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Thiel K, Lemke H, Winter A, Flinkenflügel K, Waltemate L, Bonnekoh L, Grotegerd D, Dohm K, Hahn T, Förster K, Kanske P, Repple J, Opel N, Redlich R, David F, Forstner AJ, Stein F, Brosch K, Thomas-Odenthal F, Usemann P, Teutenberg L, Straube B, Alexander N, Jamalabadi H, Jansen A, Witt SH, Andlauer TFM, Pfennig A, Bauer M, Nenadić I, Kircher T, Meinert S, Dannlowski U. White and gray matter alterations in bipolar I and bipolar II disorder subtypes compared with healthy controls - exploring associations with disease course and polygenic risk. Neuropsychopharmacology 2024; 49:814-823. [PMID: 38332015 PMCID: PMC10948847 DOI: 10.1038/s41386-024-01812-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/28/2023] [Accepted: 01/21/2024] [Indexed: 02/10/2024]
Abstract
Patients with bipolar disorder (BD) show alterations in both gray matter volume (GMV) and white matter (WM) integrity compared with healthy controls (HC). However, it remains unclear whether the phenotypically distinct BD subtypes (BD-I and BD-II) also exhibit brain structural differences. This study investigated GMV and WM differences between HC, BD-I, and BD-II, along with clinical and genetic associations. N = 73 BD-I, n = 63 BD-II patients and n = 136 matched HC were included. Using voxel-based morphometry and tract-based spatial statistics, main effects of group in GMV and fractional anisotropy (FA) were analyzed. Associations between clinical and genetic features and GMV or FA were calculated using regression models. For FA but not GMV, we found significant differences between groups. BD-I patients showed lower FA compared with BD-II patients (ptfce-FWE = 0.006), primarily in the anterior corpus callosum. Compared with HC, BD-I patients exhibited lower FA in widespread clusters (ptfce-FWE < 0.001), including almost all major projection, association, and commissural fiber tracts. BD-II patients also demonstrated lower FA compared with HC, although less pronounced (ptfce-FWE = 0.049). The results remained unchanged after controlling for clinical and genetic features, for which no independent associations with FA or GMV emerged. Our findings suggest that, at a neurobiological level, BD subtypes may reflect distinct degrees of disease expression, with increasing WM microstructure disruption from BD-II to BD-I. This differential magnitude of microstructural alterations was not clearly linked to clinical and genetic variables. These findings should be considered when discussing the classification of BD subtypes within the spectrum of affective disorders.
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Affiliation(s)
- Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Kira Flinkenflügel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lena Waltemate
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Translational Psychotherapy, Institute of Psychology, University of Göttingen, Göttingen, Germany
| | - Linda Bonnekoh
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Förster
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
- Department of Psychology, University of Halle, Halle, Germany
- Center for Intervention and Research on adaptive and maladaptive brain circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Halle, Germany
| | - Friederike David
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Florian Thomas-Odenthal
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Paula Usemann
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Lea Teutenberg
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Nina Alexander
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Hamidreza Jamalabadi
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
- Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Stephanie H Witt
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Till F M Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, TU Dresden University of Technology, Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, TU Dresden University of Technology, Dresden, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute of Translational Neuroscience, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.
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2
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Zhu W, Chen X, Wu J, Li Z, Im H, Chen S, Deng K, Zhang B, Wei C, Feng J, Zhang M, Yang S, Wang H, Wang Q. Neuroanatomical and functional substrates of the hypomanic personality trait and its prediction on aggression. Int J Clin Health Psychol 2023; 23:100397. [PMID: 37560478 PMCID: PMC10407439 DOI: 10.1016/j.ijchp.2023.100397] [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: 03/27/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
Hypomanic personality manifests a close link with several psychiatric disorders and its abnormality is a risk indicator for developing bipolar disorders. We systematically investigated the potential neuroanatomical and functional substrates underlying hypomanic personality trait (HPT) and its sub-dimensions (i.e., Social Vitality, Mood Volatility, and Excitement) combined with structural and functional imaging data as well as their corresponding brain networks in a large non-clinical sample across two studies (n = 464). Behaviorally, HPT, specifically Mood Volatility and Excitement, was positively associated with aggressive behaviors in both studies. Structurally, sex-specific morphological characteristics were further observed in the motor and top-down control networks especially for Mood Volatility, although HPT was generally positively associated with grey matter volumes (GMVs) in the prefrontal, temporal, visual, and limbic systems. Functionally, brain activations related to immediate or delayed losses were found to predict individual variability in HPT, specifically Social Vitality and Excitement, on the motor and prefrontal-parietal cortices. Topologically, connectome-based prediction model analysis further revealed the predictive role of individual-level morphological and resting-state functional connectivity on HPT and its sub-dimensions, although it did not reveal any links with general brain topological properties. GMVs in the temporal, limbic (e.g., amygdala), and visual cortices mediated the effects of HPT on behavioral aggression. These findings suggest that the imbalance between motor and control circuits may be critical for HPT and provide novel insights into the neuroanatomical, functional, and topological mechanisms underlying the specific temperament and its impacts on aggression.
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Affiliation(s)
- Wenwei Zhu
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Xiongying Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Jie Wu
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China
- Tianjin Social Science Laboratory of Students’ Mental Development and Learning, Tianjin 300387, China
| | - Zixi Li
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Hohjin Im
- Department of Psychological Science, University of California, Irvine, CA 92697-7085, USA
| | - Shuning Chen
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Kun Deng
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Bin Zhang
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Chuqiao Wei
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Junjiao Feng
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China
- Tianjin Social Science Laboratory of Students’ Mental Development and Learning, Tianjin 300387, China
| | - Manman Zhang
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China
- Tianjin Social Science Laboratory of Students’ Mental Development and Learning, Tianjin 300387, China
| | - Shaofeng Yang
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China
- Tianjin Social Science Laboratory of Students’ Mental Development and Learning, Tianjin 300387, China
| | - He Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300192, China
| | - Qiang Wang
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China
- Tianjin Social Science Laboratory of Students’ Mental Development and Learning, Tianjin 300387, China
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Olivito G, Siciliano L, Clausi S, Lupo M, Baiocco R, Gragnani A, Saettoni M, Delle Chiaie R, Laghi F, Leggio M. The Cerebellum Gets Social: Evidence from an Exploratory Study of Cerebellar, Neurodevelopmental, and Psychiatric Disorders. Biomedicines 2023; 11:309. [PMID: 36830846 PMCID: PMC9953169 DOI: 10.3390/biomedicines11020309] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
Social prediction is a key feature of social cognition (SC), a function in which the modulating role of the cerebellum is recognized. Accordingly, cerebellar alterations are reported in cerebellar pathologies, neurodevelopmental disorders, and psychiatric conditions that show SC deficits. Nevertheless, to date, no study has directly compared populations representative of these three conditions with respect to SC and cerebellar alterations. Therefore, the present exploratory study aimed to compare the SC profiles of individuals with cerebellar neurodegenerative disorders (CB), autism (ASD), bipolar disorder type 2 (BD2), or healthy subjects (HS) using a battery of social tests requiring different degrees of prediction processing. The patterns of cerebellar gray matter (GM) alterations were compared among the groups using voxel-based morphometry. Compared to HS, the clinical groups showed common SC deficits in tasks involving a moderate to high level of prediction. The behavioral results of the clinical groups are consistent with the presence of overlapping GM reduction in cerebellar right Crus II, an area notably involved in complex social processing and prediction. Although exploratory and preliminary, these results deepen the cerebellar role in social prediction and highlight the transdiagnostic value of the cerebellum in social functioning and prediction in pathologies of different aetiologies, forecasting novel possibilities for shared interventions.
