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Squarcina L, Lucini Paioni S, Bellani M, Rossetti MG, Houenou J, Polosan M, Phillips ML, Wessa M, Brambilla P. White matter integrity in bipolar disorder investigated with diffusion tensor magnetic resonance imaging and fractal geometry. J Affect Disord 2024; 345:200-207. [PMID: 37863367 DOI: 10.1016/j.jad.2023.10.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/14/2023] [Accepted: 10/15/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Growing evidence suggests the presence of white matter (WM) alterations in bipolar disorder (BD). In this study we aimed to investigate the state of WM structures, in terms of tissue integrity and morphological complexity, in BD patients compared to healthy controls (HC), in an attempt to better elucidate the microstructural changes associated with BD. METHODS We collected a dataset of 399 Diffusion Tensor Magnetic Resonance Imaging (167 BD and 232 healthy controls) images, acquired at five different sites, which was processed with Tract-Based Spatial Statistics (TBSS) and fractal analysis. RESULTS The TBSS analysis demonstrated significantly lower FA values in the BD group. Diffusion abnormalities were primarily located in the temporo-parietal network. The Fractal Dimension (FD) analysis did not reveal consistent significant differences in the morphological complexity of WM structures between the groups. When the FD values of patients were considered individually, it is possible to notice some localized significant deviations from the healthy population. LIMITATIONS DTI sequences have not been harmonized before acquisition, samples' sizes are heterogeneous. CONCLUSIONS This study, by applying both TBSS and FD analyses, allows to evaluate diffusion and structural alterations of WM at the same time. The evaluation of WM integrity from these two different perspectives could be useful to better understand the pathophysiological and morphological changes underpinning bipolar disorder.
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Affiliation(s)
- Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Susanna Lucini Paioni
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Marcella Bellani
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - Maria Gloria Rossetti
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy; UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy
| | - Josselin Houenou
- APHP, Mondor Univ Hospitals, DMU IMPACT, INSERM U955, Translational NeuroPsychiatry Team, UPEC, Créteil, France & NeuroSpin, UNIACT Lab, PsyBrain Team, CEA Saclay, Gif-sur-Yvette, France
| | - Mircea Polosan
- Univ. Grenoble-Alpes, Grenoble Institut Neurosciences, Inserm U1216, CHU Grenoble Alpes, France
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America
| | - Michèle Wessa
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy.
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Jones G, Suchting R, Zanetti MV, Leung E, da Costa SC, Sousa RTD, Busatto G, Soares J, Otaduy MC, Gattaz WF, Machado-Vieira R. Lithium increases cortical and subcortical volumes in subjects with bipolar disorder. Psychiatry Res Neuroimaging 2022; 324:111494. [PMID: 35640450 DOI: 10.1016/j.pscychresns.2022.111494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/24/2022] [Accepted: 05/06/2022] [Indexed: 11/26/2022]
Abstract
Bipolar disorder (BD) is a highly variable and burdensome disease for patients and caregivers. A BD diagnosis almost triples the likelihood of developing dementia as the disease progresses. Neurocognitive reserve appears to be one of the most important influences on lifelong functional outcomes and quality of life in BD. Though several prior studies have assessed the effects of lithium on regional gray and white matter volumes in this population, representative cohorts are typically middle-aged, have a more severe pathology, and are not as commonly assessed in the depressive phase (which represents the majority of most patients' lifespans outside of remission). Here we have shown that positive adaptations with lithium can be observed throughout the brain after only six weeks of monotherapy at low-therapeutic serum levels. Importantly, these results remove some confounders seen in prior studies (patients were treatment free at time of enrollment and mostly treatment naïve). This cohort also includes underrepresented demographics in the literature (young adult patients, mostly bipolar II, and exclusively in the depressed phase). These findings bolster the extensive body of evidence in support of long-term lithium therapy in BD, furthering the possibility of its expanded use to wider demographics.
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Affiliation(s)
- Gregory Jones
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054, USA
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054, USA
| | - Marcus V Zanetti
- LIM27, Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Edison Leung
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054, USA
| | | | - Rafael T de Sousa
- LIM27, Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Geraldo Busatto
- LIM21, Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Jair Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054, USA
| | - Maria C Otaduy
- Department of Radiology, University of São Paulo, São Paulo, Brazil
| | - Wagner F Gattaz
- LIM27, Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Rodrigo Machado-Vieira
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054, USA.
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Hørlyck LD, Jespersen AE, King JA, Ullum H, Miskowiak KW. Impaired allocentric spatial memory in patients with affective disorders. J Psychiatr Res 2022; 150:153-159. [PMID: 35378488 DOI: 10.1016/j.jpsychires.2022.01.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Memory disturbances are frequent in unipolar depression (UD) and bipolar disorder (BD) and may comprise important predisposing and maintaining factors. Previous studies have demonstrated hippocampal abnormalities in UD and BD but there is a lack of studies specifically assessing hippocampus-dependent memory. METHODS We used a virtual task to assess hippocampus-dependent (allocentric) vs non-hipppocampal (egocentric) spatial memory in remitted and partially remitted patients with UD or BD (N = 22) and a healthy control group (N = 32). Participants also completed a range of standard neuropsychological and functional assessments. RESULTS Participants in the UD/BD group showed selective impairments on high-load hippocampal (allocentric) memory compared to egocentric memory and this effect was independent of residual mood symptoms. Across both samples, both allocentric and egocentric spatial memory correlated with more general measures of memory and other aspects of cognition measured on standard neuropsychological tests but only high-load allocentric memory showed a significant relationship with functional capacity. CONCLUSION Results show a selective impairment in high-load allocentric spatial memory compared to egocentric memory in the patient group, suggesting impaired hippocampal functioning in patients with remitted UD/BD.
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Affiliation(s)
- Lone D Hørlyck
- Neurocognition and Emotion in Affective Disorder (NEAD) Group, Copenhagen Affective Disorder Research Centre (CADIC), Copenhagen Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353, Copenhagen, Denmark
| | - Andreas E Jespersen
- Neurocognition and Emotion in Affective Disorder (NEAD) Group, Copenhagen Affective Disorder Research Centre (CADIC), Copenhagen Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353, Copenhagen, Denmark
| | - John A King
- Department of Clinical and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kamilla W Miskowiak
- Neurocognition and Emotion in Affective Disorder (NEAD) Group, Copenhagen Affective Disorder Research Centre (CADIC), Copenhagen Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353, Copenhagen, Denmark.
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Genetic and environment effects on structural neuroimaging endophenotype for bipolar disorder: a novel molecular approach. Transl Psychiatry 2022; 12:137. [PMID: 35379780 PMCID: PMC8980067 DOI: 10.1038/s41398-022-01892-3] [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: 05/05/2021] [Revised: 03/03/2022] [Accepted: 03/10/2022] [Indexed: 12/15/2022] Open
Abstract
We investigated gene-environment effects on structural brain endophenotype in bipolar disorder (BD) using a novel method of combining polygenic risk scores with epigenetic signatures since traditional methods of examining the family history and trauma effects have significant limitations. The study enrolled 119 subjects, including 55 BD spectrum (BDS) subjects diagnosed with BD or major depressive disorder (MDD) with subthreshold BD symptoms and 64 non-BDS subjects comprising 32 MDD subjects without BD symptoms and 32 healthy subjects. The blood samples underwent genome-wide genotyping and methylation quantification. We derived polygenic risk score (PRS) and methylation profile score (MPS) as weighted summations of risk single nucleotide polymorphisms and methylation probes, respectively, which were considered as molecular measures of genetic and environmental risks for BD. Linear regression was used to relate PRS, MPS, and their interaction to 44 brain structure measures quantified from magnetic resonance imaging (MRI) on 47 BDS subjects, and the results were compared with those based on family history and childhood trauma. After multiplicity corrections using false discovery rate (FDR), MPS was found to be negatively associated with the volume of the medial geniculate thalamus (FDR = 0.059, partial R2 = 0.208). Family history, trauma scale, and PRS were not associated with any brain measures. PRS and MPS show significant interactions on whole putamen (FDR = 0.09, partial R2 = 0.337). No significant gene-environment interactions were identified for the family history and trauma scale. PRS and MPS generally explained greater proportions of variances of the brain measures (range of partial R2 = [0.008, 0.337]) than the clinical risk factors (range = [0.004, 0.228]).
