1
|
Valizadeh P, Cattarinussi G, Sambataro F, Brambilla P, Delvecchio G. Neuroimaging alterations associated with medication use in early-onset bipolar disorder: An updated review. J Affect Disord 2023; 339:984-997. [PMID: 37481130 DOI: 10.1016/j.jad.2023.07.098] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Pediatric bipolar disorder (PBD) is a severe disorder characterized by mood fluctuations starting at a young age. Several neuroimaging studies revealed a specific biological signature of PBD involving alterations in the amygdala and prefrontal regions. Considering the growing concerns regarding the effects of PBD treatments on developing brains, this review aims to provide an overview of the studies investigating the effect of mood stabilizers, antipsychotics, and anticonvulsants on neuroimaging findings in PBD. METHODS We searched PubMed, Scopus, and Web of Science to identify all structural magnetic resonance imaging (sMRI), functional magnetic resonance imaging (fMRI), and diffusion tensor imaging (DTI) studies exploring the effects of medications on neuroimaging findings in PBD. A total of 18 studies met our inclusion criteria (fMRI n = 11, sMRI n = 6, DTI n = 1). RESULTS Although the findings varied highly across the studies, some investigations consistently indicated that medications primarily affect the prefrontal cortex and the amygdala. Moreover, despite some exceptions, the reported medication effects predominantly lean towards structural and functional normalization. LIMITATIONS The reviewed studies differ in methods, medications, and fMRI paradigms. Furthermore, most studies used observational approaches with small sample sizes, minimizing the statistical power. CONCLUSIONS Evidence suggests the potential of antipsychotics and mood stabilizers to modulate the neuroimaging findings in PBD patients, mostly normalizing brain structure and function in key mood-regulating regions.
Collapse
Affiliation(s)
- Parya Valizadeh
- School of Medicine, Tehran University of Medical Science, Tehran, Iran; Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| |
Collapse
|
2
|
Singh A, Arya A, Agarwal V, Shree R, Kumar U. Computing brain cortical complexity in euthymic children with bipolar disorder: A surface-based approach. Asian J Psychiatr 2023; 80:103352. [PMID: 36481621 DOI: 10.1016/j.ajp.2022.103352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/17/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Anshita Singh
- Centre of Bio-Medical Research, Sanjay Gandhi Postgraduate Institute of Medical Sciences Campus, Lucknow, India; Department of Information Technology, Babasaheb Bhimrao Ambedkar University, Lucknow, India
| | - Amit Arya
- Department of Psychiatry, King George Medical University, Lucknow, India
| | - Vivek Agarwal
- Department of Psychiatry, King George Medical University, Lucknow, India
| | - Raj Shree
- Department of Information Technology, Babasaheb Bhimrao Ambedkar University, Lucknow, India
| | - Uttam Kumar
- Centre of Bio-Medical Research, Sanjay Gandhi Postgraduate Institute of Medical Sciences Campus, Lucknow, India.
| |
Collapse
|
3
|
Li W, Lei D, Tallman MJ, Ai Y, Welge JA, Blom TJ, Fleck DE, Klein CC, Patino LR, Strawn JR, Gong Q, Strakowski SM, Sweeney JA, Adler CM, DelBello MP. Pretreatment Alterations and Acute Medication Treatment Effects on Brain Task-Related Functional Connectivity in Youth With Bipolar Disorder: A Neuroimaging Randomized Clinical Trial. J Am Acad Child Adolesc Psychiatry 2022; 61:1023-1033. [PMID: 35091050 PMCID: PMC9479201 DOI: 10.1016/j.jaac.2021.12.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 12/02/2021] [Accepted: 01/18/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Disruptions in cognition are a clinically significant feature of bipolar disorder (BD). The effects of different treatments on these deficits and the brain systems that support them remain to be established. METHOD A continuous performance test was administered to 55 healthy controls and 71 acutely ill youths with mixed/manic BD to assess vigilance and working memory during task-based functional magnetic resonance imaging studies. Patients, who were untreated for at least 7 days at baseline, and controls were scanned at pretreatment baseline and at weeks 1 and 6. After baseline testing, patients (n = 71) were randomly assigned to 6-week double-blind treatment with lithium (n = 26; 1.0-1.2 mEq/L) or quetiapine (n = 45; 400-600 mg). Weighted seed-based connectivity (wSBC) was used to assess regional brain interactions during the attention task compared with the control condition. RESULTS At baseline, youths with BD showed reduced connectivity between bilateral anterior cingulate cortex and both left ventral lateral prefrontal cortex and left insula and increased connectivity between left ventral lateral prefrontal cortex and left temporal pole, left orbital frontal cortex and right postcentral gyrus, and right amygdala and right occipital pole compared with controls. At 1-week follow-up, quetiapine, but not lithium, treatment led to a significant shift of connectivity patterns toward those of the controls. At week 6, compared with baseline, there was no difference between treatment conditions, at which time both patient groups showed significant normalization of brain connectivity toward that of controls. CONCLUSION Functional alterations in several brain regions associated with cognitive processing and the integration of cognitive and affective processing were demonstrated in untreated youths with BD before treatment. Treatment reduced several of these alterations, with significant effects at week 1 only in the quetiapine treatment group. Normalization of functional connectivity might represent a promising biomarker for early target engagement in youth with BD. CLINICAL TRIAL REGISTRATION INFORMATION Multimodal Neuroimaging of Treatment Effects in Adolescent Mania; https://clinicaltrials.gov/; NCT00893581.
Collapse
Affiliation(s)
- Wenbin Li
- West China Hospital of Sichuan University, Sichuan, China.,Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio.,The First Affiliated Hospital of Zhengzhou, University, Zhengzhou, Henan, China
| | - Du Lei
- Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio
| | - Maxwell J. Tallman
- Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio
| | - Yuan Ai
- West China Hospital of Sichuan University, Sichuan, China.,Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio
| | - Jeffrey A. Welge
- Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio
| | - Thomas J. Blom
- Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio
| | - David E. Fleck
- Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio
| | - Christina C. Klein
- Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio
| | - Luis R. Patino
- Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio
| | - Jeffrey R. Strawn
- Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China; Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian Province, China.
