1
|
Francia M, Bot M, Boltz T, De la Hoz JF, Boks M, Kahn RS, Ophoff RA. Fibroblasts as an in vitro model of circadian genetic and genomic studies. Mamm Genome 2024:10.1007/s00335-024-10050-7. [PMID: 38960898 DOI: 10.1007/s00335-024-10050-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 06/25/2024] [Indexed: 07/05/2024]
Abstract
Bipolar disorder (BD) is a heritable disorder characterized by shifts in mood that manifest in manic or depressive episodes. Clinical studies have identified abnormalities of the circadian system in BD patients as a hallmark of underlying pathophysiology. Fibroblasts are a well-established in vitro model for measuring circadian patterns. We set out to examine the underlying genetic architecture of circadian rhythm in fibroblasts, with the goal to assess its contribution to the polygenic nature of BD disease risk. We collected, from primary cell lines of 6 healthy individuals, temporal genomic features over a 48 h period from transcriptomic data (RNA-seq) and open chromatin data (ATAC-seq). The RNA-seq data showed that only a limited number of genes, primarily the known core clock genes such as ARNTL, CRY1, PER3, NR1D2 and TEF display circadian patterns of expression consistently across cell cultures. The ATAC-seq data identified that distinct transcription factor families, like those with the basic helix-loop-helix motif, were associated with regions that were increasing in accessibility over time. Whereas known glucocorticoid receptor target motifs were identified in those regions that were decreasing in accessibility. Further evaluation of these regions using stratified linkage disequilibrium score regression analysis failed to identify a significant presence of them in the known genetic architecture of BD, and other psychiatric disorders or neurobehavioral traits in which the circadian rhythm is affected. In this study, we characterize the biological pathways that are activated in this in vitro circadian model, evaluating the relevance of these processes in the context of the genetic architecture of BD and other disorders, highlighting its limitations and future applications for circadian genomic studies.
Collapse
Affiliation(s)
- Marcelo Francia
- Interdepartmental Program for Neuroscience, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
| | - Merel Bot
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Toni Boltz
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Juan F De la Hoz
- Bioinformatics Interdepartamental Program, University of California Los Angeles, Los Angeles, CA, USA
| | - Marco Boks
- Department Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Roel A Ophoff
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
2
|
Francia M, Bot M, Boltz T, De la Hoz JF, Boks M, Kahn R, Ophoff R. Fibroblasts as an in vitro model of circadian genetic and genomic studies: A temporal analysis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.05.19.541494. [PMID: 38496579 PMCID: PMC10942276 DOI: 10.1101/2023.05.19.541494] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Bipolar disorder (BD) is a heritable disorder characterized by shifts in mood that manifest in manic or depressive episodes. Clinical studies have identified abnormalities of the circadian system in BD patients as a hallmark of underlying pathophysiology. Fibroblasts are a well-established in vitro model for measuring circadian patterns. We set out to examine the underlying genetic architecture of circadian rhythm in fibroblasts, with the goal to assess its contribution to the polygenic nature of BD disease risk. We collected, from primary cell lines of 6 healthy individuals, temporal genomic features over a 48 hour period from transcriptomic data (RNA-seq) and open chromatin data (ATAC-seq). The RNA-seq data showed that only a limited number of genes, primarily the known core clock genes such as ARNTL, CRY1, PER3, NR1D2 and TEF display circadian patterns of expression consistently across cell cultures. The ATAC-seq data identified that distinct transcription factor families, like those with the basic helix-loop-helix motif, were associated with regions that were increasing in accessibility over time. Whereas known glucocorticoid receptor target motifs were identified in those regions that were decreasing in accessibility. Further evaluation of these regions using stratified linkage disequilibrium score regression (sLDSC) analysis failed to identify a significant presence of them in the known genetic architecture of BD, and other psychiatric disorders or neurobehavioral traits in which the circadian rhythm is affected. In this study, we characterize the biological pathways that are activated in this in vitro circadian model, evaluating the relevance of these processes in the context of the genetic architecture of BD and other disorders, highlighting its limitations and future applications for circadian genomic studies.