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Díaz Ortiz AC, Vargas Upeguí C, Zapata Ospina JP, Aguirre Acevedo DC, Pineda Zapata JA, López Jaramillo CA. Correlation between cognitive performance and structural neuroanatomy in patients with type I bipolar affective disorder treated with and without lithium. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:133-145. [PMID: 35717384 DOI: 10.1016/j.rcpeng.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/05/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Lithium treatment of bipolar disorder (BD) has been associated with less cognitive impairment and fewer changes in structural brain anatomy compared to other treatments. However, the studies are heterogeneous and few assess whether these effects are related. The objective of this study was to evaluate and relate cognitive performance and structural neuroanatomy in patients treated with and without lithium. METHODS Cross-sectional study that included 48 subjects with BD-I, of which 22 were treated with lithium and 26 without lithium. Performance was assessed on Wechsler III (WAIS III), TMT A and B (Trial Making Test) neuropsychological tests, California verbal learning test (CVLT), Rey complex figure test and Wisconsin card sorting test. Brain structures obtained by magnetic resonance imaging (MRI) were evaluated. The standardised mean difference (SMD) between both groups was calculated, adjusted for confounding variables using a propensity score, and the Spearman correlation coefficient (ρ) was used to assess the relationship between cognitive performance and neuroanatomical regions. RESULTS Compared to the group without lithium, the group with lithium had fewer perseverative errors in the Wisconsin test (SMD = -0.69) and greater left and right cortical areas (SMD = 0.85; SMD = 0.92); greater surface area in the left anterior cingulate (SMD = 1.32), right medial orbitofrontal cortex (SMD = 1.17), right superior frontal gyrus (SMD = 0.82), and right and left precentral gyrus (SMD = 1.33; SMD = 0.98); greater volume of the right amygdala (SMD = 0.57), right hippocampus (SMD = 0.66), right putamen (SMD = 0.87) and right thalamus (SMD = .67). In the lithium group, a correlation was found with these errors and the thickness of the left precentral gyrus (ρ = -0.78), the volume of the right thalamus (ρ = -0.44), and the right amygdala (ρ = 0.6). CONCLUSIONS The lithium group had better cognitive flexibility and greater dimension in some frontal and subcortical cortical regions. Furthermore, there was a moderate to high correlation between performance in this executive function and the thickness of the right precentral gyrus, and the volumes of the thalamus and the right amygdala. These findings could suggest a neuroprotective effect of lithium.
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Affiliation(s)
- Andrés Camilo Díaz Ortiz
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - Cristian Vargas Upeguí
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan Pablo Zapata Ospina
- Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | | | - Carlos Alberto López Jaramillo
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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The Limits between Schizophrenia and Bipolar Disorder: What Do Magnetic Resonance Findings Tell Us? Behav Sci (Basel) 2022; 12:bs12030078. [PMID: 35323397 PMCID: PMC8944966 DOI: 10.3390/bs12030078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/10/2022] [Accepted: 03/10/2022] [Indexed: 02/01/2023] Open
Abstract
Schizophrenia and bipolar disorder, two of the most severe psychiatric illnesses, have historically been regarded as dichotomous entities but share many features of the premorbid course, clinical profile, genetic factors and treatment approaches. Studies focusing on neuroimaging findings have received considerable attention, as they plead for an improved understanding of the brain regions involved in the pathophysiology of schizophrenia and bipolar disorder. In this review, we summarize the main magnetic resonance imaging findings in both disorders, aiming at exploring the neuroanatomical and functional similarities and differences between the two. The findings show that gray and white matter structural changes and functional dysconnectivity predominate in the frontal and limbic areas and the frontotemporal circuitry of the brain areas involved in the integration of executive, cognitive and affective functions, commonly affected in both disorders. Available evidence points to a considerable overlap in the affected regions between the two conditions, therefore possibly placing them at opposite ends of a psychosis continuum.
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Fico G, Anmella G, Gomez-Ramiro M, de Miquel C, Hidalgo-Mazzei D, Manchia M, Alda M, Gonzalez-Pinto A, Carvalho AF, Vieta E, Murru A. Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study. J Affect Disord 2021; 294:513-520. [PMID: 34330047 DOI: 10.1016/j.jad.2021.07.062] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/16/2021] [Accepted: 07/11/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND We primarily aimed to explore the associations between duration of untreated illness (DUI), treatment response, and functioning in a cohort of patients with bipolar disorder (BD). METHODS 261 participants with BD were recruited. DUI was defined as months from the first affective episode to the start of a mood-stabilizer. The functioning assessment short test (FAST) scores and treatment response scores for lithium, valproate, or lamotrigine according to the Alda Scale Total Score (TS) were compared between patients with short (<24 months) or long DUI. Differences in FAST scores among good (GR; TS≥7), poor (PR; TS=2-6), or non-responders (NR; TS<2) to each mood-stabilizer were analyzed. Linear regression was computed using the FAST global score as the dependent variable. RESULTS DUI and FAST scores showed no statistically significant correlation. Patients with a longer DUI showed poorer response to lithium (Z=-3.196; p<0.001), but not to valproate or lamotrigine. Response to lithium (β=-1.814; p<0.001), number of hospitalizations (β=0.237; p<0.001), and illness duration (β=0.160; p=0.028) were associated with FAST total scores. GR to lithium was associated with better global functioning compared to PR or NR [H=27.631; p<0.001]. LIMITATIONS The retrospective design could expose our data to a recall bias. Also, only few patients were on valproate or lamotrigine treatment. CONCLUSIONS Poor functioning in BD could be the result of multiple affective relapses, rather than a direct effect of DUI. A timely diagnosis with subsequent effective prophylactic treatment, such as lithium, may prevent poor functional outcomes in real-world patients with BD.
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Affiliation(s)
- Giovanna Fico
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Gerard Anmella
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Marta Gomez-Ramiro
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic of Barcelona, Department of Medicine, Neuroscience Institute, Universitat de Barcelona, CIBERSAM, IDIBAPS, Barcelona, Catalonia, Spain
| | - Carlota de Miquel
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Diego Hidalgo-Mazzei
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | | | - Andre F Carvalho
- IMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain.
| | - Andrea Murru
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
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Lithium effects on Hippocampus volumes in patients with bipolar disorder. J Affect Disord 2021; 294:521-526. [PMID: 34330048 DOI: 10.1016/j.jad.2021.07.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/11/2021] [Accepted: 07/11/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Lithium is one of the most effective medications for bipolar disorder episode prevention, but its mechanism of action is still largely unknown. The hippocampus is a subcortical cerebral structure involved in the formation of emotional responses, cognition and various primitive functions, altered during affective episodes. Deviations in the anatomy or physiology of the hippocampus would partially explain the symptomatology of bipolar subjects, and restoration may reflect treatment response. METHODS In this mini review, we summarize the studies which have investigated the effect of lithium intake on the volume of hippocampus, measured using magnetic resonance imaging (MRI). We performed a bibliographic search on PubMed, using the terms terms "hippocampus", "lithium", "bipolar disorder", "volume" and "MRI". Only original studies were considered. RESULTS Thirteen studies met the inclusion criteria. Nine studies demonstrated increased total hippocampal volume or hippocampal subfield volumes in BD patients on lithium treatment (Li BD) compared to those not taking lithium (non-Li BD), while four failed to show significant differences between groups. When healthy controls were compared to either the Li subjects or the non-Li ones, the findings were more heterogeneous. LIMITATIONS Heterogeneity in the methodology and definition of groups limits the comparison of study results. CONCLUSIONS Lithium may be associated with increased hippocampal volume in BD, potentially due to its putative neurotrophic action, but further research is needed better define the morphological alterations of hippocampus in BD and the longitudinal effects of lithium in the short and long-term.