| | - Stephen M. Strakowski
- Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio.,Dell Medical School, University of Texas at Austin, Texas
| | - John A. Sweeney
- West China Hospital of Sichuan University, Sichuan, China.,Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio
| | - Caleb M. Adler
- Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio
| | - Melissa P. DelBello
- Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Ohio
| |
Collapse
|
4
|
Lu L, Mills JA, Li H, Schroeder HK, Mossman SA, Varney ST, Cecil KM, Huang X, Gong Q, Ramsey LB, DelBello MP, Sweeney JA, Strawn JR. Acute Neurofunctional Effects of Escitalopram in Pediatric Anxiety: A Double-Blind, Placebo-Controlled Trial. J Am Acad Child Adolesc Psychiatry 2021; 60:1309-1318. [PMID: 33548492 PMCID: PMC8333264 DOI: 10.1016/j.jaac.2020.11.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/09/2020] [Accepted: 01/28/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Amygdala-ventrolateral prefrontal cortex (VLPFC) circuitry is disrupted in pediatric anxiety disorders, yet how selective serotonin reuptake inhibitors (SSRIs) affect this circuitry is unknown. We examined the impact of the SSRI escitalopram on functional connectivity (FC) within this circuit, and whether early FC changes predicted treatment response in adolescents with generalized anxiety disorder (GAD). METHOD Resting-state functional magnetic resonance (MR) images were acquired before and after 2 weeks of treatment in 41 adolescents with GAD (12-17 years of age) who received double-blind escitalopram or placebo for 8 weeks. Change in amygdala-based whole-brain FC and anxiety severity were analyzed. RESULTS Controlling for age, sex, and pretreatment anxiety, escitalopram increased amygdala-VLPFC connectivity compared to placebo (F = 17.79, p = .002 FWE-corrected). This early FC change predicted 76.7% of the variability in improvement trajectory in patients who received escitalopram (p < .001) but not placebo (p = .169); the predictive power of early amygdala-VLPFC FC change significantly differed between placebo and escitalopram (p = .013). Furthermore, this FC change predicted improvement better than baseline FC or clinical/demographic characteristics. Exploratory analyses of amygdala subfields' FC revealed connectivity of left basolateral amygdala (BLA) -VLPFC (F = 19.64, p < .001 FWE-corrected) and superficial amygdala-posterior cingulate cortex (F = 22.92, p = .001 FWE-corrected) were also increased by escitalopram, but only BLA-VLPFC FC predicted improvement in anxiety over 8 weeks of treatment. CONCLUSION In adolescents with GAD, escitalopram increased amygdala-prefrontal connectivity within the first 2 weeks of treatment, and the magnitude of this change predicted subsequent clinical improvement. Early normalization of amygdala-VLPFC circuitry might represent a useful tool for identifying future treatment responders as well as a promising biomarker for drug development. CLINICAL TRIAL REGISTRATION INFORMATION Neurofunctional Predictors of Escitalopram Treatment Response in Adolescents With Anxiety; https://www.clinicaltrials.gov/; NCT02818751.
Collapse
Affiliation(s)
- Lu Lu
- West China Hospital of Sichuan University, Chengdu, China; University of Cincinnati, Ohio
| | | | - Hailong Li
- West China Hospital of Sichuan University, Chengdu, China
| | | | | | | | - Kim M Cecil
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Xiaoqi Huang
- West China Hospital of Sichuan University, Chengdu, China
| | - Qiyong Gong
- West China Hospital of Sichuan University, Chengdu, China.
| | | | | | - John A Sweeney
- West China Hospital of Sichuan University, Chengdu, China; University of Cincinnati, Ohio
| | | |
Collapse
|
5
|
Li F, Sun H, Biswal BB, Sweeney JA, Gong Q. Artificial intelligence applications in psychoradiology. PSYCHORADIOLOGY 2021; 1:94-107. [PMID: 37881257 PMCID: PMC10594695 DOI: 10.1093/psyrad/kkab009] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/10/2021] [Accepted: 06/04/2021] [Indexed: 02/05/2023]
Abstract
One important challenge in psychiatric research is to translate findings from brain imaging research studies that identified brain alterations in patient groups into an accurate diagnosis at an early stage of illness, prediction of prognosis before treatment, and guidance for selection of effective treatments that target patient-relevant pathophysiological features. This is the primary aim of the field of Psychoradiology. Using databases collected from large samples at multiple centers, sophisticated artificial intelligence (AI) algorithms may be used to develop clinically useful image analysis pipelines that can help physicians diagnose, predict, and make treatment decisions. In this review, we selectively summarize psychoradiological research using magnetic resonance imaging of the brain to explore the neural mechanism of psychiatric disorders, and outline progress and the path forward for the combination of psychoradiology and AI for complementing clinical examinations in patients with psychiatric disorders, as well as limitations in the application of AI that should be considered in future translational research.
Collapse
Affiliation(s)
- Fei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, P.R. China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, Sichuan, P.R. China
- Functional and Molecular Imaging Key Laboratory of Sichuan Provience, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, P.R. China
| | - Huaiqiang Sun
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, P.R. China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, Sichuan, P.R. China
- Functional and Molecular Imaging Key Laboratory of Sichuan Provience, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, P.R. China
| | - Bharat B Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 610054, Sichuan, P.R. China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, P.R. China
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH 45219, USA
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, P.R. China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, Sichuan, P.R. China
- Functional and Molecular Imaging Key Laboratory of Sichuan Provience, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, P.R. China
| |
Collapse
|
6
|
Wang Y, Gao Y, Tang S, Lu L, Zhang L, Bu X, Li H, Hu X, Hu X, Jiang P, Jia Z, Gong Q, Sweeney JA, Huang X. Large-scale network dysfunction in the acute state compared to the remitted state of bipolar disorder: A meta-analysis of resting-state functional connectivity. EBioMedicine 2020; 54:102742. [PMID: 32259712 PMCID: PMC7136605 DOI: 10.1016/j.ebiom.2020.102742] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/28/2020] [Accepted: 03/16/2020] [Indexed: 02/08/2023] Open
Abstract
Background Bipolar disorder (BD) is a mental disorder characterized by mood fluctuations between an acute episodic state of either mania or depression and a clinically remitted state. Dysfunction of large-scale intrinsic brain networks has been demonstrated in this disorder, but it remains unknown whether those network alterations are related to different states. Methods In the present study, we performed a meta-analysis of whole-brain seed-based resting-state functional connectivity (rsFC) studies in BD patients to compare the intrinsic function of brain networks between episodic and remitted states. Thirty-nine seed-based voxel-wise rsFC datasets from thirty publications (1047 BD patients vs 1081 controls) were included in the meta-analysis. Seeds were categorized into networks by their locations within a priori functional networks. Seed-based d mapping analysis of between-state effects identified brain systems in which different states were associated with increased connectivity or decreased connectivity within and between each seed network. Findings We found that BD patients presented decreased connectivity within the affective network (AN) in acute episodes but not in the remitted state of the illness. Similar decreased connectivity within the default-mode network (DMN) was also found in the acute state, but it was replaced by increased connectivity in the remitted state. In addition, different patterns of between-network dysconnectivity were observed between the acute and remitted states. Interpretation This study is the first to identify different patterns of intrinsic function in large-scale brain networks between the acute and remitted states of BD through meta-analysis. The findings suggest that a shift in network function between the acute and remitted states may be related to distinct emotional and cognitive dysfunctions in BD, which may have important implications for identifying clinically relevant biomarkers to guide alternative treatment strategies for BD patients during active episodes or remission. Funding This study was supported by grants from the National Natural Science Foundation of China (81171488, 81671669 and 81820108018) and by a Sichuan Provincial Youth Grant (2017JQ0001).
