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Pérez-Ramos A, Romero-López-Alberca C, Hidalgo-Figueroa M, Berrocoso E, Pérez-Revuelta JI. A systematic review of the biomarkers associated with cognition and mood state in bipolar disorder. Int J Bipolar Disord 2024; 12:18. [PMID: 38758506 PMCID: PMC11101403 DOI: 10.1186/s40345-024-00340-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a severe psychiatric disorder characterized by changes in mood that alternate between (hypo) mania or depression and mixed states, often associated with functional impairment and cognitive dysfunction. But little is known about biomarkers that contribute to the development and sustainment of cognitive deficits. The aim of this study was to review the association between neurocognition and biomarkers across different mood states. METHOD Search databases were Web of Science, Scopus and PubMed. A systematic review was carried out following the PRISMA guidelines. Risk of bias was assessed with the Newcastle-Ottawa Scale. Studies were selected that focused on the correlation between neuroimaging, physiological, genetic or peripheral biomarkers and cognition in at least two phases of BD: depression, (hypo)mania, euthymia or mixed. PROSPERO Registration No.: CRD42023410782. RESULTS A total of 1824 references were screened, identifying 1023 published articles, of which 336 were considered eligible. Only 16 provided information on the association between biomarkers and cognition in the different affective states of BD. The included studies found: (i) Differences in levels of total cholesterol and C reactive protein depending on mood state; (ii) There is no association found between cognition and peripheral biomarkers; (iii) Neuroimaging biomarkers highlighted hypoactivation of frontal areas as distinctive of acute state of BD; (iv) A deactivation failure has been reported in the ventromedial prefrontal cortex (vmPFC), potentially serving as a trait marker of BD. CONCLUSION Only a few recent articles have investigated biomarker-cognition associations in BD mood phases. Our findings underline that there appear to be central regions involved in BD that are observed in all mood states. However, there appear to be underlying mechanisms of cognitive dysfunction that may vary across different mood states in BD. This review highlights the importance of standardizing the data and the assessment of cognition, as well as the need for biomarkers to help prevent acute symptomatic phases of the disease, and the associated functional and cognitive impairment.
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Affiliation(s)
- Anaid Pérez-Ramos
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, Faculty of Medicine, University of Cadiz, Cadiz, Spain
| | - Cristina Romero-López-Alberca
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain.
- Personality, Evaluation and Psychological Treatment Area, Department of Psychology, University of Cadiz, Cadiz, Spain.
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain.
| | - Maria Hidalgo-Figueroa
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Psychobiology Area, Department of Psychology, University of Cadiz, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain
| | - Esther Berrocoso
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, Faculty of Medicine, University of Cadiz, Cadiz, Spain
| | - Jose I Pérez-Revuelta
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Clinical Management of Mental Health Unit, University Hospital of Jerez, Andalusian Health Service, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain
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Martino M, Magioncalda P. A three-dimensional model of neural activity and phenomenal-behavioral patterns. Mol Psychiatry 2024; 29:639-652. [PMID: 38114633 DOI: 10.1038/s41380-023-02356-w] [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: 07/18/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
How phenomenal experience and behavior are related to neural activity in physiology and psychopathology represents a fundamental question in neuroscience and psychiatry. The phenomenal-behavior patterns may be deconstructed into basic dimensions, i.e., psychomotricity, affectivity, and thought, which might have distinct neural correlates. This work provides a data overview on the relationship of these phenomenal-behavioral dimensions with brain activity across physiological and pathological conditions (including major depressive disorder, bipolar disorder, schizophrenia, attention-deficit/hyperactivity disorder, anxiety disorders, addictive disorders, Parkinson's disease, Tourette syndrome, Alzheimer's disease, and frontotemporal dementia). Accordingly, we propose a three-dimensional model of neural activity and phenomenal-behavioral patterns. In this model, neural activity is organized into distinct units in accordance with connectivity patterns and related input/output processing, manifesting in the different phenomenal-behavioral dimensions. (1) An external neural unit, which involves the sensorimotor circuit/brain's sensorimotor network and is connected with the external environment, processes external inputs/outputs, manifesting in the psychomotor dimension (processing of exteroception/somatomotor activity). External unit hyperactivity manifests in psychomotor excitation (hyperactivity/hyperkinesia/catatonia), while external unit hypoactivity manifests in psychomotor inhibition (retardation/hypokinesia/catatonia). (2) An internal neural unit, which involves the interoceptive-autonomic circuit/brain's salience network and is connected with the internal/body environment, processes internal inputs/outputs, manifesting in the affective dimension (processing of interoception/autonomic activity). Internal unit hyperactivity manifests in affective excitation (anxiety/dysphoria-euphoria/panic), while internal unit hypoactivity manifests in affective inhibition (anhedonia/apathy/depersonalization). (3) An associative neural unit, which involves the brain's associative areas/default-mode network and is connected with the external/internal units (but not with the environment), processes associative inputs/outputs, manifesting in the thought dimension (processing of ideas). Associative unit hyperactivity manifests in thought excitation (mind-wandering/repetitive thinking/psychosis), while associative unit hypoactivity manifests in thought inhibition (inattention/cognitive deficit/consciousness loss). Finally, these neural units interplay and dynamically combine into various neural states, resulting in the complex phenomenal experience and behavior across physiology and neuropsychiatric disorders.
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Affiliation(s)
- Matteo Martino
- Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan.
| | - Paola Magioncalda
- Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan.
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Radiology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
- Department of Medical Research, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
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Wu Y, Su YA, Zhu L, Li J, Si T. Advances in functional MRI research in bipolar disorder: from the perspective of mood states. Gen Psychiatr 2024; 37:e101398. [PMID: 38292862 PMCID: PMC10826570 DOI: 10.1136/gpsych-2023-101398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/20/2023] [Indexed: 02/01/2024] Open
Abstract
Bipolar disorder is characterised by recurrent and alternating episodes of mania/hypomania and depression. Current breakthroughs in functional MRI techniques have uncovered the functional neuroanatomy of bipolar disorder. However, the pathophysiology underlying mood instability, mood switching and the development of extreme mood states is less well understood. This review presents a comprehensive overview of current evidence from functional MRI studies from the perspective of mood states. We first summarise the disrupted brain activation patterns and functional connectivity that have been reported in bipolar disorder, irrespective of the mood state. We next focus on research that solely included patients in a single mood state for a better understanding of the pathophysiology of bipolar disorder and research comparing patients with different mood states to dissect mood state-related effects. Finally, we briefly summarise current theoretical models and conclude this review by proposing potential avenues for future research. A comprehensive understanding of the pathophysiology with consideration of mood states could not only deepen our understanding of how acute mood episodes develop at a neurophysiological level but could also facilitate the identification of biological targets for personalised treatment and the development of new interventions for bipolar disorder.
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Affiliation(s)
- Yankun Wu
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yun-Ai Su
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Linlin Zhu
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jitao Li
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Tianmei Si
- Department of Clinical Psychopharmacology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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Caruana GF, Carruthers SP, Berk M, Rossell SL, Van Rheenen TE. To what extent does white matter map to cognition in bipolar disorder? A systematic review of the evidence. Prog Neuropsychopharmacol Biol Psychiatry 2024; 128:110868. [PMID: 37797735 DOI: 10.1016/j.pnpbp.2023.110868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/19/2023] [Accepted: 10/01/2023] [Indexed: 10/07/2023]
Abstract
Cognitive impairment is a prominent feature of bipolar disorder (BD), however the neural substrates underpinning it remain unclear. Several studies have explored white matter as a correlate of cognitive functioning in BD cohorts, but mixed results and varied methodologies from one to another make inferences about this relationship difficult to draw. Here we sought to systematically synthesise the findings of these studies to more clearly explicate the nature and extent of relationships between white matter and cognition in BD and determine best practice methodologies and areas for future research in this area. Using PRISMA guidelines, we identified and systematically reviewed 37 relevant studies, all of which were cross-sectional by design. There was substantial methodological heterogeneity and variability in the clinical presentations of BD cohorts encapsulated within the studies we reviewed, which complicated our synthesis of the findings. Nonetheless, there was some evidence that cognition is related to both white matter macrostructure and microstructure in people with BD. In particular, multiple microstructural studies consistently reported that higher fractional anisotropy, both globally and in the corpus callosum, associated with better complex attention skills and executive functioning. However, several reports did not identify any associations at all, and in general, associations between WM and cognition tended to only be evident in studies utilising larger samples and post-hoc selection of WM regions of interest. Further research with increased statistical power and standardised methods are required moving forward.
