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Rozovsky R, Bertocci M, Iyengar S, Stiffler RS, Bebko G, Skeba AS, Brady T, Aslam H, Phillips ML. Identifying tripartite relationship among cortical thickness, neuroticism, and mood and anxiety disorders. Sci Rep 2024; 14:8449. [PMID: 38600283 PMCID: PMC11006921 DOI: 10.1038/s41598-024-59108-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/08/2024] [Indexed: 04/12/2024] Open
Abstract
The number of young adults seeking help for emotional distress, subsyndromal-syndromal mood/anxiety symptoms, including those associated with neuroticism, is rising and can be an early manifestation of mood/anxiety disorders. Identification of gray matter (GM) thickness alterations and their relationship with neuroticism and mood/anxiety symptoms can aid in earlier diagnosis and prevention of risk for future mood and anxiety disorders. In a transdiagnostic sample of young adults (n = 252;177 females; age 21.7 ± 2), Hypothesis (H) 1:regularized regression followed by multiple regression examined relationships among GM cortical thickness and clinician-rated depression, anxiety, and mania/hypomania; H2:the neuroticism factor and its subfactors as measured by NEO Personality Inventory (NEO-PI-R) were tested as mediators. Analyses revealed positive relationships between left parsopercularis thickness and depression (B = 4.87, p = 0.002), anxiety (B = 4.68, p = 0.002), mania/hypomania (B = 6.08, p ≤ 0.001); negative relationships between left inferior temporal gyrus (ITG) thickness and depression (B = - 5.64, p ≤ 0.001), anxiety (B = - 6.77, p ≤ 0.001), mania/hypomania (B = - 6.47, p ≤ 0.001); and positive relationships between left isthmus cingulate thickness (B = 2.84, p = 0.011), and anxiety. NEO anger/hostility mediated the relationship between left ITG thickness and mania/hypomania; NEO vulnerability mediated the relationship between left ITG thickness and depression. Examining the interrelationships among cortical thickness, neuroticism and mood and anxiety symptoms enriches the potential for identifying markers conferring risk for mood and anxiety disorders and can provide targets for personalized intervention strategies for these disorders.
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Affiliation(s)
- Renata Rozovsky
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, 302 Loeffler Building, 121 Meyran Ave., Pittsburgh, PA, USA.
| | - Michele Bertocci
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, 302 Loeffler Building, 121 Meyran Ave., Pittsburgh, PA, USA
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Richelle S Stiffler
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, 302 Loeffler Building, 121 Meyran Ave., Pittsburgh, PA, USA
| | - Genna Bebko
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, 302 Loeffler Building, 121 Meyran Ave., Pittsburgh, PA, USA
| | - Alexander S Skeba
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, 302 Loeffler Building, 121 Meyran Ave., Pittsburgh, PA, USA
| | - Tyler Brady
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, 302 Loeffler Building, 121 Meyran Ave., Pittsburgh, PA, USA
| | - Haris Aslam
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, 302 Loeffler Building, 121 Meyran Ave., Pittsburgh, PA, USA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, 302 Loeffler Building, 121 Meyran Ave., Pittsburgh, PA, USA
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Niu L, Fang K, Han S, Xu C, Sun X. Resolving heterogeneity in schizophrenia, bipolar I disorder, and attention-deficit/hyperactivity disorder through individualized structural covariance network analysis. Cereb Cortex 2024; 34:bhad391. [PMID: 38142281 DOI: 10.1093/cercor/bhad391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 09/30/2023] [Accepted: 10/01/2023] [Indexed: 12/25/2023] Open
Abstract
Disruptions in large-scale brain connectivity are hypothesized to contribute to psychiatric disorders, including schizophrenia, bipolar I disorder, and attention-deficit/hyperactivity disorder. However, high inter-individual variation among patients with psychiatric disorders hinders achievement of unified findings. To this end, we adopted a newly proposed method to resolve heterogeneity of differential structural covariance network in schizophrenia, bipolar I disorder, and attention-deficit/hyperactivity disorder. This method could infer individualized structural covariance aberrance by assessing the deviation from healthy controls. T1-weighted anatomical images of 114 patients with psychiatric disorders (schizophrenia: n = 37; bipolar I disorder: n = 37; attention-deficit/hyperactivity disorder: n = 37) and 110 healthy controls were analyzed to obtain individualized differential structural covariance network. Patients exhibited tremendous heterogeneity in profiles of individualized differential structural covariance network. Despite notable heterogeneity, patients with the same disorder shared altered edges at network level. Moreover, individualized differential structural covariance network uncovered two distinct psychiatric subtypes with opposite differences in structural covariance edges, that were otherwise obscured when patients were merged, compared with healthy controls. These results provide new insights into heterogeneity and have implications for the nosology in psychiatric disorders.
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Affiliation(s)
- Lianjie Niu
- Department of Breast Disease, Henan Breast Cancer Center. The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Keke Fang
- Department of Pharmacy, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - Chunmiao Xu
- Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Xianfu Sun
- Department of Breast Disease, Henan Breast Cancer Center. The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
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Shan Y, Yan SZ, Wang Z, Cui BX, Yang HW, Yuan JM, Yin YY, Shi F, Lu J. Impact of brain segmentation methods on regional metabolism quantification in 18F-FDG PET/MR analysis. EJNMMI Res 2023; 13:79. [PMID: 37668814 PMCID: PMC10480127 DOI: 10.1186/s13550-023-01028-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/28/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Accurate analysis of quantitative PET data plays a crucial role in studying small, specific brain structures. The integration of PET and MRI through an integrated PET/MR system presents an opportunity to leverage the benefits of precisely aligned structural MRI and molecular PET images in both spatial and temporal dimensions. However, in many clinical workflows, PET studies are often performed without the aid of individually matched structural MRI scans, primarily for the sake of convenience in the data collection and brain segmentation possesses. Currently, two commonly employed segmentation strategies for brain PET analysis are distinguished: methods with or without MRI registration and methods employing either atlas-based or individual-based algorithms. Moreover, the development of artificial intelligence (AI)-assisted methods for predicting brain segmentation holds promise but requires further validation of their efficiency and accuracy for clinical applications. This study aims to compare and evaluate the correlations, consistencies, and differences among the above-mentioned brain segmentation strategies in quantification of brain metabolism in 18F-FDG PET/MR analysis. RESULTS Strong correlations were observed among all methods (r = 0.932 to 0.999, P < 0.001). The variances attributable to subject and brain region were higher than those caused by segmentation methods (P < 0.001). However, intraclass correlation coefficient (ICC)s between methods with or without MRI registration ranged from 0.924 to 0.975, while ICCs between methods with atlas- or individual-based algorithms ranged from 0.741 to 0.879. Brain regions exhibiting significant standardized uptake values (SUV) differences due to segmentation methods were the basal ganglia nuclei (maximum to 11.50 ± 4.67%), and various cerebral cortexes in temporal and occipital regions (maximum to 18.03 ± 5.52%). The AI-based method demonstrated high correlation (r = 0.998 and 0.999, P < 0.001) and ICC (0.998 and 0.997) with FreeSurfer, substantially reducing the time from 8.13 h to 57 s on per subject. CONCLUSIONS Different segmentation methods may have impact on the calculation of brain metabolism in basal ganglia nuclei and specific cerebral cortexes. The AI-based approach offers improved efficiency and is recommended for its enhanced performance.
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Affiliation(s)
- Yi Shan
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, #45 Changchunjie, Xicheng District, Beijing, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China
| | - Shao-Zhen Yan
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, #45 Changchunjie, Xicheng District, Beijing, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China
| | - Zhe Wang
- Central Research Institute, United Imaging Healthcare Group, Shanghai, 201807, China
| | - Bi-Xiao Cui
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, #45 Changchunjie, Xicheng District, Beijing, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China
| | - Hong-Wei Yang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, #45 Changchunjie, Xicheng District, Beijing, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China
| | - Jian-Min Yuan
- Central Research Institute, United Imaging Healthcare Group, Shanghai, 201807, China
| | - Ya-Yan Yin
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, #45 Changchunjie, Xicheng District, Beijing, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China
| | - Feng Shi
- Shanghai United Imaging Intelligence Co., Ltd., Shanghai, 200030, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, #45 Changchunjie, Xicheng District, Beijing, 100053, China.
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China.
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Impact of Preexisting Alcohol Use Disorder, Bipolar Disorder, and Schizophrenia on Ischemic Stroke Risk and Severity: A Lebanese Case-Control Study. Healthcare (Basel) 2023; 11:healthcare11040538. [PMID: 36833072 PMCID: PMC9957385 DOI: 10.3390/healthcare11040538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Stroke remains a major leading cause of morbidity and death globally. For ischemic stroke, the most frequent type of stroke, there are numerous risk models and risk assessments offered. Further research into potential risk factors or triggers is being sought to improve stroke risk models. Schizophrenia, bipolar disorder, and alcohol use disorder are all common causes of serious mental illnesses in the general population. Due to the tangled relationship between stroke and many chronic illnesses, lifestyle factors, and diet that may be present in a patient with a mental disease, the relationship between mental diseases and stroke requires further validation. Consequently, the purpose of this study is to assess the potential influence of bipolar disorder, schizophrenia, and alcohol use disorder on stroke patients as compared to non-stroke participants, after controlling for demographic, physical, and medical conditions. We aimed, as a secondary objective, to evaluate the impact of these pre-existing disorders on stroke severity levels. METHODS This research is a case-control survey study involving 113 Lebanese patients with a clinical diagnosis of ischemic stroke and 451 gender-matched volunteers without clinical signs of stroke as controls recruited from several hospitals in Lebanon (April 2020-April 2021). Based on the participant's consent, data was collected by filling out an anonymous paper-based questionnaire. RESULTS All of the odds ratios (ORs) generated by our regression model were greater than 1, indicating that the factors studied were associated with an increased risk of ischemic stroke. As such having schizophrenia (adjusted OR [aOR]: 6.162, 95% confidence interval [CI]: 1.136-33.423), bipolar disorder (aOR: 4.653, 95% CI: 1.214-17.834), alcohol use disorder (aOR: 3.918, 95% CI: 1.584-9.689), atrial fibrillation (aOR: 2.415, 95% CI: 1.235-4.721), diabetes (aOR: 1.865, 95% CI: 1.117-3.115), heart diseases (aOR: 9.890, 95% CI: 5.099-19.184), and asthma-COPD (aOR: 1.971, 95% CI: 1.190-3.263) were all involved with a high risk of developing an ischemic stroke. Moreover, obesity (aOR: 1.732, 95% CI: 1.049-2.861) and vigorous physical activity (aOR: 4.614, 95% CI: 2.669-7.978) were also linked to an increased risk of stroke. Moreover, our multinomial regression model revealed that the odds of moderate to severe/severe stroke were significantly higher in people with pre-stroke alcohol use disorder (aOR: 1.719, 95% CI: 1.385-2.133), bipolar disorder (aOR: 1.656, 95% CI: 1.281-2.141), and schizophrenia (aOR: 6.884, 95% CI: 3.294-11.492) compared to people who had never had a stroke. CONCLUSION The findings in our study suggest that individuals with schizophrenia, bipolar disorder, and alcohol use disorder may be at a higher risk for ischemic stroke and exhibit more severe symptoms. We believe that the first step toward creating beneficial preventative and treatment interventions is determining individuals with schizophrenia, bipolar disorder, or alcohol use disorder, assessing their risk of ischemic stroke, developing more integrated treatments, and closely monitoring the long-term outcome in the event of an ischemic stroke.
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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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Deisenhammer EA, Strasser A, Kemmler G. Reduced ability to discriminate colours - an under-recognised feature of depressive disorders? A pilot study. Int J Psychiatry Clin Pract 2022; 26:321-326. [PMID: 34689697 DOI: 10.1080/13651501.2021.1993263] [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] [Indexed: 10/20/2022]
Abstract
Background: Although in clinical practice an impairment of sensory perception is frequently reported by depressed patients no mention of these symptoms is made in DSM-5, ICD-10 or ICD-11. Previous studies on colour perception have largely relied on patient self-reports and few have studied colour discrimination.Methods: The ability to discriminate small colour differences was assessed in 30 patients currently experiencing a moderate to severe depressive episode (ICD-10: F32.1-2, F33.1-2 or F31.3-4) and 32 healthy controls using the colour buttons of the Farnsworth Munsell 100-Hue test. Data were analysed by standard tests for comparing two groups (t-test, Mann-Whitney U-test, Chi-square test) and by ordinal regression and generalised estimating equation models.Results: Depressed patients failed significantly earlier (i.e., at larger differences between adjacent buttons) to discriminate between colours. This finding was retained after adjustment for potential confounders. There was no significant association with age, gender or depression score.Conclusions: We found a reduction in the ability to discriminate colours in depressed patients. This finding underlines the importance of sensory deficits as part of the symptomatology of depression. Sensory impairments should be taken into account in clinical care of patients with depression and should be included in diagnostic manuals. Further studies in larger samples including intra-individual comparisons between the depressed and the remitted state of patients are needed.Key pointsIn clinical practice, an impairment of sensory perception is frequently reported by depressed patients.However, no mention of these symptoms is made in the commonly used diagnostic manuals.In this pilot study, depressed patients and controls differed significantly in terms of the ability to discriminate colours with patients performing worse than their healthy counterparts.Sensory impairments should be taken into account in clinical care of patients with depression and should be included in diagnostic manuals.
