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Jahandideh M, Ebrahimi E, Farzaei MH, Barzegari E. The effect of chronic lithium treatment on hippocampal progenitor cells: Transcriptomic analysis and systems pharmacology. Brain Behav 2023; 13:e3215. [PMID: 37553827 PMCID: PMC10570482 DOI: 10.1002/brb3.3215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 07/24/2023] [Accepted: 07/29/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE To identify the genomics underpinning the increased volume of the hippocampus after long-term administration of lithium (Li) in bipolar disorder patients, hypothesizing the possible contribution of cell growth and differentiation pathways to this complication. METHODS RNA-seq profiles of four samples of hippocampal progenitor cells chronically treated with a high dose of Li and three samples chronically treated with the therapeutic dose were retrieved from NCBI-GEO. The raw data underwent filtration, quality control, expression fold change, adjusted significance, functional enrichment, and pharmacogenomic analyses. RESULTS CCND1, LOXL2, and PRNP were identified as the genes involved in the drug response and the chronic effects of Li in the hippocampal cells. GSK-3β was also a hub in the pharmacogenomic network of Li. In addition, ZMPSTE24 and DHX35 were identified as the important genes in lithium therapy. CONCLUSIONS As shown by gene ontology results, these findings conclude that lithium may increase the size of the hippocampus in bipolar patients by stimulating the generation of new neurons and promoting their differentiation into neuroblasts, neurons, or microglia.
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Affiliation(s)
- Mina Jahandideh
- Medical Biology Research CenterHealth Technology InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Erfan Ebrahimi
- Student Research CommitteeKermanshah University of Medical SciencesKermanshahIran
| | - Mohammad Hosein Farzaei
- Pharmaceutical Sciences Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Ebrahim Barzegari
- Medical Biology Research CenterHealth Technology InstituteKermanshah University of Medical SciencesKermanshahIran
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2
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Saleem A, Harmata G, Jain S, Voss MW, Fiedorowicz JG, Williams AJ, Shaffer JJ, Richards JG, Barsotti EJ, Sathyaputri L, Schmitz SL, Christensen GE, Long JD, Xu J, Wemmie JA, Magnotta VA. Functional connectivity of the cerebellar vermis in bipolar disorder and associations with mood. Front Psychiatry 2023; 14:1147540. [PMID: 37215681 PMCID: PMC10196126 DOI: 10.3389/fpsyt.2023.1147540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/12/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose Studies of the neural underpinnings of bipolar type I disorder have focused on the emotional control network. However, there is also growing evidence for cerebellar involvement, including abnormal structure, function, and metabolism. Here, we sought to assess functional connectivity of the cerebellar vermis with the cerebrum in bipolar disorder and to assess whether connectivity might depend on mood. Methods This cross-sectional study enrolled 128 participants with bipolar type I disorder and 83 control comparison participants who completed a 3 T magnetic resonance imaging (MRI) study, which included anatomical as well as resting state Blood Oxygenation Level Dependent (BOLD) imaging. Functional connectivity of the cerebellar vermis to all other brain regions was assessed. Based on quality control metrics of the fMRI data, 109 participants with bipolar disorder and 79 controls were included in the statistical analysis comparing connectivity of the vermis. In addition, the data was explored for the potential impacts of mood, symptom burden, and medication in those with bipolar disorder. Results Functional connectivity between the cerebellar vermis and the cerebrum was found to be aberrant in bipolar disorder. The connectivity of the vermis was found to be greater in bipolar disorder to regions involved in motor control and emotion (trending), while reduced connectivity was observed to a region associated with language production. In the participants with bipolar disorder, past depression symptom burden affected connectivity; however, no effects of medication were observed. Functional connectivity between the cerebellar vermis and all other regions revealed an inverse association with current mood ratings. Conclusion Together the findings may suggest that the cerebellum plays a compensatory role in bipolar disorder. The proximity of the cerebellar vermis to the skull may make this region a potential target for treatment with transcranial magnetic stimulation.
