTS Increasing AUDIT-C score was linearly associated with thinner cortex in medial and dorsolateral frontal and parieto-occipital regions, and with larger left lateral ventricle volume. There was no significant interaction between AUDIT-C score and diagnostic group. The findings remained significant after controlling for substance use disorders, antipsychotic medication and illness severity. CONCLUSION The results show a dose-dependent relationship between alcohol use and thinner cortex and ventricular expansion. The findings are present also at lower levels of alcohol consumption and do not differ between schizophrenia or bipolar disorder patients compared to healthy controls. Our results do not support previous findings of increased vulnerability for alcohol-related brain damage in severe mental illness.
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Affiliation(s)
- E H Lange
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - S Nerland
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - K N Jørgensen
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - L Mørch-Johnsen
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - R Nesvåg
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - C B Hartberg
- NORMENT and K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo,Oslo,Norway
| | - U K Haukvik
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - K Osnes
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - I Melle
- NORMENT and K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo,Oslo,Norway
| | - O A Andreassen
- NORMENT and K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo,Oslo,Norway
| | - I Agartz
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
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9
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Kozicky JM, McGirr A, Bond DJ, Gonzalez M, Silveira LE, Keramatian K, Torres IJ, Lam RW, Yatham LN. Neuroprogression and episode recurrence in bipolar I disorder: A study of gray matter volume changes in first-episode mania and association with clinical outcome. Bipolar Disord 2016; 18:511-519. [PMID: 27759214 DOI: 10.1111/bdi.12437] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 08/31/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Bipolar I disorder (BD-I) is associated with gray matter volume (GMV) alterations in neural regions important for emotional regulation. Reductions found in patients with multiple episodes are not seen at illness onset, suggesting that changes occur with illness progression, although no prospective studies to date have examined this. In the present study, we assessed GMV at baseline and one year following a first manic episode, examining the impact of episode recurrence on the trajectory of change. METHODS A total of 41 recently remitted first manic episode patients with BD-I and 25 healthy subjects (HS) underwent 3T magnetic resonance imaging at baseline and one year later. Using voxel-based morphometry, we compared GMV change between HS, patients who experienced a recurrence of a mood episode (BDrecurr ), and patients in sustained remission (BDwell ). RESULTS The GMV change from baseline to one year did not differ significantly between HS and the full BD-I group or BDwell and HS. However, the BDrecurr group had greater GMV loss than HS in left frontal and bilateral temporal regions, and BDwell patients involving bilateral frontal, temporal and left parietal regions. CONCLUSIONS GMV change early in the course of BD-I is associated with clinical outcome, such that neuroprogression found in patients who experience a recurrence of a mood episode is not seen in those with sustained remission. These findings have important implications for the treatment of BD-I as they suggest that prevention of recurrence might minimize neuroprogression of the disease, possibly requiring a multipronged early intervention approach to achieve this goal.
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Affiliation(s)
- Jan-Marie Kozicky
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Alexander McGirr
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - David J Bond
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Marjorie Gonzalez
- Department of Nuclear Medicine, Vancouver Coastal Health Authority, Vancouver, BC, Canada
| | - Leonardo E Silveira
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Laboratory of Molecular Psychiatry, Centro de Pesquisas Experimentais, Hospital de Clínicas de Porto Alegre and INCT for Translational Medicine, Porto Alegre, RS, Brazil
| | - Kamyar Keramatian
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Ivan J Torres
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,BC Psychosis Program, British Columbia Mental Health and Addictions Services, Vancouver, BC, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
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10
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Yang X, Tian F, Zhang H, Zeng J, Chen T, Wang S, Jia Z, Gong Q. Cortical and subcortical gray matter shrinkage in alcohol-use disorders: a voxel-based meta-analysis. Neurosci Biobehav Rev 2016; 66:92-103. [PMID: 27108216 DOI: 10.1016/j.neubiorev.2016.03.034] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 02/17/2016] [Accepted: 03/24/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Xun Yang
- School of Sociality and Psychology, Southwest University for Nationalities, Chengdu 610041, China; Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Fangfang Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Handi Zhang
- School of Sociality and Psychology, Southwest University for Nationalities, Chengdu 610041, China
| | - Jianguang Zeng
- School of Accounting, Southwestern University of Finance and Economics, Chengdu 611130, China
| | - Taolin Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Zhiyun Jia
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, China.