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The magnitude and variability of brain structural alterations in bipolar disorder: A double meta-analysis of 5534 patients and 6651 healthy controls. J Affect Disord 2021; 291:171-176. [PMID: 34038834 DOI: 10.1016/j.jad.2021.04.090] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/19/2020] [Accepted: 04/25/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Bipolar disorder is thought to be associated with structural brain alterations, but findings have been inconsistent. Our double meta-analysis investigated the variability and magnitude of differences in regional brain volumes in patients with bipolar disorder relative to healthy volunteers. METHODS Databases were systematically searched for MRI studies reporting regional brain volumetric measures in patients with bipolar disorder and controls. The primary outcome measures were variability ratio (VR), coefficient of variability ratio (CVR) and Hedge's g. RESULTS 118 studies comprising 5534 patients and 6651 controls were included. The variability meta-analysis showed higher variability in amygdala (VR, 1.14; P = .02; CVR, 1.25; P = .005) and hippocampal (VR, 1.16; P = .001; CVR, 1.22; P = <.001) volumes in patients relative to controls. The meta-analysis of volume differences showed higher lateral (g, -0.43; P = <.0001) and third ventricle (g, -0.22; P = .01) volumes in patients; and lower hippocampus (g, 0.41; P = .001), grey matter (g, 0.25; P = .001), white matter (g, 0.23; P = .0002) and total brain volumes (g, 0.20; P = .003) in patients relative to controls. A higher proportion of male subjects was associated with decreased mean volumes of the amygdala, hippocampus and thalamus and increased lateral ventricle volumes. LIMITATIONS There was significant publication bias and between-study inconsistency for several brain regions. CONCLUSIONS Bipolar disorder is associated with generalised alterations in white and grey matter brain volumes, particularly marked in the hippocampus volumes, which were smaller but showed greater variability in volumes relative to controls. This suggests that heterogeneity in neurobiological processes involving the hippocampus contribute to clinical heterogeneity in the disorder, and this may be more marked in males than females.
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Hozer F, Sarrazin S, Laidi C, Favre P, Pauling M, Cannon D, McDonald C, Emsell L, Mangin JF, Duchesnay E, Bellani M, Brambilla P, Wessa M, Linke J, Polosan M, Versace A, Phillips ML, Delavest M, Bellivier F, Hamdani N, d'Albis MA, Leboyer M, Houenou J. Lithium prevents grey matter atrophy in patients with bipolar disorder: an international multicenter study. Psychol Med 2021; 51:1201-1210. [PMID: 31983348 DOI: 10.1017/s0033291719004112] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Lithium (Li) is the gold standard treatment for bipolar disorder (BD). However, its mechanisms of action remain unknown but include neurotrophic effects. We here investigated the influence of Li on cortical and local grey matter (GM) volumes in a large international sample of patients with BD and healthy controls (HC). METHODS We analyzed high-resolution T1-weighted structural magnetic resonance imaging scans of 271 patients with BD type I (120 undergoing Li) and 316 HC. Cortical and local GM volumes were compared using voxel-wise approaches with voxel-based morphometry and SIENAX using FSL. We used multiple linear regression models to test the influence of Li on cortical and local GM volumes, taking into account potential confounding factors such as a history of alcohol misuse. RESULTS Patients taking Li had greater cortical GM volume than patients without. Patients undergoing Li had greater regional GM volumes in the right middle frontal gyrus, the right anterior cingulate gyrus, and the left fusiform gyrus in comparison with patients not taking Li. CONCLUSIONS Our results in a large multicentric sample support the hypothesis that Li could exert neurotrophic and neuroprotective effects limiting pathological GM atrophy in key brain regions associated with BD.
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Affiliation(s)
- Franz Hozer
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Issy-les-Moulineaux, France
- Paris Descartes University, PRES Sorbonne Paris Cité, Paris, France
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
| | - Samuel Sarrazin
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
| | - Charles Laidi
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Pauline Favre
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
| | - Melissa Pauling
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Dara Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), NCBES Galway Neuroscience Centre, National University of Ireland Galway, H91 TK33Galway, Ireland
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), NCBES Galway Neuroscience Centre, National University of Ireland Galway, H91 TK33Galway, Ireland
| | - Louise Emsell
- Translational MRI, Department of Imaging & Pathology, KU Leuven, Leuven, Belgium
- Department of Old Age Psychiatry, University Psychiatry Centre, KU Leuven, Leuven, Belgium
| | | | - Edouard Duchesnay
- UNATI Lab, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
| | - Marcella Bellani
- UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona (AOUI), Verona, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Grand Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Michele Wessa
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Julia Linke
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Mircea Polosan
- Grenoble Alpes University, Grenoble Institute of Neuroscience, INSERM U1216, Hôpital Grenoble Alpes, Grenoble, France
| | - Amelia Versace
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mary L Phillips
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Marine Delavest
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Lariboisière-Fernand Widal, INSERM U705 CNRS UMR 8206, Paris, France
- Paris Diderot University, Paris, France
| | - Frank Bellivier
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Lariboisière-Fernand Widal, INSERM U705 CNRS UMR 8206, Paris, France
- Paris Diderot University, Paris, France
| | - Nora Hamdani
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Marc-Antoine d'Albis
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Marion Leboyer
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
- Faculté de Médecine de Créteil, Université Paris Est Créteil, Créteil, France
| | - Josselin Houenou
- UNIACT Lab, Psychiatry Team, NeuroSpin Neuroimaging Platform, CEA Saclay, Gif-sur-Yvette, France
- INSERM U955, Mondor Institute for Biomedical Research, Team 15, Translational Psychiatry, Créteil, France
- Department of Psychiatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
- Faculté de Médecine de Créteil, Université Paris Est Créteil, Créteil, France
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11
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Xiao Q, Wu Z, Jiao Q, Zhong Y, Zhang Y, Lu G. Children with euthymic bipolar disorder during an emotional go/nogo task: Insights into the neural circuits of cognitive-emotional regulation. J Affect Disord 2021; 282:669-676. [PMID: 33445090 DOI: 10.1016/j.jad.2020.12.157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/30/2020] [Accepted: 12/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pediatric bipolar disorder (PBD), manifested by alternating episodes of depression and mania, is more likely to relapse than adult BD and develop into chronic BD. Although it can be asymptomatic during the remission of PBD, subtle changes in the brain neural response can still exist. Abnormal activities in the neural circuits of cognitive-emotional regulation have been found in adult BD patients using fMRI. However, few fMRI studies focus on emotional regulation on cognitive function in euthymic PBD, especially during an emotional go/nogo task. Therefore, this study aims to compare differences in the activities of both emotional and cognitive circuits between euthymic BD children and healthy controls. METHODS 18 euthymic PBD and 17 healthy subjects from 12 to 17 years of age were enrolled in our study. Simultaneous neural activity was recorded during the overall task and the effect of emotional factors on task performances was assessed. RESULTS There were no significant differences in behavioral performances between the PBD group and the control group. During a task with emotional versus neutral distractors, euthymic PBD patients showed increased activities in the DLPFC, inferior parietal lobule, superior/middle frontal gyrus, superior/middle temporal gyrus, insula, posterior cingulate gyrus and posterior cerebellum lobe relative to healthy controls. The insula and DLPFC activities in response to emotional versus neutral distractors were positively associated with the differences in false response errors. CONCLUSIONS This study confirms the enhanced neural activities in euthymic PBD during a task with emotional versus control distractors. These brain regions supporting the cognitive and emotional dysregulation of PBD mainly coincide with the salience and executive control networks. As neural responses are more sensitive than behavioral manifestations in euthymic PBD, our findings will inspire more clinical studies to unveil the characteristic neuromechanism of PBD.
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Affiliation(s)
- Qian Xiao
- Mental Health Centre of Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Zhou Wu
- School of Psychology, Nanjing Normal University, Nanjing 210097, China
| | - Qing Jiao
- Department of Radiology, Taishan Medical University, Taian 271016, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing 210097, China.
| | - Yun Zhang
- Medical Department, Northwest Minzu University, Lanzhou 730030, China.
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
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12
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Manic and euthymic states in pediatric bipolar disorder patients during an emotional Go/Nogo task: A functional magnetic resonance imaging study. J Affect Disord 2021; 282:82-90. [PMID: 33401127 DOI: 10.1016/j.jad.2020.12.105] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/14/2020] [Accepted: 12/24/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Neural abnormalities in emotional response inhibition still exist in the euthymic phase of bipolar disorder (BD). Few studies on comparisons of functional magnetic resonance imaging (fMRI) manifestations between different mood phases of pediatric bipolar disorder (PBD) have ever been published. The goal of this study was to explore the differences in neural activities between manic and euthymic PBD during emotional response inhibition. METHODS Simultaneous imaging of neural activity was recorded during an emotional Go/Nogo paradigm and the effect of emotional response inhibition was analyzed. Neural activities were compared between the three groups. RESULTS In the presence of emotional versus neutral distractors, both manic and euthymic PBD subjects similarly showed widespreadly increased activities in the cognitive and emotional regulation circuits compared with healthy individuals. Compared with euthymic PBD patients, those with manic PBD exhibited increased activities in the left superior frontal gyrus. Hyperactivity in the left superior frontal, left middle frontal and right inferior frontal gyrus in manic PBD was positively associated with false response errors. CONCLUSION Increased activity in the left superior frontal gyrus may be characteristic of manic episodes in PBD patients, and such a disparity between manic and euthymic phrases may attribute to more severe emotional dysregulation.