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Affiliation(s)
- Eberhard A Deisenhammer
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University of Innsbruck, Innsbruck, Austria
| | - Anna Strasser
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University of Innsbruck, Innsbruck, Austria
| | - Georg Kemmler
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University of Innsbruck, Innsbruck, Austria
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Visual electrophysiology and neuropsychology in bipolar disorders: a review on current state and perspectives. Neurosci Biobehav Rev 2022; 140:104764. [DOI: 10.1016/j.neubiorev.2022.104764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/21/2022] [Accepted: 07/01/2022] [Indexed: 11/21/2022]
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Kang Y, Kang W, Han KM, Tae WS, Ham BJ. Associations between cognitive impairment and cortical thickness alterations in patients with euthymic and depressive bipolar disorder. Psychiatry Res Neuroimaging 2022; 322:111462. [PMID: 35231679 DOI: 10.1016/j.pscychresns.2022.111462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 10/19/2022]
Affiliation(s)
- Youbin Kang
- 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
| | - Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo-Suk Tae
- Korea University, Brain Convergence Research Center
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
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Zhu Z, Zhao Y, Wen K, Li Q, Pan N, Fu S, Li F, Radua J, Vieta E, Kemp GJ, Biswa BB, Gong Q. Cortical thickness abnormalities in patients with bipolar disorder: A systematic review and meta-analysis. J Affect Disord 2022; 300:209-218. [PMID: 34971699 DOI: 10.1016/j.jad.2021.12.080] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/10/2021] [Accepted: 12/19/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND An increasing number of neuroimaging studies report alterations of cortical thickness (CT) related to the neuropathology of bipolar disorder (BD). We provide here a whole-brain vertex-wise meta-analysis, which may help improve the spatial precision of these identifications. METHODS A comprehensive meta-analysis was performed to investigate the differences in CT between patients with BD and healthy controls (HCs) by using a newly developed mask for CT analysis in seed-based d mapping (SDM) meta-analytic software. We used meta-regression to explore the effects of demographics and clinical characteristics on CT. This meta-review was conducted in accordance with PRISMA guideline. RESULTS We identified 21 studies meeting criteria for the systematic review, of which 11 were eligible for meta-analysis. The meta-analysis comprising 649 BD patients and 818 HCs showed significant cortical thinning in the left insula extending to left Rolandic operculum and Heschl gyrus, the orbital part of left inferior frontal gyrus (IFG), the medial part of left superior frontal gyrus (SFG) as well as bilateral anterior cingulate cortex (ACC) in BD. In meta-regression analyses, mean patient age was negatively correlated with reduced CT in the left insula. LIMITATIONS All enrolled studies were cross-sectional; we could not explore the potential effects of medication and mood states due to the limited data. CONCLUSIONS Our results suggest that BD patients have significantly thinner frontoinsular cortex than HCs, and the results may be helpful in revealing specific neuroimaging biomarkers of BD patients.
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Affiliation(s)
- Ziyu Zhu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Youjin Zhao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan, China
| | - Keren Wen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qian Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shiqin Fu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan, China
| | - Joaquim Radua
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan, China; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain; Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, Northern Ireland United Kingdom
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain; Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Bharat B Biswa
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA; The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China.
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Chen M, Chen G, Tian H, Dou G, Fang T, Cai Z, Cheng L, Chen S, Chen C, Ping J, Lin X, Chen C, Zhu J, Zhao F, Liu C, Yue W, Song X, Zhuo C. Brain Neural Activity Patterns in an Animal Model of Antidepressant-Induced Manic Episodes. Front Behav Neurosci 2022; 15:771975. [PMID: 35250499 PMCID: PMC8889145 DOI: 10.3389/fnbeh.2021.771975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background: In the treatment of patients with bipolar disorder (BP), antidepressant-induced mania is usually observed. The rate of phase switching (from depressive to manic) in these patients exceeds 22%. The exploration of brain activity patterns during an antidepressant-induced manic phase may aid the development of strategies to reduce the phase-switching rate. The use of a murine model to explore brain activity patterns in depressive and manic phases can help us to understandthe pathological features of BP. The novel object recognition preference ratio is used to assess cognitive ability in such models. Objective: To investigate brain Ca2+ activity and behavioral expression in the depressive and manic phases in the same murine model, to aid understanding of brain activity patterns in phase switching in BP. Methods: In vivo two-photon imaging was used to observe brain activity alterations in a murine model in which induce depressive-like and manic-like behaviors were induced sequentially. The immobility time was used to assess depressive-like symptoms and the total distance traveled was used to assess manic-like symptoms. Results: In vivo two-photon imaging revealed significantly reduced brain Ca2+ activity in temporal cortex pyramidal neurons in the depressive phase in mice exposed to chronic unpredictable mild stress compared with naïve controls. The brain Ca2+ activity correlated negatively with the novel object recognition preference ratio within the immobility time. Significantly increased brain Ca2+ activity was observed in the ketamine-induced manic phase. However, this activity did not correlate with the total distance traveled. The novel object recognition preference ratio correlated negatively with the total distance traveled in the manic phase.
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Affiliation(s)
- Min Chen
- Micro-imaging Center of Psychiatric Disorder, Institute of Mental Health, Jining Medical University, Jining, China
| | - Guangdong Chen
- Center of Psychiatric Animal Model, Institute of Mental Health, Wenzhou Seventh Peoples Hospital, Wenzhou, China
- Department of Psychiatry Medical Center, Wenzhou Seventh Peoples Hospital, Wenzhou, China
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Hongjun Tian
- Key Laboratory of Real Time Tracing of Brain Circuits in Psychiatry and Neurology (RTBNP_Lab), Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
| | - Guangqian Dou
- Key Laboratory of Real Time Tracing of Brain Circuits in Psychiatry and Neurology (RTBNP_Lab), Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
| | - Tao Fang
- Key Laboratory of Real Time Tracing of Brain Circuits in Psychiatry and Neurology (RTBNP_Lab), Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
| | - Ziyao Cai
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Langlang Cheng
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Suling Chen
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Ce Chen
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Jing Ping
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Xiaodong Lin
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Chunmian Chen
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Jingjing Zhu
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Feifei Zhao
- Department of Clinical Laboratory, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Chuanxin Liu
- Micro-imaging Center of Psychiatric Disorder, Institute of Mental Health, Jining Medical University, Jining, China
| | - Weihua Yue
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- *Correspondence: Chuanjun Zhuo Weihua Yue Xueqin Song
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Chuanjun Zhuo Weihua Yue Xueqin Song
| | - Chuanjun Zhuo
- Key Laboratory of Real Time Tracing of Brain Circuits in Psychiatry and Neurology (RTBNP_Lab), Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Chuanjun Zhuo Weihua Yue Xueqin Song
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11
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Digiovanni A, Ajdinaj P, Russo M, Sensi SL, Onofrj M, Thomas A. Bipolar spectrum disorders in neurologic disorders. Front Psychiatry 2022; 13:1046471. [PMID: 36620667 PMCID: PMC9811836 DOI: 10.3389/fpsyt.2022.1046471] [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: 09/16/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Psychiatric symptoms frequently predate or complicate neurological disorders, such as neurodegenerative diseases. Symptoms of bipolar spectrum disorders (BSD), like mood, behavioral, and psychotic alterations, are known to occur - individually or as a syndromic cluster - in Parkinson's disease and in the behavioral variant of frontotemporal dementia (FTD). Nonetheless, due to shared pathophysiological mechanisms, or genetic predisposition, several other neurological disorders show significant, yet neglected, clinical and biological overlaps with BSD like neuroinflammation, ion channel dysfunctions, neurotransmission imbalance, or neurodegeneration. BSD pathophysiology is still largely unclear, but large-scale network dysfunctions are known to participate in the onset of mood disorders and psychotic symptoms. Thus, functional alterations can unleash BSD symptoms years before the evidence of an organic disease of the central nervous system. The aim of our narrative review was to illustrate the numerous intersections between BSD and neurological disorders from a clinical-biological point of view and the underlying predisposing factors, to guide future diagnostic and therapeutical research in the field.
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Affiliation(s)
- Anna Digiovanni
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Paola Ajdinaj
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Astrid Thomas
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
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12
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OUP accepted manuscript. Cereb Cortex 2022; 32:4386-4396. [DOI: 10.1093/cercor/bhab490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/15/2022] Open
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13
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Calcium imaging reveals depressive- and manic-phase-specific brain neural activity patterns in a murine model of bipolar disorder: a pilot study. Transl Psychiatry 2021; 11:619. [PMID: 34876553 PMCID: PMC8651770 DOI: 10.1038/s41398-021-01750-8] [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: 09/01/2021] [Revised: 11/18/2021] [Accepted: 11/29/2021] [Indexed: 12/25/2022] Open
Abstract
Brain pathological features during manic/hypomanic and depressive episodes in the same patients with bipolar disorder (BPD) have not been described precisely. The study aimed to investigate depressive and manic-phase-specific brain neural activity patterns of BPD in the same murine model to provide information guiding investigation of the mechanism of phase switching and tailored prevention and treatment for patients with BPD. In vivo two-photon imaging was used to observe brain activity alterations in the depressive and manic phases in the same murine model of BPD. Two-photon imaging showed significantly reduced Ca2+ activity in temporal cortex pyramidal neurons in the depression phase in mice exposed to chronic unpredictable mild stress (CUMS), but not in the manic phase in mice exposed to CUMS and ketamine. Total integrated calcium values correlated significantly with immobility times. Brain Ca2+ hypoactivity was observed in the depression and manic phases in the same mice exposed to CUMS and ketamine relative to naïve controls. The novel object recognition preference ratio correlated negatively with the immobility time in the depression phase and the total distance traveled in the manic phase. With recognition of its limitations, this study revealed brain neural activity impairment indicating that intrinsic emotional network disturbance is a mechanism of BPD and that brain neural activity is associated with cognitive impairment in the depressive and manic phases of this disorder. These findings are consistent with those from macro-imaging studies of patients with BPD. The observed correlation of brain neural activity with the severity of depressive, but not manic, symptoms need to be investigated further.
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14
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Woo Y, Kang W, Kang Y, Kim A, Han KM, Tae WS, Ham BJ. Cortical Thickness and Surface Area Abnormalities in Bipolar I and II Disorders. Psychiatry Investig 2021; 18:850-863. [PMID: 34500506 PMCID: PMC8473857 DOI: 10.30773/pi.2021.0074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/11/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Although bipolar II disorder (BD II) is not simply a mitigated form of bipolar I disorder (BD I), their neurobiological differences have not been elucidated. The present study aimed to explore cortical thickness (CT) and surface area (SA) in patients with BD I and BD II and healthy controls (HCs) to investigate the shared and unique neurobiological mechanisms of BD subtypes. METHODS We enrolled 30 and 44 patients with BD I and BD II, respectively, and 100 HCs. We evaluated CT and SA using FreeSurfer and estimated differences in CT and SA among the three groups (BD I vs. BD II vs. HC). We adjusted for age, sex, educational level, and intracranial volume as confounding factors. RESULTS We found widespread cortical thinning in the bilateral frontal, temporal, and occipital regions; cingulate gyrus; and insula in patients with BD. Alterations in SA, including increased SA of the pars triangularis and decreased SA of the insula, were noted in patients with BD. Overall, we found BD II patients demonstrated decreased SA in the right long insula compared to BD I patients. CONCLUSION Our results suggest that decreased SA in the right long insula is crucial for differentiating BD subtypes.
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Affiliation(s)
- Yoonmi Woo
- Department of Psychiatry, Korea University Anam Hospital, 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
| | - Aram Kim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyu-Man Han
- 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
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15
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Ochoa ELM. Lithium as a Neuroprotective Agent for Bipolar Disorder: An Overview. Cell Mol Neurobiol 2021; 42:85-97. [PMID: 34357564 DOI: 10.1007/s10571-021-01129-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/14/2021] [Indexed: 11/28/2022]
Abstract
Lithium (Li+) is a first option treatment for adult acute episodes of Bipolar Disorder (BD) and for the prophylaxis of new depressed or manic episodes. It is also the preferred choice as maintenance treatment. Numerous studies have shown morphological abnormalities in the brains of BD patients, suggesting that this highly heritable disorder may exhibit progressive and deleterious changes in brain structure. Since treatment with Li+ ameliorates these abnormalities, it has been postulated that Li+ is a neuroprotective agent in the same way atypical antipsychotics are neuroprotective in patients diagnosed with schizophrenia spectrum disorders. Li+'s neuroprotective properties are related to its modulation of nerve growth factors, inflammation, mitochondrial function, oxidative stress, and programmed cell death mechanisms such as autophagy and apoptosis. Notwithstanding, it is not known whether Li+-induced neuroprotection is related to the inhibition of its putative molecular targets in a BD episode: the enzymes inositol-monophosphatase, (IMPase), glycogen-synthase-kinase 3β (GSK3), and Protein kinase C (PKC). Furthermore, it is uncertain whether these neuroprotective mechanisms are correlated with Li+'s clinical efficacy in maintaining mood stability. It is expected that in a nearby future, precision medicine approaches will improve diagnosis and expand treatment options. This will certainly contribute to ameliorating the medical and economic burden created by this devastating mood disorder.