Collapse
Affiliation(s)
- Marcelo Francia
- Interdepartmental Program for Neuroscience, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Merel Bot
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, UCLA
| | - Toni Boltz
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Juan F De la Hoz
- Bioinformatics Interdepartamental Program, University of California Los Angeles, Los Angeles, CA, USA
| | - Marco Boks
- Brain Center University Medical Center Utrecht, Department Psychiatry, University Utrecht,Utrecht, The Netherlands
| | - René Kahn
- Brain Center University Medical Center Utrecht, Department Psychiatry, University Utrecht,Utrecht, The Netherlands
| | - Roel Ophoff
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, UCLA
| |
Collapse
|
3
|
Daniels SD, Boison D. Bipolar mania and epilepsy pathophysiology and treatment may converge in purine metabolism: A new perspective on available evidence. Neuropharmacology 2023; 241:109756. [PMID: 37820933 PMCID: PMC10841508 DOI: 10.1016/j.neuropharm.2023.109756] [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: 04/11/2023] [Revised: 09/25/2023] [Accepted: 10/07/2023] [Indexed: 10/13/2023]
Abstract
Decreased ATPergic signaling is an increasingly recognized pathophysiology in bipolar mania disease models. In parallel, adenosine deficit is increasingly recognized in epilepsy pathophysiology. Under-recognized ATP and/or adenosine-increasing mechanisms of several antimanic and antiseizure therapies including lithium, valproate, carbamazepine, and ECT suggest a fundamental pathogenic role of adenosine deficit in bipolar mania to match the established role of adenosine deficit in epilepsy. The depletion of adenosine-derivatives within the purine cycle is expected to result in a compensatory increase in oxopurines (uric acid precursors) and secondarily increased uric acid, observed in both bipolar mania and epilepsy. Cortisol-based inhibition of purine conversion to adenosine-derivatives may be reflected in observed uric acid increases and the well-established contribution of cortisol to both bipolar mania and epilepsy pathology. Cortisol-inhibited conversion from IMP to AMP as precursor of both ATP and adenosine may represent a mechanism for treatment resistance common in both bipolar mania and epilepsy. Anti-cortisol therapies may therefore augment other treatments both in bipolar mania and epilepsy. Evidence linking (i) adenosine deficit with a decreased need for sleep, (ii) IMP/cGMP excess with compulsive hypersexuality, and (iii) guanosine excess with grandiose delusions may converge to suggest a novel theory of bipolar mania as a condition characterized by disrupted purine metabolism. The potential for disease-modification and prevention related to adenosine-mediated epigenetic changes in epilepsy may be mirrored in mania. Evaluating the purinergic effects of existing agents and validating purine dysregulation may improve diagnosis and treatment in bipolar mania and epilepsy and provide specific targets for drug development.
Collapse
Affiliation(s)
- Scott D Daniels
- Hutchings Psychiatric Center, New York State Office of Mental Health, Syracuse, NY, 13210, USA
| | - Detlev Boison
- Dept. of Neurosurgery, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, 08854, USA.
| |
Collapse
|
4
|
Zandifar A, Badrfam R, Gholamian F, Shafiee A. Efficacy of spironolactone as adjunctive therapy to sodium valproate in bipolar-I disorder: A double-blind, randomized, placebo-controlled clinical trial. Brain Behav 2023; 13:e3313. [PMID: 37933420 PMCID: PMC10726882 DOI: 10.1002/brb3.3313] [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: 06/20/2023] [Revised: 10/01/2023] [Accepted: 10/25/2023] [Indexed: 11/08/2023] Open
Abstract
INTRODUCTION Treatment of mood and cognitive symptoms of patients with bipolar disorder is associated with many complications and is generally not associated with therapeutic satisfaction. In this clinical trial, we evaluated the effectiveness of spironolactone in controlling mood and cognitive symptoms, sleep quality, appetite, and body mass index in patients with bipolar disorder in manic episodes. METHODS Sixty inpatients with bipolar disorder in manic episodes were treated with spironolactone/placebo in an 8-week randomized, double-blind, placebo-controlled clinical trial. They were evaluated using the Young Mania Rating Scale (YMRS), mini-mental state examination (MMSE), Pittsburgh sleep quality index, Simplified Nutritional Appetite Questionnaire, and body mass index in weeks 1, 4, and 8. RESULTS For cognitive impairment (MMSE), there were significant interaction effects of group and time at week 8 (B = -1.60, SE = 0.69, t = -2.33, p = .021) such that individuals in the spironolactone group experienced more improvement in their cognitive performance. For manic symptoms (YMRS), there were no significant interaction effects of group and time at week 8 (B = -2.53, SE = 1.46, t = -1.73, p = .085). CONCLUSIONS Considering the promising findings in this clinical trial, further study of spironolactone as adjunctive therapy in bipolar disorder in manic episodes with larger sample sizes, multicenter settings, and longer follow-ups are recommended.
