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Yin J, Li S, Li J, Gong R, Jia Z, Liu J, Jin Z, Yang J, Liu Y. Association of serum oleic acid level with depression in American adults: a cross-sectional study. BMC Psychiatry 2023; 23:845. [PMID: 37974120 PMCID: PMC10652490 DOI: 10.1186/s12888-023-05271-0] [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: 05/18/2023] [Accepted: 10/11/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND As the most abundant fatty acid in plasma, oleic acid has been found to be associated with multiple neurological diseases; however, results from studies of the relationship between oleic acid and depression are inconsistent. METHODS This cross-sectional study analyzed 4,459 adults from the National Health and Nutrition Examination Survey 2011-2014. The following covariates were adjusted in multivariable logistic regression models: age, sex, race/ethnicity, education level, marital status, body mass index, physical activity, smoking status, alcohol status, metabolic syndrome, omega-3 polyunsaturated fatty acids, and total cholesterol. RESULTS Serum oleic acid levels were positively associated with depression. After adjusting for all covariates, for every 1 mmol/L increase in oleic acid levels, the prevalence of depression increased by 40% (unadjusted OR: 1.35, 95%CI: 1.16-1.57; adjusted OR: 1.40, 95% CI: 1.03-1.90). CONCLUSIONS Our study suggests that oleic acid may play a role in depression. Further research is needed to investigate the potential benefits of changing oleic acid levels for the treatment and prevention of depression.
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Affiliation(s)
- Jiahui Yin
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Siyuan Li
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinling Li
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China
| | | | - Zhixia Jia
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Junjun Liu
- Nanjing Meishan Hospital, Nanjing, China
| | - Zhi Jin
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Jiguo Yang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China.
| | - Yuanxiang Liu
- Department of Neurology, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China.
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2
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Jadranin M, Avramović N, Miladinović Z, Gavrilović A, Tasic L, Tešević V, Mandić B. Untargeted Lipidomics Study of Bipolar Disorder Patients in Serbia. Int J Mol Sci 2023; 24:16025. [PMID: 38003221 PMCID: PMC10671390 DOI: 10.3390/ijms242216025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
The Lipidomic profiles of serum samples from patients with bipolar disorder (BD) and healthy controls (C) were explored and compared. The sample cohort included 31 BD patients and 31 control individuals. An untargeted lipidomics study applying liquid chromatography (LC) coupled with high-resolution mass spectrometry (HRMS) was conducted to achieve the lipid profiles. Multivariate statistical analyses (principal component analysis and partial least squares discriminant analysis) were performed, and fifty-six differential lipids were confirmed in BD and controls. Our results pointed to alterations in lipid metabolism, including pathways of glycerophospholipids, sphingolipids, glycerolipids, and sterol lipids, in BD patient sera. This study emphasized the role of lipid pathways in BD, and comprehensive research using the LC-HRMS platform is necessary for future application in the diagnosis and improvement of BD treatments.
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Affiliation(s)
- Milka Jadranin
- University of Belgrade—Institute of Chemistry, Technology and Metallurgy, Department of Chemistry, Njegoševa 12, 11000 Belgrade, Serbia;
| | - Nataša Avramović
- University of Belgrade—Faculty of Medicine, Institute of Medical Chemistry, Višegradska 26, 11000 Belgrade, Serbia
| | - Zoran Miladinović
- Institute of General and Physical Chemistry, Studentski trg 12–16, 11158 Belgrade, Serbia;
| | - Aleksandra Gavrilović
- Special Hospital for Psychiatric Diseases “Kovin”, Cara Lazara 253, 26220 Kovin, Serbia;
| | - Ljubica Tasic
- Institute of Chemistry, Organic Chemistry Department, State University of Campinas, Campinas 13083-970, Sao Paulo, Brazil;
| | - Vele Tešević
- University of Belgrade—Faculty of Chemistry, Studentski trg 12–16, 11000 Belgrade, Serbia;
| | - Boris Mandić
- University of Belgrade—Faculty of Chemistry, Studentski trg 12–16, 11000 Belgrade, Serbia;
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3
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Zhao K, Xie H, Fonzo GA, Tong X, Carlisle N, Chidharom M, Etkin A, Zhang Y. Individualized fMRI connectivity defines signatures of antidepressant and placebo responses in major depression. Mol Psychiatry 2023; 28:2490-2499. [PMID: 36732585 DOI: 10.1038/s41380-023-01958-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 02/04/2023]
Abstract
Though sertraline is commonly prescribed in patients with major depressive disorder (MDD), its superiority over placebo is only marginal. This is in part due to the neurobiological heterogeneity of the individuals. Characterizing individual-unique functional architecture of the brain may help better dissect the heterogeneity, thereby defining treatment-predictive signatures to guide personalized medication. In this study, we investigate whether individualized brain functional connectivity (FC) can define more predictable signatures of antidepressant and placebo treatment in MDD. The data used in the present work were collected by the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study. Patients (N = 296) were randomly assigned to antidepressant sertraline or placebo double-blind treatment for 8 weeks. The whole-brain FC networks were constructed from pre-treatment resting-state functional magnetic resonance imaging (rs-fMRI). Then, FC was individualized by removing the common components extracted from the raw baseline FC to train regression-based connectivity predictive models. With individualized FC features, the established prediction models successfully identified signatures that explained 22% variance for the sertraline group and 31% variance for the placebo group in predicting HAMD17 change. Compared with the raw FC-based models, the individualized FC-defined signatures significantly improved the prediction performance, as confirmed by cross-validation. For sertraline treatment, predictive FC metrics were predominantly located in the left middle temporal cortex and right insula. For placebo, predictive FC metrics were primarily located in the bilateral cingulate cortex and left superior temporal cortex. Our findings demonstrated that through the removal of common FC components, individualization of FC metrics enhanced the prediction performance compared to raw FC. Associated with previous MDD clinical studies, our identified predictive biomarkers provided new insights into the neuropathology of antidepressant and placebo treatment.
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Affiliation(s)
- Kanhao Zhao
- Department of Bioengineering, Lehigh University, Bethlehem, PA, USA
| | - Hua Xie
- Center for Neuroscience Research, Children's National Hospital, Washington, DC, USA
| | - Gregory A Fonzo
- Center for Psychedelic Research and Therapy, Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Xiaoyu Tong
- Department of Bioengineering, Lehigh University, Bethlehem, PA, USA
| | - Nancy Carlisle
- Department of Psychology, Lehigh University, Bethlehem, PA, USA
| | | | - Amit Etkin
- Alto Neuroscience, Inc, Los Altos, CA, USA
| | - Yu Zhang
- Department of Bioengineering, Lehigh University, Bethlehem, PA, USA.
- Department of Electrical and Computer Engineering, Lehigh University, Bethlehem, PA, USA.
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4
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Sinclair AJ, Wang Y, Li D. What Is the Evidence for Dietary-Induced DHA Deficiency in Human Brains? Nutrients 2022; 15:nu15010161. [PMID: 36615819 PMCID: PMC9824463 DOI: 10.3390/nu15010161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
Docosahexaenoic acid (DHA) is a major constituent of neural and visual membranes and is required for optimal neural and visual function. DHA is derived from food or by endogenous synthesis from α-linolenic acid (ALA), an essential fatty acid. Low blood levels of DHA in some westernised populations have led to speculations that child development disorders and various neurological conditions are associated with sub-optimal neural DHA levels, a proposition which has been supported by the supplement industry. This review searched for evidence of deficiency of DHA in human populations, based on elevated levels of the biochemical marker of n-3 deficiency, docosapentaenoic acid (22:5n-6). Three scenarios/situations were identified for the insufficient supply of DHA, namely in the brain of new-born infants fed with high-linoleic acid (LA), low-ALA formulas, in cord blood of women at birth who were vegetarians and in the milk of women from North Sudan. Twenty post-mortem brain studies from the developed world from adults with various neurological disorders revealed no evidence of raised levels of 22:5n-6, even in the samples with reduced DHA levels compared with control subjects. Human populations most likely at risk of n-3 deficiency are new-born and weanling infants, children and adolescents in areas of dryland agriculture, in famines, or are refugees, however, these populations have rarely been studied. This is an important topic for future research.
