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Li D, Hao J, Hao J, Cui X, Niu Y, Xiang J, Wang B. Enhanced Dynamic Laterality Based on Functional Subnetworks in Patients with Bipolar Disorder. Brain Sci 2023; 13:1646. [PMID: 38137094 PMCID: PMC10741828 DOI: 10.3390/brainsci13121646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 12/24/2023] Open
Abstract
An ocean of studies have pointed to abnormal brain laterality changes in patients with bipolar disorder (BD). Determining the altered brain lateralization will help us to explore the pathogenesis of BD. Our study will fill the gap in the study of the dynamic changes of brain laterality in BD patients and thus provide new insights into BD research. In this work, we used fMRI data from 48 BD patients and 48 normal controls (NC). We constructed the dynamic laterality time series by extracting the dynamic laterality index (DLI) at each sliding window. We then used k-means clustering to partition the laterality states and the Arenas-Fernandez-Gomez (AFG) community detection algorithm to determine the number of states. We characterized subjects' laterality characteristics using the mean laterality index (MLI) and laterality fluctuation (LF). Compared with NC, in all windows and state 1, BD patients showed higher MLI in the attention network (AN) of the right hemisphere, and AN in the left hemisphere showed more frequent laterality fluctuations. AN in the left hemisphere of BD patients showed higher MLI in all windows and state 3 compared to NC. In addition, in the AN of the right hemisphere in state 1, higher MLI in BD patients was significantly associated with patient symptoms. Our study provides new insights into the understanding of BD neuropathology in terms of brain dynamic laterality.
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Affiliation(s)
- Dandan Li
- College of Computer Science and Technology, Taiyuan University of Technology, Jinzhong 030600, China; (J.H.)
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Hu Z, Tan Y, Zhou F, He L. Aberrant functional connectivity within and between brain networks in patients with early-onset bipolar disorder. J Affect Disord 2023; 338:41-51. [PMID: 37257780 DOI: 10.1016/j.jad.2023.05.057] [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: 11/24/2022] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE This study used independent component analysis (ICA) to investigate the connectivity patterns of resting-state functional large-scale brain networks in patients with early-onset bipolar disorder (BD). METHODS ICA was used to extract brain functional network components from 43 early-onset BD patients and 21 healthy controls (HCs). Then, the functional connectivity (FC) and functional network connectivity (FNC) within and between the independent brain networks was calculated, and the correlation between the connectivity changes and neuropsychological scale was evaluated. RESULTS Compared with HCs, FC increased in the right hippocampus and inferior temporal gyrus, and left triangular inferior frontal gyrus of the anterior default mode network (aDMN); right median cingulate and paracingulate gyri, and inferior parietal lobule of the posterior DMN (pDMN); and right precentral and postcentral gyrus of the sensorimotor network (SMN) in early-onset BD patients. However, FC decreased in the left superior frontal gyrus of the aDMN, left paracentral lobule of the SMN, and left lingual gyrus and calcarine of the visual network in early-onset BD patients. There was no significant correlation between FC values of differential brain regions within resting-state networks (RSNs) and neuropsychological scores (uncorrected p > 0.05). In addition, the FNC among the pDMN-auditory network, pDMN-visual network, left frontoparietal network (lFPN)-visual network, lFPN-aDMN and dorsal attention network-ventral attention network (DAN-VAN) were increased in early-onset BD patients. The zFNC of the pDMN-visual network was positively correlated with the anxiety/somatization score (r = 0.5833, p < 0.0001) and sleep disorders (r = 0.6150, p < 0.0001). The zFNC of the lFPN-aDMN was positively correlated with despair (r = 0.4505, p = 0.004 × 10 < 0.05 after Bonferroni correction). The zFNC of the DAN-VAN was positively correlated with cognitive impairment (r = 0.4598, p = 0.0032 × 10 < 0.05 after Bonferroni correction). The zFNC of the DAN-VAN showed a positive correlation trend with the Hamilton Depression Scale (HAMD) total score (r = 0.4404, p = 0.005 × 10 = 0.05 after Bonferroni correction). CONCLUSIONS Patients with early-onset BD showed changes in a wide range of neural functional networks, involving changes in executive control, attention, perceptual regulation, cognition and other neural networks, which may provide new imaging evidence for understanding the pathogenesis of early-onset BD and for therapeutic intervention targets.
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Affiliation(s)
- Ziyi Hu
- Department of Radiology, the First Affiliated Hospital of Nanchang university, Nanchang 330006, China
| | - Yongming Tan
- Department of Radiology, the First Affiliated Hospital of Nanchang university, Nanchang 330006, China
| | - Fuqing Zhou
- Department of Radiology, the First Affiliated Hospital of Nanchang university, Nanchang 330006, China
| | - Laichang He
- Department of Radiology, the First Affiliated Hospital of Nanchang university, Nanchang 330006, China.
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Holmes SE, Asch RH, Davis MT, DellaGioia N, Pashankar N, Gallezot JD, Nabulsi N, Matuskey D, Sanacora G, Carson RE, Blumberg HP, Esterlis I. Differences in Quantification of the Metabotropic Glutamate Receptor 5 Across Bipolar Disorder and Major Depressive Disorder. Biol Psychiatry 2023; 93:1099-1107. [PMID: 36764853 PMCID: PMC10164841 DOI: 10.1016/j.biopsych.2022.10.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/06/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Understanding the neurobiology underlying bipolar disorder (BD) versus major depressive disorder (MDD) is crucial for accurate diagnosis and for driving the discovery of novel treatments. A promising target is the metabotropic glutamate receptor 5 (mGluR5), a modulator of glutamate transmission associated with synaptic plasticity. We measured mGluR5 availability in individuals with MDD and BD for the first time using positron emission tomography. METHODS Individuals with BD (n = 17 depressed; n = 10 euthymic) or MDD (n = 17) and healthy control (HC) individuals (n = 18) underwent imaging with [18F]FPEB positron emission tomography to quantify mGluR5 availability in regions of the prefrontal cortex, which was compared across groups and assessed in relation to depressive symptoms and cognitive function. RESULTS Prefrontal cortex mGluR5 availability was significantly different across groups (F6,116 = 2.18, p = .050). Specifically, mGluR5 was lower in BD versus MDD and HC groups, with no difference between MDD and HC groups. Furthermore, after dividing the BD group, mGluR5 was lower in both BD-depression and BD-euthymia groups versus both MDD and HC groups across regions of interest. Interestingly, lower dorsolateral prefrontal cortex mGluR5 was associated with worse depression in MDD (r = -0.67, p = .005) but not in BD. Significant negative correlations were observed between mGluR5 and working memory in MDD and BD-depression groups. CONCLUSIONS This work suggests that mGluR5 could be helpful in distinguishing BD and MDD as a possible treatment target for depressive symptoms in MDD and for cognitive alterations in both disorders. Further work is needed to confirm differentiating roles for mGluR5 in BD and MDD and to probe modulation of mGluR5 as a preventive/treatment strategy.
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Affiliation(s)
- Sophie E Holmes
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Ruth H Asch
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Margaret T Davis
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Department of Psychology, Yale University, New Haven, Connecticut
| | - Nicole DellaGioia
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Neha Pashankar
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Jean-Dominique Gallezot
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Nabeel Nabulsi
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - David Matuskey
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Gerard Sanacora
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Child Study Center, Yale School of Medicine, New Haven, Connecticut; Clinical Neurosciences Division, U.S. Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut.
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Tseng HH, Hsu CF, Lu TH, Yang YK, Chen PS, Lin PT, Chang YPE, Weng JC. Disrupted white matter network of brain structural connectomes in bipolar disorder patients revealed by q-ball imaging. J Affect Disord 2023; 330:239-244. [PMID: 36870453 DOI: 10.1016/j.jad.2023.02.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Structural and functional brain changes have been found to be associated with altered emotion and cognition in patients with bipolar disorder (BD). Widespread microstructural white matter abnormalities have been observed using traditional structural imaging in BD. q-Ball imaging (QBI) and graph theoretical analysis (GTA) improve the specificity and sensitivity and high accuracy of fiber tracking. We applied QBI and GTA to investigate and compare the structural connectivity alterations and network alterations in patients with and without BD. METHODS Sixty-two patients with BD and 62 healthy controls (HCs) completed a MR scan. We evaluated the group differences in generalized fractional anisotropy (GFA) and normalized quantitative anisotropy (NQA) values by voxel-based statistical analysis with QBI. We also evaluated the group differences in topological parameters of GTA and subnetwork interconnections in network-based statistical analysis (NBS). RESULTS The QBI indices in the BD group were significantly lower than those in the HC group in the corpus callosum, cingulate gyrus, and caudate. The GTA indices indicated that the BD group demonstrated less global integration and higher local segregation than the HC group, but they retained small-world properties. NBS evaluation showed that the majority of the more connected subnetworks in BD occurred in thalamo-temporal/parietal connectivity. CONCLUSION Our findings supported white matter integrity with network alterations in BD.
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Affiliation(s)
- Huai-Hsuan Tseng
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Fen Hsu
- Division of Clinical Psychology, Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Tsung-Hua Lu
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Po See Chen
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Pei-Ti Lin
- Department of Medical Imaging and Radiological Sciences and Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Peng Eve Chang
- Department of Counseling and Clinical Psychology, Columbia University, New York City, NY, USA
| | - Jun-Cheng Weng
- Department of Medical Imaging and Radiological Sciences and Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan; Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan.
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Luciano M, Di Vincenzo M, Mancuso E, Marafioti N, Di Cerbo A, Giallonardo V, Sampogna G, Fiorillo A. Does the Brain Matter? Cortical Alterations in Pediatric Bipolar Disorder: A Critical Review of Structural and Functional Magnetic Resonance Studies. Curr Neuropharmacol 2023; 21:1302-1318. [PMID: 36173069 PMCID: PMC10324338 DOI: 10.2174/1570159x20666220927114417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/14/2022] [Accepted: 07/28/2022] [Indexed: 11/22/2022] Open
Abstract
Pediatric bipolar disorder (PBD) is associated with significant psychosocial impairment, high use of mental health services and a high number of relapses and hospitalization. Neuroimaging techniques provide the opportunity to study the neurodevelopmental processes underlying PBD, helping to identify the endophenotypic markers of illness and early biological markers of PBD. The aim of the study is to review available studies assessing structural and functional brain correlates associated with PBD. PubMed, ISI Web of Knowledge and PsychINFO databases have been searched. Studies were included if they enrolled patients aged 0-18 years with a main diagnosis of PBD according to ICD or DSM made by a mental health professional, adopted structural and/or functional magnetic resonance as the main neuroimaging method, were written in English and included a comparison with healthy subjects. Of the 400 identified articles, 46 papers were included. Patients with PBD present functional and anatomic alterations in structures normally affecting regulations and cognition. Structural neuroimaging revealed a significant reduction in gray matter, with cortical thinning in bilateral frontal, parietal and occipital cortices. Functional neuroimaging studies reported a reduced engagement of the frontolimbic and hyperactivation of the frontostriatal circuitry. Available studies on brain connectivity in PBD patients potentially indicate less efficient connections between regions involved in cognitive and emotional functions. A greater functional definition of alteration in brain functioning of PBD patients will be useful to set up a developmentally sensitive targeted pharmacological and nonpharmacological intervention.
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Affiliation(s)
- Mario Luciano
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Matteo Di Vincenzo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Emiliana Mancuso
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Niccolò Marafioti
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Arcangelo Di Cerbo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | | | - Gaia Sampogna
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
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Cattarinussi G, Bellani M, Maggioni E, Sambataro F, Brambilla P, Delvecchio G. Resting-state functional connectivity and spontaneous brain activity in early-onset bipolar disorder: A review of functional Magnetic Resonance Imaging studies. J Affect Disord 2022; 311:463-471. [PMID: 35580695 DOI: 10.1016/j.jad.2022.05.055] [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: 12/17/2021] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Early-onset bipolar disorder (BD) is a complex psychiatric illness characterized by mood swings, irritability and functional impairments. To improve our understanding of the pathophysiology of the disorder, we collected the existing resting-state functional Magnetic Resonance Imaging (rs-fMRI) studies exploring resting-state functional connectivity (rs-FC) and spontaneous activity alterations in children and adolescents with BD. METHODS A search on PubMed, Web of Science and Scopus was conducted to identify all the relevant rs-fMRI investigations conducted in early-onset BD. A total of 14 studies employing different methodological approaches to explore rs-FC and spontaneous activity in early-onset BD were included (independent component analysis, n = 1; seed-based analysis, n = 7; amplitude of low frequency fluctuations analysis, n = 2; regional homogeneity analysis, n = 4). RESULTS Overall, the studies showed abnormalities within the Default Mode Network (DMN) and between the DMN and the Salience Network (SN). Moreover, widespread alterations in rs-FC and spontaneous brain activity within and between cortico-limbic structures, involving primarily the occipital and frontal lobes, amygdala, hippocampus, insula, thalamus and striatum were also reported. LIMITATIONS The small sample sizes, the use of medications, the presence of comorbidities and the heterogeneity in methods hamper the integration of the study findings. CONCLUSIONS Early-onset BD seems to be characterized by selective rs-FC and spontaneous activity dysfunctions in DMN and SN as well as in the cortico-limbic and cortico-striatal circuits, which could explain the emotive and cognitive deficits observed in this disabling psychiatric illness.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Marcella Bellani
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Electronics Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Chen P, Chen G, Zhong S, Chen F, Ye T, Gong J, Tang G, Pan Y, Luo Z, Qi Z, Huang L, Wang Y. Thyroid hormones disturbances, cognitive deficits and abnormal dynamic functional connectivity variability of the amygdala in unmedicated bipolar disorder. J Psychiatr Res 2022; 150:282-291. [PMID: 35429738 DOI: 10.1016/j.jpsychires.2022.03.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/16/2022] [Accepted: 03/21/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Accumulating evidence suggests that hypothalamus-pituitary-thyroid (HPT) axis dysfunction is relevant to the neuropsychological and pathophysiology functions of bipolar disorder (BD). However, no research has investigated the inter-relationships among thyroid hormones disturbance, neurocognitive deficits, and aberrant brain function (particularly in the amygdala) in patients with BD. MATERIALS AND METHODS Data of dynamic resting-state functional connectivity (rs-dFC) were gathered from 59 patients with unmedicated BD II during depressive episodes and 52 healthy controls (HCs). Four seeds were selected (the bilateral lateral amygdala and the bilateral medial amygdala). The sliding-window analysis was applied to investigate dynamic functional connectivity (dFC). Additionally, the serum thyroid hormone (free tri-iodothyronine (FT3), total tri-iodothyronine (TT3), free thyroxin (FT4), total thyroxin (TT4) and thyroid-stimulating hormone (TSH)) levels, and cognitive scores on the MATRICS Consensus Cognitive Battery (MCCB) in patients and HCs were detected. RESULTS The BD group exhibited increased dFC variability between the left medial amygdala and right medial prefrontal cortex (mPFC) when compared with the HC group. Additionally, the BD group showed lower FT3, TT3, and TSH level, higher FT4 level, and poorer cognitive score. Moreover, a significant negative correlation was observed between the dFC variability of the left medial amygdala-right mPFC and TSH level, or reasoning and problem solving of MCCB score in BD group. Multiple regression analysis showed that the TSH level × dFC variability of the medial amygdala-mPFC was an independent predictor for cognitive processing speed in BD group. CONCLUSIONS This study revealed patients with BD II depression had excessive variability in dFC between the medial amygdala and mPFC. Moreover, both HPT axis dysfunction and abnormal dFC of the amygdala-mPFC might be implicated in cognitive impairment in the early stages of BD.