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Affiliation(s)
- Georgia F Caruana
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria 3053, Australia
| | - Sean P Carruthers
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Victoria 3122, Australia
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong 3220, Australia; Centre for Youth Mental Health and Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Victoria 3052, Australia; Barwon Health, University Hospital Geelong, Victoria 3220, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Victoria 3052, Australia
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Victoria 3122, Australia; St Vincent's Mental Health, St Vincent's Hospital, VIC, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria 3053, Australia; Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Victoria 3122, Australia; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong 3220, Australia.
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Claeys EHI, Mantingh T, Morrens M, Yalin N, Stokes PRA. Resting-state fMRI in depressive and (hypo)manic mood states in bipolar disorders: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2022; 113:110465. [PMID: 34736998 DOI: 10.1016/j.pnpbp.2021.110465] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 10/01/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Abnormalities in spontaneous brain activity, measured with resting-state functional magnetic resonance imaging (rs-fMRI), may be key biomarkers for bipolar disorders. This systematic review compares rs-fMRI findings in people experiencing a bipolar depressive or (hypo)manic episode to bipolar euthymia and/or healthy participants. METHODS Medline, Web of Science and Embase were searched up until April 2021. Studies without control group, or including minors, neurological co-morbidities or mixed episodes, were excluded. Qualitative synthesis was used to report results and risk of bias was assessed using the National Heart, Lung and Blood Institute tool for case-control studies. RESULTS Seventy-one studies were included (3167 bipolar depressed/706 (hypo)manic). In bipolar depression, studies demonstrated default-mode (DMN) and frontoparietal network (FPN) dysfunction, altered baseline activity in the precuneus, insula, striatum, cingulate, frontal and temporal cortex, and disturbed regional homogeneity in parietal, temporal and pericentral areas. Functional connectivity was altered in thalamocortical circuits and between the cingulate cortex and precuneus. In (hypo)mania, studies reported altered functional connectivity in the amygdala, frontal and cingulate cortex. Finally, rs-fMRI disturbances in the insula and putamen correlate with depressive symptoms, cerebellar resting-state alterations could evolve with disease progression and altered amygdala connectivity might mediate lithium effects. CONCLUSIONS Our results suggest DMN and FPN dysfunction in bipolar depression, whereas local rs-fMRI alterations might differentiate mood states. Future studies should consider controlling rs-fMRI findings for potential clinical confounding factors such as medication. Considerable heterogeneity of methodology between studies limits conclusions. Standardised clinical reporting and consistent analysis approaches would increase coherence in this promising field.
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Affiliation(s)
- Eva H I Claeys
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, S.033, Universiteitsplein 1, 2610 Antwerpen, Belgium; Department of Psychiatry, University Psychiatric Centre Duffel, Stationsstraat 22, 2570 Duffel, Belgium
| | - Tim Mantingh
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Manuel Morrens
- Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, S.033, Universiteitsplein 1, 2610 Antwerpen, Belgium; Department of Psychiatry, University Psychiatric Centre Duffel, Stationsstraat 22, 2570 Duffel, Belgium
| | - Nefize Yalin
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Paul R A Stokes
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Tracing the psychopathology of bipolar disorder to the functional architecture of intrinsic brain activity and its neurotransmitter modulation: a three-dimensional model. Mol Psychiatry 2022; 27:793-802. [PMID: 33414499 DOI: 10.1038/s41380-020-00982-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/22/2020] [Accepted: 12/01/2020] [Indexed: 12/17/2022]
Abstract
Bipolar disorder (BD) shows complex alterations in psychomotor, affective, and thought dimensions, as described by Kraepelin in his fundamental model of manic-depressive illness. In turn, the expression of behavioral/phenomenological dimensions is traceable to intrinsic brain activity. We reported a data overview on intrinsic brain functioning and its changes in BD. Accordingly, we proposed a three-dimensional model of the relationship between brain functioning and behavioral/phenomenological patterns, along with its application to BD. In this model, intrinsic brain activity is organized in distinct units in accordance to connectivity patterns and related setting of input/output processing, underlying the different behavioral/phenomenological dimensions. An external unit (mainly involving the sensorimotor network) is connected with the external environment and sets the exteroceptive input/somatomotor output processing, underlying the psychomotor dimension. An internal unit (mainly involving the salience network) is connected to the internal/body environment and sets the interoceptive input/visceromotor output processing, underlying the affective dimension. Finally, an associative unit (mainly involving the default-mode network) is not connected with the environment and sets the processing of associative inputs/outputs, underlying the thought dimension. In each unit, neurotransmitter signaling couples the subcortical-cortical loop, which modulates the network activity levels, in turn setting input/output processing and related expression levels of the behavioral/phenomenological dimension. Different combinations in neurotransmitter signaling favor network balancing into distinct functional brain states, which manifest in different combinations of excitation or inhibition in psychomotricity, affectivity, and thought, resulting in the manic, depressive, and mixed states of BD. Our working model might provide a coherent framework for tracing the complex BD psychopathology to core functional brain alterations.
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Sun F, Liu Z, Yang J, Fan Z, Xi C, Cheng P, He Z, Yang J. Shared and distinct patterns of dynamical degree centrality in bipolar disorder across different mood states. Front Psychiatry 2022; 13:941073. [PMID: 35966464 PMCID: PMC9364672 DOI: 10.3389/fpsyt.2022.941073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies have probed the brain static activity pattern in bipolar disorder across different states. However, human intrinsic brain activity is time-varying and dynamic. There is a lack of knowledge about the brain dynamical pattern in bipolar disorder across different mood states. METHODS This study used the dynamical degree centrality (dDC) to investigate the resting-state whole-brain dynamical pattern voxel-wise in a total of 62 bipolar disorder [28 bipolar depression (BD), 13 bipolar mania (BM), 21 bipolar euthymia (BE)], and 30 healthy controls (HCs). One-way analysis of variance (ANOVA) was applied to explore the omnibus differences of the dDC pattern across all groups, and Pearson's correlation analysis was used to evaluate the relationship between the dDC variability in detected regions with clinical symptom severity. RESULTS One-way ANOVA analysis showed the omnibus differences in the left inferior parietal lobule/middle occipital gyrus (IPL/MOG) and right precuneus/posterior cingulate cortex (PCUN/PCC) across all groups. The post hoc analysis revealed that BD showed decreased dDC in the IPL/MOG compared with all other groups, and both BD and BM exhibited decreased dDC in the PCUN/PCC compared with BE and HCs. Furthermore, correlation analysis showed that the dDC variability of the IPL/MOG and PCUN/PCC negatively correlated with the depression symptom levels in all patients with bipolar disorder. CONCLUSION This study demonstrated the distinct and shared brain dynamical pattern of the depressive, manic, and euthymia states. Our findings provide new insights into the pathophysiology of bipolar disorder across different mood states from the dynamical brain network pattern perspective.
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Affiliation(s)
- Fuping Sun
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhening Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zebin Fan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chang Xi
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Peng Cheng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhong He
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jie Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
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A unified model of the pathophysiology of bipolar disorder. Mol Psychiatry 2022; 27:202-211. [PMID: 33859358 DOI: 10.1038/s41380-021-01091-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/17/2021] [Accepted: 03/29/2021] [Indexed: 02/02/2023]
Abstract
This work provides an overview of the most consistent alterations in bipolar disorder (BD), attempting to unify them in an internally coherent working model of the pathophysiology of BD. Data on immune-inflammatory changes, structural brain abnormalities (in gray and white matter), and functional brain alterations (from neurotransmitter signaling to intrinsic brain activity) in BD were reviewed. Based on the reported data, (1) we hypothesized that the core pathological alteration in BD is a damage of the limbic network that results in alterations of neurotransmitter signaling. Although heterogeneous conditions can lead to such damage, we supposed that the main pathophysiological mechanism is traceable to an immune/inflammatory-mediated alteration of white matter involving the limbic network connections, which destabilizes the neurotransmitter signaling, such as dopamine and serotonin signaling. Then, (2) we suggested that changes in such neurotransmitter signaling (potentially triggered by heterogeneous stressors onto a structurally-damaged limbic network) lead to phasic (and often recurrent) reconfigurations of intrinsic brain activity, from abnormal subcortical-cortical coupling to changes in network activity. We suggested that the resulting dysbalance between networks, such as sensorimotor networks, salience network, and default-mode network, clinically manifest in combined alterations of psychomotricity, affectivity, and thought during the manic and depressive phases of BD. Finally, (3) we supposed that an additional contribution of gray matter alterations and related cognitive deterioration characterize a clinical-biological subgroup of BD. This model may provide a general framework for integrating the current data on BD and suggests novel specific hypotheses, prompting for a better understanding of the pathophysiology of BD.