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Affiliation(s)
- Andrew J. Sinclair
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, VIC 3168, Australia
- Faculty of Health, Deakin University, Burwood, VIC 3152, Australia
- Correspondence: ; Tel.: +61-(0)414-906-341
| | - Yonghua Wang
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510641, China
| | - Duo Li
- Institute of Nutrition & Health, College of Public Health, Qingdao University, Qingdao 266071, China
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Di Miceli M, Martinat M, Rossitto M, Aubert A, Alashmali S, Bosch-Bouju C, Fioramonti X, Joffre C, Bazinet RP, Layé S. Dietary Long-Chain n-3 Polyunsaturated Fatty Acid Supplementation Alters Electrophysiological Properties in the Nucleus Accumbens and Emotional Behavior in Naïve and Chronically Stressed Mice. Int J Mol Sci 2022; 23:ijms23126650. [PMID: 35743093 PMCID: PMC9224532 DOI: 10.3390/ijms23126650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 02/01/2023] Open
Abstract
Long-chain (LC) n-3 polyunsaturated fatty acids (PUFAs) have drawn attention in the field of neuropsychiatric disorders, in particular depression. However, whether dietary supplementation with LC n-3 PUFA protects from the development of mood disorders is still a matter of debate. In the present study, we studied the effect of a two-month exposure to isocaloric diets containing n-3 PUFAs in the form of relatively short-chain (SC) (6% of rapeseed oil, enriched in α-linolenic acid (ALA)) or LC (6% of tuna oil, enriched in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) PUFAs on behavior and synaptic plasticity of mice submitted or not to a chronic social defeat stress (CSDS), previously reported to alter emotional and social behavior, as well as synaptic plasticity in the nucleus accumbens (NAc). First, fatty acid content and lipid metabolism gene expression were measured in the NAc of mice fed a SC (control) or LC n-3 (supplemented) PUFA diet. Our results indicate that LC n-3 supplementation significantly increased some n-3 PUFAs, while decreasing some n-6 PUFAs. Then, in another cohort, control and n-3 PUFA-supplemented mice were subjected to CSDS, and social and emotional behaviors were assessed, together with long-term depression plasticity in accumbal medium spiny neurons. Overall, mice fed with n-3 PUFA supplementation displayed an emotional behavior profile and electrophysiological properties of medium spiny neurons which was distinct from the ones displayed by mice fed with the control diet, and this, independently of CSDS. Using the social interaction index to discriminate resilient and susceptible mice in the CSDS groups, n-3 supplementation promoted resiliency. Altogether, our results pinpoint that exposure to a diet rich in LC n-3 PUFA, as compared to a diet rich in SC n-3 PUFA, influences the NAc fatty acid profile. In addition, electrophysiological properties and emotional behavior were altered in LC n-3 PUFA mice, independently of CSDS. Our results bring new insights about the effect of LC n-3 PUFA on emotional behavior and synaptic plasticity.
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Affiliation(s)
- Mathieu Di Miceli
- Laboratoire NutriNeuro, UMR INRAE 1286, Bordeaux INP, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France; (M.D.M.); (M.M.); (M.R.); (A.A.); (C.B.-B.); (X.F.); (C.J.)
- Worcester Biomedical Research Group, School of Science and the Environment, University of Worcester, Worcester WR2 6AJ, UK
- International Research Network Food4BrainHealth;
| | - Maud Martinat
- Laboratoire NutriNeuro, UMR INRAE 1286, Bordeaux INP, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France; (M.D.M.); (M.M.); (M.R.); (A.A.); (C.B.-B.); (X.F.); (C.J.)
- International Research Network Food4BrainHealth;
| | - Moïra Rossitto
- Laboratoire NutriNeuro, UMR INRAE 1286, Bordeaux INP, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France; (M.D.M.); (M.M.); (M.R.); (A.A.); (C.B.-B.); (X.F.); (C.J.)
- International Research Network Food4BrainHealth;
| | - Agnès Aubert
- Laboratoire NutriNeuro, UMR INRAE 1286, Bordeaux INP, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France; (M.D.M.); (M.M.); (M.R.); (A.A.); (C.B.-B.); (X.F.); (C.J.)
- International Research Network Food4BrainHealth;
| | - Shoug Alashmali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 22254, Saudi Arabia;
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Clémentine Bosch-Bouju
- Laboratoire NutriNeuro, UMR INRAE 1286, Bordeaux INP, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France; (M.D.M.); (M.M.); (M.R.); (A.A.); (C.B.-B.); (X.F.); (C.J.)
- International Research Network Food4BrainHealth;
| | - Xavier Fioramonti
- Laboratoire NutriNeuro, UMR INRAE 1286, Bordeaux INP, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France; (M.D.M.); (M.M.); (M.R.); (A.A.); (C.B.-B.); (X.F.); (C.J.)
- International Research Network Food4BrainHealth;
| | - Corinne Joffre
- Laboratoire NutriNeuro, UMR INRAE 1286, Bordeaux INP, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France; (M.D.M.); (M.M.); (M.R.); (A.A.); (C.B.-B.); (X.F.); (C.J.)
- International Research Network Food4BrainHealth;
| | - Richard P. Bazinet
- International Research Network Food4BrainHealth;
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Sophie Layé
- Laboratoire NutriNeuro, UMR INRAE 1286, Bordeaux INP, Université de Bordeaux, 146 Rue Léo Saignat, 33076 Bordeaux, France; (M.D.M.); (M.M.); (M.R.); (A.A.); (C.B.-B.); (X.F.); (C.J.)
- International Research Network Food4BrainHealth;
- Correspondence:
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Yamashina K, Yamamoto S, Matsumoto M, Iwasa K, Takeda N, Haruta C, Maruyama K, Shimizu K, Yoshikawa K. Suppressive Effect of Fruiting Bodies of Medicinal Mushrooms on Demyelination and Motor Dysfunction in a Cuprizone-Induced Multiple Sclerosis Mouse Model. Int J Med Mushrooms 2022; 24:15-24. [DOI: 10.1615/intjmedmushrooms.2022044840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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7
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Castellanos DB, Martín-Jiménez CA, Rojas-Rodríguez F, Barreto GE, González J. Brain lipidomics as a rising field in neurodegenerative contexts: Perspectives with Machine Learning approaches. Front Neuroendocrinol 2021; 61:100899. [PMID: 33450200 DOI: 10.1016/j.yfrne.2021.100899] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/21/2020] [Accepted: 01/10/2021] [Indexed: 12/14/2022]
Abstract
Lipids are essential for cellular functioning considering their role in membrane composition, signaling, and energy metabolism. The brain is the second most abundant organ in terms of lipid concentration and diversity only after adipose tissue. However, in the central system (CNS) lipid dysregulation has been linked to the etiology, progression, and severity of neurodegenerative diseases such as Alzheimeŕs, Parkinson, and Multiple Sclerosis. Advances in the human genome and subsequent sequencing technologies allowed us the study of lipidomics as a promising approach to diagnosis and treatment of neurodegeneration. Lipidomics advances rapidly increased the amount and quality of data allowing the integration with other omic types as well as implementing novel bioinformatic and quantitative tools such as machine learning (ML). Integration of lipidomics data with ML, as a powerful quantitative predictive approach, led to improvements in diagnostic biomarker prediction, clinical data integration, network, and systems approaches for neural behavior, novel etiology markers for inflammation, and neurodegeneration progression and even Mass Spectrometry image analysis. In this sense, by exploiting lipidomics data with ML is possible to improve the identification of new biomarkers or unveil new molecular mechanisms associated with lipid impairment across neurodegeneration. In this review, we present the lipidomic neurobiology state-of-the-art highlighting its potential applications to study neurodegenerative conditions. Also, we present theoretical background, applications, and advances in the integration of lipidomics with ML. This review opens the door to new approaches in this rising field.
