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Zachos KA, Choi J, Godin O, Chernega T, Kwak HA, Jung JH, Aouizerate B, Aubin V, Bellivier F, Belzeaux-R R, Courtet P, Dubertret C, Etain B, Haffen E, Lefrere A A, Llorca PM, Olié E, Polosan M, Samalin L, Schwan R, Roux P, Barau C, Richard JR, Tamouza R, Leboyer M, Andreazza AC. Mitochondrial Biomarkers and Metabolic Syndrome in Bipolar Disorder. Psychiatry Res 2024; 339:116063. [PMID: 39003800 DOI: 10.1016/j.psychres.2024.116063] [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: 01/08/2024] [Revised: 06/21/2024] [Accepted: 06/27/2024] [Indexed: 07/16/2024]
Abstract
The object of this study is test whether mitochondrial blood-based biomarkers are associated with markers of metabolic syndrome in bipolar disorder, hypothesizing higher lactate but unchanged cell-free circulating mitochondrial DNA levels in bipolar disorder patients with metabolic syndrome. In a cohort study, primary testing from the FondaMental Advanced Centers of Expertise for bipolar disorder (FACE-BD) was conducted, including 837 stable bipolar disorder patients. The I-GIVE validation cohort consists of 237 participants: stable and acute bipolar patients, non-psychiatric controls, and acute schizophrenia patients. Multivariable regression analyses show significant lactate association with triglycerides, fasting glucose and systolic and diastolic blood pressure. Significantly higher levels of lactate were associated with presence of metabolic syndrome after adjusting for potential confounding factors. Mitochondrial-targeted metabolomics identified distinct metabolite profiles in patients with lactate presence and metabolic syndrome, differing from those without lactate changes but with metabolic syndrome. Circulating cell-free mitochondrial DNA was not associated with metabolic syndrome. This thorough analysis mitochondrial biomarkers indicate the associations with lactate and metabolic syndrome, while showing the mitochondrial metabolites can further stratify metabolic profiles in patients with BD. This study is relevant to improve the identification and stratification of bipolar patients with metabolic syndrome and provide potential personalized-therapeutic opportunities.
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Affiliation(s)
- Kassandra A Zachos
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Mitochondrial Innovation Initiative, MITO2i, Toronto, ON, Canada
| | - Jaehyoung Choi
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Mitochondrial Innovation Initiative, MITO2i, Toronto, ON, Canada
| | - Ophelia Godin
- INSERM U955 IMRB, Translational Neuropsychiatry laboratory, AP-HP, Hôpital Henri Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris Est Créteil University (UPEC), ECNP Immuno-NeuroPsychiatry Network; Fondation FondaMental, Créteil, France
| | - Timofei Chernega
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Haejin Angela Kwak
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jae H Jung
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Pôle de Psychiatrie Générale et Universitaire, Laboratoire NutriNeuro (UMR INRAE 1286), Université de Bordeaux, Bordeaux, France
| | - Valérie Aubin
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - Frank Bellivier
- Fondation FondaMental, Créteil, France; Université Paris Cité, INSERM UMR-S1144, AP-HPm GH Saint-Louis-Bariboisière-Fernand Widal, Pôle Neurosciences, Paris Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Raoul Belzeaux-R
- Fondation FondaMental, Créteil, France; Univ. Montpellier & Department of Psychiatry, CHU de Montpellier, France
| | - Philippe Courtet
- Fondation FondaMental, Créteil, France; IGF, Univ. Montpellier, CNRS, INSERM, Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hôpital Louis Mourier, Colombes, France, Université de Paris, Inserm UMR1266, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Bruno Etain
- Fondation FondaMental, Créteil, France; Université Paris Cité, INSERM UMR-S1144, AP-HPm GH Saint-Louis-Bariboisière-Fernand Widal, Pôle Neurosciences, Paris Optimisation Thérapeutique en Neuropsychopharmacologie OTeN, Paris, France; AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Emmanuel Haffen
- Fondation FondaMental, Créteil, France; Université de Franche-Comté, UR 481 LINC, Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, F-2500, France
| | - Antoine Lefrere A
- Fondation FondaMental, Créteil, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France, INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France
| | - Emilie Olié
- Fondation FondaMental, Créteil, France; IGF, Univ. Montpellier, CNRS, INSERM, Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
| | - Mircea Polosan
- Fondation FondaMental, Créteil, France; Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France
| | - Ludovic Samalin
- Fondation FondaMental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France
| | - Raymund Schwan
- Université de Lorraine, Centre Psychothérapique de Nancy, Inserm U1254, Nancy, France
| | - Paul Roux
- Fondation FondaMental, Créteil, France; Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie d'Adulte et d'Addictologie, Le Chesnay, France; Université Paris-Saclay & Université Versailles Saint-Quentin-En-Yvelines, INSERM UMR1018, Centre de recherche en Épidémiologie et Santé des Populations, Equipe DevPsy-DisAP, Paris, France
| | - Caroline Barau
- Plateforme de Ressources Biologiques, HU Henri Mondor, Créteil, France
| | - Jean Romain Richard
- INSERM U955 IMRB, Translational Neuropsychiatry laboratory, AP-HP, Hôpital Henri Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris Est Créteil University (UPEC), ECNP Immuno-NeuroPsychiatry Network
| | - Ryad Tamouza
- INSERM U955 IMRB, Translational Neuropsychiatry laboratory, AP-HP, Hôpital Henri Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris Est Créteil University (UPEC), ECNP Immuno-NeuroPsychiatry Network; Fondation FondaMental, Créteil, France
| | - Marion Leboyer
- INSERM U955 IMRB, Translational Neuropsychiatry laboratory, AP-HP, Hôpital Henri Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Paris Est Créteil University (UPEC), ECNP Immuno-NeuroPsychiatry Network; Fondation FondaMental, Créteil, France.
| | - Ana C Andreazza
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Mitochondrial Innovation Initiative, MITO2i, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Cai Y, Guo H, Han T, Wang H. Lactate: a prospective target for therapeutic intervention in psychiatric disease. Neural Regen Res 2024; 19:1473-1479. [PMID: 38051889 PMCID: PMC10883489 DOI: 10.4103/1673-5374.387969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 09/07/2023] [Indexed: 12/07/2023] Open
Abstract
ABSTRACT Although antipsychotics that act via monoaminergic neurotransmitter modulation have considerable therapeutic effect, they cannot completely relieve clinical symptoms in patients suffering from psychiatric disorders. This may be attributed to the limited range of neurotransmitters that are regulated by psychotropic drugs. Recent findings indicate the need for investigation of psychotropic medications that target less-studied neurotransmitters. Among these candidate neurotransmitters, lactate is developing from being a waste metabolite to a glial-neuronal signaling molecule in recent years. Previous studies have suggested that cerebral lactate levels change considerably in numerous psychiatric illnesses; animal experiments have also shown that the supply of exogenous lactate exerts an antidepressant effect. In this review, we have described how medications targeting newer neurotransmitters offer promise in psychiatric diseases; we have also summarized the advances in the use of lactate (and its corresponding signaling pathways) as a signaling molecule. In addition, we have described the alterations in brain lactate levels in depression, anxiety, bipolar disorder, and schizophrenia and have indicated the challenges that need to be overcome before brain lactate can be used as a therapeutic target in psychopharmacology.
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Affiliation(s)
- Yanhui Cai
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Haiyun Guo
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Tianle Han
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China
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3
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Campbell IH, Campbell H. The metabolic overdrive hypothesis: hyperglycolysis and glutaminolysis in bipolar mania. Mol Psychiatry 2024; 29:1521-1527. [PMID: 38273108 PMCID: PMC11189810 DOI: 10.1038/s41380-024-02431-w] [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: 08/14/2023] [Revised: 12/12/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
Evidence from diverse areas of research including chronobiology, metabolomics and magnetic resonance spectroscopy indicate that energy dysregulation is a central feature of bipolar disorder pathophysiology. In this paper, we propose that mania represents a condition of heightened cerebral energy metabolism facilitated by hyperglycolysis and glutaminolysis. When oxidative glucose metabolism becomes impaired in the brain, neurons can utilize glutamate as an alternative substrate to generate energy through oxidative phosphorylation. Glycolysis in astrocytes fuels the formation of denovo glutamate, which can be used as a mitochondrial fuel source in neurons via transamination to alpha-ketoglutarate and subsequent reductive carboxylation to replenish tricarboxylic acid cycle intermediates. Upregulation of glycolysis and glutaminolysis in this manner causes the brain to enter a state of heightened metabolism and excitatory activity which we propose to underlie the subjective experience of mania. Under normal conditions, this mechanism serves an adaptive function to transiently upregulate brain metabolism in response to acute energy demand. However, when recruited in the long term to counteract impaired oxidative metabolism it may become a pathological process. In this article, we develop these ideas in detail, present supporting evidence and propose this as a novel avenue of investigation to understand the biological basis for mania.
