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Chen Y, Zhao P, Pan C, Chang M, Zhang X, Duan J, Wei Y, Tang Y, Wang F. State- and trait-related dysfunctions in bipolar disorder across different mood states: a graph theory study. J Psychiatry Neurosci 2024; 49:E11-E22. [PMID: 38238036 PMCID: PMC10803102 DOI: 10.1503/jpn.230069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/10/2023] [Accepted: 09/14/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The interplay between state- and trait-related disruptions in structural networks remains unclear in bipolar disorder (BD), but graph theory can offer insights into global and local network changes. We sought to use diffusion-tensor imaging (DTI) and graph theory approaches to analyze structural topological properties across distinct mood states and identify high-risk individuals by examining state- and trait-related impairments in BD. METHODS We studied changes in white matter network among patients with BD and healthy controls, exploring relationships with clinical variables. Secondary analysis involved comparing patients with BD with unaffected people at high genetic risk for BD. RESULTS We included 152 patients with BD, including 52 with depressive BD (DBD), 64 with euthymic BD (EBD) and 36 with manic BD (MBD); we also included 75 healthy controls. Secondary analyses involved 27 unaffected people at high genetic risk for BD. Patients with DBD and MBD exhibited significantly lower global efficiencies than those with EBD and healthy controls, with patients with DBD showing the lowest global efficiencies. In addition, patients with DBD displayed impaired local efficiency and normalized clustering coefficient (γ). At a global level, γ correlated negatively with depression and anxiety. Compared with healthy controls, and across mood states, patients with BD showed abnormal shortest path lengths in the frontolimbic circuit, a trend mirrored among those at high genetic risk for BD. LIMITATIONS Considerations include medication effects, absence of recorded BD episode counts and the cross-sectional nature of the study. CONCLUSION Mood-specific whole-brain network metrics could serve as potential biomarkers in BD for transitions between mood states. Moreover, these findings contribute to evidence of trait-related frontolimbic circuit irregularities, shedding light on underlying pathophysiological mechanisms in BD.
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Affiliation(s)
- Yifan Chen
- From the Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chen, Wang); the Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China (Chen, Zhao, Pan, Duan, Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China (Chen, Zhao, Duan, Wei, Wang); the Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China (Zhang); the School of Computer Science and Engineering, Northeastern University, Shenyang, China (Pan); and the Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, Liaoning, PR China (Tang)
| | - Pengfei Zhao
- From the Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chen, Wang); the Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China (Chen, Zhao, Pan, Duan, Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China (Chen, Zhao, Duan, Wei, Wang); the Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China (Zhang); the School of Computer Science and Engineering, Northeastern University, Shenyang, China (Pan); and the Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, Liaoning, PR China (Tang)
| | - Chunyu Pan
- From the Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chen, Wang); the Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China (Chen, Zhao, Pan, Duan, Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China (Chen, Zhao, Duan, Wei, Wang); the Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China (Zhang); the School of Computer Science and Engineering, Northeastern University, Shenyang, China (Pan); and the Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, Liaoning, PR China (Tang)
| | - Miao Chang
- From the Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chen, Wang); the Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China (Chen, Zhao, Pan, Duan, Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China (Chen, Zhao, Duan, Wei, Wang); the Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China (Zhang); the School of Computer Science and Engineering, Northeastern University, Shenyang, China (Pan); and the Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, Liaoning, PR China (Tang)
| | - Xizhe Zhang
- From the Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chen, Wang); the Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China (Chen, Zhao, Pan, Duan, Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China (Chen, Zhao, Duan, Wei, Wang); the Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China (Zhang); the School of Computer Science and Engineering, Northeastern University, Shenyang, China (Pan); and the Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, Liaoning, PR China (Tang)
| | - Jia Duan
- From the Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chen, Wang); the Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China (Chen, Zhao, Pan, Duan, Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China (Chen, Zhao, Duan, Wei, Wang); the Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China (Zhang); the School of Computer Science and Engineering, Northeastern University, Shenyang, China (Pan); and the Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, Liaoning, PR China (Tang)
| | - Yange Wei
- From the Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chen, Wang); the Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China (Chen, Zhao, Pan, Duan, Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China (Chen, Zhao, Duan, Wei, Wang); the Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China (Zhang); the School of Computer Science and Engineering, Northeastern University, Shenyang, China (Pan); and the Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, Liaoning, PR China (Tang)
| | - Yanqing Tang
- From the Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chen, Wang); the Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China (Chen, Zhao, Pan, Duan, Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China (Chen, Zhao, Duan, Wei, Wang); the Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China (Zhang); the School of Computer Science and Engineering, Northeastern University, Shenyang, China (Pan); and the Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, Liaoning, PR China (Tang)
| | - Fei Wang
- From the Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chen, Wang); the Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China (Chen, Zhao, Pan, Duan, Wang); the Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China (Chen, Zhao, Duan, Wei, Wang); the Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China (Chang); the School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China (Zhang); the School of Computer Science and Engineering, Northeastern University, Shenyang, China (Pan); and the Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, Liaoning, PR China (Tang)
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2
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Macoveanu J, Damgaard V, Ysbæk-Nielsen AT, Frangou S, Yatham LN, Chakrabarty T, Stougaard ME, Knudsen GM, Vinberg M, Kessing LV, Kjærstad HL, Miskowiak KW. Early longitudinal changes in brain structure and cognitive functioning in remitted patients with recently diagnosed bipolar disorder. J Affect Disord 2023; 339:153-161. [PMID: 37442440 DOI: 10.1016/j.jad.2023.07.026] [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: 02/03/2023] [Revised: 06/08/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Patients with bipolar disorder (BD) who are presenting with cognitive impairment and associated structural brain abnormalities have generally a poorer clinical outcome. This study aims to map the early longitudinal trajectories in brain structure and cognition in patients with recently diagnosed BD. METHODS Fully or partially remitted patients with a recent diagnosis of BD and matched healthy controls (HC) underwent structural MRI and neuropsychological testing at baseline (BD n = 97; HC n = 66) and again following an average of 16 (range 6-27) months (BD n = 50; HC n = 38). We investigated the differential trajectories in BD vs. HC in cortical gray matter volume and thickness, total cerebral white matter, hippocampal and amygdala volumes, estimated brain age, and cognitive functioning using linear mixed models. Within patients, we further investigated whether brain structural abnormalities detected at baseline were associated with subsequent mood episodes. RESULTS Compared to HC, patients showed a decline in total white matter volume over time and they had a larger amygdala volume, both at baseline and at follow-up time. Patients further showed lower cognitive performance at both times of investigation with no significant change over time. There were no differences between patients and HC in cortical gray matter volume or thickness, hippocampal volume, or brain-aging patterns. CONCLUSIONS Cognitive impairment and amygdala enlargement may represent stable markers of BD early in the course of illness, whereas subtle white matter decline may result from illness progression.
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Affiliation(s)
- Julian Macoveanu
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark.
| | - Viktoria Damgaard
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Denmark
| | - Alexander Tobias Ysbæk-Nielsen
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Denmark
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lakshmi N Yatham
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Canada
| | - Trisha Chakrabarty
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Canada
| | - Marie Eschau Stougaard
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Maj Vinberg
- Department of Clinical Medicine, University of Copenhagen, Denmark; Psychiatric Research Unit, Psychiatric Centre North Zealand, Hillerød, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Hanne Lie Kjærstad
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Denmark
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3
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Grewal S, McKinlay S, Kapczinski F, Pfaffenseller B, Wollenhaupt-Aguiar B. Biomarkers of neuroprogression and late staging in bipolar disorder:
A systematic review. Aust N Z J Psychiatry 2023; 57:328-343. [PMID: 35403455 PMCID: PMC9950598 DOI: 10.1177/00048674221091731] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Bipolar disorder may undertake a progressive course in a subset of patients, and research efforts have been made to understand the biological basis underlying this process. This systematic review examined the literature available on biological markers associated with illness progression in bipolar disorder. METHODS Peer-reviewed articles were assessed using Embase, PsycINFO and PubMed, as well as from external sources. After initial screening, a total of 871 citations from databases and other sources were identified. Participants with a diagnosis of bipolar disorder were included in our systematic review; however, studies with participants younger than 15 or older than 65 were excluded. All studies were assessed using the Newcastle-Ottawa Scale assessment tool, and data pertaining to the results were extracted into tabular form using Google Sheets and Google Documents. The systematic review was registered on PROSPERO international prospective register of systematic reviews (ID Number: CRD42020154305). RESULTS A total of 35 studies were included in the systematic review. Increased ventricular size and reduction of grey matter volume were the most common brain changes associated with illness progression in bipolar disorder. Among the several biomarkers evaluated in this systematic review, findings also indicate a role of peripheral inflammatory markers in this process. DISCUSSION The studies evaluating the biological basis of the illness progression in bipolar disorder are still scarce and heterogeneous. However, current evidence supports the notion of neuroprogression, the pathophysiological process related to progressive brain changes associated with clinical progression in patients with bipolar disorder. The increase in peripheral inflammatory biomarkers and the neuroanatomical changes in bipolar disorder suggest progressive systemic and structural brain alterations, respectively.