Collapse
Affiliation(s)
- Atefeh Zandifar
- Social Determinants of Health Research CenterAlborz University of Medical SciencesKarajIran
- Department of Psychiatry, Imam Hossein Hospital, School of MedicineAlborz University of Medical SciencesKarajIran
| | - Rahim Badrfam
- Department of Psychiatry, Imam Hossein Hospital, School of MedicineAlborz University of Medical SciencesKarajIran
| | | | - Arman Shafiee
- Clinical Research Development UnitAlborz University of Medical SciencesKarajIran
- Student Research Committee, School of MedicineAlborz University of Medical SciencesKarajIran
| |
Collapse
|
5
|
Weiss F, Brancati GE, Elefante C, Petrucci A, Gemmellaro T, Lattanzi L, Perugi G. Type 2 diabetes mellitus is associated with manic morbidity in elderly patients with mood disorders. Int Clin Psychopharmacol 2023:00004850-990000000-00101. [PMID: 37824397 DOI: 10.1097/yic.0000000000000515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
The association between mood disorders, especially bipolar disorder (BD), and metabolic disorders, is long known. However, to which extent metabolic disorders affect the course of mood disorders in late life is still open to inquiring. To assess the impact of type 2 diabetes mellitus (T2DM) on late-life mood disorders a retrospective chart review was performed. Elderly depressive patients (≥ 65 years) diagnosed with Major Depressive Disorder (N = 57) or BD (N = 43) and followed up for at least 18 months were included and subdivided according to the presence of T2DM comorbidity. Vascular encephalopathy (39.1% vs. 15.6%, P = 0.021) and neurocognitive disorders (21.7% vs. 5.2%, P = 0.028), were more frequently reported in patients with T2DM than in those without. Patients with T2DM showed a greater percentage of follow-up time in manic episodes (r = -0.23, P = 0.020) and a higher rate of manic episode(s) during follow-up (21.7% vs. 5.2%, P = 0.028) than those without. When restricting longitudinal analyses to patients with bipolar spectrum disorders, results were confirmed. In line with the well-known connection between BD and metabolic disorders, our data support an association between T2DM and unfavorable course of illness in the elderly with BD.