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Zeng C, Ross B, Xue Z, Huang X, Wu G, Liu Z, Tao H, Pu W. Abnormal Large-Scale Network Activation Present in Bipolar Mania and Bipolar Depression Under Resting State. Front Psychiatry 2021; 12:634299. [PMID: 33841204 PMCID: PMC8032940 DOI: 10.3389/fpsyt.2021.634299] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/16/2021] [Indexed: 01/14/2023] Open
Abstract
Introduction: Previous studies have primarily focused on the neuropathological mechanisms of the emotional circuit present in bipolar mania and bipolar depression. Recent studies applying resting-state functional magnetic resonance imaging (fMRI) have raise the possibility of examining brain-wide networks abnormality between the two oppositional emotion states, thus this study aimed to characterize the different functional architecture represented in mania and depression by employing group-independent component analysis (gICA). Materials and Methods: Forty-one bipolar depressive patients, 20 bipolar manic patients, and 40 healthy controls (HCs) were recruited and received resting-state fMRI scans. Group-independent component analysis was applied to the brain network functional connectivity analysis. Then, we calculated the correlation between the value of between-group differences and clinical variables. Results: Group-independent component analysis identified 15 components in all subjects, and ANOVA showed that functional connectivity (FC) differed significantly in the default mode network, central executive network, and frontoparietal network across the three groups. Further post-hoc t-tests showed a gradient descent of activity-depression > HC > mania-in all three networks, with the differences between depression and HCs, as well as between depression and mania, surviving after family wise error (FWE) correction. Moreover, central executive network and frontoparietal network activities were positively correlated with Hamilton depression rating scale (HAMD) scores and negatively correlated with Young manic rating scale (YMRS) scores. Conclusions: Three brain networks heighten activity in depression, but not mania; and the discrepancy regions mainly located in prefrontal, which may imply that the differences in cognition and emotion between the two states is associated with top-down regulation in task-independent networks.
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Affiliation(s)
- Can Zeng
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Brendan Ross
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Zhimin Xue
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaojun Huang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Guowei Wu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhening Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Haojuan Tao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Weidan Pu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
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10
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Radoeva PD, Jenkins GA, Schettini E, Gilbert AC, Barthelemy CM, DeYoung LLA, Kudinova AY, Kim KL, MacPherson HA, Dickstein DP. White matter correlates of cognitive flexibility in youth with bipolar disorder and typically developing children and adolescents. Psychiatry Res Neuroimaging 2020; 305:111169. [PMID: 33011484 PMCID: PMC8015187 DOI: 10.1016/j.pscychresns.2020.111169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 05/31/2020] [Accepted: 07/21/2020] [Indexed: 01/04/2023]
Abstract
Prior studies using behavioral tasks and neuroimaging have shown that children and adolescents with bipolar disorder (BD) have deficits in cognitive flexibility (CF)-defined as adaptation to changing rewards and punishments. However, no study, to our knowledge, has examined the white matter microstructural correlates of CF in youth with BD. To address this gap, we examined the relationship between CF assessed with the Cambridge Neuropsychological Testing Automated Battery (CANTAB)'s Intra-Extra Dimensional Set Shift task (ID/ED) and diffusion tensor imaging analyzed with FSL's preprocessing tools and Tract-Based Spatial Statistics (TBSS). We found a significantly different relationship between microstructural integrity of multiple white matter regions and CF performance in BD (n=28) and age-matched typically developing control (TDC) youths (n=26). Evaluation of the slopes of linear regressions in BD vs. TDC (ID/ED Simple Reversal error rate vs. fractional anisotropy) revealed significantly different slopes across the groups, indicating an aberrant relationship between CF and underlying white matter microstructure in youth with BD. These results underscore the importance of examining specific CF-neuroimaging relationships in BD youth. Future longitudinal studies could seek to define the white matter microstructural trajectories in BD vs. TDC, and relative to CF deficits and BD illness course.
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Affiliation(s)
- Petya D Radoeva
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA; Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Gracie A Jenkins
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA; Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Elana Schettini
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA; Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Anna C Gilbert
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA; Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Christine M Barthelemy
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA; Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Lena L A DeYoung
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA; Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Anastacia Y Kudinova
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA; Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Kerri L Kim
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA; Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Heather A MacPherson
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA; Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Daniel P Dickstein
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA; Division of Child Psychiatry, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
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11
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Disruption of Conscious Access in Psychosis Is Associated with Altered Structural Brain Connectivity. J Neurosci 2020; 41:513-523. [PMID: 33229501 DOI: 10.1523/jneurosci.0945-20.2020] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/10/2020] [Accepted: 09/20/2020] [Indexed: 11/21/2022] Open
Abstract
According to global neuronal workspace (GNW) theory, conscious access relies on long-distance cerebral connectivity to allow a global neuronal ignition coding for conscious content. In patients with schizophrenia and bipolar disorder, both alterations in cerebral connectivity and an increased threshold for conscious perception have been reported. The implications of abnormal structural connectivity for disrupted conscious access and the relationship between these two deficits and psychopathology remain unclear. The aim of this study was to determine the extent to which structural connectivity is correlated with consciousness threshold, particularly in psychosis. We used a visual masking paradigm to measure consciousness threshold, and diffusion MRI tractography to assess structural connectivity in 97 humans of either sex with varying degrees of psychosis: healthy control subjects (n = 46), schizophrenia patients (n = 25), and bipolar disorder patients with (n = 17) and without (n = 9) a history of psychosis. Patients with psychosis (schizophrenia and bipolar disorder with psychotic features) had an elevated masking threshold compared with control subjects and bipolar disorder patients without psychotic features. Masking threshold correlated negatively with the mean general fractional anisotropy of white matter tracts exclusively within the GNW network (inferior frontal-occipital fasciculus, cingulum, and corpus callosum). Mediation analysis demonstrated that alterations in long-distance connectivity were associated with an increased masking threshold, which in turn was linked to psychotic symptoms. Our findings support the hypothesis that long-distance structural connectivity within the GNW plays a crucial role in conscious access, and that conscious access may mediate the association between impaired structural connectivity and psychosis.
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12
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Liu M, Wang Y, Zhang A, Yang C, Liu P, Wang J, Zhang K, Wang Y, Sun N. Altered dynamic functional connectivity across mood states in bipolar disorder. Brain Res 2020; 1750:147143. [PMID: 33068632 DOI: 10.1016/j.brainres.2020.147143] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/02/2020] [Accepted: 09/30/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study aims to identify how the large-scale brain dynamic functional connectivity (dFC) differs between mood states in bipolar disorder (BD). The authors analyzed dFC in subjects with BD in depressed and euthymic states using resting-state functional magnetic resonance imaging (rsfMRI) data, and compared these states to healthy controls (HCs). METHOD 20 subjects with BD in a depressive episode, 23 euthymic BD subjects, and 31 matched HCs underwent rsfMRI scans. Using an existing parcellation of the whole brain, we measured dFC between brain regions and identified the different patterns of brain network connections between groups. RESULTS In the analysis of whole brain dFC, the connectivity between the left Superior Temporal Gyrus (STG) in the somatomotor network (SMN), the right Middle Temporal Gyrus (MTG) in the default mode network (DMN) and the bilateral Postcentral Gyrus (PoG) in the DMN of depressed BD was greater than that of euthymic BD, while there was no significant difference between euthymic BD and HCs in these brain regions. Euthymic BD patients had abnormalities in the frontal-striatal-thalamic (FST) circuit compared to HCs. CONCLUSIONS Differences in dFC within and between DMN and SMN can be used to distinguish depressed and euthymic states in bipolar patients. The hyperconnectivity within and between DMN and SMN may be a state feature of depressed BD. The abnormal connectivity of the FST circuit can help identify euthymic BD from HCs.