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Affiliation(s)
- Sonya Grewal
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Stuart McKinlay
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Flávio Kapczinski
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada,Mood Disorders Program, St. Joseph’s
Healthcare Hamilton, Hamilton, ON, Canada,Instituto Nacional de Ciência e
Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil,Department of Psychiatry, Universidade
Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Bianca Pfaffenseller
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada,Mood Disorders Program, St. Joseph’s
Healthcare Hamilton, Hamilton, ON, Canada
| | - Bianca Wollenhaupt-Aguiar
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada,Mood Disorders Program, St. Joseph’s
Healthcare Hamilton, Hamilton, ON, Canada,Bianca Wollenhaupt de Aguiar, Department of
Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th
Street, Suite G116, Hamilton, ON L8N 3K7, Canada.
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4
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Valdés-Tovar M, Rodríguez-Ramírez AM, Rodríguez-Cárdenas L, Sotelo-Ramírez CE, Camarena B, Sanabrais-Jiménez MA, Solís-Chagoyán H, Argueta J, López-Riquelme GO. Insights into myelin dysfunction in schizophrenia and bipolar disorder. World J Psychiatry 2022; 12:264-285. [PMID: 35317338 PMCID: PMC8900585 DOI: 10.5498/wjp.v12.i2.264] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/10/2021] [Accepted: 01/17/2022] [Indexed: 02/06/2023] Open
Abstract
Schizophrenia and bipolar disorder are disabling psychiatric disorders with a worldwide prevalence of approximately 1%. Both disorders present chronic and deteriorating prognoses that impose a large burden, not only on patients but also on society and health systems. These mental illnesses share several clinical and neurobiological traits; of these traits, oligodendroglial dysfunction and alterations to white matter (WM) tracts could underlie the disconnection between brain regions related to their symptomatic domains. WM is mainly composed of heavily myelinated axons and glial cells. Myelin internodes are discrete axon-wrapping membrane sheaths formed by oligodendrocyte processes. Myelin ensheathment allows fast and efficient conduction of nerve impulses through the nodes of Ranvier, improving the overall function of neuronal circuits. Rapid and precisely synchronized nerve impulse conduction through fibers that connect distant brain structures is crucial for higher-level functions, such as cognition, memory, mood, and language. Several cellular and subcellular anomalies related to myelin and oligodendrocytes have been found in postmortem samples from patients with schizophrenia or bipolar disorder, and neuroimaging techniques have revealed consistent alterations at the macroscale connectomic level in both disorders. In this work, evidence regarding these multilevel alterations in oligodendrocytes and myelinated tracts is discussed, and the involvement of proteins in key functions of the oligodendroglial lineage, such as oligodendrogenesis and myelination, is highlighted. The molecular components of the axo-myelin unit could be important targets for novel therapeutic approaches to schizophrenia and bipolar disorder.
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Affiliation(s)
- Marcela Valdés-Tovar
- Departamento de Farmacogenética, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | | | - Leslye Rodríguez-Cárdenas
- Departamento de Farmacogenética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Carlo E Sotelo-Ramírez
- Departamento de Farmacogenética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
- Doctorado en Biología Experimental, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City 09340, Mexico
| | - Beatriz Camarena
- Departamento de Farmacogenética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | | | - Héctor Solís-Chagoyán
- Laboratorio de Neurofarmacología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Jesús Argueta
- Doctorado en Biología Experimental, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City 09340, Mexico
- Laboratorio de Neurofarmacología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Germán Octavio López-Riquelme
- Laboratorio de Socioneurobiología, Centro de Investigación en Ciencias Cognitivas, Universidad del Estado de Morelos, Cuernavaca 62209, Morelos, Mexico
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5
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Tremain H, Fletcher K, Scott J, McEnery C, Berk M, Murray G. The influence of stage of illness on functional outcomes after psychological treatment in bipolar disorder: A systematic review. Bipolar Disord 2020; 22:666-692. [PMID: 32621794 DOI: 10.1111/bdi.12974] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The aim of this study was to advance understanding of stage of illness in bipolar disorder (BD), by interrogating the literature for evidence of an influence of stage of illness on functional (ie non-symptom) outcomes following psychosocial intervention. METHODS A systematic literature search following PRISMA guidelines was conducted to identify empirical studies of psychosocial interventions for established BD. To investigate stage as a predictor of three functional outcomes (general/social functioning, cognitive functioning and quality of life [QoL]), study samples were dichotomised into earlier and later stage using proxy measures identified in existing staging models. Findings were integrated using data-based convergent synthesis. RESULTS A total of 88 analyses from 62 studies were identified. Synthesis across studies suggested that psychosocial intervention was more likely to be effective for general functioning outcomes earlier in the course of established BD. No stage-related differences were found for cognitive or QoL outcomes. Exploratory investigations found some evidence of an interaction between specific intervention type and stage of illness in predicting outcomes. CONCLUSIONS A novel systematic review provided preliminary evidence that benefits general/social functioning may be more pronounced in earlier versus later stages of established BD. The review also generated hypotheses about a potential three-way interaction, whereby specific psychosocial interventions may be best placed to target functional outcomes in earlier versus later stage BD. The strength of conclusions is limited by the overall low-quality and significant heterogeneity of studies. Further research is urgently required to understand the impact of illness stage on the effectiveness of psychosocial interventions.
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Affiliation(s)
- Hailey Tremain
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University, Melbourne, Vic, Australia
| | - Kathryn Fletcher
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University, Melbourne, Vic, Australia
| | - Jan Scott
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University, Melbourne, Vic, Australia.,Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Carla McEnery
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University, Melbourne, Vic, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Vic, Australia
| | - Michael Berk
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Vic, Australia.,IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Vic, Australia.,The Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, the University of Melbourne, Parkville, Vic, Australia
| | - Greg Murray
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University, Melbourne, Vic, Australia
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6
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Millett C, Harder J, Locascio J, Shanahan M, Santone G, Fichorova R, Corrigan A, Baecher-Allan C, Burdick K. TNF-α and its soluble receptors mediate the relationship between prior severe mood episodes and cognitive dysfunction in euthymic bipolar disorder. Brain Behav Immun 2020; 88:403-410. [PMID: 32272224 PMCID: PMC8577222 DOI: 10.1016/j.bbi.2020.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/31/2020] [Accepted: 04/04/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) is one of the most disabling mental health conditions in the world. Symptoms of cognitive impairment in BD contribute directly to occupational and social deficiencies and are very difficult to treat. Converging evidence suggests that BD patients have increased peripheral markers of inflammation. The hypothesis of neuroprogression in BD postulates that cognitive deficits develop over the course of the illness and are influenced by prior severe mood episodes, leading to wear-and-tear on the brain- however, there exists a paucity of data statistically testing a mediating role of immune molecules in cognitive dysfunction in BD. METHODS This is a cross-sectional study. We measured serum levels of tumor necrosis factor alpha (TNF-α), and soluble (s) TNF receptors one and two (sTNF-R1 and sTNF-R2) in 219 euthymic BD patients and 52 Healthy Controls (HCs). Structural equation modeling (SEM) was used for the primary purpose of assessing whether TNF markers (measured by the multiple indicators TNF-α, sTNF-R1 and sTNF-R2) mediate the effect or number of prior severe mood episodes (number of prior psychiatric hospitalizations) on cognitive performance. RESULTS BD and HC groups did not differ on circulating levels of TNF molecules in the present study. However, we found higher sTNF-R1 concentration in 'late-stage' BD illness (>1 prior psychiatric hospitalization) compared to those in early stage illness. In the subsequent SEM, we found that the model fits the data acceptably (Chi-square = 49.2, p = 0.3), and had a 'close fit' (RMSEA = 0.02, PCLOSE = 0.9). Holding covariates constant (age, sex, premorbid IQ, education, and race), we found that the standardized indirect effect was significant, p = 0.015, 90%CI [-0.07, -0.01], indicating that the estimated model was consistent with peripheral TNF markers partially mediating a causal effect of severe mood episodes on executive function. CONCLUSIONS Our results indicate that circulating levels of TNF molecules partially mediate the relationship between prior severe mood episodes and executive function in BD. These results may implicate TNF variables in the neuroprogressive course of BD and could point to novel interventions for cognition.