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Affiliation(s)
- Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Feng Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Tao Ye
- Clinical Laboratory Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - JiaYing Gong
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China; Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Youling Pan
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Zhenye Luo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China.
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Zhang L, Wu H, Zhang A, Bai T, Ji GJ, Tian Y, Wang K. Aberrant brain network topology in the frontoparietal-limbic circuit in bipolar disorder: a graph-theory study. Eur Arch Psychiatry Clin Neurosci 2021; 271:1379-1391. [PMID: 33386961 DOI: 10.1007/s00406-020-01219-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/02/2020] [Indexed: 12/21/2022]
Abstract
Characterizing the properties of brain networks across mood states seen in bipolar disorder (BP) can provide a deeper insight into the mechanisms involved in this type of affective disorder. In this study, graph theoretical methods were used to examine global, modular and nodal brain network topology in the resting state using functional magnetic resonance imaging data acquired from 95 participants, including those with bipolar depression (BPD; n = 30) and bipolar mania (BPM; n = 39) and healthy control (HC) subjects (n = 26). The threshold value of the individual subjects' connectivity matrix varied from 0.15 to 0.30 with steps of 0.01. We found that: (1) at the global level, BP patients showed a significantly increased global efficiency and synchronization and a decreased path length; (2) at the nodal level, BP patients showed impaired nodal parameters, predominantly within the frontoparietal and limbic sub-network; (3) at the module level, BP patients were characterized by denser FCs (edges) between Module III (the front-parietal system) and Module V (limbic/paralimbic systems); (4) at the nodal level, the BPD and BPM groups showed state-specific differences in the orbital part of the left superior-frontal gyrus, right putamen, right parahippocampal gyrus and left fusiform gyrus. These results revealed abnormalities in topological organization in the whole brain, especially in the frontoparietal-limbic circuit in both BPD and BPM. These deficits may reflect the pathophysiological processes occurring in BP. In addition, state-specific regional nodal alterations in BP could potentially provide biomarkers of conversion across different mood states.
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Affiliation(s)
- Li Zhang
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Huiling Wu
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Aiguo Zhang
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Tongjian Bai
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
| | - Gong-Jun Ji
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China
- Department of Medical Psychology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
- Department of Medical Psychology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China.
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China.
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China.
- Department of Medical Psychology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
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Dynamics of amygdala connectivity in bipolar disorders: a longitudinal study across mood states. Neuropsychopharmacology 2021; 46:1693-1701. [PMID: 34099869 PMCID: PMC8280117 DOI: 10.1038/s41386-021-01038-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 11/25/2022]
Abstract
Alterations in activity and connectivity of brain circuits implicated in emotion processing and emotion regulation have been observed during resting-state for different clinical phases of bipolar disorders (BD), but longitudinal investigations across different mood states in the same patients are still rare. Furthermore, measuring dynamics of functional connectivity patterns offers a powerful method to explore changes in the brain's intrinsic functional organization across mood states. We used a novel co-activation pattern (CAP) analysis to explore the dynamics of amygdala connectivity at rest in a cohort of 20 BD patients prospectively followed-up and scanned across distinct mood states: euthymia (20 patients; 39 sessions), depression (12 patients; 18 sessions), or mania/hypomania (14 patients; 18 sessions). We compared them to 41 healthy controls scanned once or twice (55 sessions). We characterized temporal aspects of dynamic fluctuations in amygdala connectivity over the whole brain as a function of current mood. We identified six distinct networks describing amygdala connectivity, among which an interoceptive-sensorimotor CAP exhibited more frequent occurrences during hypomania compared to other mood states, and predicted more severe symptoms of irritability and motor agitation. In contrast, a default-mode CAP exhibited more frequent occurrences during depression compared to other mood states and compared to controls, with a positive association with depression severity. Our results reveal distinctive interactions between amygdala and distributed brain networks in different mood states, and foster research on interoception and default-mode systems especially during the manic and depressive phase, respectively. Our study also demonstrates the benefits of assessing brain dynamics in BD.
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Increased Global-Brain Functional Connectivity Is Associated with Dyslipidemia and Cognitive Impairment in First-Episode, Drug-Naive Patients with Bipolar Disorder. Neural Plast 2021; 2021:5560453. [PMID: 34194487 PMCID: PMC8203345 DOI: 10.1155/2021/5560453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/10/2021] [Accepted: 05/22/2021] [Indexed: 01/01/2023] Open
Abstract
Objectives Previous researches have demonstrated that abnormal functional connectivity (FC) is associated with the pathophysiology of bipolar disorder (BD). However, inconsistent results were obtained due to different selections of regions of interest in previous researches. This study is aimed at examining voxel-wise brain-wide functional connectivity (FC) alterations in the first-episode, drug-naive patient with BD in an unbiased way. Methods A total of 35 patients with BD and 37 age-, sex-, and education-matched healthy controls underwent resting-state functional magnetic resonance imaging (rs-fMRI). Global-brain FC (GFC) was applied to analyze the image data. Support vector machine (SVM) was adopted to probe whether GFC abnormalities could be used to identify the patients from the controls. Results Patients with BD exhibited increased GFC in the left inferior frontal gyrus (LIFG), pars triangularis and left precuneus (PCu)/superior occipital gyrus (SOG). The left PCu belongs to the default mode network (DMN). Furthermore, increased GFC in the LIFG, pars triangularis was positively correlated with the triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) and negatively correlated with the scores of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) coding test and Stroop color. Increased GFC values in the left PCu/SOG can be applied to discriminate patients from controls with preferable sensitivity (80.00%), specificity (75.68%), and accuracy (77.78%). Conclusions This study found increased GFC in the brain regions of DMN; LIFG, pars triangularis; and LSOG, which was associated with dyslipidemia and cognitive impairment in patients with BD. Moreover, increased GFC values in the left PCu/SOG may be utilized as a potential biomarker to differentiate patients with BD from controls.
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11
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Chrobak AA, Bohaterewicz B, Sobczak AM, Marszał-Wiśniewska M, Tereszko A, Krupa A, Ceglarek A, Fafrowicz M, Bryll A, Marek T, Dudek D, Siwek M. Time-Frequency Characterization of Resting Brain in Bipolar Disorder during Euthymia-A Preliminary Study. Brain Sci 2021; 11:brainsci11050599. [PMID: 34067189 PMCID: PMC8150994 DOI: 10.3390/brainsci11050599] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/28/2021] [Accepted: 05/04/2021] [Indexed: 11/21/2022] Open
Abstract
The goal of this paper is to investigate the baseline brain activity in euthymic bipolar disorder (BD) patients by comparing it to healthy controls (HC) with the use of a variety of resting state functional magnetic resonance imaging (rs-fMRI) analyses, such as amplitude of low frequency fluctuations (ALFF), fractional ALFF (f/ALFF), ALFF-based functional connectivity (FC), and r egional homogeneity (ReHo). We hypothesize that above-mentioned techniques will differentiate BD from HC indicating dissimilarities between the groups within different brain structures. Forty-two participants divided into two groups of euthymic BD patients (n = 21) and HC (n = 21) underwent rs-fMRI evaluation. Typical band ALFF, slow-4, slow-5, f/ALFF, as well as ReHo indexes were analyzed. Regions with altered ALFF were chosen as ROI for seed-to-voxel analysis of FC. As opposed to HC, BD patients revealed: increased ALFF in left insula; increased slow-5 in left middle temporal pole; increased f/ALFF in left superior frontal gyrus, left superior temporal gyrus, left middle occipital gyrus, right putamen, and bilateral thalamus. There were no significant differences between BD and HC groups in slow-4 band. Compared to HC, the BD group presented higher ReHo values in the left superior medial frontal gyrus and lower ReHo values in the right supplementary motor area. FC analysis revealed significant hyper-connectivity within the BD group between left insula and bilateral middle frontal gyrus, right superior parietal gyrus, right supramarginal gyrus, left inferior parietal gyrus, left cerebellum, and left supplementary motor area. To our best knowledge, this is the first rs-fMRI study combining ReHo, ALFF, f/ALFF, and subdivided frequency bands (slow-4 and slow-5) in euthymic BD patients. ALFF, f/ALFF, slow-5, as well as REHO analysis revealed significant differences between two studied groups. Although results obtained with the above methods enable to identify group-specific brain structures, no overlap between the brain regions was detected. This indicates that combination of foregoing rs-fMRI methods may complement each other, revealing the bigger picture of the complex resting state abnormalities in BD.
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Affiliation(s)
- Adrian Andrzej Chrobak
- Department of Adult Psychiatry, Jagiellonian University Medical College, Kopernika st. 21a, 31-501 Kraków, Poland; (A.A.C.); (D.D.)
| | - Bartosz Bohaterewicz
- Department of Psychology of Individual Differences, Psychological Diagnosis and Psychometrics, Faculty of Psychology in Warsaw, SWPS University of Social Sciences and Humanities, Chodakowska st. 19/31, 03-815 Warsaw, Poland; (B.B.); (M.M.-W.)
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Prof. Stanisława Łojasiewicza st. 4, 30-348 Kraków, Poland; (A.C.); (M.F.); (T.M.)
| | - Anna Maria Sobczak
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Prof. Stanisława Łojasiewicza st. 4, 30-348 Kraków, Poland; (A.C.); (M.F.); (T.M.)
- Correspondence:
| | - Magdalena Marszał-Wiśniewska
- Department of Psychology of Individual Differences, Psychological Diagnosis and Psychometrics, Faculty of Psychology in Warsaw, SWPS University of Social Sciences and Humanities, Chodakowska st. 19/31, 03-815 Warsaw, Poland; (B.B.); (M.M.-W.)
| | - Anna Tereszko
- Chair of Psychiatry, Jagiellonian University Medical College, Kopernika st. 21a, 31-501 Kraków, Poland;
| | - Anna Krupa
- Department of Psychiatry, Jagiellonian University Medical College, Kopernika st. 21a, 31-501 Kraków, Poland;
| | - Anna Ceglarek
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Prof. Stanisława Łojasiewicza st. 4, 30-348 Kraków, Poland; (A.C.); (M.F.); (T.M.)
| | - Magdalena Fafrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Prof. Stanisława Łojasiewicza st. 4, 30-348 Kraków, Poland; (A.C.); (M.F.); (T.M.)
