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Wang W, Pan D, Liu Q, Chen X, Wang S. L-Carnitine in the Treatment of Psychiatric and Neurological Manifestations: A Systematic Review. Nutrients 2024; 16:1232. [PMID: 38674921 PMCID: PMC11055039 DOI: 10.3390/nu16081232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/13/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVE L-carnitine (LC), a vital nutritional supplement, plays a crucial role in myocardial health and exhibits significant cardioprotective effects. LC, being the principal constituent of clinical-grade supplements, finds extensive application in the recovery and treatment of diverse cardiovascular and cerebrovascular disorders. However, controversies persist regarding the utilization of LC in nervous system diseases, with varying effects observed across numerous mental and neurological disorders. This article primarily aims to gather and analyze database information to comprehensively summarize the therapeutic potential of LC in patients suffering from nervous system diseases while providing valuable references for further research. METHODS A comprehensive search was conducted in PubMed, Web Of Science, Embase, Ovid Medline, Cochrane Library and Clinicaltrials.gov databases. The literature pertaining to the impact of LC supplementation on neurological or psychiatric disorders in patients was reviewed up until November 2023. No language or temporal restrictions were imposed on the search. RESULTS A total of 1479 articles were retrieved, and after the removal of duplicates through both automated and manual exclusion processes, 962 articles remained. Subsequently, a meticulous re-screening led to the identification of 60 relevant articles. Among these, there were 12 publications focusing on hepatic encephalopathy (HE), while neurodegenerative diseases (NDs) and peripheral nervous system diseases (PNSDs) were represented by 9 and 6 articles, respectively. Additionally, stroke was addressed in five publications, whereas Raynaud's syndrome (RS) and cognitive disorder (CD) each had three dedicated studies. Furthermore, migraine, depression, and amyotrophic lateral sclerosis (ALS) each accounted for two publications. Lastly, one article was found for other symptoms under investigation. CONCLUSION In summary, LC has demonstrated favorable therapeutic effects in the management of HE, Alzheimer's disease (AD), carpal tunnel syndrome (CTS), CD, migraine, neurofibromatosis (NF), PNSDs, RS, and stroke. However, its efficacy appears to be relatively limited in conditions such as ALS, ataxia, attention deficit hyperactivity disorder (ADHD), depression, chronic fatigue syndrome (CFS), Down syndrome (DS), and sciatica.
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Affiliation(s)
- Wenbo Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China; (W.W.); (D.P.); (X.C.)
| | - Da Pan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China; (W.W.); (D.P.); (X.C.)
| | - Qi Liu
- Department of Public Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China;
| | - Xiangjun Chen
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China; (W.W.); (D.P.); (X.C.)
- Department of Public Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China;
| | - Shaokang Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China; (W.W.); (D.P.); (X.C.)
- Department of Public Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China;
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Naghibi N, Jahangiri N, Khosrowabadi R, Eickhoff CR, Eickhoff SB, Coull JT, Tahmasian M. Embodying Time in the Brain: A Multi-Dimensional Neuroimaging Meta-Analysis of 95 Duration Processing Studies. Neuropsychol Rev 2024; 34:277-298. [PMID: 36857010 PMCID: PMC10920454 DOI: 10.1007/s11065-023-09588-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/05/2022] [Indexed: 03/02/2023]
Abstract
Time is an omnipresent aspect of almost everything we experience internally or in the external world. The experience of time occurs through such an extensive set of contextual factors that, after decades of research, a unified understanding of its neural substrates is still elusive. In this study, following the recent best-practice guidelines, we conducted a coordinate-based meta-analysis of 95 carefully-selected neuroimaging papers of duration processing. We categorized the included papers into 14 classes of temporal features according to six categorical dimensions. Then, using the activation likelihood estimation (ALE) technique we investigated the convergent activation patterns of each class with a cluster-level family-wise error correction at p < 0.05. The regions most consistently activated across the various timing contexts were the pre-SMA and bilateral insula, consistent with an embodied theory of timing in which abstract representations of duration are rooted in sensorimotor and interoceptive experience, respectively. Moreover, class-specific patterns of activation could be roughly divided according to whether participants were timing auditory sequential stimuli, which additionally activated the dorsal striatum and SMA-proper, or visual single interval stimuli, which additionally activated the right middle frontal and inferior parietal cortices. We conclude that temporal cognition is so entangled with our everyday experience that timing stereotypically common combinations of stimulus characteristics reactivates the sensorimotor systems with which they were first experienced.
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Affiliation(s)
- Narges Naghibi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Nadia Jahangiri
- Faculty of Psychology & Education, Allameh Tabataba'i University, Tehran, Iran
| | - Reza Khosrowabadi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Claudia R Eickhoff
- Institute of Neuroscience and Medicine Research, Structural and functional organisation of the brain (INM-1), Jülich Research Center, Jülich, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine Research, Brain and Behaviour (INM-7), Jülich Research Center, Wilhelm-Johnen-Straße, Jülich, Germany
- Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Jennifer T Coull
- Laboratoire de Neurosciences Cognitives (UMR 7291), Aix-Marseille Université & CNRS, Marseille, France
| | - Masoud Tahmasian
- Institute of Neuroscience and Medicine Research, Brain and Behaviour (INM-7), Jülich Research Center, Wilhelm-Johnen-Straße, Jülich, Germany.
- Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
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Cattarinussi G, Grimaldi DA, Sambataro F. Spontaneous Brain Activity Alterations in First-Episode Psychosis: A Meta-analysis of Functional Magnetic Resonance Imaging Studies. Schizophr Bull 2023; 49:1494-1507. [PMID: 38029279 PMCID: PMC10686347 DOI: 10.1093/schbul/sbad044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND AND HYPOTHESIS Several studies have shown that spontaneous brain activity, including the total and fractional amplitude of low-frequency fluctuations (LFF) and regional homogeneity (ReHo), is altered in psychosis. Nonetheless, neuroimaging results show a high heterogeneity. For this reason, we gathered the extant literature on spontaneous brain activity in first-episode psychosis (FEP), where the effects of long-term treatment and chronic disease are minimal. STUDY DESIGN A systematic research was conducted on PubMed, Scopus, and Web of Science to identify studies exploring spontaneous brain activity and local connectivity in FEP estimated using functional magnetic resonance imaging. 20 LFF and 15 ReHo studies were included. Coordinate-Based Activation Likelihood Estimation Meta-Analyses stratified by brain measures, age (adolescent vs adult), and drug-naïve status were performed to identify spatially-convergent alterations in spontaneous brain activity in FEP. STUDY RESULTS We found a significant increase in LFF in FEP compared to healthy controls (HC) in the right striatum and in ReHo in the left striatum. When pooling together all studies on LFF and ReHo, spontaneous brain activity was increased in the bilateral striatum and superior and middle frontal gyri and decreased in the right precentral gyrus and the right inferior frontal gyrus compared to HC. These results were also replicated in the adult and drug-naïve samples. CONCLUSIONS Abnormalities in the frontostriatal circuit are present in early psychosis independently of treatment status. Our findings support the view that altered frontostriatal can represent a core neural alteration of the disorder and could be a target of treatment.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
- Department of Neuroscience (DNS), Padova Neuroscience Center, University of Padova, Padua, Italy
| | | | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
- Department of Neuroscience (DNS), Padova Neuroscience Center, University of Padova, Padua, Italy
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Reimann GM, Küppers V, Camilleri JA, Hoffstaedter F, Langner R, Laird AR, Fox PT, Spiegelhalder K, Eickhoff SB, Tahmasian M. Convergent abnormality in the subgenual anterior cingulate cortex in insomnia disorder: A revisited neuroimaging meta-analysis of 39 studies. Sleep Med Rev 2023; 71:101821. [PMID: 37481961 DOI: 10.1016/j.smrv.2023.101821] [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: 06/29/2022] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
The neurobiological underpinnings of insomnia disorder (ID) are still poorly understood. A previous meta-analysis conducted by our research group in 2018 revealed no consistent regional alterations based on the limited number of eligible studies. Given the number of studies published during the last few years, we revisited the meta-analysis to provide an update to the field. Following the best-practice guidelines for conducting neuroimaging meta-analyses, we searched several databases (PubMed, Web of Science, and BrainMap) and identified 39 eligible structural and functional studies, reporting coordinates reflecting significant group differences between ID patients and healthy controls. A significant convergent regional alteration in the subgenual anterior cingulate cortex (sgACC) was observed using the activation likelihood estimation algorithm. Behavioural decoding using the BrainMap database indicated that this region is involved in fear-related emotional and cognitive processing. The sgACC showed robust task-based co-activation in meta-analytic connectivity modelling and task-free functional connectivity in a resting-state functional connectivity analysis with the main hubs of the salience and default mode networks, including the posterior cingulate cortex and dorsal ACC, amygdala, hippocampus, and medial prefrontal cortex. Collectively, the findings from this large-scale meta-analysis suggest a critical role of the sgACC in the pathophysiology of ID.
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Affiliation(s)
- Gerion M Reimann
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Vincent Küppers
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia A Camilleri
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Felix Hoffstaedter
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Robert Langner
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Centre, San Antonio, TX, USA; South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Centre, University of Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Masoud Tahmasian
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
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Cao Y, Tian F, Zeng J, Gong Q, Yang X, Jia Z. The brain activity pattern in alcohol-use disorders under inhibition response Task. J Psychiatr Res 2023; 163:127-134. [PMID: 37209618 DOI: 10.1016/j.jpsychires.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/18/2023] [Accepted: 05/01/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Inhibitory control impairment in alcohol use disorder (AUD) may indicate detrimental effects of chronic alcohol use on different functional systems in the brain, but the current studies lack consistency. This study aims to identify the most consistent response inhibition-related brain dysfunction based on existing data. METHODS We performed systematic searches of the PubMed, Embase, Web of Science, and PsychINFO databases for available studies. Anisotropic effect-size signed differential mapping was used to quantitatively analyze the differences in response inhibition-related brain activation between AUD patients and HCs. Meta regression was used to explore the relationship between brain alterations and clinical variables. RESULTS The brain hypoactivation or hyperactivation in AUD patients compared with HCs during the response inhibition tasks was mainly located in the prefrontal cortex including the superior frontal gyrus, inferior frontal gyrus, and middle frontal gyrus, anterior cingulate gyrus (ACC), superior temporal gyrus, occipital gyrus, and somatosensory areas including postcentral gyrus and supramarginal gyrus. The meta-regression revealed that older patients were more likely to present activation in the left superior frontal gyrus when performing the response inhibition tasks. CONCLUSIONS The response inhibitive dysfunctions in a distinct prefrontal-cingulate cortices may presumably reflect the core impairment in cognitive control abilities. Dysfunction in the occipital gyrus and somatosensory areas may indicate an abnormal motor-sensory and visual function in AUD. Such functional abnormalities may represent neurophysiological correlates of the executive deficits observed in AUD patients. This study has been registered in PROSPERO (number CRD42022339384).
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Affiliation(s)
- Yuan Cao
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Fangfang Tian
- Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, PR China
| | - Jianguang Zeng
- School of Economics and Business Administration, Chongqing University, Chongqing, 400044, PR China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, PR China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Xun Yang
- School of Public Affairs, Chongqing University, Chongqing, 400044, PR China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China; Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.
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6
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Miola A, Meda N, Perini G, Sambataro F. Structural and functional features of treatment-resistant depression: A systematic review and exploratory coordinate-based meta-analysis of neuroimaging studies. Psychiatry Clin Neurosci 2023; 77:252-263. [PMID: 36641802 DOI: 10.1111/pcn.13530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/16/2023]
Abstract
OBJECTIVES A third of people suffering from major depressive disorder do not experience a significant improvement in their symptoms even after adequate treatment with two different antidepressant medications. This common condition, termed treatment-resistant depression (TRD), severely affects the quality of life of millions of people worldwide, causing long-lasting interpersonal problems and social costs. Given its epidemiological and clinical relevance and the little consensus on whether the neurobiological underpinnings of TRD differ from treatment-sensitive depression (TSD), we sought to highlight the convergent morphometric and functional neuroimaging correlates of TRD. METHODS We systematically reviewed the published literature on structural and resting-state functional neuroimaging of TRD compared to TSD and healthy controls (HC) and performed exploratory coordinate-based meta-analyses (CBMA) of significant results separately for each modality and multimodally ("all-effects"). CBMAs were also performed for each direction and combining both directions of group contrasts. RESULTS Out of the initial 1929 studies, only eight involving 555 participants (189 patients with TRD, 156 with TSD, and 210 HC) were included. In all-effects CBMA, precentral/superior frontal gyrus showed a significant difference between TRD and HC. Functional and structural imaging meta-analyses did not yield statistically significant results. A marginally significant cluster of altered intrinsic activity was found between TRD and HC in the cerebellum/pons. CONCLUSIONS Frontal, cerebellar, and brainstem functions can be involved in the pathophysiology of TRD. However, the design and heterogeneity of the (scarce) published literature hinder the generalizability of the findings.