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Affiliation(s)
- Iain H Campbell
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, UK.
| | - Harry Campbell
- Usher Institute, Centre for Global Health Research, University of Edinburgh, Craigour House, 450 Old Dalkeith Rd, Edinburgh, EH16 4SS, UK
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4
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Hagihara H, Shoji H, Hattori S, Sala G, Takamiya Y, Tanaka M, Ihara M, Shibutani M, Hatada I, Hori K, Hoshino M, Nakao A, Mori Y, Okabe S, Matsushita M, Urbach A, Katayama Y, Matsumoto A, Nakayama KI, Katori S, Sato T, Iwasato T, Nakamura H, Goshima Y, Raveau M, Tatsukawa T, Yamakawa K, Takahashi N, Kasai H, Inazawa J, Nobuhisa I, Kagawa T, Taga T, Darwish M, Nishizono H, Takao K, Sapkota K, Nakazawa K, Takagi T, Fujisawa H, Sugimura Y, Yamanishi K, Rajagopal L, Hannah ND, Meltzer HY, Yamamoto T, Wakatsuki S, Araki T, Tabuchi K, Numakawa T, Kunugi H, Huang FL, Hayata-Takano A, Hashimoto H, Tamada K, Takumi T, Kasahara T, Kato T, Graef IA, Crabtree GR, Asaoka N, Hatakama H, Kaneko S, Kohno T, Hattori M, Hoshiba Y, Miyake R, Obi-Nagata K, Hayashi-Takagi A, Becker LJ, Yalcin I, Hagino Y, Kotajima-Murakami H, Moriya Y, Ikeda K, Kim H, Kaang BK, Otabi H, Yoshida Y, Toyoda A, Komiyama NH, Grant SGN, Ida-Eto M, Narita M, Matsumoto KI, Okuda-Ashitaka E, Ohmori I, Shimada T, Yamagata K, Ageta H, Tsuchida K, Inokuchi K, Sassa T, Kihara A, Fukasawa M, Usuda N, Katano T, Tanaka T, Yoshihara Y, Igarashi M, Hayashi T, Ishikawa K, Yamamoto S, Nishimura N, Nakada K, Hirotsune S, Egawa K, Higashisaka K, Tsutsumi Y, Nishihara S, Sugo N, Yagi T, Ueno N, Yamamoto T, Kubo Y, Ohashi R, Shiina N, Shimizu K, Higo-Yamamoto S, Oishi K, Mori H, Furuse T, Tamura M, Shirakawa H, Sato DX, Inoue YU, Inoue T, Komine Y, Yamamori T, Sakimura K, Miyakawa T. Large-scale animal model study uncovers altered brain pH and lactate levels as a transdiagnostic endophenotype of neuropsychiatric disorders involving cognitive impairment. eLife 2024; 12:RP89376. [PMID: 38529532 DOI: 10.7554/elife.89376] [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] [Indexed: 03/27/2024] Open
Abstract
Increased levels of lactate, an end-product of glycolysis, have been proposed as a potential surrogate marker for metabolic changes during neuronal excitation. These changes in lactate levels can result in decreased brain pH, which has been implicated in patients with various neuropsychiatric disorders. We previously demonstrated that such alterations are commonly observed in five mouse models of schizophrenia, bipolar disorder, and autism, suggesting a shared endophenotype among these disorders rather than mere artifacts due to medications or agonal state. However, there is still limited research on this phenomenon in animal models, leaving its generality across other disease animal models uncertain. Moreover, the association between changes in brain lactate levels and specific behavioral abnormalities remains unclear. To address these gaps, the International Brain pH Project Consortium investigated brain pH and lactate levels in 109 strains/conditions of 2294 animals with genetic and other experimental manipulations relevant to neuropsychiatric disorders. Systematic analysis revealed that decreased brain pH and increased lactate levels were common features observed in multiple models of depression, epilepsy, Alzheimer's disease, and some additional schizophrenia models. While certain autism models also exhibited decreased pH and increased lactate levels, others showed the opposite pattern, potentially reflecting subpopulations within the autism spectrum. Furthermore, utilizing large-scale behavioral test battery, a multivariate cross-validated prediction analysis demonstrated that poor working memory performance was predominantly associated with increased brain lactate levels. Importantly, this association was confirmed in an independent cohort of animal models. Collectively, these findings suggest that altered brain pH and lactate levels, which could be attributed to dysregulated excitation/inhibition balance, may serve as transdiagnostic endophenotypes of debilitating neuropsychiatric disorders characterized by cognitive impairment, irrespective of their beneficial or detrimental nature.
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Affiliation(s)
- Hideo Hagihara
- Division of Systems Medical Science, Center for Medical Science, Fujita Health University, Toyoake, Japan
| | - Hirotaka Shoji
- Division of Systems Medical Science, Center for Medical Science, Fujita Health University, Toyoake, Japan
| | - Satoko Hattori
- Division of Systems Medical Science, Center for Medical Science, Fujita Health University, Toyoake, Japan
| | - Giovanni Sala
- Division of Systems Medical Science, Center for Medical Science, Fujita Health University, Toyoake, Japan
| | - Yoshihiro Takamiya
- Division of Systems Medical Science, Center for Medical Science, Fujita Health University, Toyoake, Japan
| | - Mika Tanaka
- Division of Systems Medical Science, Center for Medical Science, Fujita Health University, Toyoake, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Mihiro Shibutani
- Laboratory of Genome Science, Biosignal Genome Resource Center, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Izuho Hatada
- Laboratory of Genome Science, Biosignal Genome Resource Center, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Kei Hori
- Department of Biochemistry and Cellular Biology, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Mikio Hoshino
- Department of Biochemistry and Cellular Biology, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Akito Nakao
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Yasuo Mori
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Shigeo Okabe
- Department of Cellular Neurobiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masayuki Matsushita
- Department of Molecular Cellular Physiology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Anja Urbach
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Yuta Katayama
- Department of Molecular and Cellular Biology, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan
| | - Akinobu Matsumoto
- Department of Molecular and Cellular Biology, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan
| | - Keiichi I Nakayama
- Department of Molecular and Cellular Biology, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan
| | - Shota Katori
- Laboratory of Mammalian Neural Circuits, National Institute of Genetics, Mishima, Japan
| | - Takuya Sato
- Laboratory of Mammalian Neural Circuits, National Institute of Genetics, Mishima, Japan
| | - Takuji Iwasato
- Laboratory of Mammalian Neural Circuits, National Institute of Genetics, Mishima, Japan
| | - Haruko Nakamura
- Department of Molecular Pharmacology and Neurobiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yoshio Goshima
- Department of Molecular Pharmacology and Neurobiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Matthieu Raveau
- Laboratory for Neurogenetics, RIKEN Center for Brain Science, Wako, Japan
| | - Tetsuya Tatsukawa
- Laboratory for Neurogenetics, RIKEN Center for Brain Science, Wako, Japan
| | - Kazuhiro Yamakawa
- Laboratory for Neurogenetics, RIKEN Center for Brain Science, Wako, Japan
- Department of Neurodevelopmental Disorder Genetics, Institute of Brain Sciences, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Noriko Takahashi
- Laboratory of Structural Physiology, Center for Disease Biology and Integrative Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Physiology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Haruo Kasai
- Laboratory of Structural Physiology, Center for Disease Biology and Integrative Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
- International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan
| | - Johji Inazawa
- Research Core, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ikuo Nobuhisa
- Department of Stem Cell Regulation, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsushi Kagawa
- Department of Stem Cell Regulation, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Taga
- Department of Stem Cell Regulation, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mohamed Darwish
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo, Egypt
- Department of Behavioral Physiology, Graduate School of Innovative Life Science, University of Toyama, Toyama, Japan
| | | | - Keizo Takao
- Department of Behavioral Physiology, Graduate School of Innovative Life Science, University of Toyama, Toyama, Japan
- Department of Behavioral Physiology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kiran Sapkota
- Department of Neuroscience, Southern Research, Birmingham, United States
| | - Kazutoshi Nakazawa
- Department of Neuroscience, Southern Research, Birmingham, United States
| | - Tsuyoshi Takagi
- Institute for Developmental Research, Aichi Developmental Disability Center, Kasugai, Japan
| | - Haruki Fujisawa
- Department of Endocrinology, Diabetes and Metabolism, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yoshihisa Sugimura
- Department of Endocrinology, Diabetes and Metabolism, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Kyosuke Yamanishi
- Department of Neuropsychiatry, Hyogo Medical University School of Medicine, Nishinomiya, Japan
| | - Lakshmi Rajagopal
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, United States
| | - Nanette Deneen Hannah
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, United States
| | - Herbert Y Meltzer
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, United States
| | - Tohru Yamamoto
- Department of Molecular Neurobiology, Faculty of Medicine, Kagawa University, Kita-gun, Japan
| | - Shuji Wakatsuki
- Department of Peripheral Nervous System Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Toshiyuki Araki
- Department of Peripheral Nervous System Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Katsuhiko Tabuchi
- Department of Molecular & Cellular Physiology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tadahiro Numakawa
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Freesia L Huang
- Program of Developmental Neurobiology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, United States
| | - Atsuko Hayata-Takano
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Japan
- Department of Pharmacology, Graduate School of Dentistry, Osaka University, Suita, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Hitoshi Hashimoto
- Laboratory of Molecular Neuropharmacology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
- Division of Bioscience, Institute for Datability Science, Osaka University, Suita, Japan
- Transdimensional Life Imaging Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan
- Department of Molecular Pharmaceutical Science, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Kota Tamada
- RIKEN Brain Science Institute, Wako, Japan
- Department of Physiology and Cell Biology, Kobe University School of Medicine, Kobe, Japan
| | - Toru Takumi
- RIKEN Brain Science Institute, Wako, Japan
- Department of Physiology and Cell Biology, Kobe University School of Medicine, Kobe, Japan
| | - Takaoki Kasahara
- Laboratory for Molecular Dynamics of Mental Disorders, RIKEN Center for Brain Science, Wako, Japan
- Institute of Biology and Environmental Sciences, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Tadafumi Kato
- Laboratory for Molecular Dynamics of Mental Disorders, RIKEN Center for Brain Science, Wako, Japan
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Isabella A Graef
- Department of Pathology, Stanford University School of Medicine, Stanford, United States
| | - Gerald R Crabtree
- Department of Pathology, Stanford University School of Medicine, Stanford, United States
| | - Nozomi Asaoka
- Department of Pharmacology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hikari Hatakama