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Affiliation(s)
- Daniel Báez Castellanos
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Cynthia A Martín-Jiménez
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Felipe Rojas-Rodríguez
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - George E Barreto
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Janneth González
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia.
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Lipidomic UPLC-MS/MS Profiles of Normal-Appearing White Matter Differentiate Primary and Secondary Progressive Multiple Sclerosis. Metabolites 2020; 10:metabo10090366. [PMID: 32911763 PMCID: PMC7569864 DOI: 10.3390/metabo10090366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 09/07/2020] [Indexed: 01/20/2023] Open
Abstract
Multiple sclerosis (MS) is a neurodegenerative inflammatory disease where an autoimmune response to components of the central nervous system leads to a loss of myelin and subsequent neurological deterioration. People with MS can develop primary or secondary progressive disease (PPMS, SPMS) and differentiation of the specific differences in the pathogenesis of these two courses, at the molecular level, is currently unclear. Recently, lipidomics studies using human biofluids, mainly plasma and cerebrospinal fluid, have highlighted a possible role for lipids in the initiation and progression of MS. However, there is a lack of lipidomics studies in MS on CNS tissues, such as normal-appearing white matter (NAWM), where local inflammation initially occurs. Herein, we developed an untargeted reverse phase ultra-performance liquid chromatography time of flight tandem mass spectrometry (RP-UPLC-TOF MSE)-based workflow, in combination with multivariate and univariate statistical analysis, to assess significant differences in lipid profiles in brain NAWM from post-mortem cases of PPMS, SPMS and controls. Groups of eight control, nine PPMS and seven SPMS NAWM samples were used. Correlation analysis of the identified lipids by RP-UPLC-TOF MSE was undertaken to remove those lipids that correlated with age, gender and post-mortem interval as confounding factors. We demonstrate that there is a significantly altered lipid profile of control cases compared with MS cases and that progressive disease, PPMS and SPMS, can be differentiated on the basis of the lipidome of NAWM with good sensitivity, specificity and prediction accuracy based on receiver operating characteristic (ROC) curve analysis. Metabolic pathway analysis revealed that the most altered lipid pathways between PPMS and SPMS were glycerophospholipid metabolism, glycerophosphatidyl inositol (GPI) anchor synthesis and linoleic acid metabolism. Further understanding of the impact of these lipid alterations described herein associated with progression will provide an increased understanding of the mechanisms underpinning progression and highlight possible new therapeutic targets.
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Matsubara T, Kusano K, Tashiro T, Ukai K, Uehara K. Deep Generative Model of Individual Variability in fMRI Images of Psychiatric Patients. IEEE Trans Biomed Eng 2020; 68:592-605. [PMID: 32746057 DOI: 10.1109/tbme.2020.3008707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Neuroimaging techniques, such as the resting-state functional magnetic resonance imaging (fMRI), have been investigated to find objective biomarkers of neuro-logical and psychiatric disorders. Objective biomarkers potentially provide a refined diagnosis and quantitative measurements of the effects of treatment. However, fMRI images are sensitive to individual variability, such as functional topography and personal attributes. Suppressing the irrelevant individual variability is crucial for finding objective biomarkers for multiple subjects. Herein, we propose a structured generative model based on deep learning (i.e., a deep generative model) that considers such individual variability. The proposed model builds a joint distribution of (preprocessed) fMRI images, state (with or without a disorder), and individual variability. It can thereby discriminate individual variability from the subject's state. Experimental results demonstrate that the proposed model can diagnose unknown subjects with greater accuracy than conventional approaches. Moreover, the diagnosis is fairer to gender and state, because the proposed model extracts subject attributes (age, gender, and scan site) in an unsupervised manner.
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10
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Mørkholt AS, Oklinski MK, Larsen A, Bockermann R, Issazadeh-Navikas S, Nieland JGK, Kwon TH, Corthals A, Nielsen S, Nieland JDV. Pharmacological inhibition of carnitine palmitoyl transferase 1 inhibits and reverses experimental autoimmune encephalitis in rodents. PLoS One 2020; 15:e0234493. [PMID: 32520953 PMCID: PMC7286491 DOI: 10.1371/journal.pone.0234493] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/26/2020] [Indexed: 02/01/2023] Open
Abstract
Multiple sclerosis (MS) is a neurodegenerative disease characterized by demyelination and inflammation. Dysregulated lipid metabolism and mitochondrial dysfunction are hypothesized to play a key role in MS. Carnitine Palmitoyl Transferase 1 (CPT1) is a rate-limiting enzyme for beta-oxidation of fatty acids in mitochondria. The therapeutic effect of pharmacological CPT1 inhibition with etomoxir was investigated in rodent models of myelin oligodendrocyte glycoprotein- and myelin basic protein-induced experimental autoimmune encephalitis (EAE). Mice receiving etomoxir showed lower clinical score compared to placebo, however this was not significant. Rats receiving etomoxir revealed significantly lower clinical score and lower body weight compared to placebo group. When comparing etomoxir with interferon-β (IFN-β), IFN-β had no significant therapeutic effects, whereas etomoxir treatment starting at day 1 and 5 significantly improved the clinical scores compared to the IFN-β and the placebo group. Immunohistochemistry and image assessments of brain sections from rats with EAE showed higher myelination intensity and decreased expression of CPT1A in etomoxir-treated rats compared to placebo group. Moreover, etomoxir mediated increased interleukin-4 production and decreased interleukin-17α production in activated T cells. In conclusion, CPT1 is a key protein in the pathogenesis of EAE and MS and a crucial therapeutic target for the treatment.