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; Department of Psychology, School of Public Administration, Sichuan University, Chengdu 610041, China
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11
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Singh S, Forty L, di Florio A, Gordon-Smith K, Jones I, Craddock N, Jones L, Smith DJ. Affective temperaments and concomitant alcohol use disorders in bipolar disorder. J Affect Disord 2015; 186:226-31. [PMID: 26253903 DOI: 10.1016/j.jad.2015.07.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/17/2015] [Accepted: 07/18/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Alcohol misuse (AM) is more common in bipolar disorder (BD) than within the general population but the mechanisms of this association are unclear. We hypothesized that certain affective temperaments (including hyperthymic, cyclothymic, anxious, depressive and/or irritability) might represent 'fundamental states' contributing to risk of both AM and BD and we aimed to assess whether extremes of these five affective temperaments were associated with BD and concomitant AM status. METHODS Our sample comprised 1420 individuals with BD who were recruited into a clinical-genetic study conducted by the Bipolar Disorder Research Network. Phenotypic assessments, including evaluation for AM and the 32-item TEMPS-A questionnaire, were conducted. Binary logistic regression was used to determine the effect of TEMPS-A scores on the likelihood of concomitant AM, with adjustment for confounders. RESULTS Mean scores for four affective temperaments (hyperthymic, cyclothymic, depressive and irritable) were higher in cases (BD+AMs) than controls (BD only) (p<0.001). Hyperthymic and irritable temperaments in particular significantly increased the odds of concomitant AM within the BD sample after adjustment for potential confounders. LIMITATIONS The definition of AM was not directly based on formal diagnostic classification systems. A retrospective, cross-sectional design was used. Our findings may not generalize to other countries and cultures. CONCLUSIONS Higher scores on measures of hyperthymic and irritable temperament may contribute to the association between AM and BD. Assessing affective temperaments early in the course of BD may help to predict the development of an AM problem in vulnerable individuals.
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Affiliation(s)
- Sukhmeet Singh
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK
| | - Liz Forty
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Arianna di Florio
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Katherine Gordon-Smith
- Department of Psychiatry, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
| | - Ian Jones
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Nick Craddock
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Lisa Jones
- Department of Psychiatry, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
| | - Daniel J Smith
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK.
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12
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Balanzá-Martínez V, Crespo-Facorro B, González-Pinto A, Vieta E. Bipolar disorder comorbid with alcohol use disorder: focus on neurocognitive correlates. Front Physiol 2015; 6:108. [PMID: 25904869 PMCID: PMC4387475 DOI: 10.3389/fphys.2015.00108] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 03/17/2015] [Indexed: 12/20/2022] Open
Abstract
Bipolar disorder (BD) and alcohol use disorders (AUDs) are usually comorbid, and both have been associated with significant neurocognitive impairment. Patients with the BD-AUD comorbidity (dual diagnosis) may have more severe neurocognitive deficits than those with a single diagnosis, but there is paucity of research in this area. To explore this hypothesis more thoroughly, we carried out a systematic literature review through January 2015. Eight studies have examined the effect of AUDs on the neurocognitive functioning of BD patients. Most studies found that BD patients with current or past history of comorbid AUDs show more severe impairments, especially in verbal memory and executive cognition, than their non-dual counterparts. Greater neurocognitive dysfunction is another facet of this severe comorbid presentation. Implications for clinical practice and research are discussed. Specifically, the application of holistic approaches, such as clinical staging and systems biology, may open new avenues of discoveries related to the BD-AUD comorbidity.