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| | - Shuji Kaneko
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| | - Takao Kohno
- Department of Biomedical Science, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Mitsuharu Hattori
- Department of Biomedical Science, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Yoshio Hoshiba
- Laboratory of Medical Neuroscience, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
| | - Ryuhei Miyake
- Laboratory for Multi-scale Biological Psychiatry, RIKEN Center for Brain Science, Wako, Japan
| | - Kisho Obi-Nagata
- Laboratory for Multi-scale Biological Psychiatry, RIKEN Center for Brain Science, Wako, Japan
| | - Akiko Hayashi-Takagi
- Laboratory of Medical Neuroscience, Institute for Molecular and Cellular Regulation, Gunma University, Maebashi, Japan
- Laboratory for Multi-scale Biological Psychiatry, RIKEN Center for Brain Science, Wako, Japan
| | - Léa J Becker
- Institut des Neurosciences Cellulaires et Intégratives, Centre National de la Recherche Scientifique, Université de Strasbourg, Strasbourg, France
| | - Ipek Yalcin
- Institut des Neurosciences Cellulaires et Intégratives, Centre National de la Recherche Scientifique, Université de Strasbourg, Strasbourg, France
| | - Yoko Hagino
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | | | - Yuki Moriya
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Hyopil Kim
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, United States
| | - Bong-Kiun Kaang
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
- Center for Cognition and Sociality, Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | - Hikari Otabi
- College of Agriculture, Ibaraki University, Ami, Japan
- United Graduate School of Agricultural Science, Tokyo University of Agriculture and Technology, Fuchu, Japan
| | - Yuta Yoshida
- College of Agriculture, Ibaraki University, Ami, Japan
| | - Atsushi Toyoda
- College of Agriculture, Ibaraki University, Ami, Japan
- United Graduate School of Agricultural Science, Tokyo University of Agriculture and Technology, Fuchu, Japan
- Ibaraki University Cooperation between Agriculture and Medical Science (IUCAM), Ibaraki, Japan
| | - Noboru H Komiyama
- Genes to Cognition Program, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Simons Initiative for the Developing Brain, Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Seth G N Grant
- Genes to Cognition Program, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Simons Initiative for the Developing Brain, Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Michiru Ida-Eto
- Department of Developmental and Regenerative Medicine, Mie University, Graduate School of Medicine, Tsu, Japan
| | - Masaaki Narita
- Department of Developmental and Regenerative Medicine, Mie University, Graduate School of Medicine, Tsu, Japan
| | - Ken-Ichi Matsumoto
- Department of Biosignaling and Radioisotope Experiment, Interdisciplinary Center for Science Research, Organization for Research and Academic Information, Shimane University, Izumo, Japan
| | - Emiko Okuda-Ashitaka
- Department of Biomedical Engineering, Osaka Institute of Technology, Osaka, Japan
| | - Iori Ohmori
- Department of Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tadayuki Shimada
- Child Brain Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kanato Yamagata
- Child Brain Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Hiroshi Ageta
- Division for Therapies Against Intractable Diseases, Center for Medical Science, Fujita Health University, Toyoake, Japan
| | - Kunihiro Tsuchida
- Division for Therapies Against Intractable Diseases, Center for Medical Science, Fujita Health University, Toyoake, Japan
| | - Kaoru Inokuchi
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
- Department of Biochemistry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
- Core Research for Evolutionary Science and Technology (CREST), Japan Science and Technology Agency (JST), University of Toyama, Toyama, Japan
| | - Takayuki Sassa
- Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Akio Kihara
- Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Motoaki Fukasawa
- Department of Anatomy II, Fujita Health University School of Medicine, Toyoake, Japan
| | - Nobuteru Usuda
- Department of Anatomy II, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tayo Katano
- Department of Medical Chemistry, Kansai Medical University, Hirakata, Japan
| | - Teruyuki Tanaka
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiro Yoshihara
- Laboratory for Systems Molecular Ethology, RIKEN Center for Brain Science, Wako, Japan
| | - Michihiro Igarashi
- Department of Neurochemistry and Molecular Cell Biology, School of Medicine, and Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Transdiciplinary Research Program, Niigata University, Niigata, Japan
| | - Takashi Hayashi
- Biomedical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Kaori Ishikawa
- Institute of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Japan
- Graduate School of Science and Technology, University of Tsukuba, Tsukuba, Japan
| | - Satoshi Yamamoto
- Integrated Technology Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company, Ltd, Fujisawa, Japan
| | - Naoya Nishimura
- Integrated Technology Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company, Ltd, Fujisawa, Japan
| | - Kazuto Nakada
- Institute of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Japan
- Graduate School of Science and Technology, University of Tsukuba, Tsukuba, Japan
| | - Shinji Hirotsune
- Department of Genetic Disease Research, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kiyoshi Egawa
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kazuma Higashisaka
- Laboratory of Toxicology and Safety Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Japan
| | - Yasuo Tsutsumi
- Laboratory of Toxicology and Safety Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Japan
| | - Shoko Nishihara
- Glycan & Life Systems Integration Center (GaLSIC), Soka University, Tokyo, Japan
| | - Noriyuki Sugo
- Graduate School of Frontier Biosciences, Osaka University, Suita, Japan
| | - Takeshi Yagi
- Graduate School of Frontier Biosciences, Osaka University, Suita, Japan
| | - Naoto Ueno
- Laboratory of Morphogenesis, National Institute for Basic Biology, Okazaki, Japan
| | - Tomomi Yamamoto
- Division of Biophysics and Neurobiology, National Institute for Physiological Sciences, Okazaki, Japan
| | - Yoshihiro Kubo
- Division of Biophysics and Neurobiology, National Institute for Physiological Sciences, Okazaki, Japan
| | - Rie Ohashi
- Laboratory of Neuronal Cell Biology, National Institute for Basic Biology, Okazaki, Japan
- Department of Basic Biology, SOKENDAI (Graduate University for Advanced Studies), Okazaki, Japan
- Exploratory Research Center on Life and Living Systems (ExCELLS), National Institutes of Natural Sciences, Okazaki, Japan
| | - Nobuyuki Shiina
- Laboratory of Neuronal Cell Biology, National Institute for Basic Biology, Okazaki, Japan
- Department of Basic Biology, SOKENDAI (Graduate University for Advanced Studies), Okazaki, Japan
- Exploratory Research Center on Life and Living Systems (ExCELLS), National Institutes of Natural Sciences, Okazaki, Japan
| | - Kimiko Shimizu
- Department of Biological Sciences, School of Science, The University of Tokyo, Tokyo, Japan
| | - Sayaka Higo-Yamamoto
- Healthy Food Science Research Group, Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Katsutaka Oishi
- Healthy Food Science Research Group, Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
- Department of Applied Biological Science, Graduate School of Science and Technology, Tokyo University of Science, Noda, Japan
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Japan
- School of Integrative and Global Majors (SIGMA), University of Tsukuba, Tsukuba, Japan
| | - Hisashi Mori
- Department of Molecular Neuroscience, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Tamio Furuse
- Mouse Phenotype Analysis Division, Japan Mouse Clinic, RIKEN BioResource Research Center (BRC), Tsukuba, Japan
| | - Masaru Tamura
- Mouse Phenotype Analysis Division, Japan Mouse Clinic, RIKEN BioResource Research Center (BRC), Tsukuba, Japan
| | - Hisashi Shirakawa
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
| | - Daiki X Sato
- Division of Systems Medical Science, Center for Medical Science, Fujita Health University, Toyoake, Japan
- Graduate School of Life Sciences, Tohoku University, Sendai, Japan
| | - Yukiko U Inoue
- Department of Biochemistry and Cellular Biology, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Takayoshi Inoue
- Department of Biochemistry and Cellular Biology, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yuriko Komine
- Young Researcher Support Group, Research Enhancement Strategy Office, National Institute for Basic Biology, National Institute of Natural Sciences, Okazaki, Japan
- Division of Brain Biology, National Institute for Basic Biology, Okazaki, Japan
| | - Tetsuo Yamamori
- Division of Brain Biology, National Institute for Basic Biology, Okazaki, Japan
- Laboratory for Molecular Analysis of Higher Brain Function, RIKEN Center for Brain Science, Wako, Japan
| | - Kenji Sakimura
- Department of Cellular Neurobiology, Brain Research Institute, Niigata University, Niigata, Japan
- Department of Animal Model Development, Brain Research Institute, Niigata University, Niigata, Japan
| | - Tsuyoshi Miyakawa
- Division of Systems Medical Science, Center for Medical Science, Fujita Health University, Toyoake, Japan
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5
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O’Donnell CM, Barrett DW, O’Connor P, Gonzalez-Lima F. Prefrontal photobiomodulation produces beneficial mitochondrial and oxygenation effects in older adults with bipolar disorder. Front Neurosci 2023; 17:1268955. [PMID: 38027522 PMCID: PMC10644301 DOI: 10.3389/fnins.2023.1268955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/02/2023] [Indexed: 12/01/2023] Open
Abstract
There is growing evidence of mitochondrial dysfunction and prefrontal cortex (PFC) hypometabolism in bipolar disorder (BD). Older adults with BD exhibit greater decline in PFC-related neurocognitive functions than is expected for age-matched controls, and clinical interventions intended for mood stabilization are not targeted to prevent or ameliorate mitochondrial deficits and neurocognitive decline in this population. Transcranial infrared laser stimulation (TILS) is a non-invasive form of photobiomodulation, in which photons delivered to the PFC photo-oxidize the mitochondrial respiratory enzyme, cytochrome-c-oxidase (CCO), a major intracellular photon acceptor in photobiomodulation. TILS at 1064-nm can significantly upregulate oxidized CCO concentrations to promote differential levels of oxygenated vs. deoxygenated hemoglobin (HbD), an index of cerebral oxygenation. The objective of this controlled study was to use non-invasive broadband near-infrared spectroscopy to assess if TILS to bilateral PFC (Brodmann area 10) produces beneficial effects on mitochondrial oxidative energy metabolism (oxidized CCO) and cerebral oxygenation (HbD) in older (≥50 years old) euthymic adults with BD (N = 15). As compared to sham, TILS to the PFC in adults with BD increased oxidized CCO both during and after TILS, and increased HbD concentrations after TILS. By significantly increasing oxidized CCO and HbD concentrations above sham levels, TILS has the potential ability to stabilize mitochondrial oxidative energy production and prevent oxidative damage in the PFC of adults with BD. In conclusion, TILS was both safe and effective in enhancing metabolic function and subsequent hemodynamic responses in the PFC, which might help alleviate the accelerated neurocognitive decline and dysfunctional mitochondria present in BD.