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13
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Athey TL, Ceritoglu C, Tward DJ, Kutten KS, DePaulo JR, Glazer K, Goes FS, Kelsoe JR, Mondimore F, Nievergelt CM, Rootes-Murdy K, Zandi PP, Ratnanather JT, Mahon PB. A 7 Tesla Amygdalar-Hippocampal Shape Analysis of Lithium Response in Bipolar Disorder. Front Psychiatry 2021; 12:614010. [PMID: 33664682 PMCID: PMC7920967 DOI: 10.3389/fpsyt.2021.614010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/19/2021] [Indexed: 11/15/2022] Open
Abstract
Research to discover clinically useful predictors of lithium response in patients with bipolar disorder has largely found them to be elusive. We demonstrate here that detailed neuroimaging may have the potential to fill this important gap in mood disorder therapeutics. Lithium treatment and bipolar disorder have both been shown to affect anatomy of the hippocampi and amygdalae but there is no consensus on the nature of their effects. We aimed to investigate structural surface anatomy changes in amygdala and hippocampus correlated with treatment response in bipolar disorder. Patients with bipolar disorder (N = 14) underwent lithium treatment, were classified by response status at acute and long-term time points, and scanned with 7 Tesla structural MRI. Large Deformation Diffeomorphic Metric Mapping was applied to detect local differences in hippocampal and amygdalar anatomy between lithium responders and non-responders. Anatomy was also compared to 21 healthy comparison participants. A patch of the ventral surface of the left hippocampus was found to be significantly atrophied in non-responders as compared to responders at the acute time point and was associated at a trend-level with long-term response status. We did not detect an association between response status and surface anatomy of the right hippocampus or amygdala. To the best of our knowledge, this is the first shape analysis of hippocampus and amygdala in bipolar disorder using 7 Tesla MRI. These results can inform future work investigating possible neuroimaging predictors of lithium response in bipolar disorder.
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Affiliation(s)
- Thomas L Athey
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States.,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States.,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Can Ceritoglu
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States
| | - Daniel J Tward
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States.,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States.,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Kwame S Kutten
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Kara Glazer
- Department of Occupational Therapy, Boston University, Boston, MA, United States
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - John R Kelsoe
- Department of Psychiatry, VA San Diego Healthcare System, La Jolla, CA, United States.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Francis Mondimore
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Kelly Rootes-Murdy
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - J Tilak Ratnanather
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States.,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States.,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Pamela B Mahon
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States.,Department of Psychiatry, Brigham & Women's Hospital, Boston, MA, United States.,Department of Psychiatry, Harvard School of Medicine, Boston, MA, United States
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14
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Díaz Ortiz AC, Upeguí CV, Ospina JPZ, Acevedo DCA, Pineda Zapata JA, Jaramillo CAL. Correlation Between Cognitive Performance and Structural Neuroanatomy in Patients with Type I Bipolar Affective Disorder Treated with and Without Lithium. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 51:S0034-7450(20)30094-9. [PMID: 33735049 DOI: 10.1016/j.rcp.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/05/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Lithium treatment of bipolar disorder (BD) has been associated with less cognitive impairment and fewer changes in structural brain anatomy compared to other treatments. However, the studies are heterogeneous and few assess whether these effects are related. The objective of this study was to evaluate and relate cognitive performance and structural neuroanatomy in patients treated with and without lithium. METHODS Cross-sectional study that included 48 subjects with BD-I, of which 22 were treated with lithium and 26 without lithium. Performance was assessed on Wechsler III (WAIS III), TMT A and B (Trial Making Test) neuropsychological tests, California verbal learning test (CVLT), Rey complex figure test and Wisconsin card sorting test. Brain structures obtained by magnetic resonance imaging (MRI) were evaluated. The standardised mean difference (SMD) between both groups was calculated, adjusted for confounding variables using a propensity score, and the Spearman correlation coefficient (ρ) was used to assess the relationship between cognitive performance and neuroanatomical regions. RESULTS Compared to the group without lithium, the group with lithium had fewer perseverative errors in the Wisconsin test (SMD = -0.69) and greater left and right cortical areas (SMD = 0.85; SMD = 0.92); greater surface area in the left anterior cingulate (SMD = 1.32), right medial orbitofrontal cortex (SMD = 1.17), right superior frontal gyrus (SMD = 0.82), and right and left precentral gyrus (SMD = 1.33; SMD = 0.98); greater volume of the right amygdala (SMD = 0.57), right hippocampus (SMD = 0.66), right putamen (SMD = 0.87) and right thalamus (SMD=.67). In the lithium group, a correlation was found with these errors and the thickness of the left precentral gyrus (ρ = -0.78), the volume of the right thalamus (ρ =-0.44), and the right amygdala (ρ = 0.6). CONCLUSIONS The lithium group had better cognitive flexibility and greater dimension in some frontal and subcortical cortical regions. Furthermore, there was a moderate to high correlation between performance in this executive function and the thickness of the right precentral gyrus, and the volumes of the thalamus and the right amygdala. These findings could suggest a neuroprotective effect of lithium.
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Affiliation(s)
- Andrés Camilo Díaz Ortiz
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - Cristian Vargas Upeguí
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan Pablo Zapata Ospina
- Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | | | - Carlos Alberto López Jaramillo
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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15
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[Neurological complications attributable to lithium: An update]. Rev Med Interne 2020; 42:120-126. [PMID: 33203541 DOI: 10.1016/j.revmed.2020.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 07/15/2020] [Accepted: 08/03/2020] [Indexed: 12/24/2022]
Abstract
Lithium intoxication may induce neurological complications, initially characterised by a conscience alteration and an encephalopathy clinical picture with a risk of death or sever long-term consequences. With an occurrence sometimes atypical and possibly without initial hyperlitemia, the diagnosis delay of these complications might be important. Moreover, no specific guidelines focused on these complications are available. The aim of this article is to propose an update on diagnosis and treatment of neurological complications attributable to lithium, as encephalopathy.
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16
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Person-based similarity in brain structure and functional connectivity in bipolar disorder. J Affect Disord 2020; 276:38-44. [PMID: 32697714 PMCID: PMC7568424 DOI: 10.1016/j.jad.2020.06.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/26/2020] [Accepted: 06/16/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Bipolar disorder shows significant variability in clinical presentation. Here we adopt a personalized approach to quantify the brain structural and functional similarity of each individual patient to other patients and to healthy individuals. METHODS Brain morphometric and resting-state functional connectivity measures from two independent samples of patients with bipolar disorder and healthy individuals (total number of participants=215) were modeled as single vectors to generated individualized morphometric and connectivity profiles. These profiles were then used to compute a person-based similarity indices which quantified the similarity in neuroimaging profiles amongst patients and between patients and health individuals. RESULTS The morphometric and connectivity profiles of patients showed within-diagnosis similarity which was comparable to that observed in healthy individuals. They also showed minimal deviance from those of healthy individuals; the correlation between the profiles of patients and healthy individuals was high (range: 0.71-0.94, p<10-5). The degree of similarity between imaging profiles was associated with IQ (for cortical thickness) and age (functional integration) rather than clinical variables. Patients who were prescribed lithium, compared to those who were not, showed greater similarity to healthy individuals in terms of network integration (t = 2.2, p = 0.03). LIMITATIONS We focused on patients with Bipolar disorder, type I only. CONCLUSIONS High inter-individual similarity in neuroimaging profiles was observed amongst patients with bipolar disorder and between patients and healthy individuals. We infer that brain alterations associated with bipolar disorder may be nested within the normal biological diversity consistent with the high prevalence of mood symptoms in the general population.