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Affiliation(s)
- Min Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China; School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, China
| | - Yuchen Wang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China; School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, China
| | - Aixia Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Chunxia Yang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Penghong Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Junyan Wang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yanfang Wang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China.
| | - Ning Sun
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China; Department of Mental Health, Shanxi Medical University, Taiyuan, China.
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13
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Individual-specific functional connectivity markers track dimensional and categorical features of psychotic illness. Mol Psychiatry 2020; 25:2119-2129. [PMID: 30443042 PMCID: PMC6520219 DOI: 10.1038/s41380-018-0276-1] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 12/23/2022]
Abstract
Neuroimaging studies of psychotic disorders have demonstrated abnormalities in structural and functional connectivity involving widespread brain networks. However, these group-level observations have failed to yield any biomarkers that can provide confirmatory evidence of a patient's current symptoms, predict future symptoms, or predict a treatment response. Lack of precision in both neuroanatomical and clinical boundaries have likely contributed to the inability of even well-powered studies to resolve these key relationships. Here, we employed a novel approach to defining individual-specific functional connectivity in 158 patients diagnosed with schizophrenia (n = 49), schizoaffective disorder (n = 37), or bipolar disorder with psychosis (n = 72), and identified neuroimaging features that track psychotic symptoms in a dimension- or disorder-specific fashion. Using individually specified functional connectivity, we were able to estimate positive, negative, and manic symptoms that showed correlations ranging from r = 0.35 to r = 0.51 with the observed symptom scores. Comparing optimized estimation models among schizophrenia spectrum patients, positive and negative symptoms were associated with largely non-overlapping sets of cortical connections. Comparing between schizophrenia spectrum and bipolar disorder patients, the models for positive symptoms were largely non-overlapping between the two disorder classes. Finally, models derived using conventional region definition strategies performed at chance levels for most symptom domains. Individual-specific functional connectivity analyses revealed important new distinctions among cortical circuits responsible for the positive and negative symptoms, as well as key new information about how circuits underlying symptom expressions may vary depending on the underlying etiology and illness syndrome from which they manifest.
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14
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Russo D, Martino M, Magioncalda P, Inglese M, Amore M, Northoff G. Opposing Changes in the Functional Architecture of Large-Scale Networks in Bipolar Mania and Depression. Schizophr Bull 2020; 46:971-980. [PMID: 32047938 PMCID: PMC7342167 DOI: 10.1093/schbul/sbaa004] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Manic and depressive phases of bipolar disorder (BD) show opposite symptoms in psychomotor, thought, and affective dimensions. Neuronally, these may depend on distinct patterns of alterations in the functional architecture of brain intrinsic activity. Therefore, the study aimed to characterize the spatial and temporal changes of resting-state activity in mania and depression, by investigating the regional homogeneity (ReHo) and degree of centrality (DC), in different frequency bands. METHODS Using resting-state functional magnetic resonance imaging (fMRI), voxel-wise ReHo and DC were calculated-in the standard frequency band (SFB: 0.01-0.10 Hz), as well as in Slow5 (0.01-0.027 Hz) and Slow4 (0.027-0.073 Hz)-and compared between manic (n = 36), depressed (n = 43), euthymic (n = 29) patients, and healthy controls (n = 112). Finally, clinical correlations were investigated. RESULTS Mania was mainly characterized by decreased ReHo and DC in Slow4 in the medial prefrontal cortex (as part of the default-mode network [DMN]), which in turn correlated with manic symptomatology. Conversely, depression was mainly characterized by decreased ReHo in SFB in the primary sensory-motor cortex (as part of the sensorimotor network [SMN]), which in turn correlated with depressive symptomatology. CONCLUSIONS Our data show a functional reconfiguration of the spatiotemporal structure of intrinsic brain activity to occur in BD. Mania might be characterized by a predominance of sensorimotor over associative networks, possibly driven by a deficit of the DMN (reflecting in internal thought deficit). Conversely, depression might be characterized by a predominance of associative over sensorimotor networks, possibly driven by a deficit of the SMN (reflecting in psychomotor inhibition).
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Affiliation(s)
- Daniel Russo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy,Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Matteo Martino
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Paola Magioncalda
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy,Brain and Consciousness Research Center, Taipei Medical University – Shuang Ho Hospital, New Taipei City, Taiwan,Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan,To whom correspondence should be addressed; Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, No. 250 Wuxing Street, 11031 Taipei, Taiwan; tel: 00886-2-2736-1661-8601, fax: 00886-2-8732-5288, e-mail:
| | - Matilde Inglese
- Ospedale Policlinico San Martino IRCCS, Genoa, Italy,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Neurology, University of Genoa, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy,Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Georg Northoff
- University of Ottawa Brain and Mind Research Institute, and Mind Brain Imaging and Neuroethics Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada,Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China
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15
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Wang Y, Gao Y, Tang S, Lu L, Zhang L, Bu X, Li H, Hu X, Hu X, Jiang P, Jia Z, Gong Q, Sweeney JA, Huang X. Large-scale network dysfunction in the acute state compared to the remitted state of bipolar disorder: A meta-analysis of resting-state functional connectivity. EBioMedicine 2020; 54:102742. [PMID: 32259712 PMCID: PMC7136605 DOI: 10.1016/j.ebiom.2020.102742] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/28/2020] [Accepted: 03/16/2020] [Indexed: 02/08/2023] Open
Abstract
Background Bipolar disorder (BD) is a mental disorder characterized by mood fluctuations between an acute episodic state of either mania or depression and a clinically remitted state. Dysfunction of large-scale intrinsic brain networks has been demonstrated in this disorder, but it remains unknown whether those network alterations are related to different states. Methods In the present study, we performed a meta-analysis of whole-brain seed-based resting-state functional connectivity (rsFC) studies in BD patients to compare the intrinsic function of brain networks between episodic and remitted states. Thirty-nine seed-based voxel-wise rsFC datasets from thirty publications (1047 BD patients vs 1081 controls) were included in the meta-analysis. Seeds were categorized into networks by their locations within a priori functional networks. Seed-based d mapping analysis of between-state effects identified brain systems in which different states were associated with increased connectivity or decreased connectivity within and between each seed network. Findings We found that BD patients presented decreased connectivity within the affective network (AN) in acute episodes but not in the remitted state of the illness. Similar decreased connectivity within the default-mode network (DMN) was also found in the acute state, but it was replaced by increased connectivity in the remitted state. In addition, different patterns of between-network dysconnectivity were observed between the acute and remitted states. Interpretation This study is the first to identify different patterns of intrinsic function in large-scale brain networks between the acute and remitted states of BD through meta-analysis. The findings suggest that a shift in network function between the acute and remitted states may be related to distinct emotional and cognitive dysfunctions in BD, which may have important implications for identifying clinically relevant biomarkers to guide alternative treatment strategies for BD patients during active episodes or remission. Funding This study was supported by grants from the National Natural Science Foundation of China (81171488, 81671669 and 81820108018) and by a Sichuan Provincial Youth Grant (2017JQ0001).
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Affiliation(s)
- Yanlin Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Shi Tang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Lu Lu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xuan Bu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xiaoxiao Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Ping Jiang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Zhiyun Jia
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China.