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Affiliation(s)
- Alessandro Miola
- Department of Neuroscience, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy.,Casa di Cura Parco dei Tigli, Padova, Italy
| | - Nicola Meda
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Giulia Perini
- Department of Neuroscience, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy.,Casa di Cura Parco dei Tigli, Padova, Italy
| | - Fabio Sambataro
- Department of Neuroscience, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy.,Padova University Hospital, Padova, Italy
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Jiang J, Li L, Lin J, Hu X, Zhao Y, Sweeney JA, Gong Q. A voxel-based meta-analysis comparing medication-naive patients of major depression with treated longer-term ill cases. Neurosci Biobehav Rev 2023; 144:104991. [PMID: 36476776 DOI: 10.1016/j.neubiorev.2022.104991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/19/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
Structural neuroimaging studies have identified brain areas implicated in the pathogenesis of major depressive disorder (MDD). However, findings have been inconsistent, potentially due to variable illness duration and effects of antidepressant treatment. Using a meta-analytic approach, we compared gray matter (GM) volumes in patients grouped by medication status (naïve and treated) and illness duration (early course and long-term ill) to identify potential treatment and illness duration effects on brain structure. A total of 70 studies were included, including 3682 patients and 3469 controls. The pooled analysis found frontal, temporal and limbic regions with decreased GM volume in MDD patients. Additional analyses indicated that larger GM volume in the right striatum and smaller GM volume in the right precuneus are likely to be associated with drug effects, while smaller GM volume in the right temporal gyrus may correlate with longer illness duration. Similar GM decreases in bilateral medial frontal cortex between patient subgroups suggest that this alteration may persist over the course of illness and drug treatment.
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Affiliation(s)
- Jing Jiang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, Sichuan, China
| | - Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - Jinping Lin
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, Sichuan, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - Youjin Zhao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219, USA
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen 361021, Fujian, China.
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8
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Yu Z, Wang RR, Wei W, Liu LY, Wen CB, Yu SG, Guo XL, Yang J. A coordinate-based meta-analysis of acupuncture for chronic pain: Evidence from fMRI studies. Front Neurosci 2022; 16:1049887. [PMID: 36590302 PMCID: PMC9795831 DOI: 10.3389/fnins.2022.1049887] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
Background Chronic pain (CP) patients tend to represent aberrant functional brain activity. Acupuncture is an effective clinical treatment for CP, and some fMRI studies were conducted to discover the alternation of brain regions after acupuncture therapy for CP. However, the heterogeneity of neuroimaging studies has prevented researchers from systematically generalizing the central mechanisms of acupuncture in the treatment of CP. Methods We searched bibliographic databases, including PubMed, EMBASE, PsycINFO, Web of Science Core Collection, ScienceDirect, China Academic Journal Network Publishing Database, etc., and trials registration platforms (From inception to September 1st, 2022). Two independent researchers assessed the study's bias and quality. Furthermore, activation likelihood estimation (ALE) analysis was applied to explore aberrant brain functional activity and acupuncture's central mechanism for CP. Results Totally 14 studies with 524 CP patients were included in the study. ALE analysis showed that CP patients presented with decreased ALFF/ReHo in the precuneus, posterior cingulate cortex, right inferior parietal lobule, right superior temporal gyrus, cingulate gyrus, superior frontal gyrus, left medial frontal gyrus including medial prefrontal gurus, left middle frontal gyrus. Conclusion This ALE meta-analysis pointed out that acupuncture could modulate the default mode network, the frontoparietal network to treat CP. This provided a systematic summary of the neuroimage biomarker of acupuncture for the treatment of CP. Systematic review registration PROSPERO, identifier: CRD42021239633.
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Affiliation(s)
- Zheng Yu
- School of Intelligent Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rong-Rong Wang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wei Wei
- Traditional Chinese Medicine Department, Chengdu Xinan Gynecological Hospital, Chengdu, China
| | - Li-Ying Liu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chuan-Biao Wen
- School of Intelligent Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shu-Guang Yu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiao-Li Guo
- Traditional Chinese Medicine Department, Chengdu Xinan Gynecological Hospital, Chengdu, China,Xiao-Li Guo
| | - Jie Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China,*Correspondence: Jie Yang
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Investigation of endophenotype potential of decreased fractional anisotropy in pediatric bipolar disorder patients and unrelated offspring of bipolar disorder patients. CNS Spectr 2022; 27:709-715. [PMID: 34044907 DOI: 10.1017/s1092852921000584] [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] [Indexed: 01/29/2023]
Abstract
BACKGROUND Bipolar disorder (BD) is a severe psychiatric disorder associated with structural and functional brain abnormalities, some of which have been found in unaffected relatives as well. In this study, we examined the potential role of decreased fractional anisotropy (FA) as a BD endophenotype, in adolescents at high risk for BD. METHODS We included 15 offspring of patients with BD, 16 pediatric BD patients, and 16 matched controls. Diffusion weighted scans were obtained on a 3T scanner using an echo-planar sequence. Scans were segmented using FreeSurfer. RESULTS Our results showed significantly decreased FA in six brain areas of offspring group; left superior temporal gyrus (LSTG; P < .0001), left transverse temporal gyrus (LTTG; P = .002), left banks of the superior temporal sulcus (LBSTS; P = .002), left anterior cingulum (LAC; P = .003), right temporal pole (RTP; P = .004) and left frontal pole (LFP; P = .017). On analysis, LSTG, LAC, and RTP demonstrated a potential to be an endophenotype when comparing all three groups. FA values in three regions, LBSTS, LTTG, and LFP were increased only in controls. CONCLUSION Our findings point at decreased FA as a possible endophenotype for BD, as they were found in children of patients with BD. Most of these areas were previously found to have morphological and functional changes in adult and pediatric BD, and are thought to play important roles in affected domains of functioning. Prospective follow up studies should be performed to detect reliability of decreased FA as an endophenotype and effects of treatment on FA.
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Cattarinussi G, Kubera KM, Hirjak D, Wolf RC, Sambataro F. Neural Correlates of the Risk for Schizophrenia and Bipolar Disorder: A Meta-analysis of Structural and Functional Neuroimaging Studies. Biol Psychiatry 2022; 92:375-384. [PMID: 35523593 DOI: 10.1016/j.biopsych.2022.02.960] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/28/2022] [Accepted: 02/23/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Clinical features and genetics overlap in schizophrenia (SCZ) and bipolar disorder (BD). Identifying brain alterations associated with genetic vulnerability for SCZ and BD could help to discover intermediate phenotypes, quantifiable biological traits with greater prevalence in unaffected relatives (RELs), and early recognition biomarkers in ultrahigh risk populations. However, a comprehensive meta-analysis of structural and functional magnetic resonance imaging (MRI) studies examining relatives of patients with SCZ and BD has not been performed yet. METHODS We systematically searched PubMed, Scopus, and Web of Science for structural and functional MRI studies investigating relatives and healthy control subjects. A total of 230 eligible neuroimaging studies (6274 SCZ-RELs, 1900 BD-RELs, 10,789 healthy control subjects) were identified. We conducted coordinate-based activation likelihood estimation meta-analyses on 26 structural MRI and 81 functional MRI investigations, including stratification by task type. We also meta-analyzed regional and global volumetric changes. Finally, we performed a meta-analysis of all MRI studies combined. RESULTS Reduced thalamic volume was present in both SCZ and BD RELs. Moreover, SCZ-RELs showed alterations in corticostriatal-thalamic networks, spanning the dorsolateral prefrontal cortex and temporal regions, while BD-RELs showed altered thalamocortical and limbic regions, including the ventrolateral prefrontal, superior parietal, and medial temporal cortices, with frontoparietal alterations in RELs of BD type I. CONCLUSIONS Familiarity for SCZ and BD is associated with alterations in the thalamocortical circuits, which may be the expression of the shared genetic mechanism underlying both disorders. Furthermore, the involvement of different prefrontocortical and temporal nodes may be associated with a differential symptom expression in the two disorders.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience, Università degli studi di Padova, Padova, Italy; Padova Neuroscience Center, Università degli studi di Padova, Padova, Italy
| | - Katharina M Kubera
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Robert C Wolf
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Fabio Sambataro
- Department of Neuroscience, Università degli studi di Padova, Padova, Italy; Padova Neuroscience Center, Università degli studi di Padova, Padova, Italy.
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11
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Brain gyrification in bipolar disorder: a systematic review of neuroimaging studies. Brain Imaging Behav 2022; 16:2768-2784. [PMID: 36042153 DOI: 10.1007/s11682-022-00713-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 11/02/2022]
Abstract
Bipolar disorder (BD) is a severe mental illness with a strong genetic component. Genetic variations have been involved in the risk of this disorder, including those mediating brain function and neurodevelopment. Early neurodevelopment and neuroprogression processes could be reflected in brain gyrification patterns and help optimize the prediction and diagnosis of such disorders that is often delayed. Previous neuroimaging studies using this measure in patients with bipolar disorder revealed controversial results. This systematic review aimed to summarize available neuroimaging investigations on gyrification in BD compared to healthy controls (HC) and/or other psychiatric groups. Fourteen studies including 733 patients with BD, 585 patients with schizophrenia (SCZ), 90 with schizoaffective disorder (SZA), and 1380 healthy subjects were identified. Overall, a heterogeneous pattern of gyrification emerged between patients with BD and HC. Interestingly, increased gyrification or no differences were also observed in patients with BD compared to those with the schizophrenia-spectrum disorders. Furthermore, relatives of patients with BD showed lower or no differences in gyrification compared to healthy subjects without a family history of affective illness. Differences in the design and in methodological approaches could have contributed to the heterogeneity of the findings. The current review supports an altered brain gyrification pattern that underlies the pathophysiology of BD spanning large anatomical and functional neural networks, associated with altered cognitive functioning, difficulties in processing and affective regulation, and clinical symptoms. Longitudinal studies are needed to test different bipolar phenotypes and pharmacological effects on gyrification.
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12
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Kamalian A, Khodadadifar T, Saberi A, Masoudi M, Camilleri JA, Eickhoff CR, Zarei M, Pasquini L, Laird AR, Fox PT, Eickhoff SB, Tahmasian M. Convergent regional brain abnormalities in behavioral variant frontotemporal dementia: A neuroimaging meta-analysis of 73 studies. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12318. [PMID: 35664889 PMCID: PMC9148620 DOI: 10.1002/dad2.12318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/13/2022] [Accepted: 04/10/2022] [Indexed: 12/19/2022]
Abstract
Introduction Numerous studies have reported brain alterations in behavioral variant frontotemporal dementia (bvFTD). However, they pointed to inconsistent findings. Methods We used a meta‐analytic approach to identify the convergent structural and functional brain abnormalities in bvFTD. Following current best‐practice neuroimaging meta‐analysis guidelines, we searched PubMed and Embase databases and performed reference tracking. Then, the coordinates of group comparisons between bvFTD and controls from 73 studies were extracted and tested for convergence using activation likelihood estimation. Results We identified convergent abnormalities in the anterior cingulate cortices, anterior insula, amygdala, paracingulate, striatum, and hippocampus. Task‐based and resting‐state functional connectivity pointed to the networks that are connected to the obtained consistent regions. Functional decoding analyses suggested associated dysfunction of emotional processing, interoception, reward processing, higher‐order cognitive functions, and olfactory and gustatory perceptions in bvFTD. Discussion Our findings highlighted the key role of the salience network and subcortical regions in the pathophysiology of bvFTD.
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Affiliation(s)
- Aida Kamalian
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Tina Khodadadifar
- School of Cognitive Sciences Institute for Research in Fundamental Sciences Tehran Iran
| | - Amin Saberi
- Institute of Neuroscience and Medicine Brain and Behavior (INM-7) Research Center Jülich Jülich Germany.,Institute for Systems Neuroscience Medical Faculty Heinrich-Heine University Düsseldorf Düsseldorf Germany
| | - Maryam Masoudi
- School of Medicine Tehran University of Medical Sciences Tehran Iran
| | - Julia A Camilleri
- Institute of Neuroscience and Medicine Brain and Behavior (INM-7) Research Center Jülich Jülich Germany.,Institute for Systems Neuroscience Medical Faculty Heinrich-Heine University Düsseldorf Düsseldorf Germany
| | - Claudia R Eickhoff
- Institute of Clinical Neuroscience and Medical Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany.,Institute of Neuroscience and Medicine Research Center Jülich Structural and Functional Organisation of the Brain (INM-1) Jülich Germany
| | - Mojtaba Zarei
- Institute of Medical Science and Technology Shahid Beheshti University Tehran Iran
| | - Lorenzo Pasquini
- Department of Neurology Memory and Aging Center University of California-San Francisco San Francisco California USA
| | - Angela R Laird
- Department of Physics Florida International University Miami Florida USA
| | - Peter T Fox
- Research Imaging Institute University of Texas Health Science Center San Antonio Texas USA.,South Texas Veterans Health Care System San Antonio Texas USA
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine Brain and Behavior (INM-7) Research Center Jülich Jülich Germany.,Institute for Systems Neuroscience Medical Faculty Heinrich-Heine University Düsseldorf Düsseldorf Germany
| | - Masoud Tahmasian
- Institute of Neuroscience and Medicine Brain and Behavior (INM-7) Research Center Jülich Jülich Germany.,Institute for Systems Neuroscience Medical Faculty Heinrich-Heine University Düsseldorf Düsseldorf Germany
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13
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Chen P, Chen G, Zhong S, Chen F, Ye T, Gong J, Tang G, Pan Y, Luo Z, Qi Z, Huang L, Wang Y. Thyroid hormones disturbances, cognitive deficits and abnormal dynamic functional connectivity variability of the amygdala in unmedicated bipolar disorder. J Psychiatr Res 2022; 150:282-291. [PMID: 35429738 DOI: 10.1016/j.jpsychires.2022.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/16/2022] [Accepted: 03/21/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Accumulating evidence suggests that hypothalamus-pituitary-thyroid (HPT) axis dysfunction is relevant to the neuropsychological and pathophysiology functions of bipolar disorder (BD). However, no research has investigated the inter-relationships among thyroid hormones disturbance, neurocognitive deficits, and aberrant brain function (particularly in the amygdala) in patients with BD. MATERIALS AND METHODS Data of dynamic resting-state functional connectivity (rs-dFC) were gathered from 59 patients with unmedicated BD II during depressive episodes and 52 healthy controls (HCs). Four seeds were selected (the bilateral lateral amygdala and the bilateral medial amygdala). The sliding-window analysis was applied to investigate dynamic functional connectivity (dFC). Additionally, the serum thyroid hormone (free tri-iodothyronine (FT3), total tri-iodothyronine (TT3), free thyroxin (FT4), total thyroxin (TT4) and thyroid-stimulating hormone (TSH)) levels, and cognitive scores on the MATRICS Consensus Cognitive Battery (MCCB) in patients and HCs were detected. RESULTS The BD group exhibited increased dFC variability between the left medial amygdala and right medial prefrontal cortex (mPFC) when compared with the HC group. Additionally, the BD group showed lower FT3, TT3, and TSH level, higher FT4 level, and poorer cognitive score. Moreover, a significant negative correlation was observed between the dFC variability of the left medial amygdala-right mPFC and TSH level, or reasoning and problem solving of MCCB score in BD group. Multiple regression analysis showed that the TSH level × dFC variability of the medial amygdala-mPFC was an independent predictor for cognitive processing speed in BD group. CONCLUSIONS This study revealed patients with BD II depression had excessive variability in dFC between the medial amygdala and mPFC. Moreover, both HPT axis dysfunction and abnormal dFC of the amygdala-mPFC might be implicated in cognitive impairment in the early stages of BD.