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Affiliation(s)
| | | | - Agnete Larsen
- Department of Biomedicine, Aarhus University, Aarhus C, Denmark
| | - Robert Bockermann
- Biotech Research and Innovation Centre, Copenhagen University, Copenhagen N, Denmark
| | | | | | - Tae-Hwan Kwon
- Department of Biochemistry and Cell Biology, School of Medicine, Kyungpook National University, Taegu, Korea
| | - Angelique Corthals
- Department of Science, John Jay College of Criminal Justice, City University of New York, New York, New York, United States of America
| | - Søren Nielsen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Meta-IQ, ApS, Aarhus C, Denmark
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11
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Chai X, Zhang R, Xue C, Li Z, Xiao W, Huang Q, Xiao C, Xie S. Altered Patterns of the Fractional Amplitude of Low-Frequency Fluctuation in Drug-Naive First-Episode Unipolar and Bipolar Depression. Front Psychiatry 2020; 11:587803. [PMID: 33312139 PMCID: PMC7704435 DOI: 10.3389/fpsyt.2020.587803] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/12/2020] [Indexed: 12/18/2022] Open
Abstract
Background: An early and correct diagnosis is crucial for treatment of unipolar depression (UD) and bipolar disorder (BD). The fractional amplitude of low-frequency fluctuations (fALFFs) has been widely used in the study of neuropsychiatric diseases, as it can detect spontaneous brain activities. This study was conducted to survey changes of fALFF within various frequency bands of the UD and BD patients, as well as to explore the effects on changes in fALFF on cognitive function. Methods: In total, 58 drug-naive first-episode patients, including 32 UD and 26 BD, were enrolled in the study. The fALFF values were calculated under slow-5 band (0.01-0.027 Hz) and slow-4 band (0.027-0.073 Hz) among UD patients, BD patients, and healthy control (HC). Additionally, we conducted correlation analyses to examine the association between altered fALFF values and cognitive function. Results: Under the slow-5 band, compared to the HC group, the UD group showed increased fALFF values in the right cerebellum posterior lobe, whereas the BD group showed increased fALFF values in the left middle temporal gyrus (MTG). Under the slow-4 band, in comparison to HC, the UD group showed increased fALFF values in the left superior temporal gyrus, whereas the right inferior parietal lobule (IPL) and BD group showed increased fALFF values in the bilateral postcentral gyrus. Notably, compared to BD, the UD group showed increased fALFF values in the right IPL under the slow-4 band. Furthermore, altered fALFF values in the left MTG and the right IPL were significantly positively correlated with Verbal Fluency Test scores. Conclusions: This current study indicated that there were changes in brain activities in the early UD and BD groups, and changes were related to executive function. The fALFF values can serve as potential biomarker to diagnose and differentiate UD and BD patients.
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Affiliation(s)
- Xue Chai
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Rongrong Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zonghong Li
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wang Xiao
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qingling Huang
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chaoyong Xiao
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shiping Xie
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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12
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Liu LY, Zhang HJ, Luo LY, Pu JB, Liang WQ, Zhu CQ, Li YP, Wang PR, Zhang YY, Yang CY, Zhang ZJ. Blood and urinary metabolomic evidence validating traditional Chinese medicine diagnostic classification of major depressive disorder. Chin Med 2018; 13:53. [PMID: 30386416 PMCID: PMC6203264 DOI: 10.1186/s13020-018-0211-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/18/2018] [Indexed: 02/08/2023] Open
Abstract
Background Major depressive disorder (MDD) is a highly heterogeneous disease. Further classification may characterize its heterogeneity. The purpose of this study was to examine whether metabolomic variables could differentiate traditional Chinese medicine (TCM) diagnostic subtypes of MDD. Methods Fifty medication-free patients who were experiencing a recurrent depressive episode were classified into Liver Qi Stagnation (LQS, n = 30) and Heart and Spleen Deficiency (HSD, n = 20) subtypes according to TCM diagnosis. Healthy volunteers (n = 28) were included as controls. Gas chromatography-mass spectrometry (GC–MS) was used to examine serum and urinary metabolomic profiles. Results Twenty-eight metabolites were identified for good separations between TCM subtypes and healthy controls in serum samples. Both TCM subtypes had similar profiles in proteinogenic branched-chain amino acids (BCAAs) (valine, leucine, and isoleucine) and energy metabolism-related metabolites that were differentiated from healthy controls. The LQS subtype additionally differed from healthy controls in multiple amino acid metabolites that are involved in biosynthesis of monoamine and amino acid neurotransmitters, including phenylalanine, 3-hydroxybutric acid, o-tyrosine, glycine, l-tryptophan, and N-acetyl-l-aspartic acid. Threonic acid, methionine, stearic acid, and isobutyric acid are differentially associated with the two subtypes. Conclusions While both TCM subtypes are associated with aberrant BCAA and energy metabolism, the LQS subtype may represent an MDD subpopulation characterized by abnormalities in the biosynthesis of monoamine and amino acid neurotransmitters and closer associations with stress-related pathophysiology. The metabolites differentially associated with the two subtypes are promising biomarkers for predicting TCM subtype-specific antidepressant response [registered at http://www.clinicaltrials.gov (NCT02346682) on January 27, 2015]. Electronic supplementary material The online version of this article (10.1186/s13020-018-0211-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lan-Ying Liu
- 1Department of Psychiatry, Tongde Hospital of Zhejiang Province, Hangzhou, 310012 Zhejiang China
| | - Hong-Jian Zhang
- 2Zhejiang Academy of Traditional Chinese Medicine, Hangzhou, 310007 Zhejiang China
| | - Li-Yuan Luo
- 1Department of Psychiatry, Tongde Hospital of Zhejiang Province, Hangzhou, 310012 Zhejiang China
| | - Jin-Bao Pu
- 2Zhejiang Academy of Traditional Chinese Medicine, Hangzhou, 310007 Zhejiang China
| | - Wei-Qing Liang
- 2Zhejiang Academy of Traditional Chinese Medicine, Hangzhou, 310007 Zhejiang China
| | - Chun-Qin Zhu
- 1Department of Psychiatry, Tongde Hospital of Zhejiang Province, Hangzhou, 310012 Zhejiang China
| | - Ya-Ping Li
- 3Department of Internal Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012 Zhejiang China
| | - Pei-Rong Wang
- 1Department of Psychiatry, Tongde Hospital of Zhejiang Province, Hangzhou, 310012 Zhejiang China
| | - Yuan-Yuan Zhang
- 1Department of Psychiatry, Tongde Hospital of Zhejiang Province, Hangzhou, 310012 Zhejiang China
| | - Chun-Yu Yang
- 1Department of Psychiatry, Tongde Hospital of Zhejiang Province, Hangzhou, 310012 Zhejiang China
| | - Zhang-Jin Zhang
- 4School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong, China
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13
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Atagün Mİ, Şıkoğlu EM, Can SS, Uğurlu GK, Kaymak SU, Çayköylü A, Algın O, Phillips ML, Moore CM, Öngür D. Neurochemical differences between bipolar disorder type I and II in superior temporal cortices: A proton magnetic resonance spectroscopy study. J Affect Disord 2018; 235:15-19. [PMID: 29631202 PMCID: PMC5951770 DOI: 10.1016/j.jad.2018.04.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 02/26/2018] [Accepted: 04/02/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Despite the diagnostic challenges in categorizing bipolar disorder subtypes, bipolar I and II disorders (BD-I and BD-II respectively) are valid indices for researchers. Subtle neurobiological differences may underlie clinical differences between mood disorder subtypes. The aims of this study were to investigate neurochemical differences between bipolar disorder subtypes. METHODS Euthymic BD-II patients (n = 21) are compared with BD-I (n = 28) and healthy comparison subjects (HCs, n = 30). Magnetic Resonance Imaging (MRI) and proton spectroscopy (1H MRS) were performed on a 3T Siemens Tim Trio system. MRS voxels were located in the left/right superior temporal cortices, and spectra acquired with the single voxel Point REsolved Spectroscopy Sequence (PRESS). The spectroscopic data were analyzed with LCModel (Version 6.3.0) software. RESULTS There were significant differences between groups in terms of glutamate [F = 6.27, p = 0.003], glutamate + glutamine [F = 6.08, p = 0.004], inositol containing compounds (Ino) (F = 9.25, p < 0.001), NAA [F = 7.63, p = 0.001] and creatine + phosphocreatine [F = 11.06, p < 0.001] in the left hemisphere and Ino [F = 5.65, p = 0.005] in the right hemisphere. Post-hoc comparisons showed that the BD-I disorder group had significantly lower metabolite levels in comparison to the BD-II and the HC groups. LIMITATIONS This was a cross-sectional study with a small sample size. In addition, patients were on various psychotropic medications, which may have impacted the results. CONCLUSIONS Neurochemical levels, in the superior temporal cortices, measured with 1H-MRS discriminated between BD-II and BD-I. Although further studies are needed, one may speculate that the superior temporal cortices (particularly left hemispheric) play a critical role, whose pathology may be related to subtyping bipolar disorder.