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Affiliation(s)
- C.E. Millett
- Mood and Psychosis Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - J. Harder
- Mood and Psychosis Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - J.J. Locascio
- Massachusetts Alzheimer’s Disease Research Center, Massachusetts General Hospital and Harvard Medical School
| | - M. Shanahan
- Mood and Psychosis Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA,Massachusetts Alzheimer’s Disease Research Center, Massachusetts General Hospital and Harvard Medical School
| | - G. Santone
- Laboratory of Genital Tract Biology, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - R. Fichorova
- Laboratory of Genital Tract Biology, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - A. Corrigan
- Mood and Psychosis Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA
| | - C. Baecher-Allan
- Ann Romney Center for Neurologic Disease, Harvard Medical School, Boston, MA 02115 USA,Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115 USA
| | - K.E. Burdick
- Mood and Psychosis Research Program, Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
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7
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Tremain H, Fletcher K, Murray G. Number of episodes in bipolar disorder: The case for more thoughtful conceptualization and measurement. Bipolar Disord 2020; 22:231-244. [PMID: 31730294 DOI: 10.1111/bdi.12872] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Number of mood episodes (NoE) may be an important prognostic indicator in bipolar disorder, with implications for treatment. However, NoE has been conceptualized and measured inconsistently throughout the literature. This review examines the construct of NoE in bipolar disorder, with the aim of enhancing its conceptualization and measurement. METHODS A critical evaluation of literatures on important correlates of NoE, conceptually and phenomenologically overlapping features, and previous studies considering and measuring this construct was undertaken. RESULTS The literature indicates that despite frequent use, NoE has been inconsistently defined and measured. Multiple studies have linked NoE with important clinical factors, including relapse, functioning, cognitive impairment and the effectiveness of both pharmacological and psychosocial interventions, yet conclusions are limited by its inconsistent treatment. Additionally, it seems evident that that NoE may best be treated as a fuzzy construct (rather than precise figure), with yet to be defined overlaps with clinical variables such as age at onset and severity. Attempts to measure this construct have varied in comprehensiveness and structure. CONCLUSIONS The NoE construct may have important implications for individuals with bipolar disorders. However, more consistent and systematic definition and assessment of NoE is required to advance this literature and clarify its role. Recommendations aimed at advancing the conceptualization and the measurement of NoE are provided. Conceptualization may be advanced by considering and exploring relationships between NoE and factors with which it overlaps, while measurement may best be improved with increased consistency and balancing accuracy with feasibility.
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Affiliation(s)
- Hailey Tremain
- Faculty of Health Arts and Design, Centre for Mental Health, Swinburne University, Melbourne, Australia
| | - Kathryn Fletcher
- Faculty of Health Arts and Design, Centre for Mental Health, Swinburne University, Melbourne, Australia
| | - Greg Murray
- Faculty of Health Arts and Design, Centre for Mental Health, Swinburne University, Melbourne, Australia
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Kim HJ, Song C, Bang M, Lee SH. Early sexual trauma is related with the tapetum in patients with panic disorder. J Affect Disord 2020; 267:107-113. [PMID: 32063561 DOI: 10.1016/j.jad.2020.02.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/04/2020] [Accepted: 02/06/2020] [Indexed: 02/09/2023]
Abstract
BACKGROUND Early trauma exposure is suggested to confer a greater risk for the development of panic disorder (PD) by altering neurodevelopmental processes. A body of studies have shown that white matter microstructures, particularly in the fronto-limbic and callosal regions, could be affected by a history of early trauma in patients with PD. The tapetum, the extended posterior part of the corpus callosum connecting the bilateral temporal lobes, has not yet been studied regarding its relationship with early trauma, especially sexual one. METHODS Seventy participants with PD, sixty age- and sex-matched healthy controls were enrolled. The Early Trauma Inventory Self Report-Short Form (ETISR-SF), Neuroticism Scale, and Panic Disorder Severity Scale (PDSS) were administered. Voxel-wise statistical analysis of diffusion tensor imaging data was performed within the bilateral tapetum regions using Tract-Based Spatial Statistics (TBSS). RESULTS In participants with PD, higher levels of sexual trauma were significantly associated with the increased fractional anisotropies (FAs) in a cluster of the right tapetum. Exploratory correlation analysis revealed that FAs in this cluster were significantly correlated with higher neuroticism and poorer treatment response after one year of pharmacotherapy. No significant correlation was found between FAs of the right tapetum cluster and the PDSS scores. LIMITATIONS The possibility of retrospective recall bias for early trauma cannot be completely ruled out. CONCLUSIONS The findings of this study suggest that the right tapetum may serve as a potential neural marker of early sexual trauma in patients with PD and contribute to personal vulnerability and poorer treatment outcome after pharmacotherapy.
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Affiliation(s)
- Hyun-Ju Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Chaerim Song
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea; Clinical Counseling Psychology Graduate School, CHA University, Seongnam, South Korea
| | - Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea; Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
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9
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Barichello T, Giridharan VV, Bhatti G, Sayana P, Doifode T, Macedo D, Quevedo J. Inflammation as a Mechanism of Bipolar Disorder Neuroprogression. Curr Top Behav Neurosci 2020; 48:215-237. [PMID: 33040314 DOI: 10.1007/7854_2020_173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Bipolar disorder (BD) is a severe, debilitating psychiatric condition with onset in adolescence or young adulthood and often follows a relapsing and remitting course throughout life. The concept of neuroprogression in BD refers to the progressive path with an identifiable trajectory that takes place with recurrent mood episodes, which eventually leads to cognitive, functional, and clinical deterioration in the course of BD. Understanding the biological basis of neuroprogression helps to explain the subset of BD patients who experience worsening of their disorder over time. Additionally, the study of the neurobiological mechanisms underpinning neuroprogression will help BD staging based on systems biology. Replicated epidemiological studies have suggested inflammatory mechanisms as primary contributors to the neuroprogression of mood disorders. It is known that dysregulated inflammatory/immune pathways are often associated with BD pathophysiology. Hence, in this chapter, we focus on the evidence for the involvement of inflammation and immune regulated pathways in the neurobiological consequences of BD neuroprogression. Herein we put forth the evidence of immune markers from autoimmune disorders, chronic infections, and gut-brain axis that lead to BD neuroprogression. Further, we highlighted the peripheral and central inflammatory components measured along with BD progression.
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Affiliation(s)
- Tatiana Barichello
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA. .,Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil. .,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.
| | - Vijayasree Vayalanellore Giridharan
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Gursimrat Bhatti
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Pavani Sayana
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Tejaswini Doifode
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Danielle Macedo
- Neuropsychopharmacology Laboratory, Drug Research, and Development Center, Faculty of Medicine, Universidade Federal do Ceará, Fortaleza, CE, Brazil.,National Institute for Translational Medicine (INCT-TM, CNPq), Ribeirao Preto, Brazil
| | - Joao Quevedo
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.,Laboratory of Neurosciences, Graduate Program in Health Sciences, University of Southern Santa Catarina-UNESC, Criciúma, SC, Brazil.,Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
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10
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Structural and Functional Brain Correlates of Neuroprogression in Bipolar Disorder. Curr Top Behav Neurosci 2020; 48:197-213. [PMID: 33040317 DOI: 10.1007/7854_2020_177] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Neuroprogression is associated with structural and functional brain changes that occur in parallel with cognitive and functioning impairments. There is substantial evidence showing early white matter changes, as well as trajectory-related gray matter alterations. Several structures, including prefrontal, parietal, temporal cortex, and limbic structures, seem to be altered over the course of bipolar disorder, especially associated with the number of episodes and length of the disease. An important limitation is that most of the studies used either a cross-sectional design or a short follow-up period, which may be insufficient to identify all neuroprogressive changes over time. In addition, the heterogeneity of patients with bipolar disorder is another challenge to determine which subjects will have a more pernicious trajectory. Larger studies and the use of new techniques, such as machine learning, may help to enable more discoveries and evidence on the role of neuroprogression in BD.
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11
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Rodríguez-Ramírez AM, Meza-Urzúa F, Cedillo-Ríos V, Becerra-Palars C, Jiménez-Pavón J, Morales-Cedillo IP, Sanabrais-Jiménez MA, Hernández-Muñoz S, Camarena-Medellín B. CACNA1C Risk Variant and Mood Stabilizers Effects in the Prefrontal Cortical Thickness of Mexican Patients with Bipolar Disorder. Neuropsychiatr Dis Treat 2020; 16:1199-1206. [PMID: 32494139 PMCID: PMC7229798 DOI: 10.2147/ndt.s245911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/01/2020] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Bipolar disorder (BD) is a condition associated with structural alterations in the prefrontal cortex (PFC); some genetic variants and mood stabilizer medications like lithium or valproate are associated with these changes. CACNA1C is a gene involved in BD pathology and brain function; carriers of the A allele of rs1006737 are reported to have increased risk for BD and increased cortical thickness (CT) in the PFC compared to non-carriers. Lithium is also associated with increased CT in the PFC of BD subjects compared to the ones on valproate. The influence of these treatments and gene variants over the PFC structure of Mexican subjects has not been explored. Therefore, we evaluate the effects of mood stabilizers and risk A allele of CACNA1C rs1006737 on the prefrontal cortical thickness of Mexican BD patients treated with lithium or valproate. PATIENTS AND METHODS A cross-sectional study of 40 BD type I euthymic adult outpatients (20 treated with lithium and 20 with valproate) who underwent a 3T T1-weighted 3D brain scan and genotyping for CACNA1C risk allele rs1006737 was conducted. We performed a cortical thickness analysis of the dorsolateral and orbitofrontal regions of the prefrontal cortex with BrainVoyager 20.6. The effects of treatment and gene variants were analyzed with a two-way multivariate analysis of covariance. RESULTS There was no association of CACNA1C risk allele rs1006737 with CT measures of both PFCs nor significant interaction between the genetic variant and treatment. Mood stabilizers reported the main effect on the CT measures of the right PFC of our sample. Patients on treatment with lithium showed higher mean CT on the right orbitofrontal cortex. CONCLUSION We did not find any association between the prefrontal CT and CACNA1C risk A allele rs1006737 in BD Mexican patients treated with lithium or valproate. Our results suggest that mood stabilizers had the main effect in the CT of the right PFC.