- Malopolska Centre of Biotechnology, Neuroimaging Group, Jagiellonian University, Gronostajowa st. 7a, 30-387 Kraków, Poland
| | - Amira Bryll
- Department of Radiology, Jagiellonian University Medical College, Kopernika st. 19, 31-501 Kraków, Poland;
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Jagiellonian University, Prof. Stanisława Łojasiewicza st. 4, 30-348 Kraków, Poland; (A.C.); (M.F.); (T.M.)
| | - Dominika Dudek
- Department of Adult Psychiatry, Jagiellonian University Medical College, Kopernika st. 21a, 31-501 Kraków, Poland; (A.A.C.); (D.D.)
| | - Marcin Siwek
- Department of Affective Disorders, Jagiellonian University Medical College, Kopernika st. 21a, 31-501 Kraków, Poland;
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Singh MK, Nimarko AF, Garrett AS, Gorelik AJ, Roybal DJ, Walshaw PD, Chang KD, Miklowitz DJ. Changes in Intrinsic Brain Connectivity in Family-Focused Therapy Versus Standard Psychoeducation Among Youths at High Risk for Bipolar Disorder. J Am Acad Child Adolesc Psychiatry 2021; 60:458-469. [PMID: 32745598 PMCID: PMC7854810 DOI: 10.1016/j.jaac.2020.07.892] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/22/2020] [Accepted: 07/24/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE We compared intrinsic network connectivity in symptomatic youths at high risk (HR) for bipolar disorder (BD) and healthy comparison (HC) youths. In HR youths, we also investigated treatment-related changes in intrinsic connectivity after family-focused therapy for high-risk youths (FFT-HR) vs standardized family psychoeducation. METHOD HR youths (N = 34; age 9-17 years; mean 14 years, 56% girls and 44% boys) with depressive and/or hypomanic symptoms and at least 1 first- or second-degree relative with BD I or II were randomly assigned to 4 months of FFT-HR (12 sessions of psychoeducation, communication, and problem-solving skills training) or enhanced care (EC; 3 family and 3 individual psychoeducation sessions). Before and after 4 months of treatment, participants underwent resting state functional magnetic resonance imaging (rs-fMRI). A whole-brain independent component analysis compared rs-fMRI networks in HR youths and 30 age-matched HC youths at a pretreatment baseline. Then we identified pretreatment to posttreatment (4-month) changes in network connectivity in HR youths receiving FFT-HR (n = 16) or EC (n = 18) and correlated these changes with depression improvement. RESULTS At baseline, HR youths had greater connectivity between the ventrolateral prefrontal cortex (VLPFC) and the anterior default mode network (aDMN) than did HCs (p = .004). Over 4 months of treatment, FFT-HR-assigned HR youths had increased VLPFC-aDMN connectivity from pre- to posttreatment (p = .003), whereas HR youths in EC showed no significant change over time (p = .11) (treatment by time interaction, t31 = 3.33, 95% CI = 0.27-1.14, p = .002]. Reduction in depression severity over 4 months inversely correlated with enhanced anterior DMN (r = -0.71) connectivity in the FFT-HR but not in the EC (r = -0.07) group (z = -2.17, p = .015). CONCLUSION Compared to standard psychoeducation, FFT-HR is associated with stronger connectivity between the VLPFC and aDMN, suggesting possible enhancements of self-awareness, illness awareness, and emotion regulation. CLINICAL TRIAL REGISTRATION INFORMATION Early Intervention for Youth at Risk for Bipolar Disorder; https://clinicaltrials.gov/; NCT01483391.
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Affiliation(s)
| | | | - Amy S. Garrett
- University of Texas, Health Science Center at San Antonio
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13
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Murray RJ, Apazoglou K, Celen Z, Dayer A, Aubry JM, Ville DVD, Vuilleumier P, Piguet C. Maladaptive emotion regulation traits predict altered corticolimbic recovery from psychosocial stress. J Affect Disord 2021; 280:54-63. [PMID: 33202338 DOI: 10.1016/j.jad.2020.09.122] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/14/2020] [Accepted: 09/28/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Adaptive recovery from stress promotes healthy cognitive affective functioning, whereas maladaptive recovery is linked to poor psychological outcomes. Neural regions, like the anterior cingulate and hippocampus, play critical roles in psychosocial stress responding and serve as hubs in the corticolimbic neural system. To date, however, it is unknown how cognitive emotion regulation traits (cER), adaptive and maladaptive, influence corticolimbic stress recovery. Here, we examined acute psychosocial stress neural recovery, accounting for cER. METHODS Functional neuroimaging data were collected while forty-seven healthy participants performed blocks of challenging, time-sensitive, mental calculations. Participants immediately received performance feedback (positive/negative/neutral) and their ranking, relative to fictitious peers. Participants rested for 90 seconds after each feedback, allowing for a neural stress recovery period. Collected before scanning, cER scores were correlated with neural activity during each recovery condition. RESULTS Negative feedback recovery yielded increased activity within the dorsomedial prefrontal cortex and amygdala, but this effect was ultimately explained by maladaptive cER (M-cER), like rumination. Isolating positive after-effects (i.e. positive > negative recovery) yielded a significant positive correlation between M-cER and the anterior cingulate, anterior insula, hippocampus, and striatum. CONCLUSIONS We provide first evidence of M-cER to predict altered neural recovery from positive stress within corticolimbic regions. Positive feedback may be potentially threatening to individuals with poor stress regulation. Identifying positive stress-induced activation patterns in corticolimbic neural networks linked to M-cER creates the possibility to identify these neural responses as risk factors for social-emotional dysregulation subsequent to rewarding social information, often witnessed in affective disorders, like depression.
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Affiliation(s)
- Ryan J Murray
- Psychiatry Department, Faculty of Medicine, University of Geneva, Campus Biotech, 1202 Geneva, Switzerland.
| | - Kalliopi Apazoglou
- Psychiatry Department, Faculty of Medicine, University of Geneva, Campus Biotech, 1202 Geneva, Switzerland; Neuroscience Department, Laboratory for Behavioral Neurology and Imaging of Cognition, Campus Biotech, 1202 Geneva, Switzerland
| | - Zeynep Celen
- Psychiatry Department, Faculty of Medicine, University of Geneva, Campus Biotech, 1202 Geneva, Switzerland
| | - Alexandre Dayer
- Psychiatry Department, Faculty of Medicine, University of Geneva, Campus Biotech, 1202 Geneva, Switzerland; Mood Disorder Unit, Psychiatric Specialties Service, Geneva University Hospital, 1201 Geneva, Switzerland
| | - Jean-Michel Aubry
- Psychiatry Department, Faculty of Medicine, University of Geneva, Campus Biotech, 1202 Geneva, Switzerland; Mood Disorder Unit, Psychiatric Specialties Service, Geneva University Hospital, 1201 Geneva, Switzerland
| | - Dimitri Van De Ville
- Medical Image Processing Laboratory, Center for Neuroprosthetics, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Campus Biotech, 1202 Geneva, Switzerland; Department of Radiology and Medical Informatics, University of Geneva, 1211 Geneva, Switzerland
| | - Patrik Vuilleumier
- Neuroscience Department, Laboratory for Behavioral Neurology and Imaging of Cognition, Campus Biotech, 1202 Geneva, Switzerland
| | - Camille Piguet
- Psychiatry Department, Faculty of Medicine, University of Geneva, Campus Biotech, 1202 Geneva, Switzerland; Mood Disorder Unit, Psychiatric Specialties Service, Geneva University Hospital, 1201 Geneva, Switzerland
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14
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Intrinsic functional network contributions to the relationship between trait empathy and subjective happiness. Neuroimage 2020; 227:117650. [PMID: 33338612 DOI: 10.1016/j.neuroimage.2020.117650] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/24/2020] [Accepted: 12/09/2020] [Indexed: 12/30/2022] Open
Abstract
Subjective happiness (well-being) is a multi-dimensional construct indexing one's evaluations of everyday emotional experiences and life satisfaction, and has been associated with different aspects of trait empathy. Despite previous research identifying the neural substrates of subjective happiness and empathy, the mechanisms mediating the relationship between the two constructs remain largely unclear. Here, we performed a data-driven, multi-voxel pattern analysis of whole-brain intrinsic functional connectivity to reveal the neural mechanisms of subjective happiness and trait empathy in a sample of young females. Behaviorally, we found that subjective happiness was negatively associated with personal distress (i.e., self-referential experience of others' feelings). Consistent with this inverse relationship, subjective happiness was associated with the dorsolateral prefrontal cortex exhibiting decreased functional connectivity with regions important for the representation of unimodal sensorimotor information (e.g., primary sensory cortices) or multi-modal summaries of brain states (e.g., default mode network) and increased functional connectivity with regions important for the attentional modulation of these representations (e.g., frontoparietal, attention networks). Personal distress was associated with the medial prefrontal cortex exhibiting functional connectivity differences with similar networks--but in the opposite direction. Finally, intrinsic functional connectivity within and between these networks fully mediated the relationship between the two behavioral measures. These results identify an important contribution of the macroscale functional organization of the brain to human well-being, by demonstrating that lower levels of personal distress lead to higher subjective happiness through variation in intrinsic functional connectivity along a neural representation vs. modulation gradient.
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15
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Shan X, Qiu Y, Pan P, Teng Z, Li S, Tang H, Xiang H, Wu C, Tan Y, Chen J, Guo W, Wang B, Wu H. Disrupted Regional Homogeneity in Drug-Naive Patients With Bipolar Disorder. Front Psychiatry 2020; 11:825. [PMID: 32922322 PMCID: PMC7456987 DOI: 10.3389/fpsyt.2020.00825] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/30/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Studies on alterations in the regional neural activity in the brain of patients with bipolar disorder (BD) have provided conflicting results because of different medications used and study designs. A low bone mineral density (BMD) is also observed in patients with BD. This study aimed to further explore regional neural activities in unmedicated patients with BD and their association with BMD. METHODS In this study, 40 patients with BD and 42 healthy controls were scanned through resting-state functional magnetic resonance imaging (fMRI). Imaging data were analyzed with regional homogeneity (ReHo) and pattern classification. Pearson's correlation analyses were performed to explore the correlations between abnormal ReHo and BMD. RESULTS A significant increase in ReHo values in the left inferior frontal gyrus (IFG)/temporal pole, left cerebellum vermis I/vermis II/parahippocampal gyrus/brainstem, and right superior temporal gyrus (STG) and a decrease in ReHo in the occipital gyrus (OG; left middle OG/superior OG/bilateral cuneus) were found in the patients with BD (p < 0.05) compared with those in the healthy controls. No significant correlation was observed between the abnormal ReHo values in any of the brain regions of the patients with BMD.Support vector machine (SVM) analyses revealed that the ReHo values in the right STG for distinguishing patients from healthy controls showed an accuracy of 91.89%, a sensitivity of 75.68%, and a specificity of 83.78%. The ReHo values in the left cerebellum vermis I/vermis II/parahippocampal gyrus/brainstem indicated an accuracy of 78.38%, a sensitivity of 75.68%, and a specificity of 81.08%. CONCLUSION This study further confirms the abnormal brain activities in extensive regions, and these brain regions are primarily located in the fronto-temporal-occipital circuit and the cerebellum vermis of patients with BD. The regional neural activity in the right STG and the left cerebellum vermis I/vermis II/parahippocampal gyrus/brainstem may serve as potential imaging markers to distinguish patients with BD from healthy controls.
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Affiliation(s)
- Xiaoxiao Shan
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yan Qiu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Pan Pan
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ziwei Teng
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Sujuan Li
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hui Tang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hui Xiang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chujun Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yuxi Tan
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jindong Chen
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenbin Guo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Psychiatry, The Third People’s Hospital of Foshan, Foshan, China
| | - Bolun Wang
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Haishan Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
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16
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Njau S, Townsend J, Wade B, Hellemann G, Bookheimer S, Narr K, Brooks JO. Neural Subtypes of Euthymic Bipolar I Disorder Characterized by Emotion Regulation Circuitry. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:591-600. [PMID: 32513391 DOI: 10.1016/j.bpsc.2020.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Current diagnostic strategy for bipolar disorders relies on symptomological classification. Yet, responses to both pharmacological and psychotherapeutic treatments vary widely, suggesting that underlying neuropathological differences are not well defined by current nosology. Classifying patients with bipolar disorder based on emotion regulation network (ERN) activation may account for some of the heterogeneity within the disorder. METHODS Euthymic participants diagnosed with bipolar I disorder (n = 86) and healthy subjects (n = 80) underwent functional magnetic resonance imaging scans while engaged in emotional reappraisal of negative stimuli. After determining average regional activations in key network regions, we applied agglomerative hierarchical clustering to identify subtypes of bipolar disorder. Next, we examined relations among neural subtypes, demographic variables, and mood symptoms. RESULTS Analyses revealed two primary neural subtypes of euthymic bipolar I disorder participants. The first subtype, ERN cluster 1, was characterized by increased amygdala activation and slightly increased ventrolateral prefrontal and subgenual cingulate activation, whereas ERN cluster 2 was defined by decreased amygdala activation with wider-spread prefrontal activation. Cluster 1 was associated with a higher number of hospitalizations for depression (odds ratio = 1.30, 95% confidence interval = 1.02-1.64) and later onset of manic episodes (odds ratio = 1.06, 95% confidence interval = 1.00-21.13) than cluster 2. ERN clusters of healthy subjects differed from bipolar disorder clusters and were defined by differential activation of the prefrontal cortex. ERN clusters of healthy subjects, which differed from bipolar disorder clusters, were defined by differential activation of the prefrontal cortex. CONCLUSIONS Emotion regulation circuitry can distinguish neurobiological subtypes of bipolar disorder in the euthymic state. These subtypes, which are differentially associated with indices of illness severity and subsyndromal affective symptoms, may help to inform relapse risk and more personalized treatment approaches.
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Affiliation(s)
- Stephanie Njau
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California
| | - Jennifer Townsend
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Benjamin Wade
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Susan Bookheimer
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Katherine Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - John O Brooks
- Department of Psychiatry and Biobehavioral Sciences and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California.
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17
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The Amygdala in Schizophrenia and Bipolar Disorder: A Synthesis of Structural MRI, Diffusion Tensor Imaging, and Resting-State Functional Connectivity Findings. Harv Rev Psychiatry 2020; 27:150-164. [PMID: 31082993 DOI: 10.1097/hrp.0000000000000207] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Frequently implicated in psychotic spectrum disorders, the amygdala serves as an important hub for elucidating the convergent and divergent neural substrates in schizophrenia and bipolar disorder, the two most studied groups of psychotic spectrum conditions. A systematic search of electronic databases through December 2017 was conducted to identify neuroimaging studies of the amygdala in schizophrenia and bipolar disorder, focusing on structural MRI, diffusion tensor imaging (DTI), and resting-state functional connectivity studies, with an emphasis on cross-diagnostic studies. Ninety-four independent studies were selected for the present review (49 structural MRI, 27 DTI, and 18 resting-state functional MRI studies). Also selected, and analyzed in a separate meta-analysis, were 33 volumetric studies with the amygdala as the region-of-interest. Reduced left, right, and total amygdala volumes were found in schizophrenia, relative to both healthy controls and bipolar subjects, even when restricted to cohorts in the early stages of illness. No volume abnormalities were observed in bipolar subjects relative to healthy controls. Shape morphometry studies showed either amygdala deformity or no differences in schizophrenia, and no abnormalities in bipolar disorder. In contrast to the volumetric findings, DTI studies of the uncinate fasciculus tract (connecting the amygdala with the medial- and orbitofrontal cortices) largely showed reduced fractional anisotropy (a marker of white matter microstructure abnormality) in both schizophrenia and bipolar patients, with no cross-diagnostic differences. While decreased amygdalar-orbitofrontal functional connectivity was generally observed in schizophrenia, varying patterns of amygdalar-orbitofrontal connectivity in bipolar disorder were found. Future studies can consider adopting longitudinal approaches with multimodal imaging and more extensive clinical subtyping to probe amygdalar subregional changes and their relationship to the sequelae of psychotic disorders.