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16
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Conio B, Martino M, Magioncalda P, Escelsior A, Inglese M, Amore M, Northoff G. Opposite effects of dopamine and serotonin on resting-state networks: review and implications for psychiatric disorders. Mol Psychiatry 2020; 25:82-93. [PMID: 30953003 DOI: 10.1038/s41380-019-0406-4] [Citation(s) in RCA: 136] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 01/18/2019] [Accepted: 03/05/2019] [Indexed: 12/21/2022]
Abstract
Alterations in brain intrinsic activity-as organized in resting-state networks (RSNs) such as sensorimotor network (SMN), salience network (SN), and default-mode network (DMN)-and in neurotransmitters signaling-such as dopamine (DA) and serotonin (5-HT)-have been independently detected in psychiatric disorders like bipolar disorder and schizophrenia. Thus, the aim of this work was to investigate the relationship between such neurotransmitters and RSNs in healthy, by reviewing the relevant work on this topic and performing complementary analyses, in order to better understand their physiological link, as well as their alterations in psychiatric disorders. According to the reviewed data, neurotransmitters nuclei diffusively project to subcortical and cortical regions of RSNs. In particular, the dopaminergic substantia nigra (SNc)-related nigrostriatal pathway is structurally and functionally connected with core regions of the SMN, whereas the ventral tegmental area (VTA)-related mesocorticolimbic pathway with core regions of the SN. The serotonergic raphe nuclei (RNi) connections involve regions of the SMN and DMN. Coherently, changes in neurotransmitters activity impact the functional configuration and level of activity of RSNs, as measured by functional connectivity (FC) and amplitude of low-frequency fluctuations/temporal variability of BOLD signal. Specifically, DA signaling is associated with increase in FC and activity in the SMN (hypothetically via the SNc-related nigrostriatal pathway) and SN (hypothetically via the VTA-related mesocorticolimbic pathway), as well as concurrent decrease in FC and activity in the DMN. By contrast, 5-HT signaling (via the RNi-related pathways) is associated with decrease in SMN activity along with increase in DMN activity. Complementally, our empirical data showed a positive correlation between SNc-related FC and SMN activity, whereas a negative correlation between RNi-related FC and SMN activity (along with tilting of networks balance toward the DMN). According to these data, we hypothesize that the activity of neurotransmitter-related neurons synchronize the low-frequency oscillations within different RSNs regions, thus affecting the baseline level of RSNs activity and their balancing. In our model, DA signaling favors the predominance of SMN-SN activity, whereas 5-HT signaling favors the predominance of DMN activity, manifesting in distinct behavioral patterns. In turn, alterations in neurotransmitters signaling (or its disconnection) may favor a correspondent functional reorganization of RSNs, manifesting in distinct psychopathological states. The here suggested model carries important implications for psychiatric disorders, providing novel and well testable hypotheses especially on bipolar disorder and schizophrenia.
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Affiliation(s)
- Benedetta Conio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Martino
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Paola Magioncalda
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy. .,IRCCS Ospedale Policlinico San Martino, Genoa, Italy. .,Brain and Consciousness Research Center, Taipei Medical University - Shuang Ho Hospital, New Taipei City, Taiwan. .,Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan.
| | - Andrea Escelsior
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matilde Inglese
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Neurology, University of Genoa, Genoa, Italy.,Department of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Georg Northoff
- University of Ottawa Brain and Mind Research Institute, and Mind Brain Imaging and Neuroethics Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada. .,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China. .,Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
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17
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Martino M, Magioncalda P, Conio B, Capobianco L, Russo D, Adavastro G, Tumati S, Tan Z, Lee HC, Lane TJ, Amore M, Inglese M, Northoff G. Abnormal Functional Relationship of Sensorimotor Network With Neurotransmitter-Related Nuclei via Subcortical-Cortical Loops in Manic and Depressive Phases of Bipolar Disorder. Schizophr Bull 2020; 46:163-174. [PMID: 31150559 PMCID: PMC6942162 DOI: 10.1093/schbul/sbz035] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Manic and depressive phases of bipolar disorder (BD) show opposite psychomotor symptoms. Neuronally, these may depend on altered relationships between sensorimotor network (SMN) and subcortical structures. The study aimed to investigate the functional relationships of SMN with substantia nigra (SN) and raphe nuclei (RN) via subcortical-cortical loops, and their alteration in bipolar mania and depression, as characterized by psychomotor excitation and inhibition. METHOD In this resting-state functional magnetic resonance imaging (fMRI) study on healthy (n = 67) and BD patients (n = 100), (1) functional connectivity (FC) between thalamus and SMN was calculated and correlated with FC from SN or RN to basal ganglia (BG)/thalamus in healthy; (2) using an a-priori-driven approach, thalamus-SMN FC, SN-BG/thalamus FC, and RN-BG/thalamus FC were compared between healthy and BD, focusing on manic (n = 34) and inhibited depressed (n = 21) patients. RESULTS (1) In healthy, the thalamus-SMN FC showed a quadratic correlation with SN-BG/thalamus FC and a linear negative correlation with RN-BG/thalamus FC. Accordingly, the SN-related FC appears to enable the thalamus-SMN coupling, while the RN-related FC affects it favoring anti-correlation. (2) In BD, mania showed an increase in thalamus-SMN FC toward positive values (ie, thalamus-SMN abnormal coupling) paralleled by reduction of RN-BG/thalamus FC. By contrast, inhibited depression showed a decrease in thalamus-SMN FC toward around-zero values (ie, thalamus-SMN disconnection) paralleled by reduction of SN-BG/thalamus FC (and RN-BG/thalamus FC). The results were replicated in independent HC and BD datasets. CONCLUSIONS These findings suggest an abnormal relationship of SMN with neurotransmitters-related areas via subcortical-cortical loops in mania and inhibited depression, finally resulting in psychomotor alterations.
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Affiliation(s)
- Matteo Martino
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Paola Magioncalda
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Brain and Consciousness Research Center, Taipei Medical University - Shuang Ho Hospital, New Taipei City, Taiwan
- Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
- To whom correspondence should be addressed; Clinica Psichiatrica, Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132 Genoa, Italy; tel: +390103537668, fax: +390103537669, e-mail:
| | - Benedetta Conio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Laura Capobianco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Daniel Russo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giulia Adavastro
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Shankar Tumati
- University of Ottawa Brain and Mind Research Institute, and Mind Brain Imaging and Neuroethics Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
| | - Zhonglin Tan
- Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Hsin-Chien Lee
- Department of Psychiatry, College of Medicine and Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Timothy J Lane
- Brain and Consciousness Research Center, Taipei Medical University - Shuang Ho Hospital, New Taipei City, Taiwan
- Graduate Institute of Mind Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matilde Inglese
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Neurology, University of Genoa, Genoa, Italy
- Department of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Georg Northoff
- University of Ottawa Brain and Mind Research Institute, and Mind Brain Imaging and Neuroethics Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, Canada
- Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
- Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China
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18
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"Average is good, extremes are bad" - Non-linear inverted U-shaped relationship between neural mechanisms and functionality of mental features. Neurosci Biobehav Rev 2019; 104:11-25. [PMID: 31251964 DOI: 10.1016/j.neubiorev.2019.06.030] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 01/22/2023]
Abstract
Traditionally, studies emphasize differences in neural measures between pathological and healthy groups, assuming a binary distinction between the groups, and a linear relationship between neural measures and symptoms. Here, we present four examples that show a continuous relation across the divide of normal and pathological states between neural measures and mental functions. This relation can be characterized by a non-linear inverted-U shaped curve. Along this curve, mid-range or average expression of a neural measure is associated with optimal function of a mental feature (in healthy states), whereas extreme expression, either high or low, is associated with sub-optimal function, and occurs in different neural disorders. Neural expression between the optimal or intermediate and pathological or extreme values is associated with sub-optimal function and at-risk mental states. Thus, this model of neuro-mental relationship can be summarized as "average is good, extremes are bad". By focussing on neuro-mental relationships, this model can facilitate the transition of psychiatry from a categorical to a dimensional and individualized approach needed in the era of precision medicine.
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Zhang J, Magioncalda P, Huang Z, Tan Z, Hu X, Hu Z, Conio B, Amore M, Inglese M, Martino M, Northoff G. Altered Global Signal Topography and Its Different Regional Localization in Motor Cortex and Hippocampus in Mania and Depression. Schizophr Bull 2019; 45:902-910. [PMID: 30285255 PMCID: PMC6581125 DOI: 10.1093/schbul/sby138] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Bipolar disorder (BD) is a complex psychiatric disorder characterized by dominant symptom swings across different phases (manic, depressive, and euthymic). Different symptoms in BD such as abnormal episodic memory recall and psychomotor activity have been related to alterations in different regions, ie, hippocampus and motor cortex. How the abnormal regional distribution of neuronal activity relates to specific symptoms remains unclear, however. One possible neuronal mechanism of the relationship is the alteration of the global distribution of neuronal activity manifested in specific local regions; this can be measured as the correlation between the global signal (GS) and local regions. To understand the GS and its relationship to psychopathological symptoms, we here investigated the alteration of both GS variance and its regional topography in healthy controls and 3 phases of BD. We found that the variance of GS showed no significant difference between the 4 groups. In contrast, the GS topography was significantly altered in the different phases of BD, ie, the regions showing abnormally strong topographical GS contribution changed from hippocampus (and parahippocampus/fusiform gyrus) in depression to motor cortex in mania. Importantly, topographical GS changes in these regions correlated with psychopathological measures in both depression and mania. Taken together, our findings demonstrate the central importance of GS topography for psychopathological symptoms. This sheds lights on the neuronal mechanisms of specific psychopathological symptoms in BD, and its relevance in the relationship between global and local neuronal activities for behavior in general.
