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Mestre-Bach G, Granero R, Fernández-Aranda F, Jiménez-Murcia S, Potenza MN. Independent component analysis for internet gaming disorder. DIALOGUES IN CLINICAL NEUROSCIENCE 2023; 25:14-23. [PMID: 36817972 PMCID: PMC9930851 DOI: 10.1080/19585969.2023.2168135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/17/2022] [Indexed: 02/10/2023]
Abstract
Introduction: There is a growing interest in the study of the neurobiological correlates of internet gaming disorder (IGD), and new techniques are beginning to be implemented for this purpose, such as independent component analysis (ICA). Aims: The present narrative review aimed to explore the studies that had used ICA for the study of the different brain networks possibly associated with IGD. Methods: We specifically focussed on three of the main networks: default-mode network, executive-control and salience networks. Results: Most studies have identified alterations in these three brain networks in individuals with IGD, which may be involved in the development and maintenance of this disorder. Conclusion: More studies are needed to deepen an understanding of the specific role of each in the symptomatology and treatment of IGD.
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Affiliation(s)
- Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de la Rioja, La Rioja, Spain
- Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
| | - Roser Granero
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Behavioral Addictions Unit, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Behavioral Addictions Unit, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Wu Tsai Institute, Yale University School of Medicine, New Haven, CT, USA
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Goldman DA, Sankar A, Rich A, Kim JA, Pittman B, Constable RT, Scheinost D, Blumberg HP. A graph theory neuroimaging approach to distinguish the depression of bipolar disorder from major depressive disorder in adolescents and young adults. J Affect Disord 2022; 319:15-26. [PMID: 36103935 PMCID: PMC9669784 DOI: 10.1016/j.jad.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/03/2022] [Accepted: 09/09/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Markers to differentiate depressions of bipolar disorder (BD-Dep) from depressions of major depressive disorder (MDD-Dep), and for more targeted treatments, are critically needed to decrease current high rates of misdiagnosis that can lead to ineffective or potentially deleterious treatments. Distinguishing, and specifically treating the depressions, during the adolescent/young adult epoch is especially important to decrease illness progression and improve prognosis, and suicide, as it is the epoch when suicide thoughts and behaviors often emerge. With differences in functional connectivity patterns reported when BD-Dep and MDD-Dep have been studied separately, this study used a graph theory approach aimed to identify functional connectivity differences in their direct comparison. METHODS Functional magnetic resonance imaging whole-brain functional connectivity (Intrinsic Connectivity Distribution, ICD) measures were compared across adolescents/young adults with BD-Dep (n = 28), MDD-Dep (n = 20) and HC (n = 111). Follow-up seed-based connectivity was conducted on regions of significant ICD differences. Relationships with demographic and clinical measures were assessed. RESULTS Compared to the HC group, both the BD-Dep and MDD-Dep groups exhibited left-sided frontal, insular, and medial temporal ICD increases. The BD-Dep group had additional right-sided ICD increases in frontal, basal ganglia, and fusiform areas. In seed-based analyses, the BD-Dep group exhibited increased interhemispheric functional connectivity between frontal areas not seen in the MDD-Dep group. LIMITATIONS Modest sample size; medications not studied systematically. CONCLUSIONS This study supports bilateral and interhemispheric functional dysconnectivity as features of BD-Dep that may differentiate it from MDD-Dep in adolescents/young adults and serve as a target for early diagnosis and treatment strategies.
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Affiliation(s)
- Danielle A Goldman
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06511, United States of America; Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - Anjali Sankar
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, United States of America; Department of Neurology and Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Alexandra Rich
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - Jihoon A Kim
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - R Todd Constable
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, United States of America; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06511, United States of America; Child Study Center, Yale School of Medicine, New Haven, CT 06511, United States of America.
