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Macoveanu J, Fortea L, Kjærstad HL, Coello K, Faurholt-Jepsen M, Fisher PM, Knudsen GM, Radua J, Vieta E, Frangou S, Vinberg M, Kessing LV, Miskowiak KW. Longitudinal changes in resting-state functional connectivity as markers of vulnerability or resilience in first-degree relatives of patients with bipolar disorder. Psychol Med 2024:1-9. [PMID: 38634498 DOI: 10.1017/s0033291724000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND There is a significant contribution of genetic factors to the etiology of bipolar disorder (BD). Unaffected first-degree relatives of patients (UR) with BD are at increased risk of developing mental disorders and may manifest cognitive impairments and alterations in brain functional and connective dynamics, akin to their affected relatives. METHODS In this prospective longitudinal study, resting-state functional connectivity was used to explore stable and progressive markers of vulnerability i.e. abnormalities shared between UR and BD compared to healthy controls (HC) and resilience i.e. features unique to UR compared to HC and BD in full or partial remission (UR n = 72, mean age = 28.0 ± 7.2 years; HC n = 64, mean age = 30.0 ± 9.7 years; BD patients n = 91, mean age = 30.6 ± 7.7 years). Out of these, 34 UR, 48 BD, and 38 HC were investigated again following a mean time of 1.3 ± 0.4 years. RESULTS At baseline, the UR showed lower connectivity values within the default mode network (DMN), frontoparietal network, and the salience network (SN) compared to HC. This connectivity pattern in UR remained stable over the follow-up period and was not present in BD, suggesting a resilience trait. The UR further demonstrated less negative connectivity between the DMN and SN compared to HC, abnormality that remained stable over time and was also present in BD, suggesting a vulnerability marker. CONCLUSION Our findings indicate the coexistence of both vulnerability-related abnormalities in resting-state connectivity, as well as adaptive changes possibly promoting resilience to psychopathology in individual at familial risk.
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Affiliation(s)
- Julian Macoveanu
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- Neurocogntion and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Lydia Fortea
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Fundació Clínic per la Recerca Biomèdica (FCRB), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Hanne Lie Kjærstad
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- Neurocogntion and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Klara Coello
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
| | - Maria Faurholt-Jepsen
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Gitte Moos Knudsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Fundació Clínic per la Recerca Biomèdica (FCRB), Barcelona, Spain
- Centro de Investigacisón Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Fundació Clínic per la Recerca Biomèdica (FCRB), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigacisón Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, US
| | - Maj Vinberg
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Psychiatric Center Northern Zealand, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Frederiksberg Hospital, Copenhagen, Denmark
- Neurocogntion and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Wen X, Qu D, Liu D, Shu Y, Zhao S, Wu G, Wang Y, Cui Z, Zhang X, Chen R. Brain structural and functional signatures of multi-generational family history of suicidal behaviors in preadolescent children. Mol Psychiatry 2024; 29:484-495. [PMID: 38102486 DOI: 10.1038/s41380-023-02342-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 12/17/2023]
Abstract
Parent-child transmission of suicidal behaviors has been extensively studied, but the investigation of a three-generation family suicide risk paradigm remains limited. In this study, we aimed to explore the behavioral and brain signatures of multi-generational family history of suicidal behaviors (FHoS) in preadolescents, utilizing a longitudinal design and the dataset from Adolescent Brain and Cognitive DevelopmentSM Study (ABCD Study®), which comprised 4 years of data and includes a total of 9,653 preadolescents. Our findings revealed that multi-generational FHoS was significantly associated with an increased risk of problematic behaviors and suicidal behaviors (suicide ideation and suicide attempt) in offspring. Interestingly, the problematic behaviors were further identified as a mediator in the multi-generational transmission of suicidal behaviors. Additionally, we observed alterations in brain structure within superior temporal gyrus (STG), precentral/postcentral cortex, posterior parietal cortex (PPC), cingulate cortex (CC), and planum temporale (PT), as well as disrupted functional connectivity of default mode network (DMN), ventral attention network (VAN), dorsal attention network (DAN), fronto-parietal network (FPN), and cingulo-opercular network (CON) among preadolescents with FHoS. These results provide compelling longitudinal evidence at the population level, highlighting the associations between multi-generational FHoS and maladaptive behavioral and neurodevelopmental outcomes in offspring. These findings underscore the need for early preventive measures aimed at mitigating the familial transmission of suicide risk and reducing the global burden of deaths among children and adolescents.
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Affiliation(s)
- Xue Wen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Dongyu Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yinuo Shu
- Chinese Institute for Brain Research, Beijing, China
| | - Shaoling Zhao
- Chinese Institute for Brain Research, Beijing, China
| | - Guowei Wu
- Chinese Institute for Brain Research, Beijing, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Zaixu Cui
- Chinese Institute for Brain Research, Beijing, China.
| | - Xiaoqian Zhang
- Wulituo Hospital of Shijingshan District, Beijing, China.
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China.
- Institute for Healthy China, Tsinghua University, Beijing, China.
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Pan N, Qin K, Patino LR, Tallman MJ, Lei D, Lu L, Li W, Blom TJ, Bruns KM, Welge JA, Strawn JR, Gong Q, Sweeney JA, Singh MK, DelBello MP. Aberrant brain network topology in youth with a familial risk for bipolar disorder: a task-based fMRI connectome study. J Child Psychol Psychiatry 2024. [PMID: 38220469 DOI: 10.1111/jcpp.13946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Youth with a family history of bipolar disorder (BD) may be at increased risk for mood disorders and for developing side effects after antidepressant exposure. The neurobiological basis of these risks remains poorly understood. We aimed to identify biomarkers underlying risk by characterizing abnormalities in the brain connectome of symptomatic youth at familial risk for BD. METHODS Depressed and/or anxious youth (n = 119, age = 14.9 ± 1.6 years) with a family history of BD but no prior antidepressant exposure and typically developing controls (n = 57, age = 14.8 ± 1.7 years) received functional magnetic resonance imaging (fMRI) during an emotional continuous performance task. A generalized psychophysiological interaction (gPPI) analysis was performed to compare their brain connectome patterns, followed by machine learning of topological metrics. RESULTS High-risk youth showed weaker connectivity patterns that were mainly located in the default mode network (DMN) (network weight = 50.1%) relative to controls, and connectivity patterns derived from the visual network (VN) constituted the largest proportion of aberrant stronger pairs (network weight = 54.9%). Global local efficiency (Elocal , p = .022) and clustering coefficient (Cp , p = .029) and nodal metrics of the right superior frontal gyrus (SFG) (Elocal : p < .001; Cp : p = .001) in the high-risk group were significantly higher than those in healthy subjects, and similar patterns were also found in the left insula (degree: p = .004; betweenness: p = .005; age-by-group interaction, p = .038) and right hippocampus (degree: p = .003; betweenness: p = .003). The case-control classifier achieved a cross-validation accuracy of 78.4%. CONCLUSIONS Our findings of abnormal connectome organization in the DMN and VN may advance mechanistic understanding of risk for BD. Neuroimaging biomarkers of increased network segregation in the SFG and altered topological centrality in the insula and hippocampus in broader limbic systems may be used to target interventions tailored to mitigate the underlying risk of brain abnormalities in these at-risk youth.
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Affiliation(s)
- Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
- Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
- Department of Psychiatry, University of Cincinnati, Cincinnati, USA
| | - Kun Qin
- Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
- Department of Psychiatry, University of Cincinnati, Cincinnati, USA
| | - Luis R Patino
- Department of Psychiatry, University of Cincinnati, Cincinnati, USA
| | | | - Du Lei
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Lu Lu
- Huaxi MR Research Center (HMRRC), Department of Radiology, Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychiatry, University of Cincinnati, Cincinnati, USA
| | - Wenbin Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Thomas J Blom
- Department of Psychiatry, University of Cincinnati, Cincinnati, USA
| | - Kaitlyn M Bruns
- Department of Psychiatry, University of Cincinnati, Cincinnati, USA
| | - Jeffrey A Welge
- Department of Psychiatry, University of Cincinnati, Cincinnati, USA
| | - Jeffrey R Strawn
- Department of Psychiatry, University of Cincinnati, Cincinnati, USA
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, OH, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychiatry, University of Cincinnati, Cincinnati, USA
| | - Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California, USA
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Tai APL, Leung MK, Geng X, Lau WKW. Conceptualizing psychological resilience through resting-state functional MRI in a mentally healthy population: a systematic review. Front Behav Neurosci 2023; 17:1175064. [PMID: 37538200 PMCID: PMC10394620 DOI: 10.3389/fnbeh.2023.1175064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Conceptualizations and operational definitions of psychological resilience vary across resilience neuroimaging studies. Data on the neural features of resilience among healthy individuals has been scarce. Furthermore, findings from resting-state functional magnetic resonance imaging (fMRI) studies were inconsistent across studies. This systematic review summarized resting-state fMRI findings in different modalities from various operationally defined resilience in a mentally healthy population. The PubMed and MEDLINE databases were searched. Articles that focused on resting-state fMRI in relation to resilience, and published before 2022, were targeted. Orbitofrontal cortex, anterior cingulate cortex, insula and amygdala, were reported the most from the 19 included studies. Regions in emotional network was reported the most from the included studies. The involvement of regions like amygdala and orbitofrontal cortex indicated the relationships between emotional processing and resilience. No common brain regions or neural pathways were identified across studies. The emotional network appears to be studied the most in association with resilience. Matching fMRI modalities and operational definitions of resilience across studies are essential for meta-analysis.