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Affiliation(s)
- Courtney M. O’Donnell
- Department of Psychology, The University of Texas at Austin, Austin, TX, United States
| | - Douglas W. Barrett
- Department of Psychology, The University of Texas at Austin, Austin, TX, United States
| | - Patrick O’Connor
- Department of Psychology, The University of Texas at Austin, Austin, TX, United States
| | - F. Gonzalez-Lima
- Department of Psychology, The University of Texas at Austin, Austin, TX, United States
- Institute for Neuroscience, The University of Texas at Austin, Austin, TX, United States
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6
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Wang M, Barker PB, Cascella NG, Coughlin JM, Nestadt G, Nucifora FC, Sedlak TW, Kelly A, Younes L, Geman D, Palaniyappan L, Sawa A, Yang K. Longitudinal changes in brain metabolites in healthy controls and patients with first episode psychosis: a 7-Tesla MRS study. Mol Psychiatry 2023; 28:2018-2029. [PMID: 36732587 PMCID: PMC10394114 DOI: 10.1038/s41380-023-01969-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 02/04/2023]
Abstract
Seven Tesla magnetic resonance spectroscopy (7T MRS) offers a precise measurement of metabolic levels in the human brain via a non-invasive approach. Studying longitudinal changes in brain metabolites could help evaluate the characteristics of disease over time. This approach may also shed light on how the age of study participants and duration of illness may influence these metabolites. This study used 7T MRS to investigate longitudinal patterns of brain metabolites in young adulthood in both healthy controls and patients. A four-year longitudinal cohort with 38 patients with first episode psychosis (onset within 2 years) and 48 healthy controls was used to examine 10 brain metabolites in 5 brain regions associated with the pathophysiology of psychosis in a comprehensive manner. Both patients and controls were found to have significant longitudinal reductions in glutamate in the anterior cingulate cortex (ACC). Only patients were found to have a significant decrease over time in γ-aminobutyric acid, N-acetyl aspartate, myo-inositol, total choline, and total creatine in the ACC. Together we highlight the ACC with dynamic changes in several metabolites in early-stage psychosis, in contrast to the other 4 brain regions that also are known to play roles in psychosis. Meanwhile, glutathione was uniquely found to have a near zero annual percentage change in both patients and controls in all 5 brain regions during a four-year follow-up in young adulthood. Given that a reduction of the glutathione in the ACC has been reported as a feature of treatment-refractory psychosis, this observation further supports the potential of glutathione as a biomarker for this subset of patients with psychosis.
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Affiliation(s)
- Min Wang
- Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Peter B Barker
- Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.
| | - Nicola G Cascella
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer M Coughlin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Frederick C Nucifora
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas W Sedlak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexandra Kelly
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laurent Younes
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA
| | - Donald Geman
- Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA
| | - Lena Palaniyappan
- Robarts Research Institution, University of Western Ontario, London, ON, Canada
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Akira Sawa
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Kun Yang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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7
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Chabert J, Allauze E, Pereira B, Chassain C, De Chazeron I, Rotgé JY, Fossati P, Llorca PM, Samalin L. Glutamatergic and N-Acetylaspartate Metabolites in Bipolar Disorder: A Systematic Review and Meta-Analysis of Proton Magnetic Resonance Spectroscopy Studies. Int J Mol Sci 2022; 23:ijms23168974. [PMID: 36012234 PMCID: PMC9409038 DOI: 10.3390/ijms23168974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/26/2022] Open
Abstract
The exact neurobiological mechanisms of bipolar disorder (BD) remain unknown. However, some neurometabolites could be implicated, including Glutamate (Glu), Glutamine (Gln), Glx, and N-acetylaspartate (NAA). Proton Magnetic Resonance Spectroscopy (1H-MRS) allows one to quantify these metabolites in the human brain. Thus, we conducted a systematic review and meta-analysis of the literature to compare their levels between BD patients and healthy controls (HC). The main inclusion criteria for inclusion were 1H-MRS studies comparing levels of Glu, Gln, Glx, and NAA in the prefrontal cortex (PFC), anterior cingulate cortex (ACC), and hippocampi between patients with BD in clinical remission or a major depressive episode and HC. Thirty-three studies were included. NAA levels were significantly lower in the left white matter PFC (wmPFC) of depressive and remitted BD patients compared to controls and were also significantly higher in the left dorsolateral PFC (dlPFC) of depressive BD patients compared to HC. Gln levels were significantly higher in the ACC of remitted BD patients compared to in HC. The decreased levels of NAA of BD patients may be related to the alterations in neuroplasticity and synaptic plasticity found in BD patients and may explain the deep white matter hyperintensities frequently observed via magnetic resonance imagery.
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Affiliation(s)
- Jonathan Chabert
- Service de Psychiatrie Adulte, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
- Correspondence: (J.C.); (L.S.); Tel.: +33-4-73-752-124 (J.C. & L.S.)
| | - Etienne Allauze
- Service de Psychiatrie Adulte, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit (DRCI), CHU Clermont-Ferrand, Université Clermont Auvergne, 7 Place Henri Dunant, 63000 Clermont-Ferrand, France
| | - Carine Chassain
- Imaging Department, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, Clermont Auvergne INP, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
| | - Ingrid De Chazeron
- Service de Psychiatrie Adulte, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
| | - Jean-Yves Rotgé
- Service de Psychiatrie Adulte, Pitié-Salpêtrière Hospital, CNRS UMR 7593, 47-83 Bd de l’Hôpital, 75651 Paris, France
| | - Philippe Fossati
- Service de Psychiatrie Adulte, Pitié-Salpêtrière Hospital, CNRS UMR 7593, 47-83 Bd de l’Hôpital, 75651 Paris, France
| | - Pierre-Michel Llorca
- Service de Psychiatrie Adulte, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
| | - Ludovic Samalin
- Service de Psychiatrie Adulte, CHU Clermont-Ferrand, CNRS, Institut Pascal, Université Clermont Auvergne, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
- Correspondence: (J.C.); (L.S.); Tel.: +33-4-73-752-124 (J.C. & L.S.)
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8
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Anterior cingulate cortex neurometabolites in bipolar disorder are influenced by mood state and medication: A meta-analysis of 1H-MRS studies. Eur Neuropsychopharmacol 2021; 47:62-73. [PMID: 33581932 DOI: 10.1016/j.euroneuro.2021.01.096] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 12/13/2022]
Abstract
The anterior cingulate cortex (ACC), a brain region that mediates affect and cognition by connecting the frontal cortex to limbic structures, has been consistently implicated in the neurobiology of Bipolar Disorder (BD). Proton magnetic resonance spectroscopy (1H-MRS) studies have extensively compared in vivo neurometabolite levels of BD patients and healthy controls (HC) in the ACC. However, these studies have not been analyzed in a systematic review or meta-analysis and nor has the influence of mood state and medication on neurometabolites been examined in this cortical region. A systematic review and a meta-analysis of 1H-MRS studies comparing ACC neurometabolite profiles of adult BD patients and HC subjects was conducted, retrieving 27 articles published between 2000 and 2018. Overall increased ACC levels of Glx [glutamine (Gln) + glutamate)/Creatine], Gln, choline (Cho) and Cho/Creatine were found in BD compared to HC. Bipolar depression was associated with higher Cho levels, while euthymia correlated with higher glutamine (Gln) and Cho. Mood stabilizers appeared to affect ACC Glu and Gln metabolites. Increased ACC Cho observed in euthymia, depression and in medication-free groups could be considered a trait marker in BD and attributed to increased cell membrane phospholipid turnover. Overall increased ACC Glx was associated with elevated Gln levels, particularly influenced by euthymia, but no abnormality in Glu was detected. Further 1H-MRS studies, on other voxels, should assess more homogeneous (mood state-specific), larger BD samples and account for medication status using more sensitive 1H-MRS techniques.
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9
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Fan Z, Yang J, Zeng C, Xi C, Wu G, Guo S, Xue Z, Liu Z, Tao H. Bipolar Mood State Reflected in Functional Connectivity of the Hate Circuit: A Resting-State Functional Magnetic Resonance Imaging Study. Front Psychiatry 2020; 11:556126. [PMID: 33192670 PMCID: PMC7652934 DOI: 10.3389/fpsyt.2020.556126] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/28/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Previous studies suggested bipolar disorder caused an aberrant alteration in the insular, putamen, and left superior frontal gyrus, which are the main components of the hate circuit. However, the relationship between the hate circuit and the pathophysiologic substrate underlying different phases of bipolar disorder remain unclear. In this study, we aimed to identify group differences of resting-state functional connectivity within the hate circuit in healthy controls (HCs) and bipolar patients in different mood states. METHODS Resting-state functional magnetic resonance imaging of the brain were acquired from 54 HCs and 81 patients with bipolar disorder including 20 with bipolar mania (BM), 35 with bipolar depression (BD), and 26 with bipolar euthymia (BE). We selected bilateral insula (L.INS and R.INS), bilateral putamen (L.PUT and R.PUT), and left superior frontal gyrus (L.SFGd) as seed regions, and conducted the seed-based functional connectivity analysis to identify group differences of connectivity strength within the hate circuit. Spearman correlations were performed to evaluate the relationship between the hate circuit and manic/depressive symptoms. RESULTS Significant group differences of connectivity strength within the hate circuit were found in links of the R.INS-L.SFGd, R.PUT-L.SFGd, and L.INS- R.PUT after false discovery rate was corrected. The BM group showed an opposite hate circuit pattern to BD, BE, and HCs. The BD group showed decreased hate circuit connectivity in the L.INS-R.PUT compared with the BE group. No significant difference was detected among BD, BE, and HCs. Furthermore, functional connectivity of the R.INS-L.SFGd and R.PUT-L.SFGd were positively correlated with manic symptoms, while the L.INS- R.PUT was negatively correlated with depressive symptoms. CONCLUSIONS Our preliminary findings suggest that altered functional connectivity of the hate circuit in different mood phases may be related to state markers and underpin the neuropathological basis of bipolar disorder.
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Affiliation(s)
- Zebin Fan
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Jie Yang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Can Zeng
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Chang Xi
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Guowei Wu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Shuixia Guo
- Mathematics and Computer Science College, Hunan Normal University, Changsha, China
| | - Zhimin Xue
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Zhening Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
| | - Haojuan Tao
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
- National Technology Institute on Mental Disorders, Changsha, China
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10
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Achalia R, Raju VB, Jacob A, Nahar A, Achalia G, Nagendra B, Kaginalkar V, Choudhary S, Venkatasubramanian G, Rao NP. Comparison of first-episode and multiple-episode bipolar disorder: A surface-based morphometry study. Psychiatry Res Neuroimaging 2020; 302:111110. [PMID: 32505904 DOI: 10.1016/j.pscychresns.2020.111110] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 01/17/2020] [Accepted: 02/14/2020] [Indexed: 01/09/2023]
Abstract
It is still unclear whether the structural abnormalities in Bipolar disorder (BD) are static or progressive. We aimed to compare differences in cortical thickness, surface area, and volume between patients with BD and healthy volunteers (HV) and to examine whether there are differences between patients who have had a single manic episode and those with multiple episodes. We recruited 30 patients with Type I BD and 30 age and sex matched HV. All participants underwent structural magnetic resonance imaging. Cortical volume, thickness, and surface area were measured using the QDEC tool from the Freesurfer software with age and intracranial volume as covariates. Study groups were comparable across age, sex distribution, and intracranial volume. Patients had significantly lower surface area in bilateral cuneus, right postcentral gyrus, and rostral middle frontal gyri; and lower cortical volume in the left middle temporal gyrus, right postcentral gyrus, and right cuneus. BD patients with multiple episodes had lower cortical measures while those with single episode had cortical measures comparable to HV. Findings indicate that the pathophysiological processes in BD are possibly progressive in nature. Our findings underscore the potential importance of early diagnosis and intervention in preventing deterioration and improving functional recovery.