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Affiliation(s)
- Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Feng Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Tao Ye
- Clinical Laboratory Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - JiaYing Gong
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China; Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Youling Pan
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Zhenye Luo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China.
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14
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The Limits between Schizophrenia and Bipolar Disorder: What Do Magnetic Resonance Findings Tell Us? Behav Sci (Basel) 2022; 12:bs12030078. [PMID: 35323397 PMCID: PMC8944966 DOI: 10.3390/bs12030078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/10/2022] [Accepted: 03/10/2022] [Indexed: 02/01/2023] Open
Abstract
Schizophrenia and bipolar disorder, two of the most severe psychiatric illnesses, have historically been regarded as dichotomous entities but share many features of the premorbid course, clinical profile, genetic factors and treatment approaches. Studies focusing on neuroimaging findings have received considerable attention, as they plead for an improved understanding of the brain regions involved in the pathophysiology of schizophrenia and bipolar disorder. In this review, we summarize the main magnetic resonance imaging findings in both disorders, aiming at exploring the neuroanatomical and functional similarities and differences between the two. The findings show that gray and white matter structural changes and functional dysconnectivity predominate in the frontal and limbic areas and the frontotemporal circuitry of the brain areas involved in the integration of executive, cognitive and affective functions, commonly affected in both disorders. Available evidence points to a considerable overlap in the affected regions between the two conditions, therefore possibly placing them at opposite ends of a psychosis continuum.
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15
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Okanda Nyatega C, Qiang L, Jajere Adamu M, Bello Kawuwa H. Altered striatal functional connectivity and structural dysconnectivity in individuals with bipolar disorder: A resting state magnetic resonance imaging study. Front Psychiatry 2022; 13:1054380. [PMID: 36440395 PMCID: PMC9682136 DOI: 10.3389/fpsyt.2022.1054380] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Bipolar disorder (BD) is a mood swing illness characterized by episodes ranging from depressive lows to manic highs. Although the specific origin of BD is unknown, genetics, environment, and changes in brain structure and chemistry may all have a role. Through magnetic resonance imaging (MRI) evaluations, this study looked into functional abnormalities involving the striatum between BD group and healthy controls (HC), compared the whole-brain gray matter (GM) morphological patterns between the groups and see whether functional connectivity has its underlying structural basis. MATERIALS AND METHODS We applied sliding windows to functional magnetic resonance imaging (fMRI) data from 49 BD patients and 44 HCs to generate temporal correlations maps to determine strength and variability of the striatum-to-whole-brain-network functional connectivity (FC) in each window whilst also employing voxel-based morphometry (VBM) to high-resolution structural MRI data to uncover structural differences between the groups. RESULTS Our analyses revealed increased striatal connectivity in three consecutive windows 69, 70, and 71 (180, 182, and 184 s) in individuals with BD (p < 0.05; Bonferroni corrected) in fMRI images. Moreover, the VBM findings of structural images showed gray matter (GM) deficits in the left precentral gyrus and middle frontal gyrus of the BD patients (p = 0.001, uncorrected) when compared to HCs. Variability of striatal connectivity did not reveal significant differences between the groups. CONCLUSION These findings revealed that BD was associated with a weakening of the precentral gyrus and middle frontal gyrus, also implying that bipolar illness may be linked to striatal functional brain alterations.
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Affiliation(s)
- Charles Okanda Nyatega
- School of Electrical and Information Engineering, Tianjin University, Tianjin, China.,Department of Electronics and Telecommunication Engineering, Mbeya University of Science and Technology, Mbeya, Tanzania
| | - Li Qiang
- School of Microelectronics, Tianjin University, Tianjin, China
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16
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Plasma BDNF and Cytokines Correlated with Protein Biomarkers for Bipolar II Disorder. J Pers Med 2021; 11:jpm11121282. [PMID: 34945756 PMCID: PMC8703913 DOI: 10.3390/jpm11121282] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022] Open
Abstract
We have previously identified five candidate proteins (matrix metallopeptidase 9 (MMP9), phenylalanyl-TRNA synthetase subunit beta (FARSB), peroxiredoxin 2 (PRDX2), carbonic anhydrase 1 (CA-1), and proprotein convertase subtilisin/kexin Type 9 (PCSK9)) as potential biomarkers for bipolar II disorder (BD-II). These candidate proteins have been associated with neuroprotective factors (BDNF) and inflammatory factors (cytokines, C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α)). However, the correlations between these proteins with plasma BDNF and inflammatory factors remain unknown. We recruited a total of 185 patients with BD-II and 186 healthy controls. Plasma levels of candidate proteins, BDNF, cytokines (TNF-α, CRP, and interleukin-8 (IL-8)) were assessed from each participant. The correlations between levels of candidate proteins, BDNF, and cytokines were analyzed. In the BD-II group, we found that the level of FARSB was positively correlated with the BDNF level (r = 0.397, p < 0.001) and IL-8 (r = 0.320, p < 0.001). The CA-1 level positively correlated with IL-8 (r = 0.318, p < 0.001). In the control group, we found that the FARSB level positively correlated with the BDNF level (r = 0.648, p < 0.001). The CA-1 level positively correlated with TNF-α (r = 0.231, p = 0.002), while the MMP-9 level positively correlated with the CRP level (r = 0.227, p = 0.002). Our results may help in clarifying the underlying mechanism of these candidate proteins for BD-II.
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17
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Xu SX, Deng WF, Qu YY, Lai WT, Huang TY, Rong H, Xie XH. The integrated understanding of structural and functional connectomes in depression: A multimodal meta-analysis of graph metrics. J Affect Disord 2021; 295:759-770. [PMID: 34517250 DOI: 10.1016/j.jad.2021.08.120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/26/2021] [Accepted: 08/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND From the perspective of information processing, an integrated understanding of the structural and functional connectomes in depression patients is important, a multimodal meta-analysis is required to detect the robust alterations in graph metrics across studies. METHODS Following a systematic search, 952 depression patients and 1447 controls in nine diffusion magnetic resonance imaging (dMRI) and twelve rest state functional MRI (rs-fMRI) studies with high methodological quality met the inclusion criteria and were included in the meta-analysis. RESULTS Regarding the dMRI results, no significant differences of meta-analytic metrics were found; regarding the rs-fMRI results, the modularity and local efficiency were found to be significantly lower in the depression group than in the controls (Hedge's g = -0.330 and -0.349, respectively). CONCLUSION Our findings suggested a lower modularity and network efficiency in the rs-fMRI network in depression patients, indicating that the pathological imbalances in brain connectomes needs further exploration. LIMITATIONS Included number of trials was low and heterogeneity should be noted.
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Affiliation(s)
- Shu-Xian Xu
- Brain Function and Psychosomatic Medicine Institute, Second People's Hospital of Huizhou, Huizhou, Guangdong, China; Department of Psychiatry, Shenzhen Kangning Hospital and Shenzhen Mental Health Center, Shenzhen, Guangdong, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wen-Feng Deng
- Huizhou Center for Disease Control and Prevention, Huizhou, Guangdong, China
| | - Ying-Ying Qu
- Center of Acute Psychiatry Service, Second People's Hospital of Huizhou, Huizhou, Guangdong, China
| | - Wen-Tao Lai
- Department of Radiology, Shenzhen Kangning Hospital and Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Tan-Yu Huang
- Department of Radiology, Second People's Hospital of Huizhou, Huizhou, Guangdong, China
| | - Han Rong
- Department of Psychiatry, Shenzhen Kangning Hospital and Shenzhen Mental Health Center, Shenzhen, Guangdong, China; Affiliated Shenzhen Clinical College of Psychiatry, Jining Medical University, Jining, Shandong, China
| | - Xin-Hui Xie
- Brain Function and Psychosomatic Medicine Institute, Second People's Hospital of Huizhou, Huizhou, Guangdong, China; Department of Psychiatry, Shenzhen Kangning Hospital and Shenzhen Mental Health Center, Shenzhen, Guangdong, China; Center of Acute Psychiatry Service, Second People's Hospital of Huizhou, Huizhou, Guangdong, China.
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18
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Lai M, Jiang P, Xu J, Luo D, Hao X, Li J. Abnormal brain activity in nonsuicidal self-injury: a coordinate-based activation likelihood meta-analysis of functional neuroimaging studies. PSYCHORADIOLOGY 2021; 1:249-256. [PMID: 38666222 PMCID: PMC11025552 DOI: 10.1093/psyrad/kkab020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 02/05/2023]
Abstract
Background The high prevalence of nonsuicidal self-injury (NSSI) in youths demonstrates a substantial population-level burden on society. NSSI is often associated with emotional and social skill deficits. To date, several studies have aimed to identify the underlying neural mechanism of those deficits in NSSI by using functional magnetic resonance imaging (fMRI). However, their conclusions display poor consistency. Objective We aimed to conduct a meta-analysis using activation likelihood estimation (ALE) for fMRI data based on emotional and cognitive tasks to clarify the underlying neural processing deficits of NSSI. Methods We searched for MRI studies of NSSI in the PubMed, Cochrane, and Embase databases. We identified significant foci for the included studies and conducted two ALE meta-analyses as follows: (i) activation for the NSSI contrast healthy control group and (ii) deactivation for the NSSI contrast healthy controls. Considering the diverse sex composition of study participants and possible bias from one large sample study, we conducted sensitivity analyses for the meta-analysis. Results Nine studies comprising 359 participants were included, and the results demonstrated substantial activation in NSSI patients compared with healthy controls in two clusters located in the right medial frontal gyrus extending to the rostral anterior cingulate and the left inferior frontal gyrus extending to the insula. Conclusions The results suggest that individuals with NSSI show brain activity alterations that underpin their core symptoms, including poor emotional regulation and reward processing deficits. Our findings provide new insights into the neural mechanism of NSSI, which may serve as functional biomarkers for developing effective diagnosis and therapeutic interventions for these patients.
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Affiliation(s)
- Mingfeng Lai
- Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu 610041, Sichuan, China
| | - Ping Jiang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, Sichuan, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu 610041, Sichuan, China
| | - Jiajun Xu
- Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu 610041, Sichuan, China
| | - Dan Luo
- Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu 610041, Sichuan, China
| | - Xiaoting Hao
- Department of Neurology, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu 610041, Sichuan, China
| | - Jing Li
- Mental Health Center, West China Hospital, Sichuan University, No. 28 Dian Xin Nan Road, Chengdu 610041, Sichuan, China
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19
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Insula activity in resting-state differentiates bipolar from unipolar depression: a systematic review and meta-analysis. Sci Rep 2021; 11:16930. [PMID: 34417487 PMCID: PMC8379217 DOI: 10.1038/s41598-021-96319-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/26/2021] [Indexed: 02/07/2023] Open
Abstract
Symptomatic overlap of depressive episodes in bipolar disorder (BD) and major depressive disorder (MDD) is a major diagnostic and therapeutic problem. Mania in medical history remains the only reliable distinguishing marker which is problematic given that episodes of depression compared to episodes of mania are more frequent and predominantly present at the beginning of BD. Resting-state functional magnetic resonance imaging (rs-fMRI) is a non-invasive, task-free, and well-tolerated method that may provide diagnostic markers acquired from spontaneous neural activity. Previous rs-fMRI studies focused on differentiating BD from MDD depression were inconsistent in their findings due to low sample power, heterogeneity of compared samples, and diversity of analytical methods. This meta-analysis investigated resting-state activity differences in BD and MDD depression using activation likelihood estimation. PubMed, Web of Science, Scopus and Google Scholar databases were searched for whole-brain rs-fMRI studies which compared MDD and BD currently depressed patients between Jan 2000 and August 2020. Ten studies were included, representing 234 BD and 296 MDD patients. The meta-analysis found increased activity in the left insula and adjacent area in MDD compared to BD. The finding suggests that the insula is involved in neural activity patterns during resting-state that can be potentially used as a biomarker differentiating both disorders.