Collapse
Affiliation(s)
- Yanlin Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Shi Tang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Lu Lu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xuan Bu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xiaoxiao Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Ping Jiang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Zhiyun Jia
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China.
| |
Collapse
|
7
|
Sepede G, Chiacchiaretta P, Gambi F, Di Iorio G, De Berardis D, Ferretti A, Perrucci MG, Di Giannantonio M. Bipolar disorder with and without a history of psychotic features: fMRI correlates of sustained attention. Prog Neuropsychopharmacol Biol Psychiatry 2020; 98:109817. [PMID: 31756418 DOI: 10.1016/j.pnpbp.2019.109817] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/08/2019] [Accepted: 11/09/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Gianna Sepede
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy.
| | - Piero Chiacchiaretta
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy; ITAB - Institute for Advanced Biomedical Technologies, University "G. d'Annunzio", Chieti, Italy
| | - Francesco Gambi
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy
| | | | | | - Antonio Ferretti
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy; ITAB - Institute for Advanced Biomedical Technologies, University "G. d'Annunzio", Chieti, Italy
| | - Mauro Gianni Perrucci
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy; ITAB - Institute for Advanced Biomedical Technologies, University "G. d'Annunzio", Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G. d'Annunzio", Chieti, Italy; Department of Mental Health - Chieti, National Health Trust, Italy
| |
Collapse
|
8
|
Chen Y, Huang X, Wu M, Li K, Hu X, Jiang P, Chen L, He N, Dai J, Wang S, He M, Guo L, Sweeney JA, Gong Q. Disrupted brain functional networks in drug-naïve children with attention deficit hyperactivity disorder assessed using graph theory analysis. Hum Brain Mapp 2019; 40:4877-4887. [PMID: 31361385 DOI: 10.1002/hbm.24743] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 07/10/2019] [Accepted: 07/15/2019] [Indexed: 02/05/2023] Open
Abstract
Neuroimaging studies have revealed functional brain network abnormalities in attention deficit hyperactivity disorder (ADHD), but the results have been inconsistent, potentially related to confounding medication effects. Furthermore, specific topological alterations in functional networks and their role in behavioral inhibition dysfunction remain to be established. Resting-state functional magnetic resonance imaging was performed on 51 drug-naïve children with ADHD and 55 age-matched healthy controls. Brain functional networks were constructed by thresholding the partial correlation matrices of 90 brain regions, and graph theory was used to analyze network topological properties. The Stroop test was used to assess cognitive inhibitory abilities. Nonparametric permutation tests were used to compare the topological architectures in the two groups. Compared with healthy subjects, brain networks in ADHD patients demonstrated altered topological characteristics, including lower global (FDR q = 0.01) and local efficiency (p = 0.032, uncorrected) and a longer path length (FDR q = 0.01). Lower nodal efficiencies were found in the left inferior frontal gyrus and anterior cingulate cortex in the ADHD group (FDR both q < 0.05). Altered global and nodal topological efficiencies were associated with the severity of inhibitory cognitive control deficits and hyperactivity symptoms in ADHD (p <0 .05). Alterations in network topologies in drug-naïve ADHD patients indicate weaker small-worldization with decreased segregation and integration of functional brain networks. Deficits in the cingulo-fronto-parietal attention network were associated with inhibitory control deficits.
Collapse
Affiliation(s)
- Ying Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Min Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Kaiming Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Ping Jiang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Lizhou Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Ning He
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Dai
- Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Manxi He
- Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, China
| | - Lanting Guo
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
9
|
Lee MS, Anumagalla P, Talluri P, Pavuluri MN. Attentional engagement increases inferior frontal gyrus activity and mutes limbic activity in pediatric bipolar disorder: Meta-analyses of fMRI studies. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91:14-19. [PMID: 29782956 DOI: 10.1016/j.pnpbp.2018.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/25/2018] [Accepted: 05/16/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Attention deficit has been shown to exist in adult and pediatric bipolar disorder across the life span. Given that emotion dysregulation is central to bipolar disorder, this study hypothesizes that emotional circuitry regions are altered along with anomalies in the attentional systems during cognitive deployment in bipolar disorder. METHODS An activation likelihood estimation meta-analysis of attentional activities using GingerALE software was completed for adult and pediatric bipolar disorder populations in all published studies till December 2017. The meta-analysis of all fMRI studies included a total of ten pediatric studies (comprised of pediatric bipolar disorder (PBD) and typically developing (TD) groups) and nine adult patient studies (comprised of adult bipolar disorder (ABD) and healthy control (HC) groups). RESULTS While engaged in attentional tasks, increased activation was seen in inferior frontal gyrus with decreased activation in limbic regions in subjects with PBD, relative to TD. Differential patterns of underactivity were also noted in the dorsal attentional system i.e., frontostriatal circuit (dorsolateral prefrontal cortex, anterior cingulate cortex, right lentiform nucleus and right globus pallidus) in PBD patients relative to the TD. However, we did not see any significant differences between the adult groups i.e., ABD vs. HC. CONCLUSIONS In PBD, deploying attentional system potentially improves the fronto-limbic affective circuitry function, despite impaired dorsal attentional system i.e., fronto-striatal circuitry. In contrast, these neural correlates underlying attentional engagement appeared to be not significant in adult BD. LIMITATIONS We examined the PBD vs. TD and the ABD vs. HC separately instead of four-way contrast (dual meta-analytic study). Also, attentional tasks were not unidimensional and tend to capture selective and sustained attention along with response inhibition, thereby recruiting multiple brain circuits.
Collapse
Affiliation(s)
- Moon-Soo Lee
- Pediatric Mood Disorders Program, University of Illinois at Chicago, USA; Divison of Child and Adolescent Psychiatry, Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Purnima Anumagalla
- Pediatric Mood Disorders Program, University of Illinois at Chicago, USA
| | - Prasanth Talluri
- Pediatric Mood Disorders Program, University of Illinois at Chicago, USA
| | - Mani N Pavuluri
- Pediatric Mood Disorders Program, University of Illinois at Chicago, USA; Brain and Wellness Institute, Chicago, USA.
| |
Collapse
|
10
|
Aberrant Resting-State Functional Connectivity in the Default Mode Network in Pediatric Bipolar Disorder Patients with and without Psychotic Symptoms. Neurosci Bull 2018; 35:581-590. [PMID: 30515682 DOI: 10.1007/s12264-018-0315-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 10/03/2018] [Indexed: 01/04/2023] Open
Abstract
Mood disorders/psychosis have been associated with dysfunctions in the default mode network (DMN). However, the relative contributions of DMN regions to state and trait disturbances in pediatric bipolar disorder (PBD) remain unclear. The aim of this study was to investigate the possible mechanisms of PBD through brain imaging and explore the influence of psychotic symptoms on functional alterations in PBD patients. Twenty-nine psychotic and 26 non-psychotic PBD patients, as well as 19 age- and sex-matched healthy controls underwent a resting-state functional MRI scan and the data were analyzed by independent component analysis. The DMN component from the fMRI data was extracted for each participant. Spearman's rank correlation analysis was performed between aberrant connectivity and clinical measurements. The results demonstrated that psychotic PBD was characterized by aberrant DMN connectivity in the anterior cingulate cortex/medial prefrontal cortex, bilateral caudate nucleus, bilateral angular gyri, and left middle temporal gyrus, while non-psychotic PBD was not, suggesting further impairment with the development of psychosis. In summary, we demonstrated unique impairment in DMN functional connectivity in the psychotic PBD group. These specific neuroanatomical abnormalities may shed light on the underlying pathophysiology and presentation of PBD.