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Affiliation(s)
- Giusy Olivito
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Libera Siciliano
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Silvia Clausi
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
- Klinikos Center for Psychodiagnostics and Psychotherapy, Viale delle Milizie 38, 00192 Roma, Italy
| | - Michela Lupo
- Servizio di Tutela della Salute Mentale e Riabilitazione dell’Età Evolutiva ASL, Roma 2, 00145 Rome, Italy
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Roma, Italy
| | - Andrea Gragnani
- Scuola di Psicoterapia Cognitiva SPC, 58100 Grosseto, Italy
- Associazione Psicologia Cognitiva (APC)/Scuola di Psicoterapia Cognitiva (SPC), 00185 Rome, Italy
| | - Marco Saettoni
- Scuola di Psicoterapia Cognitiva SPC, 58100 Grosseto, Italy
- Unità Funzionale Salute Mentale Adulti ASL Toscana Nord-Ovest Valle del Serchio, 56121 Pisa, Italy
| | - Roberto Delle Chiaie
- Department of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Roma, Italy
| | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
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4
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Clausi S, Siciliano L, Olivito G, Leggio M. Cerebellum and Emotion in Social Behavior. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1378:235-253. [PMID: 35902475 DOI: 10.1007/978-3-030-99550-8_15] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Accumulating evidence suggests that the cerebellum plays a crucial role not only in the motor and cognitive domains but also in emotions and social behavior. In the present chapter, after a general introduction on the significance of the emotional components of social behavior, we describe recent efforts to understand the contributions of the cerebellum in social cognition focusing on the emotional and affective aspects. Specifically, starting from the description of the cerebello-cortical networks subtending the social-affective domains, we illustrate the most recent findings on the social cerebellum and the possible functional mechanisms by which the cerebellum modulate social-affective behavior. Finally, we discuss the possible consequences of cerebellar dysfunction in the social-affective domain, focusing on those neurological and psychopathological conditions in which emotional and social behavior difficulties have been described as being associated with cerebellar structural or functional alterations.
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Affiliation(s)
- Silvia Clausi
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy. .,Psychology Department, Sapienza University, Rome, Italy.
| | - Libera Siciliano
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy.,Psychology Department, Sapienza University, Rome, Italy
| | - Giusy Olivito
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy.,Psychology Department, Sapienza University, Rome, Italy
| | - Maria Leggio
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy.,Psychology Department, Sapienza University, Rome, Italy
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Cui L, Li H, Li JB, Zeng H, Zhang Y, Deng W, Zhou W, Cao L. Altered cerebellar gray matter and cerebellar-cortex resting-state functional connectivity in patients with bipolar disorder Ⅰ. J Affect Disord 2022; 302:50-57. [PMID: 35074460 DOI: 10.1016/j.jad.2022.01.073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Bipolar disorder (BP) is a common psychiatric disorder characterized by extreme fluctuations in mood. Recent studies have indicated the involvement of cerebellum in the pathogenesis of BP. However, no study has focused on the precise role of cerebellum exclusively in patients with bipolar I disorder (BP-I). METHODS Forty-five patients with BP-I and 40 healthy controls were recruited. All subjects underwent clinical evaluation and Magnetic Resonance diffusion Tension Imaging scans. For structural images, we used a spatially unbiased infratentorial template toolbox to isolate the cerebellum and then preformed voxel-based morphometry (VBM) analyses to assess the difference in cerebellar gray matter volume (GMV) between the two groups. For the functional images, we chose the clusters that survived from VBM analysis as seeds and performed functional connectivity (FC) analysis. Between-group differences were assessed using the independent Students t test or the nonparametric Mann-Whitney U Test. For multiple comparisons, the results were further corrected with Gaussian random field (GRF) approach (voxel-level P < 0.001, cluster-level P < 0.05). RESULTS Compared with healthy controls, BP-I patients showed significantly decreased GMV in left lobule V and left lobule VI (P < 0.05, GRF corrected). The FC of cerebellum with bilateral superior temporal gyrus, bilateral insula, bilateral rolandic operculum, right putamen, and left precentral gyrus was disrupted in BP-I patients (P < 0.05, GRF corrected). CONCLUSIONS BP-I patients showed decreased cerebellar GMV and disrupted cerebellar-cortex resting-state FC. This suggests that cerebellar abnormalities may play an important role in the pathogenesis of BP-I.
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Affiliation(s)
- Liqian Cui
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China.
| | - Hao Li
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Jin Biao Li
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Huixing Zeng
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Yizhi Zhang
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
| | - Wenhao Deng
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
| | - Wenjin Zhou
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
| | - Liping Cao
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China.