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20
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Sretavan Wong K, Migó M, Dougherty DD, Ghaemi SN. Neural correlates of citalopram and placebo response in acute bipolar depression: A randomized trial. J Psychiatr Res 2021; 138:463-466. [PMID: 33965734 PMCID: PMC8192448 DOI: 10.1016/j.jpsychires.2021.04.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/14/2021] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
While serotonin reuptake inhibitors are sometimes used in clinical practice to treat acute bipolar depression, the neurophysiological substrates underlying their efficacy are little studied. In the context of a larger clinical efficacy trial, the present study explored neural mechanisms associated with citalopram versus placebo treatment for bipolar depression. FDG-PET imaging examined whole-brain metabolic changes before and after treatment. Clinical efficacy was similar for citalopram versus placebo. Neuroimaging results demonstrated greater glucose metabolism in the left orbitofrontal cortex (OFC) before treatment (combined citalopram and placebo subjects) relative to after treatment, but did not correlate with clinical recovery. Glucose metabolism in the left OFC was also a predictor of depression severity when baseline scans were regressed with baseline MADRS scores. Despite of our small sample size and possibly underpowered whole-brain analysis approach, these preliminary results suggest the OFC, a key region involved in reward circuity, may be a neural substrate for depressive symptom improvement in bipolar depression, regardless of whether due to active treatment or placebo.
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Affiliation(s)
- Karianne Sretavan Wong
- Division of Neurotherapeutics, Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, MA, USA.
| | - Marta Migó
- Division of Neurotherapeutics, Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, Massachusetts
| | - Darin D. Dougherty
- Division of Neurotherapeutics, Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, Boston, Massachusetts
| | - S. Nassir Ghaemi
- Department of Psychiatry, Tufts University School of Medicine, Boston, Massachusetts,Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
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21
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Emmerzaal TL, Nijkamp G, Veldic M, Rahman S, Andreazza AC, Morava E, Rodenburg RJ, Kozicz T. Effect of neuropsychiatric medications on mitochondrial function: For better or for worse. Neurosci Biobehav Rev 2021; 127:555-571. [PMID: 34000348 DOI: 10.1016/j.neubiorev.2021.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/12/2021] [Accepted: 05/04/2021] [Indexed: 01/22/2023]
Abstract
Individuals with mitochondrial disease often present with psychopathological comorbidity, and mitochondrial dysfunction has been proposed as the underlying pathobiology in various psychiatric disorders. Several studies have suggested that medications used to treat neuropsychiatric disorders could directly influence mitochondrial function. This review provides a comprehensive overview of the effect of these medications on mitochondrial function. We collected preclinical information on six major groups of antidepressants and other neuropsychiatric medications and found that the majority of these medications either positively influenced mitochondrial function or showed mixed effects. Only amitriptyline, escitalopram, and haloperidol were identified as having exclusively adverse effects on mitochondrial function. In the absence of formal clinical trials, and until such trials are completed, the data from preclinical studies reported and discussed here could inform medication prescribing practices for individuals with psychopathology and impaired mitochondrial function in the underlying pathology.
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Affiliation(s)
- Tim L Emmerzaal
- Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Medical Imaging, Anatomy, Nijmegen, The Netherlands; Mayo Clinic, Department of Clinical Genomics, Rochester, MN, USA
| | - Gerben Nijkamp
- Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Medical Imaging, Anatomy, Nijmegen, The Netherlands
| | - Marin Veldic
- Mayo Clinic, Department of Psychiatry, Rochester, MN, USA
| | - Shamima Rahman
- Mitochondrial Research Group, UCL Great Ormond Street Institute of Child Health, London, United Kingdom; Metabolic Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Ana Cristina Andreazza
- University of Toronto, Temerty Faculty of Medicine, Department of Pharmacology & Toxicology and Psychiatry, Toronto, Canada
| | - Eva Morava
- Mayo Clinic, Department of Clinical Genomics, Rochester, MN, USA; Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, MN, USA
| | - Richard J Rodenburg
- Radboud Center for Mitochondrial Medicine, Translational Metabolic Laboratory, Department of Pediatrics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tamas Kozicz
- Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Medical Imaging, Anatomy, Nijmegen, The Netherlands; Mayo Clinic, Department of Clinical Genomics, Rochester, MN, USA; Mayo Clinic, Department of Biochemistry and Molecular Biology, Rochester, MN, USA.
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22
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Tian F, Wang X, Long X, Roberts N, Feng C, Yue S, Jia Z. The Correlation of Reduced Fractional Anisotropy in the Cingulum With Suicide Risk in Bipolar Disorder. Front Psychiatry 2021; 12:707622. [PMID: 34803753 PMCID: PMC8595246 DOI: 10.3389/fpsyt.2021.707622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 10/06/2021] [Indexed: 02/04/2023] Open
Abstract
Objective: This study aims to investigate the significant alterations in brain white matter integrity in individuals with bipolar disorder (BD) who had attempted suicide by applying a tract-based spatial statistics (TBSS) approach with tensor-based spatial normalization. Methods: A TBSS approach with novel tensor-based registration was used to compare the white matter fractional anisotropy (FA) between 51 individuals with BD, of whom 19 had attempted suicide, and 43 healthy controls (HC). The suicide attempt was assessed with the Columbia-Suicide Severity Rating Scale (C-SSRS). In addition, we also investigated the correlations of FA values with clinical measures in BD, including illness duration, and the severity of depression and anxiety measured by the Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA), respectively. Results: A significant reduction of FA value in the hippocampal cingulum was observed in BD individuals who had attempted suicide compared with those who had not. For the genu/body of the corpus callosum, inferior fronto-occipital fasciculus, uncinate fasciculus, and anterior thalamic radiation, the reductions in FA values were significantly greater in both BD subgroups who attempted suicide and who did not, compared to HC. The correlation analysis showed that the illness duration of attempters was correlated to the FA value of the genu of the corpus callosum, while the HAMD and HAMA scores of non-attempters were relevant to the FA of the superior longitudinal fasciculus. Conclusion: The observation that white matter integrity was altered in the hippocampal cingulum in BD individuals who attempted suicide suggested that this brain area may be the neurobiological basis of suicide attempts. Our findings also support the involvement of white matter (WM) microstructure of frontal-subcortical circuits in the neurobiological mechanism of BD. In addition, the illness duration of patients with attempted suicide may have an effect on the altered integrity of the corpus callosum.
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Affiliation(s)
- Fangfang Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.,Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiuli Wang
- Department of Clinical Psychology, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Xipeng Long
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Neil Roberts
- School of Clinical Sciences, The Queens Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Can Feng
- Department of Clinical Psychology, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Suping Yue
- Department of Clinical Psychology, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China
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23
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Sonmez AI, Lewis CP, Port JD, Cabello-Arreola A, Blacker CJ, Seewoo BJ, McKean AJ, Leffler JM, Frye MA, Croarkin PE. Glutamatergic Correlates of Bipolar Symptoms in Adolescents. J Child Adolesc Psychopharmacol 2020; 30:599-605. [PMID: 33179961 PMCID: PMC7757593 DOI: 10.1089/cap.2020.0082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objectives: Prior studies demonstrate elevated cortical glutamate (Glu) in patients with bipolar disorder (BD). Studies assessing neurochemistry in early stages of bipolar illness before the emergence of manic symptoms are lacking. This study aimed to examine neurochemical correlates measured by proton magnetic resonance spectroscopy (1H-MRS) and a dimensional measure of bipolarity in a sample of depressed adolescents. Methods: Adolescent participants (aged 13-21 years) underwent a semistructured diagnostic interview and clinical assessment, which included the General Behavior Inventory Parent Version (P-GBI), a 73-item, parent-rated assessment of symptoms and behaviors. 1H-MRS scans of a left dorsolateral prefrontal cortex (L-DLPFC) voxel (8 cm3) were collected using a two-dimensional J-averaged sequence to assess N-acetylaspartate (NAA), Glu, Glx (glutamate + glutamine), and NAA/Glx concentrations. We used generalized linear models to assess the relationships between P-GBI scores and metabolite levels in L-DLPFC. Results: Thirty-six participants (17 healthy controls, 19 depressed) underwent 1H-MRS scans and clinical evaluation with the P-GBI. There was a significant negative relationship between P-GBI score and L-DLPFC NAA/Glx in the whole sample. However, the magnitude of the effect was small and statistical significance was lost after correcting for multiple comparisons. Conclusions: These preliminary results suggest that NAA/Glx may have utility as a marker of bipolar traits in healthy and depressed adolescents. If replicated, 1H-MRS measures of glutamatergic metabolism anomalies might have a role in identifying depressed adolescents at risk for mixed symptom presentations or BD. Identifying bipolarity in the early stages of the disease would have a significant impact on treatment planning and prognosis. Further longitudinal studies should examine neurochemical correlates of mood state during the developmental emergence of BD.
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Affiliation(s)
- A. Irem Sonmez
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Charles P. Lewis
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - John D. Port
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Caren J. Blacker
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Bhedita J. Seewoo
- Experimental and Regenerative Neurosciences, School of Biological Sciences, University of Western Australia, Crawley, Australia
| | - Alastair J. McKean
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jarrod M. Leffler
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark A. Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Paul E. Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.,Address correspondence to: Paul E. Croarkin, DO, MSCS, Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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24
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Li D, Liu W, Yan T, Cui X, Zhang Z, Wei J, Ma Y, Zhang N, Xiang J, Wang B. Disrupted Rich Club Organization of Hemispheric White Matter Networks in Bipolar Disorder. Front Neuroinform 2020; 14:39. [PMID: 32982711 PMCID: PMC7479125 DOI: 10.3389/fninf.2020.00039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/22/2020] [Indexed: 11/19/2022] Open
Abstract
Neuroimaging studies suggest disrupted connections of the brain white matter (WM) network in bipolar disorder (BD). A group of highly interconnected high-density structures, termed the 'rich club,' represents an important network for brain functioning. Recent works have revealed abnormal rich club organization in brain networks in BD. However, little is known regarding changes in the rich club organization of the hemispheric WM network in BD. Forty-nine BD patients and fifty-five age- and sex-matched normal controls (NCs) underwent diffusion tensor imaging (DTI). Graph theory approaches were applied to quantify group-specific rich club organization and nodal degree of hemispheric WM networks. We demonstrated that rich club organization of hemispheric WM networks in BD was disrupted, with disrupted feeder and local connections among hub and peripheral regions located in the default mode network (DMN) and the control execution network (CEN). In addition, BD patients showed abnormal asymmetry in the feeder and local connections, involving the hub and peripheral regions associated with emotion regulation and visuospatial functions. Moreover, the clinical symptoms of BD showed a significant correlation with the aberrant asymmetry in the regional degree of peripheral regions. These findings reveal that BD is closely associated with disrupted feeder and local connections but no alteration in rich-club connections in the rich club organization of hemispheric WM networks and provide novel insight into the changes of brain functions in BD.
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Affiliation(s)
- Dandan Li
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, China
| | - Weichen Liu
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, China
| | - Ting Yan
- Translational Medicine Research Center, Shanxi Medical University, Taiyuan, China
| | - Xiaohong Cui
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, China
| | - Zehua Zhang
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, China
| | - Jing Wei
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, China
| | - Yunxiao Ma
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, China
| | - Nan Zhang
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, China
| | - Jie Xiang
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, China
| | - Bin Wang
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, China
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25
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Song H, Chon MW, Ryu V, Yu R, Lee DK, Lee H, Lee W, Lee JH, Park DY. Cortical Volumetric Correlates of Childhood Trauma, Anxiety, and Impulsivity in Bipolar Disorder. Psychiatry Investig 2020; 17:627-635. [PMID: 32571005 PMCID: PMC7385221 DOI: 10.30773/pi.2019.0305] [Citation(s) in RCA: 8] [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: 11/13/2019] [Accepted: 03/17/2020] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE More recently, attention has turned to the linkage between childhood trauma and emotional dysregulation, but the evidence in bipolar disorder (BD) is limited. To determine neurobiological relationships between childhood trauma, current anxiety, and impulsivity, we investigated cortical volumetric correlates of these clinical factors in BD. METHODS We studied 36 patients with DSM-5 BD and 29 healthy controls. Childhood trauma, coexisting anxiety, and impulsivity were evaluated with the Korean version-Childhood Trauma Questionnaire (CTQ), the Korean version-Beck Anxiety Inventory (BAI), and the Korean version-Barratt Impulsiveness Scale (BIS). Voxel-based morphometry (VBM) was used to assess gray matter volume (GMV) alterations on the brain magnetic resonance imaging (MRI). Partial correlation analyses were conducted to examine associations between the GMV and each scale in the BD group. RESULTS Childhood trauma, anxiety, and impulsivity were interrelated in BD. BD patients revealed significant inverse correlations between the GMV in the right precentral gyrus and CTQ scores (r=-0.609, p<0.0003); between the GMV in the left middle frontal gyrus and BAI scores (r=-0.363, p=0.044). Moreover, patients showed similar tendency of negative correlations between the GMV in the right precentral gyrus and BIS scores; between the GMV in the left middle frontal gyrus and CTQ scores. CONCLUSION The present study provides evidence for a neural basis between childhood trauma and affect regulations in BD. The GMV alterations in multiple frontal lobe areas may represent neurobiological markers for anticipating the course of BD.