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Affiliation(s)
- Arshaq Saleem
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Gail Harmata
- Department of Radiology, University of Iowa, Iowa City, IA, United States
| | - Shivangi Jain
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Michelle W. Voss
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States
| | - Jess G. Fiedorowicz
- The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | | | - Joseph J. Shaffer
- Department of Radiology, University of Iowa, Iowa City, IA, United States
- Department of Biosciences, Kansas City University, Kansas City, MO, United States
| | | | | | - Leela Sathyaputri
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States
- Embracing the World, Elburn, IL, United States
| | - Samantha L. Schmitz
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States
- College of Osteopathic Medicine, Des Moines University, Des Moines, IA, United States
| | - Gary E. Christensen
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IA, United States
- Department of Radiation Oncology, University of Iowa, Iowa City, IA, United States
| | - Jeffrey D. Long
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States
- Department of Biostatistics, University of Iowa, Iowa City, IA, United States
| | - Jia Xu
- Department of Radiology, University of Iowa, Iowa City, IA, United States
| | - John A. Wemmie
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States
- Veterans Affairs Medical Center, Iowa City, IA, United States
- Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, IA, United States
- Department of Neurosurgery, University of Iowa, Iowa City, IA, United States
| | - Vincent A. Magnotta
- Department of Radiology, University of Iowa, Iowa City, IA, United States
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, United States
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3
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Saleem A, Harmata G, Jain S, Voss MW, Fiedorowicz JG, Williams A, Shaffer JJ, Richards JG, Barsotti EJ, Sathyaputri L, Schmitz SL, Christensen GE, Long JD, Xu J, Wemmie JA, Magnotta VA. Functional Connectivity of the Cerebellar Vermis in Bipolar Disorder and Associations with Mood. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.02.526878. [PMID: 36778335 PMCID: PMC9915674 DOI: 10.1101/2023.02.02.526878] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Purpose Studies of the neural underpinnings of bipolar type I disorder have focused on the emotional control network. However, there is also growing evidence for cerebellar involvement, including abnormal structure, function, and metabolism. Here, we sought to assess functional connectivity of the cerebellum with the cerebrum in bipolar disorder and to assess whether any effects might depend on mood. Methods This cross-sectional study enrolled 128 participants with bipolar type I disorder and 83 control comparison participants who completed a 3T MRI scan, which included anatomical imaging as well as resting state BOLD imaging. Functional connectivity of the cerebellar vermis to all other brain regions was assessed. Based on quality control metrics of the fMRI data, 109 participants with bipolar disorder and 79 controls were used to in the statistical analysis comparing connectivity of the vermis as well as associations with mood. Potential impacts of medications were also explored. Results Functional connectivity of the cerebellar vermis in bipolar disorder was found to differ significantly between brain regions known to be involved in the control of emotion, motor function, and language. While connections with emotion and motor control areas were significantly stronger in bipolar disorder, connection to a region associated language production was significantly weaker. In the participants with bipolar disorder, ratings of depression and mania were inversely associated with vermis functional connectivity. No effect of medications on these connections were observed. Conclusion Together the findings suggest cerebellum may play a compensatory role in bipolar disorder and when it can no longer fulfill this role, depression and mania develop. The proximity of the cerebellar vermis to the skull may make this region a potential target for treatment with transcranial magnetic stimulation.
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Affiliation(s)
- Arshaq Saleem
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Gail Harmata
- Department of Radiology, University of Iowa, Iowa City, IA, 52242
| | - Shivangi Jain
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Michelle W. Voss
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Jess G. Fiedorowicz
- The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa Brain & Mind Research Institute, Ottawa ON Canada K1H 8L6
| | - Aislinn Williams
- Department of Psychiatry, University of Iowa, Iowa City, IA, 52242
| | | | | | | | - Leela Sathyaputri
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Samantha L. Schmitz
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242
| | - Gary E. Christensen
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IA, 52242,Department of Radiation Oncology, University of Iowa, Iowa City, IA, 52242
| | - Jeffrey D. Long
- Department of Psychiatry, University of Iowa, Iowa City, IA, 52242,Department of Biostatistics, University of Iowa, Iowa City, IA, 52242
| | - Jia Xu
- Department of Radiology, University of Iowa, Iowa City, IA, 52242
| | - John A. Wemmie
- Department of Psychiatry, University of Iowa, Iowa City, IA, 52242,Veterans Affairs Medical Center, Iowa City, Iowa, USA,Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, Iowa, USA,Department of Neurosurgery, University of Iowa, Iowa City, IA, 52242