Collapse
Affiliation(s)
- Francesco Weiss
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa
| | | | - Camilla Elefante
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa
| | | | - Teresa Gemmellaro
- Department of Psychiatry, North-Western Tuscany Region, NHS, Local Health Unit, Cecina-LI
| | | | - Giulio Perugi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa
- Institute of Behavioral Science 'G. De Lisio', Pisa, Italy
| |
Collapse
|
6
|
Obi‐Azuike C, Ebiai R, Gibson T, Hernandez A, Khan A, Anugwom G, Urhi A, Prasad S, Souabni SA, Oladunjoye F. A systematic review on gut-brain axis aberrations in bipolar disorder and methods of balancing the gut microbiota. Brain Behav 2023; 13:e3037. [PMID: 37127945 PMCID: PMC10275531 DOI: 10.1002/brb3.3037] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 03/21/2023] [Accepted: 04/17/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a mood disorder that affects millions worldwide. Up to half of the diagnosed patients are reported to not receive adequate treatment. This study aims to assess the relationship between the gut-brain axis and BD and to discuss and compare the efficacy of varying methods of balancing gut microbiotas in BD. METHODS Using PubMed, Embase, and Google Scholar from November 2021 to February 2022, we found 5310 studies on gut microbiota and its relation to BD. Using our inclusion criteria, 5283 studies were excluded. A total of 27 full-text articles were assessed for eligibility. Also, 12 articles that met our criteria and eligibility criteria reported on 613 BD patients. RESULTS Most studies analyzed found an overall difference in gut microbiota composition in bipolar patients compared to healthy controls, though the alterations found were not consistent. Differences in Lactobacillus, Faecalibacterium, and Ruminococcus abundance in BD compared to controls were found to be the most consistent across a few of the studies, but their effects on the gut-brain axis conflicted. Probiotic supplementation was found to lower patient rehospitalizations and significantly improve depressive symptoms and cognitive impairments among patients with BD. CONCLUSIONS Multiple studies included in this review point toward a possible link between BD and the gut microbiota. Probiotic supplements and other gut-balancing therapies could serve as effective adjunctive methods for the treatment of BD. Notable limitations of the studies included for analysis were small sample sizes and majority observational study designs. Furthermore, the microbiota aberrations found in patients with BD were not consistent across multiple studies. Despite these limitations, our findings demonstrate the need for further research regarding the relationship between aberrant gut microbiota profiles and BD, as well as the effectiveness of gut balancing methods as adjunctive treatments.
Collapse
Affiliation(s)
- Crystal Obi‐Azuike
- Department of Psychiatry and Behavioral SciencesTulane University School of MedicineNew Orleans, Los AngelesUSA
| | - Ruona Ebiai
- Department of Internal MedicineOchsner Clinic FoundationNew OrleansLouisianaUSA
| | - Taneil Gibson
- Department of PsychiatryUniversity of Medicine and Health Sciences (UMHS)New YorkNew YorkUSA
| | - Ariana Hernandez
- Department of PsychiatryUniversity of Medicine and Health Sciences (UMHS)New YorkNew YorkUSA
| | - Asma Khan
- Department of PsychiatryLake Erie College of Osteopathic MedicineEriePennsylvaniaUSA
| | - Gibson Anugwom
- Menninger Department of Psychiatry & Behavioral SciencesBaylor College of MedicineHoustonTexasUSA
| | - Alexsandra Urhi
- Department of Mental HealthFederal Medical CenterAsaba, Delta StateNigeria
| | - Sakshi Prasad
- Department of PsychiatryNational Pirogov Memorial Medical UniversityVinnytsya, VinnytsyaUkraine
| | - Sara Ait Souabni
- Faculty of Medicine and Pharmacy of MarrakeshCadi Ayyad University‐Marrakech, MarrakechMorocco
| | - Funso Oladunjoye
- Menninger Department of Psychiatry & Behavioral SciencesBaylor College of MedicineHoustonTexasUSA
| |
Collapse
|
7
|
Hassan M, Elzehery R, Mosaad YM, Mostafa M, Elkalla IHR, Elwasify M. Clinical characteristics of bipolar 1 disorder in relation to interleukin-6: a cross-sectional study among Egyptian patients. MIDDLE EAST CURRENT PSYCHIATRY 2023. [DOI: 10.1186/s43045-023-00297-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Abstract
Background
Strong evidence in the literature points to the role of pro-inflammatory cytokines in bipolar disorder (BD) pathophysiology. Interleukin-6 (IL-6) is a pro and anti-inflammatory cytokine that was repeatedly found higher in bipolar patients than in healthy controls. However, studies on the phasic differences of IL-6 in bipolar type I (BP-I) were limited. This study aims to explore the phasic differences of serum IL-6 levels in BP-I during euthymia, depression, and mania and their association with the disease’s clinical characteristics in a sample of Egyptian BP-I patients. Thirty currently euthymic, 24 currently depressed, 29 currently manic BP-I patients, and 20 healthy subjects were recruited. Serum IL-6 levels were compared among BP-I groups and then between each group and a group of 20 healthy controls. Serum IL-6 levels (pg/ml) were measured with a sandwich enzyme-linked immunosorbent assay (ELISA). Depression and mania symptoms were assessed using the Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS), respectively. Clinical characteristics were evaluated through a semi-structured clinical psychiatric interview, and cognitive status was tested using the Montreal Cognitive Assessment (MoCA).