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Affiliation(s)
- Hyehyun Song
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Myong-Wuk Chon
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Vin Ryu
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Rina Yu
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Dong-Kyun Lee
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Hyeongrae Lee
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Wonhye Lee
- Department of Clinical Psychology, National Center for Mental Health, Seoul, Republic of Korea
| | - Jung Hyun Lee
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Dong Yeon Park
- Department of Mood Disorders, National Center for Mental Health, Seoul, Republic of Korea
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26
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Estudillo-Guerra MA, Pacheco-Barrios K, Cardenas-Rojas A, Adame-Ocampo G, Camprodon JA, Morales-Quezada L, Gutiérrez-Mora D, Flores-Ramos M. Brain perfusion during manic episode and at 6-month follow-up period in bipolar disorder patients: Correlation with cognitive functions. Brain Behav 2020; 10:e01615. [PMID: 32356600 PMCID: PMC7303383 DOI: 10.1002/brb3.1615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/17/2020] [Accepted: 03/09/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Patterns of altered cerebral perfusion and cognitive dysfunction have been described in Bipolar Disorder (BD) acute episodes and euthymia. Knowledge of the relationship between cognitive function and perfusion in a manic state and status when followed up is still limited. OBJECTIVE To describe brain perfusion alterations and its relationship with cognitive impairment in patients with BD during manic episodes and after 6 months. METHODS Observational-prospective study in 10 type I BD adults during moderate-severe manic episodes. We assessed sociodemographic data and clinical variables as well as cognitive function through Screening for Cognitive Impairment in Psychiatry (SCIP-S). Finally, we performed a Brain Perfusion SPECT using a Tc99m-ethyl cysteine dimer. RESULTS During manic episodes, patients showed cognitive impairment with a mean SCIP-S score of 63.8 ± 17.16. This was positively correlated with perfusion measured as relative reuptake index (RRI) at the right temporal pole (ρ = 0.65 p = .0435) and negatively correlated with right the orbitofrontal cortex (ρ = -0.70 p = .0077) and the right subgenual cingulate cortex (ρ = -0.70 p = .0256). Episode severity measured by the Young Mania Rating Scale (YMRS) positively correlated with RRI at the right temporal pole (ρ = 0.75, p = .01). At follow-up, six patients were taking treatment and were euthymic, we found a negative correlation with the YMRS and RRI at the bilateral orbitofrontal cortex (ρ = -0.8827, p = .019). They did not show significant improvement in cognitive performance at SCIP-S, and there was negative correlation with the following of the SCIP-S subscales; processing speed with the bilateral dorsolateral prefrontal, the bilateral medial prefrontal, the left temporal pole cortex RRI, and verbal fluency with the bilateral anterior cingulate cortex RRI. CONCLUSION Cognitive impairment was correlated with brain perfusion patterns at baseline and follow-up. Large sample size studies with longer follow-up are needed to describe the changes in perfusion and cognitive functions in BD.
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Affiliation(s)
- Maria Anayali Estudillo-Guerra
- Clínica de Trastornos de Afecto, National Institute of Psychiatry "Ramón de la Fuente Muñiz", México City, México.,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, MA, USA.,San Ignacio de Loyola University, Lima, Peru
| | - Alejandra Cardenas-Rojas
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, MA, USA
| | - Gloria Adame-Ocampo
- National Institute of Psychiatry "Ramón de la Fuente Muñiz" Servicio de Neuroimagen, México City, México
| | - Joan A Camprodon
- Department of Psychiatry, Laboratory for Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Leon Morales-Quezada
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Doris Gutiérrez-Mora
- Clínica de Trastornos de Afecto, National Institute of Psychiatry "Ramón de la Fuente Muñiz", México City, México
| | - Mónica Flores-Ramos
- National Council on Science and Technology, CONACYT, México City, México.,Teaching Department, National Institute of Psychiatry "Ramón de la Fuente Muñiz", México City, México
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27
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Tang Y, Wang M, Zheng T, Yuan F, Yang H, Han F, Chen G. Grey matter volume alterations in trigeminal neuralgia: A systematic review and meta-analysis of voxel-based morphometry studies. Prog Neuropsychopharmacol Biol Psychiatry 2020; 98:109821. [PMID: 31756417 DOI: 10.1016/j.pnpbp.2019.109821] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/29/2019] [Accepted: 11/12/2019] [Indexed: 02/08/2023]
Abstract
In recent decades, a growing number of structural neuroimaging studies of grey matter (GM) in trigeminal neuralgia (TN) have reported inconsistent alterations. We carried out a systematic review and meta-analysis to identify consistent and replicable GM volume abnormalities using effect-size signed differential mapping (ES-SDM). Furthermore, we conducted a meta-regression to explore the potential effects of clinical characteristics on GM volume alterations in patients with TN. A total of 13 studies with 15 datasets, representing 407 TN patients and 376 healthy individuals, were included in the present study. The results revealed that TN patients had GM volume abnormalities mainly in the basal ganglia, including the putamen, nucleus accumbens (NAc), caudate nucleus and amygdala, as well as the cingulate cortex (CC), thalamus, insula and superior temporal gyrus (STG). The meta-regression analysis showed that verbal rating scale (VRS) scores were negatively correlated with decreased GM volume in the left striatum and that illness duration was negatively correlated with decreased GM volume in the left STG and left insula. These results provide a thorough profile of GM volume alterations in TN patients and constitute robust evidence that aberrant GM volumes in the brain regions regulating and moderating sensory-motor and affective processing may play an important role in the pathophysiology of TN.
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Affiliation(s)
- Yu Tang
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Maohua Wang
- Department of Anesthesiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Ting Zheng
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Fengying Yuan
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Han Yang
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Fugang Han
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Guangxiang Chen
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
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28
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Lee SY, Wang TY, Chen SL, Chang YH, Chen PS, Huang SY, Tzeng NS, Wang LJ, Lee IH, Chen KC, Yang YK, Hong JS, Lu RB. Combination of dextromethorphan and memantine in treating bipolar spectrum disorder: a 12-week double-blind randomized clinical trial. Int J Bipolar Disord 2020; 8:11. [PMID: 32115672 PMCID: PMC7049537 DOI: 10.1186/s40345-019-0174-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/16/2019] [Indexed: 11/12/2022] Open
Abstract
Background The aim of this study is to determine whether adding combination of agents with anti-inflammatory and neurotrophic effects is more efficacious than mood stabilizer alone in improving clinical symptoms, plasma brain-derived neurotrophic factor (BDNF), cytokine levels, and metabolic profiles in patients with bipolar spectrum disorder. Methods In a randomized, double-blind, controlled 12-week clinical trial, patients with moderate mood symptoms (HDRS ≥ 18 or YMRS ≥ 14) were recruited. The patients were randomly assigned to a group while still undergoing regular valproate (VPA) treatments: VPA + dextromethorphan (DM) (30 mg/day) + memantine (MM) (5 mg/day) (DM30 + MM5) (n = 66), VPA + DM (30 mg/day) (DM30) (n = 69), VPA + MM (5 mg/day) (MM5) (n = 66), or VPA + Placebo (Placebo) (n = 69). Symptom severity, immunological parameters [plasma tumor necrosis factor (TNF)-α and C-reactive protein (CRP)] and plasma brain-derived neurotrophic factor (BDNF) were regularly examined. Metabolic profiles [cholesterol, triglycerides, glycosylated hemoglobin (HbA1C), fasting serum glucose, body mass index (BMI)] were measured at baseline and at 2, 8, and 12 weeks. Results Depression scores were significantly (P = 0.03) decreases and BDNF levels significantly (P = 0.04) increased in the DM30 + MM5 group than in the Placebo group. However, neither depressive scores nor BDNF levels were significantly different between the DM30, MM5, and Placebo groups. Changes in certain plasma cytokine and BDNF levels were significantly correlated with metabolic parameters. Conclusion We concluded that add-on DM30 + MM5 was significantly more effective than placebo for clinical symptoms and plasma BDNF levels. Additional studies with larger samples and mechanistic studies are necessary to confirm our findings. Trial registration NCT03039842 (https://register.clinicaltrials.gov/). Trial date was from 1 Jan 2013 to 31 December 2016 in National Cheng Kung University Hospital. Registered 28 February 1 2017-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03039842?term=NCT03039842&rank=1.
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Affiliation(s)
- Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan
| | - Tzu-Yun Wang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan
| | - Shiou-Lan Chen
- Department of Neurology, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yun-Hsuan Chang
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Po-See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - I-Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan
| | - Kao-Ching Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan
| | - Yen-Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan
| | - Jau-Shyong Hong
- Laboratory of Toxicology and Pharmacology, NIH/NIEHS, Research Triangle Park, Durham, NC, USA
| | - Ru-Band Lu
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan. .,Yanjiao Furen Hospital, Hebei, China. .,Addiction Research Center, National Cheng Kung University, Tainan, Taiwan.
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29
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Imms P, Clemente A, Cook M, D'Souza W, Wilson PH, Jones DK, Caeyenberghs K. The structural connectome in traumatic brain injury: A meta-analysis of graph metrics. Neurosci Biobehav Rev 2019; 99:128-137. [PMID: 30615935 PMCID: PMC7615245 DOI: 10.1016/j.neubiorev.2019.01.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/22/2018] [Accepted: 01/03/2019] [Indexed: 12/15/2022]
Abstract
Although recent structural connectivity studies of traumatic brain injury (TBI) have used graph theory to evaluate alterations in global integration and functional segregation, pooled analysis is needed to examine the robust patterns of change in graph metrics across studies. Following a systematic search, 15 studies met the inclusion criteria for review. Of these, ten studies were included in a random-effects meta-analysis of global graph metrics, and subgroup analyses examined the confounding effects of severity and time since injury. The meta-analysis revealed significantly higher values of normalised clustering coefficient (gö=ö1.445, CI=[0.512, 2.378], pö=ö0.002) and longer characteristic path length (gö=ö0.514, CI=[0.190, 0.838], pö=ö0.002) in TBI patients compared with healthy controls. Our findings suggest that the TBI structural network has shifted away from the balanced small-world network towards a regular lattice. Therefore, these graph metrics may be useful markers of neurocognitive dysfunction in TBI. We conclude that the pattern of change revealed by our analysis should be used to guide hypothesis-driven research into the role of graph metrics as diagnostic and prognostic biomarkers.
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Affiliation(s)
- Phoebe Imms
- Mary MacKillop Institute for Heatlh Research, Faculty of Health Sciences, Australian Catholic University. 115 Victoria Parade, Melbourne, VIC, 3065, Australia.
| | - Adam Clemente
- Mary MacKillop Institute for Heatlh Research, Faculty of Health Sciences, Australian Catholic University. 115 Victoria Parade, Melbourne, VIC, 3065, Australia.
| | - Mark Cook
- Department of Medicine, St. Vincent's Hospital, University of Melbourne. 41 Victoria Parade, Melbourne, VIC, 3065, Australia.
| | - Wendyl D'Souza
- Department of Medicine, St. Vincent's Hospital, University of Melbourne. 41 Victoria Parade, Melbourne, VIC, 3065, Australia.
| | - Peter H Wilson
- Mary MacKillop Institute for Heatlh Research, Faculty of Health Sciences, Australian Catholic University. 115 Victoria Parade, Melbourne, VIC, 3065, Australia.
| | - Derek K Jones
- Mary MacKillop Institute for Heatlh Research, Faculty of Health Sciences, Australian Catholic University. 115 Victoria Parade, Melbourne, VIC, 3065, Australia; Cardiff University Brain Research Imaging Centre, School of Psychology, and Neuroscience and Mental Health Research Institute, Cardiff University, Maindy Rd, Cardiff, CF24 4HQ, United Kingdom.
| | - Karen Caeyenberghs
- Mary MacKillop Institute for Heatlh Research, Faculty of Health Sciences, Australian Catholic University. 115 Victoria Parade, Melbourne, VIC, 3065, Australia.
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30
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Conjoint and dissociated structural and functional abnormalities in first-episode drug-naive patients with major depressive disorder: a multimodal meta-analysis. Sci Rep 2017; 7:10401. [PMID: 28871117 PMCID: PMC5583354 DOI: 10.1038/s41598-017-08944-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 07/21/2017] [Indexed: 02/05/2023] Open
Abstract
Published MRI evidence of structural and resting-state functional brain abnormalities in MDD has been inconsistent. To eliminate interference by repeated disease episodes and antidepressant treatment, we conducted the first multimodal voxel-wise meta-analysis of studies of voxel-based morphometry (VBM) and the amplitude of low-frequency fluctuation (ALFF) in first-episode drug-naive MDD patients, using the Seed-based d Mapping method (SDM). Fifteen VBM data sets and 11 ALFF data sets were included. SDM-based multimodal meta-analysis was used to highlight brain regions with both structural and functional abnormalities. This identified conjoint structural and functional abnormalities in left lateral orbitofrontal cortex and right supplementary motor area, and also dissociated abnormalities of structure (decreased grey matter in right dorsolateral prefrontal cortex and right inferior temporal gyrus; increased grey matter in right insula, right putamen, left temporal pole, and bilateral thalamus) and function (increased brain activity in left supplementary motor area, left parahippocampal gyrus, and hippocampus; decreased brain activity in right lateral orbitofrontal cortex). This study reveals a complex pattern of conjoint and dissociated structural and functional abnormalities, supporting the involvement of basal ganglia-thalamocortical circuits, representing emotional, cognitive and psychomotor abnormalities, in the pathophysiology of early-stage MDD. Specifically, this study adds to Psychoradiology, an emerging subspecialty of radiology, which seems primed to play a major clinical role in guiding diagnostic and treatment planning decisions in patients with mental disorder.