| | - Vincent A. Magnotta
- Department of Radiology, University of Iowa, Iowa City, IA, 52242,Department of Psychiatry, University of Iowa, Iowa City, IA, 52242,Department of Biomedical Engineering, University of Iowa, Iowa City, IA, 52242
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4
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Chen H, Wang L, Li H, Song H, Zhang X, Wang D. Altered intrinsic brain activity and cognitive impairment in euthymic, unmedicated individuals with bipolar disorder. Asian J Psychiatr 2023; 80:103386. [PMID: 36495730 DOI: 10.1016/j.ajp.2022.103386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 09/07/2022] [Accepted: 10/08/2022] [Indexed: 12/12/2022]
Abstract
Cognitive impairment in euthymic bipolar disorder (BD) contributes to poor functional outcomes. Resting-state magnetic resonance imaging (MRI)may help us understand the neurobiology of cognitive impairment in BD. Here, forty unmedicated euthymic BD patients and thirty-nine healthy controls were recruited, undergoing MRI scans and neuropsychological measures. The amplitude of low-frequency fluctuation (ALFF) and ALFF-based functional connectivity (FC) analysis was employed to explore the potential alterations of neural activity. Voxel-wised correlation was calculated between clinical and cognitive variables and abnormal brain activity. Compared with healthy controls, euthymic BD patients showed worse cognitive performance in Trail Making Test, Digit Span Test, and Stroop Color-Word Test (SCWT). The euthymic BD group had significantly lower ALFF in the left medial frontal gyrus, right middle frontal gyrus, right postcentral gyrus, and left superior frontal gyrus. Furthermore, we found decreased ALFF values in the right middle frontal gyrus that was negatively correlated with cognitive inhibition, (r = -0.43, P = 0.015). ALFF-based FC analysis showed that BD group showed significantly decreased FC between the right middle frontal gyrus (seed) and left middle temporal gyrus and left medial frontal gyrus, (Two-tailed, PFWE < 0.05, TFCE corrected). The findings demonstrated that individuals with BD during the euthymic phase exhibited decreased ALFF and hypoconnectivity of key brain areas within the frontoparietal network. These altered spontaneous brain activity in euthymic BD patients may be involved in the pathophysiology mechanism of cognitive deficits.
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Affiliation(s)
- Hao Chen
- Department of Radiology, Suzhou Municipal Hospital, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Longxi Wang
- Department of laboratory, Rongfu Military Hospital of Jining city, Jining, China
| | - Hong Li
- Department of Psychiatry, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huihui Song
- Department of Geriatric Psychiatry, Suzhou Mental Health Center, Suzhou Guangji Hospital, the Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiaobin Zhang
- Department of Geriatric Psychiatry, Suzhou Mental Health Center, Suzhou Guangji Hospital, the Affiliated Guangji Hospital of Soochow University, Suzhou, China.
| | - Dong Wang
- Department of Geriatric Psychiatry, Suzhou Mental Health Center, Suzhou Guangji Hospital, the Affiliated Guangji Hospital of Soochow University, Suzhou, China.
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Spielberg JM, Sadeh N, Cha J, Matyi MA, Anand A. Affect Regulation-Related Emergent Brain Network Properties Differentiate Depressed Bipolar Disorder From Major Depression and Track Risk for Bipolar Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:765-773. [PMID: 34637954 PMCID: PMC8993939 DOI: 10.1016/j.bpsc.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Individuals with or at risk for bipolar disorder (BD) often present initially for the treatment of depressive symptoms. Unfortunately, pharmacological treatments for major depressive disorder (MDD) can be iatrogenic, precipitating mania that may not have otherwise occurred. Current diagnostic procedures rely solely on self-reported/observable symptoms, and thus alternative data sources, such as brain network properties, are needed to supplement current self-report/observation-based indices of risk for mania. METHODS Brain connectivity during affect maintenance/regulation was examined in a large (N = 249), medication-free sample of currently depressed patients with BD (n = 50) and MDD (n = 116) and healthy control subjects (n = 83). BD risk was categorized in a subset of patients with MDD. We used graph theory to identify emergent network properties that differentiated between patients with BD and MDD and between patients with MDD at high and low risk for BD. RESULTS BD and MDD differed in the extent to which the rostral anterior cingulate cortex was embedded in the local network, amount of influence the hippocampus exerted over global network communication, and clarity of orbitofrontal cortex communication. Patients with MDD at high risk for BD showed a pattern of local network clustering around the right amygdala that was similar to the pattern observed in healthy control subjects, whereas patients with MDD at low risk for BD deviated from this pattern. CONCLUSIONS BD and MDD differed in emergent network mechanisms subserving affect regulation, and amygdala properties tracked BD risk in patients with MDD. If replicated, our findings may be combined with other markers to assess the presence of BD and/or BD risk in individuals presenting with depressive symptoms to prevent the use of iatrogenic treatments.