Collapse
|
11
|
Lasaponara S, Mauro F, Carducci F, Paoletti P, Tombini M, Quattrocchi CC, Mallio CA, Errante Y, Scarciolla L, Ben-Soussan TD. Increased Alpha Band Functional Connectivity Following the Quadrato Motor Training: A Longitudinal Study. Front Hum Neurosci 2017; 11:282. [PMID: 28659773 PMCID: PMC5466954 DOI: 10.3389/fnhum.2017.00282] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 05/15/2017] [Indexed: 01/23/2023] Open
Abstract
Quadrato Motor Training (QMT) is a new training paradigm, which was found to increase cognitive flexibility, creativity and spatial cognition. In addition, QMT was reported to enhance inter- and intra-hemispheric alpha coherence as well as Fractional Anisotropy (FA) in a number of white matter pathways including corpus callosum. Taken together, these results seem to suggest that electrophysiological and structural changes induced by QMT may be due to an enhanced interplay and communication of the different brain areas within and between the right and the left hemisphere. In order to test this hypothesis using the exact low-resolution brain electromagnetic tomography (eLORETA), we estimated the current neural density and lagged linear connectivity (LLC) of the alpha band in the resting state electroencephalography (rsEEG) recorded with open (OE) and closed eyes (CE) at three different time points, following 6 and 12 weeks of daily QMT. Significant changes were observed for the functional connectivity. In particular, we found that limbic and fronto-temporal alpha connectivity in the OE condition increased after 6 weeks, while it enhanced at the CE condition in occipital network following 12-weeks of daily training. These findings seem to show that the QMT may have dissociable long-term effects on the functional connectivity depending on the different ways of recording rsEEG. OE recording pointed out a faster onset of Linear Lag Connectivity modulations that tend to decay as quickly, while CE recording showed sensible effect only after the complete 3-months training.
Collapse
Affiliation(s)
- Stefano Lasaponara
- Cognitive Neurophysiology Laboratory, Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation for Development and CommunicationAssisi, Italy.,Department of Neuropsychology, IRCCS Fondazione Santa LuciaRome, Italy
| | - Federica Mauro
- Cognitive Neurophysiology Laboratory, Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation for Development and CommunicationAssisi, Italy.,Department of Psychology, Sapienza Università di RomaRome, Italy
| | - Filippo Carducci
- Department of Physiology and Pharmacology, Sapienza Università di RomaRome, Italy
| | - Patrizio Paoletti
- Cognitive Neurophysiology Laboratory, Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation for Development and CommunicationAssisi, Italy
| | - Mario Tombini
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Carlo C Quattrocchi
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Carlo A Mallio
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Yuri Errante
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Laura Scarciolla
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di RomaRome, Italy
| | - Tal D Ben-Soussan
- Cognitive Neurophysiology Laboratory, Research Institute for Neuroscience, Education and Didactics, Patrizio Paoletti Foundation for Development and CommunicationAssisi, Italy
| |
Collapse
|
12
|
Diler RS. Neuroimaging can help identify biomarkers of early onset bipolar disorder. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20120214113908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Rasim Somer Diler
- University of Pittsburgh, Western Psychiatric Institute and Clinic, Medical Director, Inpatient Child & Adolescent Bipolar Services, BFT 539, 3811 O'Hara Street, Pittsburgh, PA 15213 Tel: Fax:
| |
Collapse
|
13
|
Wegbreit E, Weissman AB, Cushman GK, Puzia ME, Kim KL, Leibenluft E, Dickstein DP. Facial emotion recognition in childhood-onset bipolar I disorder: an evaluation of developmental differences between youths and adults. Bipolar Disord 2015; 17:471-85. [PMID: 25951752 PMCID: PMC4548881 DOI: 10.1111/bdi.12312] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 03/04/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Bipolar disorder (BD) is a severe mental illness with high healthcare costs and poor outcomes. Increasing numbers of youths are diagnosed with BD, and many adults with BD report that their symptoms started in childhood, suggesting that BD can be a developmental disorder. Studies advancing our understanding of BD have shown alterations in facial emotion recognition both in children and adults with BD compared to healthy comparison (HC) participants, but none have evaluated the development of these deficits. To address this, we examined the effect of age on facial emotion recognition in a sample that included children and adults with confirmed childhood-onset type-I BD, with the adults having been diagnosed and followed since childhood by the Course and Outcome in Bipolar Youth study. METHODS Using the Diagnostic Analysis of Non-Verbal Accuracy, we compared facial emotion recognition errors among participants with BD (n = 66; ages 7-26 years) and HC participants (n = 87; ages 7-25 years). Complementary analyses investigated errors for child and adult faces. RESULTS A significant diagnosis-by-age interaction indicated that younger BD participants performed worse than expected relative to HC participants their own age. The deficits occurred both for child and adult faces and were particularly strong for angry child faces, which were most often mistaken as sad. Our results were not influenced by medications, comorbidities/substance use, or mood state/global functioning. CONCLUSIONS Younger individuals with BD are worse than their peers at this important social skill. This deficit may be an important developmentally salient treatment target - that is, for cognitive remediation to improve BD youths' emotion recognition abilities.
Collapse
Affiliation(s)
- Ezra Wegbreit
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Bradley Hospital, Brown University Alpert Medical School, East Providence, RI,Department of Psychiatry and Human Behavior, Division of Child Psychiatry, Brown University Alpert Medical School, East Providence, RI
| | - Alexandra B Weissman
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Bradley Hospital, Brown University Alpert Medical School, East Providence, RI,Department of Psychiatry and Human Behavior, Division of Child Psychiatry, Brown University Alpert Medical School, East Providence, RI
| | - Grace K Cushman
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Bradley Hospital, Brown University Alpert Medical School, East Providence, RI,Department of Psychiatry and Human Behavior, Division of Child Psychiatry, Brown University Alpert Medical School, East Providence, RI
| | - Megan E Puzia
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Bradley Hospital, Brown University Alpert Medical School, East Providence, RI,Department of Psychiatry and Human Behavior, Division of Child Psychiatry, Brown University Alpert Medical School, East Providence, RI
| | - Kerri L Kim
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Bradley Hospital, Brown University Alpert Medical School, East Providence, RI,Department of Psychiatry and Human Behavior, Division of Child Psychiatry, Brown University Alpert Medical School, East Providence, RI
| | - Ellen Leibenluft
- Section on Bipolar Spectrum Disorders, Emotion and Development Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Daniel P Dickstein
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Bradley Hospital, Brown University Alpert Medical School, East Providence, RI,Department of Psychiatry and Human Behavior, Division of Child Psychiatry, Brown University Alpert Medical School, East Providence, RI
| |
Collapse
|
14
|
Wang P, Gao J, Zhao S, Guo Y, Wang Z, Qi F. Maternal Thyroxine Levels During Pregnancy and Outcomes of Cognitive Development in Children. Mol Neurobiol 2015; 53:2241-8. [DOI: 10.1007/s12035-015-9189-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 04/22/2015] [Indexed: 12/31/2022]
|
15
|
Pavuluri MN, Lee MS, Pandey G. Lithium response viewed as a biomarker to predict developmental psychopathology in offspring with bipolar disorder: a commentary. Bipolar Disord 2015; 17:224-32. [PMID: 25523965 DOI: 10.1111/bdi.12280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 09/15/2014] [Indexed: 12/27/2022]
Affiliation(s)
- Mani N Pavuluri
- Pediatric Brain Research and Intervention Center, University of Illinois at Chicago, Chicago, IL, USA
| | | | | |
Collapse
|
16
|
Pavuluri M, May A. Differential Treatment of Pediatric Bipolar Disorder and Attention-Deficit/Hyperactivity Disorder. Psychiatr Ann 2014. [DOI: 10.3928/00485713-20141003-06] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
17
|
Lee MS, Anumagalla P, Talluri P, Pavuluri MN. Meta-analyses of developing brain function in high-risk and emerged bipolar disorder. Front Psychiatry 2014; 5:141. [PMID: 25404919 PMCID: PMC4217331 DOI: 10.3389/fpsyt.2014.00141] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 09/24/2014] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Identifying early markers of brain function among those at high risk (HR) for pediatric bipolar disorder (PBD) could serve as a screening measure when children and adolescents present with subsyndromal clinical symptoms prior to the conversion to bipolar disorder. Studies on the offspring of patients with bipolar disorder who are genetically at HR have each been limited in establishing a biomarker, while an analytic review in summarizing the findings offers an improvised opportunity toward that goal. METHODS An activation likelihood estimation (ALE) meta-analysis of mixed cognitive and emotional activities using the GingerALE software from the BrainMap Project was completed. The meta-analysis of all fMRI studies contained a total of 29 reports and included PBD, HR, and typically developing (TD) groups. RESULTS The HR group showed significantly greater activation relative to the TD group in the right DLPFC-insular-parietal-cerebellar regions. Similarly, the HR group exhibited greater activity in the right DLPFC and insula as well as the left cerebellum compared to patients with PBD. Patients with PBD, relative to TD, showed greater activation in regions of the right amygdala, parahippocampal gyrus, medial PFC, left ventral striatum, and cerebellum and lower activation in the right VLPFC and the DLPFC. CONCLUSION The HR population showed increased activity, presumably indicating greater compensatory deployment, in relation to both the TD and the PBD, in the key cognition and emotion-processing regions, such as the DLPFC, insula, and parietal cortex. In contrast, patients with PBD, relative to HR and TD, showed decreased activity, which could indicate a decreased effort in multiple PFC regions in addition to widespread subcortical abnormalities, which are suggestive of a more entrenched disease process.