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O'Donoghue S, Kilmartin L, O'Hora D, Emsell L, Langan C, McInerney S, Forde NJ, Leemans A, Jeurissen B, Barker GJ, McCarthy P, Cannon DM, McDonald C. Anatomical integration and rich-club connectivity in euthymic bipolar disorder. Psychol Med 2017; 47:1609-1623. [PMID: 28573962 DOI: 10.1017/s0033291717000058] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Although repeatedly associated with white matter microstructural alterations, bipolar disorder (BD) has been relatively unexplored using complex network analysis. This method combines structural and diffusion magnetic resonance imaging (MRI) to model the brain as a network and evaluate its topological properties. A group of highly interconnected high-density structures, termed the 'rich-club', represents an important network for integration of brain functioning. This study aimed to assess structural and rich-club connectivity properties in BD through graph theory analyses. METHOD We obtained structural and diffusion MRI scans from 42 euthymic patients with BD type I and 43 age- and gender-matched healthy volunteers. Weighted fractional anisotropy connections mapped between cortical and subcortical structures defined the neuroanatomical networks. Next, we examined between-group differences in features of graph properties and sub-networks. RESULTS Patients exhibited significantly reduced clustering coefficient and global efficiency, compared with controls globally and regionally in frontal and occipital regions. Additionally, patients displayed weaker sub-network connectivity in distributed regions. Rich-club analysis revealed subtly reduced density in patients, which did not withstand multiple comparison correction. However, hub identification in most participants indicated differentially affected rich-club membership in the BD group, with two hubs absent when compared with controls, namely the superior frontal gyrus and thalamus. CONCLUSIONS This graph theory analysis presents a thorough investigation of topological features of connectivity in euthymic BD. Abnormalities of global and local measures and network components provide further neuroanatomically specific evidence for distributed dysconnectivity as a trait feature of BD.
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Affiliation(s)
- S O'Donoghue
- The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway,Galway,Republic of Ireland
| | - L Kilmartin
- College of Engineering and Informatics, National University of Ireland Galway,Galway,Republic of Ireland
| | - D O'Hora
- School of Psychology, National University of Ireland Galway,Galway,Republic of Ireland
| | - L Emsell
- Translational MRI, Department of Imaging & Pathology,KU Leuven & Radiology, University Hospitals Leuven,Leuven,Belgium
| | - C Langan
- The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway,Galway,Republic of Ireland
| | - S McInerney
- Department of Psychiatry,St Michael's Hospital,Toronto,Ontario,Canada
| | - N J Forde
- Department of Psychiatry,University Medical Centre Groningen,Groningen,The Netherlands
| | - A Leemans
- Image Sciences Institute, University Medical Center Utrecht,Utrecht,The Netherlands
| | - B Jeurissen
- Vision Lab,University of Antwerp,Antwerp,Belgium
| | - G J Barker
- Institute of Psychiatry, Psychology and Neuroscience,London,UK
| | - P McCarthy
- Radiology, University Hospital Galway,Galway,Republic of Ireland
| | - D M Cannon
- The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway,Galway,Republic of Ireland
| | - C McDonald
- The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, National University of Ireland Galway,Galway,Republic of Ireland
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Arjmand S, Behzadi M, Stephens GJ, Ezzatabadipour S, Seifaddini R, Arjmand S, Shabani M. A Brain on a Roller Coaster: Can the Dopamine Reward System Act as a Protagonist to Subdue the Ups and Downs of Bipolar Disorder? Neuroscientist 2017; 24:423-439. [DOI: 10.1177/1073858417714226] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
One of the most interesting but tenebrous parts of the bipolar disorder (BD) story is the switch between (hypo)mania and depression, which can give bipolar patients a thrilling, but somewhat perilous, ‘ride’. Numerous studies have pointed out that there are some recognizable differences (either state-dependent or state-independent) in several brain regions of people with BD, including components of the brain’s reward system. Understanding the underpinning mechanisms of high and low mood statuses in BD has potential, not only for the development of highly specific and selective pharmaceutical agents, but also for better treatment approaches and psychological interventions to manage BD and, thus, give patients a safer ride. Herein, we review evidence that supports involvement of the reward system in the pathophysiology of mood swings, with the main focus on the mesocorticolimbic dopaminergic neural circuitry. Principally using findings from neuroimaging studies, we aim to signpost readers as to how mood alterations may affect different areas of the reward system and how antipsychotic drugs can influence the activity of these brain areas. Finally, we critically evaluate the hypothesis that the mesocorticolimbic dopamine reward system may act as a functional rheostat for different mood states.
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Affiliation(s)
- Shokouh Arjmand
- Kerman Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Mina Behzadi
- Kerman Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Gary J. Stephens
- School of Pharmacy, Reading University, Whiteknights, Reading, UK
| | - Sara Ezzatabadipour
- Kerman Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Rostam Seifaddini
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahrad Arjmand
- Department of Psychology, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Mohammad Shabani
- Kerman Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
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Jiang J, Zhao YJ, Hu XY, Du MY, Chen ZQ, Wu M, Li KM, Zhu HY, Kumar P, Gong QY. Microstructural brain abnormalities in medication-free patients with major depressive disorder: a systematic review and meta-analysis of diffusion tensor imaging. J Psychiatry Neurosci 2017; 42:150-163. [PMID: 27780031 PMCID: PMC5403660 DOI: 10.1503/jpn.150341] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Multiple meta-analyses of diffusion tensor imaging (DTI) studies have reported impaired white matter integrity in patients with major depressive disorder (MDD). However, owing to inclusion of medicated patients in these studies, it is difficult to conclude whether these reported alterations are associated with MDD or confounded by medication effects. A meta-analysis of DTI studies on medication-free (medication-naive and medication washout) patients with MDD would therefore be necessary to disentangle MDD-specific effects. METHODS We analyzed white matter alterations between medication-free patients with MDD and healthy controls using anisotropic effect size-signed differential mapping (AES-SDM). We used DTI query software for fibre tracking. RESULTS Both pooled and subgroup meta-analyses in medication washout patients showed robust fractional anisotropy (FA) reductions in white matter of the right cerebellum hemispheric lobule, body of the corpus callosum (CC) and bilateral superior longitudinal fasciculus III (SLF III), whereas FA reductions in the genu of the CC and right anterior thalamic projections were seen in only medication-naive patients. Fibre tracking showed that the main tracts with observed FA reductions included the right cerebellar tracts, body of the CC, bilateral SLF III and arcuate fascicle. LIMITATIONS The analytic techniques, patient characteristics and clinical variables of the included studies were heterogeneous; we could not exclude the effects of nondrug therapies owing to a lack of data. CONCLUSION By excluding the confounding influences of current medication status, findings from the present study may provide a better understanding of the underlying neuropathology of MDD.
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Affiliation(s)
| | | | | | | | | | | | | | - Hong-Yan Zhu
- Correspondence to: H. Zhu or Q. Gong, Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China; or
| | | | - Qi-Yong Gong
- Correspondence to: H. Zhu or Q. Gong, Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China; or
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Tan HZ, Li H, Liu CF, Guan JT, Guo XB, Wen CH, Ou SM, Zhang YN, Zhang J, Xu CT, Shen ZW, Wu RH, Wang XQ. Main Effects of Diagnoses, Brain Regions, and their Interaction Effects for Cerebral Metabolites in Bipolar and Unipolar Depressive Disorders. Sci Rep 2016; 6:37343. [PMID: 27869127 PMCID: PMC5116758 DOI: 10.1038/srep37343] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 10/25/2016] [Indexed: 02/05/2023] Open
Abstract
Previous studies suggested patients with bipolar depressive disorder (BDd) or unipolar depressive disorder (UDd) have cerebral metabolites abnormalities. These abnormalities may stem from multiple sub-regions of gray matter in brain regions. Thirteen BDd patients, 20 UDd patients and 20 healthy controls (HC) were enrolled to investigate these abnormalities. Absolute concentrations of 5 cerebral metabolites (glutamate-glutamine (Glx), N-acetylaspartate (NAA), choline (Cho), myo-inositol (mI), creatine (Cr), parietal cortex (PC)) were measured from 4 subregions (the medial frontal cortex (mPFC), anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), and parietal cortex (PC)) of gray matter. Main and interaction effects of cerebral metabolites across subregions of gray matter were evaluated. For example, the Glx was significantly higher in BDd compared with UDd, and so on. As the interaction analyses showed, some interaction effects existed. The concentrations of BDds' Glx, Cho, Cr in the ACC and HCs' mI and Cr in the PC were higher than that of other interaction effects. In addition, the concentrations of BDds' Glx and Cr in the PC and HCs' mI in the ACC were statistically significant lower than that of other interaction effects. These findings point to region-related abnormalities of cerebral metabolites across subjects with BDd and UDd.
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Affiliation(s)
- Hai-Zhu Tan
- Department of Physics and Computer Applications, Shantou University Medical College, Shanou, 515041, China
- Southern China Center for Statistical Science, Sun Yat-Sen University, Guangzhou, 510275, China
| | - Hui Li
- Department of Medical Imaging, 2nd Affiliated Hospital, Shantou University Medical College, Shantou, 515041, China
- Mental Health Center; Shantou University Medical College, Shantou, 515000, China
| | - Chen-Feng Liu
- Southern China Center for Statistical Science, Sun Yat-Sen University, Guangzhou, 510275, China
- Department of Statistical Science, School of Mathematics, Sun Yat-Sen University, Guangzhou, 510275, China
| | - Ji-Tian Guan
- Department of Medical Imaging, 2nd Affiliated Hospital, Shantou University Medical College, Shantou, 515041, China
| | - Xiao-Bo Guo
- Southern China Center for Statistical Science, Sun Yat-Sen University, Guangzhou, 510275, China
- Department of Statistical Science, School of Mathematics, Sun Yat-Sen University, Guangzhou, 510275, China
| | - Can-Hong Wen
- Southern China Center for Statistical Science, Sun Yat-Sen University, Guangzhou, 510275, China
- Department of Statistical Science, School of Mathematics, Sun Yat-Sen University, Guangzhou, 510275, China
| | - Shao-Min Ou
- Department of Physics and Computer Applications, Shantou University Medical College, Shanou, 515041, China
| | - Yin-Nan Zhang
- Mental Health Center; Shantou University Medical College, Shantou, 515000, China
| | - Jie Zhang
- Mental Health Center; Shantou University Medical College, Shantou, 515000, China
| | - Chong-Tao Xu
- Mental Health Center; Shantou University Medical College, Shantou, 515000, China
| | - Zhi-Wei Shen
- Department of Medical Imaging, 2nd Affiliated Hospital, Shantou University Medical College, Shantou, 515041, China
| | - Ren-Hua Wu
- Department of Medical Imaging, 2nd Affiliated Hospital, Shantou University Medical College, Shantou, 515041, China
- Provincial Key Laboratory of Medical Molecular Imaging, Guangdong, Shantou, 515041, China
| | - Xue-Qin Wang
- Southern China Center for Statistical Science, Sun Yat-Sen University, Guangzhou, 510275, China
- Department of Statistical Science, School of Mathematics, Sun Yat-Sen University, Guangzhou, 510275, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, China
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Joshi SH, Vizueta N, Foland-Ross L, Townsend JD, Bookheimer SY, Thompson PM, Narr KL, Altshuler LL. Relationships Between Altered Functional Magnetic Resonance Imaging Activation and Cortical Thickness in Patients With Euthymic Bipolar I Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:507-517. [PMID: 27990494 PMCID: PMC5157843 DOI: 10.1016/j.bpsc.2016.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Performance during cognitive control functional magnetic resonance imaging (fMRI) tasks are associated with frontal lobe hypoactivation in patients with bipolar disorder, even while euthymic. Here, we study the structural underpinnings for this functional abnormality simultaneously with brain activation data. METHODS In a sample of ninety adults (45 with inter-episode Bipolar I disorder and 45 healthy controls), we explored whether abnormal functional activation patterns in bipolar euthymic subjects during a Go-NoGo fMRI task are associated with regional deficits in cortical gray matter thickness in the same regions. Cross-sectional differences in fMRI activation were used to form a-priori hypotheses for region-of-interest cortical gray matter thickness analyses. fMRI BOLD to structural magnetic resonance imaging (sMRI) thickness correlations were conducted across the sample and within patients and controls separately. RESULTS During response inhibition (NoGo minus Go), bipolar subjects showed significant hypoactivation and reduced thickness in the inferior frontal cortex (IFC), superior frontal gyrus and cingulate compared to controls. Cingulate hypoactivation corresponded with reduced regional thickness. A significant activation by disease state interaction was observed with thickness in left prefrontal areas. CONCLUSIONS Reduced cingulate fMRI activation is associated with reduced cortical thickness. In the left frontal lobe, a thinner cortex was associated with increased fMRI activation in patients, but showed a reverse trend in controls. These findings suggest that reduced activation in the IFC and cingulate during a response inhibition task may have an underlying structural etiology, which may explain task-related functional hypoactivation that persists even when patients are euthymic.