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Affiliation(s)
- Jeffrey M Spielberg
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware.
| | - Naomi Sadeh
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware
| | - Jungwon Cha
- Center for Behavioral Health, Cleveland Clinic, Cleveland, Ohio; Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Melanie A Matyi
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware
| | - Amit Anand
- Center for Behavioral Health, Cleveland Clinic, Cleveland, Ohio; Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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Cha J, Spielberg JM, Hu B, Altinay M, Anand A. Resting-state functional connectivity graph-properties correlate with bipolar disorder-risk in young medication-free depressed subjects: Bipolar-risk Resting State Functional Connectivity in Major Depression. J Affect Disord 2022; 301:52-59. [PMID: 35007643 DOI: 10.1016/j.jad.2022.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 12/28/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Major Depressive Disorder (MDD) is frequently associated with risk factors for the development of Bipolar Disorder (BD). Using graph theory, we investigated brain network properties associated with BD risk factors in young MDD subjects. METHODS Resting-state fMRI was acquired from a large cohort (N= 104) of medication-free currently depressed participants (25 BD depression (BDD), 79 MDD). Lifetime mania symptom count (LMSC), current Young Mania Rating Scale (YMRS) score, and family history of mood disorders (FHMD) were examined as BD risk factors. Functional connectivity matrices from 280 regions of interests (ROIs) were first entered into the Network Based Statistic (NBS) toolbox to identify connections that varied with each risk factor. Next, within the correlated network for each risk factor, global and nodal graph properties for the top five linked nodes were calculated. Last, using identified graph properties, machine learning classification (MLC) between BDD, MDD with BD risk factors (MDD+), and without BD risk factors (MDD-) was conducted. RESULTS LMSC positively correlated with left lateral orbitofrontal cortex (LOFC) Communication Efficiency and with left middle temporal Eigenvector Centrality. Current YMRS score positively correlated with right amygdala Communication Efficiency and Closeness Centrality. FHMD positively correlated with right insula Eigenvector Centrality. Acceptable MLC accuracy was seen between BDD and MDD- using middle temporal Eigenvector Centrality, whereas moderate accuracy was seen between MDD+ and MDD- using OFC Communication Efficiency. LIMITATION Although participants were medication-free, they were not medication-naïve. CONCLUSION Functional connectome graph properties may serve as BD vulnerability biomarkers in young individuals with MDD.
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Affiliation(s)
- Jungwon Cha
- Department of Psychiatry, Mass General Brigham, Harvard Medical School, United States
| | - Jeffrey M Spielberg
- Department of Psychological and Brain Sciences, University of Delaware, United States
| | - Bo Hu
- Center for Quantitative Health Sciences, Cleveland Clinic, United States
| | - Murat Altinay
- Center for Behavioral Health, Cleveland Clinic, United States
| | - Amit Anand
- Department of Psychiatry, Mass General Brigham, Harvard Medical School, United States.
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7
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Lithium treatment and human hippocampal neurogenesis. Transl Psychiatry 2021; 11:555. [PMID: 34718328 PMCID: PMC8557207 DOI: 10.1038/s41398-021-01695-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022] Open
Abstract
Lithium is a first-line treatment for bipolar disorder, where it acts as a mood-stabilizing agent. Although its precise mechanism remains unclear, neuroimaging studies have shown that lithium accumulates in the hippocampus and that chronic use amongst bipolar disorder patients is associated with larger hippocampal volumes. Here, we tested the chronic effects of low (0.75 mM) and high (2.25 mM) doses of lithium on human hippocampal progenitor cells and used immunocytochemistry to investigate the effects of lithium on cell parameters implicated in neurogenesis. Corresponding RNA-sequencing and gene-set enrichment analyses were used to evaluate whether genes affected by lithium in our model overlap with those regulating the volume of specific layers of the dentate gyrus. We observed that high-dose lithium treatment in human hippocampal progenitors increased the generation of neuroblasts (P ≤ 0.01), neurons (P ≤ 0.01), and glia (P ≤ 0.001), alongside the expression of genes, which regulate the volume of the molecular layer of the dentate gyrus. This study provides empirical support that adult hippocampal neurogenesis and gliogenesis are mechanisms that could contribute to the effects of lithium on human hippocampal volume.