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3
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Goldman DA, Sankar A, Colic L, Villa L, Kim JA, Pittman B, Constable RT, Scheinost D, Blumberg HP. A graph theory-based whole brain approach to assess mood state differences in adolescents and young adults with bipolar disorder. Bipolar Disord 2022; 24:412-423. [PMID: 34665907 PMCID: PMC9016085 DOI: 10.1111/bdi.13144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 09/21/2021] [Accepted: 10/14/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Identifying hubs of brain dysfunction in adolescents and young adults with Bipolar I Disorder (BDAYA ) could provide targets for early detection, prevention, and treatment. Previous neuroimaging studies across mood states of BDAYA are scarce and often examined limited brain regions potentially prohibiting detection of other important regions. We used a data-driven whole-brain Intrinsic Connectivity Distribution (ICD) approach to investigate dysconnectivity hubs across mood states in BDAYA . METHODS Functional magnetic resonance imaging whole-brain ICD data were investigated for differences across four groups: BDAYA -depressed (n = 22), BDAYA -euthymic (n = 45), BDAYA -elevated (n = 24), and healthy controls (HC, n = 111). Clusters of ICD differences were assessed for regional dysconnectivity and mood symptom relationships. Analyses were also performed for BDAYA overall (vs. HC) ICD differences persisting across mood states. RESULTS ICD was higher in the BDAYA- depressed group than other groups in bilateral ventral/rostral/dorsal prefrontal cortex (PFC) and right lenticular nucleus (LN) (pcorrected <0.05). In BDAYA -depressed, functional connectivity (FC) was increased between these regions with their contralateral homologues and PFC-medial temporal FC was more negative (p < 0.005). PFC-related findings correlated with depression scores (p < 0.05). The overall BDAYA group showed ICD increases in more ventral left PFC and right cerebellum, present across euthymia and acute mood states. CONCLUSIONS This ICD approach supports a PFC hub of inter- and intra-hemispheric frontotemporal dysconnectivity in BDAYA with potential trait features and disturbances of higher magnitude during depression. Hubs were also revealed in LN and cerebellum, less common foci of BD research. The hubs are potential targets for early interventions to detect, prevent, and treat BD.
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Affiliation(s)
- Danielle A Goldman
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Anjali Sankar
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Neurology and Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lejla Colic
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Luca Villa
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Jihoon A Kim
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Brian Pittman
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - R Todd Constable
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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Marino M, Romeo Z, Angrilli A, Semenzato I, Favaro A, Magnolfi G, Padovan GB, Mantini D, Spironelli C. Default mode network shows alterations for low-frequency fMRI fluctuations in euthymic bipolar disorder. J Psychiatr Res 2021; 144:59-65. [PMID: 34600288 DOI: 10.1016/j.jpsychires.2021.09.051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/13/2021] [Accepted: 09/23/2021] [Indexed: 11/18/2022]
Abstract
Bipolar disorder (BD) is a psychiatric condition causing acute dysfunctional mood states and emotion regulation. Specific neuropsychological features are often present also among patients in euthymic phase, who do not show clear psychotic symptoms, and for whom the characterization from functional magnetic resonance imaging (fMRI) is very limited. This study aims at identifying the neural and behavioral correlates of the default mode network (DMN) using the fractional amplitude of low frequency fluctuations (fALFF). Eighteen euthymic BD patients (10 females; age = 54.50 ± 11.38 years) and sixteen healthy controls (HC) (8 females; age = 51.16 ± 11.44 years) underwent a 1.5T fMRI scan at rest. The DMN was extracted through independent component analysis. Then, DMN time series was used to compute the fALFF, which was correlated with clinical scales. From the between-group comparison, no significant differences emerged in correspondence to regions belonging to the DMN. For fALFF analysis, we reported significant increase of low-frequency fluctuations for lower frequencies, and decreases for higher frequencies compared to HC. Correlations with clinical scales showed that an increase in higher frequency spectral content was associated with lower levels of mania and higher levels of anxious symptoms, while an increase in lower frequencies was linked to lower depressive symptoms. Starting from our findings on the DMN in euthymic BD patients, we suggest that the fALFF derived from network time series represents a viable approach to investigate the behavioral correlates of resting state networks, and the pathophysiological mechanisms of different psychiatric conditions.