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Lupo M, Olivito G, Gragnani A, Saettoni M, Siciliano L, Pancheri C, Panfili M, Bozzali M, Delle Chiaie R, Leggio M. Comparison of Cerebellar Grey Matter Alterations in Bipolar and Cerebellar Patients: Evidence from Voxel-Based Analysis. Int J Mol Sci 2021; 22:ijms22073511. [PMID: 33805296 PMCID: PMC8036397 DOI: 10.3390/ijms22073511] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 03/26/2021] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to compare the patterns of cerebellar alterations associated with bipolar disease with those induced by the presence of cerebellar neurodegenerative pathologies to clarify the potential cerebellar contribution to bipolar affective disturbance. Twenty-nine patients affected by bipolar disorder, 32 subjects affected by cerebellar neurodegenerative pathologies, and 37 age-matched healthy subjects underwent a 3T MRI protocol. A voxel-based morphometry analysis was used to show similarities and differences in cerebellar grey matter (GM) loss between the groups. We found a pattern of GM cerebellar alterations in both bipolar and cerebellar groups that involved the anterior and posterior cerebellar regions (p = 0.05). The direct comparison between bipolar and cerebellar patients demonstrated a significant difference in GM loss in cerebellar neurodegenerative patients in the bilateral anterior and posterior motor cerebellar regions, such as lobules I-IV, V, VI, VIIIa, VIIIb, IX, VIIb and vermis VI, while a pattern of overlapping GM loss was evident in right lobule V, right crus I and bilateral crus II. Our findings showed, for the first time, common and different alteration patterns of specific cerebellar lobules in bipolar and neurodegenerative cerebellar patients, which allowed us to hypothesize a cerebellar role in the cognitive and mood dysregulation symptoms that characterize bipolar disorder.
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Affiliation(s)
- Michela Lupo
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (G.O.); (M.L.)
- Correspondence: ; Tel.: +39-065-150-1115
| | - Giusy Olivito
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (G.O.); (M.L.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Gragnani
- Scuola di Psicoterapia Cognitiva SPC, 58100 Grosseto, Italy; (A.G.); (M.S.)
- Associazione Psicologia Cognitiva (APC)/Scuola di Psicoterapia Cognitiva (SPC), 00185 Rome, Italy
| | - Marco Saettoni
- Scuola di Psicoterapia Cognitiva SPC, 58100 Grosseto, Italy; (A.G.); (M.S.)
- Unità Funzionale Salute Mentale Adulti ASL Toscana Nord-Ovest Valle del Serchio, 56121 Pisa, Italy
| | - Libera Siciliano
- PhD Program in Behavioral Neuroscience, Sapienza University of Rome, 00185 Rome, Italy;
| | - Corinna Pancheri
- Departement of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.P.); (R.D.C.)
| | - Matteo Panfili
- Departement of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.P.); (R.D.C.)
| | - Marco Bozzali
- Clinical Imaging Science Center, Brighton and Sussex Medical School, Brighton BN1 9RR, UK;
| | - Roberto Delle Chiaie
- Departement of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.P.); (R.D.C.)
| | - Maria Leggio
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (G.O.); (M.L.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
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7
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Argyropoulos GD, Christidi F, Karavasilis E, Velonakis G, Antoniou A, Bede P, Seimenis I, Kelekis N, Douzenis A, Papakonstantinou O, Efstathopoulos E, Ferentinos P. Cerebro-cerebellar white matter connectivity in bipolar disorder and associated polarity subphenotypes. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110034. [PMID: 32710925 DOI: 10.1016/j.pnpbp.2020.110034] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/08/2020] [Accepted: 07/12/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The cerebellum has a crucial role in mood regulation. While cerebellar grey matter (GM) alterations have been previously reported in bipolar disorder (BD), cerebro-cerebellar white matter (WM) connectivity alterations and cerebellar GM profiles have not been characterised in the context of predominant polarity (PP) and onset polarity (OP) subphenotypes of BD patients which is the aim of the present study. METHODS Forty-two euthymic BD patients stratified for PP and OP and 42 healthy controls (HC) were included in this quantitative neuroimaging study to evaluate cerebellar GM patterns and cerebro-cerebellar WM connections. Diffusion tensor tractography was used to characterise afferent and efferent cerebro-cerebellar tract integrity. False discovery rate corrections were applied in post-hoc comparisons. RESULTS BD patients exhibited higher fractional anisotropy (FA) in fronto-ponto-cerebellar tracts bilaterally compared to HC. Subphenotype-specific FA profiles were identified within the BD cohort. Regarding PP subgroups, we found FA changes in a) left contralateral fronto-ponto-cerebellar tract (depressive-PP > HC) and b) contralateral/ipsilateral fronto-ponto-cerebellar tracts bilaterally (manic-PP > HC). Regarding OP subgroups, we observed FA changes in a) left/right contralateral fronto-ponto-cerebellar tracts (depressive-OP > HC) and b) all fronto-ponto-cerebellar, most parieto-ponto-cerebellar and right contralateral occipito-ponto-cerebellar tracts (manic-OP>HC). In general, greater and more widespread cerebro-cerebellar changes were observed in manic-OP patients than in depressive-OP patients compared to HC. Manic-OP showed higher FA compared to depressive-OP patients in several afferent WM tracts. No GM differences were identified between BD and HC and across BD subgroups. CONCLUSIONS Our findings highlight fronto-ponto-cerebellar connectivity alterations in euthymic BD. Polarity-related subphenotypes have distinctive cerebro-cerebellar WM signatures with potential clinical and pathobiological implications.
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Affiliation(s)
- Georgios D Argyropoulos
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Foteini Christidi
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Efstratios Karavasilis
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Velonakis
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Antoniou
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Peter Bede
- Biomedical Imaging Laboratory, Sorbonne University, CNRS, INSERM, Paris, France; Computational Neuroimaging Group, Trinity College Dublin, Ireland
| | - Ioannis Seimenis
- Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Kelekis
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Douzenis
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Olympia Papakonstantinou
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathios Efstathopoulos
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Ferentinos
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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8
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Van Overwalle F, Manto M, Cattaneo Z, Clausi S, Ferrari C, Gabrieli JDE, Guell X, Heleven E, Lupo M, Ma Q, Michelutti M, Olivito G, Pu M, Rice LC, Schmahmann JD, Siciliano L, Sokolov AA, Stoodley CJ, van Dun K, Vandervert L, Leggio M. Consensus Paper: Cerebellum and Social Cognition. CEREBELLUM (LONDON, ENGLAND) 2020; 19:833-868. [PMID: 32632709 PMCID: PMC7588399 DOI: 10.1007/s12311-020-01155-1] [Citation(s) in RCA: 186] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The traditional view on the cerebellum is that it controls motor behavior. Although recent work has revealed that the cerebellum supports also nonmotor functions such as cognition and affect, only during the last 5 years it has become evident that the cerebellum also plays an important social role. This role is evident in social cognition based on interpreting goal-directed actions through the movements of individuals (social "mirroring") which is very close to its original role in motor learning, as well as in social understanding of other individuals' mental state, such as their intentions, beliefs, past behaviors, future aspirations, and personality traits (social "mentalizing"). Most of this mentalizing role is supported by the posterior cerebellum (e.g., Crus I and II). The most dominant hypothesis is that the cerebellum assists in learning and understanding social action sequences, and so facilitates social cognition by supporting optimal predictions about imminent or future social interaction and cooperation. This consensus paper brings together experts from different fields to discuss recent efforts in understanding the role of the cerebellum in social cognition, and the understanding of social behaviors and mental states by others, its effect on clinical impairments such as cerebellar ataxia and autism spectrum disorder, and how the cerebellum can become a potential target for noninvasive brain stimulation as a therapeutic intervention. We report on the most recent empirical findings and techniques for understanding and manipulating cerebellar circuits in humans. Cerebellar circuitry appears now as a key structure to elucidate social interactions.