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Affiliation(s)
| | - Fátima Meza-Urzúa
- Kinder und Jugend Psychiatrie, Klinikum Idar-Oberstein, Idar-Oberstein, Germany
| | - Valente Cedillo-Ríos
- Departamento de Imágenes Cerebrales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Claudia Becerra-Palars
- Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Joanna Jiménez-Pavón
- Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | | | | | - Sandra Hernández-Muñoz
- Departamento de Farmacogenética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Beatriz Camarena-Medellín
- Departamento de Farmacogenética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
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12
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Tremain H, Fletcher K, Scott J, McEnery C, Berk M, Murray G. Does stage of illness influence recovery-focused outcomes after psychological treatment in bipolar disorder? A systematic review protocol. Syst Rev 2019; 8:125. [PMID: 31128591 PMCID: PMC6535183 DOI: 10.1186/s13643-019-1042-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 05/12/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is great interest in the possibility that 'stage of illness' moderates treatment outcomes in bipolar disorder (BD). Much remains unknown about the construct of stage of illness, but there is evidence that effectiveness of psychosocial interventions may depend on factors that are plausible proxy measures of stage of illness (e.g., number of episodes). To date, reviews of this data have focused solely on clinical outcomes (particularly symptoms and relapse rates), but a range of recovery-focused outcomes (including functioning, cognitive functioning, and quality of life) have been measured in individuals with established BD. The aim of the proposed systematic review is to synthesise existing evidence for plausible proxy measures of stage of illness as moderators of recovery-focused and functional outcomes in psychosocial treatment studies of BD. METHODS The proposed review will follow PRISMA guidelines; Scopus, PsychINFO, PubMed and Web of Science will be searched for empirical studies of psychosocial interventions used for established (clinical stages 2-4) BD; and findings will be summarised in a narrative synthesis of clinical stage of illness (operationalised in proxy measures identified in existing staging models) as a moderator of recovery-focused and functional outcomes of psychosocial interventions for established bipolar disorder. DISCUSSION This review will contribute to the literature by expanding upon previous reviews and potentially inform the psychosocial treatment of established BD. Implications include assisting clinicians, consumers and researchers to identify and select interventions most appropriate to recovery-focused goals based on individuals' clinical status. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016037868.
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Affiliation(s)
- Hailey Tremain
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University, PO Box 218, John St Hawthorn VIC, Melbourne, 3122 Australia
| | - Kathryn Fletcher
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University, PO Box 218, John St Hawthorn VIC, Melbourne, 3122 Australia
| | - Jan Scott
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University, PO Box 218, John St Hawthorn VIC, Melbourne, 3122 Australia
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Carla McEnery
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University, PO Box 218, John St Hawthorn VIC, Melbourne, 3122 Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- The Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, the University of Melbourne, Parkville, VIC Australia
| | - Greg Murray
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University, PO Box 218, John St Hawthorn VIC, Melbourne, 3122 Australia
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13
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Acuff HE, Versace A, Bertocci MA, Hanford LC, Ladouceur CD, Manelis A, Monk K, Bonar L, McCaffrey A, Goldstein BI, Goldstein TR, Sakolsky D, Axelson D, Birmaher B, Phillips ML. White matter - emotion processing activity relationships in youth offspring of bipolar parents. J Affect Disord 2019; 243:153-164. [PMID: 30243195 PMCID: PMC6476540 DOI: 10.1016/j.jad.2018.09.010] [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: 03/09/2018] [Revised: 07/31/2018] [Accepted: 09/09/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Early detection of Bipolar Disorder (BD) is critical for targeting interventions to delay or prevent illness onset. Yet, the absence of objective BD biomarkers makes accurately identifying at-risk youth difficult. In this study, we examined how relationships between white matter tract (WMT) structure and activity in emotion processing neural circuitry differentiate youth at risk for BD from youth at risk for other psychiatric disorders. METHODS Offspring (ages 8-17) of parents with BD (OBP, n = 32), offspring of comparison parents with non-BD psychopathology (OCP, n = 30), and offspring of healthy parents (OHP, n = 24) underwent diffusion tensor and functional magnetic resonance imaging while performing an emotional face processing task. Penalized and multiple regression analyses included GROUP(OBP,OCP)xWMT interactions as main independent variables, and emotion processing activity as dependent variables, to determine significant group differences in WMT-activity relationships. RESULTS 8 GROUPxWMT interaction variables contributed to 16.5% of the variance in amygdala and prefrontal cortical activity to happy faces. Of these, significant group differences in slopes (inverse for OBP, positive for OCP) existed for the relationship between forceps minor radial diffusivity and rostral anterior cingulate activity (p = 0.014). Slopes remained significantly different in unmedicated youth without psychiatric disorders (p = 0.017) and were moderated by affective lability symptoms (F(1,29) = 5.566, p = 0.036). LIMITATIONS Relatively small sample sizes were included. CONCLUSIONS Forceps minor radial diffusivity-rostral anterior cingulate activity relationships may reflect underlying neuropathological processes that contribute to affectively labile youth at risk for BD and may help differentiate them from youth at risk for other psychiatric disorders.
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Affiliation(s)
- Heather E. Acuff
- Departments of Neuroscience, Psychology, and Psychiatry, Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA,Medical Scientist Training Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Amelia Versace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | | | - Anna Manelis
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kelly Monk
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lisa Bonar
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alicia McCaffrey
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Tina R. Goldstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dara Sakolsky
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - David Axelson
- Department of Psychiatry, Nationwide Children’s Hospital and The Ohio State College of Medicine, Columbus, OH, USA
| | | | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mary L. Phillips
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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14
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Duarte JA, Massuda R, Goi PD, Vianna-Sulzbach M, Colombo R, Kapczinski F, Gama CS. White matter volume is decreased in bipolar disorder at early and late stages. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2018; 40:277-284. [DOI: 10.1590/2237-6089-2017-0025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 01/11/2018] [Indexed: 11/21/2022]
Abstract
Abstract Introduction: Bipolar disorder (BD) is a debilitating mood condition that affects approximately 1.3% of people worldwide, although some studies report up to 3.9% lifetime prevalence and 4-6% in adults when broad diagnostic criteria are applied. Objective: To compare differences in total white matter (WM), corpus callosum (CC) and total gray matter (GM) volumes in patients with type I BD at early and late stages compared with controls. Methods: Fifty-five subjects were enrolled in this study protocol. The double case-control design included 14 patients with BD at early stage; 15 patients at late stage; and their respective matched controls (14 and 12 subjects). Results: CC and total WM volumes were significantly smaller in patients with BD at early and late stages vs. controls. There was no difference for total GM volume in the early stage group, but in patients at late stage total GM volume was significantly smaller than in controls. The total GM volume reduction in patients at late stage is in agreement with the neuroprogression theory of BD. The reduction of WM volumes in total WM and in the CC at early and late stages supports the possibility that an early demyelination process could occur underlying the clinical manifestation of BD. Conclusion: Our findings may direct to the investigation of WM abnormalities in populations at high risk to develop BD, perhaps as early biomarkers before the overt syndrome.
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Affiliation(s)
- Juliana A. Duarte
- Hospital de Clínicas de Porto Alegre, Brazil; Tomoclínica, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
| | - Raffael Massuda
- Universidade Federal do Rio Grande do Sul, Brazil; Universidade Federal do Paraná, Brazil
| | - Pedro D. Goi
- Universidade Federal do Rio Grande do Sul, Brazil
| | | | - Rafael Colombo
- Universidade Federal do Rio Grande do Sul, Brazil; Universidade Federal do Paraná, Brazil; Universidade de Caxias do Sul, Brazil
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15
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Szepesi Z, Manouchehrian O, Bachiller S, Deierborg T. Bidirectional Microglia-Neuron Communication in Health and Disease. Front Cell Neurosci 2018; 12:323. [PMID: 30319362 PMCID: PMC6170615 DOI: 10.3389/fncel.2018.00323] [Citation(s) in RCA: 279] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 09/06/2018] [Indexed: 12/12/2022] Open
Abstract
Microglia are ramified cells that exhibit highly motile processes, which continuously survey the brain parenchyma and react to any insult to the CNS homeostasis. Although microglia have long been recognized as a crucial player in generating and maintaining inflammatory responses in the CNS, now it has become clear, that their function are much more diverse, particularly in the healthy brain. The innate immune response and phagocytosis represent only a little segment of microglia functional repertoire that also includes maintenance of biochemical homeostasis, neuronal circuit maturation during development and experience-dependent remodeling of neuronal circuits in the adult brain. Being equipped by numerous receptors and cell surface molecules microglia can perform bidirectional interactions with other cell types in the CNS. There is accumulating evidence showing that neurons inform microglia about their status and thus are capable of controlling microglial activation and motility while microglia also modulate neuronal activities. This review addresses the topic: how microglia communicate with other cell types in the brain, including fractalkine signaling, secreted soluble factors and extracellular vesicles. We summarize the current state of knowledge of physiological role and function of microglia during brain development and in the mature brain and further highlight microglial contribution to brain pathologies such as Alzheimer’s and Parkinson’s disease, brain ischemia, traumatic brain injury, brain tumor as well as neuropsychiatric diseases (depression, bipolar disorder, and schizophrenia).