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Affiliation(s)
- Shantanu H. Joshi
- Ahmanson Lovelace Brain Mapping Center, Department of
Neurology, University of California, Los Angeles, CA
| | - Nathalie Vizueta
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
| | | | - Jennifer D. Townsend
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
| | - Susan Y. Bookheimer
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
| | - Paul M. Thompson
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
- Imaging Genetics Center, University of Southern California,
Marina del Rey, CA
| | - Katherine L. Narr
- Ahmanson Lovelace Brain Mapping Center, Department of
Neurology, University of California, Los Angeles, CA
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
| | - Lori L. Altshuler
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
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Freedman D, Bao Y, Shen L, Schaefer CA, Brown AS. Maternal T. gondii, offspring bipolar disorder and neurocognition. Psychiatry Res 2016; 243:382-9. [PMID: 27449007 PMCID: PMC5014658 DOI: 10.1016/j.psychres.2016.06.057] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 06/25/2016] [Accepted: 06/29/2016] [Indexed: 01/07/2023]
Abstract
Prenatal exposure to maternal Toxoplasma gondii (T. gondii) IgG antibody titer has been associated previously with an increased risk of offspring schizophrenia (SZ) and cognitive impairment. We examined maternal T. gondii, offspring bipolar disorder (BP) and childhood cognition using a population-based birth cohort. Maternal sera, drawn in the third trimester, were analyzed for T. gondii IgG antibody titer, and offspring cognition at ages 5 and 9-11 was measured with the Peabody Picture Vocabulary Test (PPVT) and the Raven Matrices (Raven). Raw scores were standardized and the ages combined. Potential cases with BP from the cohort were identified by database linkages. This protocol identified 85 cases who were matched 1:2 to controls. Maternal T. gondii IgG was not associated with the risk of BP in offspring. Neither moderate [HR=1.43 (CI: 0.49, 4.17)] nor high IgG titer [HR=1.6 [CI: 0.74, 3.48)] were associated with offspring BP. Associations were not observed between maternal T. gondii and BP with psychotic features or BP type 1. In addition, maternal T. gondii was not associated with childhood cognition. Our study suggests that T. gondii may be specific to SZ among major psychotic disorders, though further studies with larger sample sizes are required.
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Affiliation(s)
- David Freedman
- Departments of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, 760 Westwood Plaza, A7-432, Los Angeles, CA 90024, United States.
| | - Yuanyuan Bao
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, United States
| | - Ling Shen
- Kaiser Permanente Division of Research, Oakland, CA, United States
| | | | - Alan S Brown
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, United States
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37
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Ferrari F, Villa RF. The Neurobiology of Depression: an Integrated Overview from Biological Theories to Clinical Evidence. Mol Neurobiol 2016; 54:4847-4865. [DOI: 10.1007/s12035-016-0032-y] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 08/01/2016] [Indexed: 12/21/2022]
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Marchand WR, Dilda V. New Models of Frontal-Subcortical Skeletomotor Circuit Pathology in Tardive Dyskinesia. Neuroscientist 2016; 12:186-98. [PMID: 16684965 DOI: 10.1177/1073858406288727] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Tardive dyskinesia (TD) is a hyperkinetic movement disorder that can occur as a side effect of treatment with antipsychotic medications. Because antipsychotics block the D2 family of dopamine receptors in the striatum, it has long been suspected this blockade contributes to the development of TD. Specifically, increased sensitivity of the dopamine receptors following chronic blockade has been thought to result in abnormal functioning of the frontal-subcortical (FSC) skeletomotor circuit and the symptoms of TD. However, this hypothesis remains unproven. In recent years, substantial research has focused on the basal ganglia and FSC circuits. This research has resulted in the development of the focused selection model of skeletomotor circuit function. This hypothesis provides a compelling model of neurocircuit abnormalities in TD. A greater understanding of the neuropathology of TD may lead to the development of better treatment and prevention strategies for this disorder. Furthermore, this information may contribute to a more complete understanding of normal skeletomotor circuit function and the role of circuit pathology in numerous neuropsychiatric conditions.
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Affiliation(s)
- William R Marchand
- George E. Wahlen VAMC and the University of Utah, Salt Lake City, 84148, USA
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Wang T, Liu J, Zhang J, Zhan W, Li L, Wu M, Huang H, Zhu H, Kemp GJ, Gong Q. Altered resting-state functional activity in posttraumatic stress disorder: A quantitative meta-analysis. Sci Rep 2016; 6:27131. [PMID: 27251865 PMCID: PMC4890007 DOI: 10.1038/srep27131] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 05/13/2016] [Indexed: 02/05/2023] Open
Abstract
Many functional neuroimaging studies have reported differential patterns of spontaneous brain activity in posttraumatic stress disorder (PTSD), but the findings are inconsistent and have not so far been quantitatively reviewed. The present study set out to determine consistent, specific regional brain activity alterations in PTSD, using the Effect Size Signed Differential Mapping technique to conduct a quantitative meta-analysis of resting-state functional neuroimaging studies of PTSD that used either a non-trauma (NTC) or a trauma-exposed (TEC) comparison control group. Fifteen functional neuroimaging studies were included, comparing 286 PTSDs, 203 TECs and 155 NTCs. Compared with NTC, PTSD patients showed hyperactivity in the right anterior insula and bilateral cerebellum, and hypoactivity in the dorsal medial prefrontal cortex (mPFC); compared with TEC, PTSD showed hyperactivity in the ventral mPFC. The pooled meta-analysis showed hypoactivity in the posterior insula, superior temporal, and Heschl’s gyrus in PTSD. Additionally, subgroup meta-analysis (non-medicated subjects vs. NTC) identified abnormal activation in the prefrontal-limbic system. In meta-regression analyses, mean illness duration was positively associated with activity in the right cerebellum (PTSD vs. NTC), and illness severity was negatively associated with activity in the right lingual gyrus (PTSD vs. TEC).
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Affiliation(s)
- Ting Wang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P. R. China.,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Jia Liu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Junran Zhang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P. R. China.,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Wang Zhan
- Neuroimaging Center, University of Maryland, College Park, Maryland, USA
| | - Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Min Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Hua Huang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P. R. China
| | - Hongyan Zhu
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Graham J Kemp
- Magnetic Resonance and Image Analysis Research Centre (MARIARC) and Institute of Ageing and Chronic Disease, University of Liverpool, United Kingdom
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China.,Department of Psychology, School of Public Administration, Sichuan University, Chengdu, P. R. China
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Volkert J, Schiele MA, Kazmaier J, Glaser F, Zierhut KC, Kopf J, Kittel-Schneider S, Reif A. Cognitive deficits in bipolar disorder: from acute episode to remission. Eur Arch Psychiatry Clin Neurosci 2016; 266:225-37. [PMID: 26611783 DOI: 10.1007/s00406-015-0657-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 11/12/2015] [Indexed: 11/28/2022]
Abstract
Considerable evidence demonstrates that neuropsychological deficits are prevalent in bipolar disorder during both acute episodes and euthymia. However, it is less clear whether these cognitive disturbances are state- or trait-related. We here present the first longitudinal study employing a within-subject pre- and post-testing examining acutely admitted bipolar patients (BP) in depression or mania and during euthymia, aiming to identify cognitive performance from acute illness to remission. Cognitive performance was measured during acute episodes and repeated after at least 3 months of remission. To do so, 55 BP (35 depressed, 20 hypo-/manic) and 55 healthy controls (HC) were tested with a neuropsychological test battery (attention, working memory, verbal memory, executive functioning). The results showed global impairments in acutely ill BP compared to HC: depressed patients showed a characteristic psychomotor slowing, while manic patients had severe deficits in executive functioning. Twenty-nine remitted BP could be measured in the follow-up (dropout rate 48 %), whose cognitive functions partially recovered, whereas working memory and verbal memory were still impaired. However, we found that subthreshold depressive symptoms and persisting sleep disturbances in euthymic BP were associated with reduced speed, deficits in attention and verbal memory, while working memory was correlated with psychotic symptoms (lifetime). This result indicates working memory as trait related for a subgroup of BP with psychotic symptoms. In contrast, attention and verbal memory are negatively influenced by state factors like residual symptoms, which should be more considered as possible confounders in the search of cognitive endophenotypes in remitted BP.
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Affiliation(s)
- J Volkert
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Heinrich-Hoffmann-Straße 10, 60528, Frankfurt am Main, Germany.
| | - M A Schiele
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, 97080, Würzburg, Germany
| | - Julia Kazmaier
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, 97080, Würzburg, Germany
| | - Friederike Glaser
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, 97080, Würzburg, Germany
| | - K C Zierhut
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstrasse 15, 97080, Würzburg, Germany
| | - J Kopf
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Heinrich-Hoffmann-Straße 10, 60528, Frankfurt am Main, Germany
| | - S Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Heinrich-Hoffmann-Straße 10, 60528, Frankfurt am Main, Germany
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Heinrich-Hoffmann-Straße 10, 60528, Frankfurt am Main, Germany
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Abstract
INTRODUCTION White matter hyperintensities (WMHs) are one the most common neuroimaging findings in patients with bipolar disorder (BD). It has been suggested that WMHs are associated with impaired insight in schizophrenia and schizoaffective patients; however, the relationship between insight and WMHs in BD type I has not been directly investigated. METHODS Patients with BD-I (148) were recruited and underwent brain magnetic resonance imaging (MRI). Affective symptoms were assessed using Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS17); the presence of impaired insight was based on the corresponding items of YMRS and HDRS17. RESULTS Multiple punctate periventricular WMHs (PWMHs) and deep WMHs (DWMHs) were observed in 49.3% and 39.9% of the cases, respectively. Subjects with lower insight for mania had significantly more PWMHs (54.6% vs 22.2%; p < 0.05) when compared to BD-I patients with higher insight for mania. The presence of PWMHs was independently associated with lower insight for mania: patients who denied illness according to the YMRS were 4 times more likely to have PWMHs (95% CI: 1.21/13.42) than other patients. CONCLUSIONS Impaired insight in BD-I is associated with periventricular WMHs. The early identification of BD-I subjects with PWMHs and impaired insight may be crucial for clinicians.
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Abstract
The "Kraepelinian dichotomy" between schizophrenia (SZ) and bipolar disorder (BD) has been a dominant force in our thinking on the classification of these mental disorders. Emerging evidence indicates that these 2 disorders overlap significantly with regard to epidemiology, clinical presentation, genetic susceptibility, structural neuroanatomy, and treatment. Prenatal infection and immunologic dysfunction appear to be risk factors for both SZ and BD; some of these gestational exposures are present in both disorders while others may be specific to 1 or the other of the 2 syndromes. In this paper, we shall review prior studies of prenatal infections and immunologic insults in schizophrenia and BD, including exposures which overlap and which differ between these disorders, discuss the potential utility of maternal infection as one strategy toward developing a more biologically meaningful diagnostic classification system, and propose new recommendations for future research aimed at dissecting these 2 disorders from one another at the etiologic level.
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Affiliation(s)
- Alan S. Brown
- Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, NY,*To whom correspondence should be addressed; New York State Psychiatric Institute, 1051 Riverside Drive, Unit 23, New York, NY 10032, US; tel: 646-774-6417, fax: 646-774-6408, e-mail:
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Genetic variation in the G72 gene is associated with increased frontotemporal fiber tract integrity. Eur Arch Psychiatry Clin Neurosci 2015; 265:291-301. [PMID: 25031104 DOI: 10.1007/s00406-014-0516-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 07/05/2014] [Indexed: 01/02/2023]
Abstract
G72 (syn. DAOA, D-amino acid oxidase activator) is a susceptibility gene for both schizophrenia and bipolar disorder. Diffusion tensor imaging studies hint at changes in fiber tract integrity in both disorders. We aimed to investigate whether a G72 susceptibility haplotype causes changes in fiber tract integrity in young healthy subjects. We compared fractional anisotropy in 47 subjects that were either homozygous for the M23/M24 risk haplotype (n = 20) or homozygous for M23(rs3918342)/M24(rs1421292) wild type (n = 27) using diffusion tensor imaging with 3 T. Tract-based spatial statistics, a method especially developed for diffusion data analysis, was used to delineate the major fiber tracts. We found clusters of increased FA values in homozygous risk haplotype carriers in the right periinsular region and in the right inferior parietal lobe (IPL). We did not find clusters indicating decreased FA values. The insula and the IPL have been implicated in both schizophrenia and bipolar pathophysiology. Increased FA values might reflect changes in dendritic morphology as previously described by in vitro studies. These findings further corroborate the hypothesis that a shared gene pool between schizophrenia and bipolar disorder might lead to neuroanatomic changes that confer an unspecific vulnerability for both disorders.