Collapse
Affiliation(s)
- Moon-Soo Lee
- Pediatric Brain Research and Intervention Center, University of Illinois at Chicago , Chicago, IL , USA ; College of Medicine, Korea University , Seoul , South Korea
| | - Purnima Anumagalla
- Pediatric Brain Research and Intervention Center, University of Illinois at Chicago , Chicago, IL , USA
| | - Prasanth Talluri
- Pediatric Brain Research and Intervention Center, University of Illinois at Chicago , Chicago, IL , USA
| | - Mani N Pavuluri
- Pediatric Brain Research and Intervention Center, University of Illinois at Chicago , Chicago, IL , USA
| |
Collapse
|
18
|
Lu D, Jiao Q, Zhong Y, Gao W, Xiao Q, Liu X, Lin X, Cheng W, Luo L, Xu C, Lu G, Su L. Altered baseline brain activity in children with bipolar disorder during mania state: a resting-state study. Neuropsychiatr Dis Treat 2014; 10:317-23. [PMID: 24570585 PMCID: PMC3933715 DOI: 10.2147/ndt.s54663] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Previous functional magnetic resonance imaging (fMRI) studies have shown abnormal functional connectivity in regions involved in emotion processing and regulation in pediatric bipolar disorder (PBD). Recent studies indicate, however, that task-dependent neural changes only represent a small fraction of the brain's total activity. How the brain allocates the majority of its resources at resting state is still unknown. We used the amplitude of low-frequency fluctuation (ALFF) method of fMRI to explore the spontaneous neuronal activity in resting state in PBD patients. METHODS Eighteen PBD patients during the mania phase and 18 sex-, age- and education-matched healthy subjects were enrolled in this study and all patients underwent fMRI scanning. The ALFF method was used to compare the resting-state spontaneous neuronal activity between groups. Correlation analysis was performed between the ALFF values and Young Mania Rating Scale scores. RESULTS Compared with healthy controls, PBD patients presented increased ALFF in bilateral caudate and left pallidum as well as decreased ALFF in left precuneus, left superior parietal lobule, and bilateral inferior occipital gyrus. Additionally, ALFF values in left pallidum were positively correlated with Young Mania Rating Scale score in PBD. CONCLUSION The abnormal resting-state neuronal activities of the basal ganglia, parietal cortex, and occipital cortex may play an important role in the pathophysiology in PBD patients.
Collapse
Affiliation(s)
- Dali Lu
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, People's Republic of China
| | - Qing Jiao
- Department of Radiology, Taishan Medical University, Taian, People's Republic of China
| | - Yuan Zhong
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, People's Republic of China ; School of Psychology, Nanjing Normal University, Nanjing, People's Republic of China
| | - Weijia Gao
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, People's Republic of China
| | - Qian Xiao
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, People's Republic of China
| | - Xiaoqun Liu
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, People's Republic of China
| | - Xiaoling Lin
- School of Nursing of Central South University, Changsha, People's Republic of China
| | - Wentao Cheng
- Department of Pediatric and Geriatric Psychiatry, Fuzhou Neuropsychiatric Hospital, Fuzhou, People's Republic of China
| | - Lanzhu Luo
- Department of Pediatric and Geriatric Psychiatry, Fuzhou Neuropsychiatric Hospital, Fuzhou, People's Republic of China
| | - Chuanjian Xu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, People's Republic of China
| | - Guangming Lu
- Department of Radiology, Taishan Medical University, Taian, People's Republic of China
| | - Linyan Su
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, People's Republic of China
| |
Collapse
|
19
|
Weinstein SM, West AE, Pavuluri M. Psychosocial intervention for pediatric bipolar disorder: current and future directions. Expert Rev Neurother 2013; 13:843-50. [PMID: 23898854 DOI: 10.1586/14737175.2013.811985] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pediatric bipolar disorder (PBD) affects approximately 2% of the population and disrupts mood regulation, psychosocial functioning and quality of life among affected youths and families. Given the significant psychosocial impairment and poor long-term prognosis associated with PBD, psychosocial intervention is considered to be an essential component of a multimodal treatment approach. This relatively young field of research has witnessed significant growth in the evidence base for psychosocial treatments targeting youths in the past decade, particularly family-based interventions grounded in a biopsychosocial framework. This article reviews existing empirically supported interventions for children and adolescents with PBD. Common elements of successful interventions are identified, and future research directions to address current limitations in the field and advance understanding of treatment for PBD are discussed.
Collapse
Affiliation(s)
- Sally M Weinstein
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, 1747 W Roosevelt Road, Room 155, Chicago, IL 60608, USA.
| | | | | |
Collapse
|
20
|
Diler RS, Renner Cardoso de Almeida J, Ladouceur C, Birmaher B, Axelson D, Phillips M. Neural activity to intense positive versus negative stimuli can help differentiate bipolar disorder from unipolar major depressive disorder in depressed adolescents: a pilot fMRI study. Psychiatry Res 2013; 214:277-84. [PMID: 24080517 PMCID: PMC3856642 DOI: 10.1016/j.pscychresns.2013.06.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 06/04/2013] [Accepted: 06/27/2013] [Indexed: 01/07/2023]
Abstract
Failure to distinguish bipolar depression (BDd) from the unipolar depression of major depressive disorder (UDd) in adolescents has significant clinical consequences. We aimed to identify differential patterns of functional neural activity in BDd versus UDd and employed two (fearful and happy) facial expression/ gender labeling functional magnetic resonance imaging (fMRI) experiments to study emotion processing in 10 BDd (8 females, mean age=15.1 ± 1.1) compared to age- and gender-matched 10 UDd and 10 healthy control (HC) adolescents who were age- and gender-matched to the BDd group. BDd adolescents, relative to UDd, showed significantly lower activity to both intense happy (e.g., insula and temporal cortex) and intense fearful faces (e.g., frontal precentral cortex). Although the neural regions recruited in each group were not the same, both BDd and UDd adolescents, relative to HC, showed significantly lower neural activity to intense happy and mild happy faces, but elevated neural activity to mild fearful faces. Our results indicated that patterns of neural activity to intense positive and negative emotional stimuli can help differentiate BDd from UDd in adolescents.