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18
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Damme KSF, Alloy LB, Young CB, Kelley NJ, Chein J, Ng TH, Titone MK, Black CL, Nusslock R. Amygdala subnuclei volume in bipolar spectrum disorders: Insights from diffusion-based subsegmentation and a high-risk design. Hum Brain Mapp 2020; 41:3358-3369. [PMID: 32386113 PMCID: PMC7375099 DOI: 10.1002/hbm.25021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 04/06/2020] [Accepted: 04/13/2020] [Indexed: 12/31/2022] Open
Abstract
Amygdala abnormalities are widely documented in bipolar spectrum disorders (BSD). Amygdala volume typically is measured after BSD onset; thus, it is not known whether amygdala abnormalities predict BSD risk or relate to the disorder. Additionally, past literature often treated the amygdala as a homogeneous structure, and did not consider its distinct subnuclei and their differential connectivity to other brain regions. To address these issues, we used a behavioral high‐risk design and diffusion‐based subsegmentation to examine amygdala subnuclei among medication‐free individuals with, and at risk for, BSD. The behavioral high‐risk design (N = 114) included low‐risk (N = 37), high‐risk (N = 47), and BSD groups (N = 30). Diffusion‐based subsegmentation of the amygdala was conducted to determine whether amygdala volume differences related to particular subnuclei. Individuals with a BSD diagnosis showed greater whole, bilateral amygdala volume compared to Low‐Risk individuals. Examination of subnuclei revealed that the BSD group had larger volumes compared to the High‐Risk group in both the left medial and central subnuclei, and showed larger volume in the right lateral subnucleus compared to the Low‐Risk group. Within the BSD group, specific amygdala subnuclei volumes related to time since first episode onset and number of lifetime episodes. Taken together, whole amygdala volume analyses replicated past findings of enlargement in BSD, but did not detect abnormalities in the high‐risk group. Examination of subnuclei volumes detected differences in volume between the high‐risk and BSD groups that were missed in the whole amygdala volume. Results have implications for understanding amygdala abnormalities among individuals with, and at risk for, a BSD.
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Affiliation(s)
| | - Lauren B Alloy
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Christina B Young
- Department of Psychology, Northwestern University, Evanston, Illinois, USA.,Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Nicholas J Kelley
- Department of Psychology, Northwestern University, Evanston, Illinois, USA.,School of Psychology, University of Southampton, Southampton, UK
| | - Jason Chein
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Tommy H Ng
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Madison K Titone
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Chelsea L Black
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA.,Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Robin Nusslock
- Department of Psychology, Northwestern University, Evanston, Illinois, USA
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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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Rey G, Piguet C, Benders A, Favre S, Eickhoff SB, Aubry JM, Vuilleumier P. Resting-state functional connectivity of emotion regulation networks in euthymic and non-euthymic bipolar disorder patients. Eur Psychiatry 2020; 34:56-63. [DOI: 10.1016/j.eurpsy.2015.12.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 12/15/2015] [Accepted: 12/21/2015] [Indexed: 12/20/2022] Open
Abstract
AbstractBackgroundPrevious functional magnetic resonance imaging studies in bipolar disorder (BD) have evidenced changes in functional connectivity (FC) in brain areas associated with emotion processing, but how these changes vary with mood state and specific clinical symptoms is not fully understood.MethodsWe investigated resting-state FC between a priori regions of interest (ROIs) from the default-mode network and key structures for emotion processing and regulation in 27 BD patients and 27 matched healthy controls. We further compared connectivity patterns in subgroups of 15 euthymic and 12 non-euthymic patients and tested for correlations of the connectivity strength with measures of mood, anxiety, and rumination tendency. No correction for multiple comparisons was applied given the small population sample and pre-defined target ROIs.ResultsOverall, regardless of mood state, BD patients exhibited increased FC of the left amygdala with left sgACC and PCC, relative to controls. In addition, non-euthymic BD patients showed distinctive decrease in FC between right amygdala and sgACC, whereas euthymic patients showed lower FC between PCC and sgACC. Euthymic patients also displayed increased FC between sgACC and right VLPFC. The sgACC–PCC and sgACC–left amygdala connections were modulated by rumination tendency in non-euthymic patients, whereas the sgACC-VLPFC connection was modulated by both the current mood and tendency to ruminate.ConclusionsOur results suggest that sgACC-amygdala coupling is critically affected during mood episodes, and that FC of sgACC play a pivotal role in mood normalization through its interactions with the VLPFC and PCC. However, these preliminary findings require replication with larger samples of patients.
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21
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Xu Z, Lai J, Zhang H, Ng CH, Zhang P, Xu D, Hu S. Regional homogeneity and functional connectivity analysis of resting-state magnetic resonance in patients with bipolar II disorder. Medicine (Baltimore) 2019; 98:e17962. [PMID: 31764799 PMCID: PMC6882611 DOI: 10.1097/md.0000000000017962] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
To explore the characteristics of local brain activity in patients with bipolar depression and its correlation with clinical features.In accord with the diagnostic and statistical manual of mental disorders-IV of bipolar disorder, 21 patients were enrolled while 21 healthy controls were matched with similar gender, age, level of educations. A 3.0T GE magnetic resonance scanner was used to collect the imaging data, and a 2-sample t test was performed. Regional homogeneity (ReHo) method was used to estimate regional activation patterns through indices of localized concordance. ReHo values were compared between groups. Seed-based correlation analysis was used to analyze functional connections.In the patients' group, ReHo (regional homogeneity) values of resting state functional magnetic resonance imaging data on the right cerebellum 4 and 5 area, cerebellar vermis 6 area, left insula were positively correlated with Hamilton depression scale (HAMD) scores. ReHo values on the left of the triangle of inferior frontal gyrus, right inferior frontal gyrus of orbital region showed negative correlation with HAMD scores. The value of ReHo in the patients' group was positively correlated with the patients' Hamilton anxiety scale score in the right fusiform gyrus, and negative correlation was found in the left insula. The ReHo value of the patients' group was negatively correlated with the patients' Montgomery Asberg depression rating scale score in regions of the midbrain. The value of ReHo in patients' group was significantly reduced in the right central front.The depression and anxiety severity of bipolar depression patients may be associated with the consistency activity of left insula, right cerebellum, and cerebellar vermis related area, fusiform gyrus. In addition, the ReHo of the midbrain neurons activity may be associated with depression level of patients with bipolar II disorder.
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Affiliation(s)
- Zhe Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
- The Third municipal hospital of Huzhou in Zhejiang Province, Huzhou
| | - Jianbo Lai
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou
| | - Haorong Zhang
- The Shanghai Key Laboratory of Magnetic Resonance & Institute of Cognitive Neuroscience, East China Normal University, Shanghai, China
| | - Chee H. Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Peng Zhang
- Mental Health Center, Zhejiang Xiaoshan Hospital, Hangzhou, China
| | - Dongrong Xu
- Molecular Imaging and Neuropathology Division and MRI Unit, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
- The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou
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22
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Hu K. Investigations into ventral prefrontal cortex using mediation models. J Neurosci Res 2019; 98:632-642. [PMID: 31420919 DOI: 10.1002/jnr.24512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 07/21/2019] [Accepted: 07/22/2019] [Indexed: 11/11/2022]
Abstract
The ventral prefrontal cortex (vPFC) is a major focus of investigation in neuroscience, particularly in the studies of emotion and emotion-cognition integration. A crucial question concerning the regulatory function of vPFC is how it is recruited, especially how the function maps onto the structure and determines appropriate behavior. In social exclusion studies, mediation model analyses suggest that vPFC regulates distress by disrupting anterior cingulate cortex (ACC) activities, whereas I recently report (Hu, 2018; Neuropsychologia) that ventral medial prefrontal cortex appears to defend the organism from acute stress by activating ACC. In this review, I synthesize and highlight functional imaging research with mediation analysis that over the past decades has begun to offer new insights into the brain mechanisms underlying vPFC. Toward this end, the first section of the paper outlines a model of the processes and neural systems involved in the interaction of emotion and cognition. The second and third sections survey recent research on emotional regulation with negative and positive pathways, respectively, emanating from vPFC. The fourth section summarizes the current dynamic network findings. Functional mediation analysis helps to identify signals within vPFC and others that are common and/or specific to particular information processing. Finally, I provide a personal perspective of the adoption of mediation model analysis in the investigations into vPFC.
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Affiliation(s)
- Kesong Hu
- Department of Psychology, Lake Superior State University, Sault Ste. Marie, Michigan.,Institute of Mental Health, Nanjing Xiaozhuang University, Nanjing, China
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23
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Jimenez AM, Riedel P, Lee J, Reavis EA, Green MF. Linking resting-state networks and social cognition in schizophrenia and bipolar disorder. Hum Brain Mapp 2019; 40:4703-4715. [PMID: 31322784 DOI: 10.1002/hbm.24731] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 06/21/2019] [Accepted: 07/07/2019] [Indexed: 12/25/2022] Open
Abstract
Individuals with schizophrenia and bipolar disorder show alterations in functional neural connectivity during rest. However, resting-state network (RSN) disruptions have not been systematically compared between the two disorders. Further, the impact of RSN disruptions on social cognition, a key determinant of functional outcome, has not been studied. Forty-eight individuals with schizophrenia, 46 with bipolar disorder, and 48 healthy controls completed resting-state functional magnetic resonance imaging. An atlas-based approach was used to examine functional connectivity within nine RSNs across the cortex. RSN connectivity was assessed via nonparametric permutation testing, and associations with performance on emotion perception, mentalizing, and emotion management tasks were examined. Group differences were observed in the medial and lateral visual networks and the sensorimotor network. Individuals with schizophrenia demonstrated reduced connectivity relative to healthy controls in all three networks. Individuals with bipolar disorder demonstrated reduced connectivity relative to controls in the medial visual network and connectivity within this network was significantly positively correlated with emotion management. In healthy controls, connectivity within the medial and lateral visual networks positively correlated with mentalizing. No significant correlations were found for either visual network in schizophrenia. Results highlight the role of altered early visual processing in social cognitive deficits in both schizophrenia and bipolar disorder. However, individuals with bipolar disorder appear to compensate for disrupted visual network connectivity on social cognitive tasks, whereas those with schizophrenia do not. The current study adds clarity on the neurophysiology underlying social cognitive deficits that result in impaired functioning in serious mental illness.
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Affiliation(s)
- Amy M Jimenez
- Desert Pacific MIRECC, VA Greater Los Angeles Healthcare System, Los Angeles, California.,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Philipp Riedel
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California.,Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Junghee Lee
- Desert Pacific MIRECC, VA Greater Los Angeles Healthcare System, Los Angeles, California.,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Eric A Reavis
- Desert Pacific MIRECC, VA Greater Los Angeles Healthcare System, Los Angeles, California.,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Michael F Green
- Desert Pacific MIRECC, VA Greater Los Angeles Healthcare System, Los Angeles, California.,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
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24
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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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25
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Fateh AA, Long Z, Duan X, Cui Q, Pang Y, Farooq MU, Nan X, Chen Y, Sheng W, Tang Q, Chen H. Hippocampal functional connectivity-based discrimination between bipolar and major depressive disorders. Psychiatry Res Neuroimaging 2019; 284:53-60. [PMID: 30684896 DOI: 10.1016/j.pscychresns.2019.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 01/11/2019] [Accepted: 01/11/2019] [Indexed: 01/14/2023]
Abstract
Despite the impressive advancements in the neuropathology of mood disorders, patients with bipolar disorder (BD) are often misdiagnosed on the initial presentation with major depressive disorder (MDD). With supporting evidence from neuroimaging studies, the abnormal functional connectivity (FC) of the hippocampus has been associated with various mood disorders, including BD and MDD. However, the features of the hippocampal FC underlying MDD and BD have not been directly compared. This study aims to investigate the hippocampal resting-state FC (rsFC) analyses to distinguish these two clinical conditions. Resting-state functional magnetic resonance imaging (fMRI) data was collected from a sample group of 30 patients with BD, 29 patients with MDD and 30 healthy controls (HCs). One-way ANOVA was employed to assess the potential differences of the hippocampus FC across all subjects. BD patients exhibited increased FC of the bilateral anterior/posterior hippocampus with lingual gyrus and inferior frontal gyrus (IFG) relative to patients MDD patients. In comparison with HCs, patients with BD and MDD had an increased FC between the right anterior hippocampus and lingual gyrus and a decreased FC between the right posterior hippocampus and right IFG. The results revealed a distinct hippocampal FC in MDD patients compared with that observed in BD patients. These findings may assist investigators in attempting to distinguish mood disorders by using fMRI data.
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Affiliation(s)
- Ahmed Ameen Fateh
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiliang Long
- Sleep and Neuroimaging Center, Faculty of Psychology, Southwest University, Chongqing, China
| | - Xujun Duan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Cui
- School of Political Science and Public Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Yajing Pang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Muhammad Umar Farooq
- Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, China
| | - Xiaoyu Nan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China; School of Political Science and Public Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuyan Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qin Tang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China.