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Zhang L, Wu H, Zhang A, Bai T, Ji GJ, Tian Y, Wang K. Aberrant brain network topology in the frontoparietal-limbic circuit in bipolar disorder: a graph-theory study. Eur Arch Psychiatry Clin Neurosci 2021; 271:1379-1391. [PMID: 33386961 DOI: 10.1007/s00406-020-01219-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/02/2020] [Indexed: 12/21/2022]
Abstract
Characterizing the properties of brain networks across mood states seen in bipolar disorder (BP) can provide a deeper insight into the mechanisms involved in this type of affective disorder. In this study, graph theoretical methods were used to examine global, modular and nodal brain network topology in the resting state using functional magnetic resonance imaging data acquired from 95 participants, including those with bipolar depression (BPD; n = 30) and bipolar mania (BPM; n = 39) and healthy control (HC) subjects (n = 26). The threshold value of the individual subjects' connectivity matrix varied from 0.15 to 0.30 with steps of 0.01. We found that: (1) at the global level, BP patients showed a significantly increased global efficiency and synchronization and a decreased path length; (2) at the nodal level, BP patients showed impaired nodal parameters, predominantly within the frontoparietal and limbic sub-network; (3) at the module level, BP patients were characterized by denser FCs (edges) between Module III (the front-parietal system) and Module V (limbic/paralimbic systems); (4) at the nodal level, the BPD and BPM groups showed state-specific differences in the orbital part of the left superior-frontal gyrus, right putamen, right parahippocampal gyrus and left fusiform gyrus. These results revealed abnormalities in topological organization in the whole brain, especially in the frontoparietal-limbic circuit in both BPD and BPM. These deficits may reflect the pathophysiological processes occurring in BP. In addition, state-specific regional nodal alterations in BP could potentially provide biomarkers of conversion across different mood states.
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Affiliation(s)
- Li Zhang
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Huiling Wu
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Aiguo Zhang
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Tongjian Bai
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
| | - Gong-Jun Ji
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China
- Department of Medical Psychology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
- Department of Medical Psychology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui Province, China.
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China.
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China.
- Department of Medical Psychology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
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Martens M, Filippini N, Masaki C, Godlewska BR. Functional Connectivity between Task-Positive Networks and the Left Precuneus as a Biomarker of Response to Lamotrigine in Bipolar Depression: A Pilot Study. Pharmaceuticals (Basel) 2021; 14:534. [PMID: 34204977 PMCID: PMC8229811 DOI: 10.3390/ph14060534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/23/2021] [Accepted: 05/28/2021] [Indexed: 12/12/2022] Open
Abstract
Treatment of bipolar depression poses a significant clinical challenge. Lamotrigine is one of a few efficacious drugs, however, it needs to be titrated very slowly and response can only be assessed after 10-12 weeks. With only a proportion of patients responding, an exploration of factors underlying treatment responsivity is of paramount clinical importance, as it may lead to an allocation of the drug to those most likely to respond to it. This study aimed at identifying differences in patterns of pre-treatment resting state functional connectivity (rsFC) that may underlie response to lamotrigine in bipolar depression. After a baseline MRI scan, twenty-one patients with bipolar depression were treated with lamotrigine in an open-label design; response, defined as ≥50% decrease in Hamilton Depression Rating Scale (HAMD) score, was assessed after 10-12 weeks of treatment. Twenty healthy controls had a baseline clinical assessment and scan but did not receive any treatment. Fifteen out of 21 (71%) patients responded to lamotrigine. Treatment responsivity was associated with enhanced pre-treatment rsFC of the right fronto-parietal network (FPN) and dorsal attention network (DAN) with left precuneus. The lack of treatment response was additionally characterised by reduced rsFC: of the DAN with right middle temporal gyrus; of the default mode network (DMN) with left precuneus; of the extended sensory-motor area with areas including the left hippocampus/left amygdala and left subcallosal cortex/nucleus accumbens; and of the left FPN with left inferior temporal gyrus/occipital fusiform gyrus/lateral occipital cortex. The results suggest that preserved rsFC between the FPN and DAN, the networks involved in cognitive control, and the hub of the posterior DMN, the left precuneus, may be critical for good response to lamotrigine as an add-on treatment in patients with bipolar depression. The study also suggests a more general decrease in rsFC to be related to poor treatment responsivity.