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Affiliation(s)
- Enrique L M Ochoa
- Department of Psychiatry and Behavioral Sciences, Volunteer Clinical Faculty, University of California at Davis, 2230 Stockton Boulevard, Sacramento, CA, 95817, USA.
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16
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Lu F, Cui Q, He Z, Tang Q, Chen Y, Sheng W, Yang Y, Luo W, Yu Y, Chen J, Li D, Deng J, Hu S, Chen H. Superficial white-matter functional networks changes in bipolar disorder patients during depressive episodes. J Affect Disord 2021; 289:151-159. [PMID: 33984685 DOI: 10.1016/j.jad.2021.04.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/01/2021] [Accepted: 04/20/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Bipolar disorder is a common psychiatric disorder characterized by insufficient or ineffective connections associated with white-matter (WM) abnormalities. Previous studies have detected the structural attributes of WM using magnetic resonance imaging (MRI) or diffusion tensor imaging, however, they failed to disentangle the dysfunctional organization within the WM. METHODS This study aimed to uncover the WM functional connectivity (FC) in 45 bipolar disorder patients during depressive episodes (BDD) and 45 healthy controls based on resting-state functional MRI. Eight WM functional networks were identified by using a clustering analysis of voxel-based correlation profiles, which were further classified into superficial, middle and deep layers of networks. RESULTS Group comparisons on the FCs among 8 WM networks showed that the superficial tempofrontal network (TFN) in BDD patients had increased FC with the superficial cerebellar network (CN) and with the superficial pre/post-central network (PCN). Further, support vector regression prediction analysis results revealed that the increased FCs of CN-TFN and PCN-TFN could be served as features to predict the numbers of depressive episode in BDD patients. CONCLUSIONS The current study extended our knowledge about the impaired WM functional connections associated with emotional and sensory-motor perception processing in BDD, which may facilitate the interpretation of the pathophysiology mechanisms underlying BDD.
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Affiliation(s)
- Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Qian Cui
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China.
| | - Zongling He
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Qin Tang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Yuyan Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Yang Yang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Wei Luo
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Yue Yu
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Jiajia Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Di Li
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China
| | - Jiaxin Deng
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Shan Hu
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P R China; MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 610054, P R China.
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17
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Guglielmo R, Miskowiak KW, Hasler G. Evaluating endophenotypes for bipolar disorder. Int J Bipolar Disord 2021; 9:17. [PMID: 34046710 PMCID: PMC8160068 DOI: 10.1186/s40345-021-00220-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Phenotypic heterogeneity is a major impediment to the elucidation of the neurobiology and genetics of bipolar disorder. Endophenotype could help in reducing heterogeneity by defining biological traits that are more direct expressions of gene effects. The aim of this review is to examine the recent literature on clinical, epidemiological, neurobiological, and genetic findings and to select and evaluate candidate endophenotypes for bipolar disorder. Evaluating putative endophenotype could be helpful in better understanding the neurobiology of bipolar disorder by improving the definition of bipolar-related phenotypes in genetic studies. In this manner, research on endophenotypes could be useful to improve psychopathological diagnostics in the long-run by dissecting psychiatric macro phenotypes into biologically valid components. MAIN BODY The associations among the psychopathological and biological endophenotypes are discussed with respect to specificity, temporal stability, heritability, familiarity, and clinical and biological plausibility. Numerous findings regarding brain function, brain structure, neuropsychology and altered neurochemical pathways in patients with bipolar disorder and their relatives deserve further investigation. Overall, major findings suggest a developmental origin of this disorder as all the candidate endophenotypes that we have been able to select are present both in the early stages of the disorder as well as in subjects at risk. CONCLUSIONS Among the stronger candidate endophenotypes, we suggest circadian rhythm instability, dysmodulation of emotion and reward, altered neuroimmune state, attention and executive dysfunctions, anterior cingulate cortex thickness and early white matter abnormalities. In particular, early white matter abnormalities could be the result of a vulnerable brain on which new stressors are added in young adulthood which favours the onset of the disorder. Possible pathways that lead to a vulnerable brain are discussed starting from the data about molecular and imaging endophenotypes of bipolar disorder.
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Affiliation(s)
- Riccardo Guglielmo
- Psychiatry Research Unit, Fribourg Network for Mental Health (RFSM), University of Fribourg, Chemin du Cardinal-Journet 3, 1752, Villars-sur-Glâne, Switzerland.,Department of Neuroscience, Institute of Psychiatry, Catholic University Medical School, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Gregor Hasler
- Psychiatry Research Unit, Fribourg Network for Mental Health (RFSM), University of Fribourg, Chemin du Cardinal-Journet 3, 1752, Villars-sur-Glâne, Switzerland.
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18
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Garcia-Ruiz B, de Moura MC, Muntané G, Martorell L, Bosch E, Esteller M, J Canales-Rodríguez E, Pomarol-Clotet E, Jiménez E, Vieta E, Vilella E. DDR1 methylation is associated with bipolar disorder and the isoform expression and methylation of myelin genes. Epigenomics 2021; 13:845-858. [PMID: 33942629 DOI: 10.2217/epi-2021-0006] [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] [Indexed: 11/21/2022] Open
Abstract
Aim: To investigate DDR1 methylation in the brains of bipolar disorder (BD) patients and its association with DDR1 mRNA levels and comethylation with myelin genes. Materials & methods: Genome-wide profiling of DNA methylation (Infinium MethylationEPIC BeadChip) corrected for glial composition and DDR1 gene expression analysis in the occipital cortices of individuals with BD (n = 15) and healthy controls (n = 15) were conducted. Results: DDR1 5-methylcytosine levels were increased and directly associated with DDR1b mRNA expression in the brains of BD patients. We also observed that DDR1 was comethylated with a group of myelin genes. Conclusion: DDR1 is hypermethylated in BD brain tissue and is associated with isoform expression. Additionally, DDR1 comethylation with myelin genes supports the role of this receptor in myelination.
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Affiliation(s)
- Beatriz Garcia-Ruiz
- Hospital Universitari Institut Pere Mata, Ctra. de l'Institut Pere Mata, s/n. 43206, Reus, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Visgili (IISPV), C/ Dr. Mallafrè Guasch, 4 Edifici modular Hospital Universitari de Tarragona Joan XXIII. 43007, Tarragona, Catalonia, Spain.,Universitat Rovira i Virgili (URV), Facultat de Medicina i Ciències de la Salut, Departament de Psiquiatria, C/Sant Llorenç, 21. 43201, Reus, Catalonia, Spain
| | - Manuel Castro de Moura
- Josep Carreras Leukaemia Research Institute (IJC), Josep Carreras Building, Ctra de Can Ruti, Camí de les Escoles, 08916, Badalona, Barcelona, Catalonia, Spain
| | - Gerard Muntané
- Hospital Universitari Institut Pere Mata, Ctra. de l'Institut Pere Mata, s/n. 43206, Reus, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Visgili (IISPV), C/ Dr. Mallafrè Guasch, 4 Edifici modular Hospital Universitari de Tarragona Joan XXIII. 43007, Tarragona, Catalonia, Spain.,Universitat Rovira i Virgili (URV), Facultat de Medicina i Ciències de la Salut, Departament de Psiquiatria, C/Sant Llorenç, 21. 43201, Reus, Catalonia, Spain.,Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), C/Melchor Fernández Almagro, 3. 28029, Madrid, Spain.,Departament de Ciències Experimentals i de la Salut, Institut de Biologia Evolutiva (UPF-CSIC), Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona (PRBB), C/Dr. Aiguader, 88, 08003, Barcelona, Catalonia, Spain
| | - Lourdes Martorell
- Hospital Universitari Institut Pere Mata, Ctra. de l'Institut Pere Mata, s/n. 43206, Reus, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Visgili (IISPV), C/ Dr. Mallafrè Guasch, 4 Edifici modular Hospital Universitari de Tarragona Joan XXIII. 43007, Tarragona, Catalonia, Spain.,Universitat Rovira i Virgili (URV), Facultat de Medicina i Ciències de la Salut, Departament de Psiquiatria, C/Sant Llorenç, 21. 43201, Reus, Catalonia, Spain.,Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), C/Melchor Fernández Almagro, 3. 28029, Madrid, Spain
| | - Elena Bosch
- Departament de Ciències Experimentals i de la Salut, Institut de Biologia Evolutiva (UPF-CSIC), Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona (PRBB), C/Dr. Aiguader, 88, 08003, Barcelona, Catalonia, Spain
| | - Manel Esteller
- Josep Carreras Leukaemia Research Institute (IJC), Josep Carreras Building, Ctra de Can Ruti, Camí de les Escoles, 08916, Badalona, Barcelona, Catalonia, Spain.,Centro de Investigación Biomédica en Red Cáncer (CIBERONC), C/Melchor Fernández Almagro, 3. 28029, Madrid, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Passeig de Lluís Companys, 23. 08010, Barcelona, Catalonia, Spain.,Physiological Sciences Department, School of Medicine & Health Sciences, University of Barcelona (UB), Feixa Llarga, 08907, l'Hospitalet de Llobregat, Barcelona, Catalonia, Spain
| | - Erick J Canales-Rodríguez
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), C/Melchor Fernández Almagro, 3. 28029, Madrid, Spain.,FIDMAG Research Foundation, Germanes Hospitalàries, Av. Jordà, 8. 08035, Barcelona, Catalonia, Spain.,Signal Processing Laboratory (LTS5), École Polytechnique Fédérale de Lausanne (EPFL), Station 11. CH-1015, Lausanne, Switzerland
| | - Edith Pomarol-Clotet
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), C/Melchor Fernández Almagro, 3. 28029, Madrid, Spain.,FIDMAG Research Foundation, Germanes Hospitalàries, Av. Jordà, 8. 08035, Barcelona, Catalonia, Spain
| | - Esther Jiménez
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), C/Melchor Fernández Almagro, 3. 28029, Madrid, Spain.,Bipolar & Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Villarroel, 170, 12-0. 08036, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), C/Melchor Fernández Almagro, 3. 28029, Madrid, Spain.,Bipolar & Depressive Disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Villarroel, 170, 12-0. 08036, Barcelona, Catalonia, Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata, Ctra. de l'Institut Pere Mata, s/n. 43206, Reus, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Visgili (IISPV), C/ Dr. Mallafrè Guasch, 4 Edifici modular Hospital Universitari de Tarragona Joan XXIII. 43007, Tarragona, Catalonia, Spain.,Universitat Rovira i Virgili (URV), Facultat de Medicina i Ciències de la Salut, Departament de Psiquiatria, C/Sant Llorenç, 21. 43201, Reus, Catalonia, Spain.,Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), C/Melchor Fernández Almagro, 3. 28029, Madrid, Spain
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19
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Grey and white matter alteration in euthymic children with bipolar disorder: a combined source-based morphometry (SBM) and voxel-based morphometry (VBM) study. Brain Imaging Behav 2021; 16:22-30. [PMID: 33846953 DOI: 10.1007/s11682-021-00473-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/18/2021] [Indexed: 01/01/2023]
Abstract
Bipolar disorder (BPD) is a psychiatric condition driving frequent mood swings between periodic extremes of happiness and depression in patients. In this study, a source-based morphometry (SBM) and voxel-based morphometry (VBM) analysis was utilized to measure the differences in the white matter (WM) and grey matter (GM) between euthymic children with BPD and typically developing (TD) children. We adapted both multivariate (SBM) and univariate (VBM) analysis in 20 children with BPD euthymia /remission and compared to the same number of TD age-matched children. The VBM did not reveal any increase in GM and WM voxel values in children with BPD. However, a decrease in the GM voxel values in the bilateral middle frontal and WM voxels in the left hippocampus, left caudate, left orbitofrontal and right inferior parietal cortices was identified. Conversely, SBM analysis in BPD displayed a high GM value in bilateral angular gyrus, bilateral inferior temporal, left supplementary motor area and left middle temporal region, while a low value was observed in left inferior and middle occipital, cerebellum, thalamus, left premotor area and left lingual gyrus. These findings suggested a crucial GM and WM alteration in multiple neural regions in BPD children even during sustained and substantial remission.
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20
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Lapomarda G, Pappaianni E, Siugzdaite R, Sanfey AG, Rumiati RI, Grecucci A. Out of control: An altered parieto-occipital-cerebellar network for impulsivity in bipolar disorder. Behav Brain Res 2021; 406:113228. [PMID: 33684426 DOI: 10.1016/j.bbr.2021.113228] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 01/28/2021] [Accepted: 03/01/2021] [Indexed: 12/21/2022]
Abstract
Bipolar disorder is an affective disorder characterized by rapid fluctuations in mood ranging from episodes of depression to mania, as well as by increased impulsivity. Previous studies investigated the neural substrates of bipolar disorder mainly using univariate methods, with a particular focus on the neural circuitry underlying emotion regulation difficulties. In the present study, capitalizing on an innovative whole-brain multivariate method to structural analysis known as Source-based Morphometry, we investigated the neural substrates of bipolar disorder and their relation with impulsivity, assessed with both self-report measures and performance-based tasks. Structural images from 46 patients with diagnosis of bipolar disorder and 60 healthy controls were analysed. Compared to healthy controls, patients showed decreased gray matter concentration in a parietal-occipital-cerebellar network. Notably, the lower the gray matter concentration in this circuit, the higher the self-reported impulsivity. In conclusion, we provided new evidence of an altered brain network in bipolar disorder patients related to their abnormal impulsivity. Taken together, these findings extend our understanding of the neural and symptomatic characterization of bipolar disorder.