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Affiliation(s)
- Murat İlhan Atagün
- Department of Psychiatry, Ankara Yıldırım Beyazıt University Medical School, Ankara, Turkey; Department of Psychiatry, Ankara Atatürk Training and Education Hospital, Ankara, Turkey.
| | - Elif Muazzez Şıkoğlu
- Center for Comparative NeuroImaging, Department of Psychiatry and Radiology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Serdar Süleyman Can
- Department of Psychiatry, Ankara Yıldırım Beyazıt University Medical School, Ankara, Turkey,Department of Psychiatry, Ankara Atatürk Training and Education Hospital, Ankara, Turkey
| | - Görkem Karakaş Uğurlu
- Department of Psychiatry, Ankara Yıldırım Beyazıt University Medical School, Ankara, Turkey,Department of Psychiatry, Ankara Atatürk Training and Education Hospital, Ankara, Turkey
| | - Semra Ulusoy Kaymak
- Department of Psychiatry, Ankara Atatürk Training and Education Hospital, Ankara, Turkey
| | - Ali Çayköylü
- Department of Psychiatry, Ankara Yıldırım Beyazıt University Medical School, Ankara, Turkey,Department of Psychiatry, Ankara Atatürk Training and Education Hospital, Ankara, Turkey
| | - Oktay Algın
- Department of Radiology, Ankara Atatürk Training and Education Hospital, Ankara, Turkey,National MR Research Center and Aysel Sabuncu Brain Research Center, Bilkent University, Ankara, Turkey
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh, Medical School, Pittsburgh, PA, USA
| | - Constance M Moore
- Center for Comparative NeuroImaging, Department of Psychiatry and Radiology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Dost Öngür
- Psychotic Disorders Division, McLean Hospital (Belmont), MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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14
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Mocking RJT, Assies J, Ruhé HG, Schene AH. Focus on fatty acids in the neurometabolic pathophysiology of psychiatric disorders. J Inherit Metab Dis 2018. [PMID: 29524021 DOI: 10.1007/s10545-018-0158-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Continuous research into the pathophysiology of psychiatric disorders, such as major depressive disorder (MDD), posttraumatic stress disorder (PTSD), and schizophrenia, suggests an important role for metabolism. This narrative review will provide an up-to-date summary of how metabolism is thought to be involved in the pathophysiology of these psychiatric disorders. We will focus on (I) the important role of fatty acids in these metabolic alterations, (II) whether fatty acid alterations represent epiphenomena or risk factors, and (III) similarities and dissociations in fatty acid alterations between different psychiatric disorders. (Historical) epidemiological evidence links fatty acid intake to psychiatric disorder prevalence, corroborated by altered fatty acid concentrations measured in psychiatric patients. These fatty acid alterations are connected with other concomitant pathophysiological mechanisms, including biological stress (hypothalamic-pituitary-adrenal (HPA)-axis and oxidative stress), inflammation, and brain network structure and function. Metabolomics and lipidomics studies are underway to more deeply investigate this complex network of associated neurometabolic alterations. Supplementation of fatty acids as disease-modifying nutraceuticals has clinical potential, particularly add-on eicosapentaenoic acid (EPA) in depressed patients with markers of increased inflammation. However, by interpreting the observed fatty acid alterations as partly (mal)adaptive phenomena, we attempt to nuance translational expectations and provide new clinical applications for these novel neurometabolic insights, e.g., to predict treatment response or depression recurrence. In conclusion, placing fatty acids in context can contribute to further understanding and optimized treatment of psychiatric disorders, in order to diminish their overwhelming burden of disease.
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Affiliation(s)
- R J T Mocking
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands.
| | - J Assies
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands
| | - H G Ruhé
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands
- Warneford Hospital, Department of Psychiatry, University of Oxford, Oxford, UK
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
| | - A H Schene
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, the Netherlands
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15
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Trépanier MO, Hildebrand KD, Nyamoya SD, Amor S, Bazinet RP, Kipp M. Phosphatidylcholine 36:1 concentration decreases along with demyelination in the cuprizone animal model and in post-mortem multiple sclerosis brain tissue. J Neurochem 2018; 145:504-515. [DOI: 10.1111/jnc.14335] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 03/27/2018] [Accepted: 01/30/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Marc-Olivier Trépanier
- Department of Nutritional Sciences; Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| | - Kayla D. Hildebrand
- Department of Nutritional Sciences; Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| | - Stella D. Nyamoya
- Department of Neuroanatomy; Ludwig-Maximilians-University of Munich; Munich Germany
| | - Sandra Amor
- Department of Pathology; VU University Medical Centre; Amsterdam The Netherlands
- Blizard Institute; Barts and The London School of Medicine and Dentistry; Queen Mary University of London; London UK
| | - Richard P. Bazinet
- Department of Nutritional Sciences; Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| | - Markus Kipp
- Department of Neuroanatomy; Ludwig-Maximilians-University of Munich; Munich Germany
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16
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Brain docosahexaenoic acid uptake and metabolism. Mol Aspects Med 2018; 64:109-134. [PMID: 29305120 DOI: 10.1016/j.mam.2017.12.004] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/21/2017] [Accepted: 12/28/2017] [Indexed: 12/22/2022]
Abstract
Docosahexaenoic acid (DHA) is the most abundant n-3 polyunsaturated fatty acid in the brain where it serves to regulate several important processes and, in addition, serves as a precursor to bioactive mediators. Given that the capacity of the brain to synthesize DHA locally is appreciably low, the uptake of DHA from circulating lipid pools is essential to maintaining homeostatic levels. Although, several plasma pools have been proposed to supply the brain with DHA, recent evidence suggests non-esterified-DHA and lysophosphatidylcholine-DHA are the primary sources. The uptake of DHA into the brain appears to be regulated by a number of complementary pathways associated with the activation and metabolism of DHA, and may provide mechanisms for enrichment of DHA within the brain. Following entry into the brain, DHA is esterified into and recycled amongst membrane phospholipids contributing the distribution of DHA in brain phospholipids. During neurotransmission and following brain injury, DHA is released from membrane phospholipids and converted to bioactive mediators which regulate signaling pathways important to synaptogenesis, cell survival, and neuroinflammation, and may be relevant to treating neurological diseases. In the present review, we provide a comprehensive overview of brain DHA metabolism, encompassing many of the pathways and key enzymatic regulators governing brain DHA uptake and metabolism. In addition, we focus on the release of non-esterified DHA and subsequent production of bioactive mediators and the evidence of their proposed activity within the brain. We also provide a brief review of the evidence from post-mortem brain analyses investigating DHA levels in the context of neurological disease and mood disorder, highlighting the current disparities within the field.