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17
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Accumulation of Lithium in the Hippocampus of Patients With Bipolar Disorder: A Lithium-7 Magnetic Resonance Imaging Study at 7 Tesla. Biol Psychiatry 2020; 88:426-433. [PMID: 32340717 DOI: 10.1016/j.biopsych.2020.02.1181] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/14/2020] [Accepted: 02/03/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Lithium (Li) is a first-line treatment for bipolar disorder (BD). To study its cerebral distribution and association with plasma concentrations, we used 7Li magnetic resonance imaging at 7T in euthymic patients with BD treated with Li carbonate for at least 2 years. METHODS Three-dimensional 7Li magnetic resonance imaging scans (N = 21) were acquired with an ultra-short echo-time sequence using a non-Cartesian k-space sampling scheme. Lithium concentrations ([Li]) were estimated using a phantom replacement approach accounting for differential T1 and T2 relaxation effects. In addition to the determination of mean regional [Li] from 7 broad anatomical areas, voxel- and parcellation-based group analyses were conducted for the first time for 7Li magnetic resonance imaging. RESULTS Using unprecedented spatial sensitivity and specificity, we were able to confirm the heterogeneity of the brain Li distribution and its interindividual variability, as well as the strong correlation between plasma and average brain [Li] ([Li]B ≈ 0.40 × [Li]P, R = .74). Remarkably, our statistical analysis led to the identification of a well-defined and significant cluster corresponding closely to the left hippocampus for which high Li content was displayed consistently across our cohort. CONCLUSIONS This observation could be of interest considering 1) the major role of the hippocampus in emotion processing and regulation, 2) the consistent atrophy of the hippocampus in untreated patients with BD, and 3) the normalization effect of Li on gray matter volumes. This study paves the way for the elucidation of the relationship between Li cerebral distribution and its therapeutic response, notably in newly diagnosed patients with BD.
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18
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Mancuso L, Fornito A, Costa T, Ficco L, Liloia D, Manuello J, Duca S, Cauda F. A meta-analytic approach to mapping co-occurrent grey matter volume increases and decreases in psychiatric disorders. Neuroimage 2020; 222:117220. [PMID: 32777357 DOI: 10.1016/j.neuroimage.2020.117220] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/14/2022] Open
Abstract
Numerous studies have investigated grey matter (GM) volume changes in diverse patient groups. Reports of disorder-related GM reductions are common in such work, but many studies also report evidence for GM volume increases in patients. It is unclear whether these GM increases and decreases are independent or related in some way. Here, we address this question using a novel meta-analytic network mapping approach. We used a coordinate-based meta-analysis of 64 voxel-based morphometry studies of psychiatric disorders to calculate the probability of finding a GM increase or decrease in one region given an observed change in the opposite direction in another region. Estimating this co-occurrence probability for every pair of brain regions allowed us to build a network of concurrent GM changes of opposing polarity. Our analysis revealed that disorder-related GM increases and decreases are not independent; instead, a GM change in one area is often statistically related to a change of opposite polarity in other areas, highlighting distributed yet coordinated changes in GM volume as a function of brain pathology. Most regions showing GM changes linked to an opposite change in a distal area were located in salience, executive-control and default mode networks, as well as the thalamus and basal ganglia. Moreover, pairs of regions showing coupled changes of opposite polarity were more likely to belong to different canonical networks than to the same one. Our results suggest that regional GM alterations in psychiatric disorders are often accompanied by opposing changes in distal regions that belong to distinct functional networks.
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Affiliation(s)
- Lorenzo Mancuso
- FOCUS Lab, Department of Psychology, University of Turin, Turin, Italy; GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
| | - Alex Fornito
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University,Victoria, Australia; Monash Biomedical Imaging, Monash University,Victoria, Australia
| | - Tommaso Costa
- FOCUS Lab, Department of Psychology, University of Turin, Turin, Italy; GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy.
| | - Linda Ficco
- FOCUS Lab, Department of Psychology, University of Turin, Turin, Italy; GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
| | - Donato Liloia
- FOCUS Lab, Department of Psychology, University of Turin, Turin, Italy; GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
| | - Jordi Manuello
- FOCUS Lab, Department of Psychology, University of Turin, Turin, Italy; GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
| | - Sergio Duca
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
| | - Franco Cauda
- FOCUS Lab, Department of Psychology, University of Turin, Turin, Italy; GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
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19
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Biological Targets Underlying the Antisuicidal Effects of Lithium. Curr Behav Neurosci Rep 2020. [DOI: 10.1007/s40473-020-00208-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
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20
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Ciftci E, Karacay R, Caglayan A, Altunay S, Ates N, Altintas MO, Doeppner TR, Yulug B, Kilic E. Neuroprotective effect of lithium in cold- induced traumatic brain injury in mice. Behav Brain Res 2020; 392:112719. [PMID: 32479849 DOI: 10.1016/j.bbr.2020.112719] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/20/2020] [Accepted: 05/18/2020] [Indexed: 11/17/2022]
Abstract
Apart from its well-established therapeutic activity on bipolar disorder and depression, lithium exerts neuroprotective activity upon neurodegenerative disorders, such as traumatic brain injury (TBI). However, the cellular signaling mechanisms mediating lithium's neuroprotective activity and long-term dose- and time-dependent effects on close and remote proximity are largely unknown. Herein, we tested prophylactic and acute effects of lithium (2 mmol/kg) after cold- induced TBI. In both conditions, treatments with lithium resulted in reduced infarct volume and apoptosis. Its acute treatment resulted in the increase of Akt, ERK-1/2 and GSK-3 α/β phosphoylations. Interestingly, its prophylactic treatment instead resulted in decreased phosphorylations of Akt, ERK-1/2, p38, JNK-1 moderately and GSK-3 α/β significantly. Then, we tested subacute (35-day follow-up) role of low (0.2 mmol/kg) and high dose (2 mmol/kg) lithium and revealed that high dose lithium group was the most mobile so the least depressed in the tail suspension test. Anxiety level was assessed by light-dark test, all groups' anxiety levels were decreased with time, but lithium had no effect on anxiety like behavior. When subacute effects of injury and drug treatment were evaluated on the defined brain regions, infarct volume was decreased in the high dose lithium group significantly. In contrast to other brain regions, hippocampal atrophies were observed in both lithium treatment groups, which were significant in the low dose lithium group in both hemispheres, which was associated with the reduced cell proliferation and neurogenesis. Our data demonstrate that lithium treatment protects neurons from TBI. However, long term particularly low-dose lithium causes hippocampal atrophy and decreased neurogenesis.
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Affiliation(s)
- Elvan Ciftci
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Physiology, Istanbul, Turkey
| | - Reyda Karacay
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Physiology, Istanbul, Turkey
| | - Aysun Caglayan
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Physiology, Istanbul, Turkey
| | - Serdar Altunay
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Physiology, Istanbul, Turkey
| | - Nilay Ates
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Pharmacology, Istanbul, Turkey
| | - Mehmet O Altintas
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Physiology, Istanbul, Turkey
| | - Thorsten R Doeppner
- University of Göttingen Medical School, Dept. of Neurology, Göttingen, Germany
| | - Burak Yulug
- Alanya Alaaddin Keykubat University, Faculty of Medicine, Dept. of Neurology, Antalya, Turkey
| | - Ertugrul Kilic
- Istanbul Medipol University, Regenerative and Restorative Medical Research Center, Istanbul, Turkey; Istanbul Medipol University, Faculty of Medicine, Dept. of Physiology, Istanbul, Turkey.
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21
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The Amygdala in Schizophrenia and Bipolar Disorder: A Synthesis of Structural MRI, Diffusion Tensor Imaging, and Resting-State Functional Connectivity Findings. Harv Rev Psychiatry 2020; 27:150-164. [PMID: 31082993 DOI: 10.1097/hrp.0000000000000207] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Frequently implicated in psychotic spectrum disorders, the amygdala serves as an important hub for elucidating the convergent and divergent neural substrates in schizophrenia and bipolar disorder, the two most studied groups of psychotic spectrum conditions. A systematic search of electronic databases through December 2017 was conducted to identify neuroimaging studies of the amygdala in schizophrenia and bipolar disorder, focusing on structural MRI, diffusion tensor imaging (DTI), and resting-state functional connectivity studies, with an emphasis on cross-diagnostic studies. Ninety-four independent studies were selected for the present review (49 structural MRI, 27 DTI, and 18 resting-state functional MRI studies). Also selected, and analyzed in a separate meta-analysis, were 33 volumetric studies with the amygdala as the region-of-interest. Reduced left, right, and total amygdala volumes were found in schizophrenia, relative to both healthy controls and bipolar subjects, even when restricted to cohorts in the early stages of illness. No volume abnormalities were observed in bipolar subjects relative to healthy controls. Shape morphometry studies showed either amygdala deformity or no differences in schizophrenia, and no abnormalities in bipolar disorder. In contrast to the volumetric findings, DTI studies of the uncinate fasciculus tract (connecting the amygdala with the medial- and orbitofrontal cortices) largely showed reduced fractional anisotropy (a marker of white matter microstructure abnormality) in both schizophrenia and bipolar patients, with no cross-diagnostic differences. While decreased amygdalar-orbitofrontal functional connectivity was generally observed in schizophrenia, varying patterns of amygdalar-orbitofrontal connectivity in bipolar disorder were found. Future studies can consider adopting longitudinal approaches with multimodal imaging and more extensive clinical subtyping to probe amygdalar subregional changes and their relationship to the sequelae of psychotic disorders.