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Affiliation(s)
- Gaia Lapomarda
- Clinical and Affective Neuroscience Lab, Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy.
| | - Edoardo Pappaianni
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Roma Siugzdaite
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Alan G Sanfey
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Raffaella I Rumiati
- Scuola Internazionale Superiore di Studi Avanzati (SISSA), University of Trieste, Trieste, Italy
| | - Alessandro Grecucci
- Clinical and Affective Neuroscience Lab, Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
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21
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Zeng V, Lizano P, Bolo NR, Lutz O, Brady R, Ivleva EI, Dai W, Clementz B, Tamminga C, Pearlson G, Keshavan M. Altered cerebral perfusion in bipolar disorder: A pCASL MRI study. Bipolar Disord 2021; 23:130-140. [PMID: 32583570 DOI: 10.1111/bdi.12966] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neurovascular abnormalities are relevant to the pathophysiology of bipolar disorder (BD), which can be assessed using cerebral blood flow (CBF) imaging. CBF alterations have been identified in BD, but studies to date have been small and inconclusive. We aimed to determine cortical gray matter CBF (GM-CBF) differences between BD and healthy controls (HC) and to identify relationships between CBF and clinical or cognitive measures. METHODS Cortical GM-CBF maps were generated using Pseudo-Continuous Arterial Spin Labeling (pCASL) for 109 participants (BD, n = 61; HC, n = 48). We used SnPM13 to perform non-parametric voxel-wise two-sample t-tests comparing CBF between groups. We performed multiple linear regression to relate GM-CBF with clinical and cognitive measures. Analysis was adjusted for multiple comparisons with 10,000 permutations. Significance was set at a voxel level threshold of P < .001 followed by AlphaSim cluster-wise correction of P < .05. RESULTS Compared to HCs, BD patients had greater GM-CBF in the left lateral occipital cortex, superior division and lower CBF in the right lateral occipital, angular and middle temporal gyrus. Greater GM-CBF in the left lateral occipital cortex correlated with worse working memory, verbal memory, attention and speed of processing. We found using voxel-wise regression that decreased gray matter CBF in the bilateral thalamus and cerebellum, and increased right fronto-limbic CBF were associated with worse working memory. No clusters were associated with clinical variables after FDR correction. CONCLUSIONS Cortical GM-CBF alterations are seen in BD and may be related to cognitive function, which suggest neurovascular unit dysfunction as a possible pathophysiologic mechanism.
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Affiliation(s)
- Victor Zeng
- Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Paulo Lizano
- Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Nicolas R Bolo
- Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Olivia Lutz
- Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Roscoe Brady
- Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | | | | | | | | | - Matcheri Keshavan
- Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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22
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Scaini G, Andrews T, Lima CNC, Benevenuto D, Streck EL, Quevedo J. Mitochondrial dysfunction as a critical event in the pathophysiology of bipolar disorder. Mitochondrion 2021; 57:23-36. [PMID: 33340709 PMCID: PMC10494232 DOI: 10.1016/j.mito.2020.12.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/18/2020] [Accepted: 12/10/2020] [Indexed: 01/02/2023]
Abstract
The understanding of the pathophysiology of bipolar disorder (BD) remains modest, despite recent advances in neurobiological research. The mitochondrial dysfunction hypothesis of bipolar disorder has been corroborated by several studies involving postmortem brain analysis, neuroimaging, and specific biomarkers in both rodent models and humans. Evidence suggests that BD might be related to abnormal mitochondrial morphology and dynamics, neuroimmune dysfunction, and atypical mitochondrial metabolism and oxidative stress pathways. Mitochondrial dysfunction in mood disorders is also associated with abnormal Ca2+ levels, glutamate excitotoxicity, an imbalance between pro- and antiapoptotic proteins towards apoptosis, abnormal gene expression of electron transport chain complexes, and decreased ATP synthesis. This paper aims to review and discuss the implications of mitochondrial dysfunction in BD etiology and to explore mitochondria as a potential target for novel therapeutic agents.
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Affiliation(s)
- Giselli Scaini
- Translational Psychiatry Program, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, TX, USA
| | - Taylor Andrews
- Translational Psychiatry Program, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, TX, USA
| | - Camila N C Lima
- Translational Psychiatry Program, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, TX, USA
| | - Deborah Benevenuto
- Translational Psychiatry Program, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, TX, USA
| | - Emilio L Streck
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - João Quevedo
- Translational Psychiatry Program, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, TX, USA; Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil; Center of Excellence on Mood Disorders, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UT Health), Houston, TX, USA; Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UT Health Graduate School of Biomedical Sciences, Houston, TX, USA.
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23
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Keramatian K, Su W, Saraf G, Chakrabarty T, Yatham LN. Preservation of Gray Matter Volume in Early Stage of Bipolar Disorder: A Case for Early Intervention: Préservation du volume de matière grise au stade précoce du trouble bipolaire: un cas pour intervention précoce. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:139-146. [PMID: 32419481 PMCID: PMC7918870 DOI: 10.1177/0706743720927827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE It has been proposed that different stages of the bipolar disorder might have distinct neurobiological changes. However, the evidence for this has not been consistent, as the studies in early stages of the illness are limited by small sample sizes. The purpose of this study was to investigate the gray matter volume changes in bipolar patients who recently recovered from their first episode of mania (FEM). METHODS Using a whole-brain voxel-based analysis, we compared the regional gray matter volumes of 61 bipolar patients who have recovered from their FEM in the past 3 months with 43 age- and gender-matched healthy participants. We also performed a series of subgroup analyses to determine the effects of hospitalization during the FEM, history of depressive episodes, and exposure to lithium. RESULTS No statistically significant difference was found between gray matter volumes of FEM patients and healthy participants, even at a more liberal threshold (P < 0.001, uncorrected for multiple comparisons). Voxel-based subgroup analyses did not reveal significant gray matter differences except for a trend toward decreased gray matter volume in left lateral occipital cortex (P < 0.001, uncorrected) in patients with a previous history of depression. CONCLUSION This study represents the largest structural neuroimaging investigation of FEM published to date. Early stage of bipolar disorder was not found to be associated with significant gray matter volume changes. Our findings suggest that there might be a window of opportunity for early intervention strategies to prevent or delay neuroprogression in bipolar disorder.
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Affiliation(s)
- Kamyar Keramatian
- Department of Psychiatry, 8166University of British Columbia, Vancouver, British Columbia, Canada
| | - Wayne Su
- Department of Psychiatry, 8166University of British Columbia, Vancouver, British Columbia, Canada
| | - Gayatri Saraf
- Department of Psychiatry, 8166University of British Columbia, Vancouver, British Columbia, Canada
| | - Trisha Chakrabarty
- Department of Psychiatry, 8166University of British Columbia, Vancouver, British Columbia, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, 8166University of British Columbia, Vancouver, British Columbia, Canada
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24
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Brain areas associated with resilience to depression in high-risk young women. Brain Struct Funct 2021; 226:875-888. [PMID: 33458784 DOI: 10.1007/s00429-021-02215-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
Previous structural brain-imaging studies in first-degree relatives of depressed patients showed alterations that are generally accepted as vulnerability markers for depression. However, only half of the relatives had depression at follow-up, while the other half did not. The aim of this study was to identify the brain areas associated with resilience to depression in high-risk subjects with familial depression. We recruited 59 young women with a history of depressed mothers. Twenty-nine of them (high-risk group [HRG]) had no depression history, while 30 (depressive group) had at least 1 depressive episode in adolescence. The brain structures of the groups were compared through voxel-based morphometry and analysis of cortical thickness. Individual amygdala nuclei and hippocampal subfield volumes were measured. The analysis showed larger amygdala volume, thicker subcallosal cortex and bilateral insula in the women in the HRG compared with those in the depressive group. In addition, we detected more gray matter in the left temporal pole in the HRG. The larger gray matter volume and increased cortical thickness in the key hub regions of the salience network (amygdala and insula) and structurally connected regions in the limbic network (subcallosal area and temporal pole) might prevent women in the HRG from converting to depression.
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25
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Wang J, Liu P, Zhang A, Yang C, Liu S, Wang J, Xu Y, Sun N. Specific Gray Matter Volume Changes of the Brain in Unipolar and Bipolar Depression. Front Hum Neurosci 2021; 14:592419. [PMID: 33505257 PMCID: PMC7829967 DOI: 10.3389/fnhum.2020.592419] [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] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/08/2020] [Indexed: 01/10/2023] Open
Abstract
To identify the common and specific structural basis of bipolar depression (BD) and unipolar depression (UD) is crucial for clinical diagnosis. In this study, a total of 85 participants, including 22 BD patients, 36 UD patients, and 27 healthy controls, were enrolled. A voxel-based morphology method was used to identify the common and specific changes of the gray matter volume (GMV) to determine the structural basis. Significant differences in GMV were found among the three groups. Compared with healthy controls, UD patients showed decreased GMV in the orbital part of the left inferior frontal gyrus, whereas BD patients showed decreased GMV in the orbital part of the left middle frontal gyrus. Compared with BD, UD patients have increased GMV in the left supramarginal gyrus and middle temporal gyrus. Our results revealed different structural changes in UD and BD patients suggesting BD and UD have different neurophysiological underpinnings. Our study contributes toward the biological determination of morphometric changes, which could help to discriminate between UD and BD.
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Affiliation(s)
- Junyan Wang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China.,Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Penghong Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Aixia Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Chunxia Yang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Sha Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jizhi Wang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yong Xu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China.,Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China.,Department of Mental Health, Shanxi Medical University, Taiyuan, China
| | - Ning Sun
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China.,Department of Mental Health, Shanxi Medical University, Taiyuan, China
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26
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Yoon S, Kim TD, Kim J, Lyoo IK. Altered functional activity in bipolar disorder: A comprehensive review from a large-scale network perspective. Brain Behav 2021; 11:e01953. [PMID: 33210461 PMCID: PMC7821558 DOI: 10.1002/brb3.1953] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/08/2020] [Accepted: 10/25/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Growing literature continues to identify brain regions that are functionally altered in bipolar disorder. However, precise functional network correlates of bipolar disorder have yet to be determined due to inconsistent results. The overview of neurological alterations from a large-scale network perspective may provide more comprehensive results and elucidate the neuropathology of bipolar disorder. Here, we critically review recent neuroimaging research on bipolar disorder using a network-based approach. METHODS A systematic search was conducted on studies published from 2009 through 2019 in PubMed and Google Scholar. Articles that utilized functional magnetic resonance imaging technique to examine altered functional activity of major regions belonging to a large-scale brain network in bipolar disorder were selected. RESULTS A total of 49 studies were reviewed. Within-network hypoconnectivity was reported in bipolar disorder at rest among the default mode, salience, and central executive networks. In contrast, when performing a cognitive task, hyperconnectivity among the central executive network was found. Internetwork functional connectivity in the brain of bipolar disorder was greater between the salience and default mode networks, while reduced between the salience and central executive networks at rest, compared to control. CONCLUSION This systematic review suggests disruption in the functional activity of large-scale brain networks at rest as well as during a task stimuli in bipolar disorder. Disrupted intra- and internetwork functional connectivity that are also associated with clinical symptoms suggest altered functional connectivity of and between large-scale networks plays an important role in the pathophysiology of bipolar disorder.
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Affiliation(s)
- Sujung Yoon
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea
| | - Tammy D Kim
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea
| | - Jungyoon Kim
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha W. University, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea.,Graduate School of Pharmaceutical Sciences, Ewha W. University, Seoul, South Korea.,The Brain Institute and Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
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27
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Roes MM, Yin J, Taylor L, Metzak PD, Lavigne KM, Chinchani A, Tipper CM, Woodward TS. Hallucination-Specific structure-function associations in schizophrenia. Psychiatry Res Neuroimaging 2020; 305:111171. [PMID: 32916453 DOI: 10.1016/j.pscychresns.2020.111171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 08/15/2020] [Accepted: 08/19/2020] [Indexed: 01/13/2023]
Abstract
Combining structural (sMRI) and functional magnetic resonance imaging (fMRI) data in schizophrenia patients with and without auditory hallucinations (9 SZ_AVH, 12 SZ_nAVH), 18 patients with bipolar disorder, and 22 healthy controls, we examined whether cortical thinning was associated with abnormal activity in functional brain networks associated with auditory hallucinations. Language-task fMRI data were combined with mean cortical thickness values from 148 brain regions in a constrained principal component analysis (CPCA) to identify brain structure-function associations predictable from group differences. Two components emerged from the multimodal analysis. The "AVH component" highlighted an association of frontotemporal and cingulate thinning with altered brain activity characteristic of hallucinations among patients with AVH. In contrast, the "Bipolar component" distinguished bipolar patients from healthy controls and linked increased activity in the language network with cortical thinning in the left occipital-temporal lobe. Our findings add to a body of evidence of the biological underpinnings of hallucinations and illustrate a method for multimodal data analysis of structure-function associations in psychiatric illness.