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17
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Ghosh S, Dyer RA, Beasley CL. Evidence for altered cell membrane lipid composition in postmortem prefrontal white matter in bipolar disorder and schizophrenia. J Psychiatr Res 2017; 95:135-142. [PMID: 28843843 DOI: 10.1016/j.jpsychires.2017.08.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/24/2017] [Accepted: 08/09/2017] [Indexed: 11/30/2022]
Abstract
Brain imaging suggests that white matter abnormalities, including compromised white matter integrity in the frontal lobe, are shared across bipolar disorder (BD) and schizophrenia (SCZ). However, the precise molecular and cellular correlates remain to be elucidated. Given evidence for widespread alterations in cell membrane lipid composition in both disorders, we sought to investigate whether lipid composition is disturbed in frontal white matter in SCZ and BD. The phospholipids phosphatidylethanolamine (PE) and phosphatidylcholine (PC) were quantified in white matter adjacent to the dorsolateral prefrontal cortex in subjects with BD (n = 34), SCZ (n = 35), and non-psychiatric controls (n = 35) using high-pressure liquid chromatography. Individual fatty acid species and plasmalogens were then quantified separately in PE and PC fractions by gas liquid chromatography. PC was significantly lower in the BD group, compared to controls. The fatty acids PE22:0, PE24:1 and PE20:2n6 were higher, and PC20:4n6, PE22:5n6 and PC22:5n6 lower in the BD group, relative to the control group. PE22:1 was higher and PC20:3n6, PE22:5n6 and PC22:5n6 lower in the SCZ group, compared to the control group. These data provide evidence for altered lipid composition in white matter in both BD and SCZ. Changes in white matter lipid composition could ultimately contribute to dysfunction of frontal white matter circuits in SCZ and BD.
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Affiliation(s)
- Sanjoy Ghosh
- Department of Biology, Irving K. Barber School of Arts & Sciences, University of British Columbia-Okanagan, Kelowna, British Columbia, Canada
| | - Roger A Dyer
- Nutrition and Metabolism Research Program, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Clare L Beasley
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
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18
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Ribeiro HC, Klassen A, Pedrini M, Carvalho MS, Rizzo LB, Noto MN, Zeni-Graiff M, Sethi S, Fonseca FAH, Tasic L, Hayashi MAF, Cordeiro Q, Brietzke E, Sussulini A. A preliminary study of bipolar disorder type I by mass spectrometry-based serum lipidomics. Psychiatry Res 2017; 258:268-273. [PMID: 28918859 DOI: 10.1016/j.psychres.2017.08.039] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 07/20/2017] [Accepted: 08/16/2017] [Indexed: 01/19/2023]
Abstract
The present study aimed at investigating possible alterations in the serum lipid profile of euthymic patients with bipolar disorder type I (BD) compared to healthy controls (HC). Thirty-five individuals from both genders were recruited, with 14 diagnosed and treated as BD patients (BD group) and 21 healthy subjects (HC group). Clinical assessment was based on the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Young Mania Rating Scale (YMRS), and 17-items of Hamilton Depression Rating Scale (HDRS-17) data, which were used to confirm diagnosis, to verify psychiatric comorbidities, and to estimate the severity of manic and depressive symptoms. Ultra-high performance liquid chromatography (UHPLC) coupled to high resolution mass spectrometry (HRMS) was applied to analyze the lipids extracted from all serum samples from both studied groups. In this pioneer and exploratory study, we observed different serum lipid profiles for BD and HC groups, especially regarding glycerophospholipid, glycerolipid, and sphingolipid distribution. Multivariate statistical analyses indicated that 121 lipids were significantly different between BD and HC. Phosphatidylinositols were identified as the most altered lipids in BD patient sera. The results of this preliminary study reinforce the role of lipid abnormalities in BD and offer additional methodological possibilities for investigation in the field.
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Affiliation(s)
- Henrique C Ribeiro
- Laboratory of Bioanalytics and Integrated Omics (LaBIOmics), Department of Analytical Chemistry, Institute of Chemistry, University of Campinas (UNICAMP), P.O. Box 6154, 13083-970 Campinas, SP, Brazil
| | - Aline Klassen
- Department of Chemistry, Federal University of São Paulo (UNIFESP), Diadema, SP, Brazil
| | - Mariana Pedrini
- Research Group in Behavioral and Molecular Neuroscience of Bipolar Disorder, Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Michelle S Carvalho
- Department of Pharmacology, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Lucas B Rizzo
- Research Group in Behavioral and Molecular Neuroscience of Bipolar Disorder, Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Mariane N Noto
- Research Group in Behavioral and Molecular Neuroscience of Bipolar Disorder, Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Maiara Zeni-Graiff
- Research Group in Behavioral and Molecular Neuroscience of Bipolar Disorder, Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Sumit Sethi
- Research Group in Behavioral and Molecular Neuroscience of Bipolar Disorder, Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Francisco A H Fonseca
- Cardiology Division, Department of Medicine, Federal University of São Paulo(UNIFESP), São Paulo, SP, Brazil
| | - Ljubica Tasic
- Chemical Biology Laboratory, Department of Organic Chemistry, Institute of Chemistry, University of Campinas (UNICAMP), P.O. Box 6154, 13083-970 Campinas, SP, Brazil
| | - Mirian A F Hayashi
- Department of Pharmacology, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Quirino Cordeiro
- Department of Psychiatry, Santa Casa de São Paulo, School of Medical Sciences, São Paulo, SP, Brazil
| | - Elisa Brietzke
- Research Group in Behavioral and Molecular Neuroscience of Bipolar Disorder, Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.
| | - Alessandra Sussulini
- Laboratory of Bioanalytics and Integrated Omics (LaBIOmics), Department of Analytical Chemistry, Institute of Chemistry, University of Campinas (UNICAMP), P.O. Box 6154, 13083-970 Campinas, SP, Brazil.
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19
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Knowles EEM, Meikle PJ, Huynh K, Göring HHH, Olvera RL, Mathias SR, Duggirala R, Almasy L, Blangero J, Curran JE, Glahn DC. Serum phosphatidylinositol as a biomarker for bipolar disorder liability. Bipolar Disord 2017; 19:107-115. [PMID: 28230325 PMCID: PMC5798864 DOI: 10.1111/bdi.12468] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 01/03/2017] [Accepted: 01/10/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Individuals with bipolar disorder (BPD) exhibit alterations in their phospholipid levels. It is unclear whether these alterations are a secondary consequence of illness state, or if phospholipids and illness risk overlap genetically. If the latter were true, then phospholipids might provide key insights into the pathophysiology of the illness. Therefore, we rank-ordered phospholipid classes by their genetic overlap with BPD risk in order to establish which class might be most informative in terms of increasing our understanding of illness pathophysiology. METHODS Analyses were conducted in a sample of 558 individuals, unselected for BPD, from 38 extended pedigrees (average family size=14.79, range=2-82). We calculated a coefficient of relatedness for all family members of nine individuals with BPD in the sample (N=185); this coefficient was set to be zero in unrelated individuals (N=373). Then, under an endophenotype ranking value (ERV) approach, this scalar index was tested against 13 serum-based phospholipid concentrations in order to rank-order lipid classes by their respective overlap with BPD risk. RESULTS The phosphatidylinositol class was significantly heritable (h2 =0.26, P=6.71 × 10-05 ). It was the top-ranked class, and was significantly associated with BPD risk after correction for multiple testing (β=-1.18, P=2.10 × 10-03 , ERV=0.49). CONCLUSIONS We identified a peripheral biomarker, serum-based phosphatidylinositol, which exhibits a significant association with BPD risk. Therefore, given that phosphatidylinositol and BPD risk share partially common etiology, it seems that this lipid class warrants further investigation, not only in terms of treatment, but also as a promising diagnostic and risk marker.