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Affiliation(s)
- Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry, Deparment of Medicine, School of Medicine, La Fe University and Polytechnic Hospital, University of Valencia, CIBERSAM, ISNPR Valencia, Spain
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, School of Medicine, University Hospital Marqués de Valdecilla, University of Cantabria-IDIVAL, CIBERSAM Santander, Spain
| | - Ana González-Pinto
- Álava University Hospital, CIBERSAM, University of the Basque Country Kronikgune, Vitoria, Spain
| | - Eduard Vieta
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM Barcelona, Spain
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13
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Lijffijt M, Rourke ED, Swann AC, Zunta-Soares GB, Soares JC. Illness-course modulates suicidality-related prefrontal gray matter reduction in women with bipolar disorder. Acta Psychiatr Scand 2014; 130:374-87. [PMID: 25039251 DOI: 10.1111/acps.12314] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Explore interrelationships between suicide attempt history (Objective 1) or suicide attempt severity (Objective 2) with prefrontal cortex gray matter (PFCGM ) volume and illness-course in patients with bipolar disorder (BD). METHOD Ninety-three women with BD-I or -II diagnosis (51 with and 42 without suicide attempt history) underwent structural MRI and filled out questionnaires. Measured were GM volumes of 11 PFC regions, BD illness-course, and attempt history and severity. Effects were examined with repeated measures GLM or logit analyses. RESULTS Objective 1: Attempt history was associated with increased trait impulsivity and aggression, and higher prevalence of BD-I, past drug use disorder, and past psychiatric hospitalization. PFCGM volume was lower in patients with than without attempt history in those with past psychiatric hospitalization. PFCGM volume was higher in patients with than without attempt history in those without hospitalization. Higher trait aggression predicted attempt history. Objective 2: Increased frontal pole volume and younger age at first hospitalization predicted many suicide attempts. CONCLUSION Attempt history in patients with BD related to PFCGM volume reduction or increase. Volume modulation by psychiatric hospitalization could reflect effects of illness-course or care. Attempt severity was not related to volume reduction. Research on suicidality-brain relationships should include illness-course and attempt severity measures.
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Affiliation(s)
- M Lijffijt
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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14
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Lan MJ, Chhetry BT, Oquendo MA, Sublette ME, Sullivan G, Mann JJ, Parsey RV. Cortical thickness differences between bipolar depression and major depressive disorder. Bipolar Disord 2014; 16:378-88. [PMID: 24428430 PMCID: PMC4047134 DOI: 10.1111/bdi.12175] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 09/26/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Bipolar disorder (BD) is a psychiatric disorder with high morbidity and mortality that cannot be distinguished from major depressive disorder (MDD) until the first manic episode. A biomarker able to differentiate BD and MDD could help clinicians avoid risks of treating BD with antidepressants without mood stabilizers. METHODS Cortical thickness differences were assessed using magnetic resonance imaging in BD depressed patients (n = 18), MDD depressed patients (n = 56), and healthy volunteers (HVs) (n = 54). A general linear model identified clusters of cortical thickness difference between diagnostic groups. RESULTS Compared to the HV group, the BD group had decreased cortical thickness in six regions, after controlling for age and sex, located within the frontal and parietal lobes, and the posterior cingulate cortex. Mean cortical thickness changes in clusters ranged from 7.6 to 9.6% (cluster-wise p-values from 1.0 e-4 to 0.037). When compared to MDD, three clusters of lower cortical thickness in BD were identified that overlapped with clusters that differentiated the BD and HV groups. Mean cortical thickness changes in the clusters ranged from 7.5 to 8.2% (cluster-wise p-values from 1.0 e-4 to 0.023). The difference in cortical thickness was more pronounced when the subgroup of subjects with bipolar I disorder (BD-I) was compared to the MDD group. CONCLUSIONS Cortical thickness patterns were distinct between BD and MDD. These results are a step toward developing an imaging test to differentiate the two disorders.