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Affiliation(s)
- Marco Marino
- Department of Movement Sciences, Research Center for Motor Control and Neuroplasticity, KU, Leuven, Belgium; IRCCS San Camillo Hospital, Venice, Italy.
| | - Zaira Romeo
- Department of General Psychology, University of Padova, Italy
| | - Alessandro Angrilli
- Department of General Psychology, University of Padova, Italy; Padova Neuroscience Center, University of Padova, Italy
| | | | - Angela Favaro
- Padova Neuroscience Center, University of Padova, Italy; Psychiatric Clinic, Neuroscience Department, University of Padova, Italy
| | - Gianna Magnolfi
- Psychiatric Clinic, Neuroscience Department, University of Padova, Italy
| | - Giordano Bruno Padovan
- Psychiatric Clinic, Neuroscience Department, University of Padova, Italy; Unit of Penitentiary Medicine, ULSS6, Padova, Italy
| | - Dante Mantini
- Department of Movement Sciences, Research Center for Motor Control and Neuroplasticity, KU, Leuven, Belgium; IRCCS San Camillo Hospital, Venice, Italy
| | - Chiara Spironelli
- Department of General Psychology, University of Padova, Italy; Padova Neuroscience Center, University of Padova, Italy.
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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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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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7
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Yoon S, Kim TD, Kim J, Lyoo IK. Altered functional activity in bipolar disorder: A comprehensive review from a large-scale network perspective. Brain Behav 2021; 11:e01953. [PMID: 33210461 PMCID: PMC7821558 DOI: 10.1002/brb3.1953] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/08/2020] [Accepted: 10/25/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Growing literature continues to identify brain regions that are functionally altered in bipolar disorder. However, precise functional network correlates of bipolar disorder have yet to be determined due to inconsistent results. The overview of neurological alterations from a large-scale network perspective may provide more comprehensive results and elucidate the neuropathology of bipolar disorder. Here, we critically review recent neuroimaging research on bipolar disorder using a network-based approach. METHODS A systematic search was conducted on studies published from 2009 through 2019 in PubMed and Google Scholar. Articles that utilized functional magnetic resonance imaging technique to examine altered functional activity of major regions belonging to a large-scale brain network in bipolar disorder were selected. RESULTS A total of 49 studies were reviewed. Within-network hypoconnectivity was reported in bipolar disorder at rest among the default mode, salience, and central executive networks. In contrast, when performing a cognitive task, hyperconnectivity among the central executive network was found. Internetwork functional connectivity in the brain of bipolar disorder was greater between the salience and default mode networks, while reduced between the salience and central executive networks at rest, compared to control. CONCLUSION This systematic review suggests disruption in the functional activity of large-scale brain networks at rest as well as during a task stimuli in bipolar disorder. Disrupted intra- and internetwork functional connectivity that are also associated with clinical symptoms suggest altered functional connectivity of and between large-scale networks plays an important role in the pathophysiology of bipolar disorder.
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Affiliation(s)
- Sujung Yoon
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea
| | - Tammy D Kim
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea
| | - Jungyoon Kim
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea.,Graduate School of Pharmaceutical Sciences, Ewha W. University, Seoul, South Korea.,The Brain Institute and Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
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Chen P, Chen F, Chen G, Zhong S, Gong J, Zhong H, Ye T, Tang G, Wang J, Luo Z, Qi Z, Jia Y, Yang H, Yin Z, Huang L, Wang Y. Inflammation is associated with decreased functional connectivity of insula in unmedicated bipolar disorder. Brain Behav Immun 2020; 89:615-622. [PMID: 32688026 DOI: 10.1016/j.bbi.2020.07.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/17/2020] [Accepted: 07/08/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Systemic inflammation and immune dysregulation have been considered as risk factors in the pathophysiology of mood disorders including bipolar disorder (BD). Previous neuroimaging studies have demonstrated metabolic, structural and functional abnormalities in the insula in BD, proposed that the insula played an important role in BD. We herein aimed to explore neural mechanisms underlying inflammation-induced in the insular subregions functional connectivity (FC) in patients with BD. METHODS Brain resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from 41 patients with unmedicated BD II (current episode depressed), 68 healthy controls (HCs). Three pairs of insular seed regions were selected: the bilateral anterior insula (AI), the bilateral middle insula (MI) and