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Affiliation(s)
- Alan P. L. Tai
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Integrated Centre for Wellbeing, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Bioanalytical Laboratory for Educational Sciences, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Mei-Kei Leung
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong SAR, China
| | - Xiujuan Geng
- Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Way K. W. Lau
- Department of Health Sciences, The Hong Kong Metropolitan University, Hong Kong, Hong Kong SAR, China
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5
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Nery FG, Welge JA, Fleck D, Weber W, Patino LR, Strawn JR, Adler CM, Strakowski SM, DelBello MP. Brain functional activation and first mood episode in youth at risk for bipolar disorder. J Affect Disord 2023; 331:238-244. [PMID: 36931569 PMCID: PMC10413175 DOI: 10.1016/j.jad.2023.03.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 03/06/2023] [Accepted: 03/11/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND In order to identify biomarkers of prodromal mood disorders, we examined functional brain activation in children and adolescent at familial risk for bipolar disorder. METHODS Offspring of parents with bipolar I disorder (at-risk youth; N = 115, mean ± SD age: 13.6 ± 2.7; 54 % girls) and group-matched offspring of healthy parents (healthy controls; N = 58, mean ± SD age: 14.2 ± 3.0; 53 % girls) underwent functional magnetic resonance imaging while performing a continuous performance task with emotional and neutral distracters. At baseline, at-risk youth had no history of mood episodes or psychotic disorders. Subjects were followed longitudinally until developing their first mood episode or being lost to follow-up. Standard event-related region-of-interest (ROI) analyses were performed to compare brain activation at baseline between groups and in survival analyses. RESULTS At baseline, at-risk youth exhibited reduced activation to emotional distracters in the right ventrolateral prefrontal cortex (VLPFC) (p = 0.04). Activation was not significantly altered in additional ROIs, including left VLPFC, bilateral amygdala, caudate, or putamen. In those at-risk youth who developed their first mood episode during follow-up (n = 17), baseline increased activation in right VLPFC, right caudate, and right putamen activation predicted the development of a mood episode. LIMITATIONS Sample size of converters, loss to follow-up, and number of statistical comparisons. CONCLUSIONS We found preliminary evidence that a reduced activation in right VLPFC might be a marker of risk for or resilience to mood disorders in at-risk youth. Conversely, an increased activation in the right VLPFC, caudate, and putamen might indicate an increased risk for the later development of their first mood episode.
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Affiliation(s)
- Fabiano G Nery
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Jeffrey A Welge
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - David Fleck
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Wade Weber
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - L Rodrigo Patino
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jeffrey R Strawn
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Caleb M Adler
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stephen M Strakowski
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Saxena K, Simonetti A, Verrico CD, Janiri D, Di Nicola M, Catinari A, Kurian S, Saxena J, Mwangi B, Soares JC. Neurocognitive Correlates of Cerebellar Volumetric Alterations in Youth with Pediatric Bipolar Spectrum Disorders and Bipolar Offspring. Curr Neuropharmacol 2023; 21:1367-1378. [PMID: 36239717 PMCID: PMC10324334 DOI: 10.2174/1570159x21666221014120332] [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: 05/02/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Emerging evidence points towards the involvement of the cerebellum in the processing of emotions and pathophysiology of mood disorders. However, cerebellar and related cognitive alterations in youth with pediatric bipolar disorder (PBD) and those at high risk to develop the disorder, such as bipolar offspring (BD-OFF) are not clearly defined. OBJECTIVE To investigate cerebellar gray and white matter volumes, cognition, and their relationship in youth with PBD and BD-OFF. METHODS Thirty youth (7 to 17 years, inclusive) with PBD, 30 BD-OFF and 40 healthy controls (HC) were recruited. Study participants underwent a computer-based cognitive battery assessing affective processing, executive function, attention, psychomotor speed, and learning. Three-tesla MRI scan was performed to assess cerebellar white and gray matter volumes. Cerebellar segmentation was performed with FreeSurfer. Statistical analyses include between-group differences in cognitive domains, cerebellar gray, and white matter volumes. Relationships between cerebellar volumes and cognitive domains were examined. RESULTS Youth with PBD showed greater cerebellar gray matter volumes than both BD-OFF and HC, whereas no differences were present between BD-OFF and HC. Both youth with PBD and BD-OFF showed altered processing of negative emotions and a bias towards positive emotions. In youth with PBD and BD-OFF, greater impairment in the processing of emotions correlated with greater cerebellar gray matter volumes. CONCLUSION The present findings corroborate hypotheses on cerebellar involvement in the processing of emotions and the pathophysiology of PBD. The presence of cerebellar dysfunction in BD-OFF is unclear.
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Affiliation(s)
- Kirti Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, TX, USA
- Department of Psychiatry, Texas Children’s Hospital, Houston, Texas, TX, USA
| | - Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, TX, USA
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Christopher D. Verrico
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, TX, USA
| | - Delfina Janiri
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonello Catinari
- Department of Neuroscience, Section of Psychiatry, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sherin Kurian
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, TX, USA
- Department of Psychiatry, Texas Children’s Hospital, Houston, Texas, TX, USA
| | - Johanna Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, TX, USA
- Department of Psychiatry, Texas Children’s Hospital, Houston, Texas, TX, USA
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, Texas, TX, USA
| | - Jair C. Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, Texas, TX, USA
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7
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Miklowitz DJ, Weintraub MJ, Walshaw PD, Schneck CD, Chang KD, Merranko J, Garrett AS, Singh MK. Early Family Intervention for Youth at Risk for Bipolar Disorder: Psychosocial and Neural Mediators of Outcome. Curr Neuropharmacol 2023; 21:1379-1392. [PMID: 36635932 PMCID: PMC10324335 DOI: 10.2174/1570159x21666230111120817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/14/2022] [Accepted: 11/25/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The impairing neurodevelopmental course of bipolar disorder (BD) suggests the importance of early intervention for youth in the beginning phases of the illness. OBJECTIVE We report the results of a 3-site randomized trial of family-focused therapy for youth at high-risk (FFT-HR) for BD, and explore psychosocial and neuroimaging variables as mediators of treatment effects. METHODS High-risk youth (<18 years) with major depressive disorder or other specified BD, active mood symptoms, and a family history of BD were randomly assigned to 4 months of FFT-HR (psychoeducation, communication and problem-solving skills training) or 4 months of enhanced care psychoeducation. Adjunctive pharmacotherapy was provided by study psychiatrists. Neuroimaging scans were conducted before and after psychosocial treatments in eligible participants. Independent evaluators interviewed participants every 4-6 months over 1-4 years regarding symptomatic outcomes. RESULTS Among 127 youth (mean 13.2 ± 2.6 years) over a median of 98 weeks, FFT-HR was associated with longer intervals prior to new mood episodes and lower levels of suicidal ideation than enhanced care. Reductions in perceived family conflict mediated the effects of psychosocial interventions on the course of mood symptoms. Among 34 participants with pre-/post-treatment fMRI scans, youth in FFT-HR had (a) stronger resting state connectivity between ventrolateral PFC and anterior default mode network, and (b) increased activity of dorsolateral and medial PFC in emotion processing and problem-solving tasks, compared to youth in enhanced care. CONCLUSION FFT-HR may delay new mood episodes in symptomatic youth with familial liability to BD. Putative treatment mechanisms include neural adaptations suggestive of improved emotion regulation.
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Affiliation(s)
- David J. Miklowitz
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Marc J. Weintraub
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Patricia D. Walshaw
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Kiki D. Chang
- Private Practice, 2460 Park Blvd, Suite 6 Palo Alto, CA 94306 USA
| | - John Merranko
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Amy S. Garrett
- Department of Psychiatry, University of Texas, Health Science Center at San Antonio, San Antonio, TX, USA
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8
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Qin K, Sweeney JA, DelBello MP. The inferior frontal gyrus and familial risk for bipolar disorder. PSYCHORADIOLOGY 2022; 2:171-179. [PMID: 38665274 PMCID: PMC10917220 DOI: 10.1093/psyrad/kkac022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 04/28/2024]
Abstract
Bipolar disorder (BD) is a familial disorder with high heritability. Genetic factors have been linked to the pathogenesis of BD. Relatives of probands with BD who are at familial risk can exhibit brain abnormalities prior to illness onset. Given its involvement in prefrontal cognitive control and in frontolimbic circuitry that regulates emotional reactivity, the inferior frontal gyrus (IFG) has been a focus of research in studies of BD-related pathology and BD-risk mechanism. In this review, we discuss multimodal neuroimaging findings of the IFG based on studies comparing at-risk relatives and low-risk controls. Review of these studies in at-risk cases suggests the presence of both risk and resilience markers related to the IFG. At-risk individuals exhibited larger gray matter volume and increased functional activities in IFG compared with low-risk controls, which might result from an adaptive brain compensation to support emotion regulation as an aspect of psychological resilience. Functional connectivity between IFG and downstream limbic or striatal areas was typically decreased in at-risk individuals relative to controls, which could contribute to risk-related problems of cognitive and emotional control. Large-scale and longitudinal investigations on at-risk individuals will further elucidate the role of IFG and other brain regions in relation to familial risk for BD, and together guide identification of at-risk individuals for primary prevention.
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Affiliation(s)
- Kun Qin
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219, USA
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219, USA
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45219, USA
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9
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Fischer AS, Holt-Gosselin B, Hagan KE, Fleming SL, Nimarko AF, Gotlib IH, Singh MK. Intrinsic Connectivity and Family Dynamics: Striatolimbic Markers of Risk and Resilience in Youth at Familial Risk for Mood Disorders. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:855-866. [PMID: 35272095 PMCID: PMC9452604 DOI: 10.1016/j.bpsc.2022.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 02/04/2022] [Accepted: 02/22/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Few studies to date have characterized functional connectivity (FC) within emotion and reward networks in relation to family dynamics in youth at high familial risk for bipolar disorder (HR-BD) and major depressive disorder (HR-MDD) relative to low-risk youth (LR). Such characterization may advance our understanding of the neural underpinnings of mood disorders and lead to more effective interventions. METHODS A total of 139 youth (43 HR-BD, 46 HR-MDD, and 50 LR) aged 12.9 ± 2.7 years were longitudinally followed for 4.5 ± 2.4 years. We characterized differences in striatolimbic FC that distinguished between HR-BD, HR-MDD, and LR and between resilience and conversion to psychopathology. We then examined whether risk status moderated FC-family dynamic associations. Finally, we examined whether baseline between-group FC differences predicted resilence versus conversion to psychopathology. RESULTS HR-BD had greater amygdala-middle frontal gyrus and dorsal striatum-middle frontal gyrus FC relative to HR-MDD and LR, and HR-MDD had lower amygdala-fusiform gyrus and dorsal striatum-precentral gyrus FC relative to HR-BD and LR (voxel-level p < .001, cluster-level false discovery rate-corrected p < .05). Resilient youth had greater amygdala-orbitofrontal cortex and ventral striatum-dorsal anterior cingulate cortex FC relative to youth with conversion to psychopathology (voxel-level p < .001, cluster-level false discovery rate-corrected p < .05). Greater family rigidity was inversely associated with amygdala-fusiform gyrus FC across all groups (false discovery rate-corrected p = .017), with a moderating effect of bipolar risk status (HR-BD vs. HR-MDD p < .001; HR-BD vs. LR p = .005). Baseline FC differences did not predict resilence versus conversion to psychopathology. CONCLUSIONS Findings represent neural signatures of risk and resilience in emotion and reward processing networks in youth at familial risk for mood disorders that may be targets for novel interventions tailored to the family context.