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Affiliation(s)
| | - Vikas B Raju
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arpitha Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Abhinav Nahar
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Bhargavi Nagendra
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | | | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, India.
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11
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Prescot AP, Prisciandaro JJ, Miller SR, Ingenito G, Kondo DG, Renshaw PF. Two-Dimensional Proton Magnetic Resonance Spectroscopy versus J-Editing for GABA Quantification in Human Brain: Insights from a GABA-Aminotransferase Inhibitor Study. Sci Rep 2018; 8:13200. [PMID: 30181656 PMCID: PMC6123452 DOI: 10.1038/s41598-018-31591-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 08/22/2018] [Indexed: 11/25/2022] Open
Abstract
Metabolite-specific, scalar spin-spin coupling constant (J)-editing 1H MRS methods have become gold-standard for measuring brain γ-amino butyric acid (GABA) levels in human brain. Localized, two-dimensional (2D) 1H MRS technology offers an attractive alternative as it significantly alleviates the problem of severe metabolite signal overlap associated with standard 1D MRS and retains spectroscopic information for all MRS-detectable species. However, for metabolites found at low concentration, a direct, in vivo, comprehensive methods comparison is challenging and has not been reported to date. Here, we document an assessment of comparability between 2D 1H MRS and J-editing methods for measuring GABA in human brain. This clinical study is unique in that it involved chronic administration a GABA-amino transferase (AT) inhibitor (CPP-115), which induces substantial increases in brain GABA concentration, with normalization after washout. We report a qualitative and quantitative comparison between these two measurement techniques. In general, GABA concentration changes detected using J-editing were closely mirrored by the 2D 1H MRS time courses. The data presented are particularly encouraging considering recent 2D 1H MRS methodological advances are continuing to improve temporal resolution and spatial coverage for achieving whole-brain, multi-metabolite mapping.
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Affiliation(s)
- Andrew P Prescot
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA.
| | - James J Prisciandaro
- Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of South Carolina, Charleston, SC, USA
| | | | | | - Douglas G Kondo
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA.,Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Perry F Renshaw
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA.,Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC), Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
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12
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Kuang H, Duong A, Jeong H, Zachos K, Andreazza AC. Lactate in bipolar disorder: A systematic review and meta-analysis. Psychiatry Clin Neurosci 2018; 72:546-555. [PMID: 29726068 DOI: 10.1111/pcn.12671] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2018] [Indexed: 11/26/2022]
Abstract
Bipolar disorder (BD) is a debilitating mood disorder with no specific biological marker. No novel treatment has been developed specifically for BD in the last several decades. Although the pathophysiology of BD remains unclear, there is strong evidence in the literature supporting the role of mitochondrial dysfunction in BD. In this systematic review, we identified and investigated 12 studies that measure lactate, which is a direct marker for mitochondrial dysfunction, in BD patients and healthy controls. Six studies measured lactate levels in the brain through proton echo-planar spectroscopy or magnetic resonance spectroscopy and five of these studies reported significantly elevated lactate levels in patients with BD. Two studies reporting cerebrospinal fluid lactate levels also found significantly elevated lactate in BD compared to healthy controls. Two other studies that reported peripheral lactate levels did not demonstrate significant findings. The meta-analysis, using standardized means and a random-effect model for five studies that measured brain lactate levels, corroborated the findings of the systematic review. Although the meta-analysis had a nearly significant overall effect (Z = 1.97, P = 0.05), high statistical heterogeneity (I2 = 86%) and possible publication bias suggest that the results should be interpreted with caution. To validate lactate abnormalities in BD, further studies should be carried out, including larger sample sizes, not excluding female patients, and using standardized methodologies. Peripheral lactate levels and other bioenergetic markers should be thoroughly studied to better understand the role of mitochondrial dysfunction in BD and to help develop more objective diagnostic tools.
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Affiliation(s)
| | | | - Hyunjin Jeong
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Kassandra Zachos
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Ana C Andreazza
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
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13
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Dogan AE, Yuksel C, Du F, Chouinard VA, Öngür D. Brain lactate and pH in schizophrenia and bipolar disorder: a systematic review of findings from magnetic resonance studies. Neuropsychopharmacology 2018; 43:1681-1690. [PMID: 29581538 PMCID: PMC6006165 DOI: 10.1038/s41386-018-0041-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 11/09/2022]
Abstract
Converging evidence from molecular to neuroimaging studies suggests brain energy metabolism abnormalities in both schizophrenia and bipolar disorder. One emerging hypothesis is: decreased oxidative phosphorylation leading to accumulation of lactic acid from glycolysis and subsequent acidification of tissue. In this regard, integrating lactate and pH data from magnetic resonance spectroscopy (MRS) studies in both diseases may help us understand underlying neurobiological mechanisms. In order to achieve this goal, we performed a systematic search of case-control studies examining brain lactate or pH among schizophrenia and/or bipolar patients by using MRS. Medline/Pubmed and EBSCO databases were searched separately for both diseases and outcomes. Our search yielded 33 studies in total composed of 7 lactate and 26 pH studies. In bipolar disorder, 5 out of 6 studies have found elevated lactate levels especially in the cingulate cortex and 4 out of 13 studies reported reduced pH in the frontal lobe. In contrast, in schizophrenia a single study has examined lactate and reported elevation, while only 2 out of 13 studies examining pH have reported reduction in this measure. There were no consistent patterns for the relationship between lactate or pH levels and medication use, disease type, mood state, and other clinical variables. We highlight the need for future studies combining 1H-MRS and 31P-MRS approaches, using longitudinal designs to examine lactate and pH in disease progression across both schizophrenia and bipolar disorders.
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Affiliation(s)
| | - Cagri Yuksel
- McLean Hospital, 115 Mill Street, Belmont, MA, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA, USA
| | - Fei Du
- McLean Hospital, 115 Mill Street, Belmont, MA, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA, USA
| | - Virginie-Anne Chouinard
- McLean Hospital, 115 Mill Street, Belmont, MA, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA, USA
| | - Dost Öngür
- McLean Hospital, 115 Mill Street, Belmont, MA, USA.
- Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
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14
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Morris G, Walder K, McGee SL, Dean OM, Tye SJ, Maes M, Berk M. A model of the mitochondrial basis of bipolar disorder. Neurosci Biobehav Rev 2017; 74:1-20. [DOI: 10.1016/j.neubiorev.2017.01.014] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 01/08/2017] [Accepted: 01/10/2017] [Indexed: 12/11/2022]
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15
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Increased Brain Lactate During Depressive Episodes and Reversal Effects by Lithium Monotherapy in Drug-Naive Bipolar Disorder: A 3-T 1H-MRS Study. J Clin Psychopharmacol 2017; 37:40-45. [PMID: 27902528 PMCID: PMC5182117 DOI: 10.1097/jcp.0000000000000616] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Mitochondrial dysfunction and energy metabolism impairment are key components in the pathophysiology of bipolar disorder (BD) and may involve a shift from aerobic to anaerobic metabolism. Measurement of brain lactate in vivo using proton magnetic resonance spectroscopy (H-MRS) represents an important tool to evaluate mitochondrial and metabolic dysfunction during mood episodes, as well as to monitor treatment response. To date, very few studies have quantified brain lactate in BD. In addition, no study has longitudinally evaluated lactate using H-MRS during depressive episodes or its association with mood stabilizer therapy. This study aimed to evaluate cingulate cortex (CC) lactate using 3-T H-MRS during acute depressive episodes in BD and the possible effects induced by lithium monotherapy. METHODS Twenty medication-free outpatients with short length of BD (80% drug-naive) in a current major depressive episode were matched with control subjects. Patients were treated for 6 weeks with lithium monotherapy at therapeutic doses in an open-label trial (blood level, 0.48 ± 0.19 mmol/L). Cingulate cortex lactate was measured before (week 0) and after lithium therapy (week 6) using H-MRS. Antidepressant efficacy was assessed with the 21-item Hamilton Depression Rating Scale as the primary outcome. RESULTS Subjects with BD depression showed a significantly higher CC lactate in comparison to control subjects. Furthermore, a significant decrease in CC lactate was observed after 6 weeks of lithium treatment compared with baseline (P = 0.002). CC Lactate levels was associated with family history of mood disorders and plasma lithium levels. CONCLUSIONS This is the first report of increased CC lactate in patients with bipolar depression and lower levels after lithium monotherapy for 6 weeks. These findings indicate a shift to anaerobic metabolism and a role for lactate as a state marker during mood episodes. Energy and redox dysfunction may represent key targets for lithium's therapeutic actions.
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16
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Brady RO, Tandon N, Masters GA, Margolis A, Cohen BM, Keshavan M, Öngür D. Differential brain network activity across mood states in bipolar disorder. J Affect Disord 2017; 207:367-376. [PMID: 27744225 PMCID: PMC5107137 DOI: 10.1016/j.jad.2016.09.041] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/21/2016] [Accepted: 09/27/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND This study aimed to identify how the activity of large-scale brain networks differs between mood states in bipolar disorder. The authors measured spontaneous brain activity in subjects with bipolar disorder in mania and euthymia and compared these states to a healthy comparison population. METHODS 23 subjects with bipolar disorder type I in a manic episode, 24 euthymic bipolar I subjects, and 23 matched healthy comparison (HC) subjects underwent resting state fMRI scans. Using an existing parcellation of the whole brain, we measured functional connectivity between brain regions and identified significant differences between groups. RESULTS In unbiased whole-brain analyses, functional connectivity between parietal, occipital, and frontal nodes within the dorsal attention network (DAN) were significantly greater in mania than euthymia or HC subjects. In the default mode network (DMN), connectivity between dorsal frontal nodes and the rest of the DMN differentiated both mood state and diagnosis. LIMITATIONS The bipolar groups were separate cohorts rather than subjects imaged longitudinally across mood states. CONCLUSIONS Bipolar mood states are associated with highly significant alterations in connectivity in two large-scale brain networks. These same networks also differentiate bipolar mania and euthymia from a HC population. State related changes in DAN and DMN connectivity suggest a circuit based pathology underlying cognitive dysfunction as well as activity/reactivity in bipolar mania. Altered activities in neural networks may be biomarkers of bipolar disorder diagnosis and mood state that are accessible to neuromodulation and are promising novel targets for scientific investigation and possible clinical intervention.