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Affiliation(s)
- Zsuzsanna Szepesi
- Experimental Neuroinflammation Laboratory, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Oscar Manouchehrian
- Experimental Neuroinflammation Laboratory, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Sara Bachiller
- Experimental Neuroinflammation Laboratory, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Tomas Deierborg
- Experimental Neuroinflammation Laboratory, Department of Experimental Medical Science, Lund University, Lund, Sweden
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16
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Sartori JM, Reckziegel R, Passos IC, Czepielewski LS, Fijtman A, Sodré LA, Massuda R, Goi PD, Vianna-Sulzbach M, Cardoso TDA, Kapczinski F, Mwangi B, Gama CS. Volumetric brain magnetic resonance imaging predicts functioning in bipolar disorder: A machine learning approach. J Psychiatr Res 2018; 103:237-243. [PMID: 29894922 DOI: 10.1016/j.jpsychires.2018.05.023] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/30/2018] [Accepted: 05/24/2018] [Indexed: 12/14/2022]
Abstract
Neuroimaging studies have been steadily explored in Bipolar Disorder (BD) in the last decades. Neuroanatomical changes tend to be more pronounced in patients with repeated episodes. Although the role of such changes in cognition and memory is well established, daily-life functioning impairments bulge among the consequences of the proposed progression. The objective of this study was to analyze MRI volumetric modifications in BD and healthy controls (HC) as possible predictors of daily-life functioning through a machine learning approach. Ninety-four participants (35 DSM-IV BD type I and 59 HC) underwent clinical and functioning assessments, and structural MRI. Functioning was assessed using the Functioning Assessment Short Test (FAST). The machine learning analysis was used to identify possible candidates of regional brain volumes that could predict functioning status, through a support vector regression algorithm. Patients with BD and HC did not differ in age, education and marital status. There were significant differences between groups in gender, BMI, FAST score, and employment status. There was significant correlation between observed and predicted FAST score for patients with BD, but not for controls. According to the model, the brain structures volumes that could predict FAST scores were: left superior frontal cortex, left rostral medial frontal cortex, right white matter total volume and right lateral ventricle volume. The machine learning approach demonstrated that brain volume changes in MRI were predictors of FAST score in patients with BD and could identify specific brain areas related to functioning impairment.
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Affiliation(s)
- Juliana M Sartori
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Ramiro Reckziegel
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Leticia S Czepielewski
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Adam Fijtman
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Leonardo A Sodré
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Raffael Massuda
- Departamento de Psiquiatria, Universidade Federal do Paraná, Rua Padre Camargo, 280 - 6º andar, 80060-240, Curitiba, Brazil
| | - Pedro D Goi
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Miréia Vianna-Sulzbach
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Taiane de Azevedo Cardoso
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil
| | - Flávio Kapczinski
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil; Department of Psychiatry and Behavioural Neurosciences, McMaster University, West 5th Campus, Administration - B3, 100 West 5th, Hamilton, ON L8N 3K7, Canada
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center, Houston, 1941 East Road, Houston, TX 77054, USA
| | - Clarissa S Gama
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Avenida Ramiro Barcelos, 2350, 90035-903, Porto Alegre, Brazil; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar, 90035-003, Porto Alegre, Brazil.
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17
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Stevelink R, Abramovic L, Verkooijen S, Begemann MJH, Sommer IEC, Boks MP, Mandl RCW, van Haren NEM, Vinkers CH. Childhood abuse and white matter integrity in bipolar disorder patients and healthy controls. Eur Neuropsychopharmacol 2018; 28:807-817. [PMID: 29866576 DOI: 10.1016/j.euroneuro.2018.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/04/2018] [Accepted: 05/17/2018] [Indexed: 10/14/2022]
Abstract
Childhood trauma has a negative impact on the developing brain and increases the risk for almost all psychiatric disorders including bipolar disorder. White matter abnormalities may play a role in the persistently increased risk for bipolar disorder following childhood trauma. We therefore examined the influence of childhood abuse and neglect on white matter integrity using diffusion tensor imaging (DTI), quantified as fractional anisotropy (FA), in patients with bipolar I disorder (N = 251) and healthy controls (N = 163). Bipolar patients experienced more childhood abuse (30.6% vs 8.0%; p< 0.001) and childhood neglect (36.3% vs 22.7%; p = 0.003) than controls. Childhood abuse had different effects on whole brain FA in patients with bipolar disorder compared to healthy individuals (F[1,410] = 3.060; p = 0.006). Specifically, whereas patients with bipolar disorder with childhood abuse had lower FA in widespread regions of the brain relative to patients without childhood abuse (t[249] = 2.28; p = 0.024), no differences were found between healthy individuals with and without abuse (t[161]=-0.18; p = 0.986). Differences in mean FA significantly mediated the association between childhood abuse and bipolar disorder. In contrast, childhood neglect was not significantly associated with FA in patients with bipolar disorder nor in healthy controls. Together, these results show that childhood abuse but not neglect is associated with lower integrity of white matter microstructure across the brain in patients with bipolar I disorder but not in healthy individuals. Therefore, white matter integrity might be involved the relationship between childhood abuse and bipolar disorder, even though the directionality cannot be proven due to the cross-sectional design of our study.
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Affiliation(s)
- Remi Stevelink
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lucija Abramovic
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sanne Verkooijen
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marieke J H Begemann
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Iris E C Sommer
- Department of Neuroscience, UMC Groningen, The Netherlands; Department of Biological and Medical Psychology, University of Bergen, Norway
| | - Marco P Boks
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rene C W Mandl
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Neeltje E M van Haren
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Christiaan H Vinkers
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
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18
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Cao B, Luo Q, Fu Y, Du L, Qiu T, Yang X, Chen X, Chen Q, Soares JC, Cho RY, Zhang XY, Qiu H. Predicting individual responses to the electroconvulsive therapy with hippocampal subfield volumes in major depression disorder. Sci Rep 2018; 8:5434. [PMID: 29615675 PMCID: PMC5882798 DOI: 10.1038/s41598-018-23685-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/15/2018] [Indexed: 12/12/2022] Open
Abstract
Electroconvulsive therapy (ECT) is one of the most effective treatments for major depression disorder (MDD). ECT can induce neurogenesis and synaptogenesis in hippocampus, which contains distinct subfields, e.g., the cornu ammonis (CA) subfields, a granule cell layer (GCL), a molecular layer (ML), and the subiculum. It is unclear which subfields are affected by ECT and whether we predict the future treatment response to ECT by using volumetric information of hippocampal subfields at baseline? In this study, 24 patients with severe MDD received the ECT and their structural brain images were acquired with magnetic resonance imaging before and after ECT. A state-of-the-art hippocampal segmentation algorithm from Freesurfer 6.0 was used. We found that ECT induced volume increases in CA subfields, GCL, ML and subiculum. We applied a machine learning algorithm to the hippocampal subfield volumes at baseline and were able to predict the change in depressive symptoms (r = 0.81; within remitters, r = 0.93). Receiver operating characteristic analysis also showed robust prediction of remission with an area under the curve of 0.90. Our findings provide evidence for particular hippocampal subfields having specific roles in the response to ECT. We also provide an analytic approach for generating predictions about clinical outcomes for ECT in MDD.
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Affiliation(s)
- Bo Cao
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, United States
| | - Qinghua Luo
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Yixiao Fu
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Lian Du
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Tian Qiu
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Xiangying Yang
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Xiaolu Chen
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Qibin Chen
- Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, United States
| | - Raymond Y Cho
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, United States
| | - Xiang Yang Zhang
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, United States
| | - Haitang Qiu
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China.