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Affiliation(s)
- Adina S Fischer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
| | | | - Kelsey E Hagan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Scott L Fleming
- Department of Biomedical Data Science, Stanford University, Stanford, California
| | - Akua F Nimarko
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, California
| | - Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
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10
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Simonetti A, Saxena K, Koukopoulos AE, Janiri D, Lijffijt M, Swann AC, Kotzalidis GD, Sani G. Amygdala structure and function in paediatric bipolar disorder and high-risk youth: A systematic review of magnetic resonance imaging findings. World J Biol Psychiatry 2022; 23:103-126. [PMID: 34165050 DOI: 10.1080/15622975.2021.1935317] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Converging evidence from structural and functional magnetic resonance imaging (MRI) studies points to amygdala alteration as crucial in the development of paediatric bipolar disorder (pBP). The high number of recent studies prompted us to comprehensively evaluate findings. We aimed to systematically review structural and functional MRI studies investigating the amygdala in patients with pBP and in youth at high-risk (HR) for developing pBP. METHODS We searched PubMed from any time to 25 September 2020 using: 'amygdala AND (MRI OR magnetic resonance imaging) AND bipolar AND (pediatr* OR child OR children OR childhood OR adolescent OR adolescents OR adolescence OR young OR familial OR at-risk OR sibling* OR offspring OR high risk)'. In this review, we adhered to the PRISMA statement. RESULTS Amygdala hyperactivity to emotional stimuli is the most commonly reported finding in youth with pBP and HR compared to healthy peers (HC), whereas findings from structural MRI studies are inconsistent. CONCLUSIONS Hyperactivation of the amygdala might be an endophenotype of pBP.
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Affiliation(s)
- Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Department of Psychiatry, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.,Centro Lucio Bini, Rome, Italy
| | - Kirti Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA
| | - Alexia E Koukopoulos
- Centro Lucio Bini, Rome, Italy.,Azienda Ospedaliera Universitaria Policlinico Umberto I, Sapienza School of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Delfina Janiri
- Centro Lucio Bini, Rome, Italy.,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Marijn Lijffijt
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Alan C Swann
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Georgios D Kotzalidis
- Centro Lucio Bini, Rome, Italy.,NESMOS Department, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.,Institute of Psychiatry, Università Cattolica del Sacro Cuore, Roma, Italy
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11
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Nimarko AF, Gorelik AJ, Carta KE, Gorelik MG, Singh MK. Neural correlates of reward processing distinguish healthy youth at familial risk for bipolar disorder from youth at familial risk for major depressive disorder. Transl Psychiatry 2022; 12:31. [PMID: 35075136 PMCID: PMC8786954 DOI: 10.1038/s41398-022-01800-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/17/2021] [Accepted: 01/12/2022] [Indexed: 11/09/2022] Open
Abstract
Youth at familial risk for bipolar disorder (BD-risk) and major depressive disorder (MDD-risk) have aberrant reward processing, a core feature of these mood disorders. Whether BD risk differentiates from MDD risk in reward processing merits further study. We compared neural activation and connectivity during anticipation and outcome of monetary gain and loss during fMRI using the Monetary Incentive Delay (MID) Task among BD-risk (n = 40), MDD-risk (n = 41), and healthy comparison youth (HC) (n = 45), in the absence of any lifetime or current history of psychopathology [mean age 13.09 ± 2.58, 56.3% female]. Participants completed the MID task at baseline and were followed for behavioral and clinical outcomes over 4.37 ± 2.29 years. Region-of-interest (ROI) analyses conducted using anatomically defined thalamus, ventrolateral prefrontal cortex, nucleus accumbens, and putamen seeds showed that relative to MDD-risk and HC, BD-risk had decreased activation of the thalamus during anticipation of monetary gain [F(2,118) = 4.64, p = 0.01 (FDR-corrected p = 0.04)]. Psychophysiological interaction analyses revealed that BD-risk had less connectivity between the thalamus and left middle frontal gyrus (Z > 3.1, p < 0.001) and left-superior temporal gyrus (Z > 3.1, p < 0.05) compared with MDD-risk. Voxelwise, BD-risk had decreased activation in the cerebellum during anticipation and outcome of monetary gain relative to MDD-risk and HC (Z > 3.1, p < 0.001; Z > 3.1, p < 0.01). In BD-risk, decreased thalamic connectivity was associated with increased impulsivity at baseline and reduced prosocial behavior at follow-up. Reduced thalamic activation and connectivity during reward processing may distinguish familial risk for BD from familial risk for MDD and represent early markers of vulnerability that may herald social dysfunction later in adolescence.
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Affiliation(s)
- Akua F. Nimarko
- grid.168010.e0000000419368956Stanford University School of Medicine, Stanford, CA United States
| | - Aaron J. Gorelik
- grid.168010.e0000000419368956Stanford University School of Medicine, Stanford, CA United States
| | - Kayla E. Carta
- grid.168010.e0000000419368956Stanford University School of Medicine, Stanford, CA United States
| | - Mark G. Gorelik
- grid.15276.370000 0004 1936 8091University of Florida, Gainesville, FL United States
| | - Manpreet K. Singh
- grid.168010.e0000000419368956Stanford University School of Medicine, Stanford, CA United States
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12
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Nimarko AF, Fischer AS, Hagan KE, Gorelik AJ, Lu Y, Young CJ, Singh MK. Neural Correlates of Positive Emotion Processing That Distinguish Healthy Youths at Familial Risk for Bipolar Versus Major Depressive Disorder. J Am Acad Child Adolesc Psychiatry 2021; 60:887-901. [PMID: 32738282 PMCID: PMC7855111 DOI: 10.1016/j.jaac.2020.07.890] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 06/17/2020] [Accepted: 07/23/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Familial risk for bipolar disorder (BD) or major depressive disorder (MDD) may lead to differential emotion processing signatures, resulting in unique neural vulnerability. METHOD Healthy offspring of a parent with BD (n = 29, "BD-risk") or MDD (n = 44, "MDD-risk") and healthy control youths without any personal or family psychopathology (n = 28, "HC") aged 8 to 17 years (13.64 ± 2.59 years) completed an implicit emotion-perception functional magnetic resonance imaging task. Whole-brain voxelwise and psychophysiological interaction analyses examined neural differences in activation and connectivity during emotion processing. Regression modeling tested for neural associations with behavioral strengths and difficulties and conversion to psychopathology at follow-up (3.71 ± 1.91 years). RESULTS BD-risk youth showed significantly reduced bilateral putamen activation, and decreased connectivity between the left putamen and the left ventral anterior cingulate cortex (vACC) and the right posterior cingulate cortex (PCC) during positive-valence emotion processing compared to MDD-risk and HC (Z >2.3; p <.001). Decreased left putamen-right PCC connectivity correlated with subsequent peer problems in BD-risk (β = -2.90; p <.05) and MDD-risk (β = -3.64; p < .05) groups. Decreased left (β = -0.09; p < .05) and right putamen activation (β = -0.07; p = .04) were associated with conversion to a mood or anxiety disorder in BD-risk youths. Decreased left putamen-right PCC connectivity was associated with a higher risk of conversion in BD-risk (HR = 8.28 , p < .01) and MDD-risk (HR = 2.31, p = .02) groups. CONCLUSION Reduced putamen activation and connectivity during positive emotion processing appear to distinguish BD-risk youths from MDD-risk and HC youths, and may represent a marker of vulnerability.
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Affiliation(s)
| | | | | | | | - Yvonne Lu
- Stanford University School of Medicine, California
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13
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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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14
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Zhang W, Nery FG, Tallman MJ, Patino LR, Adler CM, Strawn JR, Fleck DE, Barzman DH, Sweeney JA, Strakowski SM, Lui S, DelBello MP. Individual prediction of symptomatic converters in youth offspring of bipolar parents using proton magnetic resonance spectroscopy. Eur Child Adolesc Psychiatry 2021; 30:55-64. [PMID: 32008167 DOI: 10.1007/s00787-020-01483-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 01/23/2020] [Indexed: 02/05/2023]
Abstract
Children of individuals with bipolar disorder (bipolar offspring) are at increased risk for developing mood disorders, but strategies to predict mood episodes are unavailable. In this study, we used support vector machine (SVM) to characterize the potential of proton magnetic resonance spectroscopy (1H-MRS) in predicting the first mood episode in youth bipolar offspring. From a longitudinal neuroimaging study, 19 at-risk youth who developed their first mood episode (converters), and 19 without mood episodes during follow-up (non-converters) were selected and matched for age, sex and follow-up time. Baseline 1H-MRS data were obtained from anterior cingulate cortex (ACC) and bilateral ventrolateral prefrontal cortex (VLPFC). Glutamate (Glu), myo-inositol (mI), choline (Cho), N-acetyl aspartate (NAA), and phosphocreatine plus creatine (PCr + Cr) levels were calculated. SVM with a linear kernel was adopted to classify converters and non-converters based on their baseline metabolites. SVM allowed the significant classification of converters and non-converters across all regions for Cho (accuracy = 76.0%), but not for other metabolites. Considering all metabolites within each region, SVM allowed the significant classification of converters and non-converters for left VLPFC (accuracy = 76.5%), but not for right VLPFC or ACC. The combined mI, PCr + Cr, and Cho from left VLPFC achieved the highest accuracy differentiating converters from non-converters (79.0%). Our findings from this exploratory study suggested that 1H-MRS levels of mI, Cho, and PCr + Cr from left VLPFC might be useful to predict the development of first mood episode in youth bipolar offspring using machine learning. Future studies that prospectively examine and validate these metabolites as predictors of mood episodes in high-risk individuals are necessary.