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Xiao Q, Zhong Y, Jiao Q, Lu G, Su Y. Gray matter voxel-based morphometry in mania and remission states of children with bipolar disorder. J Affect Disord 2020; 268:47-54. [PMID: 32158006 DOI: 10.1016/j.jad.2020.02.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 02/07/2020] [Accepted: 02/26/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND It has been found by many studies that gray matter (GM) abnormalities exist in both adults and children with bipolar disorder (PBD) which is a serious mental illness characterized by alternating episodes of mania and depression. However, there are few studies on the comparison between brain imaging of different mood states shown by patients with bipolar disorder. This study is aimed at exploring the differences existing in brain structures between children with bipolar disorder and that of healthy controls, and then it tries to further explore whether there is a structural difference between the states of mania and remission in children with bipolar disorder. METHODS 21 PBD-mania subjects, 19 PBD-remission subjects and 18 control subjects aged 12-17 years old were engaged in this study. In the present study, magnetic resonance imaging was obtained by employing a Siemens 3.0 T scanner. With regard to the volumes of gray matter in the mania group, remission group and healthy control group, analysis was carried out by using voxel-based morphometry (VBM). Further analysis was conducted on the correlation between MRI data and clinical features of patients with PBD. RESULTS In comparison with the healthy control subjects, the gray matter volume measured from the left hippocampus, parahippocampal gyrus and amygdala in both manic and euthymic groups showed a decreasing trend, while the volume of left orbitofrontal cortex increased. However, no significant difference in volumes was found between BD manic and euthymic groups. It was observed that the volume of orbitofrontal cortex had a positive correlation with onset age in PBD euthymic group. CONCLUSIONS Our study came to the conclusion that extensive brain structural changes are available in patients with PBD. The brain regions with structural changes are distributed in the anterior limbic network (ALN), which has been proved to have been involved in the abnormal emotional and cognitive regulation of PBD. However, there is no difference in the volumes of gray matter between mania and remission in PBD .
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Affiliation(s)
- Qian Xiao
- Mental Health Centre of Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing 210097,China; Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
| | - Qing Jiao
- Department of Radiology, Taishan Medical University, Taian 271016, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
| | - Yi Su
- Child Language Lab, School of Foreign Languages, Central South University, Changsha, Hunan 410083, China.
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Ho TC, Gutman B, Pozzi E, Grabe HJ, Hosten N, Wittfeld K, Völzke H, Baune B, Dannlowski U, Förster K, Grotegerd D, Redlich R, Jansen A, Kircher T, Krug A, Meinert S, Nenadic I, Opel N, Dinga R, Veltman DJ, Schnell K, Veer I, Walter H, Gotlib IH, Sacchet MD, Aleman A, Groenewold NA, Stein DJ, Li M, Walter M, Ching CRK, Jahanshad N, Ragothaman A, Isaev D, Zavaliangos‐Petropulu A, Thompson PM, Sämann PG, Schmaal L. Subcortical shape alterations in major depressive disorder: Findings from the ENIGMA major depressive disorder working group. Hum Brain Mapp 2020; 43:341-351. [PMID: 32198905 PMCID: PMC8675412 DOI: 10.1002/hbm.24988] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/01/2020] [Accepted: 03/06/2020] [Indexed: 12/11/2022] Open
Abstract
Alterations in regional subcortical brain volumes have been investigated as part of the efforts of an international consortium, ENIGMA, to identify reliable neural correlates of major depressive disorder (MDD). Given that subcortical structures are comprised of distinct subfields, we sought to build significantly from prior work by precisely mapping localized MDD‐related differences in subcortical regions using shape analysis. In this meta‐analysis of subcortical shape from the ENIGMA‐MDD working group, we compared 1,781 patients with MDD and 2,953 healthy controls (CTL) on individual measures of shape metrics (thickness and surface area) on the surface of seven bilateral subcortical structures: nucleus accumbens, amygdala, caudate, hippocampus, pallidum, putamen, and thalamus. Harmonized data processing and statistical analyses were conducted locally at each site, and findings were aggregated by meta‐analysis. Relative to CTL, patients with adolescent‐onset MDD (≤ 21 years) had lower thickness and surface area of the subiculum, cornu ammonis (CA) 1 of the hippocampus and basolateral amygdala (Cohen's d = −0.164 to −0.180). Relative to first‐episode MDD, recurrent MDD patients had lower thickness and surface area in the CA1 of the hippocampus and the basolateral amygdala (Cohen's d = −0.173 to −0.184). Our results suggest that previously reported MDD‐associated volumetric differences may be localized to specific subfields of these structures that have been shown to be sensitive to the effects of stress, with important implications for mapping treatments to patients based on specific neural targets and key clinical features.
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Affiliation(s)
- Tiffany C. Ho
- Department of Psychiatry & Weill Institute for Neurosciences San Francisco California USA
- Department of Psychiatry & Behavioral Sciences Stanford University Stanford California USA
- Department of Psychology Stanford University Stanford California USA
| | - Boris Gutman
- Department of Biomedical Engineering Illinois Institute of Technology Chicago Illinois USA
| | - Elena Pozzi
- Melbourne Neuropsychiatry Centre, Department of Psychiatry The University of Melbourne & Melbourne Health Melbourne Australia
- Orygen, The National Centre of Excellence in Youth Mental Health Parkville Australia
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy University Medicine Greifswald Germany
- German Centre of Neurodegenerative Diseases (DZNE) site Greifswald/Rostock Germany
| | - Norbert Hosten
- Department of Diagnostic Radiology and Neuroradiology University Medicine Greifswald Germany
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy University Medicine Greifswald Germany
- German Centre of Neurodegenerative Diseases (DZNE) site Greifswald/Rostock Germany
| | - Henry Völzke
- Institute for Community Medicine University Medicine Greifswald Germany
| | - Bernhard Baune
- Department of Psychiatry University of Münster Münster Germany
- Department of Psychiatry, Melbourne Medical School The University of Melbourne Melbourne Australia
| | - Udo Dannlowski
- Department of Psychiatry University of Münster Münster Germany
| | | | | | - Ronny Redlich
- Department of Psychiatry University of Münster Münster Germany
| | - Andreas Jansen
- Department of Psychiatry Philipps‐University Marburg Germany
| | - Tilo Kircher
- Department of Psychiatry Philipps‐University Marburg Germany
| | - Axel Krug
- Department of Psychiatry Philipps‐University Marburg Germany
| | - Susanne Meinert
- Department of Psychiatry University of Münster Münster Germany
| | - Igor Nenadic
- Department of Psychiatry Philipps‐University Marburg Germany
| | - Nils Opel
- Department of Psychiatry University of Münster Münster Germany
| | - Richard Dinga
- Department of Psychiatry, Amsterdam University Medical Centers VU University Medical Center, GGZ inGeest, Amsterdam Neuroscience Amsterdam The Netherlands
| | - Dick J. Veltman
- Department of Psychiatry, Amsterdam University Medical Centers VU University Medical Center, GGZ inGeest, Amsterdam Neuroscience Amsterdam The Netherlands
| | - Knut Schnell
- Department of Psychiatry and Psychotherapy University Medical Center Göttingen Göttingen Germany
| | - Ilya Veer
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Ian H. Gotlib
- Department of Psychology Stanford University Stanford California USA
| | - Matthew D. Sacchet
- Department of Psychiatry & Behavioral Sciences Stanford University Stanford California USA
- McLean Hospital and Department of Psychiatry Harvard Medical School Belmont Massachusetts USA
| | - André Aleman
- University of Groningen, University Medical Center Groningen, Department of Neuroscience Groningen The Netherlands
| | - Nynke A. Groenewold
- University of Groningen, University Medical Center Groningen, Department of Neuroscience Groningen The Netherlands
- University of Groningen, University Medical Center Groningen Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE) Groningen The Netherlands
| | - Dan J. Stein
- Department of Psychiatry and Mental Health University of Cape Town South Africa
| | - Meng Li
- Max Planck Institute for Biological Cybernetics Tuebingen Germany
| | - Martin Walter
- Department of Psychiatry University Tuebingen Germany
| | - Christopher R. K. Ching
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute Keck USC School of Medicine California USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute Keck USC School of Medicine California USA
| | - Anjanibhargavi Ragothaman
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute Keck USC School of Medicine California USA
| | - Dmitry Isaev
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute Keck USC School of Medicine California USA
| | - Artemis Zavaliangos‐Petropulu
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute Keck USC School of Medicine California USA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute Keck USC School of Medicine California USA
| | | | - Lianne Schmaal
- Orygen, The National Centre of Excellence in Youth Mental Health Parkville Australia
- Centre for Youth Mental Health The University of Melbourne Melbourne Australia
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Kuang L, Cui D, Jiao Q, Guo Y, Cao W, Gao W, Qiu J, Su L, Lu G. Alterations of Cognition and Cerebral Ventricle Volume in Manic and Euthymic Pediatric Bipolar Disorder. Front Psychiatry 2020; 11:593629. [PMID: 33381058 PMCID: PMC7767823 DOI: 10.3389/fpsyt.2020.593629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction: It remains unknown whether volumetric alterations of ventricles are similar or not in pediatric bipolar disorder (PBD) among different mood states. The present study aims to estimate ventricular volumetric alteration of PBD patients in manic and euthymic status, as well as the relationship between this alteration and cognitive changes. Methods: T1 magnetic resonance images were obtained from 20 manic PBD patients, 21 euthymic PBD patients, and 19 healthy controls (HCs). Ventricular volumes were automatically obtained via FreeSurfer 6.0 software. Ventricular volumes and cognitive indices were compared among the three groups, and the relationship between ventricular volumes and cognitive/clinical indices was analyzed. Results: In contrast to HCs, manic and euthymic PBD patients exhibited decreased cognitive scores of the Stroop color-word test and the digit span subtest. Manic PBD subjects presented enlarged volumes in the bilateral ventricles, third ventricle, and whole ventricles, and euthymic PBD participants displayed increased volumes in the third ventricle, fourth ventricle, and whole ventricles. No significant differences in cognitive performance and ventricular volumes were found between PBD groups. No significant correlation was discovered between ventricular volumes and cognitive/clinical indices in both manic and euthymic PBD patients. Conclusions: No significant differences in cognitive performance and ventricle volume were observed between euthymic and manic PBD groups, which may imply that the alterations are not specific to mood state. It may indicate structural and functional damage of corresponding brain circuits in euthymic PBD patients similar with that of manic PBD, which may provide clues to the diagnosis and treatment of euthymic PBD.