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Affiliation(s)
- Frank Van Overwalle
- Department of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - Mario Manto
- Mediathèque Jean Jacquy, Service de Neurologie, CHU-Charleroi, Charleroi, Belgium
- Service des Neurosciences, Université de Mons, Mons, Belgium
| | - Zaira Cattaneo
- University of Milano-Bicocca, 20126 Milan, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Silvia Clausi
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - John D. E. Gabrieli
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, USA
| | - Xavier Guell
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, USA
- Ataxia Unit, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
| | - Elien Heleven
- Department of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - Michela Lupo
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Qianying Ma
- Department of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - Marco Michelutti
- Service de Neurologie & Neuroscape@NeuroTech Platform, Département des Neurosciences Cliniques, Centre Hospitalier Universitaire Vaudois (CHUV), Service de Neurologie Lausanne, Lausanne, Switzerland
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Giusy Olivito
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Min Pu
- Department of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - Laura C. Rice
- Department of Psychology and Department of Neuroscience, American University, Washington, DC USA
| | - Jeremy D. Schmahmann
- Ataxia Unit, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
| | - Libera Siciliano
- Program in Behavioral Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Arseny A. Sokolov
- Service de Neurologie & Neuroscape@NeuroTech Platform, Département des Neurosciences Cliniques, Centre Hospitalier Universitaire Vaudois (CHUV), Service de Neurologie Lausanne, Lausanne, Switzerland
- Department of Neurology, University Neurorehabilitation, University Hospital Inselspital, University of Bern, Bern, Switzerland
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London (UCL), London, UK
- Neuroscape Center, Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, CA USA
| | - Catherine J. Stoodley
- Department of Psychology and Department of Neuroscience, American University, Washington, DC USA
| | - Kim van Dun
- Neurologic Rehabilitation Research, Rehabilitation Research Institute (REVAL), Hasselt University, 3590 Diepenbeek, Belgium
| | - Larry Vandervert
- American Nonlinear Systems, 1529 W. Courtland Avenue, Spokane, WA 99205-2608 USA
| | - Maria Leggio
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
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9
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Li H, Cui L, Cao L, Zhang Y, Liu Y, Deng W, Zhou W. Identification of bipolar disorder using a combination of multimodality magnetic resonance imaging and machine learning techniques. BMC Psychiatry 2020; 20:488. [PMID: 33023515 PMCID: PMC7542439 DOI: 10.1186/s12888-020-02886-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Bipolar disorder (BPD) is a common mood disorder that is often goes misdiagnosed or undiagnosed. Recently, machine learning techniques have been combined with neuroimaging methods to aid in the diagnosis of BPD. However, most studies have focused on the construction of classifiers based on single-modality MRI. Hence, in this study, we aimed to construct a support vector machine (SVM) model using a combination of structural and functional MRI, which could be used to accurately identify patients with BPD. METHODS In total, 44 patients with BPD and 36 healthy controls were enrolled in the study. Clinical evaluation and MRI scans were performed for each subject. Next, image pre-processing, VBM and ReHo analyses were performed. The ReHo values of each subject in the clusters showing significant differences were extracted. Further, LASSO approach was recruited to screen features. Based on selected features, the SVM model was established, and discriminant analysis was performed. RESULTS After using the two-sample t-test with multiple comparisons, a total of 8 clusters were extracted from the data (VBM = 6; ReHo = 2). Next, we used both VBM and ReHo data to construct the new SVM classifier, which could effectively identify patients with BPD at an accuracy of 87.5% (95%CI: 72.5-95.3%), sensitivity of 86.4% (95%CI: 64.0-96.4%), and specificity of 88.9% (95%CI: 63.9-98.0%) in the test data (p = 0.0022). CONCLUSIONS A combination of structural and functional MRI can be of added value in the construction of SVM classifiers to aid in the accurate identification of BPD in the clinic.
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Affiliation(s)
- Hao Li
- grid.412615.5Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China ,grid.484195.5Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080 China
| | - Liqian Cui
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. .,Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, No.58 Zhongshan Road 2, Guangzhou, 510080, China.
| | - Liping Cao
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong, China.
| | - Yizhi Zhang
- grid.452505.30000 0004 1757 6882Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong China
| | - Yueheng Liu
- grid.216417.70000 0001 0379 7164Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan China ,Chinese National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan China
| | - Wenhao Deng
- grid.452505.30000 0004 1757 6882Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong China
| | - Wenjin Zhou
- grid.452505.30000 0004 1757 6882Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong China
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10
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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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11
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Yu H, Meng YJ, Li XJ, Zhang C, Liang S, Li ML, Li Z, Guo W, Wang Q, Deng W, Ma X, Coid J, Li T. Common and distinct patterns of grey matter alterations in borderline personality disorder and bipolar disorder: voxel-based meta-analysis. Br J Psychiatry 2019; 215:395-403. [PMID: 30846010 DOI: 10.1192/bjp.2019.44] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Whether borderline personality disorder (BPD) and bipolar disorder are the same or different disorders lacks consistency.AimsTo detect whether grey matter volume (GMV) and grey matter density (GMD) alterations show any similarities or differences between BPD and bipolar disorder. METHOD Web-based publication databases were searched to conduct a meta-analysis of all voxel-based studies that compared BPD or bipolar disorder with healthy controls. We included 13 BPD studies (395 patients with BPD and 415 healthy controls) and 47 bipolar disorder studies (2111 patients with bipolar disorder and 3261 healthy controls). Peak coordinates from clusters with significant group differences were extracted. Effect-size signed differential mapping meta-analysis was performed to analyse peak coordinates of clusters and thresholds (P < 0.005, uncorrected). Conjunction analyses identified regions in which disorders showed common patterns of volumetric alteration. Correlation analyses were also performed. RESULTS Patients with BPD showed decreased GMV and GMD in the bilateral medial prefrontal cortex network (mPFC), bilateral amygdala and right parahippocampal gyrus; patients with bipolar disorder showed decreased GMV and GMD in the bilateral medial orbital frontal cortex (mOFC), right insula and right thalamus, and increased GMV and GMD in the right putamen. Multi-modal analysis indicated smaller volumes in both disorders in clusters in the right medial orbital frontal cortex. Decreased bilateral mPFC in BPD was partly mediated by patient age. Increased GMV and GMD of the right putamen was positively correlated with Young Mania Rating Scale scores in bipolar disorder. CONCLUSIONS Our results show different patterns of GMV and GMD alteration and do not support the hypothesis that bipolar disorder and BPD are on the same affective spectrum.Declaration of interestNone.