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Affiliation(s)
- Wenjing Zhang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Fabiano G Nery
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, 45219, USA
| | - Maxwell J Tallman
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, 45219, USA
| | - L Rodrigo Patino
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, 45219, USA
| | - Caleb M Adler
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, 45219, USA
| | - Jeffrey R Strawn
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, 45219, USA
| | - David E Fleck
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, 45219, USA
| | - Drew H Barzman
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, 45219, USA
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, 45219, USA
| | - Stephen M Strakowski
- Department of Psychiatry, Dell Medical School, University of Texas At Austin, Austin, TX, 78712, USA
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, 45219, USA
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15
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Neuroanatomic and Functional Neuroimaging Findings. Curr Top Behav Neurosci 2020; 48:173-196. [PMID: 33040316 DOI: 10.1007/7854_2020_174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The search for brain morphology findings that could explain behavioral disorders has gone through a long path in the history of psychiatry. With the advance of brain imaging technology, studies have been able to identify brain morphology and neural circuits associated with the pathophysiology of mental illnesses, such as bipolar disorders (BD). Promising results have also shown the potential of neuroimaging findings in the identification of outcome predictors and response to treatment among patients with BD. In this chapter, we present brain imaging structural and functional findings associated with BD, as well as their hypothesized relationship with the pathophysiological aspects of that condition and their potential clinical applications.
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16
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Tymofiyeva O, Zhou VX, Lee CM, Xu D, Hess CP, Yang TT. MRI Insights Into Adolescent Neurocircuitry-A Vision for the Future. Front Hum Neurosci 2020; 14:237. [PMID: 32733218 PMCID: PMC7359264 DOI: 10.3389/fnhum.2020.00237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/29/2020] [Indexed: 11/13/2022] Open
Abstract
Adolescence is the time of onset of many psychiatric disorders. Half of pediatric patients present with comorbid psychiatric disorders that complicate both their medical and psychiatric care. Currently, diagnosis and treatment decisions are based on symptoms. The field urgently needs brain-based diagnosis and personalized care. Neuroimaging can shed light on how aberrations in brain circuits might underlie psychiatric disorders and their development in adolescents. In this perspective article, we summarize recent MRI literature that provides insights into development of psychiatric disorders in adolescents. We specifically focus on studies of brain structural and functional connectivity. Ninety-six included studies demonstrate the potential of MRI to assess psychiatrically relevant constructs, diagnose psychiatric disorders, predict their development or predict response to treatment. Limitations of the included studies are discussed, and recommendations for future research are offered. We also present a vision for the role that neuroimaging may play in pediatrics and primary care in the future: a routine neuropsychological and neuropsychiatric imaging (NPPI) protocol for adolescent patients, which would include a 30-min brain scan, a quality control and safety read of the scan, followed by computer-based calculation of the structural and functional brain network metrics that can be compared to the normative data by the pediatrician. We also perform a cost-benefit analysis to support this vision and provide a roadmap of the steps required for this vision to be implemented.
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Affiliation(s)
- Olga Tymofiyeva
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Vivian X Zhou
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Chuan-Mei Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.,Clinical Excellence Research Center, Stanford University, Stanford, CA, United States
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Christopher P Hess
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Tony T Yang
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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17
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Zhang L, Li W, Wang L, Bai T, Ji GJ, Wang K, Tian Y. Altered functional connectivity of right inferior frontal gyrus subregions in bipolar disorder: a resting state fMRI study. J Affect Disord 2020; 272:58-65. [PMID: 32379621 DOI: 10.1016/j.jad.2020.03.122] [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] [Received: 11/20/2019] [Revised: 02/04/2020] [Accepted: 03/29/2020] [Indexed: 11/26/2022]
Abstract
The right inferior frontal gyrus (rIFG) is a key cortical node in the circuits of emotion and cognitive control, and it has been frequently associated with bipolar disorder (BP); however, a reliable pattern of aberrant rIFG activation and connectivity in bipolar disorder has yet to be established. To further elucidate rIFG abnormalities in different states of bipolar disorder, we examined activation and functional connectivity (FC) in five subregions of rIFG in bipolar disorder. A total of 83 participants, including those with bipolar depression (BPD; n = 25) and bipolar mania (BPM; n = 37) along with healthy control (HC) subjects (n = 26), were examined by resting state functional magnetic resonance imaging (rs-fMRI). Both BPD and BPM groups showed higher values of amplitude of low-frequency fluctuations (ALFF) than healthy control in four of the five rIFG subregions except cluster 2(posterior-ventral rIFG). Using five subregions of rIFG as seeds, the decreased FC in bipolar disorder was mainly between posterior-ventral rIFG(cluster 2) and multiple brain regions including the postcentral gyrus, the precentral gyrus, paracentral lobule, lingual Gyrus, fusiform and cerebellum posterior lobe. These results indicated that local activity and FC were altered within specific subregions of the rIFG in BP. These findings may provide the distinct functional connectivity of rIFG subregions in BP and suggest that the cluster2 (posterior-ventral rIFG) circuitry plays a crucial role in BP. Also, such abnormalities might help define a more precise intervention targets.
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Affiliation(s)
- Li Zhang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China;; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Wenfei Li
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Long Wang
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Tongjian Bai
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, 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
| | - Kai Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, 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.
| | - Yanghua Tian
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, 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.
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18
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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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19
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Saxena K, Kurian S, Saxena J, Goldberg A, Chen E, Simonetti A. Mixed States in Early-Onset Bipolar Disorder. Psychiatr Clin North Am 2020; 43:95-111. [PMID: 32008691 DOI: 10.1016/j.psc.2019.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Pediatric bipolar disorder (PBD) is a severe and chronic illness. The occurrence of mixed symptoms might add further risk of recurrence of treatment resistance and suicidality. Early recognition and treatment of mixed symptoms might prevent illness progression and development of suicide attempts. This article provides an update on the epidemiology, clinical profile, and treatment of youth with PBD with mixed states. Mixed states in PBD are characterized by higher rates of suicide and more chronic symptoms, and are associated with younger age of onset and greater comorbidity. A careful assessment for mixed states using standardized criteria is essential.
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Affiliation(s)
- Kirti Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA; Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA.
| | - Sherin Kurian
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA; Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA
| | - Johanna Saxena
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA; Department of Psychiatry, Texas Children's Hospital, Houston, TX, USA
| | - Adam Goldberg
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School at the University of Texas Health Science Center, 1941 East Road, Houston, TX 77054, USA
| | - Eugenia Chen
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Centro Lucio Bini, Rome, Italy; Department of Psychiatry, Baylor College of Medicine, 1977 Butler Boulevard Suite E4.400, Houston, TX 77030, USA
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20
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Heinze K, Shen X, Hawkins E, Harris MA, de Nooij L, McIntosh AM, Wood SJ, Whalley HC. Aberrant structural covariance networks in youth at high familial risk for mood disorder. Bipolar Disord 2020; 22:155-162. [PMID: 31724284 PMCID: PMC7155114 DOI: 10.1111/bdi.12868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Current research suggests significant disruptions in functional brain networks in individuals with mood disorder, and in those at familial risk. Studies of structural brain networks provide important insights into synchronized maturational change but have received less attention. We aimed to investigate developmental relationships of large-scale brain networks in mood disorder using structural covariance (SC) analyses. METHODS We conducted SC analysis of baseline structural imaging data from 121 at the time of scanning unaffected high risk (HR) individuals (29 later developed mood disorder after a median time of 4.95 years), and 89 healthy controls (C-well) with no familial risk from the Scottish Bipolar Family Study (age 15-27, 64% female). Voxel-wise analyses of covariance were conducted to compare the associations between each seed region in visual, auditory, motor, speech, semantic, executive-control, salience and default-mode networks and the whole brain signal. SC maps were compared for (a) HR(all) versus C-well individuals, and (b) between those who remained well (HR-well), versus those who subsequently developed mood disorder (HR-MD), and C-well. RESULTS There were no significant differences between HR(all) and C-well individuals. On splitting the HR group based on subsequent clinical outcome, the HR-MD group however displayed greater baseline SC in the salience and executive-control network, and HR-well individuals showed less SC in the salience network, compared to C-well, respectively (P < .001). CONCLUSIONS These findings indicate differences in network-level inter-regional relationships, especially within the salience network, which precede onset of mood disorder in those at familial risk.