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Affiliation(s)
- Jianfeng Zhang
- Mental Health Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China,Department of Brain Functioning Research, Hangzhou Seventh People’s Hospital, Hangzhou, Zhejiang, China,College of Biomedical Engineering and Instrument Sciences, Zhejiang University, Hangzhou, Zhejiang, China
| | - Paola Magioncalda
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Zirui Huang
- Department of Anesthesiology, University of Michigan, Ann Arbor MI,Center for Consciousness Science, University of Michigan, Ann Arbor, MI
| | - Zhonglin Tan
- Mental Health Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiwen Hu
- Mental Health Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhiguo Hu
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China
| | - Benedetta Conio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matilde Inglese
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Neurology, University of Genoa, Genoa, Italy,Department of Neurology, Radiology, and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Matteo Martino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Georg Northoff
- Mental Health Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China,Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China,The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada,Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan,To whom correspondence should be addressed; Tianmu Road 305, Hangzhou, Zhejiang 310013, China; tel: 613-722-6521 ex. 6959, fax: 613-798-2982, e-mail:
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Wang X, Luo Q, Tian F, Cheng B, Qiu L, Wang S, He M, Wang H, Duan M, Jia Z. Brain grey-matter volume alteration in adult patients with bipolar disorder under different conditions: a voxel-based meta-analysis. J Psychiatry Neurosci 2019; 44:89-101. [PMID: 30354038 PMCID: PMC6397036 DOI: 10.1503/jpn.180002] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The literature on grey-matter volume alterations in bipolar disorder is heterogeneous in its findings. METHODS Using effect-size differential mapping, we conducted a meta-analysis of grey-matter volume alterations in patients with bipolar disorder compared with healthy controls. RESULTS We analyzed data from 50 studies that included 1843 patients with bipolar disorder and 2289 controls. Findings revealed lower grey-matter volumes in the bilateral superior frontal gyri, left anterior cingulate cortex and right insula in patients with bipolar disorder and in patients with bipolar disorder type I. Patients with bipolar disorder in the euthymic and depressive phases had spatially distinct regions of altered grey-matter volume. Meta-regression revealed that the proportion of female patients with bipolar disorder or bipolar disorder type I was negatively correlated with regional grey-matter alteration in the right insula; the proportion of patients with bipolar disorder or bipolar disorder type I taking lithium was positively correlated with regional grey-matter alterations in the left anterior cingulate/paracingulate gyri; and the proportion of patients taking antipsychotic medications was negatively correlated with alterations in the anterior cingulate/paracingulate gyri. LIMITATIONS This study was cross-sectional; analysis techniques, patient characteristics and clinical variables in the included studies were heterogeneous. CONCLUSION Structural grey-matter abnormalities in patients with bipolar disorder and bipolar disorder type I were mainly in the prefrontal cortex and insula. Patients' mood state might affect grey-matter alterations. Abnormalities in regional grey-matter volume could be correlated with patients' specific demographic and clinical features.
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Affiliation(s)
- Xiuli Wang
- From the Department of Psychiatry, the Fourth People’s Hospital of Chengdu, Chengdu, China (Duan, He, H. Wang, S. Wang, X. Wang); the Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China (Luo, Jia); the Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China (Tian, Jia); the Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China (Cheng); and the Department of Radiology, the Second People’s Hospital of Yibin, Yibin, China (Qiu)
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Mamah D, Ji A, Rutlin J, Shimony JS. White matter integrity in schizophrenia and bipolar disorder: Tract- and voxel-based analyses of diffusion data from the Connectom scanner. NEUROIMAGE-CLINICAL 2018; 21:101649. [PMID: 30639179 PMCID: PMC6411967 DOI: 10.1016/j.nicl.2018.101649] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 12/06/2018] [Accepted: 12/26/2018] [Indexed: 11/22/2022]
Abstract
Background Diffusion imaging abnormalities have been associated with schizophrenia (SZ) and bipolar disorder (BD), indicating impaired structural connectivity. Newer methods permit the automated reconstruction of major white matter tracts from diffusion-weighted MR images in each individual's native space. Using high-definition diffusion data from SZ and BP subjects, we investigated brain white matter integrity using both an automated tract-based and voxel-based methods. Methods Using a protocol matched to the NIH (Young-Adult) Human Connectome Project (and collected on the same customized ‘Connectom’ scanner), diffusion scans were acquired from 87 total participants (aged 18–30), grouped as SZ (n = 24), BD (n = 33) and healthy controls (n = 30). Fractional anisotropy (FA) of eighteen white matter tracks were analyzed using the TRACULA software. Voxel-wise statistical analyses of diffusion data was carried out using the tract-based spatial statistics (TBSS) software. TRACULA group effects and clinical correlations were investigated using analyses of variance and multiple regression. Results TRACULA analysis identified a trend towards lower tract FA in SZ patients, most significantly in the left anterior thalamic radiation (ATR; p = .04). TBSS results showed significantly lower FA voxels bilaterally within the cerebellum and unilaterally within the left ATR, posterior thalamic radiation, corticospinal tract, and superior longitudinal fasciculus in SZ patients compared to controls (FDR corrected p < .05). FA in BD patients did not significantly differ from controls using either TRACULA or TBSS. Multiple regression showed FA of the ATR as predicting chronic mania (p = .0005) and the cingulum-angular bundle as predicting recent mania (p = .02) in patients. TBSS showed chronic mania correlating with FA voxels within the left ATR and corpus callosum. Conclusions White matter abnormality in SZ varies in severity across different white matter tract regions. Our results indicate that voxel-based analysis of diffusion data is more sensitive than tract-based analysis in identifying such abnormalities. Absence of white matter abnormality in BD may be related to medication effects and age. Our study investigated white matter integrity in 87 young schizophrenia, bipolar disorder and control subjects with a tract-based (TRACULA) and a voxel-based (TBSS) approach, using high-definition diffusion imaging data obtained from the Human Connectome Project ‘Connectom’ scanner. TRACULA evaluated fractional anisotropy (FA) from 18 white matter tracts. TBSS evaluated regional white matter FA. TRACULA identified a trend towards lower tract FA in schizophrenia subjects across multiple tracts. TBSS results showed mainly unilaterally decreased FA voxels in schizophrenia subjects. FA in bipolar patients did not significantly differ from controls with either method. With TRACULA, multiple regression showed that anterior thalamic radiation FA predicted chronic affectivity and cingulum-angular bundle FA predicted recent mania in patients. With TBSS, chronic mania correlated with FA voxels within the left anterior thalamic radiation and corpus callosum.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States.
| | - Andrew Ji
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Jerrel Rutlin
- Department Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Joshua S Shimony
- Department Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States
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Piaggio N, Schiavi S, Martino M, Bommarito G, Inglese M, Magioncalda P. Exploring mania-associated white matter injury by comparison with multiple sclerosis: a diffusion tensor imaging study. Psychiatry Res Neuroimaging 2018; 281:78-84. [PMID: 30268035 DOI: 10.1016/j.pscychresns.2018.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/07/2018] [Accepted: 09/21/2018] [Indexed: 12/16/2022]
Abstract
Bipolar disorder (BD), especially in its active phases, has shown some neuroimaging and immunological similarities with multiple sclerosis (MS). The objective of this study was to compare white matter (WM) alterations in BD patients in manic phase (M-BD) and MS patients at early stage of disease and with low lesion burden. We compared diffusion tensor imaging (DTI)-derived fractional anisotropy (FA), mean diffusivity (MD) and radial diffusivity (RD) in a priori selected WM regions (i.e., corpus callosum and cingulum) betwixt 23 M-BD, 23 MS patients and 46 healthy controls. Both M-BD and MS showed WM changes in the corpus callosum, which, however, showed a greater impairment in MS patients. However, considering the different sub-regions of corpus callosum separately (i.e., genu, body, splenium), M-BD and MS presented an opposite pattern in spatial distribution of WM microstructure alterations, with a greater impairment in the anterior region in M-BD and in the posterior region in MS. Common features as well as divergent patterns in DTI changes are detected in M-BD and early MS, prompting a deeper investigation of analogies and differences in WM and immunological alterations of these disorders.