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Affiliation(s)
- Roscoe O. Brady
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts,Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts,Corresponding author. 75 Fenwood Road, Room 616, Boston, MA 02115. Tel.: 617 754 1261; Fax: 617 754 1250.
| | - Neeraj Tandon
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Grace A. Masters
- Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Allison Margolis
- Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Bruce M. Cohen
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts,Program for Neuropsychiatric Research, McLean Hospital, Belmont, Massachusetts
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Dost Öngür
- Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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17
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Aydin B, Yurt A, Gökmen N, Renshaw P, Olson D, Yildiz A. Trait-related alterations of N-acetylaspartate in euthymic bipolar patients: A longitudinal proton magnetic resonance spectroscopy study. J Affect Disord 2016; 206:315-320. [PMID: 27662572 PMCID: PMC5077644 DOI: 10.1016/j.jad.2016.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/27/2016] [Accepted: 09/08/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Neurochemical changes are responsible for bipolar disorder (BD) pathophysiology. Despite current progress in BD research, mood- and trait-related alterations in BD continue to elicit further investigation. METHODS In this study, we report a longitudinal proton magnetic resonance spectroscopy study evaluating dorsomedial prefrontal cortex (DMPFC) metabolites N-acetylaspartate (NAA), creatine plus phosphocreatine (total creatine [tCr]), phosphorylcholine plus glycerophosphocholine, myo-inositol, and glutamate plus glutamine levels of manic and euthymic adult BD type I patients (n=48) treated with standard antimanic medicines, compared to matching healthy controls (n=44). RESULTS DMPFC NAA values and NAA/tCr ratio were significantly lower in euthymic BD patients when compared with healthy controls with similar levels of other metabolites in all groups, indicating a trait-related NAA abnormality in euthymic BD patients. LIMITATIONS of our study include a relatively low (1.5T) magnetic resonance field strength and variable drugs administered to achieve euthymia despite the best efforts to standardize the open fashion treatment. CONCLUSIONS Our study contributes to the integrating models of trait-related metabolite alterations observed in euthymia since NAA is considered as a marker of neuronal viability and mitochondrial energy metabolism. In light of supporting and conflicting results reported previously, future studies with longitudinal designs and larger patient groups are warranted to better define both state- and trait-related cerebral metabolic alterations associated with BD pathophysiology.
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Affiliation(s)
- Burç Aydin
- Department of Medical Pharmacology, School of Medicine, Dokuz Eylul University, Balcova 35340, Izmir, Turkey.
| | - Ayşegül Yurt
- Department of Medical Physics, Health Sciences Institute, Dokuz Eylul University, İzmir, Turkey
| | - Necati Gökmen
- Department of Anesthesiology and Reanimation, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Perry Renshaw
- University of Utah, The Brain Institute & Department of Psychiatry, Salt Lake City, UT, USA
| | - David Olson
- Harvard Medical School, McLean Hospital, Brain Imaging Center, Belmont, MA, USA
| | - Ayşegül Yildiz
- Department of Psychiatry, School of Medicine, Dokuz Eylul University, Izmir, Turkey,International Consortium for Bipolar Disorder Research & Psychopharmacology Program, McLean Division of Massachusetts General Hospital, Boston, MA, USA
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18
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Huang JH, Berkovitch SS, Iaconelli J, Watmuff B, Park H, Chattopadhyay S, McPhie D, Öngür D, Cohen BM, Clish CB, Karmacharya R. Perturbational Profiling of Metabolites in Patient Fibroblasts Implicates α-Aminoadipate as a Potential Biomarker for Bipolar Disorder. MOLECULAR NEUROPSYCHIATRY 2016; 2:97-106. [PMID: 27606323 DOI: 10.1159/000446654] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 05/04/2016] [Indexed: 12/27/2022]
Abstract
Many studies suggest the presence of aberrations in cellular metabolism in bipolar disorder. We studied the metabolome in bipolar disorder to gain insight into cellular pathways that may be dysregulated in bipolar disorder and to discover evidence of novel biomarkers. We measured polar and nonpolar metabolites in fibroblasts from subjects with bipolar I disorder and matched healthy control subjects, under normal conditions and with two physiologic perturbations: low-glucose media and exposure to the stress-mediating hormone dexamethasone. Metabolites that were significantly different between bipolar and control subjects showed distinct separation by principal components analysis methods. The most statistically significant findings were observed in the perturbation experiments. The metabolite with the lowest p value in both the low-glucose and dexamethasone experiments was α-aminoadipate, whose intracellular level was consistently lower in bipolar subjects. Our study implicates α-aminoadipate as a possible biomarker in bipolar disorder that manifests under cellular stress. This is an intriguing finding given the known role of α-aminoadipate in the modulation of kynurenic acid in the brain, especially as abnormal kynurenic acid levels have been implicated in bipolar disorder.
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Affiliation(s)
- Joanne H Huang
- Center for Experimental Drugs and Diagnostics, Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Harvard Medical School and Massachusetts General Hospital, Boston, Mass., USA; Chemical Biology Program, Broad Institute of Harvard and MIT, Mass., USA
| | - Shaunna S Berkovitch
- Center for Experimental Drugs and Diagnostics, Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Harvard Medical School and Massachusetts General Hospital, Boston, Mass., USA; Chemical Biology Program, Broad Institute of Harvard and MIT, Mass., USA
| | - Jonathan Iaconelli
- Center for Experimental Drugs and Diagnostics, Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Harvard Medical School and Massachusetts General Hospital, Boston, Mass., USA; Chemical Biology Program, Broad Institute of Harvard and MIT, Mass., USA
| | - Bradley Watmuff
- Center for Experimental Drugs and Diagnostics, Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Harvard Medical School and Massachusetts General Hospital, Boston, Mass., USA; Chemical Biology Program, Broad Institute of Harvard and MIT, Mass., USA
| | - Hyoungjun Park
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Mass., USA
| | - Shrikanta Chattopadhyay
- MGH Cancer Center, Boston, Mass., USA; Chemical Biology Program, Broad Institute of Harvard and MIT, Mass., USA
| | - Donna McPhie
- Schizophrenia and Bipolar Disorder Program, Harvard Medical School and McLean Hospital, Belmont, Mass., USA
| | - Dost Öngür
- Schizophrenia and Bipolar Disorder Program, Harvard Medical School and McLean Hospital, Belmont, Mass., USA
| | - Bruce M Cohen
- Schizophrenia and Bipolar Disorder Program, Harvard Medical School and McLean Hospital, Belmont, Mass., USA
| | - Clary B Clish
- Chemical Biology Program, Broad Institute of Harvard and MIT, Mass., USA
| | - Rakesh Karmacharya
- Center for Experimental Drugs and Diagnostics, Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Harvard Medical School and Massachusetts General Hospital, Boston, Mass., USA; Chemical Biology Program, Broad Institute of Harvard and MIT, Mass., USA; Chemical Biology Program, Broad Institute of Harvard and MIT, Mass., USA
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19
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Soeiro-de-Souza MG, Pastorello BF, Leite CDC, Henning A, Moreno RA, Garcia Otaduy MC. Dorsal Anterior Cingulate Lactate and Glutathione Levels in Euthymic Bipolar I Disorder: 1H-MRS Study. Int J Neuropsychopharmacol 2016; 19:pyw032. [PMID: 27207914 PMCID: PMC5006200 DOI: 10.1093/ijnp/pyw032] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 04/01/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Oxidative stress and mitochondrial dysfunction are 2 closely integrated processes implicated in the physiopathology of bipolar disorder. Advanced proton magnetic resonance spectroscopy techniques enable the measurement of levels of lactate, the main marker of mitochondrial dysfunction, and glutathione, the predominant brain antioxidant. The objective of this study was to measure brain lactate and glutathione levels in bipolar disorder and healthy controls. METHODS Eighty-eight individuals (50 bipolar disorder and 38 healthy controls) underwent 3T proton magnetic resonance spectroscopy in the dorsal anterior cingulate cortex (2x2x4.5cm(3)) using a 2-D JPRESS sequence. Lactate and glutathione were quantified using the ProFit software program. RESULTS Bipolar disorder patients had higher dorsal anterior cingulate cortex lactate levels compared with controls. Glutathione levels did not differ between euthymic bipolar disorder and controls. There was a positive correlation between lactate and glutathione levels specific to bipolar disorder. No influence of medications on metabolites was observed. CONCLUSION This is the most extensive magnetic resonance spectroscopy study of lactate and glutathione in bipolar disorder to date, and results indicated that euthymic bipolar disorder patients had higher levels of lactate, which might be an indication of altered mitochondrial function. Moreover, lactate levels correlated with glutathione levels, indicating a compensatory mechanism regardless of bipolar disorder diagnosis.
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Affiliation(s)
- Márcio Gerhardt Soeiro-de-Souza
- Mood Disorders Unit (GRUDA), Institute of Psychiatry, School of Medicine (IPq-FMUSP) (Drs Soeiro-de-Souza and Moreno), Laboratory of Magnetic Resonance LIM44, Department and Institute of Radiology (InRad-FMUSP) (Drs Pastorello, Costa Leite, and Otaduy), and Genetics and Pharmacogenetics Unit (PROGENE), Institute of Psychiatry, School of Medicine (Dr Soeiro-de-Souza), University of São Paulo (IPq-FMUSP), São Paulo, Brazil; Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (Dr Henning); Max Planck Institute of Biological Cybernetics, Tubingen, Germany (Dr Henning).