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Affiliation(s)
- Meighen M Roes
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada; BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, BC, Canada
| | - John Yin
- BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Laura Taylor
- BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Paul D Metzak
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Katie M Lavigne
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Abhijit Chinchani
- BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Christine M Tipper
- BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Todd S Woodward
- BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
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28
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Scaini G, Valvassori SS, Diaz AP, Lima CN, Benevenuto D, Fries GR, Quevedo J. Neurobiology of bipolar disorders: a review of genetic components, signaling pathways, biochemical changes, and neuroimaging findings. ACTA ACUST UNITED AC 2020; 42:536-551. [PMID: 32267339 PMCID: PMC7524405 DOI: 10.1590/1516-4446-2019-0732] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/27/2019] [Indexed: 01/10/2023]
Abstract
Bipolar disorder (BD) is a chronic mental illness characterized by changes in mood that alternate between mania and hypomania or between depression and mixed states, often associated with functional impairment. Although effective pharmacological and non-pharmacological treatments are available, several patients with BD remain symptomatic. The advance in the understanding of the neurobiology underlying BD could help in the identification of new therapeutic targets as well as biomarkers for early detection, prognosis, and response to treatment in BD. In this review, we discuss genetic, epigenetic, molecular, physiological and neuroimaging findings associated with the neurobiology of BD. Despite the advances in the pathophysiological knowledge of BD, the diagnosis and management of the disease are still essentially clinical. Given the complexity of the brain and the close relationship between environmental exposure and brain function, initiatives that incorporate genetic, epigenetic, molecular, physiological, clinical, environmental data, and brain imaging are necessary to produce information that can be translated into prevention and better outcomes for patients with BD.
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Affiliation(s)
- Giselli Scaini
- Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Samira S Valvassori
- Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - Alexandre P Diaz
- Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Center of Excellence on Mood Disorders Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, UTHealth, Houston, TX, USA
| | - Camila N Lima
- Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Deborah Benevenuto
- Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Gabriel R Fries
- Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Center for Precision Health, School of Biomedical Informatics, UTHealth, Houston, TX, USA.,Neuroscience Graduate Program, Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center, UTHealth, Houston, TX, USA
| | - Joao Quevedo
- Translational Psychiatry Program Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil.,Center of Excellence on Mood Disorders Louis A. Faillace, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, UTHealth, Houston, TX, USA.,Neuroscience Graduate Program, Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center, UTHealth, Houston, TX, USA
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29
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Chen P, Chen F, Chen G, Zhong S, Gong J, Zhong H, Ye T, Tang G, Wang J, Luo Z, Qi Z, Jia Y, Yang H, Yin Z, Huang L, Wang Y. Inflammation is associated with decreased functional connectivity of insula in unmedicated bipolar disorder. Brain Behav Immun 2020; 89:615-622. [PMID: 32688026 DOI: 10.1016/j.bbi.2020.07.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/17/2020] [Accepted: 07/08/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Systemic inflammation and immune dysregulation have been considered as risk factors in the pathophysiology of mood disorders including bipolar disorder (BD). Previous neuroimaging studies have demonstrated metabolic, structural and functional abnormalities in the insula in BD, proposed that the insula played an important role in BD. We herein aimed to explore neural mechanisms underlying inflammation-induced in the insular subregions functional connectivity (FC) in patients with BD. METHODS Brain resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from 41 patients with unmedicated BD II (current episode depressed), 68 healthy controls (HCs). Three pairs of insular seed regions were selected: the bilateral anterior insula (AI), the bilateral middle insula (MI) and the bilateral posterior insula (PI), and calculated the whole-brain FC for each subregion. Additionally, the serum levels of pro-inflammatory cytokines in patients and HCs, including IL-6 and TNF-α, were detected. Then the partial correlation coefficients between the abnormal insular subregions FC values and pro-inflammatory cytokines levels in patients with BD II depression were calculated. RESULTS The BD II depression group exhibited decreased FC between the right PI and the left postcentral gyrus, and increased FC between the left AI and the bilateral insula (extended to the right putamen) when compared with the HC group. Moreover, the patients with BD II depression showed higher IL-6 and TNF-α levels than HCs, and IL-6 level was negatively correlated with FC of the right PI to the left postcentral gyrus. CONCLUSIONS Our results demonstrated that abnormal FC between the bilateral insula, and between the insula and sensorimotor areas in BD. Moreover, disrupted FC between the insula and sensorimotor areas was associated with elevated pro-inflammatory cytokine levels of IL-6 in BD.
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Affiliation(s)
- Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Feng Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - JiaYing Gong
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China; Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
| | - Hui Zhong
- Biomedical Translational Research Institute, Jinan University, Guangzhou 510630, China
| | - Tao Ye
- Clinical Laboratory Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Jurong Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Zhenye Luo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hengwen Yang
- Biomedical Translational Research Institute, Jinan University, Guangzhou 510630, China; Zhuhai Precision Medical Center, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Jinan University, Zhuhai 519000, China
| | - Zhinan Yin
- Biomedical Translational Research Institute, Jinan University, Guangzhou 510630, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China.
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30
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Sá Filho AS, Cheniaux E, de Paula CC, Murillo-Rodriguez E, Teixeira D, Monteiro D, Cid L, Yamamoto T, Telles-Correia D, Imperatori C, Budde H, Machado S. Exercise is medicine: a new perspective for health promotion in bipolar disorder. Expert Rev Neurother 2020; 20:1099-1107. [PMID: 32762382 DOI: 10.1080/14737175.2020.1807329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Similar effects in reducing the symptoms of the mood disorder are reported in the literature compared the action of drugs and aerobic exercise sessions, demonstrating the potential of exercise in the control and mood stabilization. Therefore, there are many reasons to believe that the increased cardiorespiratory fitness (VO2max) can be an important means of protection and a reducing potential of physical and mental damage in bipolar disorders (BD). This review will highlight the current pattern of response of exercise on the pathophysiology of BD, relating the possible mechanisms, and hypotheses based on exercises. AREAS COVERED The mechanism of monoaminergic action and its relationship with exercise, role of physical conditioning and increased VO2Max on neurotrophin release, and new perspectives on long-term exercise will be reviewed. EXPERT OPINION The adaptations to training, although little explored in the context of BD, can induce the expression of substances that co-regulate several processes related to the pathophysiology of BD. Furthermore, high intensity interval training (HIIT) can also be adjusted to improve the physical fitness and health in patients with BD. Future research is needed to adopt a training strategy that is both time efficient and adequate for the population in question.
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Affiliation(s)
- Alberto Souza Sá Filho
- Department of Physical Education, Paulista University (UNIP) , São Paulo, Brazil.,Department of Physical Education, University Center of Anápolis (Unievangélica) , Anápolis, Brazil
| | - Elie Cheniaux
- School of Medical Sciences, State University of Rio De Janeiro (UERJ) , Rio De Janeiro, Brazil.,Institute of Psychiatry, Federal University of Rio De Janeiro , Rio De Janeiro, Brazil
| | - Carolina Cavalcante de Paula
- Department of Cellular, Tissue and Developmental Biology, The Institute of Biomedical Science, The University of São Paulo (ICB/USP) , São Paulo, Brazil
| | - Eric Murillo-Rodriguez
- International Neuroscience Research Group , Yucatan, México.,Laboratorio De Neurociencias Moleculares E Integrativas, Escuela De Medicina, División Ciencias De La Salud, Universidad Anáhuac Mayab , Mérida, Mexico
| | - Diogo Teixeira
- International Neuroscience Research Group , Yucatan, México.,Faculty of Physical Education and Sport, ULHT , Lisbon, Portugal
| | - Diogo Monteiro
- International Neuroscience Research Group , Yucatan, México.,Research Centre in Sports, Health and Human Development, CIDESD , Rio Maior, Portugal.,Sport Science School of Rio Maior, Polytechnique Institute of Santarém , Rio Maior, Portugal
| | - Luis Cid
- International Neuroscience Research Group , Yucatan, México.,Research Centre in Sports, Health and Human Development, CIDESD , Rio Maior, Portugal.,Sport Science School of Rio Maior, Polytechnique Institute of Santarém , Rio Maior, Portugal
| | - Tetsuya Yamamoto
- International Neuroscience Research Group , Yucatan, México.,Graduate School of Technology, Industrial and Social Sciences, Tokushima University , Tokushima, Japan
| | - Diogo Telles-Correia
- International Neuroscience Research Group , Yucatan, México.,Clínica Universitária De Psicologia E Psiquiatria, Faculdade De Medicina, Universidade De Lisboa , Lisbon, Portugal.,Departamento De Psiquiatria, Faculdade De Medicina, Universidade De Lisboa , Lisbon, Portugal
| | - Claudio Imperatori
- International Neuroscience Research Group , Yucatan, México.,Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190 , Rome, Italy
| | - Henning Budde
- International Neuroscience Research Group , Yucatan, México.,Faculty of Human Sciences, Medical School Hamburg, University of Applied Science and Medical University , Hamburg, Germany
| | - Sergio Machado
- Institute of Psychiatry, Federal University of Rio De Janeiro , Rio De Janeiro, Brazil.,International Neuroscience Research Group , Yucatan, México.,Laboratory of Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program, Salgado De Oliveira University (UNIVERSO) , Niterói, Brazil.,Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados , RJ, Brazil
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31
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Achalia R, Raju VB, Jacob A, Nahar A, Achalia G, Nagendra B, Kaginalkar V, Choudhary S, Venkatasubramanian G, Rao NP. Comparison of first-episode and multiple-episode bipolar disorder: A surface-based morphometry study. Psychiatry Res Neuroimaging 2020; 302:111110. [PMID: 32505904 DOI: 10.1016/j.pscychresns.2020.111110] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 01/17/2020] [Accepted: 02/14/2020] [Indexed: 01/09/2023]
Abstract
It is still unclear whether the structural abnormalities in Bipolar disorder (BD) are static or progressive. We aimed to compare differences in cortical thickness, surface area, and volume between patients with BD and healthy volunteers (HV) and to examine whether there are differences between patients who have had a single manic episode and those with multiple episodes. We recruited 30 patients with Type I BD and 30 age and sex matched HV. All participants underwent structural magnetic resonance imaging. Cortical volume, thickness, and surface area were measured using the QDEC tool from the Freesurfer software with age and intracranial volume as covariates. Study groups were comparable across age, sex distribution, and intracranial volume. Patients had significantly lower surface area in bilateral cuneus, right postcentral gyrus, and rostral middle frontal gyri; and lower cortical volume in the left middle temporal gyrus, right postcentral gyrus, and right cuneus. BD patients with multiple episodes had lower cortical measures while those with single episode had cortical measures comparable to HV. Findings indicate that the pathophysiological processes in BD are possibly progressive in nature. Our findings underscore the potential importance of early diagnosis and intervention in preventing deterioration and improving functional recovery.
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Affiliation(s)
| | - Vikas B Raju
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arpitha Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Abhinav Nahar
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Bhargavi Nagendra
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | | | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, India.
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32
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Miller SM. Fluctuations of consciousness, mood, and science: The interhemispheric switch and sticky switch models two decades on. J Comp Neurol 2020; 528:3171-3197. [DOI: 10.1002/cne.24943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Steven M. Miller
- Perceptual and Clinical Neuroscience Laboratory, Department of Physiology Monash Biomedicine Discovery Institute, School of Biomedical Sciences, Monash University Melbourne Victoria Australia
- Monash Alfred Psychiatry Research Centre Central Clinical School, Monash University and Alfred Health Melbourne Victoria Australia
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33
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Song H, Chon MW, Ryu V, Yu R, Lee DK, Lee H, Lee W, Lee JH, Park DY. Cortical Volumetric Correlates of Childhood Trauma, Anxiety, and Impulsivity in Bipolar Disorder. Psychiatry Investig 2020; 17:627-635. [PMID: 32571005 PMCID: PMC7385221 DOI: 10.30773/pi.2019.0305] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/17/2020] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE More recently, attention has turned to the linkage between childhood trauma and emotional dysregulation, but the evidence in bipolar disorder (BD) is limited. To determine neurobiological relationships between childhood trauma, current anxiety, and impulsivity, we investigated cortical volumetric correlates of these clinical factors in BD. METHODS We studied 36 patients with DSM-5 BD and 29 healthy controls. Childhood trauma, coexisting anxiety, and impulsivity were evaluated with the Korean version-Childhood Trauma Questionnaire (CTQ), the Korean version-Beck Anxiety Inventory (BAI), and the Korean version-Barratt Impulsiveness Scale (BIS). Voxel-based morphometry (VBM) was used to assess gray matter volume (GMV) alterations on the brain magnetic resonance imaging (MRI). Partial correlation analyses were conducted to examine associations between the GMV and each scale in the BD group. RESULTS Childhood trauma, anxiety, and impulsivity were interrelated in BD. BD patients revealed significant inverse correlations between the GMV in the right precentral gyrus and CTQ scores (r=-0.609, p<0.0003); between the GMV in the left middle frontal gyrus and BAI scores (r=-0.363, p=0.044). Moreover, patients showed similar tendency of negative correlations between the GMV in the right precentral gyrus and BIS scores; between the GMV in the left middle frontal gyrus and CTQ scores. CONCLUSION The present study provides evidence for a neural basis between childhood trauma and affect regulations in BD. The GMV alterations in multiple frontal lobe areas may represent neurobiological markers for anticipating the course of BD.