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Affiliation(s)
- Hua Yu
- Associate Researcher,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
| | - Ya-Jing Meng
- Associate Researcher,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
| | - Xiao-Jing Li
- Associate Researcher,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
| | - Chengcheng Zhang
- Associate Researcher,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
| | - Sugai Liang
- Associate Researcher,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
| | - Ming-Li Li
- Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
| | - Zhe Li
- Lecturer,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
| | - Wanjun Guo
- Lecturer,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
| | - Qiang Wang
- Lecturer,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
| | - Wei Deng
- Lecturer,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
| | - Xiaohong Ma
- Researcher,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
| | - Jeremy Coid
- Researcher,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
| | - Tao Li
- Researcher,Mental Health Center,West China Hospital of Sichuan University;Psychiatric Laboratory,State Key Laboratory of Biotherapy,West China Hospital of Sichuan University;and Brain Research Center,West China Hospital of Sichuan University,China
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12
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Lupo M, Siciliano L, Leggio M. From cerebellar alterations to mood disorders: A systematic review. Neurosci Biobehav Rev 2019; 103:21-28. [PMID: 31195001 DOI: 10.1016/j.neubiorev.2019.06.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 05/30/2019] [Accepted: 06/09/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Several studies have shown cerebellar abnormalities during depressive and manic states, although the specific cerebellar role in mood fluctuations remains poorly defined. Therefore, the study of pathologies characterized by frequent mood swings, such as bipolar disorder, is of great interest to investigate the relationship between the cerebellum and mood alterations. METHODS A systematic literature search on the occurrence of mood disorders in patients with cerebellar pathologies (1st research strategy) and on the presence of cerebellar alterations in mood disorders (2nd research strategy) was conducted using the PubMed electronic Internet database. For this systematic review all information was written based on the PRISMA-P statement. RESULTS The results of the 1st research strategy generated 9 articles, and in one of these, a direct correlation between cerebellar damage and the onset of mood disorder was reported. The 2nd research strategy generated 14 articles that were grouped according to the patient's mood phase (manic or depressive) or diagnosis (bipolar I or bipolar II). CONCLUSIONS The present review suggests that the cerebellum should be considered a key structure involved in the regulation of mood.
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Affiliation(s)
- Michela Lupo
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Via Ardeatina 306-354, 00179, Rome, Italy.
| | - Libera Siciliano
- Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy.
| | - Maria Leggio
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Via Ardeatina 306-354, 00179, Rome, Italy; Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy.
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13
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Lu X, Zhong Y, Ma Z, Wu Y, Fox PT, Zhang N, Wang C. Structural imaging biomarkers for bipolar disorder: Meta-analyses of whole-brain voxel-based morphometry studies. Depress Anxiety 2019; 36:353-364. [PMID: 30475436 DOI: 10.1002/da.22866] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 10/20/2018] [Accepted: 11/06/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a common and destructive psychiatric illness worldwide. Although it is known that BD is associated with morphological abnormalities of the brain, the regions implicated in BD remain unclear. Therefore, we aimed to update current knowledge on potential structural imaging biomarkers of BD. METHODS Studies published up to January 31, 2018, were identified by a comprehensive literature search of PubMed, EBSCO, and BrainMap voxel-based morphometry (VBM) database. Whole-brain VBM studies that examined gray matter (GM) abnormalities of group comparisons between BD and healthy controls (HC) and reported results as coordinates in a standard reference space were included. Different meta-analyses were performed by activation likelihood estimation (ALE) algorithm. RESULTS A total of 46 studies with 56 experiments, including 1720 subjects and 268 foci were included. Seven different meta-analyses were calculated separately across experiments reporting decreased or increased GM volume among BD, BDΙ, BD-adults, and BD-youths groups. Fifteen regions of significantly different GM volume between four groups and HC were identified. There were extensive GM deficits in the prefrontal and temporal cortex, and enlargements in the putamen, cingulate cortex, and precuneus. CONCLUSIONS The results revealed that the thinning of prefrontal cortex was a key region in the pathophysiology of BD. The enlargement of the cingulate cortex may be implicated in a compensatory mechanism. It underscored important differences between BD-adults and BD-youths and specific biomarkers of three subgroups.
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Affiliation(s)
- Xin Lu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.,Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.,Jiangsu Key Laboratory of Mental Health and Cognitive Science, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Zijuan Ma
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yun Wu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.,Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Peter T Fox
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,South Texas Veterans Healthcare System, University of Texas Health San Antonio, San Antonio, United States.,Research Imaging Institute, University of Texas Health San Antonio, San Antonio, United States
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chun Wang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
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14
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Luo X, Chen G, Jia Y, Gong J, Qiu S, Zhong S, Zhao L, Chen F, Lai S, Qi Z, Huang L, Wang Y. Disrupted Cerebellar Connectivity With the Central Executive Network and the Default-Mode Network in Unmedicated Bipolar II Disorder. Front Psychiatry 2018; 9:705. [PMID: 30618876 PMCID: PMC6305495 DOI: 10.3389/fpsyt.2018.00705] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/03/2018] [Indexed: 11/25/2022] Open
Abstract
Objective: Bipolar disorder (BD) is a common psychiatric disease. Although structural and functional abnormalities of the cerebellum in BD patients have been reported by recent neuroimaging studies, the cerebellar-cerebral functional connectivity (FC) has not yet been examined. The present study aims to investigate the FC between the cerebellum and cerebrum, particularly the central executive network (CEN) and the default-mode network (DMN) in bipolar II disorder (BD II). Methods: Ninety-four patients with unmedicated BD II depression and 100 healthy controls (HCs) underwent the resting-state functional magnetic resonance imaging. Seed-based connectivity analyses were performed using cerebellar seeds previously identified as being involved in the CEN (bilateral Crus Ia) and DMN (bilateral Crus Ib). Results: Compared with HCs, BD II depression patients appeared decreased FC in the right Crus Ia-left dorsal lateral prefrontal cortex (dlPFC) and -left anterior cingulate cortex (ACC), the right Crus Ib-left medial prefrontal cortex (mPFC), -left middle temporal gyrus (MTG), and -left inferior temporal gyrus (ITG). No altered FC between the left Crus Ia or Crus Ib and the cerebral regions was found. Conclusions: Patients with BD II depression showed disrupted FC between the cerebellum and the CEN (mainly in the left dlPFC and ACC) and DMN (mainly in the left mPFC and temporal lobe), suggesting the significant role of the cerebellum-CEN and -DMN connectivity in the pathogenesis of BD.