Results
Serum IL-6 levels were significantly higher in each bipolar phase than in healthy subjects. In the BP-I patients, IL-6 levels were lower in patients with a current manic episode than in patients with a current depressive episode (P < 0.05) or who were currently euthymic (P < 0.001). Moreover, IL-6 levels correlated inversely with the YMRS score (rs = − 0.29; P < 0.05). Compared to patients without psychotic features, patients with psychotic features had decreased serum IL-6. Moreover, IL-6 levels were lower in inpatients compared to outpatients.
Conclusions
BP-I disorder is associated with an inflammatory state. The decreased levels of IL-6 during manic episodes, affective episodes with psychotic features, and their inverse correlation with the severity of mania symptoms indicate a possible anti-inflammatory role of IL-6 in mania and psychotic symptoms pathogenesis.
Collapse
|
8
|
Ren SY, Sun ZL, Yang J. The use of biochemical indexes in hair for clinical studies of psychiatric diseases: What can we learn about mental disease from hair? J Psychiatr Res 2023; 158:305-313. [PMID: 36628872 DOI: 10.1016/j.jpsychires.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 12/25/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023]
Abstract
Analysis of hair samples provides unique advantages, including non-invasive sampling, sample stability, and the possibility of additional optimization of high sensitivity detection methods. Hair sample analysis is often used in psychiatric disease research to evaluate previous periods of stress encountered by patients. Glucocorticoid analysis is the most frequently tested indicator of stress. Furthermore, the hypothalamus-pituitary-gonad axis and endocannabinoid system also are involved in the occurrence and development of mental disorders. The endocannabinoid and sex hormone levels in patients experiencing mental illness are considerably different from levels observed in healthy individuals. Nevertheless, due to the different methods used to assess the degree of disease and the range of analytical methods involved in clinical research, the trends in changes for these biomarkers are not uniform. The correlations between changes in biomarker concentrations and illness severity also are not clear. The observed alterations suggest these biochemical substances in hair have potential as biomarkers for diagnosis or predictive treatment. However, the variable results obtained thus far could hamper further development of hair samples for clinical assessment in psychiatric disorders. This article summarizes the published reports documenting the changes in the content of relevant substances in hair in individuals experiencing mental illness and the degree of correlation. In the discussion section, we proposed several issues that should be considered in future studies of hair samples obtained from patients with mental disorders to promote the use of hair sample assessment as an aid in diagnosis or predictive treatment.
Collapse
Affiliation(s)
- Si-Yu Ren
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zuo-Li Sun
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jian Yang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| |
Collapse
|
9
|
Abdel Aziz K, Al-Mugaddam F, Sugathan S, Saseedharan P, Jouini T, Elamin ME, Moselhy H, Aly El-Gabry D, Arnone D, Karam SM. Decreased acylated and total ghrelin levels in bipolar disorder patients recovering from a manic episode. BMC Psychiatry 2022; 22:209. [PMID: 35313855 PMCID: PMC8935687 DOI: 10.1186/s12888-022-03842-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 03/02/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To date, only few studies have investigated ghrelin levels in bipolar disorders, and all have exclusively measured acylated ghrelin, with none investigating total ghrelin (acylated and des-acylated). We aimed to investigate peripheral levels of acylated and total ghrelin in subjects experiencing a manic episode of bipolar disorder. METHODS Peripheral levels of acylated and total ghrelin were measured in hospitalised medicated individuals recovering from a manic episode. Enzyme-linked immunosorbent assays (ELISA) were used to measure ghrelin levels in patients and compared with healthy controls. The relationship between ghrelin levels in bipolar disorder, self-reported hunger measures, demographic and clinical parameters was investigated with correlational analyses. RESULTS Twenty-four subjects (15 males, 9 females) recovering from mania and 27 matched healthy controls (13 males, 14 females) were recruited for the study. Mean values of both acylated (187 vs.520 pg/mL) and total ghrelin (396 vs. 648 pg/mL) were significantly reduced in bipolar disorder (p = 0.001). Ghrelin levels correlated positively with markers of illness severity and negatively with prescribed mood stabilizers, second-generation antipsychotics, weight and body mass index. CONCLUSION Peripheral measurements of acylated and total ghrelin were both reduced in bipolar disorder patients compared to healthy controls. Whilst illness severity promotes higher ghrelin levels, pharmacological treatment and weight gain exercise the opposite effect.