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Affiliation(s)
- Liangfeng Kuang
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Dong Cui
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Qing Jiao
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Yongxin Guo
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Weifang Cao
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Weijia Gao
- Department of Child Psychology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianfeng Qiu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Linyan Su
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, China
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25
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Basal ganglia volumetric changes in psychotic spectrum disorders. J Affect Disord 2019; 255:150-157. [PMID: 31153051 DOI: 10.1016/j.jad.2019.05.048] [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] [Received: 01/29/2019] [Revised: 03/30/2019] [Accepted: 05/27/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Basal ganglia are particularly important for understanding the pathobiology of psychosis given their key roles in dopaminergic neurotransmission which are associated with psychotic symptoms and one of the target sites of antipsychotic drugs. Psychotic symptoms are prevalent in both schizophrenia (SZ) and bipolar disorder (BD). Although the components of basal ganglia are implicated in psychosis, comparative structural changes of components of the basal ganglia between SZ and BD are less clear after disentanglement of clinical effects of antipsychotic dose, duration and severity of illness. METHODS In this study, we examined the morphology of the basal ganglia in 326 subjects comprising of 45 patients of BD type I with psychotic symptoms, 97 first-episode SZ (FE-SZ) patients, 86 non-first-episode chronic SZ (NFE-SZ) patients, in comparison with 98 healthy controls (HC). RESULTS Results showed increased volumes in subregions of caudate, putamen, and pallidum in chronic SZ patients compared with HC after controlling for age, gender, and total intracranial volume. No change was found between FE-SZ patients, psychotic BD patients, and HC. Furthermore, hierarchical regressions showed that the dosage of antipsychotics had a significant contribution to basal ganglia volumetric enlargement in NFE-SZ after controlling for the effects of age, gender, total intracranial volume, age at illness onset, as well as illness duration and severity. LIMITATIONS Lack of information about the cumulative history of exposure to medication for all the three groups of patients is a major limitation in our study. CONCLUSIONS There are distinct basal ganglia structural changes in SZ and psychotic BD. Basal ganglia are enlarged in chronic SZ but not in FE-SZ and BD and this enlargement is significantly associated with antipsychotic dosage over and beyond the effects of illness duration and severity.
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26
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Pickard BS. Genomics of Lithium Action and Response. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2019; 17:308-313. [PMID: 32015722 PMCID: PMC6996056 DOI: 10.1176/appi.focus.17305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
(Reprinted with permission from Neurotherapeutics (2017) 14:582-587).
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27
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Han KM, Kim A, Kang W, Kang Y, Kang J, Won E, Tae WS, Ham BJ. Hippocampal subfield volumes in major depressive disorder and bipolar disorder. Eur Psychiatry 2019; 57:70-77. [PMID: 30721801 DOI: 10.1016/j.eurpsy.2019.01.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 01/19/2019] [Accepted: 01/21/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The hippocampus is not a uniform structure, but rather consists of multiple, functionally specialized subfields. Few studies have explored hippocampal subfield volume difference in the same sample of major depressive disorder (MDD) and bipolar disorder (BD) cases. We aimed to investigate the difference of hippocampal subfield volume between patents with MDD and BD and healthy controls (HCs). METHODS A total of 102 MDD and 55 BD patients and 135 HCs were recruited and underwent T1-weighted image. Hippocampal subfield volume was calculated by automated segmentation and volumetric procedures developed by Iglesias et al. and implemented in FreeSurfer. Volume differences between the groups were analyzed using the analysis of covariance and controlling for age, sex, and total intracranial cavity volume. RESULTS Patients with MDD had significantly reduced volumes in the bilateral cornu ammonis 1 (CA1), CA4, the granule cell layer (GCL), molecular layer (ML), whole hippocampus, the left CA2/3, and right presubiclum and subiculum. Patients with BD had significantly reduced volumes in the right CA1, GCL, and the whole hippocampus as compared to HCs. No significant volume differences were observed between the MDD and BD groups. Illness duration was negatively correlated with volumes of the left CA1, CA4, ML, presubiculum, subiculum, and the whole hippocampus in patients with BD. CONCLUSION We observed hippocampal subfield volume reductions in both MDD and BD, a finding which more prominent in MDD. The inverse correlation between BD illness duration and hippocampal subfield volume may evidence the neuroprogressive nature of BD.
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Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Aram Kim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Wooyoung Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youbin Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - June Kang
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Eunsoo Won
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo-Suk Tae
- Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea; Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea; Brain Convergence Research Center, Korea University Anam Hospital, Seoul, Republic of Korea.
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28
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Ortiz-Matamoros A, Arias C. Differential Changes in the Number and Morphology of the New Neurons after Chronic Infusion of Wnt7a, Wnt5a, and Dkk-1 in the Adult Hippocampus In Vivo. Anat Rec (Hoboken) 2019; 302:1647-1657. [PMID: 30635974 DOI: 10.1002/ar.24069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/15/2018] [Accepted: 11/29/2018] [Indexed: 12/13/2022]
Abstract
In the adult hippocampus of many mammals, a particular microenvironment in the neurogenic niche regulates the proliferation, self-renewal, and differentiation of neuronal stem cells. In this proliferative niche, a variety of molecules provide a finely regulated molecular signaling that controls stem cell properties. During development, Wnt signaling has been implicated in cell fate determination and proliferation, in the establishment of cell polarity, as well as a cue for axonal growth and dendrite orientation. In the adult brain, this pathway also participates in the stem cell self-renewal and neuronal differentiation. However, the effects of the chronic Wnt signaling modulation in the adult hippocampus, through the infusion of Wnt7a, Wnt5a, and Dkk-1, on the rate of neurogenesis and on the induction of neurite arborization have not been studied. In this study, we show that Wnt7a and Wn5a further increased the rate of newly generated neurons. However, Wnt5a exerted additional effects by promoting neurite growth and neurite misorientation in the dentate gyrus of adult rats. The chronic exposure to Dkk-1 also generated aberrant location of growing neurites. These results suggest that the interplay of canonical and non-canonical Wnt ligands participates in neuronal stem cell proliferation and in the establishment of proper neurite maturation. Anat Rec, 302:1647-1657, 2019. © 2019 American Association for Anatomy.