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19
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Chang CL, Chiu NC, Yang YC, Ho CS, Hung KL. Normal Development of the Corpus Callosum and Evolution of Corpus Callosum Sexual Dimorphism in Infancy. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:869-877. [PMID: 28990212 DOI: 10.1002/jum.14420] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/16/2017] [Accepted: 07/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The aim of this study was to establish reference ranges for the corpus callosum in infancy and to clarify how sexual dimorphism evolves between the fetal stage and infancy. METHODS Normal sonograms from cerebral ultrasonographic examinations of 1- to 6-month-old healthy full-term infants were selected. The length and thickness of the corpus callosum were determined, and the effect of sex on these values was analyzed. Studies on corpus callosum sexual dimorphism were reviewed. RESULTS In total, sonograms from 236 1- to 6-month-old infants (120 male and 116 female) were collected, and the typical values (5th-95th percentiles) of the corpus callosum were determined for each group. During the first 2 months, with and without brain size adjustment, the corpus callosum in female infants was significantly thicker than that in male infants (mean thickness ± SD: 1 month, male infant, 1.8 ± 0.3 mm; female infant, 2.1 ± 0.3 mm; P = .005; 2 months, male infant, 1.8 ± 0.2 mm; female infant, 2.0 ± 0.3 mm; P = .002). The corpus callosum thickness of male and female infants had no significant differences after 2 months of age. Sexual dimorphism was not detected in corpus callosum length. CONCLUSIONS Our study provides reference data on typical corpus callosum development in infants. In the fetal period and early infancy, the corpus callosum in female infants is thicker than that in male infants. From 3 months onward, the corpus callosum sexual dimorphism becomes insignificant throughout childhood. The evolvement of corpus callosum sexual dimorphism suggests that maternal factors may influence brain development.
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Affiliation(s)
- Chaw-Liang Chang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
- Department of Pediatrics, Cathay General Hospital, Hsinchu, Taiwan
- Department of Center for Medical Education and Research, Cathay General Hospital, Hsinchu, Taiwan
| | - Nan-Chang Chiu
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan
- Department of Pediatrics, Mackay Junior College of Medicine, Nursing, and Management, New Taipei City, Taiwan Department of Pediatrics (K.-L.H.), Cathay General Hospital, Taipei, Taiwan
| | - Yi-Chen Yang
- Department of Center for Medical Education and Research, Cathay General Hospital, Hsinchu, Taiwan
| | - Che-Sheng Ho
- Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan
- Department of Pediatrics, Mackay Junior College of Medicine, Nursing, and Management, New Taipei City, Taiwan Department of Pediatrics (K.-L.H.), Cathay General Hospital, Taipei, Taiwan
| | - Kun-Long Hung
- Department of Pediatrics, Cathay General Hospital, Hsinchu, Taiwan
- Department of Pediatrics School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
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20
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Shi J, Guo H, Fan F, Fan H, An H, Wang Z, Tan S, Yang F, Tan Y. Sex differences of hippocampal structure in bipolar disorder. Psychiatry Res Neuroimaging 2018; 273:35-41. [PMID: 29329741 DOI: 10.1016/j.pscychresns.2017.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 11/17/2017] [Accepted: 11/17/2017] [Indexed: 12/16/2022]
Abstract
Although differential patterns in clinical characteristics have been consistently noted between male and female patients with bipolar disorder (BD), the effect of sex on the hippocampal structure remains unclear. To address this, the present study investigated the effects of BD and sex on the hippocampal structure, and the relationship between the hippocampal structure and cognitive performance. Morphometric and neurocognitive analyses were performed in 91 subjects (patients with BD: male/female = 33/19; normal controls: male/female = 22/17). Patients had significantly decreased left parahippocampal gyrus area and left/right hippocampal volume compared to normal controls. Within the BD group only, female patients presented with smaller right hippocampal volume than males. In the Spatial Span (SS) test (used to assess working memory capacity) and the Maze test (used to evaluate the ability to anticipate), patients demonstrated decreased performance compared to normal controls, with a significant main effect of sex. Left parahippocampal gyrus area and right hippocampal volume were positively correlated with SS and Maze in patients; moreover, right hippocampal volume predicted 17.4% of SS performance variance. These results suggest that there may be a difference between male and female patients with regard to right hippocampal volume, and that female patients may need more attention than males.
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Affiliation(s)
- Jing Shi
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Hua Guo
- The Psychiatric Hospital of Zhumadian, Zhumadian City, Henan Province, China
| | - Fengmei Fan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Hongzhen Fan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Huimei An
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Zhiren Wang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China.
| | - Shuping Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China.
| | - Fude Yang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yunlong Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
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21
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Pinto JV, Passos IC, Librenza-Garcia D, Marcon G, Schneider MA, Conte JH, Abreu da Silva JP, Lima LP, Quincozes-Santos A, Kauer-Sant’Anna M, Kapczinski F. Neuron-glia Interaction as a Possible Pathophysiological Mechanism of Bipolar Disorder. Curr Neuropharmacol 2018; 16:519-532. [PMID: 28847296 PMCID: PMC5997869 DOI: 10.2174/1570159x15666170828170921] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 07/26/2017] [Accepted: 08/24/2017] [Indexed: 12/15/2022] Open
Abstract
Accumulating evidence has shown the importance of glial cells in the neurobiology of bipolar disorder. Activated microglia and inflammatory cytokines have been pointed out as potential biomarkers of bipolar disorder. Indeed, recent studies have shown that bipolar disorder involves microglial activation in the hippocampus and alterations in peripheral cytokines, suggesting a potential link between neuroinflammation and peripheral toxicity. These abnormalities may also be the biological underpinnings of outcomes related to neuroprogression, such as cognitive impairment and brain changes. Additionally, astrocytes may have a role in the progression of bipolar disorder, as these cells amplify inflammatory response and maintain glutamate homeostasis, preventing excitotoxicity. The present review aims to discuss neuron-glia interactions and their role in the pathophysiology and treatment of bipolar disorder.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Flávio Kapczinski
- Address correspondence to this author at the Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton-ON, Canada; Tel: +55 512 101 8845; E-mails: ,
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22
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Elevated Choline-Containing Compound Levels in Rapid Cycling Bipolar Disorder. Neuropsychopharmacology 2017; 42:2252-2258. [PMID: 28220797 PMCID: PMC5603812 DOI: 10.1038/npp.2017.39] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/30/2017] [Accepted: 02/04/2017] [Indexed: 12/16/2022]
Abstract
Previous studies have found increased levels of choline-containing compounds (ie, glycerophosphocholine plus phosphocholine (GPC+PC)) in bipolar disorder using in vivo proton magnetic resonance spectroscopy (1H MRS), especially in bipolar I disorder (BD-I). Increased levels of GPC+PC suggest alterations in the membrane phospholipids metabolism in bipolar disorder. Rapid cycling (RC) bipolar disorder is considered as a severe course of bipolar disorder, but it is unclear whether rapid cycling bipolar disorder is linked to highly altered membrane phospholipid metabolism. The purpose of this study was to investigate whether the regional extent of elevated GPC+PC were greater in BD-I patients with rapid cycling compared to BD-I patients without rapid cycling and healthy controls. Using a multi-voxel 1H MRS approach at 3 Tesla with high spatial resolution and absolute quantification, GPC+PC levels from the anterior cingulate cortex (ACC), caudate and putamen of 16 RC BD-I, 34 non-RC BD-I and 44 healthy controls were assessed. We found significantly elevated GPC+PC levels in ACC, putamen and caudate of RC BD-I patients compared to healthy controls (P<0.005) and in ACC compared to non-RC BD-I patients (P<0.05). These results suggest greater alteration of membrane phospholipid metabolisms in rapid cycling BD-I compared to non-rapid-cycling BD-I.
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23
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Cao B, Passos IC, Mwangi B, Amaral-Silva H, Tannous J, Wu MJ, Zunta-Soares GB, Soares JC. Hippocampal subfield volumes in mood disorders. Mol Psychiatry 2017; 22:1352-1358. [PMID: 28115740 PMCID: PMC5524625 DOI: 10.1038/mp.2016.262] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 12/08/2016] [Accepted: 12/19/2016] [Indexed: 01/01/2023]
Abstract
Volume reduction and shape abnormality of the hippocampus have been associated with mood disorders. However, the hippocampus is not a uniform structure and consists of several subfields, such as the cornu ammonis (CA) subfields CA1-4, the dentate gyrus (DG) including a granule cell layer (GCL) and a molecular layer (ML) that continuously crosses adjacent subiculum (Sub) and CA fields. It is known that cellular and molecular mechanisms associated with mood disorders may be localized to specific hippocampal subfields. Thus, it is necessary to investigate the link between the in vivo hippocampal subfield volumes and specific mood disorders, such as bipolar disorder (BD) and major depressive disorder (MDD). In the present study, we used a state-of-the-art hippocampal segmentation approach, and we found that patients with BD had reduced volumes of hippocampal subfields, specifically in the left CA4, GCL, ML and both sides of the hippocampal tail, compared with healthy subjects and patients with MDD. The volume reduction was especially severe in patients with bipolar I disorder (BD-I). We also demonstrated that hippocampal subfield volume reduction was associated with the progression of the illness. For patients with BD-I, the volumes of the right CA1, ML and Sub decreased as the illness duration increased, and the volumes of both sides of the CA2/3, CA4 and hippocampal tail had negative correlations with the number of manic episodes. These results indicated that among the mood disorders the hippocampal subfields were more affected in BD-I compared with BD-II and MDD, and manic episodes had focused progressive effect on the CA2/3 and CA4 and hippocampal tail.