the bilateral posterior insula (PI), and calculated the whole-brain FC for each subregion. Additionally, the serum levels of pro-inflammatory cytokines in patients and HCs, including IL-6 and TNF-α, were detected. Then the partial correlation coefficients between the abnormal insular subregions FC values and pro-inflammatory cytokines levels in patients with BD II depression were calculated. RESULTS The BD II depression group exhibited decreased FC between the right PI and the left postcentral gyrus, and increased FC between the left AI and the bilateral insula (extended to the right putamen) when compared with the HC group. Moreover, the patients with BD II depression showed higher IL-6 and TNF-α levels than HCs, and IL-6 level was negatively correlated with FC of the right PI to the left postcentral gyrus. CONCLUSIONS Our results demonstrated that abnormal FC between the bilateral insula, and between the insula and sensorimotor areas in BD. Moreover, disrupted FC between the insula and sensorimotor areas was associated with elevated pro-inflammatory cytokine levels of IL-6 in 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
| | - 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
| | - 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
| | - 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
| | - Hui Zhong
- Biomedical Translational Research Institute, Jinan University, Guangzhou 510630, China
| | - Tao Ye
- Clinical Laboratory Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, 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
| | - Jurong Wang
- 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
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hengwen Yang
- Biomedical Translational Research Institute, Jinan University, Guangzhou 510630, China; Zhuhai Precision Medical Center, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Jinan University, Zhuhai 519000, China
| | - Zhinan Yin
- Biomedical Translational Research Institute, 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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9
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Abstract
Since its discovery in 1997, the default mode network (DMN) and its components have been extensively studied in both healthy individuals and psychiatric patients. Several studies have investigated possible DMN alterations in specific mental conditions such as bipolar disorder (BD). In this review, we describe current evidence from resting-state functional magnetic resonance imaging studies with the aim to understand possible changes in the functioning of the DMN in BD. Overall, several types of analyses including seed-based and independent component have been conducted on heterogeneous groups of patients highlighting different results. Despite the differences, findings seem to indicate that BD is associated with alterations in both frontal and posterior DMN structures, mainly in the prefrontal, posterior cingulate and inferior parietal cortices. We conclude this review by suggesting possible future research directions.
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10
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Bellani M, Bontempi P, Zovetti N, Gloria Rossetti M, Perlini C, Dusi N, Squarcina L, Marinelli V, Zoccatelli G, Alessandrini F, Francesca Maria Ciceri E, Sbarbati A, Brambilla P. Resting state networks activity in euthymic bipolar disorder. Bipolar Disord 2020; 22:593-601. [PMID: 32212391 DOI: 10.1111/bdi.12900] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Bipolar disorder (BD) is a psychiatric condition causing shifts in mood, energy and activity levels severely altering the quality of life of the patients even in the euthymic phase. Although widely accepted, the neurobiological bases of the disorder in the euthymic phase remain elusive. This study aims at characterizing resting state functional activity of the BD euthymic phase in order to better understand the pathogenesis of the disease and build future neurobiological models. METHODS Fifteen euthymic BD patients (10 females; mean age 40.2; standard deviation 13.5; range 20-61) and 27 healthy controls (HC) (21 females; mean age 37; standard deviation 10.6; range 22-60) underwent a 3T functional MRI scan at rest. Resting state activity was extracted through independent component analysis (ICA) run with automatic dimensionality estimation. RESULTS ICA identified 22 resting state networks (RSNs). Within-network analysis revealed decreased connectivity in the visual, temporal, motor and cerebellar RSNs of BD patients vs HC. Between-network analysis showed increased connectivity between motor area and the default mode network (DMN) partially overlapping with the fronto-parietal network (FPN) in BD patients. CONCLUSION Within-network analysis confirmed existing evidence of altered cerebellar, temporal, motor and visual networks in BD. Increased connectivity between the DMN and the motor area network suggests the presence of alterations of the fronto-parietal regions, precuneus and cingulate cortex in the euthymic condition. These findings indicate that specific connectivity alterations might persist even in the euthymic state suggesting the importance of examining both within and between-network connectivity to achieve a global understanding of the BD euthymic condition.