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Affiliation(s)
- Hyehyun Song
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Myong-Wuk Chon
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Vin Ryu
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Rina Yu
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Dong-Kyun Lee
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Hyeongrae Lee
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Wonhye Lee
- Department of Clinical Psychology, National Center for Mental Health, Seoul, Republic of Korea
| | - Jung Hyun Lee
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Dong Yeon Park
- Department of Mood Disorders, National Center for Mental Health, Seoul, Republic of Korea
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34
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Tamura JK, McIntyre RS. Current and Future Vistas in Bipolar Disorder. Curr Behav Neurosci Rep 2020. [DOI: 10.1007/s40473-020-00202-9] [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: 11/30/2022]
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35
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Mucci F, Avella MT, Marazziti D. ADHD with Comorbid Bipolar Disorders: A Systematic Review of Neurobiological, Clinical and Pharmacological Aspects Across the Lifespan. Curr Med Chem 2020; 26:6942-6969. [PMID: 31385763 DOI: 10.2174/0929867326666190805153610] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/05/2018] [Accepted: 11/15/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Attention deficit hyperactivity (ADHD) disorder is a neurodevelopmental disorder characterized by inattention, hyperactivity, disruptive behaviour, and impulsivity. Despite considered typical of children for a long time, the persistence of ADHD symptoms in adulthood gained increasing interest during the last decades. Indeed, its diagnosis, albeit controversial, is rarely carried out even because ADHD is often comorbid with several other psychiatric diosrders, in particular with bipolar disorders (BDs), a condition that complicates the clinical picture, assessment and treatment. AIMS The aim of this paper was to systematically review the scientific literature on the neurobiological, clinical features and current pharmacological management of ADHD comorbid with BDs across the entire lifespan, with a major focus on the adulthood. DISCUSSION The pharmacology of ADHD-BD in adults is still empirical and influenced by the individual experience of the clinicians. Stimulants are endowed of a prompt efficacy and safety, whilst non-stimulants are useful when a substance abuse history is detected, although they require some weeks in order to be fully effective. In any case, an in-depth diagnostic and clinical evaluation of the single individual is mandatory. CONCLUSION The comorbidity of ADHD with BD is still a controversial matter, as it is the notion of adult ADHD as a distinct nosological category. Indeed, some findings highlighted the presence of common neurobiological mechanisms and overlapping clinical features, although disagreement does exist. In any case, while expecting to disentangle this crucial question, a correct management of this comorbidity is essential, which requires the co-administration of mood stabilizers. Further controlled clinical studies in large samples of adult ADHD-BD patients appear extremely urgent in order to better define possible therapeutic guidelines, as well as alternative approaches for this potentially invalidating condition.
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Affiliation(s)
- Federico Mucci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Fondazione BRF, Istituto per la Ricerca Scientifica in Psichiatria e Neuroscienze, Lucca, Italy
| | - Maria Teresa Avella
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Fondazione BRF, Istituto per la Ricerca Scientifica in Psichiatria e Neuroscienze, Lucca, Italy
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36
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Kim S, Kim YW, Shim M, Jin MJ, Im CH, Lee SH. Altered Cortical Functional Networks in Patients With Schizophrenia and Bipolar Disorder: A Resting-State Electroencephalographic Study. Front Psychiatry 2020; 11:661. [PMID: 32774308 PMCID: PMC7388793 DOI: 10.3389/fpsyt.2020.00661] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/25/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Pathologies of schizophrenia and bipolar disorder have been poorly understood. Brain network analysis could help understand brain mechanisms of schizophrenia and bipolar disorder. This study investigates the source-level brain cortical networks using resting-state electroencephalography (EEG) in patients with schizophrenia and bipolar disorder. METHODS Resting-state EEG was measured in 38 patients with schizophrenia, 34 patients with bipolar disorder type I, and 30 healthy controls. Graph theory based source-level weighted functional networks were evaluated: strength, clustering coefficient (CC), path length (PL), and efficiency in six frequency bands. RESULTS At the global level, patients with schizophrenia or bipolar disorder showed higher strength, CC, and efficiency, and lower PL in the theta band, compared to healthy controls. At the nodal level, patients with schizophrenia or bipolar disorder showed higher CCs, mostly in the frontal lobe for the theta band. Particularly, patients with schizophrenia showed higher nodal CCs in the left inferior frontal cortex and the left ascending ramus of the lateral sulcus compared to patients with bipolar disorder. In addition, the nodal-level theta band CC of the superior frontal gyrus and sulcus (cognition-related region) correlated with positive symptoms and social and occupational functioning scale (SOFAS) scores in the schizophrenia group, while that of the middle frontal gyrus (emotion-related region) correlated with SOFAS scores in the bipolar disorder group. CONCLUSIONS Altered cortical networks were revealed and these alterations were significantly correlated with core pathological symptoms of schizophrenia and bipolar disorder. These source-level cortical network indices could be promising biomarkers to evaluate patients with schizophrenia and bipolar disorder.
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Affiliation(s)
- Sungkean Kim
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Yong-Wook Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea.,Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Miseon Shim
- Institute of Industrial Technology, Korea University, Sejong, South Korea
| | - Min Jin Jin
- Department of Psychiatry, Wonkwang University Hospital, Iksan, South Korea
| | - Chang-Hwan Im
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea.,Department of Psychiatry, Inje University Ilsan Paik Hospital, Ilsan, South Korea
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37
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Fijtman A, Bücker J, Strange BA, Martins DS, Passos IC, Hasse-Sousa M, Lima FM, Kapczinski F, Yatham L, Kauer-Sant'Anna M. Emotional memory in bipolar disorder: Impact of multiple episodes and childhood trauma. J Affect Disord 2020; 260:206-213. [PMID: 31505398 DOI: 10.1016/j.jad.2019.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/07/2019] [Accepted: 09/01/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Emotional memory is a critical amygdala-dependent cognitive function characterized by enhanced memory for emotional events coupled with retrograde amnesia. Our study aims to assess the influence of bipolar disorder (BD), trauma, and the number of mood episodes on emotional memory. METHODS 53 subjects (33 euthymic patients with BD and 20 healthy controls) answered a clinical assessment, childhood trauma questionnaire (CTQ), and an emotional memory test composed of lists of nouns, including neutral words, one emotional (E), one preceding (E-1) and one following word (E + 1). We assessed for the influence of type, position, diagnosis, trauma, and number of mood episodes in word recall using generalized estimating equations. RESULTS Controlling for neutral words, BD had a higher recall for E-1 (p = 0.038) and a trend for a higher recall of E (p = 0.055). There was no difference between patients with and without trauma. Patients with BD who suffered multiple mood episodes had a higher recall of E compared to patients with fewer episodes (p = 0.016). LIMITATIONS Cross-sectional design and small sample size. CONCLUSION Our results indicate dysfunction in emotional memory in patients with BD, particularly after multiple mood episodes. While we expected an impaired emotional memory, patients with BD showed an increased recall for emotional stimuli and events preceding them. Childhood trauma does not seem to interfere with emotional memory changes in patients with BD. Emotional memory enhancement seems to be a promising marker of progression in BD.
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Affiliation(s)
- Adam Fijtman
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
| | - Joana Bücker
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Bryan A Strange
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, Spain
| | - Dayane Santos Martins
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Mathias Hasse-Sousa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavia Moreira Lima
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavio Kapczinski
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Neuroscience Graduate Program, McMaster University, 100 West Fifth Street, Hamilton, ON, Canada
| | - Lakshmi Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Márcia Kauer-Sant'Anna
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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38
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Madre M, Canales-Rodríguez EJ, Fuentes-Claramonte P, Alonso-Lana S, Salgado-Pineda P, Guerrero-Pedraza A, Moro N, Bosque C, Gomar JJ, Ortíz-Gil J, Goikolea JM, Bonnin CM, Vieta E, Sarró S, Maristany T, McKenna PJ, Salvador R, Pomarol-Clotet E. Structural abnormality in schizophrenia versus bipolar disorder: A whole brain cortical thickness, surface area, volume and gyrification analyses. Neuroimage Clin 2019; 25:102131. [PMID: 31911343 PMCID: PMC6948361 DOI: 10.1016/j.nicl.2019.102131] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 11/19/2019] [Accepted: 12/13/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The profiles of cortical abnormalities in schizophrenia and bipolar disorder, and how far they resemble each other, have only been studied to a limited extent. The aim of this study was to identify and compare the changes in cortical morphology associated with these pathologies. METHODS A total of 384 subjects, including 128 patients with schizophrenia, 128 patients with bipolar disorder and 127 sex-age-matched healthy subjects, were examined using cortical surface-based morphology. Four cortical structural measures were studied: cortical volume (CV), cortical thickness (CT), surface area (SA) and gyrification index (GI). Group comparisons for each separate cortical measure were conducted. RESULTS At a threshold of P = 0.05 corrected, both patient groups showed significant widespread CV and CT reductions in similar areas compared to healthy subjects. However, the changes in schizophrenia were more pronounced. While CV decrease in bipolar disorder was exclusively explained by cortical thinning, in schizophrenia it was driven by changes in CT and partially by SA. Reduced GI was only found in schizophrenia. The direct comparison between both disorders showed significant reductions in all measures in patients with schizophrenia. CONCLUSIONS Cortical volume and cortical thickness deficits are shared between patients with schizophrenia and bipolar disorder, suggesting that both pathologies may be affected by similar environmental and neurodegenerative factors. However, the exclusive alteration in schizophrenia of metrics related to the geometry and curvature of the brain cortical surface (SA, GI) suggests that this group is influenced by additional neurodevelopmental and genetic factors.
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Affiliation(s)
- Mercè Madre
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain.
| | - Erick J Canales-Rodríguez
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - Paola Fuentes-Claramonte
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Silvia Alonso-Lana
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Pilar Salgado-Pineda
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | | | - Noemí Moro
- Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain
| | - Clara Bosque
- Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain
| | - Jesús J Gomar
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; The Litwin-Zucker Alzheimer's Research Center, NY, USA
| | - Jordi Ortíz-Gil
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Hospital General de Granollers, Granollers, Catalonia, Spain
| | - José M Goikolea
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Bipolar Disorder Program, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Caterina M Bonnin
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Bipolar Disorder Program, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Bipolar Disorder Program, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Teresa Maristany
- Diagnostic Imaging Department, Fundació de Recerca Hospital Sant Joan de Déu, Barcelona, Spain
| | - Peter J McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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39
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Delvecchio G, Ciappolino V, Perlini C, Barillari M, Ruggeri M, Altamura AC, Bellani M, Brambilla P. Cingulate abnormalities in bipolar disorder relate to gender and outcome: a region-based morphometry study [corrected]. Eur Arch Psychiatry Clin Neurosci 2019; 269:777-784. [PMID: 29594394 DOI: 10.1007/s00406-018-0887-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 03/16/2018] [Indexed: 12/22/2022]
Abstract
Structural magnetic resonance imaging (MRI) studies reported gray matter (GM) loss in bipolar disorder (BD) in cingulate cortices, key regions subserving emotional regulation and cognitive functions in humans. The aim of this study was to further explore cingulate GM volumes in a sizeable group of BD patients with respect to healthy controls, particularly investigating the impact of gender and clinical variables. 39 BD patients (mean Age = 48.6 ± 9.7, 15 males and 24 females) and 39 demographically matched healthy subjects (mean Age = 47.9 ± 9.1, 15 males and 24 females) underwent a 1.5T MRI scan. GM volumes within the cingulate cortex were manually detected, including anterior and posterior regions. BD patients had decreased left anterior cingulate volumes compared with healthy controls (F = 6.7, p = 0.01). Additionally, a significant gender effect was observed, with male patients showing reduced left anterior cingulate cortex (ACC) volumes compared to healthy controls (F = 5.1, p = 0.03). Furthermore, a significant inverse correlation between right ACC volumes and number of hospitalizations were found in the whole group of BD patients (r = - 0.51, p = 0.04) and in male BD patients (r = - 0.88, p = 0.04). Finally, no statistically significant correlations were observed in female BD patients. Our findings further confirm the putative role of the ACC in the pathophysiology of BD. Interestingly, this study also suggested the presence of gender-specific GM volume reductions in ACC in BD, which may also be associated to poor outcome.
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Affiliation(s)
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
| | - Cinzia Perlini
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy
| | - Marco Barillari
- Section of Radiology, Department of Neurological and Movement Sciences, University Hospital of Verona, Verona, Italy
| | - Mirella Ruggeri
- Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy.,Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - A Carlo Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
| | - Marcella Bellani
- Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy.,Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy. .,Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA.