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Affiliation(s)
- Xiaomei Luo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - JiaYing Gong
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China.,The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shaojuan Qiu
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lianping Zhao
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Feng Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
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15
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Buoli M, Serati M, Altamura AC. Biological aspects and candidate biomarkers for rapid-cycling in bipolar disorder: A systematic review. Psychiatry Res 2017; 258:565-575. [PMID: 28864122 DOI: 10.1016/j.psychres.2017.08.059] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/24/2017] [Accepted: 08/23/2017] [Indexed: 01/23/2023]
Abstract
Rapid-cycling bipolar disorder represents a frequent severe subtype of illness which has been associated with poor response to pharmacological treatment. Aim of the present article is to provide an updated review of biological markers associated with rapid-cycling bipolar disorder. A research in the main database sources has been conducted to identify relevant papers about the topic. Rapid-cycling bipolar disorder patients seem to have a more frequent family history for bipolar spectrum disorders (d range: 0.44-0.74) as well as an increased susceptibility to DNA damage or mRNA hypo-transcription (d range: 0.78-1.67) than non rapid-cycling ones. A susceptibility to hypothyroidism, which is exacerbated by treatment with lithium, is possible in rapid-cycling bipolar disorder, but further studies are needed to draw definitive conclusions. Rapid-cycling bipolar patients might have more insuline resistance as well as more severe brain changes in frontal areas (d range: 0.82-0.94) than non rapid-cycling ones. Many questions are still open about this topic. The first is whether the rapid-cycling is inheritable or is more generally the manifestation of a severe form of bipolar disorder. The second is whether some endocrine dysfunctions (diabetes and hypothyroidism) predispose to rapid-cycling or rapid-cycling is the consequence of drug treatment or medical comorbidities (e.g. obesity).
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Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy.
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
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Ganzola R, Duchesne S. Voxel-based morphometry meta-analysis of gray and white matter finds significant areas of differences in bipolar patients from healthy controls. Bipolar Disord 2017; 19:74-83. [PMID: 28444949 DOI: 10.1111/bdi.12488] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 03/06/2017] [Accepted: 03/12/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We present a retrospective meta-analysis of voxel-based morphometry (VBM) of gray (GM) and white matter (WM) differences between patients with bipolar disorder (BD) and behaviorally healthy controls. METHODS We used the activation likelihood estimation and Sleuth software for our meta-analysis, considering P-value maps at the cluster level inference of .05 with uncorrected P<.001. Results were visualized with the software MANGO. RESULTS We included twenty-five articles in the analysis, and separated the comparisons where BD patients had lower GM or WM concentrations than controls (573 subjects, 21 experiments, and 117 locations/180 subjects, five experiments, and 15 locations, respectively) and the comparisons where BD patients had greater GM concentrations than controls (217 subjects, nine experiments, and 49 locations). Higher WM concentrations in BD patients were not detected. We observed for BD reduced GM concentrations in the left medial frontal gyrus and right inferior/precentral gyri encompassing the insular cortex, and greater GM concentrations in the left putamen. Further, lower WM concentrations were detected in the left inferior longitudinal fasciculus, left superior corona radiata, and left posterior cingulum. CONCLUSIONS This meta-analysis confirms deterioration of frontal and insular regions as already found in previous meta-analysis. GM reductions in these regions could be related to emotional processing and decision making, which are typically impaired in BD. Moreover, we found abnormalities in precentral frontal areas and putamen that have been linked to more basic functions, which could point to sensory and specific cognitive deficits. Finally, WM reductions involved circuitry that may contribute to emotional dysregulation in BD.
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Affiliation(s)
- Rossana Ganzola
- Institut universitaire en santé mentale de Québec, Québec City, Québec, Canada
| | - Simon Duchesne
- Institut universitaire en santé mentale de Québec, Québec City, Québec, Canada.,Départment de Radiologie, Faculté de Médecine, Université Laval, Québec City, Québec, Canada
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Hanford LC, Hall GB, Minuzzi L, Sassi RB. Gray matter volumes in symptomatic and asymptomatic offspring of parents diagnosed with bipolar disorder. Eur Child Adolesc Psychiatry 2016; 25:959-67. [PMID: 26767977 DOI: 10.1007/s00787-015-0809-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/07/2015] [Indexed: 12/12/2022]
Abstract
Children of parents diagnosed with bipolar disorder (BD), termed high-risk offspring (HRO), are at greater risk of developing psychiatric disorders compared to healthy children of healthy parents (HCO). Gray matter volume (GMV) abnormalities have been observed in HRO, however, these reports are inconsistent. We posit that this variability may be attributed to differences in methodology among offspring studies; in particular, the presence of psychiatric symptoms in HRO. Here, we directly compared GMVs between symptomatic and asymptomatic HRO, and HCO. High-resolution T1-weighted MR images were collected from 31 HRO (18 symptomatic and 13 asymptomatic) and 20 age- and sex-matched HCO. HRO had at least one parent diagnosed with BD. Symptomatic HRO were defined as having a psychiatric diagnosis other than BD, while asymptomatic HRO were required to be free of any psychiatric diagnosis. Scans were processed using voxel-based morphometry methods and between group analyses were performed in SPM. Compared to HCO, the HRO group showed decreased GMV in the right inferior orbitofrontal, right middle frontal, and bilateral superior and middle temporal regions. Both symptomatic and asymptomatic HRO groups showed decreased GMV in these regions separately when compared to HCO. When comparing symptomatic and asymptomatic HRO, GMVs were comparable in all regions except the lateral occipital cortex. Our study compared symptomatic and asymptomatic HRO directly. In doing so, we provided further support for the presence of discrete GMV deficits in HRO, and confirmed that these deficits are present irrespective of the presence of symptoms in HRO.