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Affiliation(s)
- Bo Cao
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Ives Cavalcante Passos
- Graduation Program in Psychiatry and Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Henrique Amaral-Silva
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Jonika Tannous
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Mon-Ju Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Giovana B. Zunta-Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Jair C. Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, Texas, USA
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24
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Cao B, Passos IC, Wu MJ, Zunta-Soares GB, Mwangi B, Soares JC. Brain gyrification and neuroprogression in bipolar disorder. Acta Psychiatr Scand 2017; 135:612-613. [PMID: 28430365 PMCID: PMC7083164 DOI: 10.1111/acps.12738] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Bo Cao
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA,Correspond to: Bo Cao, 1941 East Rd, Houston TX, 77054,
| | - Ives Cavalcante Passos
- Graduation Program in Psychiatry and Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Mon-Ju Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Giovana B. Zunta-Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jair C. Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
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25
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Gifuni AJ, Olié E, Ding Y, Cyprien F, le Bars E, Bonafé A, Courtet P, Jollant F. Corpus callosum volumes in bipolar disorders and suicidal vulnerability. Psychiatry Res Neuroimaging 2017; 262:47-54. [PMID: 28232274 DOI: 10.1016/j.pscychresns.2017.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/22/2017] [Accepted: 02/09/2017] [Indexed: 12/30/2022]
Abstract
Reduced size of the corpus callosum (CC) has been associated with bipolar disorders and suicidality. Here, we aimed at investigating the relative independence of these associations in a large sample of patients. Two samples of males and females totaling 209 euthymic participants were recruited, including 72 patients with a major depressive disorder, 64 with bipolar disorders and 73 healthy controls. Among patients, 61 had a lifetime history of suicide attempt and 75 had none. Structural scans were acquired with 1.5T magnetic resonance imaging. Surface-based morphometry (Freesurfer) analysis was used to compute the volumes of the CC. In the whole sample, there was a significant reduction in the volume of mid-anterior, central, and mid-posterior (all p<0.008) CC in bipolar patients independently from suicidality, with medium effect sizes between unipolar and bipolar patients (Cohen's d between 0.46 and 0.62). In contrast, suicide attempters did not differ from non-attempters. This significant association between CC volumes and bipolar disorders was mainly found in the male sample, while a trend was found in the female sample. Within each patient group, medication had no major effect. Our study adds to the growing body of evidence linking corpus callosum alterations and bipolar disorders.
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Affiliation(s)
- Anthony J Gifuni
- McGill University & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montreal, Québec, Canada
| | - Emilie Olié
- Université Montpellier I, Montpellier, France & Montpellier Academic Hospital (CHU), Department of psychiatry, Montpellier, France & Inserm, U1061 Montpellier, France
| | - Yang Ding
- McGill University & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montreal, Québec, Canada
| | - Fabienne Cyprien
- Université Montpellier I, Montpellier, France & Montpellier Academic Hospital (CHU), Department of psychiatry, Montpellier, France & Inserm, U1061 Montpellier, France
| | - Emmanuelle le Bars
- Université Montpellier I, Montpellier, France & Montpellier Academic Hospital (CHU), Department of radiology, Montpellier, France
| | - Alain Bonafé
- Université Montpellier I, Montpellier, France & Montpellier Academic Hospital (CHU), Department of radiology, Montpellier, France
| | - Philippe Courtet
- Université Montpellier I, Montpellier, France & Montpellier Academic Hospital (CHU), Department of psychiatry, Montpellier, France & Inserm, U1061 Montpellier, France
| | - Fabrice Jollant
- McGill University & Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montreal, Québec, Canada; Department of Psychiatry, Nîmes Academic Hospital (CHU), Nîmes, France.
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26
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Cao B, Mwangi B, Passos IC, Wu MJ, Keser Z, Zunta-Soares GB, Xu D, Hasan KM, Soares JC. Lifespan Gyrification Trajectories of Human Brain in Healthy Individuals and Patients with Major Psychiatric Disorders. Sci Rep 2017; 7:511. [PMID: 28360420 PMCID: PMC5428697 DOI: 10.1038/s41598-017-00582-1] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 03/03/2017] [Indexed: 12/12/2022] Open
Abstract
Cortical gyrification of the brain represents the folding characteristic of the cerebral cortex. How the brain cortical gyrification changes from childhood to old age in healthy human subjects is still unclear. Additionally, studies have shown regional gyrification alterations in patients with major psychiatric disorders, such as major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SCZ). However, whether the lifespan trajectory of gyrification over the brain is altered in patients diagnosed with major psychiatric disorders is still unknown. In this study, we investigated the trajectories of gyrification in three independent cohorts based on structural brain images of 881 subjects from age 4 to 83. We discovered that the trajectory of gyrification during normal development and aging was not linear and could be modeled with a logarithmic function. We also found that the gyrification trajectories of patients with MDD, BD and SCZ were deviated from the healthy one during adulthood, indicating altered aging in the brain of these patients.
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Affiliation(s)
- Bo Cao
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Ives Cavalcante Passos
- Graduation Program in Psychiatry and Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Mon-Ju Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Zafer Keser
- Department of Neurology, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Giovana B Zunta-Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Dianping Xu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Khader M Hasan
- Department of Diagnostic and Interventional Imaging, The University of Texas Science Center at Houston, Houston, Texas, USA
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
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27
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Kessing LV, Andersen PK. Evidence for clinical progression of unipolar and bipolar disorders. Acta Psychiatr Scand 2017; 135:51-64. [PMID: 27858964 DOI: 10.1111/acps.12667] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVE It is a widely held belief that affective disorders are progressive of nature; however, some recent reviews have questioned this belief. The objective of the present systematic literature review was to present evidence for associations between number of affective episodes and (i) the risk of recurrence of episodes, (ii) probability of recovery from episodes, (iii) severity of episodes, (iv) the threshold for developing episodes, and (v) progression of cognitive deficits in unipolar and bipolar disorders. METHOD A systematic review comprising an extensive literature search conducted in Medline, Embase, and PsychInfo up to September 2016 and including cross-references from identified papers and reviews. RESULTS Most of the five areas are superficially investigated and hampered by methodological challenges. Nevertheless, studies with the longest follow-up periods, using survival analysis methods, taking account of the individual heterogeneity all support a clinical progressive course of illness. Overall, increasing number of affective episodes seems to be associated with (i) increasing risk of recurrence, (ii) increasing duration of episodes, (iii) increasing symptomatic severity of episodes, (iv) decreasing threshold for developing episodes, and (v) increasing risk of developing dementia. CONCLUSION Although the course of illness is heterogeneous, there is evidence for clinical progression of unipolar and bipolar disorders.
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Affiliation(s)
- L V Kessing
- Department O, Psychiatric Center Copenhagen, Copenhagen, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | - P K Andersen
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
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Cyprien F, de Champfleur NM, Deverdun J, Olié E, Le Bars E, Bonafé A, Mura T, Jollant F, Courtet P, Artero S. Corpus callosum integrity is affected by mood disorders and also by the suicide attempt history: A diffusion tensor imaging study. J Affect Disord 2016; 206:115-124. [PMID: 27472413 DOI: 10.1016/j.jad.2016.07.026] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 06/24/2016] [Accepted: 07/18/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Some MRI studies have noted alterations in the corpus callosum (CC) white matter integrity of individuals with mood disorders and also in patients with suicidal behavior. We investigated the specific impact of suicidal behavior on CC integrity in mood disorders. METHODS CC structural changes were assessed by diffusion tensor imaging (DTI) in 121 women 18-50-year-old): 41 with bipolar disorder (BD), 50 with major depressive disorder (MDD) and 30 healthy controls (HC). Fractional anisotropy (FA) and DTI metrics were calculated for the genu, body and splenium of CC and compared in the three groups by MANCOVA. Then, they were re-analyzed relative to the suicide attempt history within the MDD and BD groups and to the suicide number/severity. RESULTS FA values for the CC genu and body were lower in non-suicide attempters with BD than with MDD and in HC. Conversely, FA values for all CC regions were significantly lower in suicide attempters with BD than in HC. Finally, higher number of suicide attempts (>2) and elevated Suicidal Intent Scale score were associated with significant splenium alterations. LIMITATIONS Limitations include the cross-sectional design (non-causal study), the potential influence of medications and concerns about the generalizability to men. CONCLUSION Genu and body are altered in non-suicide attempters with BD, while splenium is specifically altered in suicide attempters, independently from their psychiatric status. History of suicide attempts may be a source of heterogeneity in the association between CC alterations and BD and may partially explain the variable results of previous studies.