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Affiliation(s)
- Niccolò Piaggio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Neurology, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Simona Schiavi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Neurology, University of Genoa, Genoa, Italy
| | - Matteo Martino
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genova, Genoa, Italy.
| | - Giulia Bommarito
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Neurology, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Neurology, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Paola Magioncalda
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genova, Genoa, Italy
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Magioncalda P, Martino M, Tardito S, Sterlini B, Conio B, Marozzi V, Adavastro G, Capobianco L, Russo D, Parodi A, Kalli F, Nasi G, Altosole T, Piaggio N, Northoff G, Fenoglio D, Inglese M, Filaci G, Amore M. White matter microstructure alterations correlate with terminally differentiated CD8+ effector T cell depletion in the peripheral blood in mania: Combined DTI and immunological investigation in the different phases of bipolar disorder. Brain Behav Immun 2018; 73:192-204. [PMID: 29723656 DOI: 10.1016/j.bbi.2018.04.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 04/23/2018] [Accepted: 04/26/2018] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND White matter (WM) microstructural abnormalities and, independently, signs of immunological activation were consistently demonstrated in bipolar disorder (BD). However, the relationship between WM and immunological alterations as well as their occurrence in the various phases of BD remain unclear. METHOD In 60 type I BD patients - 20 in manic, 20 in depressive, 20 in euthymic phases - and 20 controls we investigated: (i) diffusion tensor imaging (DTI)-derived fractional anisotropy (FA), radial diffusivity (RD) and axial diffusivity (AD) using a tract-based spatial statistics (TBSS) approach; (ii) circulating T cell subpopulations frequencies, as well as plasma levels of different cytokines; (iii) potential relationships between WM and immunological data. RESULTS We found: (i) a significant widespread combined FA-RD alteration mainly in mania, with involvement of the body of corpus callosum (BCC) and superior corona radiata (SCR); (ii) significant increase in CD4+ T cells as well as significant decrease in CD8+ T cells and their subpopulations effector memory (CD8+ CD28-CD45RA-), terminal effector memory (CD8+ CD28-CD45RA+) and CD8+ IFNγ+ in mania; (iii) a significant relationship between WM and immunological alterations in the whole cohort, and a significant correlation of FA-RD abnormalities in the BCC and SCR with reduced frequencies of CD8+ terminal effector memory and CD8+ IFNγ+ T cells in mania only. CONCLUSIONS Our data show a combined occurrence of WM and immunological alterations in mania. WM abnormalities highly correlated with reduction in circulating CD8+ T cell subpopulations that are terminally differentiated effector cells prone to tissue migration, suggesting that these T cells could play a role in WM alteration in BD.
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Affiliation(s)
- Paola Magioncalda
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Matteo Martino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Samuele Tardito
- Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
| | - Bruno Sterlini
- Department of Experimental Medicine, University of Genoa, Genoa, Italy; Center for Synaptic Neuroscience and Technology, Istituto Italiano di Tecnologia, Genoa, Italy.
| | - Benedetta Conio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Valentina Marozzi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Giulia Adavastro
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Laura Capobianco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Daniel Russo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Alessia Parodi
- Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
| | - Francesca Kalli
- Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
| | - Giorgia Nasi
- Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
| | - Tiziana Altosole
- Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
| | - Niccolò Piaggio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Neurology, University of Genoa, Genoa, Italy.
| | - Georg Northoff
- University of Ottawa Brain and Mind Research Institute, and Mind Brain Imaging and Neuroethics Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, Canada; Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China; TMU Research Center for Brain and Consciousness, Taipei, Taiwan.
| | - Daniela Fenoglio
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy; Department of Internal Medicine, University of Genoa, Genoa, Italy.
| | - Matilde Inglese
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Neurology, University of Genoa, Genoa, Italy; Department of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, NY, USA.
| | - Gilberto Filaci
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy; Department of Internal Medicine, University of Genoa, Genoa, Italy.
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
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Cabeen RP, Laidlaw DH, Ruggieri A, Dickstein DP. Preliminary mapping of the structural effects of age in pediatric bipolar disorder with multimodal MR imaging. Psychiatry Res 2018; 273:54-62. [PMID: 29361347 PMCID: PMC5815932 DOI: 10.1016/j.pscychresns.2017.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 12/31/2017] [Accepted: 12/31/2017] [Indexed: 10/18/2022]
Abstract
This study investigates multimodal structural MR imaging biomarkers of development trajectories in pediatric bipolar disorder. T1-weighted and diffusion-weighted MR imaging was conducted to investigate cross-sectional group differences with age between typically developing controls (N = 26) and youths diagnosed with bipolar disorder (N = 26). Region-based analysis was used to examine cortical thickness of gray matter and diffusion tensor parameters in superficial white matter, and tractography-based analysis was used to examine deep white matter fiber bundles. Patients and controls showed significantly different maturation trajectories across brain areas; however, the magnitude of differences varied by region. The rate of cortical thinning with age was greater in patients than controls in the left frontal pole. While controls showed increasing fractional anisotropy (FA) and axial diffusivity (AD) with age, patients showed an opposite trend of decreasing FA and AD with age in fronto-temporal-striatal regions located in both superficial and deep white matter. The findings support fronto-temporal-striatal alterations in the developmental trajectories of youths diagnosed with bipolar disorder, and further, show the value of multimodal computational techniques in the assessment of neuropsychiatric disorders. These preliminary results warrant further investigation into longitudinal changes and the effects of treatment in the brain areas identified in this study.
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Affiliation(s)
- Ryan P Cabeen
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA.
| | - David H Laidlaw
- Department of Computer Science, Brown University, Providence, RI, USA
| | - Amanda Ruggieri
- Pediatric Mood, Imaging & NeuroDevelopment Program, Bradley Hospital, Alpert Medical School of Brown University, Providence, RI, USA
| | - Daniel P Dickstein
- Pediatric Mood, Imaging & NeuroDevelopment Program, Bradley Hospital, Alpert Medical School of Brown University, Providence, RI, USA
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Ninomiya T, Oshita H, Kawano Y, Goto C, Matsuhashi M, Masuda K, Takita F, Izumi T, Inoue A, Higuma H, Kanehisa M, Akiyoshi J. Reduced white matter integrity in borderline personality disorder: A diffusion tensor imaging study. J Affect Disord 2018; 225:723-732. [PMID: 28922736 DOI: 10.1016/j.jad.2017.09.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/30/2017] [Accepted: 09/07/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Borderline personality disorder (BPD) has a pervasive pattern of instability in interpersonal relationships, self-image, and emotions. BPD may be linked to an abnormal brain anatomy, but little is known about possible impairments of the white matter microstructure in BPD or their relationship with impulsivity or risky behaviors. The aims of the present study were to explore the relationship between BPD and diffusion tensor imaging (DTI) parameters and psychological tests. METHODS We evaluated 35 un-medicated BPD patients in a medication-free state and 50 healthy controls (HCs). We performed DTI tractography in BPD patients and HCs. The Childhood Trauma Questionnaire (CTQ), Profile of Mood State (POMS), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Social Adaptation Self-Evaluation Scale (SASS), and Depression and Anxiety Cognition Scale (DACS) were administered to BPD patients and HCs. RESULTS A tract-based spatial statistics (TBSS) revealed that the BPD group had three clusters with a significantly lower axial diffusivity (AD) than the HC group: one located mainly in the cingulum and the other mainly in the inferior front-occipital fasciculus and inferior longitudinal fasciculus. Regarding the AD values, one cluster correlated negatively and significantly with POMS (Depression) and it was located in the cingulum, while another cluster correlated positively and significantly with DACS (Future Denial) and it was located in the inferior front-occipital fasciculus (IFOF). LIMITATIONS The small sample size of this study prevents us from forming any definitive conclusions, meaning that more studies are needed to confirm our findings. We are unable to generalize our findings to include other ethnic groups. CONCLUSIONS Our results suggested that hypo-metabolism in a front-limbic network dysfunction is characterized by the cingulum and a front-occipital network dysfunction characterized by the occipital lobe, while an occipital-temporal network dysfunction characterized by the inferior longitudinal fasciculus.
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Affiliation(s)
- Taiga Ninomiya
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Harumi Oshita
- Department of Applied Linguistics, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | | | - Chiharu Goto
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Mai Matsuhashi
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Koji Masuda
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Fuku Takita
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Toshihiko Izumi
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Ayako Inoue
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Haruka Higuma
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Masayuki Kanehisa
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan
| | - Jotaro Akiyoshi
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Oita 879-5593, Japan.