Collapse
Affiliation(s)
- Karim Abdel Aziz
- Department of Psychiatry and Behavioural Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fadwa Al-Mugaddam
- Department of Psychiatry and Behavioural Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Subi Sugathan
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Prashanth Saseedharan
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Dept of Chemical Engineering and Biotechnology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Tarek Jouini
- Behavioural Science Institute, Al-Ain Hospital, Al-Ain, United Arab Emirates
| | | | - Hamdy Moselhy
- American Center for Psychiatry and Neurology (ACPN), Dubai, United Arab Emirates
| | - Dina Aly El-Gabry
- Okasha Institute of Psychiatry, Neuropsychiatry Department, Ain Shams University, Cairo, Egypt
| | - Danilo Arnone
- Department of Psychiatry and Behavioural Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
- Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, Kings' College London, London, UK.
| | - Sherif M Karam
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| |
Collapse
|
10
|
Tournikioti K, Alevizaki M, Michopoulos I, Mantzou A, Soldatos CR, Douzenis A, Dikeos D, Ferentinos P. Differential association of cortisol with visual memory/learning and executive function in Bipolar Disorder. Psychiatry Res 2022; 307:114301. [PMID: 34861422 DOI: 10.1016/j.psychres.2021.114301] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/29/2021] [Accepted: 11/19/2021] [Indexed: 11/17/2022]
Abstract
The association of cortisol with cognition has been understudied in Bipolar Disorder (BD); available evidence is inconsistent while it is unknown whether cortisol's effects vary across neurocognitive domains implicating different brain structures. This study aimed to examine the association of cortisol with two cognitive tasks targeting visual memory and executive function (planning) in BD, related to the hippocampus and prefrontal lobe, respectively. Cambridge Neuropsychological Test Automated Battery (CANTAB) tasks targeting paired associative learning (PAL) and planning (Stockings of Cambridge; SOC) were administered to 60 BD type I patients. Basal serum cortisol was also measured. Higher cortisol was associated with worse performance in PAL, but not SOC, after controlling for gender, education, illness duration and treatment with mood stabilizers. This is the first study to examine the association of cortisol with neurocognitive function in BD while controlling for clinicodemographic and treatment-related factors. We found a significant association of cortisol with hippocampal-related visual memory/learning but not with prefrontal lobe-related executive function, suggesting domain-specific underlying mechanisms of cognitive dysfunction in BD. Future studies should further explore cortisol's brain structure-specific effects on cognitive functioning in BD.