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20
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Magioncalda P, Martino M, Conio B, Piaggio N, Teodorescu R, Escelsior A, Marozzi V, Rocchi G, Roccatagliata L, Northoff G, Inglese M, Amore M. Patterns of microstructural white matter abnormalities and their impact on cognitive dysfunction in the various phases of type I bipolar disorder. J Affect Disord 2016; 193:39-50. [PMID: 26766032 DOI: 10.1016/j.jad.2015.12.050] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 11/30/2015] [Accepted: 12/24/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND In recent years, diffusion tensor imaging (DTI) studies have detected subtle microstructural abnormalities of white matter (WM) in type I bipolar disorder (BD). However, WM alterations in the different phases of BD remain to be explored. The aims of this study is to investigate the WM alterations in the various phases of illness and their correlations with clinical and neurocognitive features. METHODS We investigated the DTI-derived fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) in patients with type I BD (n=61) subdivided in manic (n=21), depressive (n=20) and euthymic phases (n=20) vs. healthy controls (n=42), using a tract-based spatial statistics (TBSS) approach. Then, we investigated whether the subgroups of patients in the various phases of illness present different patterns of WM abnormalities. Finally we studied the correlations between WM alterations and clinical-cognitive parameters. RESULTS We found a widespread alteration in WM microstructure (decrease in FA and increase in MD and RD) in BD when compared to controls. The various subgroups of BD showed different spatial patterns of WM alterations. A gradient of increasing WM abnormalities from the euthymic (low degree and localized WM alterations mainly in the midline structures) to the manic (more diffuse WM alterations affecting both midline and lateral structures) and, finally, to the depressive phase (high degree and widespread WM alterations), was found. Furthermore, the WM diffuse alterations correlated with cognitive deficits in BD, such as decreased fluency prompted by letter and decreased hits and increased omission errors at the continuous performance test. LIMITATIONS Patients under treatment. CONCLUSIONS The WM alterations in type I BD showed different spatial patterns in the various phases of illness, mainly affecting the active phases, and correlated with some cognitive deficits. This suggests a complex trait- and state-dependent pathogenesis of WM abnormalities in BD.
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Affiliation(s)
- Paola Magioncalda
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
| | - Matteo Martino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
| | - Benedetta Conio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
| | - Niccolò Piaggio
- Department of Radiology, Section of Neuroradiology, University of Genoa, Genoa, Italy.
| | - Roxana Teodorescu
- Department of Neurology, Radiology and Neuroscience, Mount Sinai School of Medicine, New York, USA.
| | - Andrea Escelsior
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
| | - Valentina Marozzi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
| | - Giulio Rocchi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
| | - Luca Roccatagliata
- Magnetic Resonance Research Center on Nervous System Diseases, University of Genoa, Genoa, Italy.
| | - Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada; Taipei Medical University, Graduate Institute of Humanities in Medicine, Taipei, Taiwan; Taipei Medical University-Shuang Ho Hospital, Brain and Consciousness Research Center, New Taipei City, Taiwan; National Chengchi University, Research Center for Mind, Brain and Learning, Taipei, Taiwan; Centre for Cognition and Brain Disorders (CCBD), Normal University Hangzhou, Hangzhou, China.
| | - Matilde Inglese
- Department of Neurology, Radiology and Neuroscience, Mount Sinai School of Medicine, New York, USA; Magnetic Resonance Research Center on Nervous System Diseases, University of Genoa, Genoa, Italy.
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
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21
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Mintzopoulos D, Gillis TE, Robertson HR, Dalia T, Feng G, Rauch SL, Kaufman MJ. Striatal magnetic resonance spectroscopy abnormalities in young adult SAPAP3 knockout mice. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:39-48. [PMID: 26858992 PMCID: PMC4742338 DOI: 10.1016/j.bpsc.2015.10.001] [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: 12/11/2022]
Abstract
BACKGROUND Obsessive compulsive disorder (OCD) is a debilitating condition with lifetime prevalence of 1-3%. OCD typically arises in youth but delays in diagnosis impede optimal treatment and developmental studies of the disorder. Research using genetically modified rodents may provide models of etiology that enable earlier detection and intervention. The SAPAP3 knockout (KO) transgenic mouse was developed as an animal model of OCD and related disorders (OCRD). KO mice exhibit compulsive self-grooming behavior analogous to behaviors found in people with OCRD. Striatal hyperactivity has been reported in these mice and in humans with OCD. METHODS Striatal and medial frontal cortex 9.4 Tesla proton spectra were acquired from young adult SAPAP3 KO and wild-type control mice to determine whether KO mice have metabolic and neurochemical abnormalities. RESULTS Young adult KO mice had lower striatal lactate (P=0.006) and glutathione (P=0.039) levels. Among all mice, striatal lactate and glutathione levels were associated (R=0.73, P=0.007). We found no group differences in medial frontal cortex metabolites. At the age range studied, only 1 of 8 KO mice had skin lesions indicative of severe compulsive grooming. CONCLUSION Young adult SAPAP3 KO mice have striatal but not medial frontal cortex MRS abnormalities that may reflect striatal hypermetabolism accompanied by oxidative stress. These abnormalities typically preceded the onset of severe compulsive grooming. Our findings are consistent with striatal hypermetabolism in OCD. Together, these results suggest that striatal MRS measures of lactate or glutathione might be useful biomarkers for early detection of risk for developing compulsive behavior disorders.
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Abnormal high-energy phosphate molecule metabolism during regional brain activation in patients with bipolar disorder. Mol Psychiatry 2015; 20:1079-84. [PMID: 25754079 DOI: 10.1038/mp.2015.13] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 11/21/2014] [Accepted: 12/19/2014] [Indexed: 12/24/2022]
Abstract
Converging evidence suggests bioenergetic abnormalities in bipolar disorder (BD). In the brain, phosphocreatine (PCr) acts a reservoir of high-energy phosphate (HEP) bonds, and creatine kinases (CK) catalyze the transfer of HEP from adenosine triphosphate (ATP) to PCr and from PCr back to ATP, at times of increased need. This study examined the activity of this mechanism in BD by measuring the levels of HEP molecules during a stimulus paradigm that increased local energy demand. Twenty-three patients diagnosed with BD-I and 22 healthy controls (HC) were included. Levels of phosphorus metabolites were measured at baseline and during visual stimulation in the occipital lobe using (31)P magnetic resonance spectroscopy at 4T. Changes in metabolite levels showed different patterns between the groups. During stimulation, HC had significant reductions in PCr but not in ATP, as expected. In contrast, BD patients had significant reductions in ATP but not in PCr. In addition, PCr/ATP ratio was lower at baseline in patients, and there was a higher change in this measure during stimulation. This pattern suggests a disease-related failure to replenish ATP from PCr through CK enzyme catalysis during tissue activation. Further studies measuring the CK flux in BD are required to confirm and extend this finding.
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Balaraman Y, Lahiri DK, Nurnberger JI. Variants in Ion Channel Genes Link Phenotypic Features of Bipolar Illness to Specific Neurobiological Process Domains. MOLECULAR NEUROPSYCHIATRY 2015; 1:23-35. [PMID: 27602355 DOI: 10.1159/000371886] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 01/05/2015] [Indexed: 11/19/2022]
Abstract
Recent advances in genome-wide association studies are pointing towards a major role for voltage-gated ion channels in neuropsychiatric disorders and, in particular, bipolar disorder (BD). The phenotype of BD is complex, with symptoms during mood episodes and deficits persisting between episodes. We have tried to elucidate the common neurobiological mechanisms associated with ion channel signaling in order to provide a new perspective on the clinical symptoms and possible endophenotypes seen in BD patients. We propose a model in which the multiple variants in genes coding for ion channel proteins would perturb motivational circuits, synaptic plasticity, myelination, hypothalamic-pituitary-adrenal axis function, circadian neuronal rhythms, and energy regulation. These changes in neurobiological mechanisms would manifest in endophenotypes of aberrant reward processing, white matter hyperintensities, deficits in executive function, altered frontolimbic connectivity, increased amygdala activity, increased melatonin suppression, decreased REM latency, and aberrant myo-inositol/ATP shuttling. The endophenotypes result in behaviors of poor impulse control, motivational changes, cognitive deficits, abnormal stress response, sleep disturbances, and energy changes involving different neurobiological process domains. The hypothesis is that these disturbances start with altered neural circuitry during development, following which multiple environmental triggers may disrupt the neuronal excitability balance through an activity-dependent molecular process, resulting in clinical mood episodes.
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Affiliation(s)
- Yokesh Balaraman
- Institute of Psychiatric Research, Department of Psychiatry, Neuroscience Research Center, Indiana University School of Medicine, Indianapolis, Ind., USA
| | - Debomoy K Lahiri
- Institute of Psychiatric Research, Department of Psychiatry, Neuroscience Research Center, Indiana University School of Medicine, Indianapolis, Ind., USA
| | - John I Nurnberger
- Institute of Psychiatric Research, Department of Psychiatry, Neuroscience Research Center, Indiana University School of Medicine, Indianapolis, Ind., USA
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Mansur RB, Brietzke E, McIntyre RS. Is there a "metabolic-mood syndrome"? A review of the relationship between obesity and mood disorders. Neurosci Biobehav Rev 2015; 52:89-104. [PMID: 25579847 DOI: 10.1016/j.neubiorev.2014.12.017] [Citation(s) in RCA: 193] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 12/19/2014] [Accepted: 12/31/2014] [Indexed: 12/12/2022]
Abstract
Obesity and mood disorders are highly prevalent and co-morbid. Epidemiological studies have highlighted the public health relevance of this association, insofar as both conditions and its co-occurrence are associated with a staggering illness-associated burden. Accumulating evidence indicates that obesity and mood disorders are intrinsically linked and share a series of clinical, neurobiological, genetic and environmental factors. The relationship of these conditions has been described as convergent and bidirectional; and some authors have attempted to describe a specific subtype of mood disorders characterized by a higher incidence of obesity and metabolic problems. However, the nature of this association remains poorly understood. There are significant inconsistencies in the studies evaluating metabolic and mood disorders; and, as a result, several questions persist about the validity and the generalizability of the findings. An important limitation in this area of research is the noteworthy phenotypic and pathophysiological heterogeneity of metabolic and mood disorders. Although clinically useful, categorical classifications in both conditions have limited heuristic value and its use hinders a more comprehensive understanding of the association between metabolic and mood disorders. A recent trend in psychiatry is to move toward a domain specific approach, wherein psychopathology constructs are agnostic to DSM-defined diagnostic categories and, instead, there is an effort to categorize domains based on pathogenic substrates, as proposed by the National Institute of Mental Health (NIMH) Research Domain Criteria Project (RDoC). Moreover, the substrates subserving psychopathology seems to be unspecific and extend into other medical illnesses that share in common brain consequences, which includes metabolic disorders. Overall, accumulating evidence indicates that there is a consistent association of multiple abnormalities in neuropsychological constructs, as well as correspondent brain abnormalities, with broad-based metabolic dysfunction, suggesting, therefore, that the existence of a "metabolic-mood syndrome" is possible. Nonetheless, empirical evidence is necessary to support and develop this concept. Future research should focus on dimensional constructs and employ integrative, multidisciplinary and multimodal approaches.