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Affiliation(s)
- Kareen Heinze
- School of PsychologyUniversity of BirminghamBirminghamUK,Institute for Mental HealthUniversity of BirminghamBirminghamUK,Centre for Human Brain HealthUniversity of BirminghamBirminghamUK
| | - Xueyi Shen
- Division of PsychiatryUniversity of EdinburghEdinburghUK
| | - Emma Hawkins
- Division of PsychiatryUniversity of EdinburghEdinburghUK
| | | | - Laura de Nooij
- Division of PsychiatryUniversity of EdinburghEdinburghUK
| | | | - Stephen J. Wood
- School of PsychologyUniversity of BirminghamBirminghamUK,Institute for Mental HealthUniversity of BirminghamBirminghamUK,Orygen, The National Centre of Excellence in Youth Mental HealthMelbourneVic.Australia,Centre for Youth Mental HealthUniversity of MelbourneMelbourneVic.Australia
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21
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Association between spontaneous activity of the default mode network hubs and leukocyte telomere length in late childhood and early adolescence. J Psychosom Res 2019; 127:109864. [PMID: 31706071 DOI: 10.1016/j.jpsychores.2019.109864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/25/2019] [Accepted: 10/25/2019] [Indexed: 12/11/2022]
Abstract
The impact of early life stress on mental health and telomere length shortening have been reported. Changes in brain default mode network (DMN) were found to be related to a myriad of psychiatric conditions in which stress may play a role. In this context, family environment and adverse childhood experiences (ACEs) are potential causes of stress. This is a hypothesis-driven study focused on testing two hypotheses: (i) there is an association between telomere length and the function of two main hubs of DMN: the posterior cingulate cortex (PCC) and the medial prefrontal cortex (mPFC); (ii) this association is modulated by family environment and/or ACEs. To the best of our knowledge, this is the first study investigating these hypotheses. Resting-state functional magnetic resonance imaging data and blood sample were collected from 389 subjects (6-15 age range). We assessed DMN fractional amplitude of low-frequency fluctuations (fALFF) and leukocyte telomere length (LTL). We fitted general linear models to test the main effects of LTL on DMN hubs and the interaction effects with Family Environment Scale (FES) and ACEs. The results did not survive a strict Bonferroni correction. However, uncorrected p-values suggest that LTL was positively correlated with fALFF in PCC and a FES interaction between FES and LTL at mPFC. Although marginal, our results encourage further research on the interaction between DMN hubs, telomere length and family environment, which may play a role on the biological embedding of stress.
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22
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Vandevelde A, Leroux E, Delcroix N, Dollfus S. Fronto-subcortical functional connectivity in patients with schizophrenia and bipolar disorder during a verbal fluency task. World J Biol Psychiatry 2019; 19:S124-S132. [PMID: 28669318 DOI: 10.1080/15622975.2017.1349339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Impairments in language production are common of schizophrenia (SZ) and bipolar disorder (BD). Identifying distinct functional connectivity (FC) patterns in SZ and BD may provide biomarkers for their diagnoses. METHODS Forty-nine participants (15 SZ, 14 BD and 20 healthy controls (HC)) underwent a verbal fluency task consisting of mentally generating verbs in French, alternated with periods of silence. Functional network allowed identifying activation clusters: the medio-frontal cluster (MFC), the left subcortical cluster (LSCC) and the left fronto-lateral cluster (LFLC). FC was calculated between the average blood oxygen level-dependent signal time series in each cluster. Analyses of covariance were performed to test group differences on FC among the three paired-seed regions. RESULTS SZ presented a significant reduced FC compared to HC within two paired-seed regions between the LFLC and the LSCC and between the MFC and the LSCC while BD were not significantly different from HC. SZ compared to BD exhibited a reduced FC within one paired-seed region between the MFC and the LSCC. There was no group effect between the MFC and the LFLC. CONCLUSIONS A specific medio-prefronto-striato-thalamic functional dysconnectivity may be implicated in the pathophysiology of schizophrenia. This reduced fronto-subcortical FC could be a functional brain biomarker of schizophrenia.
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Affiliation(s)
- Anaïs Vandevelde
- a CHU de Caen, Service de Psychiatrie, Centre Esquirol , Caen , France.,b Normandie Univ, UNICAEN, ISTS, GIP Cyceron, Bd Henri Becquerel , Caen , France.,c Normandie Univ, UNICAEN, UFR de médecine (Medical School) , Caen , France
| | - Elise Leroux
- b Normandie Univ, UNICAEN, ISTS, GIP Cyceron, Bd Henri Becquerel , Caen , France
| | - Nicolas Delcroix
- d CNRS, UMS 3408, GIP CYCERON, Bd Henri Becquerel , Caen , France
| | - Sonia Dollfus
- a CHU de Caen, Service de Psychiatrie, Centre Esquirol , Caen , France.,b Normandie Univ, UNICAEN, ISTS, GIP Cyceron, Bd Henri Becquerel , Caen , France.,c Normandie Univ, UNICAEN, UFR de médecine (Medical School) , Caen , France
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23
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Neural correlates of emotion processing predict resilience in youth at familial risk for mood disorders. Dev Psychopathol 2019; 31:1037-1052. [PMID: 31064610 DOI: 10.1017/s0954579419000579] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Aberrant face emotion processing has been demonstrated in youth with and at a familial risk for bipolar and major depressive disorders. However, the neurobiological factors related to emotion processing that underlie resilience from youth-onset mood disorders are not well understood. Functional magnetic resonance imaging data during an implicit emotion processing task were collected at baseline from a sample of 50 youth, ages 8-17, who were healthy but also familially at high risk for either bipolar disorder or major depressive disorder, and 24 healthy controls with no family history of psychopathology (HCL). Participants were reevaluated 3 years later and classified into three groups for analysis: high-risk youth who converted to a psychiatric diagnosis (CVT; N = 23), high-risk youth who were resilient from developing any psychopathology (RES; N = 27), and HCL youth (N = 24) who remained healthy at follow-up. For happy > calm faces, the CVT and RES groups had significantly lower activation in the left inferior parietal lobe (IPL), while the RES group had lower activation in the right supramarginal gyrus. For fear > calm faces, the RES group had lower activation in the right precuneus and inferior frontal gyrus (IFG) compared to the CVT group. Connectivity analyses revealed the RES group exhibited higher left IPL connectivity with visual cortical regions for happy > calm faces, and higher IFG connectivity with frontal, temporal, and limbic regions for fear > calm faces. These connectivities were correlated with improvements in prosocial behaviors and global functioning. Our findings suggest that differential activation and connectivity in the IPL, IFG, and precuneus in response to emotional stimuli may represent distinct resilience and risk markers for youth-onset mood disorders.
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24
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Hafeman DM, Chase HW, Monk K, Bonar L, Hickey MB, McCaffrey A, Graur S, Manelis A, Ladouceur CD, Merranko J, Axelson DA, Goldstein BI, Goldstein TR, Birmaher B, Phillips ML. Intrinsic functional connectivity correlates of person-level risk for bipolar disorder in offspring of affected parents. Neuropsychopharmacology 2019; 44:629-634. [PMID: 30410014 PMCID: PMC6333834 DOI: 10.1038/s41386-018-0264-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/05/2018] [Accepted: 10/28/2018] [Indexed: 12/31/2022]
Abstract
Offspring of parents with bipolar disorder (OBP) are at increased risk to develop bipolar disorder (BD). Alterations in resting-state functional connectivity (rsFC) have been identified in OBP; however, replication has been limited and correlation with person-level risk is unknown. A recent study found reduced rsFC between left inferior frontal gyrus (IFG) and clusters in the left insula (LINS), lentiform nucleus (LENT), and midcingulate cortex (MCING) in OBP (Roberts et al. 2017); here, we aim to extend these findings to at-risk youth. We scanned a subset of the Pittsburgh Bipolar Offspring Study, a longitudinal study of OBP and community controls. Twenty-four OBP, 20 offspring of control parents with non-bipolar psychopathology (OCP), and 27 healthy controls (HC) had acceptable rsFC data. After preprocessing steps, we assessed group differences in seed-based rsFC between the IFG and target clusters (LINS, LENT, MCING) using multivariate regression. Next, we tested whether rsFC correlated with person-level risk score and with other dimensional measures. We did not find group differences in rsFC between IFG and target regions. Within OBP, risk score negatively correlated with IFG-LINS rsFC (p = 0.002). Across groups, mood lability correlated negatively with rsFC between IFG and target regions (p = 0.0002), due to negative correlation with IFG-LINS (p = 0.0003) and IFG-MCING (p = 0.001) rsFC. While group-level differences were not replicated, IFG-LINS rsFC was negatively correlated with a person-level risk score in OBP and with mood lability (a predictor of BD) across the sample. Thus, IFG-LINS rsFC might constitute a risk marker, within OBP, for the development of BD.
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Affiliation(s)
- Danella M. Hafeman
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
| | - Henry W. Chase
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
| | - Kelly Monk
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
| | - Lisa Bonar
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
| | - Mary Beth Hickey
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
| | - Alicia McCaffrey
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
| | - Simona Graur
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
| | - Anna Manelis
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
| | - Cecile D. Ladouceur
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
| | - John Merranko
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
| | - David A. Axelson
- 0000 0004 0392 3476grid.240344.5Nationwide Children’s Hospital and The Ohio State University, Columbus, OH USA
| | - Benjamin I. Goldstein
- 0000 0001 2157 2938grid.17063.33Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Tina R. Goldstein
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
| | - Boris Birmaher
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
| | - Mary L. Phillips
- 0000 0004 1936 9000grid.21925.3dUniversity of Pittsburgh, 3811O Hara St, Pittsburgh, PA 15213 USA
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25
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Acuff HE, Versace A, Bertocci MA, Ladouceur CD, Hanford LC, Manelis A, Monk K, Bonar L, McCaffrey A, Goldstein BI, Goldstein TR, Sakolsky D, Axelson D, Birmaher B, Phillips ML. Association of Neuroimaging Measures of Emotion Processing and Regulation Neural Circuitries With Symptoms of Bipolar Disorder in Offspring at Risk for Bipolar Disorder. JAMA Psychiatry 2018; 75:1241-1251. [PMID: 30193355 PMCID: PMC6528787 DOI: 10.1001/jamapsychiatry.2018.2318] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE Bipolar disorder (BD) is difficult to distinguish from other psychiatric disorders. Neuroimaging studies can identify objective markers of BD risk. OBJECTIVE To identify neuroimaging measures in emotion processing and regulation neural circuitries and their associations with symptoms specific to youth at risk for BD. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional (August 1, 2011, to July 31, 2017) and longitudinal (February 1, 2013, to November 30, 2017) neuroimaging study performed at the University of Pittsburgh Medical Center compared a sample of 31 offspring of parents with BD (OBP) with 28 offspring of comparison parents with non-BD psychopathologies (OCP) and 21 offspring of healthy parents (OHP); OBP, OCP, and OHP were recruited from the Bipolar Offspring Study and the Longitudinal Assessment of Manic Symptoms Study. MAIN OUTCOMES AND MEASURES Group differences in activity and functional connectivity during emotional face processing and n-back task performance in amygdala, dorsolateral and ventrolateral prefrontal cortices (PFC), caudal anterior cingulate cortices (cACC), and rostral anterior cingulate cortices (rACC) neuroimaging measures showing between-group differences and symptom severity (anxiety, affective lability, depression, mania). We hypothesized that elevated amygdala activity and/or lower PFC activity and abnormal amygdala to PFC functional connectivity would distinguish OBP from OCP and OHP, and magnitudes of these abnormalities would positively correlate with elevated symptom severity. We explored associations between changes in neuroimaging and symptom measures over follow-up (mean [SD], 2.9 [1.4] years) in a subset of participants (n = 30). RESULTS Eighty participants were included (mean [SD] age, 14.2 (2.1) years; 35 female). Twelve neuroimaging measures explained 51% of the variance in the results of neuroimaging measures overall. Of the 12, 9 showed significant main associations of the group; however, after post hoc analyses and Bonferroni corrections, only 7 showed statistically significant associations between groups (corrected P < .05 for all). Of the 7, 2 showed significant relationships with symptoms. Offspring of parents with BD had greater right rACC activity when regulating attention to happy faces vs OCP (mean [SD] difference, 0.744 [0.249]; 95% CI, 0.134-1.354; P = .01), which positively correlated with affective lability severity (ρ = 0.304; uncorrected P = .006). Offspring of parents with BD had greater amygdala to left cACC functional connectivity when regulating attention to fearful faces vs OCP (mean [SD] difference, 0.493 [0.169]; 95% CI, 0.079-0.908; P = .01). Increases in this measure positively correlated with increases in affective lability over follow-up (r = 0.541; P = .003). CONCLUSIONS AND RELEVANCE Greater anterior cingulate cortex activity and functional connectivity during emotion regulation tasks may be specific markers of BD risk. These findings highlight potential neural targets to aid earlier identification of and guide new treatment developments for BD.