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Affiliation(s)
- Lindsay C Hanford
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Geoffrey B Hall
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Mood Disorders Program, St. Joseph's Healthcare Hamilton, 100 West 5th St., Hamilton, ON, L8N3K7, Canada
| | - Roberto B Sassi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
- Mood Disorders Program, St. Joseph's Healthcare Hamilton, 100 West 5th St., Hamilton, ON, L8N3K7, Canada.
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18
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Hozer F, Houenou J. Can neuroimaging disentangle bipolar disorder? J Affect Disord 2016; 195:199-214. [PMID: 26896814 DOI: 10.1016/j.jad.2016.01.039] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 01/02/2016] [Accepted: 01/24/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Bipolar disorder heterogeneity is large, leading to difficulties in identifying neuropathophysiological and etiological mechanisms and hindering the formation of clinically homogeneous patient groups in clinical trials. Identifying markers of clinically more homogeneous groups would help disentangle BD heterogeneity. Neuroimaging may aid in identifying such groups by highlighting specific biomarkers of BD subtypes or clinical dimensions. METHODS We performed a systematic literature search of the neuroimaging literature assessing biomarkers of relevant BD phenotypes (type-I vs. II, presence vs. absence of psychotic features, suicidal behavior and impulsivity, rapid cycling, good vs. poor medication response, age at onset, cognitive performance and circadian abnormalities). RESULTS Consistent biomarkers were associated with suicidal behavior, i.e. frontal/anterior alterations (prefrontal and cingulate grey matter, prefrontal white matter) in patients with a history of suicide attempts; and with cognitive performance, i.e. involvement of frontal and temporal regions, superior and inferior longitudinal fasciculus, right thalamic radiation, and corpus callosum in executive dysfunctions. For the other dimensions and sub-types studied, no consistent biomarkers were identified. LIMITATIONS Studies were heterogeneous both in methodology and outcome. CONCLUSIONS Though theoretically promising, neuroimaging has not yet proven capable of disentangling subtypes and dimensions of bipolar disorder, due to high between-study heterogeneity. We issue recommendations for future studies.
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Affiliation(s)
- Franz Hozer
- Neurospin, UNIACT, Psychiatry Team, I2BM, CEA Saclay, F-91191 Gif-Sur-Yvette, France; INSERM U955, IMRB, Université Paris Est, Equipe 15 "Psychiatrie Translationnelle", Créteil F-94000, France; Fondation Fondamental, Créteil F-94010, France
| | - Josselin Houenou
- Neurospin, UNIACT, Psychiatry Team, I2BM, CEA Saclay, F-91191 Gif-Sur-Yvette, France; INSERM U955, IMRB, Université Paris Est, Equipe 15 "Psychiatrie Translationnelle", Créteil F-94000, France; Fondation Fondamental, Créteil F-94010, France; AP-HP, Hôpitaux Universitaires Mondor, DHU PePsy, Pôle de Psychiatrie, Créteil F-94000, France.
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Elvsåshagen T, Westlye LT, Bøen E, Hol PK, Andreassen OA, Boye B, Malt UF. Bipolar II disorder is associated with thinning of prefrontal and temporal cortices involved in affect regulation. Bipolar Disord 2013; 15:855-64. [PMID: 23980618 DOI: 10.1111/bdi.12117] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 05/20/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The neurobiological substrate of bipolar II disorder (BD-II) remains largely unknown. A few previous studies have found evidence for cerebral cortical thinning in mixed samples of BD-II and bipolar I disorder patients; however, no study of cortical thickness or surface area has been limited to BD-II. In the present study, we compared magnetic resonance imaging (MRI)-based indices of cortical thickness and surface area between individuals with BD-II and healthy controls. METHODS Thirty-six individuals with a DSM-IV diagnosis of BD-II and 42 controls underwent 3T MRI. Comparisons of thickness and relative surface areal expansion across the cerebral cortical mantle were performed using Freesurfer. RESULTS Individuals with BD-II showed significant thinning in two prefrontal clusters primarily comprising the left subgenual anterior cingulate cortex, left perigenual ventromedial prefrontal cortex (PFC), bilateral dorsomedial PFC, and bilateral dorsolateral PFC (p < 0.0002 for both clusters, cluster size corrected) and in a left temporal cluster involving the superior, middle, and inferior temporal gyrus (p = 0.006, cluster size corrected). No group differences in cortical surface area were found. No significant effect of medication, mood state, illness duration, or family history of bipolar disorders on cortical thinning was observed. CONCLUSIONS These results indicate that BD-II is associated with thinning of prefrontal and temporal cortices implicated in the expression and regulation of negative and positive affect. Longitudinal studies are needed to clarify whether cortical thinning is a stable trait of BD-II, an illness effect that might progress during the course of the disease, or a combination of the two.
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Affiliation(s)
- Torbjørn Elvsåshagen
- Department of Psychosomatic Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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20
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Ambrosi E, Rossi-Espagnet MC, Kotzalidis GD, Comparelli A, Del Casale A, Carducci F, Romano A, Manfredi G, Tatarelli R, Bozzao A, Girardi P. Structural brain alterations in bipolar disorder II: a combined voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) study. J Affect Disord 2013; 150:610-5. [PMID: 23489395 DOI: 10.1016/j.jad.2013.02.023] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Revised: 02/13/2013] [Accepted: 02/13/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Brain structural changes have been described in bipolar disorder (BP), but usually studies focused on both I and II subtypes indiscriminately and investigated changes in either brain volume or white matter (WM) integrity. We used combined voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) analysis to track changes in the grey matter (GM) and WM in the brains of patients affected by BPII, as compared to healthy controls. METHODS Using VBM and DTI, we scanned 20 DSM-IV-TR BPII patients in their euthymic phase and 21 healthy, age- and gender-matched volunteers with no psychiatric history. RESULTS VBM showed decreases in GM of BPII patients, compared to controls, which were diffuse in nature and most prominent in the right middle frontal gyrus and in the right superior temporal gurus. DTI showed significant and widespread FA reduction in BPII patients in all major WM tracts, including cortico-cortical association tracts. LIMITATIONS The small sample size limits the generalisability of our findings. CONCLUSIONS Reduced GM volumes and WM integrity changes in BPII patients are not prominent like those previously reported in bipolar disorder type-I and involve cortical structures and their related association tracts.
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Affiliation(s)
- Elisa Ambrosi
- Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, Sapienza University, School of Medicine and Psychology, Unit of Psychiatry, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, Rome 00189, Italy.