Collapse
Affiliation(s)
- Rasim Somer Diler
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA.
| | | | | | | | | | | |
Collapse
|
21
|
Altered regional homogeneity in pediatric bipolar disorder during manic state: a resting-state fMRI study. PLoS One 2013. [PMID: 23526961 DOI: 10.1371/journal.pone.0057978.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED Pediatric bipolar disorder (PBD) is a severely debilitating illness, which is characterized by episodes of mania and depression separated by periods of remission. Previous fMRI studies investigating PBD were mainly task-related. However, little is known about the abnormalities in PBD, especially during resting state. Resting state brain activity measured by fMRI might help to explore neurobiological biomarkers of the disorder. METHODS Regional homogeneity (ReHo) was examined with resting-state fMRI (RS-fMRI) on 15 patients with PBD in manic state, with 15 age-and sex-matched healthy youth subjects as controls. RESULTS Compared with the healthy controls, the patients with PBD showed altered ReHo in the cortical and subcortical structures. The ReHo measurement of the PBD group was negatively correlated with the score of Young Mania Rating Scale (YMRS) in the superior frontal gyrus. Positive correlations between the ReHo measurement and the score of YMRS were found in the hippocampus and the anterior cingulate cortex in the PBD group. CONCLUSIONS Altered regional brain activity is present in patients with PBD during manic state. This study presents new evidence for abnormal ventral-affective and dorsal-cognitive circuits in PBD during resting state and may add fresh insights into the pathophysiological mechanisms underlying PBD.
Collapse
|
22
|
Xiao Q, Zhong Y, Lu D, Gao W, Jiao Q, Lu G, Su L. Altered regional homogeneity in pediatric bipolar disorder during manic state: a resting-state fMRI study. PLoS One 2013; 8:e57978. [PMID: 23526961 PMCID: PMC3590243 DOI: 10.1371/journal.pone.0057978] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 01/29/2013] [Indexed: 12/21/2022] Open
Abstract
UNLABELLED Pediatric bipolar disorder (PBD) is a severely debilitating illness, which is characterized by episodes of mania and depression separated by periods of remission. Previous fMRI studies investigating PBD were mainly task-related. However, little is known about the abnormalities in PBD, especially during resting state. Resting state brain activity measured by fMRI might help to explore neurobiological biomarkers of the disorder. METHODS Regional homogeneity (ReHo) was examined with resting-state fMRI (RS-fMRI) on 15 patients with PBD in manic state, with 15 age-and sex-matched healthy youth subjects as controls. RESULTS Compared with the healthy controls, the patients with PBD showed altered ReHo in the cortical and subcortical structures. The ReHo measurement of the PBD group was negatively correlated with the score of Young Mania Rating Scale (YMRS) in the superior frontal gyrus. Positive correlations between the ReHo measurement and the score of YMRS were found in the hippocampus and the anterior cingulate cortex in the PBD group. CONCLUSIONS Altered regional brain activity is present in patients with PBD during manic state. This study presents new evidence for abnormal ventral-affective and dorsal-cognitive circuits in PBD during resting state and may add fresh insights into the pathophysiological mechanisms underlying PBD.
Collapse
Affiliation(s)
- Qian Xiao
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, Mental Health Institute of The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Dali Lu
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, Mental Health Institute of The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Weijia Gao
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, Mental Health Institute of The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qing Jiao
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Linyan Su
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, Mental Health Institute of The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| |
Collapse
|
23
|
Abstract
Children with epilepsy are at risk for behavioral and cognitive comorbidities. Potential etiologies can be assessed in part by neuroimaging. Functional magnetic resonance imaging (MRI) has a major role in presurgical evaluation and prediction of postoperative outcome by mapping of language and memory. Structural MRI and functional MRI have shown changes in children and adolescents with attention deficit hyperactivity disorder and disruptive behavior, common comorbidities in children with epilepsy. Neuroimaging has the potential for significantly increasing understanding of the basis of cognitive and behavioral problems in children with epilepsy.
Collapse
|
24
|
Allott K, Proffitt TM, McGorry PD, Pantelis C, Wood SJ, Cumner M, Brewer WJ. Clinical neuropsychology within adolescent and young-adult psychiatry: conceptualizing theory and practice. APPLIED NEUROPSYCHOLOGY-CHILD 2012; 2:47-63. [PMID: 23427777 DOI: 10.1080/08841233.2012.670566] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Historically, clinical neuropsychology has made significant contributions to the understanding of brain-behavior relationships, particularly in neurological conditions. During the past several decades, neuropsychology has also become established as an important discipline in psychiatric settings. Cognition is increasingly recognized as being core to psychiatric illnesses and predictive of functional outcomes, augmenting theories regarding symptomatology and illness progression. Adult-type psychiatric disorders (including schizophrenia and other psychotic, mood, anxiety, eating, substance-related, and personality disorders) typically emerge during adolescence or young adulthood, a critical neurodevelopmental period. Clinical neuropsychological assessment in adolescent psychiatric patients is particularly valuable in informing clinical formulation and intervention and can be therapeutic across a number of levels. This article articulates the theoretical considerations and practical challenges and applications of clinical neuropsychology within adolescent and young-adult psychiatry. The importance of considering the neurodevelopmental context and its relationship to current theoretical models underpinning clinical practice are discussed.
Collapse
|
25
|
Abstract
This article discusses recent findings on the neurobiology of pediatric depression as well as the interplay between genetic and environmental factors in determining the risk for the disorder. Utilizing data from both animal and human studies, the authors focus on the evolving understanding of the developmental neurobiology of emotional regulation, cognitive function and social behavior as it applies to the risk and clinical course of depression. Treatment implications and directions for future research are also discussed.