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Affiliation(s)
- Martin J Lan
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
| | - Binod Thapa Chhetry
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
| | - Maria A Oquendo
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
| | - M Elizabeth Sublette
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
| | - Gregory Sullivan
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY
| | - J John Mann
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY,Department of Radiology, Columbia University College of Physicians and Surgeons, New York, NY
| | - Ramin V Parsey
- Presently at Department of Psychiatry and Behavioral Health Sciences and Department of Radiology, Stony Brook University Medical Center, Stony Brook, NY, USA
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15
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Nery FG, Monkul ES, Lafer B. Gray matter abnormalities as brain structural vulnerability factors for bipolar disorder: A review of neuroimaging studies of individuals at high genetic risk for bipolar disorder. Aust N Z J Psychiatry 2013; 47:1124-35. [PMID: 23864160 DOI: 10.1177/0004867413496482] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Cortical and subcortical gray matter abnormalities have been reported in individuals at high genetic risk for bipolar disorder, but the findings are inconsistent. The aim of this study was to review the available literature to identify common findings that could represent brain structural vulnerability factors for bipolar disorder and to discuss challenges for the advancement of the field. METHOD A systematic search was conducted using the PubMed database to identify all original articles investigating cortical or subcortical gray matter abnormalities in first-degree relatives of bipolar disorder patients. RESULTS Very few findings were replicated, with the exception of larger insular cortex volumes in adult first-degree relatives and larger right inferior frontal gyrus in offspring of probands with bipolar disorder, both when compared with healthy controls. Isolated findings included decreased gray matter density in the left thalamus, decreased gray matter volumes in the left hippocampus and parahippocampal gyrus, and thicker right hippocampus in unaffected first-degree relatives. Genetic liability for bipolar disorder was associated with gray matter volumes in regions of the anterior cingulate cortex, ventral striatum, medial frontal gyrus, right precentral gyrus, right insular cortex, and medial orbital gyrus. Some studies found no evidence for gray matter abnormalities in first-degree relatives of bipolar disorder patients. CONCLUSIONS Possible reasons for the discrepancies of findings across studies include small samples sizes, small effect size of susceptibility genes, the phenotypic heterogeneity of bipolar disorder, and the possible confounding effect of other Axis I psychopathologies among the relatives of patients. Future multisite, prospective, large studies with more homogeneous samples would be a key strategy to advance the field. The ultimate benefit would be an understanding of how to use brain imaging tools to identify individuals at increased risk for bipolar disorder and develop preventive strategies for that population.
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Affiliation(s)
- Fabiano G Nery
- 1Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Brazil
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16
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Rakofsky JJ, Dunlop BW. Do alcohol use disorders destabilize the course of bipolar disorder? J Affect Disord 2013; 145:1-10. [PMID: 22858208 DOI: 10.1016/j.jad.2012.06.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 06/12/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine whether long-term data implicate a negative effect of alcohol-use disorders (AUDs) on time to remission, risk of mood episode recurrence, and risk of mood switch/cycling in patients with bipolar disorder (BD). The short-term temporal sequence between alcohol use and onset of mood episodes was also examined. METHODS A MEDLINE literature search was conducted for measurement-based reports of alcohol and course of bipolar disorder. RESULTS Twenty-three original data publications were identified. Three out of 5 studies addressing the impact of AUDs on recovery from a mood episode demonstrated that alcohol did not prolong index mood episodes of any type. Six out of 11 reports evaluating the relationship between alcohol and the long term risk of mood episode recurrences suggested that high levels of alcohol intake increase the risk of a mood recurrence. Five out of 7 studies evaluating the short-term temporal sequence of AUDs and development of mood episodes among BD patients found that increased alcohol use preceded the development of new mood episodes. Four out of 5 studies examining the association between alcohol and rapid cycling indicated that AUDs were associated with higher rates of rapid-cycling. LIMITATIONS We limited our review to studies that were large enough to perform statistical testing, which may have led us to overlook informative smaller studies. CONCLUSIONS Although alcohol does not seem to affect time to mood episode remission, alcohol use destabilizes the course of illness over the long run as evidenced by associations with more rapid cycling and mood episode recurrence.
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Affiliation(s)
- Jeffrey J Rakofsky
- Mood and Anxiety Disorders Program, Emory University, Department of Psychiatry and Behavioral Sciences, 1256 Briarcliff Rd, 3rd Floor North, Atlanta, GA 30306, USA.
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