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Davis AK, DelBello MP, Eliassen J, Welge J, Blom TJ, Fleck DE, Weber WA, Jarvis KB, Rummelhoff E, Strakowski SM, Adler CM. Neurofunctional effects of quetiapine in patients with bipolar mania. Bipolar Disord 2015; 17:444-9. [PMID: 25359589 DOI: 10.1111/bdi.12274] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 09/23/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Several lines of evidence suggest that abnormalities within portions of the extended limbic network involved in affective regulation and expression contribute to the neuropathophysiology of bipolar disorder. In particular, portions of the prefrontal cortex have been implicated in the appearance of manic symptomatology. The effect of atypical antipsychotics on activation of these regions, however, remains poorly understood. METHODS Twenty-two patients diagnosed with bipolar mania and 26 healthy subjects participated in a baseline functional magnetic resonance imaging scan during which they performed a continuous performance task with neutral and emotional distractors. Nineteen patients with bipolar disorder were treated for eight weeks with quetiapine monotherapy and then rescanned. Regional activity in response to emotional stimuli was compared between healthy and manic subjects at baseline; and in the subjects with bipolar disorder between baseline and eight-week scans. RESULTS At baseline, functional activity did not differ between subjects with bipolar disorder and healthy subjects in any region examined. After eight weeks of treatment, subjects with bipolar disorder showed a significant decrease in ratings on the Young Mania Rating Scale (YMRS) (p < 0.001), and increased activation in the right orbitofrontal cortex (OFC) (p = 0.002); there was a significant association between increased right OFC activity and YMRS improvement (p = 0.003). CONCLUSIONS These findings are consistent with suggestions that mania involves a loss of emotional modulatory activity in the prefrontal cortex--restoration of the relatively greater elevation in prefrontal activity widely observed in euthymic patients is associated with clinical improvement. It is not clear, however, whether changes are related to quetiapine treatment or represent a non-specific marker of affective change.
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Affiliation(s)
- Andrew K Davis
- Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - James Eliassen
- Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jeffrey Welge
- Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Thomas J Blom
- Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - David E Fleck
- Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Wade A Weber
- Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kelly B Jarvis
- Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Emily Rummelhoff
- Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stephen M Strakowski
- Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Caleb M Adler
- Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Chen SL, Lee SY, Chang YH, Chen PS, Lee IH, Wang TY, Chen KC, Yang YK, Hong JS, Lu RB. Therapeutic effects of add-on low-dose dextromethorphan plus valproic acid in bipolar disorder. Eur Neuropsychopharmacol 2014; 24:1753-9. [PMID: 25262178 DOI: 10.1016/j.euroneuro.2014.09.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 08/08/2014] [Accepted: 09/03/2014] [Indexed: 12/24/2022]
Abstract
UNLABELLED Changes in inflammatory cytokines and dysfunction of the neurotrophic system are thought to be involved in the pathology of bipolar disorder (BP). We investigated whether inflammatory and neurotrophic factors were changed in BP. We also investigated whether treating BP with valproic acid (VPA) plus low-dose (30 or 60 mg/day) dextromethorphan (DM) is more effective than treating it with VPA only, and whether DM affects plasma cytokines and brain derived neurotrophic factor (BDNF) levels. In a 12-week, randomized, double-blind study, patients were randomly assigned to the VPA+DM30, VPA+DM60, or VPA+Placebo groups. The Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS) were used to evaluate symptom severity, and ELISA to analyze plasma cytokine and BDNF levels. We recruited 309 patients with BP and 123 healthy controls. Before treatment, patients with BP had significantly higher plasma cytokine and lower plasma BDNF levels than did healthy controls. After treatment, HDRS and YMRS scores in each group showed significant improvement. Plasma cytokine levels tended to decline in all groups. Changes in plasma BDNF levels were significantly greater in the VPA+DM60 group than in the VPA+Placebo group. CONCLUSION patients with BP have a certain degree of systemic inflammation and BDNF dysfunction. Treatment with VPA plus DM (60 mg/day) provided patients with BP significantly more neurotrophic benefit than did VPA treatment alone.
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Affiliation(s)
- Shiou-Lan Chen
- Department of Neurology, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veteran׳s General Hospital, Kaohsiung, Taiwan
| | - Yun-Hsuan Chang
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Po-See Chen
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - I-Hui Lee
- Department of Neurology, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Institute of Behavioral Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzu-Yun Wang
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Kao-Ching Chen
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yen-Kuang Yang
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Jau-Shyong Hong
- Laboratory of Toxicology and Pharmacology, NIH/NIEHS, Research Triangle Park, NC, USA
| | - Ru-Band Lu
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan; Center for Neuropsychiatric Research, National Health Research Institute, Miaoli, Taiwan.
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46
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Du M, Liu J, Chen Z, Huang X, Li J, Kuang W, Yang Y, Zhang W, Zhou D, Bi F, Kendrick KM, Gong Q. Brain grey matter volume alterations in late-life depression. J Psychiatry Neurosci 2014; 39:397-406. [PMID: 24949867 PMCID: PMC4214874 DOI: 10.1503/jpn.130275] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Voxel-based morphometry (VBM) studies have demonstrated that grey matter abnormalities are involved in the pathophysiology of late-life depression (LLD), but the findings are inconsistent and have not been quantitatively reviewed. The aim of the present study was to conduct a meta-analysis that integrated the reported VBM studies, to determine consistent grey matter alterations in individuals with LLD. METHODS A systematic search was conducted to identify VBM studies that compared patients with LLD and healthy controls. We performed a meta-analysis using the effect size signed differential mapping method to quantitatively estimate regional grey matter abnormalities in patients with LLD. RESULTS We included 9 studies with 11 data sets comprising 292 patients with LLD and 278 healthy controls in our meta-analysis. The pooled and subgroup meta-analyses showed robust grey matter reductions in the right lentiform nucleus extending into the parahippocampus, the hippocampus and the amygdala, the bilateral medial frontal gyrus and the right subcallosal gyrus as well as a grey matter increase in the right lingual gyrus. Meta-regression analyses showed that mean age and the percentage of female patients with LLD were not significantly related to grey matter changes. LIMITATIONS The analysis techniques, patient characteristics and clinical variables of the studies included were heterogeneous, and most participants were medicated. CONCLUSION The present meta-analysis is, to our knowledge, the first to overcome previous inconsistencies in the VBM studies of LLD and provide robust evidence for grey matter alterations within fronto-striatal-limbic networks, thereby implicating them in the pathophysiology of LLD. The mean age and the percentage of female patients with LLD did not appear to have a measurable impact on grey matter changes, although we cannot rule out the contributory effects of medication.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Qiyong Gong
- Correspondence to: Q. Gong, Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, PR China;
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Cerullo MA, Eliassen JC, Smith CT, Fleck DE, Nelson EB, Strawn JR, Lamy M, DelBello MP, Adler CM, Strakowski SM. Bipolar I disorder and major depressive disorder show similar brain activation during depression. Bipolar Disord 2014; 16:703-12. [PMID: 24990479 PMCID: PMC4213254 DOI: 10.1111/bdi.12225] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 02/27/2014] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Despite different treatments and courses of illness, depressive symptoms appear similar in major depressive disorder (MDD) and bipolar I disorder (BP-I). This similarity of depressive symptoms suggests significant overlap in brain pathways underlying neurovegetative, mood, and cognitive symptoms of depression. These shared brain regions might be expected to exhibit similar activation in individuals with MDD and BP-I during functional magnetic resonance imaging (fMRI). METHODS fMRI was used to compare regional brain activation in participants with BP-I (n = 25) and MDD (n = 25) during a depressive episode as well as 25 healthy comparison (HC) participants. During the scans, participants performed an attentional task that incorporated emotional pictures. RESULTS During the viewing of emotional images, subjects with BP-I showed decreased activation in the middle occipital gyrus, lingual gyrus, and middle temporal gyrus compared to both subjects with MDD and HC participants. During attentional processing, participants with MDD had increased activation in the parahippocampus, parietal lobe, and postcentral gyrus. However, among these regions, only the postcentral gyrus also showed differences between MDD and HC participants. CONCLUSIONS No differences in cortico-limbic regions were found between participants with BP-I and MDD during depression. Instead, the major differences occurred in primary and secondary visual processing regions, with decreased activation in these regions in BP-I compared to major depression. These differences were driven by abnormal decreases in activation seen in the participants with BP-I. Posterior activation changes are a common finding in studies across mood states in participants with BP-I.
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Affiliation(s)
- Michael A Cerullo
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - James C Eliassen
- Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Christopher T Smith
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - David E Fleck
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA,Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Erik B Nelson
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jeffrey R Strawn
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Martine Lamy
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Melissa P DelBello
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Caleb M Adler
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA,Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stephen M Strakowski
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA,Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Renk K, White R, Lauer BA, McSwiggan M, Puff J, Lowell A. Bipolar disorder in children. PSYCHIATRY JOURNAL 2014; 2014:928685. [PMID: 24800202 PMCID: PMC3994906 DOI: 10.1155/2014/928685] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 12/21/2013] [Indexed: 12/31/2022]
Abstract
Although bipolar disorder historically was thought to only occur rarely in children and adolescents, there has been a significant increase in children and adolescents who are receiving this diagnosis more recently (Carlson, 2005). Nonetheless, the applicability of the current bipolar disorder diagnostic criteria for children, particularly preschool children, remains unclear, even though much work has been focused on this area. As a result, more work needs to be done to further the understanding of bipolar symptoms in children. It is hoped that this paper can assist psychologists and other health service providers in gleaning a snapshot of the literature in this area so that they can gain an understanding of the diagnostic criteria and other behaviors that may be relevant and be informed about potential approaches for assessment and treatment with children who meet bipolar disorder criteria. First, the history of bipolar symptoms and current diagnostic criteria will be discussed. Next, assessment strategies that may prove helpful for identifying bipolar disorder will be discussed. Then, treatments that may have relevance to children and their families will be discussed. Finally, conclusions regarding work with children who may have a bipolar disorder diagnosis will be offered.
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Affiliation(s)
- Kimberly Renk
- University of Central Florida, P.O. Box 161390, Orlando, FL 32816, USA
| | - Rachel White
- University of Central Florida, P.O. Box 161390, Orlando, FL 32816, USA
| | - Brea-Anne Lauer
- University of Central Florida, P.O. Box 161390, Orlando, FL 32816, USA
| | - Meagan McSwiggan
- University of Central Florida, P.O. Box 161390, Orlando, FL 32816, USA
| | - Jayme Puff
- University of Central Florida, P.O. Box 161390, Orlando, FL 32816, USA
| | - Amanda Lowell
- University of Central Florida, P.O. Box 161390, Orlando, FL 32816, USA
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Magnetic resonance spectroscopy imaging of lactate in patients with bipolar disorder. Psychiatry Res 2013; 213:230-4. [PMID: 23810640 DOI: 10.1016/j.pscychresns.2013.03.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 03/05/2013] [Accepted: 03/18/2013] [Indexed: 01/02/2023]
Abstract
Although brain lactate levels are typically low and difficult to measure, a few previous investigators have reported that brain lactate levels are elevated in patients with bipolar disorder. The present study investigated the distribution of lactate in bipolar and healthy brains using 2D proton magnetic resonance spectroscopic imaging on a 4-Tesla magnetic resonance imaging system. Ratios of the concentration of lactate to N-acetylaspartate, and of lactate to total creatine, were significantly higher in bipolar than in healthy subjects. Lactate signals were primarily localized to the bipolar subjects' caudate and anterior cingulate cortices, components of the frontal-subcortical circuit, suggesting that affective dysregulation may be related to metabolic abnormalities in this network.
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Xu J, Dydak U, Harezlak J, Nixon J, Dzemidzic M, Gunn AD, Karne HS, Anand A. Neurochemical abnormalities in unmedicated bipolar depression and mania: a 2D 1H MRS investigation. Psychiatry Res 2013; 213:235-41. [PMID: 23810639 PMCID: PMC3729606 DOI: 10.1016/j.pscychresns.2013.02.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 01/13/2013] [Accepted: 02/22/2013] [Indexed: 12/28/2022]
Abstract
The neurobiology and neurochemistry of bipolar disorder and its different phases are poorly understood. This study investigated metabolite abnormalities in both unmedicated bipolar depression as well as mania using 2D 1H magnetic resonance spectroscopy imaging (MRSI). MRSI data were obtained from 24 unmedicated bipolar disorder (BP) subjects (12 (hypo)manic (BPM)) and 12 depressed (BPD), and 20 closely matched healthy controls. 2D 1H MRSI data were collected from a 15-mm axial slice placed along the anterior commissure-posterior commissure (AC-PC) line to measure brain metabolites bilaterally in the thalamus and also the anterior and posterior cingulate cortex (ACC and PCC). Brain Lac/Cr levels were significantly increased in the BP group as a whole compared to healthy controls. Glutamate abnormalities varied across bipolar state as well as brain region: significantly increased Glx/Cr values were found in the left thalamus in BPD, but BPM had decreased Glu/Cr and Glx/Cr levels in the PCC when compared to healthy controls and decreased Glu/Cr levels even when compared to the BPD subjects group. The findings of the study point to state-related abnormalities of oxidative and glutamate metabolism in bipolar disorder.
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Affiliation(s)
- Jun Xu
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine
- School of Health Sciences, Purdue University
| | - Ulrike Dydak
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine
- School of Health Sciences, Purdue University
| | | | | | - Mario Dzemidzic
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine
- Department of Neurology, Indiana University School of Medicine
| | - Abigail D. Gunn
- Department of Psychiatry, Indiana University School of Medicine
| | - Harish S Karne
- Department of Psychiatry, Indiana University School of Medicine
| | - Amit Anand
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine
- Department of Psychiatry, Indiana University School of Medicine
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