Collapse
Affiliation(s)
- Kalliopi Tournikioti
- Second Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
| | - Maria Alevizaki
- Endocrine Unit, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Ioannis Michopoulos
- Second Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Aimilia Mantzou
- Endocrine Unit, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Constantin R Soldatos
- Mental Health Care Unit, Evgenidion Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Athanasios Douzenis
- Second Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dimitris Dikeos
- First Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Panagiotis Ferentinos
- Second Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| |
Collapse
|
11
|
Zhang M, Zhao S, Chen Y, Zhang X, Li Y, Xu P, Huang Y, Sun X. Chronic Stress in Bipolar Disorders Across the Different Clinical States: Roles of HPA Axis and Personality. Neuropsychiatr Dis Treat 2022; 18:1715-1725. [PMID: 35983536 PMCID: PMC9380733 DOI: 10.2147/ndt.s372358] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Chronic stress has been linked to the pathophysiology of bipolar disorder (BD); however, the underlying mechanism remains unclear. In BD patients, hypothalamic-pituitary-adrenal (HPA) axis activity is associated with stress. This study aimed to examine the relationship between HPA axis activity and BD symptoms in various clinical states, as well as how personality influences the process. METHODS This study investigated the differences in HPA axis activity among four BD states. We enrolled 813 BD patients in an 8-week longitudinal study to examine the relationship between HPA axis activity and symptom trajectories using dynamic temporal warping (DTW) analysis and an unsupervised machine learning technique. Furthermore, using mediation analyses, the relationship between the HPA axis, personality, and BD symptoms was investigated. RESULTS Analysis of variance (ANOVA) analysis showed that glucocorticoid cortisol (CORT) and adrenocorticotropin (ACTH) did not differ significantly among the four clinical states of BD. The DTW integrating clustering analysis revealed that the two clusters were optimal, with cluster 1 characterized by severe manic symptoms, which then improved, and cluster 2, characterized by milder manic severity, which also improved. The two clusters showed different ACTH levels (t = 2.289, p = 0.022), and logistic regression analysis revealed a slight positive association between ACTH levels and cluster 1. Furthermore, the mediation analysis indicated that ACTH influences curative efficacy via conscientiousness (βc =0.103, p=0.001). DISCUSSION In conclusion, we found that a higher level of ACTH is associated with severe manic symptoms, indicating a chronic stress response in BD patients. Additionally, the ACTH levels affect short-term BD curative efficacy via the mediation of conscientiousness, providing a psychotherapeutic strategy direction for BD.
Collapse
Affiliation(s)
- Manxue Zhang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Shengnan Zhao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Yuexin Chen
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Xu Zhang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Yuwei Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Peiwei Xu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Yi Huang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Brain Research Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Xueli Sun
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| |
Collapse
|
12
|
Yang F, Hong X, Tao J, Chen Y, Zhang Y, Xiao H. Hair cortisol, social support, personality traits, and clinical course: differences in schizophrenia and bipolar disorder. Brain Behav 2021; 11:e2412. [PMID: 34775692 PMCID: PMC8671778 DOI: 10.1002/brb3.2412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/01/2021] [Accepted: 10/19/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the differences in the relationship between hair cortisol concentration (HCC) and psychosocial stress, social support, clinical features, clinical course, and outcome in schizophrenia and bipolar disorder. METHODS A total of 109 schizophrenia patients, 93 bipolar disorder patients and 86 healthy controls between 18 and 60 years old were enrolled in the study. Linear regression and factor analysis were employed to examine and compare the relationship between HCC and childhood trauma, the number of stressful life events, the amount of social support in the three months before the hair cortisol assessment, clinical fearures, clinical course, and outcome in schizophrenia and bipolar disorder. RESULTS HCC is significantly associated with clinical syndromes, including depression-anxiety factor of Positive and Negative Syndrome Scale in schizophrenia patients, and thought disorder in bipolar disorder patients. However, HCC is positively related to social support and personality traits only in schizophrenia patients but not in bipolar disorder patients. Factor analysis indicates schizophrenia and bipolar disorder share a very similar but somewhat different structure in terms of HCC, psychosocial stress, social support, clinical features, clinical course, and outcome. CONCLUSION Findings support that schizophrenia and bipolar disoder have a significant overlap in both clinical characteristics and enviromental risk factors. Aberrant HCC contributes to the complexity of clinical characteristics mainly in schizophrenia.