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21
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Yip SW, Chandler RA, Rogers RD, Mackay CE, Goodwin GM. White matter alterations in antipsychotic- and mood stabilizer-naïve individuals with bipolar II/NOS disorder. NEUROIMAGE-CLINICAL 2013; 3:271-8. [PMID: 24273712 PMCID: PMC3814955 DOI: 10.1016/j.nicl.2013.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 07/30/2013] [Accepted: 08/04/2013] [Indexed: 01/16/2023]
Abstract
Structural magnetic resonance imaging (MRI) studies using voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) have been inconsistent in demonstrating impairments in gray matter (GM) and white matter (WM) structures in bipolar disorder (BD). This may be a consequence of significant confounding effects of medication, illness history and selection of controls in existing studies. Study of bipolar II or not-otherwise-specified (BD II/NOS) disorder provides a solution to these confounds and a bridge to unipolar cases across the affective spectrum. Thirty-eight euthymic, antipsychotic- and mood stabilizer-naïve young adults (mean age = 20.9 years) with BD II/NOS and 37 age-, cognitive ability- and gender-matched healthy controls (HCs) underwent MRI. Voxel-wise and regional gray matter volume comparisons were conducted using voxel-based morphometry (VBM). Tract-based spatial statistics (TBSS) were used to assess whole-brain WM, as indexed using fractional anisotropy (FA), mean diffusivity (MD), parallel and perpendicular diffusion values. No between-group differences were observed for whole-brain VBM comparisons. By contrast, in comparison to HCs, participants with BD II/NOS had significant widespread reductions in FA and increased MD and perpendicular diffusion values in virtually all the major cortical white matter tracts. These data suggest pathophysiological involvement of WM microstructures - but not GM macrostructures - in high functioning BD II/NOS patients at an early age and before significant clinical adversity has been recorded. We propose that white matter development is a valid candidate target for understanding genetic and environmental antecedents to bipolar disorder and mood disorder more generally.
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Affiliation(s)
- Sarah W Yip
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
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22
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Kulak A, Steullet P, Cabungcal JH, Werge T, Ingason A, Cuenod M, Do KQ. Redox dysregulation in the pathophysiology of schizophrenia and bipolar disorder: insights from animal models. Antioxid Redox Signal 2013; 18:1428-43. [PMID: 22938092 DOI: 10.1089/ars.2012.4858] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
SIGNIFICANCE Schizophrenia (SZ) and bipolar disorder (BD) are classified as two distinct diseases. However, accumulating evidence shows that both disorders share genetic, pathological, and epidemiological characteristics. Based on genetic and functional findings, redox dysregulation due to an imbalance between pro-oxidants and antioxidant defense mechanisms has been proposed as a risk factor contributing to their pathophysiology. RECENT ADVANCES Altered antioxidant systems and signs of increased oxidative stress are observed in peripheral tissues and brains of SZ and BD patients, including abnormal prefrontal levels of glutathione (GSH), the major cellular redox regulator and antioxidant. Here we review experimental data from rodent models demonstrating that permanent as well as transient GSH deficit results in behavioral, morphological, electrophysiological, and neurochemical alterations analogous to pathologies observed in patients. Mice with GSH deficit display increased stress reactivity, altered social behavior, impaired prepulse inhibition, and exaggerated locomotor responses to psychostimulant injection. These behavioral changes are accompanied by N-methyl-D-aspartate receptor hypofunction, elevated glutamate levels, impairment of parvalbumin GABA interneurons, abnormal neuronal synchronization, altered dopamine neurotransmission, and deficient myelination. CRITICAL ISSUES Treatment with the GSH precursor and antioxidant N-acetylcysteine normalizes some of those deficits in mice, but also improves SZ and BD symptoms when given as adjunct to antipsychotic medication. FUTURE DIRECTIONS These data demonstrate the usefulness of GSH-deficient rodent models to identify the mechanisms by which a redox imbalance could contribute to the development of SZ and BD pathophysiologies, and to develop novel therapeutic approaches based on antioxidant and redox regulator compounds.
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Affiliation(s)
- Anita Kulak
- Department of Psychiatry, Center for Psychiatric Neuroscience, Lausanne University Hospital, Prilly-Lausanne, Switzerland
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Özdel O, Kalayci D, Sözeri-Varma G, Kiroğlu Y, Tümkaya S, Toker-Uğurlu T. Neurochemical metabolites in the medial prefrontal cortex in bipolar disorder: A proton magnetic resonance spectroscopy study. Neural Regen Res 2012; 7:2929-36. [PMID: 25317146 PMCID: PMC4190952 DOI: 10.3969/j.issn.1673-5374.2012.36.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Accepted: 11/04/2012] [Indexed: 12/30/2022] Open
Abstract
The aim of this study was to investigate proton magnetic resonance spectroscopy metabolite values in the medial prefrontal cortex of individuals with euthymic bipolar disorder. The subjects consisted of 15 patients with euthymic bipolar disorder type I and 15 healthy controls. We performed proton magnetic resonance spectroscopy of the bilateral medial prefrontal cortex and measured levels of N-acetyl aspartate, choline and creatine. Levels of these three metabolites in the medial prefrontal cortex were found to be lower in patients with bipolar disorder compared with healthy controls. A positive correlation was found between illness duration and choline levels in the right medial prefrontal cortex. Our study suggests that during the euthymic period, there are abnormalities in cellular energy and membrane phospholipid metabolism in the medial prefrontal cortex, and that this may impair neuronal activity and integrity.
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Affiliation(s)
- Osman Özdel
- Department of Psychiatry, Faculty of Medicine, Pamukkale University, Denizli 20100, Turkey
| | - Demet Kalayci
- Department of Psychiatry, Antalya Training and Research Hospital, Antalya 07050, Turkey
| | - Gülfizar Sözeri-Varma
- Department of Psychiatry, Faculty of Medicine, Pamukkale University, Denizli 20100, Turkey
| | - Yilmaz Kiroğlu
- Department of Radiology, Faculty of Medicine, Pamukkale University, Denizli 20100, Turkey
| | - Selim Tümkaya
- Department of Psychiatry, Faculty of Medicine, Pamukkale University, Denizli 20100, Turkey
| | - Tugçe Toker-Uğurlu
- Department of Psychiatry, Faculty of Medicine, Pamukkale University, Denizli 20100, Turkey
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Neuroanatomical Profile of Antimaniac Effects of Histone Deacetylases Inhibitors. Mol Neurobiol 2011; 43:207-14. [DOI: 10.1007/s12035-011-8178-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 03/03/2011] [Indexed: 11/27/2022]
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