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40
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Squarcina L, Dagnew TM, Rivolta MW, Bellani M, Sassi R, Brambilla P. Automated cortical thickness and skewness feature selection in bipolar disorder using a semi-supervised learning method. J Affect Disord 2019; 256:416-423. [PMID: 31229930 DOI: 10.1016/j.jad.2019.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/26/2019] [Accepted: 06/07/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Bipolar disorder (BD) broadly affects brain structure, in particular areas involved in emotion processing and cognition. In the last years, the psychiatric field's interest in machine learning approaches has been steadily growing, thanks to the potentiality of automatically discriminating patients from healthy controls. METHODS In this work, we employed cortical thickness of 58 regions of interest obtained from magnetic resonance imaging scans of 41 BD patients and 34 healthy controls, to automatically identify the regions which are mostly involved with the disease. We used a semi-supervised method, addressing the criticisms on supervised methods, related to the fact that the diagnosis is not unaffected by uncertainty. RESULTS Our results confirm findings in previous studies, with a classification accuracy of about 75% when mean thickness and skewness of up to five regions are considered. We obtained that the parietal lobe and some areas in the temporal sulcus were the regions which were the most involved with BD. LIMITATIONS The major limitation of our work is the limited size or our dataset, but in line with other recent machine learning works in the field. Moreover, we considered chronic patients, whose brain characteristics may thus be affected. CONCLUSIONS The automatic selection of the brain regions most involved in BD may be of great importance when dealing with the pathogenesis of the disorder. Our method selected regions which are known to be involved with BD, indicating that damage to the identified areas can be considered as a marker of disease.
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Affiliation(s)
- L Squarcina
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
| | - T M Dagnew
- Department of Computer Science, University of Milan, Milan, Italy.
| | - M W Rivolta
- Department of Computer Science, University of Milan, Milan, Italy
| | - M Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
| | - R Sassi
- Department of Computer Science, University of Milan, Milan, Italy
| | - P Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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41
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Huber RS, Subramaniam P, Kondo DG, Shi X, Renshaw PF, Yurgelun-Todd DA. Reduced lateral orbitofrontal cortex volume and suicide behavior in youth with bipolar disorder. Bipolar Disord 2019; 21:321-329. [PMID: 30471169 DOI: 10.1111/bdi.12729] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Structural abnormalities in cortical and subcortical regions, including the orbitofrontal cortex (OFC), are altered during brain development in adolescents with bipolar disorder (BD), which may increase risk for suicide. Few studies have examined the neural substrates of suicidal behavior in BD youth. The aim of the present study was to investigate the relationship between suicide behavior and the OFC in youth with BD. METHODS Thirty-seven participants with BD and 26 non-psychiatric controls, ages 13-21 years, completed a diagnostic interview and mood rating scales. Lifetime symptoms of suicide ideation and behavior were examined using the Columbia Suicide Severity Rating Scale. Participants underwent magnetic resonance imaging on a 3T Siemens Verio scanner. Morphometric analysis of brain images was performed using FreeSurfer. RESULTS Eighteen participants with BD had a history of suicide attempt (SA). Bipolar youth with a history of SA showed reduced left lateral OFC volumes compared to controls, but there was no difference between BD attempters and non-attempters. Controls and BD non-attempters had significantly greater OFC cortical thickness than BD attempters. Additionally, there was a significant negative correlation between OFC volumes and suicide lethality, demonstrating that as suicide lethality increased, OFC volume in BD youth was reduced. CONCLUSIONS The OFC is involved in decision-making, impulsivity, and reward circuitry which have shown to be impaired in BD. Reduced OFC volume and its association with lethality of suicide suggest that suicide behavior in BD may be related to the emerging neuroanatomical substrates of the disorder, particularly abnormalities of the OFC.
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Affiliation(s)
- Rebekah S Huber
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah.,Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, Utah
| | - Punitha Subramaniam
- Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, Utah
| | - Douglas G Kondo
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah.,Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, Utah.,U.S. Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah
| | - Xianfeng Shi
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah.,Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, Utah
| | - Perry F Renshaw
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah.,Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, Utah.,U.S. Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah
| | - Deborah A Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah.,Diagnostic Neuroimaging Laboratory, University of Utah, Salt Lake City, Utah.,U.S. Department of Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center, Salt Lake City, Utah
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42
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Huang MH, Cheng CM, Huang KL, Hsu JW, Bai YM, Su TP, Li CT, Tsai SJ, Lin WC, Chen TJ, Chen MH. Bipolar disorder and risk of Parkinson disease: A nationwide longitudinal study. Neurology 2019; 92:e2735-e2742. [PMID: 31118242 DOI: 10.1212/wnl.0000000000007649] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/01/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the risk of Parkinson disease (PD) among patients with bipolar disorder (BD). METHODS Using the Taiwan National Health Insurance Research Database, we examined 56,340 patients with BD and 225,360 age- and sex-matched controls between 2001 and 2009 and followed them to the end of 2011. Individuals who developed PD during the follow-up period were identified. RESULTS Patients with BD had a higher incidence of PD (0.7% vs 0.1%, p < 0.001) during the follow-up period than the controls. A Cox regression analysis with adjustments for demographic data and medical comorbid conditions revealed that patients with BD were more likely to develop PD (hazard ratio [HR] 6.78, 95% confidence interval [CI] 5.74-8.02) than the control group. Sensitivity analyses after exclusion of the first year (HR 5.82, 95% CI 4.89-6.93) or first 3 years (HR 4.42; 95% CI 3.63-5.37) of observation showed consistent findings. Moreover, a high frequency of psychiatric admission for manic/mixed and depressive episodes was associated with an increased risk of developing PD. CONCLUSION Patients with BD had a higher incidence of PD during the follow-up period than the control group. Manic/mixed and depressive episodes were associated with an elevated likelihood of developing PD. Further studies are necessary to investigate the underlying pathophysiology between BD and PD.
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Affiliation(s)
- Mao-Hsuan Huang
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Chih-Ming Cheng
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan.
| | - Kai-Lin Huang
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Ju-Wei Hsu
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Ya-Mei Bai
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Tung-Ping Su
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Cheng-Ta Li
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Shih-Jen Tsai
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Wei-Chen Lin
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Tzeng-Ji Chen
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan
| | - Mu-Hong Chen
- From the Departments of Psychiatry (M.-H.H., C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.) and Family Medicine (T.-J.C.), Taipei Veterans General Hospital; Department of Psychiatry (C.-M.C., K.-L.H., J.-W.H., Y.-M.B., T.-P.S., C.-T.L., S.-J.T., W.-C.L., M.-H.C.), College of Medicine, and Institute of Hospital and Health Care Administration (T.-J.C.), National Yang-Ming University; Department of Psychiatry (T.-P.S.), Cheng Hsin General Hospital, Taipei; and Department of Psychiatry (C.-M.C.), Taipei Veterans General Hospital, Yuanshan Branch, Taiwan.
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Melloni EMT, Poletti S, Vai B, Bollettini I, Colombo C, Benedetti F. Effects of illness duration on cognitive performances in bipolar depression are mediated by white matter microstructure. J Affect Disord 2019; 249:175-182. [PMID: 30772745 DOI: 10.1016/j.jad.2019.02.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/31/2019] [Accepted: 02/05/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cognitive deficits are a core feature of bipolar disorder (BD), and persist during the euthymic phase. White matter (WM) microstructural abnormalities are widely considered a structural marker of BD. Features of illness chronicity, such as illness duration and number of mood episodes, have been associated with worsening of both clinical profile and brain structural alterations. This study examined the role of WM integrity as a possible mediator between illness duration and cognitive performances in a sample of BD patients. METHODS We assessed 88 inpatients affected by a depressive episode in course of type I BD for verbal memory, visual memory, working memory, visuospatial constructional abilities, psychomotor coordination, executive functions, processing speed, and verbal fluency. White matter integrity was evaluated through FA measurements derived using the Enhancing Neuro Imaging Genetics Through Meta-Analysis (ENIGMA)-DTI protocol. RESULTS The effect of illness duration on processing speed, verbal memory, and visual memory was mediated by the FA values of bilateral anterior corona radiata, bilateral corona radiata, genu of corpus callosum, and fornix, adjusting for age, sex, education and lithium treatment (p < 0.05). LIMITATIONS Potential interaction factors were not examined in this study. CONCLUSIONS This is the first study to show the role of WM integrity as a mediator of the negative effect of illness duration on cognitive performances. Our data provide new insight into the neuroprogressive hypothesis of BD.
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Affiliation(s)
| | - Sara Poletti
- University Vita-Salute San Raffaele, Milano, Italy
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Irene Bollettini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
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Kim S, Jeon H, Jang KI, Kim YW, Im CH, Lee SH. Mismatch Negativity and Cortical Thickness in Patients With Schizophrenia and Bipolar Disorder. Schizophr Bull 2019; 45:425-435. [PMID: 29684224 PMCID: PMC6403065 DOI: 10.1093/schbul/sby041] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Mismatch negativity (MMN) is a measure of automatic neurophysiological brain processes for detecting unexpected sensory stimuli. This study investigated MMN reduction in patients with schizophrenia and bipolar disorder and examined whether cortical thickness is associated with MMN, for exploratory purposes. METHODS Electroencephalograms were recorded in 38 patients with schizophrenia, 37 patients with bipolar disorder, and 32 healthy controls (HCs) performing a passive auditory oddball paradigm. All participants underwent T1 structural magnetic resonance imaging scanning to investigate the cortical thickness of MMN-generating regions. Average MMN amplitudes from the frontocentral electrodes were analyzed. RESULTS Patients with schizophrenia and bipolar disorder exhibited significantly reduced MMN amplitude compared with HCs. In bipolar disorder, we found intermediate MMN amplitude among the groups. Average MMN and cortical thickness of the right superior temporal gyrus (STG) were significantly negatively correlated in patients with schizophrenia. In patients with bipolar disorder, average MMN was significantly correlated with cortical thickness of the left anterior cingulate cortex and the right STG. MMN showed negative correlations with social and occupational functioning in schizophrenia, and with the Korean auditory verbal learning test for delayed recall in bipolar disorder. CONCLUSIONS MMN reduction was associated with cortical thinning in frontal and temporal areas in patients, particularly with an auditory verbal hallucination-related region in schizophrenia and emotion-related regions in bipolar disorder. MMN was associated with functional outcomes in schizophrenia, whereas it was associated with neurocognition in bipolar disorder.
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Affiliation(s)
- Sungkean Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea,Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Hyeonjin Jeon
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Kuk-In Jang
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea,Department of Biomedicine & Health Sciences, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea
| | - Yong-Wook Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea,Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Chang-Hwan Im
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea,Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Goyang, Republic of Korea,To whom correspondence should be addressed; Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Juhwa-ro 170, Ilsanseo-Gu, Goyang 411-706, Republic of Korea; tel: +82-31-910-7260, fax: +82-31-910-7268, e-mail:
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45
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Toma S, Islam AH, Metcalfe AWS, Mitchell RHB, Fiksenbaum L, MacIntosh BJ, Goldstein BI. Cortical Volume and Thickness Across Bipolar Disorder Subtypes in Adolescents: A Preliminary Study. J Child Adolesc Psychopharmacol 2019; 29:141-151. [PMID: 30359542 DOI: 10.1089/cap.2017.0137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Neuroimaging studies of adults with bipolar disorder (BD) have identified several BD subtype distinctions, including greater deficits in prefrontal gray matter volumes in BD-I (bipolar I disorder) compared to BD-II (bipolar II disorder). We sought to investigate BD subtype differences in brain structure among adolescents and young adults. METHODS Forty-four youth with BD (14 BD-I, 16 BD-II, and 14 BD-not otherwise specified [NOS], mean age 17) underwent 3T-MRI and images were analyzed using FreeSurfer software. Cortical volume and thickness were analyzed for region of interest (ROI): ventrolateral prefrontal cortex, ventromedial prefrontal cortex, anterior cingulate cortex (ACC), subgenual cingulate cortex, and amygdala, controlling for age, sex, and total intracranial volume. ROIs were selected as found to be implicated in BD in prior studies. A whole brain vertex-wise exploratory analysis was also performed. Uncorrected results are presented. RESULTS There were group differences in ACC thickness (F = 3.88, p = 0.03, η2 = 0.173 uncorrected), which was reduced in BD-II in comparison to BD-I (p = 0.027 uncorrected) and BD-NOS (p = 0.019 uncorrected). These results did not survive correction for multiple comparisons and no other group differences were observed. The exploratory vertex-wise analysis found a similar pattern of lower cortical thickness in BD-II in the left and right superior frontal gyrus and left caudal middle frontal gyrus. CONCLUSIONS This study found reduced cortical thickness for youth with BD-II, relative to BD-I, in regions associated with cognitive control. Further neurostructural differences between subtypes may emerge later during the course of illness.