Collapse
Affiliation(s)
- John M. Weir
- Center for Molecular and Behavioral Neuroscience, Meharry Medical College, Nashville Tennessee
| | - Arthurine Zakama
- Vanderbilt University, Nashville, Tennessee, Nashville Tennessee
| | - Uma Rao
- Center for Molecular and Behavioral Neuroscience, Meharry Medical College, Nashville Tennessee
- Vanderbilt University, Nashville, Tennessee, Nashville Tennessee
- Department of Psychiatry and Behavioral Sciences, Meharry Medical College, Nashville Tennessee
| |
Collapse
|
26
|
Wegbreit E, Ellis JA, Nandam A, Fitzgerald JM, Passarotti AM, Pavuluri MN, Stevens MC. Amygdala functional connectivity predicts pharmacotherapy outcome in pediatric bipolar disorder. Brain Connect 2011; 1:411-22. [PMID: 22432455 PMCID: PMC3604767 DOI: 10.1089/brain.2011.0035] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The aim of this study was to determine functional connectivity among patients with pediatric bipolar disorder (PBD) who are responders to pharmacotherapy and those who are nonresponders, and learn how they differ from healthy controls (HC) while performing a task that engages affective and cognitive neural systems. PBD participants (n = 34; 13.4 ± 2.3 years) were defined as responders if there was ≥ 50% improvement in Young Mania Rating Scale (YMRS) scores (n = 22) versus nonresponders with < 50% improvement (n = 12) with one of three mood stabilizing medications (divalproex, risperidone, or lamotrigine). HC (n = 14; 14.2 ± 3.1 years) participants also were scanned at baseline and follow-up. During functional magnetic resonance imaging, participants performed a color-matching task in which they had to match the color of positive, negative, or neutral words with colored dots. Independent component analysis was used to identify functionally connected networks across the whole brain, which were subsequently interrogated using region-of-interest analyses to test for group differences. A frontolimbic network was identified that showed impaired functional integration in PBD relative to HC when participants viewed negatively valenced words. PBD medication responders showed greater connectivity of the amygdala into the network before and after treatment compared with nonresponders, with responders showing a pattern more similar to HC than to nonresponders. Regardless of medication type, the degree of amygdala functional connectivity predicted medication response as well as the improvement in YMRS scores across responders and nonresponders. These findings suggest that increased functional integration of the amygdala within the frontolimbic network might be a biomarker of general mood stabilizer medication responsivity in bipolar disorder.
Collapse
Affiliation(s)
- Ezra Wegbreit
- Pediatric Brain Research and Intervention Center, Department of Psychiatry, Colbeth Clinic, University of Illinois at Chicago, Chicago, Illinois 60608, USA
| | | | | | | | | | | | | |
Collapse
|
27
|
Pavuluri MN, Ellis JA, Wegbreit E, Passarotti AM, Stevens MC. Pharmacotherapy impacts functional connectivity among affective circuits during response inhibition in pediatric mania. Behav Brain Res 2011; 226:493-503. [PMID: 22004983 DOI: 10.1016/j.bbr.2011.10.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 09/23/2011] [Accepted: 10/03/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the current study was to determine the influence of implicated affective circuitry disturbance in pediatric bipolar disorder (PBD) on behavioral inhibition. The differential influence of an antipsychotic and an anti-epileptic medication on the functional connectivity across affective and cognitive neural operations in PBD was examined. METHODS This was a six-week double blind randomized fMRI trial of risperidone plus placebo vs. divalproex plus placebo for patients with mania (n=22; 13.6 ± 2.5 years). Healthy controls (HC; n=14, 14.5 ± 2.8 years) were also scanned for normative comparison. Participants performed a response inhibition fMRI task where a motor response, already 'on the way' to execution, had to be voluntarily inhibited on trials where a stop signal was presented. Independent component analysis was used to map functional connectivity across the whole brain. RESULTS While there were no behavioral differences between the groups at pre- or post-drug trial, there was significant improvement on manic symptoms in the patient groups. All participants engaged an evaluative affective circuit (EAC: bilateral inferior frontal gyrus, middle frontal gyrus, anterior cingulate cortex (ACC), middle temporal gyrus, insulae, caudate and putamen) and a reactive affective circuit (RAC: bilateral occipital cortex, amygdala, medial frontal gyrus and insula) during task performance. Within the EAC, post-treatment and relative to HC, greater engagement was seen in left insula in risperidone group and left subgenual ACC in divalproex group. Within the RAC, greater baseline amygdala connectivity in patients did not alter with treatment. CONCLUSION EAC and RAC are two key circuits that moderate emotional influence on response inhibition in PBD. Risperidone and divalproex differentially engage the EAC. Limited change in amygdala activity with treatment in all patients indicates a likely trait deficit in PBD.
Collapse
Affiliation(s)
- Mani N Pavuluri
- Pediatric Brain Research and Intervention Center, Institute for Juvenile Research, Berger-Colbeth Clinic, University of Illinois at Chicago, IL 60608, USA.
| | | | | | | | | |
Collapse
|
28
|
Gilliam M, Stockman M, Malek M, Sharp W, Greenstein D, Lalonde F, Clasen L, Giedd J, Rapoport J, Shaw P. Developmental trajectories of the corpus callosum in attention-deficit/hyperactivity disorder. Biol Psychiatry 2011; 69:839-46. [PMID: 21247556 PMCID: PMC3078980 DOI: 10.1016/j.biopsych.2010.11.024] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 11/19/2010] [Accepted: 11/20/2010] [Indexed: 02/08/2023]
Abstract
BACKGROUND It was recently found that the development of typical patterns of prefrontal, but not posterior, cortical asymmetry is disrupted in right-handed youth with attention-deficit/hyperactivity disorder (ADHD). Using longitudinal data, we tested the hypothesis that there would be a congruent disruption in the growth of the anterior corpus callosum, which contains white matter tracts connecting prefrontal cortical regions. METHODS Areas of five subregions of the corpus callosum were quantified using a semiautomated method from 828 neuroanatomic magnetic resonance scans acquired from 236 children and adolescents with ADHD (429 scans) and 230 typically developing youth (399 scans), most of whom had repeated neuroimaging. Growth rates of each diagnostic group were defined using mixed-model linear regression. RESULTS Right-handed participants with ADHD showed a significantly higher rate of growth in the anterior-most region of the corpus callosum (estimated annual increase in area of .97%, SEM .12%) than their typically developing peers (annual increase in area of .32% SEM .13%; t = 3.64, p = .0003). No significant diagnostic differences in growth rates were found in any other regions in right-handed participants, and no significant diagnostic differences were found in non-right-handed participants. CONCLUSIONS As hypothesized, we found anomalous growth trajectories in the anterior corpus callosum in ADHD. This disrupted anterior callosal growth may reflect, or even drive, the previously reported disruption in the development of prefrontal cortex asymmetry. The finding documents the dynamic, age-dependent nature of callosal and congruent prefrontal cortical abnormalities characterizing ADHD.