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26
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Minuzzi L, Syan SK, Smith M, Hall A, Hall GB, Frey BN. Structural and functional changes in the somatosensory cortex in euthymic females with bipolar disorder. Aust N Z J Psychiatry 2018; 52:1075-1083. [PMID: 29232965 DOI: 10.1177/0004867417746001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Current evidence from neuroimaging data suggests possible dysfunction of the fronto-striatal-limbic circuits in individuals with bipolar disorder. Somatosensory cortical function has been implicated in emotional recognition, risk-taking and affective responses through sensory modalities. This study investigates anatomy and function of the somatosensory cortex in euthymic bipolar women. METHODS In total, 68 right-handed euthymic women (bipolar disorder = 32 and healthy controls = 36) between 16 and 45 years of age underwent high-resolution anatomical and functional magnetic resonance imaging during the mid-follicular menstrual phase. The somatosensory cortex was used as a seed region for resting-state functional connectivity analysis. Voxel-based morphometry was used to evaluate somatosensory cortical gray matter volume between groups. RESULTS We found increased resting-state functional connectivity between the somatosensory cortex and insular cortex, inferior prefrontal gyrus and frontal orbital cortex in euthymic bipolar disorder subjects compared to healthy controls. Voxel-based morphometry analysis showed decreased gray matter in the left somatosensory cortex in the bipolar disorder group. Whole-brain voxel-based morphometry analysis controlled by age did not reveal any additional significant difference between groups. CONCLUSION This study is the first to date to evaluate anatomy and function of the somatosensory cortex in a well-characterized sample of euthymic bipolar disorder females. Anatomical and functional changes in the somatosensory cortex in this population might contribute to the pathophysiology of bipolar disorder.
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Affiliation(s)
- Luciano Minuzzi
- 1 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,2 MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,3 Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,4 Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Sabrina K Syan
- 2 MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,4 Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Mara Smith
- 1 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Alexander Hall
- 4 Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Geoffrey Bc Hall
- 2 MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,5 Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Benicio N Frey
- 1 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,2 MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,3 Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,4 Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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27
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Ellard KK, Gosai AG, Bernstein EE, Kaur N, Sylvia LG, Camprodon JA, Dougherty DD, Nierenberg AA, Deckersbach T. Intrinsic functional neurocircuitry associated with treatment response to transdiagnostic CBT in bipolar disorder with anxiety. J Affect Disord 2018; 238:383-391. [PMID: 29909301 PMCID: PMC7980284 DOI: 10.1016/j.jad.2018.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/16/2018] [Accepted: 06/01/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Anxiety in bipolar disorder (BD) exacerbates emotion dysregulation and reduces treatment response. We recently conducted a pilot trial of transdiagnostic CBT to target anxiety and emotion dysregulation in BD adjunctive to pharmacotherapy. Reductions in depression and anxiety symptoms were significantly predicted by baseline levels of neuroticism and perceived affective control, as well as changes over time in emotion regulation skills. The present study investigates mechanism of treatment response by examining the relationship between baseline emotion regulation-related neural circuitry and trial outcomes. METHODS Nineteen patients completed baseline resting state fMRI scans prior to treatment randomization. Functional connectivity between the anterior insula (AI) and regions in the salience network (SN), default mode network (DMN), and executive control network (ECN) were examined as predictors of baseline and treatment-related changes in emotion regulation. RESULTS Greater improvements in emotion regulation were predicted by weaker right dorsal AI - right ventrolateral prefrontal cortex (VLPFC; SN) and stronger bilateral dorsal AI - bilateral amygdala functional connectivity. Baseline neuroticism was negatively correlated with right dorsal AI- inferior parietal lobule (ECN) functional connectivity, and baseline deficits in perceived affective control were positively associated with ventral AI - bilateral dACC (SN) connectivity. LIMITATIONS Small sample limits interpretability of treatment-specific effects. CONCLUSION Baseline functional connectivity of emotion-regulation related neural circuitry significantly predicted change in emotion regulation-related dimensions associated with anxiety and depression symptom reduction. Future studies are needed to determine if employing methods such as neuromodulation to rehabilitate relevant neural circuitry may improve ultimate treatment outcomes of transdiagnostic CBT for BD and anxiety.
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Affiliation(s)
- Kristen K Ellard
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA 02114, United States.
| | - Aishwarya G Gosai
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA 02114, United States
| | | | | | - Lousia G Sylvia
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA 02114, United States
| | - Joan A Camprodon
- Division of Neurotherapeutics, Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, United States
| | - Darin D Dougherty
- Division of Neurotherapeutics, Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, United States
| | - Andrew A Nierenberg
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA 02114, United States
| | - Thilo Deckersbach
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA 02114, United States
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28
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Syan SK, Smith M, Frey BN, Remtulla R, Kapczinski F, Hall GBC, Minuzzi L. Resting-state functional connectivity in individuals with bipolar disorder during clinical remission: a systematic review. J Psychiatry Neurosci 2018; 43:298-316. [PMID: 30125243 PMCID: PMC6158027 DOI: 10.1503/jpn.170175] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 12/21/2017] [Accepted: 01/19/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Bipolar disorder is chronic and debilitating. Studies investigating resting-state functional connectivity in individuals with bipolar disorder may help to inform neurobiological models of illness. METHODS We conducted a systematic review with the following goals: to summarize the literature on resting-state functional connectivity in bipolar disorder during clinical remission (euthymia) compared with healthy controls; to critically appraise the literature and research gaps; and to propose directions for future research. We searched PubMed/MEDLINE, Embase, PsycINFO, CINAHL and grey literature up to April 2017. RESULTS Twenty-three studies were included. The most consistent finding was the absence of differences in resting-state functional connectivity of the default mode network (DMN), frontoparietal network (FPN) and salience network (SN) between people with bipolar disorder and controls, using independent component analysis. However, 2 studies in people with bipolar disorder who were positive for psychosis history reported DMN hypoconnectivity. Studies using seed-based analysis largely reported aberrant resting-state functional connectivity with the amygdala, ventrolateral prefrontal cortex, cingulate cortex and medial prefrontal cortex in people with bipolar disorder compared with controls. Few studies used regional homogeneity or amplitude of low-frequency fluctuations. LIMITATIONS We found heterogeneity in the analysis methods used. CONCLUSION Stability of the DMN, FPN and SN may reflect a state of remission. Further, DMN hypoconnectivity may reflect a positive history of psychosis in patients with bipolar disorder compared with controls, highlighting a potentially different neural phenotype of psychosis in people with bipolar disorder. Resting-state functional connectivity changes between the amygdala, prefrontal cortex and cingulate cortex may reflect a neural correlate of subthreshold symptoms experienced in bipolar disorder euthymia, the trait-based pathophysiology of bipolar disorder and/or a compensatory mechanism to maintain a state of euthymia.
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Affiliation(s)
- Sabrina K Syan
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
| | - Mara Smith
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
| | - Benicio N Frey
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
| | - Raheem Remtulla
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
| | - Flavio Kapczinski
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
| | - Geoffrey B C Hall
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
| | - Luciano Minuzzi
- From the MiNDS Neuroscience Graduate Program, McMaster University (Syan, Frey, Kapczinski, Hall, Minuzzi); the Women's Health Concerns Clinic (Syan, Frey, Remtulla, Minuzzi); the Mood Disorders Program, St. Joseph's Healthcare (Frey, Kapczinski, Minuzzi); the Department of Psychiatry and Behavioural Neurosciences, McMaster University (Smith, Frey, Kapczinski, Minuzzi, Smith); and the Department of Psychology, Neuroscience and Behaviour, McMaster University (Hall), Hamilton, Ontario, Canada
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29
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Kotzalidis GD, Rapinesi C, Savoja V, Cuomo I, Simonetti A, Ambrosi E, Panaccione I, Gubbini S, De Rossi P, De Chiara L, Janiri D, Sani G, Koukopoulos AE, Manfredi G, Napoletano F, Caloro M, Pancheri L, Puzella A, Callovini G, Angeletti G, Del Casale A. Neurobiological Evidence for the Primacy of Mania Hypothesis. Curr Neuropharmacol 2018; 15:339-352. [PMID: 28503105 PMCID: PMC5405607 DOI: 10.2174/1570159x14666160708231216] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 05/23/2016] [Accepted: 05/24/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Athanasios Koukopoulos proposed the primacy of mania hypothesis (PoM) in a 2006 book chapter and later, in two peer-reviewed papers with Nassir Ghaemi and other collaborators. This hypothesis supports that in bipolar disorder, mania leads to depression, while depression does not lead to mania. OBJECTIVE To identify evidence in literature that supports or falsifies this hypothesis. METHOD We searched the medical literature (PubMed, Embase, PsycINFO, and the Cochrane Library) for peer-reviewed papers on the primacy of mania, the default mode function of the brain in normal people and in bipolar disorder patients, and on illusion superiority until 6 June, 2016. Papers resulting from searches were considered for appropriateness to our objective. We adopted the PRISMA method for our review. The search for consistency with PoM was filtered through the neurobiological results of superiority illusion studies. RESULTS Out of a grand total of 139 records, 59 were included in our analysis. Of these, 36 were of uncertain value as to the primacy of mania hypothesis, 22 favoured it, and 1 was contrary, but the latter pooled patients in their manic and depressive phases, so to invalidate possible conclusions about its consistency with regard to PoM. All considered studies were not focused on PoM or superiority illusion, hence most of their results were, as expected, unrelated to the circuitry involved in superiority illusion. A considerable amount of evidence is consistent with the hypothesis, although indirectly so. LIMITATIONS Only few studies compared manic with depressive phases, with the majority including patients in euthymia. CONCLUSION It is possible that humans have a natural tendency for elation/optimism and positive self-consideration, that are more akin to mania; the depressive state could be a consequence of frustrated or unsustainable mania. This would be consistent with PoM.
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Affiliation(s)
- Georgios D Kotzalidis
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Chiara Rapinesi
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Valeria Savoja
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,ASL Roma 3, Rome, Italy
| | - Ilaria Cuomo
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Clinica Neuropsichiatrica Villa von Siebenthal, Genzano di Roma (Rome), Italy
| | - Alessio Simonetti
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Baylor College of Medicine, Houston, Texas, USA.,Centro Lucio Bini, Rome, Italy
| | - Elisa Ambrosi
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Baylor College of Medicine, Houston, Texas, USA
| | - Isabella Panaccione
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Centro Lucio Bini, Rome, Italy
| | - Silvia Gubbini
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Centro Lucio Bini, Rome, Italy.,USL Umbria 2, Terni, Italy
| | - Pietro De Rossi
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Centro Lucio Bini, Rome, Italy
| | - Lavinia De Chiara
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Centro Lucio Bini, Rome, Italy
| | - Delfina Janiri
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Gabriele Sani
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Centro Lucio Bini, Rome, Italy
| | - Alexia E Koukopoulos
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Centro Lucio Bini, Rome, Italy
| | - Giovanni Manfredi
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Centro Lucio Bini, Rome, Italy
| | - Flavia Napoletano
- Core Trainee in Psychiatry, NELFT (North East London Foundation Trust), London, UK.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, 16 De Crespigny Park, London SE5 8AF London, UK
| | - Matteo Caloro
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | | | | | - Gemma Callovini
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Department of Psychiatry, Federico II University, Naples, Italy
| | - Gloria Angeletti
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Centro Lucio Bini, Rome, Italy
| | - Antonio Del Casale
- NESMOS Department, Sapienza University - Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.,Department of Psychiatric Rehabilitation, Father A. Mileno Onlus Foundation, San Francesco Institute, Vasto (Chieti), Italy
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30
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Jeganathan J, Perry A, Bassett DS, Roberts G, Mitchell PB, Breakspear M. Fronto-limbic dysconnectivity leads to impaired brain network controllability in young people with bipolar disorder and those at high genetic risk. NEUROIMAGE-CLINICAL 2018; 19:71-81. [PMID: 30035004 PMCID: PMC6051310 DOI: 10.1016/j.nicl.2018.03.032] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/20/2018] [Accepted: 03/25/2018] [Indexed: 01/19/2023]
Abstract
Recent investigations have used diffusion-weighted imaging to reveal disturbances in the neurocircuitry that underlie cognitive-emotional control in bipolar disorder (BD) and in unaffected siblings or children at high genetic risk (HR). It has been difficult to quantify the mechanism by which structural changes disrupt the superimposed brain dynamics, leading to the emotional lability that is characteristic of BD. Average controllability is a concept from network control theory that extends structural connectivity data to estimate the manner in which local neuronal fluctuations spread from a node or subnetwork to alter the state of the rest of the brain. We used this theory to ask whether structural connectivity deficits previously observed in HR individuals (n = 84, mean age 22.4), patients with BD (n = 38, mean age 23.9), and age- and gender-matched controls (n = 96, mean age 22.6) translate to differences in the ability of brain systems to be manipulated between states. Localized impairments in network controllability were seen in the left parahippocampal, left middle occipital, left superior frontal, right inferior frontal, and right precentral gyri in BD and HR groups. Subjects with BD had distributed deficits in a subnetwork containing the left superior and inferior frontal gyri, postcentral gyrus, and insula (p = 0.004). HR participants had controllability deficits in a right-lateralized subnetwork involving connections between the dorsomedial and ventrolateral prefrontal cortex, the superior temporal pole, putamen, and caudate nucleus (p = 0.008). Between-group controllability differences were attenuated after removal of topological factors by network randomization. Some previously reported differences in network connectivity were not associated with controllability-differences, likely reflecting the contribution of more complex brain network properties. These analyses highlight the potential functional consequences of altered brain networks in BD, and may guide future clinical interventions. Control theory estimates how neuronal fluctuations spread from local networks. We compare brain controllability in bipolar disorder and their high-risk relatives. These groups have impaired controllability in networks supporting cognitive and emotional control. Weaker connectivity as well as topological alterations contribute to these changes.