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Affiliation(s)
- Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.
| | - Elisa Brietzke
- Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada
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Chen HC, Lirng JF, Soong BW, Guo WY, Wu HM, Chen CCC, Chang CY. The merit of proton magnetic resonance spectroscopy in the longitudinal assessment of spinocerebellar ataxias and multiple system atrophy-cerebellar type. CEREBELLUM & ATAXIAS 2014; 1:17. [PMID: 26331041 PMCID: PMC4552155 DOI: 10.1186/s40673-014-0017-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 09/26/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Spinocerebellar ataxia (SCA) and multiple system atrophy-cerebellar type (MSA-C) often present with similar clinical manifestations in the beginning. Magnetic resonance spectroscopy (MRS) has been proved to be a useful tool to help differentiate different types of SCA and MSA-C on cross-sectional studies. However, longitudinal changes of the MRS metabolites in these subjects have never been reported. The purpose of this study was to track the longitudinal evolution of the MRS metabolites in these patients and to ascertain the correlation between clinical severity measured by Scale of the Assessment and Rating of Ataxia (SARA) and MRS metabolites. RESULTS Significant reductions of NAA/Cr and NAA/Cho in the cerebellar hemispheres in all patients and lower Cho/Cr in the cerebellar hemispheres in patients with SCA2 or MSA-C were found at all times. At initial assessments, patients with MSA-C or SCA2 tended to have lower NAA/Cr and Cho/Cr in the cerebellar hemispheres than those with SCA3 or SCA6. At follow-ups, patients with SCA2 or MSA-C had a lower NAA/Cr in cerebellar hemispheres than those with SCA3 or SCA6. Patients with MSA-C had a lower NAA/Cr in the vermis and Cho/Cr in the cerebellar hemispheres than those with SCA2 at the start, and had a lower NAA/Cr in cerebellar hemispheres than those with SCA2 at follow-ups. CONCLUSION Characteristic patterns of neurodegenerative evolution were observed in patients with disparate SCAs and MSA-C using MRS and SARA. A continual impairment of neuronal integrity was observed in all groups of patients. The longitudinal changes of MRS metabolites and SARA scores were most striking in patients with SCA2 and MSA-C. Although the changes in the metabolites on MRS may still be used to help understand the pathophysiology of ataxia disorders, they are short of being a good biomarker.
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Affiliation(s)
- Hung-Chieh Chen
- Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan ; Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jiing-Feng Lirng
- Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan ; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Bing-Wen Soong
- Department of Neurology, National Yang-Ming University School of Medicine and Taipei Veterans General Hospital, 155, Sec. 2, Linung St, Taipei, Taiwan ; Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wan Yuo Guo
- Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan ; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiu-Mei Wu
- Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan ; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Clayton Chi-Chang Chen
- Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan ; Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Cheng-Yen Chang
- Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan ; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
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Kondo DG, Hellem TL, Shi XF, Sung YH, Prescot AP, Kim TS, Huber RS, Forrest LN, Renshaw PF. A review of MR spectroscopy studies of pediatric bipolar disorder. AJNR Am J Neuroradiol 2014; 35:S64-80. [PMID: 24557702 DOI: 10.3174/ajnr.a3844] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Pediatric bipolar disorder is a severe mental illness whose pathophysiology is poorly understood and for which there is an urgent need for improved diagnosis and treatment. MR spectroscopy is a neuroimaging method capable of in vivo measurement of neurochemicals relevant to bipolar disorder neurobiology. MR spectroscopy studies of adult bipolar disorder provide consistent evidence for alterations in the glutamate system and mitochondrial function. In bipolar disorder, these 2 phenomena may be linked because 85% of glucose in the brain is consumed by glutamatergic neurotransmission and the conversion of glutamate to glutamine. The purpose of this article is to review the MR spectroscopic imaging literature in pediatric bipolar disorder, at-risk samples, and severe mood dysregulation, with a focus on the published findings that are relevant to glutamatergic and mitochondrial functioning. Potential directions for future MR spectroscopy studies of the glutamate system and mitochondrial dysfunction in pediatric bipolar disorder are discussed.
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Affiliation(s)
- D G Kondo
- From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, UtahDepartments of Psychiatry (D.G.K., X.F.S., Y.H.S., P.F.R.)
| | - T L Hellem
- From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, Utah
| | - X-F Shi
- From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, UtahDepartments of Psychiatry (D.G.K., X.F.S., Y.H.S., P.F.R.)
| | - Y H Sung
- From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, UtahDepartments of Psychiatry (D.G.K., X.F.S., Y.H.S., P.F.R.)
| | - A P Prescot
- From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, UtahRadiology (A.P.P.), University of Utah School of Medicine, Salt Lake City, Utah
| | - T S Kim
- and Department of Psychiatry (T.S.K.), Catholic University of Korea Graduate School of Medicine, Seoul, Republic of Korea
| | - R S Huber
- From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, Utah
| | - L N Forrest
- From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, Utah
| | - P F Renshaw
- From The Brain Institute (D.G.K., T.L.H., X.F.S., Y.H.S., A.P.P., R.S.H., L.N.F., P.F.R), University of Utah, Salt Lake City, UtahDepartments of Psychiatry (D.G.K., X.F.S., Y.H.S., P.F.R.)Veterans Integrated Service Network 19 Mental Illness Research (P.F.R.), Education and Clinical Center, VA Salt Lake City Health Care System, Salt Lake City, Utah
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Abstract
OBJECTIVE Neuroimaging techniques have begun to elucidate the neurophysiology of bipolar disorder (BPD). Several features of BPD have hindered understanding of how mood-state changes are reflected in changes in brain physiology. Longitudinal studies have advantages in isolating state-related changes and in studying the instability, inherent in these disorders, that gives rise to pathological mood states. METHODS To assess the state of the art in longitudinal neuroimaging studies in BPD, we conducted a literature review, searching MEDLINE for articles that included the key words bipolar disorder and magnetic resonance spectroscopy (MRS), magnetic resonance imaging (MRI), or emission tomography. The search was limited to studies with multiple subjects at two distinct and defined mood states. This search yielded eight MRS studies, four functional MRI studies, and three positron emission tomography studies. RESULTS Although longitudinally designed studies allow for the isolation of biomarkers of mood state (including euthymia), the current literature is hampered by a lack of replication between studies. CONCLUSIONS The current body of longitudinal BPD imaging studies is heterogeneous and incomplete, and does not lend itself to the construction of an explanatory model of mood-state transitions. Drawing on extant studies, we propose a hypothetical framework for future experiments combining multimodal imaging with a longitudinal study design.
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Prospective neurochemical characterization of child offspring of parents with bipolar disorder. Psychiatry Res 2013; 214:153-60. [PMID: 24028795 PMCID: PMC3796054 DOI: 10.1016/j.pscychresns.2013.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 03/28/2013] [Accepted: 05/16/2013] [Indexed: 01/04/2023]
Abstract
We wished to determine whether decreases in N-acetyl aspartate (NAA) and increases in myoinositol (mI) concentrations as a ratio of creatine (Cr) occurred in the dorsolateral prefrontal cortex (DLPFC) of pediatric offspring of parents with bipolar disorder (BD) and a healthy comparison group (HC) over a 5-year period using proton magnetic resonance spectroscopy ((1)H-MRS). Paticipants comprised 64 offspring (9-18 years old) of parents with BD (36 with established BD, and 28 offspring with symptoms subsyndromal to mania) and 28 HCs, who were examined for group differences in NAA/Cr and mI/Cr in the DLPFC at baseline and follow-up at either 8, 10, 12, 52, 104, 156, 208, or 260 weeks. No significant group differences were found in metabolite concentrations at baseline or over time. At baseline, BD offspring had trends for higher mI/Cr concentrations in the right DLPFC than the HC group. mI/Cr concentrations increased with age, but no statistically significant group differences were found between groups on follow-up. It may be the case that with intervention youth at risk for BD are normalizing otherwise potentially aberrant neurochemical trajectories in the DLPFC. A longer period of follow-up may be required before observing any group differences.
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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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Dodd S, Maes M, Anderson G, Dean OM, Moylan S, Berk M. Putative neuroprotective agents in neuropsychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 2013. [PMID: 23178231 DOI: 10.1016/j.pnpbp.2012.11.007] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In many individuals with major neuropsychiatric disorders including depression, bipolar disorder and schizophrenia, their disease characteristics are consistent with a neuroprogressive illness. This includes progressive structural brain changes, cognitive and functional decline, poorer treatment response and an increasing vulnerability to relapse with chronicity. The underlying molecular mechanisms of neuroprogression are thought to include neurotrophins and regulation of neurogenesis and apoptosis, neurotransmitters, inflammatory, oxidative and nitrosative stress, mitochondrial dysfunction, cortisol and the hypothalamic-pituitary-adrenal axis, and epigenetic influences. Knowledge of the involvement of each of these pathways implies that specific agents that act on some or multiple of these pathways may thus block this cascade and have neuroprotective properties. This paper reviews the potential of the most promising of these agents, including lithium and other known psychotropics, aspirin, minocycline, statins, N-acetylcysteine, leptin and melatonin. These agents are putative neuroprotective agents for schizophrenia and mood disorders.
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Affiliation(s)
- Seetal Dodd
- School of Medicine, Deakin University, Geelong, Victoria, Australia; Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia.
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