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Affiliation(s)
- Marieke Martens
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK; (M.M.); (C.M.)
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX3 9DU, UK;
| | - Nicola Filippini
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX3 9DU, UK;
- Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
| | - Charles Masaki
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK; (M.M.); (C.M.)
| | - Beata R. Godlewska
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK; (M.M.); (C.M.)
- Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK
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10
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Schizophrenia and bipolar disorder are associated with opposite brain reward anticipation-associated response. Neuropsychopharmacology 2021; 46:1152-1160. [PMID: 33452432 PMCID: PMC8115687 DOI: 10.1038/s41386-020-00940-0] [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: 09/09/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 12/17/2022]
Abstract
Blunted and exaggerated neuronal response to rewards are hypothesized to be core features of schizophrenia spectrum disorders (SZ) and bipolar disorder (BD), respectively. Nonetheless, direct tests of this hypothesis, in which response between SZ and BD is compared in the same study, are lacking. Here we examined the functional correlates of reward processing during the Incentivized Control Engagement Task (ICE-T) using 3T fMRI. Reward-associated activation was examined in 49 healthy controls (HCs), 52 recent-onset individuals with SZ, and 22 recent-onset individuals with Type I BD using anterior cingulate (ACC), anterior insula, and ventral striatal regions of interest. Significant group X reward condition (neutral vs. reward) interactions were observed during reward anticipation in the dorsal ACC (F(2,120) = 4.21, P = 0.017) and right insula (F(2,120) = 4.77, P = 0.010). The ACC interaction was driven by relatively higher activation in the BD group vs. HCs (P = 0.007) and vs. individuals with SZ (P = 0.010). The insula interaction was driven by reduced activation in the SZ group relative to HCs (P = 0.018) and vs. people with BD (P = 0.008). A composite of reward anticipation-associated response across all associated ROIs also differed significantly by diagnosis (F(1,120) = 5.59, P = 0.02), BD > HC > SZ. No effects of group or group X reward interactions were observed during reward feedback. These results suggest that people with SZ and BD have opposite patterns of activation associated with reward anticipation but not reward receipt. Implications of these findings in regard to Research Domain Criteria-based classification of illness and the neurobiology of reward in psychosis are discussed.
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11
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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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12
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Bergamelli E, Del Fabro L, Delvecchio G, D’Agostino A, Brambilla P. The Impact of Lithium on Brain Function in Bipolar Disorder: An Updated Review of Functional Magnetic Resonance Imaging Studies. CNS Drugs 2021; 35:1275-1287. [PMID: 34773217 PMCID: PMC9537229 DOI: 10.1007/s40263-021-00869-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 11/13/2022]
Abstract
Lithium remains a gold standard treatment for bipolar disorder (BD), and functional magnetic resonance imaging (fMRI) studies have contributed to clarifying its impact on neural circuitries in affected individuals. However, the specific neurobiological mechanisms through which lithium exerts its effects on brain function are not fully understood. In this review, we aimed to summarize the results of recent fMRI studies evaluating the impact of lithium on brain functional activity and connectivity in patients diagnosed with BD. We performed a literature search of available sources found in the PubMed database reported in English since 2016, when the last available review on this topic was published. Five fMRI studies in resting-state condition and six studies performed during the execution of emotional tasks met the inclusion criteria. Overall, the available evidence supports normalizing effects of lithium on brain activity and connectivity. Most of these studies reported a normalization in prefrontal regions and interconnected areas involved in emotion regulation and processing, regardless of the task employed. Importantly, lithium treatment showed distinct patterns of activity/connectivity changes compared with other treatments. Finally, lithium modulation of neural circuitries was found to be associated with clinical improvement in BD. These results are consistent with the hypothesis that selective abnormalities in neural circuitries supporting emotion processing and regulation improve during lithium treatment in BD. However, the heterogeneity of the examined studies regarding study design, sample selection, and analysis methods might limit the generalizability of the findings and lead to difficulties in comparing the results. Therefore, in future studies, larger cohorts and homogeneous experimental tasks are needed to further corroborate these findings.