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Affiliation(s)
- Simina Toma
- 1 Centre for Youth Bipolar Disorder , Sunnybrook Health Sciences Centre, Toronto, Canada .,2 Department of Psychiatry, University of Toronto , Toronto, Canada
| | - Alvi H Islam
- 1 Centre for Youth Bipolar Disorder , Sunnybrook Health Sciences Centre, Toronto, Canada .,2 Department of Psychiatry, University of Toronto , Toronto, Canada
| | - Arron W S Metcalfe
- 1 Centre for Youth Bipolar Disorder , Sunnybrook Health Sciences Centre, Toronto, Canada .,3 Brain Sciences , Sunnybrook Health Sciences Centre, Toronto, Canada .,4 Heart and Stroke Foundation Canadian Partnership for Stroke Recovery , Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Rachel H B Mitchell
- 1 Centre for Youth Bipolar Disorder , Sunnybrook Health Sciences Centre, Toronto, Canada .,2 Department of Psychiatry, University of Toronto , Toronto, Canada
| | - Lisa Fiksenbaum
- 1 Centre for Youth Bipolar Disorder , Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Bradley J MacIntosh
- 3 Brain Sciences , Sunnybrook Health Sciences Centre, Toronto, Canada .,4 Heart and Stroke Foundation Canadian Partnership for Stroke Recovery , Sunnybrook Health Sciences Centre, Toronto, Canada .,5 Department of Medical Biophysics, University of Toronto , Toronto, Canada .,6 Department of Physical Sciences, Sunnybrook Health Sciences Centre , Toronto, Canada
| | - Benjamin I Goldstein
- 1 Centre for Youth Bipolar Disorder , Sunnybrook Health Sciences Centre, Toronto, Canada .,2 Department of Psychiatry, University of Toronto , Toronto, Canada .,4 Heart and Stroke Foundation Canadian Partnership for Stroke Recovery , Sunnybrook Health Sciences Centre, Toronto, Canada .,7 Department of Pharmacology, University of Toronto , Toronto, Canada
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Wang X, Luo Q, Tian F, Cheng B, Qiu L, Wang S, He M, Wang H, Duan M, Jia Z. Brain grey-matter volume alteration in adult patients with bipolar disorder under different conditions: a voxel-based meta-analysis. J Psychiatry Neurosci 2019; 44:89-101. [PMID: 30354038 PMCID: PMC6397036 DOI: 10.1503/jpn.180002] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The literature on grey-matter volume alterations in bipolar disorder is heterogeneous in its findings. METHODS Using effect-size differential mapping, we conducted a meta-analysis of grey-matter volume alterations in patients with bipolar disorder compared with healthy controls. RESULTS We analyzed data from 50 studies that included 1843 patients with bipolar disorder and 2289 controls. Findings revealed lower grey-matter volumes in the bilateral superior frontal gyri, left anterior cingulate cortex and right insula in patients with bipolar disorder and in patients with bipolar disorder type I. Patients with bipolar disorder in the euthymic and depressive phases had spatially distinct regions of altered grey-matter volume. Meta-regression revealed that the proportion of female patients with bipolar disorder or bipolar disorder type I was negatively correlated with regional grey-matter alteration in the right insula; the proportion of patients with bipolar disorder or bipolar disorder type I taking lithium was positively correlated with regional grey-matter alterations in the left anterior cingulate/paracingulate gyri; and the proportion of patients taking antipsychotic medications was negatively correlated with alterations in the anterior cingulate/paracingulate gyri. LIMITATIONS This study was cross-sectional; analysis techniques, patient characteristics and clinical variables in the included studies were heterogeneous. CONCLUSION Structural grey-matter abnormalities in patients with bipolar disorder and bipolar disorder type I were mainly in the prefrontal cortex and insula. Patients' mood state might affect grey-matter alterations. Abnormalities in regional grey-matter volume could be correlated with patients' specific demographic and clinical features.
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Affiliation(s)
- Xiuli Wang
- From the Department of Psychiatry, the Fourth People’s Hospital of Chengdu, Chengdu, China (Duan, He, H. Wang, S. Wang, X. Wang); the Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China (Luo, Jia); the Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China (Tian, Jia); the Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China (Cheng); and the Department of Radiology, the Second People’s Hospital of Yibin, Yibin, China (Qiu)
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Zhong S, Chen G, Zhao L, Jia Y, Chen F, Qi Z, Huang L, Wang Y. Correlation between Intrinsic Brain Activity and Thyroid-Stimulating Hormone Level in Unmedicated Bipolar II Depression. Neuroendocrinology 2019; 108:232-243. [PMID: 30673659 DOI: 10.1159/000497182] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 01/21/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Although abnormalities of amplitude of low-frequency fluctuations (ALFF) and hormone levels of hypothalamus-pituitary-thyroid axis have been reported in patients with bipolar disorder (BD), the association between abnormal ALFF and serum thyroid hormone levels remains unknown. METHOD A total of 90 patients with unmedicated BD II depression and 100 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging, and then routine band (0.01-0.1 Hz), slow-5 band (0.01-0.027 Hz), and slow-4 band (0.027-0.073 Hz) ALFF analysis were performed. Additionally, serum thyroid hormone levels including free tri-iodothyronine (FT3), total tri-iodothyronine (TT3), free thyroxin (FT4), total thyroxin (TT4), and thyroid-stimulating hormone (TSH) were detected. The correlation between abnormal serum thyroid hormone levels and ALFF values in patients with BD II depression was calculated. RESULTS Compared with the HCs, patients with BD II depression showed decreased ALFF in bilateral precuneus (PCu)/posterior cingulate cortex (PCC) in routine and slow-4 frequency bands, decreased ALFF in the right PCu, and increased ALFF in the right middle occipital gyrus (MOG) in the slow-5 frequency band. Additionally, patients with BD II depression showed lower TSH level than HCs, and TSH level was positively correlated with ALFF values in the bilateral PCu/PCC in the routine frequency band. CONCLUSIONS These findings suggest that patients with BD II depression display intrinsic activity abnormalities, mainly in the PCu/PCC and MOG, which are associated with specific frequency bands. Moreover, altered intrinsic activity in the PCu/PCC may be related to TSH levels in bipolar II depression.
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Affiliation(s)
- Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Lianping Zhao
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Department of Radiology, Gansu Provincial Hospital, Gansu, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Feng Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China,
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China,
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Teixeira AL, Colpo GD, Fries GR, Bauer IE, Selvaraj S. Biomarkers for bipolar disorder: current status and challenges ahead. Expert Rev Neurother 2018; 19:67-81. [PMID: 30451546 DOI: 10.1080/14737175.2019.1550361] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Bipolar disorder (BD) is a chronic psychiatric disorder marked by clinical and pathophysiological heterogeneity. There is a high expectation that personalized approaches can improve the management of patients with BD. For that, identification and validation of potential biomarkers are fundamental. Areas covered: This manuscript will critically review the current status of different biomarkers for BD, including peripheral, genetic, neuroimaging, and neurophysiological candidates, discussing the challenges to move the field forward. Expert commentary: There are no lab or complementary tests currently recommended for the diagnosis or management of patients with BD. Panels composed by multiple biomarkers will probably contribute to stratifying patients according to their clinical stage, therapeutic response, and prognosis.
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Affiliation(s)
- Antonio L Teixeira
- a Department of Psychiatry & Behavioral Sciences , McGovern Medical School, UT Health , Houston , TX , USA.,b Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina , Universidade Federal de Minas Gerais (UFMG) , Belo Horizonte , Brazil
| | - Gabriela D Colpo
- a Department of Psychiatry & Behavioral Sciences , McGovern Medical School, UT Health , Houston , TX , USA
| | - Gabriel R Fries
- a Department of Psychiatry & Behavioral Sciences , McGovern Medical School, UT Health , Houston , TX , USA
| | - Isabelle E Bauer
- a Department of Psychiatry & Behavioral Sciences , McGovern Medical School, UT Health , Houston , TX , USA
| | - Sudhakar Selvaraj
- a Department of Psychiatry & Behavioral Sciences , McGovern Medical School, UT Health , Houston , TX , USA
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Minuzzi L, Syan SK, Smith M, Hall A, Hall GB, Frey BN. Structural and functional changes in the somatosensory cortex in euthymic females with bipolar disorder. Aust N Z J Psychiatry 2018; 52:1075-1083. [PMID: 29232965 DOI: 10.1177/0004867417746001] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Current evidence from neuroimaging data suggests possible dysfunction of the fronto-striatal-limbic circuits in individuals with bipolar disorder. Somatosensory cortical function has been implicated in emotional recognition, risk-taking and affective responses through sensory modalities. This study investigates anatomy and function of the somatosensory cortex in euthymic bipolar women. METHODS In total, 68 right-handed euthymic women (bipolar disorder = 32 and healthy controls = 36) between 16 and 45 years of age underwent high-resolution anatomical and functional magnetic resonance imaging during the mid-follicular menstrual phase. The somatosensory cortex was used as a seed region for resting-state functional connectivity analysis. Voxel-based morphometry was used to evaluate somatosensory cortical gray matter volume between groups. RESULTS We found increased resting-state functional connectivity between the somatosensory cortex and insular cortex, inferior prefrontal gyrus and frontal orbital cortex in euthymic bipolar disorder subjects compared to healthy controls. Voxel-based morphometry analysis showed decreased gray matter in the left somatosensory cortex in the bipolar disorder group. Whole-brain voxel-based morphometry analysis controlled by age did not reveal any additional significant difference between groups. CONCLUSION This study is the first to date to evaluate anatomy and function of the somatosensory cortex in a well-characterized sample of euthymic bipolar disorder females. Anatomical and functional changes in the somatosensory cortex in this population might contribute to the pathophysiology of bipolar disorder.
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Affiliation(s)
- Luciano Minuzzi
- 1 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,2 MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,3 Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,4 Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Sabrina K Syan
- 2 MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,4 Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Mara Smith
- 1 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Alexander Hall
- 4 Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Geoffrey Bc Hall
- 2 MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,5 Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Benicio N Frey
- 1 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,2 MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,3 Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,4 Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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50
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Kunst J, Marecek R, Klobusiakova P, Balazova Z, Anderkova L, Nemcova-Elfmarkova N, Rektorova I. Patterns of Grey Matter Atrophy at Different Stages of Parkinson's and Alzheimer's Diseases and Relation to Cognition. Brain Topogr 2018; 32:142-160. [PMID: 30206799 DOI: 10.1007/s10548-018-0675-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 09/04/2018] [Indexed: 11/25/2022]
Abstract
Using MRI, a characteristic pattern of grey matter (GM) atrophy has been described in the early stages of Alzheimer's disease (AD); GM patterns at different stages of Parkinson's disease (PD) have been inconclusive. Few studies have directly compared structural changes in groups with mild cognitive impairment (MCI) caused by different pathologies (AD, PD). We used several analytical methods to determine GM changes at different stages of both PD and AD. We also evaluated associations between GM changes and cognitive measurements. Altogether 144 subjects were evaluated: PD with normal cognition (PD-NC; n = 23), PD with MCI (PD-MCI; n = 24), amnestic MCI (aMCI; n = 27), AD (n = 12), and age-matched healthy controls (HC; n = 58). All subjects underwent structural MRI and cognitive examination. GM volumes were analysed using two different techniques: voxel-based morphometry (VBM) and source-based morphometry (SBM), which is a multivariate method. In addition, cortical thickness (CT) was evaluated to assess between-group differences in GM. The cognitive domain z-scores were correlated with GM changes in individual patient groups. GM atrophy in the anterior and posterior cingulate, as measured by VBM, in the temporo-fronto-parietal component, as measured by SBM, and in the posterior cortical regions as well as in the anterior cingulate and frontal region, as measured by CT, differentiated aMCI from HC. Major hippocampal and temporal lobe atrophy (VBM, SBM) and to some extent occipital atrophy (SBM) differentiated AD from aMCI and from HC. Correlations with cognitive deficits were present only in the AD group. PD-MCI showed greater GM atrophy than PD-NC in the orbitofrontal regions (VBM), which was related to memory z-scores, and in the left superior parietal lobule (CT); more widespread limbic and fronto-parieto-occipital neocortical atrophy (all methods) differentiated this group from HC. Only CT revealed subtle GM atrophy in the anterior cingulate, precuneus, and temporal neocortex in PD-NC as compared to HC. None of the methods differentiated PD-MCI from aMCI. Both MCI groups showed distinct limbic and fronto-temporo-parietal neocortical atrophy compared to HC with no specific between-group differences. AD subjects displayed a typical pattern of major temporal lobe atrophy which was associated with deficits in all cognitive domains. VBM and CT were more sensitive than SBM in identifying frontal and posterior cortical atrophy in PD-MCI as compared to PD-NC. Our data support the notion that the results of studies using different analytical methods cannot be compared directly. Only CT measures revealed some subtle differences between HC and PD-NC.
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Affiliation(s)
- Jonas Kunst
- Medical Faculty, Masaryk University, Brno, Czech Republic.,Brain and Mind Research Programme, CEITEC Masaryk University, Brno, Czech Republic
| | - Radek Marecek
- Brain and Mind Research Programme, CEITEC Masaryk University, Brno, Czech Republic
| | - Patricia Klobusiakova
- Medical Faculty, Masaryk University, Brno, Czech Republic.,Brain and Mind Research Programme, CEITEC Masaryk University, Brno, Czech Republic
| | - Zuzana Balazova
- Brain and Mind Research Programme, CEITEC Masaryk University, Brno, Czech Republic
| | - Lubomira Anderkova
- Brain and Mind Research Programme, CEITEC Masaryk University, Brno, Czech Republic
| | | | - Irena Rektorova
- Brain and Mind Research Programme, CEITEC Masaryk University, Brno, Czech Republic. .,Movement Disorders Centre, First Department of Neurology, St Anne's University Hospital, Masaryk University, Pekarska 53, 656 91, Brno, Czech Republic.
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