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Affiliation(s)
- Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Pietro Bontempi
- Department of Computer Science, University of Verona, Verona, Italy
| | - Niccolò Zovetti
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Maria Gloria Rossetti
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy.,Department of Neuroscience and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Nicola Dusi
- Psychiatry Unit, Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Letizia Squarcina
- Department of Neuroscience and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Veronica Marinelli
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
| | - Giada Zoccatelli
- Neuroradiology Department, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Franco Alessandrini
- Neuroradiology Department, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Elisa Francesca Maria Ciceri
- Neuroradiology Department, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.,Department of Neurosurgery, IRCCS Fondazione Istituto Neurologico "C.Besta", Milano, Italy
| | - Andrea Sbarbati
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona
| | - Paolo Brambilla
- Department of Neuroscience and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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11
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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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12
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Reich DB, Belleau EL, Temes CM, Gonenc A, Pizzagalli DA, Gruber SA. Amygdala Resting State Connectivity Differences between Bipolar II and Borderline Personality Disorders. Neuropsychobiology 2019; 78:229-237. [PMID: 31553999 PMCID: PMC7968721 DOI: 10.1159/000502440] [Citation(s) in RCA: 9] [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: 06/14/2019] [Accepted: 07/22/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Borderline personality disorder (BPD) and bipolar II disorder (BD II) have significant clinical overlap, leaving the potential for diagnostic inaccuracies and inadequate treatment recommendations. However, few studies have probed for clinical and neurobiological differences between the two disorders. Clinically, some prior studies have linked BPD with greater impulsivity and more frequent negative affective shifts than BD II, whereas previous neuroimaging studies have highlighted both similar and distinct neural abnormalities in BPD and BD II. Notably, no prior study has specifically targeted cortico-limbic neural differences, which have been hypothesized to underlie these core clinical differences. METHODS Individuals with BPD (n = 14) and BD II (n = 15) completed various clinical measures and a resting state functional imaging scan at 3T. Whole-brain amygdala resting state functional connectivity (RSFC) was compared between the two groups. RESULTS Relative to the BD II group, BPD participants reported significantly higher levels of impulsivity, trait anxiety, more frequent negative affective shifts, greater interpersonally reactive affective instability, lower overall functioning, and were characterized by lower amygdala-middle frontal gyrus RSFC. Lower amygdala-middle frontal gyrus RSFC was associated with greater impulsivity, trait anxiety, affective shifts, interpersonal affective reactivity, and functional impairment. LIMITATIONS The current study consisted of small sample sizes and lacked a control group. CONCLUSIONS This preliminary study suggests that amygdala-frontal RSFC may distinguish BPD from BD II. These results may guide future work aimed at identifying neural markers that can help disentangle these two disorders, leading to greater diagnostic accuracy and appropriate treatment implementation.
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Affiliation(s)
- D Bradford Reich
- Laboratory for the Study of Adult Development, McLean Hospital, Belmont, Massachusetts, USA,
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA,
| | - Emily L Belleau
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts, USA
| | - Christina M Temes
- Laboratory for the Study of Adult Development, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Atilla Gonenc
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts, USA
- McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, USA
| | - Staci A Gruber
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, USA
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13
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Altered regional homogeneity in pediatric bipolar disorder during manic and euthymic state: a resting-state fMRI study. Brain Imaging Behav 2019; 13:1789-1798. [DOI: 10.1007/s11682-019-00117-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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14
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Thomas SA, Christensen RE, Schettini E, Saletin JM, Ruggieri AL, MacPherson HA, Kim KL, Dickstein DP. Preliminary analysis of resting state functional connectivity in young adults with subtypes of bipolar disorder. J Affect Disord 2019; 246:716-726. [PMID: 30616161 PMCID: PMC8805680 DOI: 10.1016/j.jad.2018.12.068] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 11/25/2018] [Accepted: 12/23/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND A precision medicine approach to bipolar disorder (BD) requires greater knowledge of neural mechanisms, especially within the BD phenotype. The present study evaluated differences in resting state functional connectivity (RSFC) between young adults followed longitudinally since childhood with full-threshold type I BD (BD-I)-characterized by distinct manic episodes-or a more sub-syndromal presentation of BD (BD Not Otherwise Specified [BD-NOS]), compared to one another and to healthy controls (HC). Independent Components Analysis (ICA), a multivariate data-driven method, and dual regression were used to explore whether connectivity within resting state networks (RSNs) differentiated the groups, especially for characteristic fronto-limbic alterations in BD. METHODS Young adults (ages 18-30) with BD-I (n = 28), BD-NOS (n = 14), and HCs (n = 52) underwent structural and RSFC neuroimaging. ICA derived 30 components from RSFC data; a subset of these components, representing well-characterized RSNs, was used for between-group analyses. RESULTS Participants with BD-I had significantly greater connectivity strength between the executive control network and right caudate vs. HCs. Participants with BD-NOS had significantly greater connectivity strength between the sensorimotor network and left precentral gyrus vs. HCs, which was significantly related to psychiatric symptoms. LIMITATIONS Limitations included small BD-NOS sample size and variation in BD mood state and medication status. CONCLUSIONS Results for BD-I participants support prior findings of fronto-limbic alterations characterizing BD. Alterations in the sensorimotor network for adults with BD-NOS aligns with the small but growing body of evidence that sensorimotor network alterations may represent a marker for vulnerability to BD. Further study is required to evaluate specificity.