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Affiliation(s)
- Fabienne Cyprien
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France; CHRU Montpellier, Montpellier F-34093, France
| | | | - Jérémy Deverdun
- University of Montpellier, Montpellier F-34000, France; CHRU Montpellier, Montpellier F-34093, France; CNRS, UMR 5221, Montpellier F-34093, France
| | - Emilie Olié
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France; CHRU Montpellier, Montpellier F-34093, France
| | | | - Alain Bonafé
- University of Montpellier, Montpellier F-34000, France; CHRU Montpellier, Montpellier F-34093, France
| | - Thibault Mura
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France; CHRU Montpellier, Montpellier F-34093, France; CIC 1001, Montpellier F-34000, France
| | - Fabrice Jollant
- McGill University, Department of Psychiatry, Canada; Douglas Mental Health University Institute, McGill Group for Suicide Studies, Montréal, Québec, Canada
| | - Philippe Courtet
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France; CHRU Montpellier, Montpellier F-34093, France; Fondamental Foundation, France.
| | - Sylvaine Artero
- Inserm, U1061, La Colombière Hospital, Montpellier F-34093, France; University of Montpellier, Montpellier F-34000, France.
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29
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Kapczinski NS, Mwangi B, Cassidy RM, Librenza-Garcia D, Bermudez MB, Kauer-Sant’anna M, Kapczinski F, Passos IC. Neuroprogression and illness trajectories in bipolar disorder. Expert Rev Neurother 2016; 17:277-285. [DOI: 10.1080/14737175.2017.1240615] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Natália S Kapczinski
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ryan M Cassidy
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Diego Librenza-Garcia
- Graduation Program in Psychiatry, Universidade Federal das Ciências da Saúde, Porto Alegre, Brazil
| | - Mariane Bagatin Bermudez
- Graduation Program in Psychiatry, Universidade Federal das Ciências da Saúde, Porto Alegre, Brazil
| | - Márcia Kauer-Sant’anna
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flávio Kapczinski
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Ives Cavalcante Passos
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Passos IC, Mwangi B, Vieta E, Berk M, Kapczinski F. Areas of controversy in neuroprogression in bipolar disorder. Acta Psychiatr Scand 2016; 134:91-103. [PMID: 27097559 DOI: 10.1111/acps.12581] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE We aimed to review clinical features and biological underpinnings related to neuroprogression in bipolar disorder (BD). Also, we discussed areas of controversy and future research in the field. METHOD We systematically reviewed the extant literature pertaining to neuroprogression and BD by searching PubMed and EMBASE for articles published up to March 2016. RESULTS A total of 114 studies were included. Neuroimaging and clinical evidence from cross-sectional and longitudinal studies show that a subset of patients with BD presents a neuroprogressive course with brain changes and unfavorable outcomes. Risk factors associated with these unfavorable outcomes are number of mood episodes, early trauma, and psychiatric and clinical comorbidity. CONCLUSION Illness trajectories are largely variable, and illness progression is not a general rule in BD. The number of manic episodes seems to be the clinical marker more robustly associated with neuroprogression in BD. However, the majority of the evidence came from cross-sectional studies that are prone to bias. Longitudinal studies may help to identify signatures of neuroprogression and integrate findings from the field of neuroimaging, neurocognition, and biomarkers.
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Affiliation(s)
- I C Passos
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - B Mwangi
- Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
| | - E Vieta
- Bipolar Disorders Program, Institut d'Investigacions Biomédiques Agustí Pi Sunyer, CIBERSAM, University of Barcelona Hospital Clinic, Barcelona, Catalonia, Spain
| | - M Berk
- IMPACT Strategic Research Centre, School of Medicine, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health and the Centre for Youth Mental Health, the Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, the University of Melbourne, Parkville, VIC, Australia
| | - F Kapczinski
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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31
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Cao B, Bauer IE, Sharma AN, Mwangi B, Frazier T, Lavagnino L, Zunta-Soares GB, Walss-Bass C, Glahn DC, Kapczinski F, Nielsen DA, Soares JC. Reduced hippocampus volume and memory performance in bipolar disorder patients carrying the BDNF val66met met allele. J Affect Disord 2016; 198:198-205. [PMID: 27018938 PMCID: PMC5214589 DOI: 10.1016/j.jad.2016.03.044] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/08/2016] [Accepted: 03/09/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previous studies investigated the impact of brain-derived neurotrophic factor (BDNF) val66met (rs6265) on hippocampus volumes and neurocognition in bipolar disorders (BD), but the results were not consistent. This study aimed to investigate the effect of BDNF polymorphism on hippocampus volumes and memory performance in well-characterized adult populations diagnosed with type I BD (BD-I) and major depressive disorder (MDD) compared with healthy controls (HC). METHODS 48 BD-I patients, 33 MDD patients and 60 HC were genotyped for BDNF rs6265 using DNA isolated from white blood cells. Individuals with val/met and met/met genotypes were grouped as met carriers and compared to those with the val/val. Brain segmentations were obtained from structural magnetic resonance imaging (MRI) using the Freesurfer. Memory performance was assessed with the California Verbal Learning Task (CVLT). RESULTS We found a significant diagnosis effect and marginal interaction between diagnosis and BDNF genotype group for both hippocampus volumes and memory performance. BDNF met allele carrier BD patients had smaller hippocampus volumes and reduced performance on multiple CVLT scores compared to MDD patients and HC. CONCLUSIONS We provide strong evidence for the BDNF val66met polymorphism as a putative biological signature for the neuroanatomical and cognitive abnormalities commonly observed in BD patients.
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Affiliation(s)
- Bo Cao
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States.
| | | | | | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Thomas Frazier
- The Center for Pediatric Behavioral Health and Center for Autism, Cleveland Clinic, Cleveland, OH, United States
| | - Luca Lavagnino
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Giovana B. Zunta-Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Consuelo Walss-Bass
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - David C. Glahn
- The Olin Neuropsychiatry Research Center, Institute of Living, and Department of Psychiatry, Yale University School of Medicine, CT, United States
| | - Flavio Kapczinski
- Department of Psychiatry, Universidade Federal Rio Grande do Sul, Rua Ramiro Barcelos, 2350, 90035-903, Rio Grande do Sul, Brazil
| | - David A. Nielsen
- Department of Psychiatry and Behavioral Sciences, Michael E. DeBakey V.A. Medical Center, Baylor College of Medicine, Houston, TX, United States
| | - Jair C. Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
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Cao B, Passos IC, Mwangi B, Bauer IE, Zunta-Soares GB, Kapczinski F, Soares JC. Hippocampal volume and verbal memory performance in late-stage bipolar disorder. J Psychiatr Res 2016; 73:102-107. [PMID: 26714201 PMCID: PMC4985176 DOI: 10.1016/j.jpsychires.2015.12.012] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 12/07/2015] [Accepted: 12/10/2015] [Indexed: 11/17/2022]
Abstract
Studies about changes in hippocampal volumes in subjects with bipolar disorder (BD) have been contradictory. Since the number of manic episodes and hospitalization has been associated with brain changes and poor cognitive outcomes among BD patients, we have hypothesized that these variables could clarify this issue. We stratified subjects with BD in early (BD-Early), intermediate (BD-intermediate) and late (BD-Late) stages as a function of number of manic episodes and prior hospitalization. Then, we compared their hippocampal volumes and California Verbal Learning Test-II (CVLT-II) scores with healthy controls (HC) using the general linear model. A total of 173 subjects were included in the study (112 HC, 15 BD-Early, 30 BD-Intermediate, and 16 BD-Late). We found a significant group effect on hippocampus volume (F(3,167) = 3.227, p = 0.024). Post-hoc analysis showed that BD-Late subjects had smaller hippocampus than HC (p = 0.017). BD-Early and BD-Intermediate subjects showed no significant difference in hippocampus volume compared to HC and BD-Late subjects. The CVLT trial 1 to 5 scores were significantly different across the groups (F(3,167) = 6.371, p < 0.001). Post-hoc analysis showed that BD-Intermediate (p = 0.006) and BD-Late (p = 0.017) subjects had worse memory performance during immediate recall than HC, while the performance difference between BD-Early subjects and HC was not significant (p = 0.208). These findings add to the notion that BD is a neuroprogressive disorder with brain changes and cognitive impairment according to prior morbidity (number of manic episodes and hospitalization). Also, they suggest that hippocampus is a brain marker and a potential therapeutic target for patients at late stage.
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Affiliation(s)
- Bo Cao
- UT Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
| | - Ives Cavalcante Passos
- UT Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
- Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Benson Mwangi
- UT Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
| | - Isabelle E. Bauer
- UT Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
| | - Giovana B. Zunta-Soares
- UT Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
| | - Flávio Kapczinski
- UT Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
- Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Jair C. Soares
- UT Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Science Center at Houston, Houston, TX, USA
- Corresponding author. University of Texas Health Science Center at Houston, Biomedical and Behavioral Sciences Building (BBSB), 1941 East Rd Suite 3208 Houston, TX 77054, USA. (J.C. Soares)
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