Collapse
Affiliation(s)
- Mary Gilliam
- Child Psychiatry Branch, Room 3N202, Bldg 10, Center Drive, National Institute of Mental Health, Bethesda, MD, 20892
| | - Michael Stockman
- Child Psychiatry Branch, Room 3N202, Bldg 10, Center Drive, National Institute of Mental Health, Bethesda, MD, 20892
| | - Meaghan Malek
- Child Psychiatry Branch, Room 3N202, Bldg 10, Center Drive, National Institute of Mental Health, Bethesda, MD, 20892
| | - Wendy Sharp
- Child Psychiatry Branch, Room 3N202, Bldg 10, Center Drive, National Institute of Mental Health, Bethesda, MD, 20892
| | - Deanna Greenstein
- Child Psychiatry Branch, Room 3N202, Bldg 10, Center Drive, National Institute of Mental Health, Bethesda, MD, 20892
| | - Francois Lalonde
- Child Psychiatry Branch, Room 3N202, Bldg 10, Center Drive, National Institute of Mental Health, Bethesda, MD, 20892
| | - Liv Clasen
- Child Psychiatry Branch, Room 3N202, Bldg 10, Center Drive, National Institute of Mental Health, Bethesda, MD, 20892
| | - Jay Giedd
- Child Psychiatry Branch, Room 3N202, Bldg 10, Center Drive, National Institute of Mental Health, Bethesda, MD, 20892
| | - Judith Rapoport
- Child Psychiatry Branch, Room 3N202, Bldg 10, Center Drive, National Institute of Mental Health, Bethesda, MD, 20892
| | - Philip Shaw
- Child Psychiatry Branch, Room 3N202, Bldg 10, Center Drive, National Institute of Mental Health, Bethesda, MD, 20892.,Corresponding author: P Shaw,
| |
Collapse
|
29
|
Lu LH, Zhou XJ, Keedy SK, Reilly JL, Sweeney JA. White matter microstructure in untreated first episode bipolar disorder with psychosis: comparison with schizophrenia. Bipolar Disord 2011; 13:604-13. [PMID: 22085473 PMCID: PMC3612986 DOI: 10.1111/j.1399-5618.2011.00958.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES White matter abnormalities have been reported in bipolar disorder. The present study aimed to investigate white matter integrity in untreated first episode patients with psychotic bipolar disorder using diffusion tensor imaging, and to compare observations with those from untreated first episode schizophrenia patients. METHODS Fractional anisotropy and mean diffusivity were measured in first episode psychotic patients with bipolar disorder (n = 13) or schizophrenia (n = 21) and healthy individuals (n = 18). Group differences were evaluated using voxel-based morphometry. Axial and radial diffusivity were examined in regions with altered fractional anisotropy in post-hoc analyses. RESULTS Patients with bipolar disorder showed lower fractional anisotropy than healthy controls in several white matter tracts. Compared with schizophrenia patients, bipolar disorder patients showed lower fractional anisotropy in the cingulum, internal capsule, posterior corpus callosum, tapetum, and occipital white matter including posterior thalamic radiation and inferior longitudinal fasciculus/inferior fronto-occipital fasciculus. Lower fractional anisotropy in bipolar disorder was characterized by increased radial diffusion rather than axial diffusion along the orientation of fiber tracts. Across several white matter tracts, both patient groups showed greater mean diffusivity than healthy individuals. CONCLUSIONS Selectively increased radial diffusivity in bipolar disorder patients suggests structural disorganization in fiber tract coherence of neurodevelopmental origin or alterations in myelin sheaths along fiber tracts. In contrast, increased isotropic diffusion along white matter tracts in schizophrenia patients with alterations in both radial and axial diffusivity suggests increased water content outside the axonal space. Thus, the present results suggest that different pathophysiological mechanisms may underlie white matter microstructural abnormalities in bipolar disorder and schizophrenia.
Collapse
Affiliation(s)
- Lisa H Lu
- Department of Psychology, Roosevelt University, Chicago, IL 60605, USA.
| | - Xiaohong Joe Zhou
- Center for Magnetic Resonance Research, Departments of Radiology, Neurosurgery, and Bioengineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Sarah K Keedy
- Center for Cognitive Medicine, University of Illinois at Chicago, Chicago, IL
| | - James L Reilly
- Center for Cognitive Medicine, University of Illinois at Chicago, Chicago, IL
| | - John A Sweeney
- Center for Cognitive Medicine, University of Illinois at Chicago, Chicago, IL
| |
Collapse
|
30
|
Pavuluri MN. Effects of early intervention on the course of bipolar disorder: theories and realities. Curr Psychiatry Rep 2010; 12:490-8. [PMID: 20922506 DOI: 10.1007/s11920-010-0155-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Given the severity and early onset of pediatric bipolar disorder, early intervention is important to bring about recovery and alter the course of the illness. There is a new and burgeoning body of literature on the biological basis of early signs of the illness and the mechanistic understanding of treatment interventions. Biological findings based on multimodal imaging, genomic studies of cellular proteins, and performance-based findings of neurocognitive studies are beginning to assemble a cohesive and interlinked model of systems neuroscience. This offers the promise of identifying biomarkers, predictors of illness, and treatment outcomes. In complement, at the tier of clinical application is a multitude of efficacy trials, yet neither a single medication nor a combination of choices seems to suffice in reality. The current review develops a point of view bridging scientific developments to where comprehensive, multipronged treatment strategies find their clinical application-a model that is similarly applicable in adult bipolar disorder.
Collapse
Affiliation(s)
- Mani N Pavuluri
- Department of Psychiatry, Institute for Juvenile Research, Chicago, IL 60612, USA.
| |
Collapse
|
31
|
Kondo DG, Hellem TL, Sung YH, Kim N, Jeong EK, DelMastro KK, Shi X, Renshaw PF. Review: magnetic resonance spectroscopy studies of pediatric major depressive disorder. DEPRESSION RESEARCH AND TREATMENT 2010; 2011:650450. [PMID: 21197097 PMCID: PMC3003951 DOI: 10.1155/2011/650450] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Accepted: 08/20/2010] [Indexed: 12/22/2022]
Abstract
Introduction. This paper focuses on the application of Magnetic Resonance Spectroscopy (MRS) to the study of Major Depressive Disorder (MDD) in children and adolescents. Method. A literature search using the National Institutes of Health's PubMed database was conducted to identify indexed peer-reviewed MRS studies in pediatric patients with MDD. Results. The literature search yielded 18 articles reporting original MRS data in pediatric MDD. Neurochemical alterations in Choline, Glutamate, and N-Acetyl Aspartate are associated with pediatric MDD, suggesting pathophysiologic continuity with adult MDD. Conclusions. The MRS literature in pediatric MDD is modest but growing. In studies that are methodologically comparable, the results have been consistent. Because it offers a noninvasive and repeatable measurement of relevant in vivo brain chemistry, MRS has the potential to provide insights into the pathophysiology of MDD as well as the mediators and moderators of treatment response.
Collapse
Affiliation(s)
- Douglas G. Kondo
- The Brain Institute at the University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108-1201, USA
- Department of Psychiatry, University of Utah School of Medicine, 30 N. 1900 E, Salt Lake City, UT 84132, USA
| | - Tracy L. Hellem
- The Brain Institute at the University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108-1201, USA
| | - Young-Hoon Sung
- The Brain Institute at the University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108-1201, USA
- Department of Psychiatry, University of Utah School of Medicine, 30 N. 1900 E, Salt Lake City, UT 84132, USA
| | - Namkug Kim
- The Brain Institute at the University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108-1201, USA
| | - Eun-Kee Jeong
- Department of Radiology, University of Utah School of Medicine, 30 N. 1900 E, Salt Lake City, UT 84132, USA
| | - Kristen K. DelMastro
- The Brain Institute at the University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108-1201, USA
| | - Xianfeng Shi
- The Brain Institute at the University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108-1201, USA
| | - Perry F. Renshaw
- The Brain Institute at the University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108-1201, USA
- Department of Psychiatry, University of Utah School of Medicine, 30 N. 1900 E, Salt Lake City, UT 84132, USA
| |
Collapse
|
32
|
Should clinicians engaged in delivering evidence-based child and adolescent mental healthcare be excited about findings from empirical research? Curr Opin Psychiatry 2010; 23:299-303. [PMID: 20495457 DOI: 10.1097/yco.0b013e32833b519b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
33
|
|
34
|
Skating to where the puck will be: the importance of neuroimaging literacy in child psychiatry. J Am Acad Child Adolesc Psychiatry 2008; 47:1213-6. [PMID: 18931607 PMCID: PMC2635416 DOI: 10.1097/chi.0b013e318185dab8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|