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Affiliation(s)
- Heather E. Acuff
- Departments of Neuroscience, Psychology, and Psychiatry, Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA,Medical Scientist Training Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Amelia Versace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | | | - Anna Manelis
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kelly Monk
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lisa Bonar
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alicia McCaffrey
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Tina R. Goldstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dara Sakolsky
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - David Axelson
- Department of Psychiatry, Nationwide Children’s Hospital and The Ohio State College of Medicine, Columbus, Ohio, USA
| | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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26
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Rebello K, Moura LM, Pinaya WHL, Rohde LA, Sato JR. Default Mode Network Maturation and Environmental Adversities During Childhood. ACTA ACUST UNITED AC 2018; 2:2470547018808295. [PMID: 32440587 PMCID: PMC7219900 DOI: 10.1177/2470547018808295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 09/28/2018] [Indexed: 12/14/2022]
Abstract
Default mode network (DMN) plays a central role in cognition and brain disorders.
It has been shown that adverse environmental conditions impact neurodevelopment,
but how these conditions impact in DMN maturation is still poorly understood.
This article reviews representative neuroimaging functional studies addressing
the interactions between DMN development and environmental factors, focusing on
early life adversities, a critical period for brain changes. Studies focused on
this period of life offer a special challenge: to disentangle the
neurodevelopmental connectivity changes from those related to environmental
conditions. We first summarized the literature on DMN maturation, providing an
overview of both typical and atypical development patterns in childhood and
early adolescence. Afterward, we focused on DMN changes associated with chronic
exposure to environmental adversities during childhood. This summary suggests
that changes in DMN development could be a potential allostatic neural feature
associated with an embodiment of environmental circumstances. Finally, we
discuss about some key methodological issues that should be considered in
paradigms addressing environmental adversities and open questions for future
investigations.
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Affiliation(s)
- Keila Rebello
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Brazil
| | - Luciana M Moura
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Brazil
| | - Walter H L Pinaya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Luis A Rohde
- Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
| | - João R Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Brazil
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27
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Hanford LC, Schmithorst VJ, Panigrahy A, Lee V, Ridley J, Bonar L, Versace A, Hipwell AE, Phillips ML. The Impact of Caregiving on the Association Between Infant Emotional Behavior and Resting State Neural Network Functional Topology. Front Psychol 2018; 9:1968. [PMID: 30374323 PMCID: PMC6196255 DOI: 10.3389/fpsyg.2018.01968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 09/25/2018] [Indexed: 11/13/2022] Open
Abstract
The extent to which neural networks underlying emotional behavior in infancy serve as precursors of later behavioral and emotional problems is unclear. Even less is known about caregiving influences on these early brain-behavior relationships. To study brain-emotional behavior relationships in infants, we examined resting-state functional network metrics and infant emotional behavior in the context of early maternal caregiving. We assessed 46 3-month-old infants and their mothers from a community sample. Infants underwent functional MRI during sleep. Resting-state data were processed using graph theory techniques to examine specific nodal metrics as indicators of network functionality. Infant positive and negative emotional behaviors, and positive, negative and mental-state talk (MST) indices of maternal caregiving were coded independently from filmed interactions. Regression analyses tested associations among nodal metrics and infant emotionality, and the moderating effects of maternal behavior on these relationships. All results were FDR corrected at alpha = 0.05. While relationships between infant emotional behavior or maternal caregiving, and nodal metrics were weak, higher levels of maternal MST strengthened associations between infant positive emotionality and nodal metrics within prefrontal (p < 0.0001), and occipital (p < 0.0001) cortices more generally. Positive and negative aspects of maternal caregiving had little effect. Our findings suggest that maternal MST may play an important role in strengthening links between emotion regulation neural circuitry and early infant positive behavior. They also provide objective neural markers that could inform and monitor caregiving-based interventions designed to improve the health and well-being of vulnerable infants at-risk for behavioral and emotional problems.
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Affiliation(s)
- Lindsay C. Hanford
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Vincent J. Schmithorst
- Department of Pediatric Radiology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Ashok Panigrahy
- Department of Pediatric Radiology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Vincent Lee
- Department of Pediatric Radiology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Julia Ridley
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lisa Bonar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Amelia Versace
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Alison E. Hipwell
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Mary L. Phillips
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, United States
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28
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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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Sung YW, Kawachi Y, Choi US, Kang D, Abe C, Otomo Y, Ogawa S. A Set of Functional Brain Networks for the Comprehensive Evaluation of Human Characteristics. Front Neurosci 2018; 12:149. [PMID: 29593488 PMCID: PMC5861187 DOI: 10.3389/fnins.2018.00149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 02/26/2018] [Indexed: 12/21/2022] Open
Abstract
Many human characteristics must be evaluated to comprehensively understand an individual, and measurements of the corresponding cognition/behavior are required. Brain imaging by functional MRI (fMRI) has been widely used to examine brain function related to human cognition/behavior. However, few aspects of cognition/behavior of individuals or experimental groups can be examined through task-based fMRI. Recently, resting state fMRI (rs-fMRI) signals have been shown to represent functional infrastructure in the brain that is highly involved in processing information related to cognition/behavior. Using rs-fMRI may allow diverse information about the brain through a single MRI scan to be obtained, as rs-fMRI does not require stimulus tasks. In this study, we attempted to identify a set of functional networks representing cognition/behavior that are related to a wide variety of human characteristics and to evaluate these characteristics using rs-fMRI data. If possible, these findings would support the potential of rs-fMRI to provide diverse information about the brain. We used resting-state fMRI and a set of 130 psychometric parameters that cover most human characteristics, including those related to intelligence and emotional quotients and social ability/skill. We identified 163 brain regions by VBM analysis using regression analysis with 130 psychometric parameters. Next, using a 163 × 163 correlation matrix, we identified functional networks related to 111 of the 130 psychometric parameters. Finally, we made an 8-class support vector machine classifiers corresponding to these 111 functional networks. Our results demonstrate that rs-fMRI signals contain intrinsic information about brain function related to cognition/behaviors and that this set of 111 networks/classifiers can be used to comprehensively evaluate human characteristics.
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Affiliation(s)
- Yul-Wan Sung
- Kansei Fukushi Research Institute, Tohoku Fukushi University, Sendai, Japan
| | - Yousuke Kawachi
- Kansei Fukushi Research Institute, Tohoku Fukushi University, Sendai, Japan
| | - Uk-Su Choi
- Neuroscience Research Institute, Gachon University, Incheon, South Korea
| | - Daehun Kang
- Kansei Fukushi Research Institute, Tohoku Fukushi University, Sendai, Japan
| | - Chihiro Abe
- Kansei Fukushi Research Institute, Tohoku Fukushi University, Sendai, Japan
| | - Yuki Otomo
- Kansei Fukushi Research Institute, Tohoku Fukushi University, Sendai, Japan
| | - Seiji Ogawa
- Kansei Fukushi Research Institute, Tohoku Fukushi University, Sendai, Japan
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30
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Angeler DG, Allen CR, Persson ML. Resilience concepts in psychiatry demonstrated with bipolar disorder. Int J Bipolar Disord 2018; 6:2. [PMID: 29423550 PMCID: PMC6161999 DOI: 10.1186/s40345-017-0112-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 12/19/2017] [Indexed: 01/24/2023] Open
Abstract
Background The term resilience describes stress–response patterns of subjects across scientific disciplines. In ecology, advances have been made to clearly distinguish resilience definitions based on underlying mechanistic assumptions. Engineering resilience (rebound) is used for describing the ability of subjects to recover from adverse conditions (disturbances), and is the rate of recovery. In contrast, the ecological resilience definition considers a systemic change: when complex systems (including humans) respond to disturbances by reorganizing into a new regime (stable state) where structural and functional aspects have fundamentally changed relative to the prior regime. In this context, resilience is an emergent property of complex systems. We argue that both resilience definitions and uses are appropriate in psychology and psychiatry, but although the differences are subtle, the implications and uses are profoundly different. Methods We borrow from the field of ecology to discuss resilience concepts in the mental health sciences. Results In psychology and psychiatry, the prevailing view of resilience is adaptation to, coping with, and recovery (engineering resilience) from adverse social and environmental conditions. Ecological resilience may be useful for describing vulnerability, onset, and the irreversibility patterns of mental disorders. We discuss this in the context of bipolar disorder. Conclusion Rebound, adaptation, and coping are processes that are subsumed within the broader systemic organization of humans, from which ecological resilience emanates. Discerning resilience concepts in psychology and psychiatry has potential for a mechanistically appropriate contextualization of mental disorders at large. This might contribute to a refinement of theory and contextualize clinical practice within the broader systemic functioning of mental illnesses.