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Qiu M, Zhang H, Mellor D, Shi J, Wu C, Huang Y, Zhang J, Shen T, Peng D. Aberrant Neural Activity in Patients With Bipolar Depressive Disorder Distinguishing to the Unipolar Depressive Disorder: A Resting-State Functional Magnetic Resonance Imaging Study. Front Psychiatry 2018; 9:238. [PMID: 29922189 PMCID: PMC5996277 DOI: 10.3389/fpsyt.2018.00238] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/15/2018] [Indexed: 01/21/2023] Open
Abstract
This study aims to explore the intrinsic patterns of spontaneous activity of bipolar depression (BD) patients by analyzing the fractional amplitude of low frequency fluctuation (fALFF) that help differentiate BD from unipolar depressive disorder(UD). Twenty eight patients with BD, 47 patients with UD and 29 healthy controls were enrolled to receive the resting-state functional magnetic resonance imaging (rs-fMRI) scans. The group differences of fALFF values were calculated among three groups. In addition, the correlations between the clinical variables and mfALFF values were estimated. The brain regions with activation discrepancies among three groups are located in precuneus, the left middle temporal gyrus (MTG) and left inferior parietal lobe (IPL) and lingual gyrus. Compared with HC group, BD group shows decreased fALFF in precuneus, the left IPL and increased fALFF in lingual gyrus remarkably; UD group shows significantly decreased fALFF in precuneus, the left MTG and the left IPL. On the contrast of patients with UD, patients with BD have significantly increased fALFF value in the left precuneus, the left MGT and lingual gyrus. Furthermore, a negative correlation is found between the mfALFF values in precuneus and the scores of cognitive impairment factor in the UD group. The similar pattern of intrinsic activity in PCC suggests depressive state-dependent change. The aberrant patterns of intrinsic activity in precuneus, the IPL and lingual gyrus might be provide quantitative nodes that help to conduct further study for better distinguishing between BD and UD.
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Affiliation(s)
- Meihui Qiu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huifeng Zhang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - David Mellor
- School of Psychology, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - Jun Shi
- Institute of Biomedical Engineering, School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Chuangxin Wu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yueqi Huang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianye Zhang
- Department of Medical Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Shen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daihui Peng
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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27
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Canna A, Prinster A, Monteleone AM, Cantone E, Monteleone P, Volpe U, Maj M, Di Salle F, Esposito F. Interhemispheric functional connectivity in anorexia and bulimia nervosa. Eur J Neurosci 2017; 45:1129-1140. [PMID: 27992088 DOI: 10.1111/ejn.13507] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 11/15/2016] [Accepted: 12/14/2016] [Indexed: 01/18/2023]
Abstract
The functional interplay between hemispheres is fundamental for behavioral, cognitive, and emotional control. Anorexia nervosa (AN) and bulimia nervosa (BN) have been largely studied with brain magnetic resonance imaging (MRI) in relation to the functional mechanisms of high-level processing, but not in terms of possible inter-hemispheric functional connectivity anomalies. Using resting-state functional MRI (fMRI), voxel-mirrored homotopic connectivity (VMHC) and regional inter-hemispheric spectral coherence (IHSC) were studied in 15 AN and 13 BN patients and 16 healthy controls (HC). Using T1-weighted and diffusion tensor imaging MRI scans, regional VMHC values were correlated with the left-right asymmetry of corresponding homotopic gray matter volumes and with the white matter callosal fractional anisotropy (FA). Compared to HC, AN patients exhibited reduced VMHC in cerebellum, insula, and precuneus, while BN patients showed reduced VMHC in dorso-lateral prefrontal and orbito-frontal cortices. The regional IHSC analysis highlighted that the inter-hemispheric functional connectivity was higher in the 'Slow-5' band in all regions except the insula. No group differences in left-right structural asymmetries and in VMHC vs. callosal FA correlations were significant in the comparisons between cohorts. These anomalies, not explained by structural changes, indicate that AN and BN, at least in their acute phase, are associated with a loss of inter-hemispheric connectivity in regions implicated in self-referential, cognitive control and reward processing. These findings may thus gather novel functional markers to explore aberrant features of these eating disorders.
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Affiliation(s)
- Antonietta Canna
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via S. Allende, 84081, Baronissi (Salerno), Italy
| | - Anna Prinster
- Biostructure and Bioimaging Institute, National Research Council, Naples, Italy.,IRCCS SDN, Istituto di Ricerca Diagnostica e Nucleare, Naples, Italy
| | | | - Elena Cantone
- Section of ENT, Department of Neurosciences, Reproductive Sciences and Odontostomatology, "Federico II" University, Naples, Italy
| | - Palmiero Monteleone
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via S. Allende, 84081, Baronissi (Salerno), Italy.,Department of Psychiatry, Second University of Naples, Naples, Italy
| | - Umberto Volpe
- Department of Psychiatry, Second University of Naples, Naples, Italy
| | - Mario Maj
- Department of Psychiatry, Second University of Naples, Naples, Italy
| | - Francesco Di Salle
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via S. Allende, 84081, Baronissi (Salerno), Italy
| | - Fabrizio Esposito
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via S. Allende, 84081, Baronissi (Salerno), Italy
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28
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Alamian G, Hincapié AS, Combrisson E, Thiery T, Martel V, Althukov D, Jerbi K. Alterations of Intrinsic Brain Connectivity Patterns in Depression and Bipolar Disorders: A Critical Assessment of Magnetoencephalography-Based Evidence. Front Psychiatry 2017; 8:41. [PMID: 28367127 PMCID: PMC5355450 DOI: 10.3389/fpsyt.2017.00041] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/28/2017] [Indexed: 12/21/2022] Open
Abstract
Despite being the object of a thriving field of clinical research, the investigation of intrinsic brain network alterations in psychiatric illnesses is still in its early days. Because the pathological alterations are predominantly probed using functional magnetic resonance imaging (fMRI), many questions about the electrophysiological bases of resting-state alterations in psychiatric disorders, particularly among mood disorder patients, remain unanswered. Alongside important research using electroencephalography (EEG), the specific recent contributions and future promise of magnetoencephalography (MEG) in this field are not fully recognized and valued. Here, we provide a critical review of recent findings from MEG resting-state connectivity within major depressive disorder (MDD) and bipolar disorder (BD). The clinical MEG resting-state results are compared with those previously reported with fMRI and EEG. Taken together, MEG appears to be a promising but still critically underexploited technique to unravel the neurophysiological mechanisms that mediate abnormal (both hyper- and hypo-) connectivity patterns involved in MDD and BD. In particular, a major strength of MEG is its ability to provide source-space estimations of neuromagnetic long-range rhythmic synchronization at various frequencies (i.e., oscillatory coupling). The reviewed literature highlights the relevance of probing local and interregional rhythmic synchronization to explore the pathophysiological underpinnings of each disorder. However, before we can fully take advantage of MEG connectivity analyses in psychiatry, several limitations inherent to MEG connectivity analyses need to be understood and taken into account. Thus, we also discuss current methodological challenges and outline paths for future research. MEG resting-state studies provide an important window onto perturbed spontaneous oscillatory brain networks and hence supply an important complement to fMRI-based resting-state measurements in psychiatric populations.
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Affiliation(s)
- Golnoush Alamian
- Department of Psychology, University of Montreal , Montreal, QC , Canada
| | - Ana-Sofía Hincapié
- Department of Psychology, University of Montreal, Montreal, QC, Canada; Department of Computer Science, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile; Interdisciplinary Center for Neurosciences, School of Psychology, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - Etienne Combrisson
- Department of Psychology, University of Montreal, Montreal, QC, Canada; Center of Research and Innovation in Sport, Mental Processes and Motor Performance, University Claude Bernard Lyon I, University of Lyon, Villeurbanne, France; Brain Dynamics and Cognition, Lyon Neuroscience Research Center, INSERM U1028, UMR 5292, University of Lyon, Villeurbanne, France
| | - Thomas Thiery
- Department of Psychology, University of Montreal , Montreal, QC , Canada
| | - Véronique Martel
- Department of Psychology, University of Montreal , Montreal, QC , Canada
| | - Dmitrii Althukov
- Department of Psychology, University of Montreal, Montreal, QC, Canada; Department of Computer Sciences, National Research Institution Higher School of Economics, Moscow, Russia; MEG Center, Moscow State University of Pedagogics and Education, Moscow, Russia
| | - Karim Jerbi
- Department of Psychology, University of Montreal, Montreal, QC, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
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