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Affiliation(s)
- Jayson Jeganathan
- Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
| | - Alistair Perry
- Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Max Planck Institute for Human Development, Berlin, Germany
| | - Danielle S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Electrical & Systems Engineering, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Michael Breakspear
- Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; Metro North Mental Health Service, Brisbane, QLD, Australia
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31
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Li G, Liu P, Andari E, Zhang A, Zhang K. The Role of Amygdala in Patients With Euthymic Bipolar Disorder During Resting State. Front Psychiatry 2018; 9:445. [PMID: 30283367 PMCID: PMC6156348 DOI: 10.3389/fpsyt.2018.00445] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 08/29/2018] [Indexed: 12/20/2022] Open
Abstract
The current study aims to explore the functional changes of the amygdala in patients with euthymic Bipolar Disorder (BD) using resting state fMRI (rs-fMRI). Twenty-one euthymic patients with bipolar disorder and 28 healthy controls participated in this study. Two of the euthymic patients with BD and three of the healthy controls were excluded due to excessive head motion. We found that patients with euthymia (38.79 ± 12.03) show higher fALFF (fractional Amplitude of low-frequency fluctuation) value of the amygdala (t = 2.076, P = 0.044), and lower functional connectivity between the amygdala and supplementary motor area (p < 0.01, GRF corrected) than healthy controls (33.40 ± 8.21). However, euthymic patients did not show a differential activity in ReHo (Regional Homogeneity) and gray matter of the amygdala region as compared to healthy controls. Thus, despite the absence of clinical symptoms in euthymic patients with BD, the amygdala functional activity and its connectivity to other brain regions remain altered. Further investigation of negative emotions and social functioning in euthymic patients with BD are needed and can help pave the way for a better understanding of BD psychopathology.
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Affiliation(s)
- Gaizhi Li
- Shanxi Medical University, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Penghong Liu
- Shanxi Medical University, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Elissar Andari
- Department of Psychiatry and Behavioral Sciences, Center for Translational Social Neuroscience, Silvio O. Conte Center for Oxytocin and Social Cognition, Yerkes National Primate Research Center, Emory University School of Medicine, Atlanta, GA, United States
| | - Aixia Zhang
- Shanxi Medical University, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Kerang Zhang
- Shanxi Medical University, The First Hospital of Shanxi Medical University, Taiyuan, China
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32
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Lithium monotherapy associated clinical improvement effects on amygdala-ventromedial prefrontal cortex resting state connectivity in bipolar disorder. J Affect Disord 2018; 225:4-12. [PMID: 28772145 PMCID: PMC5844774 DOI: 10.1016/j.jad.2017.06.047] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 06/08/2017] [Accepted: 06/20/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND This study, for the first time, investigated lithium monotherapy associated effects on amygdala- ventromedial prefrontal cortex (vMPFC) resting-state functional connectivity and correlation with clinical improvement in bipolar disorder (BP) METHODS: Thirty-six medication-free subjects - 24 BP (12 hypomanic BPM) and 12 depressed (BPD)) and 12 closely matched healthy controls (HC), were included. BP subjects were treated with lithium and scanned at baseline, after 2 weeks and 8 weeks. HC were scanned at same time points but were not treated. The effect of lithium was studied for the BP group as a whole using two way (group, time) ANOVA while regressing out effects of state. Next, correlation between changes in amygdala-vMPFC resting-state connectivity and clinical global impression (CGI) of severity and improvement scale scores for overall BP illness was calculated. An exploratory analysis was also conducted for the BPD and BPM subgroups separately. RESULTS Group by time interaction revealed that lithium monotherapy in patients was associated with increase in amygdala-medial OFC connectivity after 8 weeks of treatment (p = 0.05 (cluster-wise corrected)) compared to repeat testing in healthy controls. Increased amygdala-vMPFC connectivity correlated with clinical improvement at week 2 and week 8 as measured with the CGI-I scale. LIMITATIONS The results pertain to open-label treatment and do not account for non-treatment related improvement effects. Only functional connectivity was measured which does not give information regarding one regions effect on the other. CONCLUSIONS Lithium monotherapy in BP is associated with modulation of amygdala-vMPFC connectivity which correlates with state-independent global clinical improvement.
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33
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He H, Sui J, Du Y, Yu Q, Lin D, Drevets WC, Savitz JB, Yang J, Victor TA, Calhoun VD. Co-altered functional networks and brain structure in unmedicated patients with bipolar and major depressive disorders. Brain Struct Funct 2017; 222:4051-4064. [PMID: 28600678 DOI: 10.1007/s00429-017-1451-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 05/28/2017] [Indexed: 01/10/2023]
Abstract
Bipolar disorder (BD) and major depressive disorder (MDD) share similar clinical characteristics that often obscure the diagnostic distinctions between their depressive conditions. Both functional and structural brain abnormalities have been reported in these two disorders. However, the direct link between altered functioning and structure in these two diseases is unknown. To elucidate this relationship, we conducted a multimodal fusion analysis on the functional network connectivity (FNC) and gray matter density from MRI data from 13 BD, 40 MDD, and 33 matched healthy controls (HC). A data-driven fusion method called mCCA+jICA was used to identify the co-altered FNC and gray matter components. Comparing to HC, BD exhibited reduced gray matter density in the parietal and occipital cortices, which correlated with attenuated functional connectivity within sensory and motor networks, as well as hyper-connectivity in regions that are putatively engaged in cognitive control. In addition, lower gray matter density was found in MDD in the amygdala and cerebellum. High accuracy in discriminating across groups was also achieved by trained classification models, implying that features extracted from the fusion analysis hold the potential to ultimately serve as diagnostic biomarkers for mood disorders.
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Affiliation(s)
- Hao He
- The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd, NE, Albuquerque, NM, 87106, USA.,Electrical and Computer Engineering Department, University of New Mexico, Albuquerque, NM, USA
| | - Jing Sui
- The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd, NE, Albuquerque, NM, 87106, USA. .,Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China. .,CAS Center for Excellence in Brain Science and Intelligence Technology, University of Chinese Academy of Sciences, Beijing, China.
| | - Yuhui Du
- The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd, NE, Albuquerque, NM, 87106, USA.,School of Computer and Information Technology, Shanxi University, Taiyuan, China
| | - Qingbao Yu
- The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd, NE, Albuquerque, NM, 87106, USA
| | - Dongdong Lin
- The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd, NE, Albuquerque, NM, 87106, USA
| | - Wayne C Drevets
- Janssen Pharmaceuticals of Johnson & Johnson, Inc., Titusville, NJ, USA
| | | | - Jian Yang
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Electronics, Beijing Institute of Technology, Beijing, 10081, China
| | | | - Vince D Calhoun
- The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd, NE, Albuquerque, NM, 87106, USA. .,Electrical and Computer Engineering Department, University of New Mexico, Albuquerque, NM, USA. .,Department of Psychiatry, Yale University, New Haven, CT, USA.
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34
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Son YD, Han DH, Kim SM, Min KJ, Renshaw PF. A functional connectivity comparison between attention deficit hyperactivity disorder and bipolar disorder in medication-naïve adolescents with mood fluctuation and attention problems. Psychiatry Res Neuroimaging 2017; 263:1-7. [PMID: 28264765 DOI: 10.1016/j.pscychresns.2017.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 02/15/2017] [Accepted: 02/15/2017] [Indexed: 11/23/2022]
Abstract
In order to compare patterns of connectivity between affective and attention networks in adolescents with bipolar disorder (BD) and attention deficit hyperactivity disorder (ADHD), we investigated differences in resting state functional connectivity (RSFC) between these populations. Study participants were medication-naïve adolescents (aged 13-18 years) with BD (N=22) or ADHD (N=25) and age- and sex-matched healthy adolescents (healthy controls [HC]) (N=22). Forty-seven adolescents with mood fluctuation and attention problems showed increased functional correlation (FC) between two pairs of regions within the affective network (AFN), compared to 22 HC: the left orbitofrontal cortex (OFC) to the left thalamus and the left OFC to the right thalamus. In post-hoc testing, adolescents with BD showed increased FC between two pairs of regions compared to ADHD: the right amygdala to the left temporoparietal junction (TPJ) and the right amygdala to the right TPJ. Adolescents with BD showed increased FC within the attention network (ATN) as well as increased FC between the ATN and the AFN, while those with ADHD showed decreased FC within the ATN. The current suggests that these features could be used as biomarkers for differentiating BD from ADHD in adolescents.
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Affiliation(s)
- Young Don Son
- Department of Biomedical Engineering, Gachon University, Incheon, South Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung Ang University Hospital, Seoul, South Korea.
| | - Sun Mi Kim
- Department of Psychiatry, Chung Ang University Hospital, Seoul, South Korea
| | - Kyung Joon Min
- Department of Psychiatry, Chung Ang University Hospital, Seoul, South Korea
| | - Perry F Renshaw
- Brain Institute, University of Utah, Salt Lake City, UT, USA
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35
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Roberts G, Lord A, Frankland A, Wright A, Lau P, Levy F, Lenroot RK, Mitchell PB, Breakspear M. Functional Dysconnection of the Inferior Frontal Gyrus in Young People With Bipolar Disorder or at Genetic High Risk. Biol Psychiatry 2017; 81:718-727. [PMID: 28031150 DOI: 10.1016/j.biopsych.2016.08.018] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 07/20/2016] [Accepted: 08/04/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is characterized by a dysregulation of affect and impaired integration of emotion with cognition. These traits are also expressed in probands at high genetic risk of BD. The inferior frontal gyrus (IFG) is a key cortical hub in the circuits of emotion and cognitive control, and it has been frequently associated with BD. Here, we studied resting-state functional connectivity of the left IFG in participants with BD and in those at increased genetic risk. METHODS Using resting-state functional magnetic resonance imaging we compared 49 young BD participants, 71 individuals with at least one first-degree relative with BD (at-risk), and 80 control subjects. We performed between-group analyses of the functional connectivity of the left IFG and used graph theory to study its local functional network topology. We also used machine learning to study classification based solely on the functional connectivity of the IFG. RESULTS In BD, the left IFG was functionally dysconnected from a network of regions, including bilateral insulae, ventrolateral prefrontal gyri, superior temporal gyri, and the putamen (p < .001). A small network incorporating neighboring insular regions and the anterior cingulate cortex showed weaker functional connectivity in at-risk than control participants (p < .006). These constellations of regions overlapped with frontolimbic regions that a machine learning classifier selected as predicting group membership with an accuracy significantly greater than chance. CONCLUSIONS Functional dysconnectivity of the IFG from regions involved in emotional regulation may represent a trait abnormality for BD and could potentially aid clinical diagnosis.
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Affiliation(s)
- Gloria Roberts
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Black Dog Institute, Randwick, New South Wales
| | - Anton Lord
- Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Andrew Frankland
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Black Dog Institute, Randwick, New South Wales
| | - Adam Wright
- Black Dog Institute, Randwick, New South Wales
| | - Phoebe Lau
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Black Dog Institute, Randwick, New South Wales
| | - Florence Levy
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Department of •••, Prince of Wales Hospital, Randwick, New South Wales
| | - Rhoshel K Lenroot
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Neuroscience Research Australia, Randwick, New South Wales
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Black Dog Institute, Randwick, New South Wales; Department of •••, Prince of Wales Hospital, Randwick, New South Wales
| | - Michael Breakspear
- School of Psychiatry, University of New South Wales, Randwick, New South Wales; Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; Metro North Mental Health Service, Brisbane, Queensland, Australia.
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36
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Takamura T, Hanakawa T. Clinical utility of resting-state functional connectivity magnetic resonance imaging for mood and cognitive disorders. J Neural Transm (Vienna) 2017; 124:821-839. [PMID: 28337552 DOI: 10.1007/s00702-017-1710-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/14/2017] [Indexed: 12/15/2022]
Abstract
Although functional magnetic resonance imaging (fMRI) has long been used to assess task-related brain activity in neuropsychiatric disorders, it has not yet become a widely available clinical tool. Resting-state fMRI (rs-fMRI) has been the subject of recent attention in the fields of basic and clinical neuroimaging research. This method enables investigation of the functional organization of the brain and alterations of resting-state networks (RSNs) in patients with neuropsychiatric disorders. Rs-fMRI does not require participants to perform a demanding task, in contrast to task fMRI, which often requires participants to follow complex instructions. Rs-fMRI has a number of advantages over task fMRI for application with neuropsychiatric patients, for example, although applications of task fMR to participants for healthy are easy. However, it is difficult to apply these applications to patients with psychiatric and neurological disorders, because they may have difficulty in performing demanding cognitive task. Here, we review the basic methodology and analysis techniques relevant to clinical studies, and the clinical applications of the technique for examining neuropsychiatric disorders, focusing on mood disorders (major depressive disorder and bipolar disorder) and dementia (Alzheimer's disease and mild cognitive impairment).