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Affiliation(s)
- Emma EM Knowles
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA,Correspondence: Emma E. M. Knowles, Department of Psychiatry, Yale University, New Haven, CT, USA.,
| | - Peter J Meikle
- Baker Heart and Diabetes Institute, Melbourne, Vic., Australia
| | - Kevin Huynh
- Baker Heart and Diabetes Institute, Melbourne, Vic., Australia
| | - Harald HH Göring
- South Texas Diabetes and Obesity, Institute, University of Texas Rio Grande Valley, School of Medicine, Brownsville, TX, USA
| | - Rene L Olvera
- Department of Psychiatry, University of Texas, Health Science Center at San Antonio, San Antonio, TX, USA
| | - Samuel R Mathias
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA
| | - Ravi Duggirala
- South Texas Diabetes and Obesity, Institute, University of Texas Rio Grande Valley, School of Medicine, Brownsville, TX, USA
| | - Laura Almasy
- Department of Genetics, University of Pennsylvania and Department of Biomedical and Health Informatics at Children’s Hospital of Philadelphia, PA, USA
| | - John Blangero
- South Texas Diabetes and Obesity, Institute, University of Texas Rio Grande Valley, School of Medicine, Brownsville, TX, USA
| | - Joanne E Curran
- South Texas Diabetes and Obesity, Institute, University of Texas Rio Grande Valley, School of Medicine, Brownsville, TX, USA
| | - David C Glahn
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
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20
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Chang YW, Assari S, Prossin AR, Stertz L, McInnis MG, Evans SJ. Bipolar disorder moderates associations between linoleic acid and markers of inflammation. J Psychiatr Res 2017; 85:29-36. [PMID: 27821270 PMCID: PMC5191991 DOI: 10.1016/j.jpsychires.2016.10.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 10/21/2016] [Accepted: 10/26/2016] [Indexed: 12/13/2022]
Abstract
Dietary polyunsaturated fatty acids (PUFA) and inflammatory proteins associate with immune activation and have been implicated in the pathophysiology of mood disorders. We have previously reported that individuals with bipolar disorder (BPD) have decreased PUFA intake, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and arachidonic acid (AA); and decreased PUFA concentration of plasma EPA and linoleic acid (LA). We have also reported an association between plasma LA and its metabolites and burden of disease measures in BPD. In the current cross-sectional study we collected blood samples and diet records from both bipolar (n = 91) and control subjects (n = 75) to quantify plasma cytokine concentrations and dietary LA intake, respectively. Using multiple linear regression techniques, we tested for case control differences in plasma cytokine levels and associations between cytokines and dietary LA intake, adjusting for sex, age, BMI, and total energy intake. We found significantly higher plasma levels of interleukin 18 (IL-18) (p = 0.036), IL-18 binding protein (IL-18BP) (p = 0.001), soluble tumor necrosis factor receptor (sTNFR) 1 (p = 0.006), and sTNFR2 (p = 0.007) in BPD compared with controls. Moreover, BPD significantly moderated the associations of dietary LA intake with plasma levels of IL-18, sTNFR1 and sTNFR2, which were inverse associations in bipolar individuals and positive associations in controls (p for dietary LA x BPD diagnosis interaction < 0.05 for all three). These findings suggest potential dysregulation of LA metabolism in BPD, which may extend to a modified influence of dietary LA on specific inflammatory pathways in individuals with BPD compared to healthy controls.
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Affiliation(s)
- Ya-Wen Chang
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Alan R. Prossin
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX
| | - Laura Stertz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX
| | | | - Simon J. Evans
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
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21
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Polyunsaturated fatty acids and recurrent mood disorders: Phenomenology, mechanisms, and clinical application. Prog Lipid Res 2017; 66:1-13. [PMID: 28069365 DOI: 10.1016/j.plipres.2017.01.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 12/20/2016] [Accepted: 01/05/2017] [Indexed: 01/25/2023]
Abstract
A body of evidence has implicated dietary deficiency in omega-3 polyunsaturated fatty acids (n-3 PUFA), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), in the pathophysiology and etiology of recurrent mood disorders including major depressive disorder (MDD) and bipolar disorder. Cross-national and cross-sectional evidence suggests that greater habitual intake of n-3 PUFA is associated with reduced risk for developing mood symptoms. Meta-analyses provide strong evidence that patients with mood disorders exhibit low blood n-3 PUFA levels which are associated with increased risk for the initial development of mood symptoms in response to inflammation. While the etiology of this n-3 PUFA deficit may be multifactorial, n-3 PUFA supplementation is sufficient to correct this deficit and may also have antidepressant effects. Rodent studies suggest that n-3 PUFA deficiency during perinatal development can recapitulate key neuropathological, neurochemical, and behavioral features associated with mood disorders. Clinical neuroimaging studies suggest that low n-3 PUFA biostatus is associated with abnormalities in cortical structure and function also observed in mood disorders. Collectively, these findings implicate dietary n-3 PUFA insufficiency, particularly during development, in the pathophysiology of mood dysregulation, and support implementation of routine screening for and treatment of n-3 PUFA deficiency in patients with mood disorders.
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Fatty acid composition of the postmortem corpus callosum of patients with schizophrenia, bipolar disorder, or major depressive disorder. Eur Psychiatry 2016; 39:51-56. [PMID: 27821355 DOI: 10.1016/j.eurpsy.2016.05.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/22/2016] [Accepted: 05/13/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Studies investigating the relationship between n-3 polyunsaturated fatty acid (PUFA) levels and psychiatric disorders have thus far focused mainly on analyzing gray matter, rather than white matter, in the postmortem brain. In this study, we investigated whether PUFA levels showed abnormalities in the corpus callosum, the largest area of white matter, in the postmortem brain tissue of patients with schizophrenia, bipolar disorder, or major depressive disorder. METHODS Fatty acids in the phospholipids of the postmortem corpus callosum were evaluated by thin-layer chromatography and gas chromatography. Specimens were evaluated for patients with schizophrenia (n=15), bipolar disorder (n=15), or major depressive disorder (n=15) and compared with unaffected controls (n=15). RESULTS In contrast to some previous studies, no significant differences were found in the levels of PUFAs or other fatty acids in the corpus callosum between patients and controls. A subanalysis by sex gave the same results. No significant differences were found in any PUFAs between suicide completers and non-suicide cases regardless of psychiatric disorder diagnosis. CONCLUSIONS Patients with psychiatric disorders did not exhibit n-3 PUFAs deficits in the postmortem corpus callosum relative to the unaffected controls, and the corpus callosum might not be involved in abnormalities of PUFA metabolism. This area of research is still at an early stage and requires further investigation.