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Affiliation(s)
- Emilio Bergamelli
- grid.415093.a0000 0004 1793 3800Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Health Sciences, University of Milan, Milan, Italy
| | - Lorenzo Del Fabro
- grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, 20122 Milan, Italy ,grid.414818.00000 0004 1757 8749Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Armando D’Agostino
- grid.415093.a0000 0004 1793 3800Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Health Sciences, University of Milan, Milan, Italy
| | - Paolo Brambilla
- grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, 20122 Milan, Italy ,grid.414818.00000 0004 1757 8749Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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13
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Taylor JJ, Kurt HG, Anand A. Resting State Functional Connectivity Biomarkers of Treatment Response in Mood Disorders: A Review. Front Psychiatry 2021; 12:565136. [PMID: 33841196 PMCID: PMC8032870 DOI: 10.3389/fpsyt.2021.565136] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 02/26/2021] [Indexed: 12/24/2022] Open
Abstract
There are currently no validated treatment biomarkers in psychiatry. Resting State Functional Connectivity (RSFC) is a popular method for investigating the neural correlates of mood disorders, but the breadth of the field makes it difficult to assess progress toward treatment response biomarkers. In this review, we followed general PRISMA guidelines to evaluate the evidence base for mood disorder treatment biomarkers across diagnoses, brain network models, and treatment modalities. We hypothesized that no treatment biomarker would be validated across these domains or with independent datasets. Results are organized, interpreted, and discussed in the context of four popular analytic techniques: (1) reference region (seed-based) analysis, (2) independent component analysis, (3) graph theory analysis, and (4) other methods. Cortico-limbic connectivity is implicated across studies, but there is no single biomarker that spans analyses or that has been replicated in multiple independent datasets. We discuss RSFC limitations and future directions in biomarker development.
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Affiliation(s)
- Joseph J Taylor
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Hatice Guncu Kurt
- Center for Behavioral Health, Cleveland Clinic, Cleveland, OH, United States
| | - Amit Anand
- Center for Behavioral Health, Cleveland Clinic, Cleveland, OH, United States
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14
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Cattarinussi G, Delvecchio G, Prunas C, Brambilla P. Effects of pharmacological treatments on neuroimaging findings in first episode affective psychosis: A review of longitudinal studies. J Affect Disord 2020; 276:1046-1051. [PMID: 32763589 DOI: 10.1016/j.jad.2020.07.118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/30/2020] [Accepted: 07/22/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Affective psychosis is a common mental disorder characterized by structural/functional brain abnormalities, which seem to occur also at the early stages of the disease. However, the role of psychotropic medications on brain structure and function in affective first episode psychosis (A-FEP) still remains uncertain. Therefore, with this review we aim to gain more robust understanding regarding the potential effect of pharmacological treatments on the brain in A-FEP patients also experiencing a first manic episode. METHODS A search on PuBMed and Web of Science of longitudinal structural and functional Magnetic Resonance Imaging (MRI) as well as Diffusion Tensor Imaging (DTI) studies, exploring the effect of medications on the brain in A-FEP, was conducted. We selected nine studies, three randomized or pseudo-randomized controlled trials and six observational studies. RESULTS Overall the studies showed that a) mood stabilizers (MS) have no effect on gray matter (GM) volumes and a protective role on white matter (WM) volumes, b) antipsychotics (AP) have an unclear effect on GM volumes and a less potent effect on WM volumes compared to MS and c) both MS and AP tend to normalize brain activation and connectivity. LIMITATIONS The small sample size, the observational design of the majority of the studies and the different methodological approaches limit the conclusion of this review. CONCLUSIONS Medications seem to have a minor role on structural changes occurring in A-FEP patients during the early stages of the disease, while their effect on brain activation and connectivity seems more pronounced, but far to be conclusive.
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Affiliation(s)
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Cecilia Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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15
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Neuroanatomic and Functional Neuroimaging Findings. Curr Top Behav Neurosci 2020; 48:173-196. [PMID: 33040316 DOI: 10.1007/7854_2020_174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The search for brain morphology findings that could explain behavioral disorders has gone through a long path in the history of psychiatry. With the advance of brain imaging technology, studies have been able to identify brain morphology and neural circuits associated with the pathophysiology of mental illnesses, such as bipolar disorders (BD). Promising results have also shown the potential of neuroimaging findings in the identification of outcome predictors and response to treatment among patients with BD. In this chapter, we present brain imaging structural and functional findings associated with BD, as well as their hypothesized relationship with the pathophysiological aspects of that condition and their potential clinical applications.
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