Collapse
Affiliation(s)
- Fuzhong Yang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiangfei Hong
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jing Tao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yupeng Chen
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yanbo Zhang
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Hua Xiao
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic and Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
13
|
Torrecilla P, Barrantes-Vidal N. Examining the Relationship Between Hair Cortisol With Stress-Related and Transdiagnostic Subclinical Measures. Front Psychiatry 2021; 12:746155. [PMID: 34858226 PMCID: PMC8631911 DOI: 10.3389/fpsyt.2021.746155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Hair cortisol concentrations (HCC) provide a retrospective examination of long-term cortisol production as a measure of the hypothalamic-pituitary-adrenal (HPA) axis functioning, one of the major neural systems implicated in mediating the effects of stress on mental illness. However, evidence about the relationship between HCC with stressors and symptoms is scattered. In the present study, we aimed to examine the association between HCC and a wide range of stress-related and transdiagnostic subclinical measures in a sample of non-clinical young adults with a wide distribution of schizotypy. Methods: A total sample of 132 non-clinical young adults recruited at college and technical schools oversampled for schizotypy scores were assessed on distal and proximal stressful experiences, appraisals of stress, traits and symptoms of the affective, psychosis and dissociation spectrums, as well as stress-buffering measures, and provided 3 cm-hair samples. Results: No significant associations were found between HCC and any of the stress-related and subclinical measures. Only suspiciousness and disorganization showed a trend for a positive association with HCC but the magnitude was small. Conclusions: The present findings support previous studies indicating an overall lack of concordance between a broad range of stress-related and (sub)clinical phenotypic measures with hair cortisol. This study examined for the first time the relationship of HCC with the non-clinical expression of the psychosis spectrum, that is, schizotypy, which complements previous studies on clinical high risk and established psychosis and offers a promising strategy for studying possible HPA dysfunctions characterizing the subclinical psychosis continuum without the confounds associated to clinical psychosis.
Collapse
Affiliation(s)
- Pilar Torrecilla
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Edifici B, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Edifici B, Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament de Salut Mental, Sant Pere Claver—Fundació Sanitària, Barcelona, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| |
Collapse
|
14
|
Van Drunen R, Eckel-Mahan K. Circadian Rhythms of the Hypothalamus: From Function to Physiology. Clocks Sleep 2021; 3:189-226. [PMID: 33668705 PMCID: PMC7931002 DOI: 10.3390/clockssleep3010012] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/11/2021] [Accepted: 02/18/2021] [Indexed: 12/13/2022] Open
Abstract
The nearly ubiquitous expression of endogenous 24 h oscillations known as circadian rhythms regulate the timing of physiological functions in the body. These intrinsic rhythms are sensitive to external cues, known as zeitgebers, which entrain the internal biological processes to the daily environmental changes in light, temperature, and food availability. Light directly entrains the master clock, the suprachiasmatic nucleus (SCN) which lies in the hypothalamus of the brain and is responsible for synchronizing internal rhythms. However, recent evidence underscores the importance of other hypothalamic nuclei in regulating several essential rhythmic biological functions. These extra-SCN hypothalamic nuclei also express circadian rhythms, suggesting distinct regions that oscillate either semi-autonomously or independent of SCN innervation. Concurrently, the extra-SCN hypothalamic nuclei are also sensitized to fluctuations in nutrient and hormonal signals. Thus, food intake acts as another powerful entrainer for the hypothalamic oscillators' mediation of energy homeostasis. Ablation studies and genetic mouse models with perturbed extra-SCN hypothalamic nuclei function reveal their critical downstream involvement in an array of functions including metabolism, thermogenesis, food consumption, thirst, mood and sleep. Large epidemiological studies of individuals whose internal circadian cycle is chronically disrupted reveal that disruption of our internal clock is associated with an increased risk of obesity and several neurological diseases and disorders. In this review, we discuss the profound role of the extra-SCN hypothalamic nuclei in rhythmically regulating and coordinating body wide functions.
Collapse
Affiliation(s)
- Rachel Van Drunen
- MD Anderson UTHealth School Graduate School of Biomedical Sciences, Houston TX 77030, USA;
- Brown Foundation Institute of Molecular Medicine University of Texas McGovern Medical School, Houston, TX 77030, USA
| | - Kristin Eckel-Mahan
- MD Anderson UTHealth School Graduate School of Biomedical Sciences, Houston TX 77030, USA;
- Brown Foundation Institute of Molecular Medicine University of Texas McGovern Medical School, Houston, TX 77030, USA
| |
Collapse
|