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Affiliation(s)
- David G Angeler
- Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences, PO Box 7050, 750 07, Uppsala, Sweden.
| | - Craig R Allen
- U.S. Geological Survey, Nebraska Cooperative Fish and Wildlife Research Unit, School of Natural Resources, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Maj-Liz Persson
- PRIMA Adult Psychiatric Ward, Katrinebergsvägen 6, 117 43, Stockholm, Sweden
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31
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Zalpuri I, Singh MK. Treatment of psychiatric symptoms among offspring of parents with bipolar disorder. ACTA ACUST UNITED AC 2017; 4:341-356. [PMID: 29503793 DOI: 10.1007/s40501-017-0126-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Purpose of Review Bipolar disorder is highly familial and has a protracted and diagnostically confusing prodrome. This review critically evaluates recently published literature relevant to the treatment of psychiatric symptoms in high-risk offspring of parents with Bipolar Disorder. Recent Findings Non-pharmacological treatment options including psychotherapy, resilience promotion through good sleep, diet, and exercise hygiene, and omega-3 fatty acid supplementation are important first line interventions for high-risk offspring. There has been some success in treating this population with open-label trials with mood stabilizers and atypical antipsychotics; however, these results have not been replicated in randomized controlled trails. Summary Despite some progress in early identification of symptoms in offspring of parents with Bipolar Disorder, there is scarce evidence supporting the treatment of these high-risk youth to prevent psychiatric symptoms from progressing to threshold bipolar or other psychiatric disorders. There is a need for prospective and randomized trials and research that identifies reliable biomarkers to individualize treatments for these youth.
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Affiliation(s)
- Isheeta Zalpuri
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
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32
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Anomalous prefrontal-limbic activation and connectivity in youth at high-risk for bipolar disorder. J Affect Disord 2017; 222:7-13. [PMID: 28667891 DOI: 10.1016/j.jad.2017.05.051] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/24/2017] [Accepted: 05/30/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Abnormal prefrontal-limbic brain activation in response to facial expressions has been reported in pediatric bipolar disorder (BD). However, it is less clear whether these abnormalities exist prior to onset of mania, thus representing a biomarker predicting development of BD. METHODS We examined brain activation in 50 youth at high risk for BD (HR-BD), compared with 29 age- and gender-matched healthy control (HC) subjects. HR-BD was defined as having a parent with BD, as well as current mood or attentiondeficit/ hyperactivity disorder (ADHD) symptoms, or a history of at least one depressive episode. FMRI data were collected during an implicit emotion perception task using facial expression stimuli. Activation to fearful faces versus calm faces was compared between HR-BD and HC groups, including analyses of functional connectivity, and comparison of allele subgroups of the serotonin transporter (5-HTTLPR) gene. RESULTS While viewing fearful versus calm faces, HR-BD youth had significantly greater activation than HC youth in the right amygdala, ventrolateral prefrontal cortex (VLPFC), superior frontal cortex, cerebellum, and lingual gyrus. HR-BD youth, relative to HC youth, had greater functional connectivity between the right amygdala and the VLPFC as well as visual cortical regions Within the HR-BD group, youth with the s-allele had a trend for greater activation in the right amygdala and subgenual cingulate cortex CONCLUSIONS: Similar to youth with BD, youth at high risk for BD have greater activation than healthy controls in the amygdala and ventrolateral prefrontal cortex in response to fearful faces, as well greater functional connectivity between these regions. HR-BD youth with the s-allele of the 5-HTTLPR gene may be at greatest risk for developing BD.
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33
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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: 85] [Impact Index Per Article: 12.1] [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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34
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Miskowiak KW, Kjærstad HL, Meluken I, Petersen JZ, Maciel BR, Köhler CA, Vinberg M, Kessing LV, Carvalho AF. The search for neuroimaging and cognitive endophenotypes: A critical systematic review of studies involving unaffected first-degree relatives of individuals with bipolar disorder. Neurosci Biobehav Rev 2017; 73:1-22. [DOI: 10.1016/j.neubiorev.2016.12.011] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 10/05/2016] [Accepted: 12/09/2016] [Indexed: 12/16/2022]
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Marusak HA, Thomason ME, Peters C, Zundel C, Elrahal F, Rabinak CA. You say 'prefrontal cortex' and I say 'anterior cingulate': meta-analysis of spatial overlap in amygdala-to-prefrontal connectivity and internalizing symptomology. Transl Psychiatry 2016; 6:e944. [PMID: 27824358 PMCID: PMC5314129 DOI: 10.1038/tp.2016.218] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/31/2016] [Accepted: 09/27/2016] [Indexed: 12/12/2022] Open
Abstract
Connections between the amygdala and medial prefrontal cortex (mPFC) are considered critical for the expression and regulation of emotional behavior. Abnormalities in frontoamygdala circuitry are reported across several internalizing conditions and associated risk factors (for example, childhood trauma), which may underlie the strong phenotypic overlap and co-occurrence of internalizing conditions. However, it is unclear if these findings converge on the same localized areas of mPFC or adjacent anterior cingulate cortex (ACC). Examining 46 resting-state functional connectivity magnetic resonance imaging studies of internalizing conditions or risk factors (for example, early adversity and family history), we conducted an activation likelihood estimation meta-analysis of frontoamygdala circuitry. We included all reported amygdala to frontal coordinate locations that fell within a liberal anatomically defined frontal mask. Peak effects across studies were centered in two focal subareas of the ACC: pregenual (pgACC) and subgenual (sgACC). Using publicly available maps and databases of healthy individuals, we found that observed subareas have unique connectivity profiles, patterns of neural co-activation across a range of neuropsychological tasks, and distribution of tasks spanning various behavioral domains within peak regions, also known as 'functional fingerprints'. These results suggest disruptions in unique amygdala-ACC subcircuits across internalizing, genetic and environmental risk studies. Based on functional characterizations and the studies contributing to each peak, observed amygdala-ACC subcircuits may reflect separate transdiagnostic neural signatures. In particular, they may reflect common neurobiological substrates involved in developmental risk (sgACC), or the broad expression of emotional psychopathology (pgACC) across disease boundaries.
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Affiliation(s)
- H A Marusak
- Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA,Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Suite 2190, Detroit, MI 48202, USA. E-mail:
| | - M E Thomason
- Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI, USA,Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA,Unit on Perinatal Neural Connectivity, Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, USA
| | - C Peters
- Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA
| | - C Zundel
- Behavioral Neuroscience, Boston University, Boston, MA, USA
| | - F Elrahal
- Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA
| | - C A Rabinak
- Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA
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Abstract
Bipolar disorder in youth substantially impairs behavior, family, and social functioning and interferes with developmental course. There is increasing interest in defining a bipolar prodrome similar to that reported in early-onset psychosis that will allow for earlier intervention and reduction in overall morbidity and mortality. Several lines of research have addressed this important issue including studies of offspring of bipolar parents, high-risk cohorts, and longitudinal follow-up of subjects with major depressive disorder (MDD), ADHD, and bipolar spectrum disorder. The development and validation of bipolar prodrome rating scales also shows promise. Recent attempts to intervene at earlier stages of bipolar disorder have led to some positive outcomes. However, a controversy remains concerning the identification and management of the earliest symptoms. Further research is needed to fully validate a bipolar prodrome and to determine the optimal course of action at various stages of illness.
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37
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Benarous X, Consoli A, Milhiet V, Cohen D. Early interventions for youths at high risk for bipolar disorder: a developmental approach. Eur Child Adolesc Psychiatry 2016; 25:217-33. [PMID: 26395448 DOI: 10.1007/s00787-015-0773-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Indexed: 10/23/2022]
Abstract
In recent decades, ongoing research programmes on primary prevention and early identification of bipolar disorder (BD) have been developed. The aim of this article is to review the principal forms of evidence that support preventive interventions for BD in children and adolescents and the main challenges associated with these programmes. We performed a literature review of the main computerised databases (MEDLINE, PUBMED) and a manual search of the literature relevant to prospective and retrospective studies of prodromal symptoms, premorbid stages, risk factors, and early intervention programmes for BD. Genetic and environmental risk factors of BD were identified. Most of the algorithms used to measure the risk of developing BD and the early interventions programmes focused on the familial risk. The prodromal signs varied greatly and were age dependent. During adolescence, depressive episodes associated with genetic or environmental risk factors predicted the onset of hypomanic/manic episodes over subsequent years. In prepubertal children, the lack of specificity of clinical markers and difficulties in mood assessment were seen as impeding preventive interventions at these ages. Despite encouraging results, biomarkers have not thus far been sufficiently validated in youth samples to serve as screening tools for prevention. Additional longitudinal studies in youths at high risk of developing BD should include repeated measures of putative biomarkers. Staging models have been developed as an integrative approach to specify the individual level of risk based on clinical (e.g. prodromal symptoms and familial history of BD) and non-clinical (e.g. biomarkers and neuroimaging) data. However, there is still a lack of empirically validated studies that measure the benefits of using these models to design preventive intervention programmes.