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Affiliation(s)
- T Takamura
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - T Hanakawa
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
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37
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Syan SK, Minuzzi L, Smith M, Allega OR, Hall GB, Frey BN. Resting state functional connectivity in women with bipolar disorder during clinical remission. Bipolar Disord 2017; 19:97-106. [PMID: 28258639 DOI: 10.1111/bdi.12469] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 11/14/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Periods of euthymia in bipolar disorder (BD) serve as a valuable time to study trait-based pathophysiology. The use of resting state functional connectivity (Rs-FC) can aid in the understanding of BD pathophysiology free of task or mood state biases. The present study investigated two unexplored areas of Rs-FC research in bipolar remission: (i) Rs-FC in women, controlling for the potential influence of premenstrual symptoms, and (ii) the use of both independent component analysis (ICA) and seed-based analysis (SBA) to investigate Rs-FC. METHODS We investigated Rs-FC of the default mode network, meso-paralimbic network and fronto-parietal network in a sample of 32 euthymic women with BD and 36 age-matched controls during the mid-follicular phase of their menstrual cycle. Rs-FC was assessed with ICA and SBA using the posterior cingulate cortex (PCC), amygdala and dorsolateral prefrontal cortex (dlPFC) as seed points for their respective resting state networks. RESULTS In BD, compared to controls, SBAs revealed increased coupling between the PCC and the angular gyrus (P=.002, false discovery rate [FDR]-corrected) and between the right dlPFC and the brainstem (P=.03, FDR-corrected). In BD only, PCC-angular gyrus coupling was correlated with anxiety symptoms. Group differences in Rs-FC using ICA did not survive multiple comparisons. CONCLUSIONS Negative findings from whole-brain ICA Rs-FC may reflect a state of clinical remission in BD. Heightened activation between the PCC and the angular gyrus and between the dlPFC and the brainstem may reflect (i) an abnormal trait integration of affective information during clinical remission and/or (ii) an adaptive compensatory mechanism required for clinical stabilization.
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Affiliation(s)
- Sabrina K Syan
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada
| | - Luciano Minuzzi
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Mara Smith
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Olivia R Allega
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada
| | - Geoffrey Bc Hall
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Benicio N Frey
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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38
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Wei S, Geng H, Jiang X, Zhou Q, Chang M, Zhou Y, Xu K, Tang Y, Wang F. Amygdala-prefrontal cortex resting-state functional connectivity varies with first depressive or manic episode in bipolar disorder. Neurosci Lett 2017; 641:51-55. [PMID: 28130184 DOI: 10.1016/j.neulet.2017.01.052] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 01/20/2017] [Accepted: 01/21/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is one of the most complex mental illnesses, characterized by interactive depressive and manic states that are 2 contrary symptoms of disease states. The bilateral amygdala and prefrontal cortex (PFC) appear to play critical roles in BD; however, abnormalities seem to manifest differently in the 2 states and may provide further insight into underlying mechanisms. METHODS Sixteen participants with first-episode depressive and 13 participants with first-episode manic states of bipolar disorder as well as 30 healthy control (HC) participants underwent resting-state functional magnetic resonance imaging (fMRI). Resting-state functional connectivity (rsFC) between the bilateral amygdala and PFC was compared among the 3 groups. RESULTS Compared with depressive state participants of the BD group, manic state participants of the BD group showed a significant decrease in rsFC between the amygdala and right orbital frontal cortex (p<0.05, corrected). In addition, rsFC between the amygdala and left middle frontal cortex was significantly decreased in depressive and manic state participants of the BD group when compared with the HC group (p<0.05, corrected). CONCLUSIONS Our findings suggest that mood state during the first episodes of BD may be related to abnormality in hemispheric lateralization. The abnormalities in amygdala- left PFC functional connectivity might present the trait feature for BD, while deficits in amygdala- right PFC functional connectivity might be specific to manic episode, compared to depressive episode.
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Affiliation(s)
- Shengnan Wei
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Haiyang Geng
- Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Xiaowei Jiang
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Qian Zhou
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Miao Chang
- Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Yifang Zhou
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Geriatric Medicine, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Ke Xu
- Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Yanqing Tang
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Geriatric Medicine, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Fei Wang
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China.
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39
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Lopez-Larson MP, Shah LM, Weeks HR, King JB, Mallik AK, Yurgelun-Todd DA, Anderson JS. Abnormal Functional Connectivity Between Default and Salience Networks in Pediatric Bipolar Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:85-93. [PMID: 29560889 PMCID: PMC6422527 DOI: 10.1016/j.bpsc.2016.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/06/2016] [Accepted: 10/07/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Pediatric bipolar disorder (PBD) (occurring prior to 18 years of age) is a developmental brain disorder that is among the most severe and disabling psychiatric conditions affecting youth. Despite increasing evidence that brain connectivity is atypical in adults with bipolar disorder, it is not clear how brain connectivity may be altered in youths with PBD. METHODS This cross-sectional resting-state functional magnetic resonance imaging study included 80 participants recruited over 4 years: 32 youths with PBD, currently euthymic (13 males; 15.1 years old), and 48 healthy control (HC) subjects (27 males; 14.5 years old). Functional connectivity between eight major intrinsic connectivity networks, along with connectivity measurements between 333 brain regions, was compared between PBD and HC subjects. Additionally, connectivity differences were evaluated between PBD and HC samples in negatively correlated connections, as defined by 839 subjects of the Human Connectome Project dataset. RESULTS We found increased inter- but not intranetwork functional connectivity in PBD between the default mode and salience networks (p = .0017). Throughout the brain, atypical connections showed failure to develop anticorrelation with age during adolescence in PBD but not HC samples among connections that exhibit negative correlation in adulthood. CONCLUSIONS Youths with PBD demonstrate reduced anticorrelation between default mode and salience networks. Further evaluation of the interaction between these networks is needed in development and with other mood states such as depression and mania to clarify if this atypical connectivity is a PBD trait biomarker.
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Affiliation(s)
- Melissa P Lopez-Larson
- The Brain Institute, U.S. Department of Veterans Affairs, Salt Lake City, Utah; University of Utah, University of Utah Medical School, U.S. Department of Veterans Affairs, Salt Lake City, Utah.
| | - Lubdha M Shah
- The Brain Institute, U.S. Department of Veterans Affairs, Salt Lake City, Utah; Department of Radiology, U.S. Department of Veterans Affairs, Salt Lake City, Utah; University of Utah, University of Utah Medical School, U.S. Department of Veterans Affairs, Salt Lake City, Utah
| | - Howard R Weeks
- University of Utah, University of Utah Medical School, U.S. Department of Veterans Affairs, Salt Lake City, Utah
| | - Jace B King
- The Brain Institute, U.S. Department of Veterans Affairs, Salt Lake City, Utah; Department of Radiology, U.S. Department of Veterans Affairs, Salt Lake City, Utah; Interdepartmental Program in Neuroscience, U.S. Department of Veterans Affairs, Salt Lake City, Utah
| | - Atul K Mallik
- Department of Radiology, U.S. Department of Veterans Affairs, Salt Lake City, Utah
| | - Deborah A Yurgelun-Todd
- The Brain Institute, U.S. Department of Veterans Affairs, Salt Lake City, Utah; Interdepartmental Program in Neuroscience, U.S. Department of Veterans Affairs, Salt Lake City, Utah; University of Utah, University of Utah Medical School, U.S. Department of Veterans Affairs, Salt Lake City, Utah; VISN 19 MIRECC, U.S. Department of Veterans Affairs, Salt Lake City, Utah
| | - Jeffrey S Anderson
- The Brain Institute, U.S. Department of Veterans Affairs, Salt Lake City, Utah; Department of Radiology, U.S. Department of Veterans Affairs, Salt Lake City, Utah; Interdepartmental Program in Neuroscience, U.S. Department of Veterans Affairs, Salt Lake City, Utah; Department of Bioengineering, U.S. Department of Veterans Affairs, Salt Lake City, Utah; University of Utah, University of Utah Medical School, U.S. Department of Veterans Affairs, Salt Lake City, Utah
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40
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Tseng WL, Thomas LA, Harkins E, Stoddard J, Zarate CA, Pine DS, Leibenluft E, Brotman MA. Functional connectivity during masked and unmasked face emotion processing in bipolar disorder. Psychiatry Res 2016; 258:1-9. [PMID: 27814457 PMCID: PMC5135603 DOI: 10.1016/j.pscychresns.2016.10.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 09/22/2016] [Accepted: 10/21/2016] [Indexed: 12/19/2022]
Abstract
Little is known regarding the neural connectivity and correlates during automatic, unconscious face emotion processing in individuals with bipolar disorder (BD). In this study, 14 adults with BD and 14 healthy volunteers (HV) underwent fMRI scanning while completing an affective priming task with unconsciously perceived and consciously perceived faces (angry, happy, neutral, blank oval). We found that, regardless of awareness level and emotion types, BD patients exhibited diminished functional connectivity between amygdala and ventromedial prefrontal cortex (vmPFC) compared to HV. This connectivity finding is present in the absence of activation differences in amygdala. In addition, in medial frontal gyrus, BD patients displayed greater activation while HV displayed less activation to angry and neutral faces compared to blank ovals. These results suggest that aberrant amygdala-vmPFC connectivity and neural dysfunction in areas implicated in appraisal and expression of emotions (medial frontal gyrus) may be the pathophysiological correlates of emotional processing in BD regardless of awareness level.
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Affiliation(s)
- Wan-Ling Tseng
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
| | - Laura A Thomas
- War Related Illness and Injury Study Center, Veterans Affairs Medical Center, Washington, DC, USA
| | - Elizabeth Harkins
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Joel Stoddard
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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41
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Spielberg JM, Beall EB, Hulvershorn LA, Altinay M, Karne H, Anand A. Resting State Brain Network Disturbances Related to Hypomania and Depression in Medication-Free Bipolar Disorder. Neuropsychopharmacology 2016; 41:3016-3024. [PMID: 27356764 PMCID: PMC5101549 DOI: 10.1038/npp.2016.112] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/22/2016] [Accepted: 06/23/2016] [Indexed: 01/04/2023]
Abstract
Research on resting functional brain networks in bipolar disorder (BP) has been unable to differentiate between disturbances related to mania or depression, which is necessary to understand the mechanisms leading to each state. Past research has also been unable to elucidate the impact of BP-related network disturbances on the organizational properties of the brain (eg, communication efficiency). Thus, the present work sought to isolate network disturbances related to BP, fractionate these into components associated with manic and depressive symptoms, and characterize the impact of disturbances on network function. Graph theory was used to analyze resting functional magnetic resonance imaging data from 60 medication-free patients meeting the criteria for BP and either a current hypomanic (n=30) or depressed (n=30) episode and 30 closely age/sex-matched healthy controls. Correction for multiple comparisons was carried out. Compared with controls, BP patients evidenced hyperconnectivity in a network involving right amygdala. Fractionation revealed that (hypo)manic symptoms were associated with hyperconnectivity in an overlapping network and disruptions in the brain's 'small-world' network organization. Depressive symptoms predicted hyperconnectivity in a network involving orbitofrontal cortex along with a less resilient global network organization. Findings provide deeper insight into the differential pathophysiological processes associated with hypomania and depression, along with the particular impact these differential processes have on network function.
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Affiliation(s)
- Jeffrey M Spielberg
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA,Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA
| | - Erik B Beall
- Imaging Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Leslie A Hulvershorn
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Murat Altinay
- Center for Behavioral Health, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Harish Karne
- Center for Behavioral Health, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Amit Anand
- Center for Behavioral Health, Cleveland Clinic Foundation, Cleveland, OH, USA,Center for Behavioral Health, Cleveland Clinic Foundation, Cleveland Clinic Main Campus, 9500 Euclid Avenue P57, Cleveland, OH 44195, USA, Tel: +1 216 636 5860, Fax: +1 216 445 0827, E-mail:
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42
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Joshi SH, Vizueta N, Foland-Ross L, Townsend JD, Bookheimer SY, Thompson PM, Narr KL, Altshuler LL. Relationships Between Altered Functional Magnetic Resonance Imaging Activation and Cortical Thickness in Patients With Euthymic Bipolar I Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:507-517. [PMID: 27990494 PMCID: PMC5157843 DOI: 10.1016/j.bpsc.2016.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Performance during cognitive control functional magnetic resonance imaging (fMRI) tasks are associated with frontal lobe hypoactivation in patients with bipolar disorder, even while euthymic. Here, we study the structural underpinnings for this functional abnormality simultaneously with brain activation data. METHODS In a sample of ninety adults (45 with inter-episode Bipolar I disorder and 45 healthy controls), we explored whether abnormal functional activation patterns in bipolar euthymic subjects during a Go-NoGo fMRI task are associated with regional deficits in cortical gray matter thickness in the same regions. Cross-sectional differences in fMRI activation were used to form a-priori hypotheses for region-of-interest cortical gray matter thickness analyses. fMRI BOLD to structural magnetic resonance imaging (sMRI) thickness correlations were conducted across the sample and within patients and controls separately. RESULTS During response inhibition (NoGo minus Go), bipolar subjects showed significant hypoactivation and reduced thickness in the inferior frontal cortex (IFC), superior frontal gyrus and cingulate compared to controls. Cingulate hypoactivation corresponded with reduced regional thickness. A significant activation by disease state interaction was observed with thickness in left prefrontal areas. CONCLUSIONS Reduced cingulate fMRI activation is associated with reduced cortical thickness. In the left frontal lobe, a thinner cortex was associated with increased fMRI activation in patients, but showed a reverse trend in controls. These findings suggest that reduced activation in the IFC and cingulate during a response inhibition task may have an underlying structural etiology, which may explain task-related functional hypoactivation that persists even when patients are euthymic.