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Affiliation(s)
- Sarah A. Thomas
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA,Division of Child Psychiatry, Department of Psychiatry and
Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI,
USA,Corresponding Author: Sarah A. Thomas, Bradley
Hospital PediMIND Program, 1011 Veterans Memorial Parkway, East Providence, RI
02915, Phone: (401) 432-1618, Fax: (401) 432-1607,
| | - Rachel E. Christensen
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Elana Schettini
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Jared M. Saletin
- Division of Child Psychiatry, Department of Psychiatry and
Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI,
USA,Emma Pendleton Bradley Hospital Sleep Research Laboratory,
Providence, RI, USA
| | - Amanda L. Ruggieri
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Heather A. MacPherson
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA,Division of Child Psychiatry, Department of Psychiatry and
Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI,
USA
| | - Kerri L. Kim
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA,Division of Child Psychiatry, Department of Psychiatry and
Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI,
USA
| | - Daniel P. Dickstein
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA,Division of Child Psychiatry, Department of Psychiatry and
Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI,
USA
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15
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Yin Z, Chang M, Wei S, Jiang X, Zhou Y, Cui L, Lv J, Wang F, Tang Y. Decreased Functional Connectivity in Insular Subregions in Depressive Episodes of Bipolar Disorder and Major Depressive Disorder. Front Neurosci 2018; 12:842. [PMID: 30487732 PMCID: PMC6246657 DOI: 10.3389/fnins.2018.00842] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 10/29/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: Clinically, it is very difficult to distinguish between major depressive disorder (MDD) and bipolar disorder (BD) in the period of depression. Increasing evidence shows that the insula plays an important role in depression. We aimed to compare the resting-state functional connectivity (rsFC) of insular subregions in patients with MDD and BD in depressive episodes (BDD), who had never experienced manic or hypomanic episodes when they were scanned to identify biomarkers for the identification of two diseases. Methods: We recruited 21 BDD patients, 40 MDD patients and 70 healthy controls (HC). Resting-state functional magnetic resonance imaging (rs-fMRI) was performed. BDD patients had never had manic or hypomanic episodes when they were scanned, and the diagnoses were determined by follow-up. We divided the insula into three parts including the ventral anterior insular cortex (v-AIN), dorsal anterior insular cortex (d-AIN), and posterior insula (PI). The insular-based rsFC was compared among the three groups, and an analysis of the correlation between the rsFC value and Hamilton depression and anxiety scales was carried out. Results: BDD and MDD patients demonstrated decreased rsFC from the v-AIN to the left superior/middle frontal gyrus compared with the HC group. Versus MDD and HC groups, BDD patients exhibited decreased rsFC from the v-AIN to the area in the left orbital frontal gyrus and left superior temporal gyrus (included temporal pole), from the PI to the right lateral postcentral gyrus and from all three insular subregions to the somatosensory and motor cortex. Meanwhile, a correlation between the rsFC value of the PI-right lateral postcentral gyrus and anxiety score was observed in patients. Conclusion: Our findings show BDD and MDD patients have similar decreases in insular connectivity in the dorsal lateral frontal regions, and BDD patients have specific decreased insular connectivity, especially in the somatosensory and motor cortex, which may be used as imaging evidence for clinical identification.