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Affiliation(s)
- Xavier Benarous
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Université Pierre et Marie Curie, Hôpital Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l'Hôpital, 75013, Paris, France.
| | - Angèle Consoli
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Université Pierre et Marie Curie, Hôpital Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l'Hôpital, 75013, Paris, France.,INSERM U-669, PSIGIAM, Paris, France
| | - Vanessa Milhiet
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Université Pierre et Marie Curie, Hôpital Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l'Hôpital, 75013, Paris, France
| | - David Cohen
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Université Pierre et Marie Curie, Hôpital Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l'Hôpital, 75013, Paris, France.,CNRS UMR 7222, Institut des Systèmes Intelligents et Robotiques, Paris, France
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38
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Solé-Padullés C, Castro-Fornieles J, de la Serna E, Romero S, Calvo A, Sánchez-Gistau V, Padrós-Fornieles M, Baeza I, Bargalló N, Frangou S, Sugranyes G. Altered Cortico-Striatal Connectivity in Offspring of Schizophrenia Patients Relative to Offspring of Bipolar Patients and Controls. PLoS One 2016; 11:e0148045. [PMID: 26885824 PMCID: PMC4757444 DOI: 10.1371/journal.pone.0148045] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/12/2016] [Indexed: 02/07/2023] Open
Abstract
Schizophrenia (SZ) and bipolar disorder (BD) share clinical features, genetic risk factors and neuroimaging abnormalities. There is evidence of disrupted connectivity in resting state networks in patients with SZ and BD and their unaffected relatives. Resting state networks are known to undergo reorganization during youth coinciding with the period of increased incidence for both disorders. We therefore focused on characterizing resting state network connectivity in youth at familial risk for SZ or BD to identify alterations arising during this period. We measured resting-state functional connectivity in a sample of 106 youth, aged 7-19 years, comprising offspring of patients with SZ (N = 27), offspring of patients with BD (N = 39) and offspring of community control parents (N = 40). We used Independent Component Analysis to assess functional connectivity within the default mode, executive control, salience and basal ganglia networks and define their relationship to grey matter volume, clinical and cognitive measures. There was no difference in connectivity within any of the networks examined between offspring of patients with BD and offspring of community controls. In contrast, offspring of patients with SZ showed reduced connectivity within the left basal ganglia network compared to control offspring, and they showed a positive correlation between connectivity in this network and grey matter volume in the left caudate. Our findings suggest that dysconnectivity in the basal ganglia network is a robust correlate of familial risk for SZ and can be detected during childhood and adolescence.
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Affiliation(s)
| | - Josefina Castro-Fornieles
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, SGR489, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre Consortium (CIBERSAM), Barcelona, Spain
| | - Elena de la Serna
- Biomedical Research Networking Centre Consortium (CIBERSAM), Barcelona, Spain
| | - Soledad Romero
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, SGR489, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre Consortium (CIBERSAM), Barcelona, Spain
| | - Anna Calvo
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Magnetic Resonance Imaging Core facility, Hospital Clinic of Barcelona, Barcelona, Spain
- Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), GIB-UB, Barcelona, Spain
| | - Vanessa Sánchez-Gistau
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, SGR489, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre Consortium (CIBERSAM), Barcelona, Spain
| | - Marta Padrós-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, SGR489, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Inmaculada Baeza
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, SGR489, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centre Consortium (CIBERSAM), Barcelona, Spain
| | - Núria Bargalló
- Biomedical Research Networking Centre Consortium (CIBERSAM), Barcelona, Spain
- Magnetic Resonance Imaging Core facility, Hospital Clinic of Barcelona, Barcelona, Spain
- Centre for Diagnostic Imaging (CDI), Hospital Clinic of Barcelona, Barcelona, Spain
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, United States of America
| | - Gisela Sugranyes
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, SGR489, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
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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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40
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Goya-Maldonado R, Brodmann K, Keil M, Trost S, Dechent P, Gruber O. Differentiating unipolar and bipolar depression by alterations in large-scale brain networks. Hum Brain Mapp 2015; 37:808-18. [PMID: 26611711 DOI: 10.1002/hbm.23070] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 10/23/2015] [Accepted: 11/18/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Misdiagnosing bipolar depression can lead to very deleterious consequences of mistreatment. Although depressive symptoms may be similarly expressed in unipolar and bipolar disorder, changes in specific brain networks could be very distinct, being therefore informative markers for the differential diagnosis. We aimed to characterize specific alterations in candidate large-scale networks (frontoparietal, cingulo-opercular, and default mode) in symptomatic unipolar and bipolar patients using resting state fMRI, a cognitively low demanding paradigm ideal to investigate patients. METHODS Networks were selected after independent component analysis, compared across 40 patients acutely depressed (20 unipolar, 20 bipolar), and 20 controls well-matched for age, gender, and education levels, and alterations were correlated to clinical parameters. RESULTS Despite comparable symptoms, patient groups were robustly differentiated by large-scale network alterations. Differences were driven in bipolar patients by increased functional connectivity in the frontoparietal network, a central executive and externally-oriented network. Conversely, unipolar patients presented increased functional connectivity in the default mode network, an introspective and self-referential network, as much as reduced connectivity of the cingulo-opercular network to default mode regions, a network involved in detecting the need to switch between internally and externally oriented demands. These findings were mostly unaffected by current medication, comorbidity, and structural changes. Moreover, network alterations in unipolar patients were significantly correlated to the number of depressive episodes. CONCLUSION Unipolar and bipolar groups displaying similar symptomatology could be clearly distinguished by characteristic changes in large-scale networks, encouraging further investigation of network fingerprints for clinical use. Hum Brain Mapp 37:808-818, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Roberto Goya-Maldonado
- Department of Psychiatry and Psychotherapy, Center for Translational Research in Systems Neuroscience and Psychiatry, University Medical Center, Georg-August-University, Goettingen, Germany
| | - Katja Brodmann
- Department of Psychiatry and Psychotherapy, Center for Translational Research in Systems Neuroscience and Psychiatry, University Medical Center, Georg-August-University, Goettingen, Germany
| | - Maria Keil
- Department of Psychiatry and Psychotherapy, Center for Translational Research in Systems Neuroscience and Psychiatry, University Medical Center, Georg-August-University, Goettingen, Germany
| | - Sarah Trost
- Department of Psychiatry and Psychotherapy, Center for Translational Research in Systems Neuroscience and Psychiatry, University Medical Center, Georg-August-University, Goettingen, Germany
| | - Peter Dechent
- Department of Cognitive Neurology, Research Group 'MR-Research in Neurology and Psychiatry', University Medical Center, Georg-August-University, Goettingen, Germany
| | - Oliver Gruber
- Department of Psychiatry and Psychotherapy, Center for Translational Research in Systems Neuroscience and Psychiatry, University Medical Center, Georg-August-University, Goettingen, Germany
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Nephew BC, Murgatroyd C, Pittet F, Febo M. Brain Reward Pathway Dysfunction in Maternal Depression and Addiction: A Present and Future Transgenerational Risk. ACTA ACUST UNITED AC 2015; 1:105-116. [PMID: 27617302 PMCID: PMC5013732 DOI: 10.17756/jrds.2015-017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Two research areas that could benefit from a greater focus on the role of the reward pathway are maternal depression and maternal addiction. Both depression and addiction in mothers are mediated by deficiencies in the reward pathway and represent substantial risks to the health of offspring and future generations. This targeted review discusses maternal reward deficits in depressed and addicted mothers, neural, genetic, and epigenetic mechanisms, and the transgenerational transmission of these deficits from mother to offspring. Postpartum depression and drug use disorders may entail alterations in the reward pathway, particularly in striatal and prefrontal areas, which may affect maternal attachment to offspring and heighten the risk of transgenerational effects on the oxytocin and dopamine systems. Alterations may involve neural circuitry changes, genetic factors that impact monoaminergic neurotransmission, as well as growth factors such as BDNF and stress-associated signaling in the brain. Improved maternal reward-based preventative measures and treatments may be specifically effective for mothers and their offspring suffering from depression and/or addiction.
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Affiliation(s)
- Benjamin C Nephew
- Department of Biomedical Sciences, Section of Neuroscience and Reproductive Biology, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | | | - Florent Pittet
- Department of Biomedical Sciences, Section of Neuroscience and Reproductive Biology, Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - Marcelo Febo
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
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Choi US, Sung YW, Hong S, Chung JY, Ogawa S. Structural and functional plasticity specific to musical training with wind instruments. Front Hum Neurosci 2015; 9:597. [PMID: 26578939 PMCID: PMC4624850 DOI: 10.3389/fnhum.2015.00597] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 10/14/2015] [Indexed: 01/19/2023] Open
Abstract
Numerous neuroimaging studies have shown structural and functional changes resulting from musical training. Among these studies, changes in primary sensory areas are mostly related to motor functions. In this study, we looked for some similar functional and structural changes in other functional modalities, such as somatosensory function, by examining the effects of musical training with wind instruments. We found significant changes in two aspects of neuroplasticity, cortical thickness, and resting-state neuronal networks. A group of subjects with several years of continuous musical training and who are currently playing in university wind ensembles showed differences in cortical thickness in lip- and tongue-related brain areas vs. non-music playing subjects. Cortical thickness in lip-related brain areas was significantly thicker and that in tongue-related areas was significantly thinner in the music playing group compared with that in the non-music playing group. Association analysis of lip-related areas in the music playing group showed that the increase in cortical thickness was caused by musical training. In addition, seed-based correlation analysis showed differential activation in the precentral gyrus and supplementary motor areas (SMA) between the music and non-music playing groups. These results suggest that high-intensity training with specific musical instruments could induce structural changes in related anatomical areas and could also generate a new functional neuronal network in the brain.
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Affiliation(s)
- Uk-Su Choi
- Neuroscience Research Institute, Gachon University of Medicine and Science Incheon, South Korea
| | - Yul-Wan Sung
- Kansei Fukushi Research Institute, Tohoku Fukushi University Sendai, Japan
| | - Sujin Hong
- Reid School of Music, Edinburgh College of Art, Institute for Music and Human Society Development, University of Edinburgh Edinburgh, UK
| | - Jun-Young Chung
- Neuroscience Research Institute, Gachon University of Medicine and Science Incheon, South Korea
| | - Seiji Ogawa
- Kansei Fukushi Research Institute, Tohoku Fukushi University Sendai, Japan
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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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