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Affiliation(s)
- Shantanu H. Joshi
- Ahmanson Lovelace Brain Mapping Center, Department of
Neurology, University of California, Los Angeles, CA
| | - Nathalie Vizueta
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
| | | | - Jennifer D. Townsend
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
| | - Susan Y. Bookheimer
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
| | - Paul M. Thompson
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
- Imaging Genetics Center, University of Southern California,
Marina del Rey, CA
| | - Katherine L. Narr
- Ahmanson Lovelace Brain Mapping Center, Department of
Neurology, University of California, Los Angeles, CA
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
| | - Lori L. Altshuler
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA
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43
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Laidi C, Houenou J. Brain functional effects of psychopharmacological treatments in bipolar disorder. Eur Neuropsychopharmacol 2016; 26:1695-1740. [PMID: 27617780 DOI: 10.1016/j.euroneuro.2016.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 06/06/2016] [Accepted: 06/18/2016] [Indexed: 12/29/2022]
Abstract
Functional magnetic resonance imaging (fMRI) studies have contributed to the understanding of bipolar disorder. However the effect of medication on brain activation remains poorly understood. We conducted an extensive literature review on PubMed and ScienceDirect to investigate the influence of medication in fMRI studies, including both longitudinal and cross-sectional studies, which aimed at assessing this influence. Although we reported all reviewed studies, we gave greater emphasis to studies with the most robust methodology. One hundred and forty studies matched our inclusion criteria and forty-seven studies demonstrated an effect of pharmacological treatment on fMRI blood oxygen level dependent (BOLD) signal in adults and children with bipolar disorder. Out of these studies, nineteen were longitudinal. Most of cross-sectional studies suffered from methodological bias, due to post-hoc analyses performed on a limited number of patients and did not find any effect of medication. However, both longitudinal and cross-sectional studies showing an impact of treatment tend to suggest that medication prescribed to patients with bipolar disorder mostly influenced brain activation in prefrontal regions, when measured by tasks involving emotional regulation and processing as well as non-emotional cognitive tasks. FMRI promises to elucidate potential new biomarkers in bipolar disorder and could be used to evaluate the effect of new therapeutic compounds. Further research is needed to disentangle the effect of medication and the influence of the changes in mood state on brain activation in patients with bipolar disorder.
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Affiliation(s)
- Charles Laidi
- APHP, Mondor University Hospitals, DHU PePsy, Psychiatry Department, Créteil, France; INSERM, U955, IMRB, Translational Psychiatry, Créteil, France; Faculté de médecine de Créteil, Université Paris Est Créteil (UPEC), France; Fondation FondaMental, Créteil, France; UNIACT Lab, Psychiatry Team, NeuroSpin, I2BM, CEA Saclay, Gif Sur Yvette, Cedex, France.
| | - Josselin Houenou
- APHP, Mondor University Hospitals, DHU PePsy, Psychiatry Department, Créteil, France; INSERM, U955, IMRB, Translational Psychiatry, Créteil, France; Faculté de médecine de Créteil, Université Paris Est Créteil (UPEC), France; Fondation FondaMental, Créteil, France; UNIACT Lab, Psychiatry Team, NeuroSpin, I2BM, CEA Saclay, Gif Sur Yvette, Cedex, France
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44
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Stoddard J, Gotts SJ, Brotman MA, Lever S, Hsu D, Zarate C, Ernst M, Pine DS, Leibenluft E. Aberrant intrinsic functional connectivity within and between corticostriatal and temporal-parietal networks in adults and youth with bipolar disorder. Psychol Med 2016; 46:1509-1522. [PMID: 26924633 PMCID: PMC6996294 DOI: 10.1017/s0033291716000143] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Major questions remain regarding the dysfunctional neural circuitry underlying the pathophysiology of bipolar disorder (BD) in both youths and adults. In both age groups, studies implicate abnormal intrinsic functional connectivity among prefrontal, limbic and striatal areas. METHOD We collected resting-state functional magnetic resonance imaging (fMRI) data from youths and adults (ages 10-50 years) with BD (n = 39) and healthy volunteers (HV; n = 78). We identified brain regions with aberrant intrinsic functional connectivity in BD by first comparing voxel-wise mean global connectivity and then conducting correlation analyses. We used k-means clustering and multidimensional scaling to organize all detected regions into networks. RESULTS Across the brain, we detected areas of dysconnectivity in both youths and adults with BD relative to HV. There were no significant age-group × diagnosis interactions. When organized by interregional connectivity, the areas of dysconnectivity in patients with BD comprised two networks: one of temporal and parietal areas involved in late stages of visual processing, and one of corticostriatal areas involved in attention, cognitive control and response generation. CONCLUSIONS These data suggest that two networks show abnormal intrinsic functional connectivity in BD. Regions in these networks have been implicated previously in BD. We observed similar dysconnectivity in youths and adults with BD. These findings provide guidance for refining models of network-based dysfunction in BD.
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Affiliation(s)
- J. Stoddard
- Department of Health and Human Services, Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - S. J. Gotts
- Department of Health and Human Services, Section on Cognitive Neuropsychology, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - M. A. Brotman
- Department of Health and Human Services, Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - S. Lever
- Department of Health and Human Services, Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - D. Hsu
- School of Medicine, Emory University, Atlanta, GA, USA
| | - C. Zarate
- Department of Health and Human Services, Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - M. Ernst
- Department of Health and Human Services, Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - D. S. Pine
- Department of Health and Human Services, Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - E. Leibenluft
- Department of Health and Human Services, Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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45
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Chase HW, Phillips ML. Elucidating neural network functional connectivity abnormalities in bipolar disorder: toward a harmonized methodological approach. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:288-298. [PMID: 27453953 PMCID: PMC4956344 DOI: 10.1016/j.bpsc.2015.12.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Bipolar disorder (BD), a mood disorder characterized by emotional lability and dysregulation, is associated with alterations in functional connectivity, particularly as assessed using functional MRI. Here, we provide an overview of the extant literature, and themes that have emerged within it. We identified published research describing functional connectivity in BD using PubMed and follow-up searches. The most consistent evidence favors abnormally heightened functional connectivity between the amygdala and the lateral regions of the ventral prefrontal cortex (PFC), both during rest or emotional processing. Altered interactions between the amygdala and more medial PFC regions have been implicated in BD, but are less consistently related to core symptoms and are sometimes associated with mood state or psychosis. Interactions between medial and lateral ventral PFC have also been reported to be altered in BD, and may mediate estimates of amygdala/vlPFC connectivity. We also describe other themes, including an emerging literature examining reward circuitry, which has highlighted abnormal functional interactions between the ventral striatum and medial prefrontal cortex, as well as the advent of examining global network abnormalities in BD. Functional connectivity studies in BD have established altered interactions between PFC and the amygdala. To address the inconsistencies in the literature, we suggest avenues for the adoption of large scale, and network-based analysis of connectivity, the integration of structural connectivity and the acknowledgement of dynamic and context-related shifts in functional connectivity as a means of clarifying the abnormal neural circuitry in the disorder.
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Affiliation(s)
- Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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46
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Piguet C, Fodoulian L, Aubry JM, Vuilleumier P, Houenou J. Bipolar disorder: Functional neuroimaging markers in relatives. Neurosci Biobehav Rev 2015; 57:284-96. [PMID: 26321590 DOI: 10.1016/j.neubiorev.2015.08.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 07/31/2015] [Accepted: 08/25/2015] [Indexed: 12/30/2022]
Abstract
Neural models of anatomical and functional alterations have been proposed for bipolar disorders (BD). However, studies in affected patients do not allow disentangling alterations linked to the liability to BD from those associated with the evolution, medication and comorbidities of BD. Explorations in high risk subjects allow the study of these risk markers. We reported and summarized all functional magnetic resonance imaging (fMRI) studies focusing on first-degree relatives of BD patients. We found 29 studies reporting neural correlates of working memory (WM), emotional processing, executive functions and resting state in relatives of BD patients, compared to healthy subjects. Overall, the same regions that have been involved in patients, such as the inferior frontal gyrus and limbic areas, seem to be functionally altered in high-risk subjects. We conclude that the same brain regions already implicated in the pathophysiology of the disease such as the amygdala are also associated with the risk of BD. However longitudinal studies are required to understand their implication in the transition to BD.
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Affiliation(s)
- Camille Piguet
- Department of Neuroscience, Faculty of Medicine, University of Geneva, Switzerland; Department of Mental Health and Psychiatry, Geneva University Hospital, Switzerland.
| | - Leon Fodoulian
- Department of Neuroscience, Faculty of Medicine, University of Geneva, Switzerland
| | - Jean-Michel Aubry
- Department of Mental Health and Psychiatry, Geneva University Hospital, Switzerland
| | - Patrik Vuilleumier
- Department of Neuroscience, Faculty of Medicine, University of Geneva, Switzerland; Department of Clinical Neuroscience, Geneva University Hospital, Switzerland
| | - Josselin Houenou
- NeuroSpin Neuroimaging Center, UNIACT Lab, Psychiatry Team, CEA Saclay, France; INSERM U955 Team 15 "Translational Psychiatry", Université Paris Est, APHP, CHU Mondor, DHU PePsy, Pôle de Psychiatrie, Créteil, France; FondaMental Foundation, Créteil, France
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Kret ME, Ploeger A. Emotion processing deficits: A liability spectrum providing insight into comorbidity of mental disorders. Neurosci Biobehav Rev 2015; 52:153-71. [DOI: 10.1016/j.neubiorev.2015.02.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 02/11/2015] [Accepted: 02/17/2015] [Indexed: 12/13/2022]
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Abstract
The Kraepelinian dichotomy between schizophrenia (SZ) and bipolar disorder (BD) is being challenged by recent epidemiological and biological studies. We performed a comparative review of neuroimaging features in both conditions at several scales: whole-brain and regional volumes, brain activity, connectivity, and networks. Structural volumetric neuroimaging studies suggest a common pattern of volume decreases, but networks studies reveal a clearer distinction between BD and SZ with an altered connectivity generalized to all brain networks in SZ and restricted to limbic, paralimbic, and interhemispheric networks in BD.
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Horacek J, Mikolas P, Tintera J, Novak T, Palenicek T, Brunovsky M, Höschl C, Alda M. Sad mood induction has an opposite effect on amygdala response to emotional stimuli in euthymic patients with bipolar disorder and healthy controls. J Psychiatry Neurosci 2015; 40. [PMID: 25703646 PMCID: PMC4354819 DOI: 10.1503/jpn.140044] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Aberrant amygdala reactivity to affective stimuli represents a candidate factor predisposing patients with bipolar disorder (BD) to relapse, but it is unclear to what extent amygdala reactivity is state-dependent. We evaluated the modulatory influence of mood on amygdala reactivity and functional connectivity in patients with remitted BD and healthy controls. METHODS Amygdala response to sad versus neutral faces was investigated using fMRI during periods of normal and sad mood induced by autobiographical scripts. We assessed the functional connectivity of the amygdala to characterize the influence of mood state on the network responsible for the amygdala response. RESULTS We included 20 patients with remitted BD and 20 controls in our study. The sad and normal mood exerted opposite effects on the amygdala response to emotional faces in patients compared with controls (F1,38 = 5.85, p = 0.020). Sad mood amplified the amygdala response to sad facial stimuli in controls but attenuated the amygdala response in patients. The groups differed in functional connectivity between the amygdala and the inferior prefrontal gyrus (p ≤ 0.05, family-wise error-corrected) of ventrolateral prefrontal cortex (vlPFC) corresponding to Brodmann area 47. The sad mood challenge increased connectivity during the period of processing sad faces in patients but decreased connectivity in controls. LIMITATIONS Limitations to our study included long-term medication use in the patient group and the fact that we mapped only depressive (not manic) reactivity. CONCLUSION Our results support the role of the amygdala-vlPFC as the system of dysfunctional contextual affective processing in patients with BD. Opposite amygdala reactivity unmasked by the mood challenge paradigm could represent a trait marker of altered mood regulation in patients with BD.
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Affiliation(s)
- Jiri Horacek
- Correspondence to: J. Horacek, Prague Psychiatric Centre, Ustavni 91, 181 03 Prague 8, Czech Republic EU;
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50
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Oertel-Knöchel V, Reinke B, Matura S, Prvulovic D, Linden DEJ, van de Ven V. Functional connectivity pattern during rest within the episodic memory network in association with episodic memory performance in bipolar disorder. Psychiatry Res 2015; 231:141-50. [PMID: 25575881 DOI: 10.1016/j.pscychresns.2014.11.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 11/07/2014] [Accepted: 11/21/2014] [Indexed: 10/24/2022]
Abstract
In this study, we sought to examine the intrinsic functional organization of the episodic memory network during rest in bipolar disorder (BD). The previous work suggests that deficits in intrinsic functional connectivity may account for impaired memory performance. We hypothesized that regions involved in episodic memory processing would reveal aberrant functional connectivity in patients with bipolar disorder. We examined 21 patients with BD and 21 healthy matched controls who underwent functional magnetic resonance imaging (fMRI) during a resting condition. We did a seed-based functional connectivity analysis (SBA), using the regions of the episodic memory network that showed a significantly different activation pattern during task-related fMRI as seeds. The functional connectivity scores (FC) were further correlated with episodic memory task performance. Our results revealed decreased FC scores within frontal areas and between frontal and temporal/hippocampal/limbic regions in BD patients in comparison with controls. We observed higher FC in BD patients compared with controls between frontal and limbic regions. The decrease in fronto-frontal functional connectivity in BD patients showed a significant positive association with episodic memory performance. The association between task-independent dysfunctional frontal-limbic FC and episodic memory performance may be relevant for current pathophysiological models of the disease.
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Affiliation(s)
- Viola Oertel-Knöchel
- Laboratory of Neurophysiology und Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main 60528, Germany; Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
| | - Britta Reinke
- Laboratory of Neurophysiology und Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main 60528, Germany; Brain Imaging Center Frankfurt, Germany; Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Silke Matura
- Laboratory of Neurophysiology und Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main 60528, Germany; Brain Imaging Center Frankfurt, Germany; Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - David Prvulovic
- Laboratory of Neurophysiology und Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main 60528, Germany; Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - David E J Linden
- Brain Imaging Center Frankfurt, Germany; Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Vincent van de Ven
- MRC Centre for Neuropsychiatric Genetics & Genomics, Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, United Kingdom; Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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