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Affiliation(s)
- Zhiyang Yin
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Miao Chang
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Shengnan Wei
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaowei Jiang
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yifang Zhou
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Lingling Cui
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jing Lv
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
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16
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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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17
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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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18
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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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19
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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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20
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Connectomic markers of disease expression, genetic risk and resilience in bipolar disorder. Transl Psychiatry 2016; 6:e706. [PMID: 26731443 PMCID: PMC5068872 DOI: 10.1038/tp.2015.193] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 10/18/2015] [Accepted: 10/30/2015] [Indexed: 01/23/2023] Open
Abstract
Bipolar disorder (BD) is characterized by emotional dysregulation and cognitive deficits associated with abnormal connectivity between subcortical-primarily emotional processing regions-and prefrontal regulatory areas. Given the significant contribution of genetic factors to BD, studies in unaffected first-degree relatives can identify neural mechanisms of genetic risk but also resilience, thus paving the way for preventive interventions. Dynamic causal modeling (DCM) and random-effects Bayesian model selection were used to define and assess connectomic phenotypes linked to facial affect processing and working memory in a demographically matched sample of first-degree relatives carefully selected for resilience (n=25), euthymic patients with BD (n=41) and unrelated healthy controls (n=46). During facial affect processing, patients and relatives showed similarly increased frontolimbic connectivity; resilient relatives, however, evidenced additional adaptive hyperconnectivity within the ventral visual stream. During working memory processing, patients displayed widespread hypoconnectivity within the corresponding network. In contrast, working memory network connectivity in resilient relatives was comparable to that of controls. Our results indicate that frontolimbic dysfunction during affect processing could represent a marker of genetic risk to BD, and diffuse hypoconnectivity within the working memory network a marker of disease expression. The association of hyperconnectivity within the affect-processing network with resilience to BD suggests adaptive plasticity that allows for compensatory changes and encourages further investigation of this phenotype in genetic and early intervention studies.
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21
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Yip SW, Worhunsky PD, Rogers RD, Goodwin GM. Hypoactivation of the ventral and dorsal striatum during reward and loss anticipation in antipsychotic and mood stabilizer-naive bipolar disorder. Neuropsychopharmacology 2015; 40:658-66. [PMID: 25139065 PMCID: PMC4289954 DOI: 10.1038/npp.2014.215] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/25/2014] [Accepted: 08/13/2014] [Indexed: 01/17/2023]
Abstract
Increased activity within known reward-processing neurocircuitry (eg, ventral striatum, VS) has been reported among medicated individuals with bipolar disorder (BD) I and II. However, such findings are confounded by the potential ameliorative effects of mood-stabilizing and antipsychotic medications on neural activations. This study tests the hypothesis that a pathophysiological locus of alterations in reward processing is present within the striatum in antipsychotic and lithium-naive individuals with BD. Twenty antipsychotic and lithium-naive individuals with BD II or BD not-otherwise specified (NOS) and 20 matched healthy comparison individuals participated in functional magnetic resonance imaging during the performance of a monetary incentive delay task. Between-group comparisons were conducted using small-volume correction focusing on orthogonal a priori regions of interest centered in the VS and dorsal striatum (DS), respectively. During reward anticipation, unmedicated individuals with BD II/NOS had decreased activity within the DS (but not VS). During loss anticipation, on the other hand, decreased activation within both the VS and DS was observed. Across all participants, DS activity (during reward anticipation) was positively associated with putamen volume. This is the first report of decreased dorsal and ventral striatal activity among unmedicated individuals with BD II/NOS. These data contradict a simple 'reward hypersensitivity' model of BD, and add to a growing body of literature suggesting that blunted reward processing may be a vulnerability factor for both mood- and addiction-related disorders.
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Affiliation(s)
- Sarah W Yip
- Department of Psychiatry, University of Oxford, Oxford, UK,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, 1 Church Street, Room 732, Suite 7, New Haven, CT 06519, USA, Tel: +1 203 704 7588, Fax: +1 203 737 3591, E-mail:
| | - Patrick D Worhunsky
- Department of Psychiatry, University of Oxford, Oxford, UK,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Robert D Rogers
- Department of Psychiatry, University of Oxford, Oxford, UK,School of Psychology, Bangor University, Gwynedd, UK
| | - Guy M Goodwin
- Department of Psychiatry, University of Oxford, Oxford, UK
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