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McNamara RK. Role of Omega-3 Fatty Acids in the Etiology, Treatment, and Prevention of Depression: Current Status and Future Directions. JOURNAL OF NUTRITION & INTERMEDIARY METABOLISM 2016; 5:96-106. [PMID: 27766299 DOI: 10.1016/j.jnim.2016.04.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Over the past three decades a body of translational evidence has implicated dietary deficiency in long-chain omega-3 (LCn-3) fatty acids, including eicosapenaenoic acid (EPA) and docosahexaenoic acid (DHA), in the pathophysiology and etiology of major depressive disorder (MDD). Cross-national and cross-sectional data suggest that greater habitual intake of preformed EPA+DHA is associated with reduced risk for developing depressive symptoms and syndromal MDD. Erythrocyte EPA and DHA composition is highly correlated with habitual fish or fish oil intake, and case-control studies have consistently observed lower erythrocyte EPA and/or DHA levels in patients with MDD. Low erythrocyte EPA+DHA composition may also be associated with increased risk for suicide and cardiovascular disease, two primary causes of excess premature mortality in MDD. While controversial, dietary EPA+DHA supplementation may have antidepressant properties and may augment the therapeutic efficacy of antidepressant medications. Neuroimaging and rodent neurodevelopmental studies further suggest that low LCn-3 fatty acid intake or biostatus can recapitulate central pathophysiological features associated with MDD. Prospective findings suggest that low LCn-3 fatty acid biostatus increases risk for depressive symptoms in part by augmenting pro-inflammatory responsivity. When taken collectively, these translational findings provide a strong empirical foundation in support of dietary LCn-3 fatty acid deficiency as a modifiable risk factor for MDD. This review provides an overview of this translational evidence and then discusses future directions including strategies to translate this evidence into routine clinical screening and treatment algorithms.
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Affiliation(s)
- Robert K McNamara
- Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH 45219-0516
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McNamara RK, Jandacek R, Rider T, Tso P, Chu WJ, Weber WA, Welge JA, Strawn JR, Adler CM, DelBello MP. Effects of fish oil supplementation on prefrontal metabolite concentrations in adolescents with major depressive disorder: a preliminary 1H MRS study. Nutr Neurosci 2016; 19:145-55. [PMID: 24915543 DOI: 10.1179/1476830514y.0000000135] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To use proton magnetic resonance spectroscopy ((1)H MRS) to investigate the effects of fish oil (FO) supplementation on cortical metabolite concentrations in adolescents with major depressive disorder (MDD). METHODS Metabolite concentrations were determined by (1)H MRS in the anterior cingulate cortex and bilateral dorsolateral prefrontal cortex (DLPFC) of adolescents with MDD before and following 10-week open-label supplementation with low (2.4 g/day, n = 7) or high (16.2 g/day, n = 7) dose FO. Depressive symptom severity scores and erythrocyte fatty acid levels were also determined. RESULTS Baseline erythrocyte eicosapentaenoic acid (EPA) composition was positively correlated, and arachidonic acid (AA) and the AA/EPA ratio were inversely correlated, with choline (Cho) concentrations in the right DLPFC. Docosahexaenoic acid (DHA) composition was inversely correlated with myo-inositol (mI) concentrations in the left DLPFC. Erythrocyte EPA and DHA composition increased, and AA decreased, significantly following low-dose and high-dose FO supplementation. In the intent-to-treat sample, depressive symptom severity scores decreased significantly in the high-dose group (-40%, P < 0.0001) and there was a trend in the low-dose group (-20%, P = 0.06). There were no significant baseline-endpoint changes in metabolite levels in each voxel. In the low-dose group there were changes with large effect sizes, including a decrease in mI in the left DLPFC (-12%, P = 0.18, d = 0.8) and increases in glutamate + glutamine (Glx) (+12%, P = 0.19, d = 0.8) and Cho (+15%, P = 0.08, d = 1.2) in the right DLPFC. In the high-dose group, there was a trend for increases in Cho in the right DLPFC (+10%, P = 0.09, d = 1.2). DISCUSSION These preliminary data suggest that increasing the LCn-3 fatty acid status of adolescent MDD patients is associated with subtle changes in Glx, mI, and Cho concentrations in the DLPFC that warrant further evaluation in a larger controlled trial.
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Affiliation(s)
- Robert K McNamara
- a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Ronald Jandacek
- b Department of Pathology , University of Cincinnati , Cincinnati , OH , USA
| | - Therese Rider
- b Department of Pathology , University of Cincinnati , Cincinnati , OH , USA
| | - Patrick Tso
- b Department of Pathology , University of Cincinnati , Cincinnati , OH , USA
| | - Wen-Jang Chu
- a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Wade A Weber
- a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Jeffrey A Welge
- a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Jeffrey R Strawn
- a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Caleb M Adler
- a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Melissa P DelBello
- a Department of Psychiatry and Behavioral Neuroscience, Center for Imaging Research, Division of Bipolar Disorders Research , University of Cincinnati College of Medicine , Cincinnati , OH , USA
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25
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Medema S, Mocking RJT, Koeter MWJ, Vaz FM, Meijer C, de Haan L, van Beveren NJM, Kahn R, de Haan L, van Os J, Wiersma D, Bruggeman R, Cahn W, Meijer C, Myin-Germeys I. Levels of Red Blood Cell Fatty Acids in Patients With Psychosis, Their Unaffected Siblings, and Healthy Controls. Schizophr Bull 2016; 42:358-68. [PMID: 26385764 PMCID: PMC4753602 DOI: 10.1093/schbul/sbv133] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Two recent meta-analyses showed decreased red blood cell (RBC) polyunsaturated fatty acids (FA) in schizophrenia and related disorders. However, both these meta-analyses report considerable heterogeneity, probably related to differences in patient samples between studies. Here, we investigated whether variations in RBC FA are associated with psychosis, and thus may be an intermediate phenotype of the disorder. METHODS For the present study, a total of 215 patients (87% outpatients), 187 siblings, and 98 controls were investigated for multiple FA analyses. Based on previous studies, we investigated docosahexaenoic acid (DHA), docosapentaenoic acid (DPA), arachidonic acid (AA), linoleic acid (LA), nervonic acid (NA), and eicasopentaenoic acid (EPA). On an exploratory basis, a large number of additional FA were investigated. Multilevel mixed models were used to compare the FA between the 3 groups. RESULTS Compared to controls, both patients and siblings showed significantly increased DHA, DPA, AA, and NA. LA was significantly higher in siblings compared to controls. EPA was not significantly different between the 3 groups. Also the exploratory FA were increased in patients and siblings. CONCLUSIONS We found increased RBC FA DHA, DPA, AA, and NA in patients and siblings compared to controls. The direction of change is similar in both patients and siblings, which may suggest a shared environment and/or an intermediate phenotype. Differences between patient samples reflecting stage of disorder, dietary patterns, medication use, and drug abuse are possible modifiers of FA, contributing to the heterogeneity in findings concerning FA in schizophrenia patients.
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Affiliation(s)
- Suzanne Medema
- Department of Psychiatry, Antes Center for Mental Health Care, Rotterdam, The Netherlands; Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Roel J T Mocking
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Maarten W J Koeter
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Frédéric M Vaz
- Laboratory of Genetic and Metabolic Diseases, Academic Medical Center, Amsterdam, The Netherlands
| | - Carin Meijer
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Nico J M van Beveren
- Department of Psychiatry, Antes Center for Mental Health Care, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands; Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands;
| | - René Kahn
- Department of Psychiatry, University Medical Centre Utrecht, Rudolf Magnus Institute of Neuroscience, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Psychology, Maastricht University Medical Center, The Netherlands
| | - Durk Wiersma
- Department of Psychiatry, University Medical Center Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, University Medical Center Groningen, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, University Medical Centre Utrecht, Rudolf Magnus Institute of Neuroscience, The Netherlands
| | - Carin Meijer
- Department of Psychiatry, Antes Center for Mental Health Care, Rotterdam, The Netherlands
| | - Inez Myin-Germeys
- Department of Psychiatry and Psychology, Maastricht University Medical Center, The Netherlands
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Tonello L, Cocchi M, Gabrielli F, Tuszynski JA. On the possible quantum role of serotonin in consciousness. J Integr Neurosci 2015; 14:295-308. [DOI: 10.1142/s021963521550017x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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