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Affiliation(s)
- Abril Ortiz-Matamoros
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, AP, Mexico
| | - Clorinda Arias
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, AP, Mexico
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Bauer IE, Suchting R, Cazala F, Alpak G, Sanches M, Nery FG, Zunta-Soares GB, Soares JC. Changes in amygdala, cerebellum, and nucleus accumbens volumes in bipolar patients treated with lamotrigine. Psychiatry Res Neuroimaging 2018; 278:13-20. [PMID: 29944976 DOI: 10.1016/j.pscychresns.2018.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/08/2018] [Accepted: 06/09/2018] [Indexed: 12/21/2022]
Abstract
The neural mechanisms underlying the therapeutic effects of lamotrigine in bipolar depression are still unexplored. This preliminary study compares the effects of a 12-week treatment with lamotrigine on brain volumes in adults with bipolar disorder (BD).12 BD type II patients (age: 49.33 ± 9.95 years, 3 males, 9 females) and 12 age and gender-matched healthy controls (HC) (HC; age: 41 ± 8.60 years, 3 males, 9 females). BD patients were initially administered 25 mg/day of lamotrigine, which was progressively escalated to 200 mg/d. BD participants underwent brain imaging prior to and following lamotrigine treatment. A 50% reduction in depressive scores indicated "remission". Bayesian general linear models controlled for age, gender and intracranial volume were used to examine changes in relevant brain region following treatment. A posterior probability > 0.90 indicated evidence that there was an effect of diagnosis or remission on brain volumes. Probability distributions of interaction effects between remission and time indicated that BD responders displayed decreased amygdala, cerebellum and nucleus accumbens volumes following lamotrigine treatment. No serious adverse side effects were reported. The antidepressant effects of lamotrigine may be linked to volumetric changes in brain regions involved in mood and emotional regulation. These findings are preliminary and replication in a larger sample is warranted.
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Affiliation(s)
- Isabelle E Bauer
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States.
| | - Robert Suchting
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States
| | - Fadwa Cazala
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States
| | - Gokay Alpak
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States
| | - Marsal Sanches
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States
| | - Fabiano G Nery
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - Giovana B Zunta-Soares
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States
| | - Jair C Soares
- University of Texas Health Science Center at Houston, McGovern Medical School, Department of Psychiatry and Behavioral Sciences, Houston, TX 77054, United States
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Li L, Ji E, Han X, Tang F, Bai Y, Peng D, Fang Y, Zhang S, Zhang Z, Yang H. Cortical thickness and subcortical volumes alterations in euthymic bipolar I patients treated with different mood stabilizers. Brain Imaging Behav 2018; 13:1255-1264. [DOI: 10.1007/s11682-018-9950-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Sani G, Simonetti A, Janiri D, Banaj N, Ambrosi E, De Rossi P, Ciullo V, Arciniegas DB, Piras F, Spalletta G. Association between duration of lithium exposure and hippocampus/amygdala volumes in type I bipolar disorder. J Affect Disord 2018; 232:341-348. [PMID: 29510351 DOI: 10.1016/j.jad.2018.02.042] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/17/2018] [Accepted: 02/16/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Prior studies on the effects of lithium on limbic and subcortical gray matter volumes are mixed. It is possible that discrepant findings may be explained by the duration of lithium exposure. We investigated this issue in individuals with type I bipolar disorder (BP-I). METHODS Limbic and subcortical gray matter volume was measured using FreeSurfer in 60 subjects: 15 with BP-I without prior lithium exposure [no-exposure group (NE)]; 15 with BP-I and lithium exposure < 24 months [short-exposure group (SE)]; 15 with BP-I and lithium exposure > 24 months [long-exposure group (LE)]; and 15 healthy controls (HC). RESULTS No differences in limbic and subcortical gray matter volumes were found between LE and HC. Hippocampal and amygdalar volumes were larger bilaterally in both LE and HC when compared to NE. Amygdalar volumes were larger bilaterally in SE when compared to NE but did not differ from LE. Hippocampal volumes were smaller bilaterally in SE when compared to LE and HC but did not differ from NE. No between-group differences on subcortical gray matter or other limbic structure volumes were observed. LIMITATIONS Cross-sectional design and concurrent treatment with other medications limit attribution of between-group differences to lithium exposure alone. CONCLUSIONS The effect of lithium exposure on limbic and subcortical gray matter volumes appears to be time-dependent and relatively specific to the hippocampus and the amygdala, with short-term effects on the amygdala and long-term effects on both structures. These results support the clinical importance of long-term lithium treatment in BP-I.
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Affiliation(s)
- Gabriele Sani
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy; Centro Lucio Bini, Rome, Italy; School of Medicine, Mood Disorder Program, Tufts University, Boston, MA, USA
| | - Alessio Simonetti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Centro Lucio Bini, Rome, Italy; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Delfina Janiri
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Nerisa Banaj
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Elisa Ambrosi
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Pietro De Rossi
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Valentina Ciullo
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy; Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, 50139 Italy
| | - David B Arciniegas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Departments of Neurology and Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Fabrizio Piras
- IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy
| | - Gianfranco Spalletta
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; IRCCS Santa Lucia Foundation, Laboratory of Neuropsychiatry, Rome, Italy.
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Kessing LV, Gerds TA, Knudsen NN, Jørgensen LF, Kristiansen SM, Voutchkova D, Ernstsen V, Schullehner J, Hansen B, Andersen PK, Ersbøll AK. Lithium in drinking water and the incidence of bipolar disorder: A nation-wide population-based study. Bipolar Disord 2017; 19:563-567. [PMID: 28714553 DOI: 10.1111/bdi.12524] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 06/13/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Animal data suggest that subtherapeutic doses, including micro doses, of lithium may influence mood, and lithium levels in drinking water have been found to correlate with the rate of suicide. It has never been investigated whether consumption of lithium may prevent the development of bipolar disorder (primary prophylaxis). In a nation-wide population-based study, we investigated whether long-term exposure to micro levels of lithium in drinking water correlates with the incidence of bipolar disorder in the general population, hypothesizing an inverse association in which higher long-term lithium exposure is associated with lower incidences of bipolar disorder. METHODS We included longitudinal individual geographical data on municipality of residence, data from drinking water lithium measurements and time-specific data from all cases with a hospital contact with a diagnosis of mania/bipolar disorder from 1995 to 2013 (N=14 820) and 10 age- and gender-matched controls from the Danish population (N= 140 311). Average drinking water lithium exposure was estimated for all study individuals. RESULTS The median of the average lithium exposure did not differ between cases with a diagnosis of mania/bipolar disorder (12.7 μg/L; interquartile range [IQR]: 7.9-15.5 μg/L) and controls (12.5 μg/L; IQR: 7.6-15.7 μg/L; P=.2). Further, the incidence rate ratio of mania/bipolar disorder did not decrease with higher long-term lithium exposure, overall, or within age categories (0-40, 41-60 and 61-100 years of age). CONCLUSION Higher long-term lithium exposure from drinking water was not associated with a lower incidence of bipolar disorder. The association should be investigated in areas with higher lithium levels than in Denmark.
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Affiliation(s)
- Lars V Kessing
- Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thomas A Gerds
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Nikoline N Knudsen
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | | | | | - Denitza Voutchkova
- Geological Survey of Denmark and Greenland, Copenhagen, Denmark.,Department of Geoscience, Aarhus University, Aarhus, Denmark
| | - Vibeke Ernstsen
- Geological Survey of Denmark and Greenland, Copenhagen, Denmark
| | | | - Birgitte Hansen
- Geological Survey of Denmark and Greenland, Copenhagen, Denmark
| | - Per K Andersen
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Annette K Ersbøll
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
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Abstract
Lithium is the most successful mood stabilizer treatment for bipolar disorder. However, unlike conventional drugs that are designed to interact with a specific molecular target, the actions of lithium are distributed across many biological processes and pathways. Treatment response is subject to genetic variation between individuals and similar genetic variation may dictate susceptibility to side effects. Transcriptomic, genomic, and cell-model research strategies have all been deployed in the search for the genetic factors and biological systems that mediate the interaction between genetics and the therapeutic actions of lithium. In this review, recent findings from genome-wide studies and patient cell lines will be summarized and discussed from a standpoint that genuine progress is being made to define clinically useful mechanisms of this treatment, to place it in the context of bipolar disorder pathology, and to move towards a time when the prescription of lithium is targeted to those individuals who will derive the greatest benefit.
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Affiliation(s)
- Benjamin S Pickard
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow, G4 0RE, UK.
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