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Liang J, Yu Q, Liu Y, Qiu Y, Tang R, Yan L, Zhou P. Gray matter abnormalities in patients with major depressive disorder and social anxiety disorder: a voxel-based meta-analysis. Brain Imaging Behav 2023; 17:749-763. [PMID: 37725323 PMCID: PMC10733224 DOI: 10.1007/s11682-023-00797-z] [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] [Accepted: 08/30/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Major depressive and social anxiety disorders have a high comorbidity rate and similar cognitive patterns. However, their unique and shared neuroanatomical characteristics have not been fully identified. METHODS Voxel-based morphometric studies comparing gray matter volume between patients with major depressive disorder/social anxiety disorder and healthy controls were searched using 4 electronic databases from the inception to March 2022. Stereotactic data were extracted and subsequently tested for convergence and differences using activation likelihood estimation. In addition, based on the result of the meta-analysis, behavioral analysis was performed to assess the functional roles of the regions affected by major depressive disorder and/or social anxiety disorder. RESULTS In total, 34 studies on major depressive disorder with 2873 participants, and 10 studies on social anxiety disorder with 1004 subjects were included. Gray matter volume conjunction analysis showed that the right parahippocampal gyrus region, especially the amygdala, was smaller in patients compared to healthy controls. The contrast analysis of major depressive disorder and social anxiety disorder revealed lower gray matter volume in the right lentiform nucleus and medial frontal gyrus in social anxiety disorder and lower gray matter volume in the left parahippocampal gyrus in major depressive disorder. Behavioral analysis showed that regions with lower gray matter volume in social anxiety disorder are strongly associated with negative emotional processes. CONCLUSIONS The shared and unique patterns of gray matter volume abnormalities in patients with major depressive and social anxiety disorder may be linked to the underlying neuropathogenesis of these mental illnesses and provide potential biomarkers. PROSPERO registration number: CRD42021277546.
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Affiliation(s)
- Junquan Liang
- Shenzhen Bao'an Chinese Medicine Hospital, The Seventh Clinical Medical School of Guangzhou University of Chinese Medicine, Shenzhen, 518101, Guangdong, China
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences (CAS), Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, Guangdong, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Qiaoyun Yu
- Jingzhou Traditional Chinese Medicine Hospital, Jingzhou, Hubei, China
| | - Yuchen Liu
- Shenzhen Luohu District Hospital of TCM, Shenzhen, Guangdong, China
| | - Yidan Qiu
- Centre for the Study of Applied Psychology, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, Guangdong, China
| | - Rundong Tang
- Shenzhen Bao'an Chinese Medicine Hospital, The Seventh Clinical Medical School of Guangzhou University of Chinese Medicine, Shenzhen, 518101, Guangdong, China
| | - Luda Yan
- Shenzhen Bao'an Chinese Medicine Hospital, The Seventh Clinical Medical School of Guangzhou University of Chinese Medicine, Shenzhen, 518101, Guangdong, China
| | - Peng Zhou
- Shenzhen Bao'an Chinese Medicine Hospital, The Seventh Clinical Medical School of Guangzhou University of Chinese Medicine, Shenzhen, 518101, Guangdong, China.
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Rostami R, Kazemi R, Nasiri Z, Ataei S, Hadipour AL, Jaafari N. Cold Cognition as Predictor of Treatment Response to rTMS; A Retrospective Study on Patients With Unipolar and Bipolar Depression. Front Hum Neurosci 2022; 16:888472. [PMID: 35959241 PMCID: PMC9358278 DOI: 10.3389/fnhum.2022.888472] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/06/2022] [Indexed: 01/10/2023] Open
Abstract
BackgroundCognitive impairments are prevalent in patients with unipolar and bipolar depressive disorder (UDD and BDD, respectively). Considering the fact assessing cognitive functions is increasingly feasible for clinicians and researchers, targeting these problems in treatment and using them at baseline as predictors of response to treatment can be very informative.MethodIn a naturalistic, retrospective study, data from 120 patients (Mean age: 33.58) with UDD (n = 56) and BDD (n = 64) were analyzed. Patients received 20 sessions of bilateral rTMS (10 Hz over LDLPFC and 1 HZ over RDLPFC) and were assessed regarding their depressive symptoms, sustained attention, working memory, and executive functions, using the Beck Depression Inventory (BDI-II) and Neuropsychological Test Automated Battery Cambridge, at baseline and after the end of rTMS treatment course. Generalized estimating equations (GEE) and logistic regression were used as the main statistical methods to test the hypotheses.ResultsFifty-three percentage of all patients (n = 64) responded to treatment. In particular, 53.1% of UDD patients (n = 34) and 46.9% of BDD patients (n = 30) responded to treatment. Bilateral rTMS improved all cognitive functions (attention, working memory, and executive function) except for visual memory and resulted in more modulations in the working memory of UDD compared to BDD patients. More improvements in working memory were observed in responded patients and visual memory, age, and sex were determined as treatment response predictors. Working memory, visual memory, and age were identified as treatment response predictors in BDD and UDD patients, respectively.ConclusionBilateral rTMS improved cold cognition and depressive symptoms in UDD and BDD patients, possibly by altering cognitive control mechanisms (top-down), and processing negative emotional bias.
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Affiliation(s)
- Reza Rostami
- Department of Psychology, University of Tehran, Tehran, Iran
- *Correspondence: Reza Rostami
| | - Reza Kazemi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies>, Tehran, Iran
| | - Zahra Nasiri
- Convergent Technologies Research Center, University of Tehran, Tehran, Iran
| | - Somayeh Ataei
- Department of Neuropsychology, Faculty of Psychology, Institute of Cognitive Neuroscience, Ruhr-University Bochum, Bochum, Germany
| | - Abed L. Hadipour
- Department of Cognitive Sciences, University of Messina, Messina, Italy
| | - Nematollah Jaafari
- Unité de Recherche Clinique Intersectorielle en Psychiatrie Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, France
- University Poitiers & CHU Poitiers, INSERM U1084, Laboratoire Expérimental et Clinique en Neurosciences, Poitiers, France
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Sheng L, Ma H, Dai Z, Yao L, Hu J. Is first episode mania associated with grey matter abnormalities? We are not sure! Bipolar Disord 2021; 23:409-410. [PMID: 33511750 DOI: 10.1111/bdi.13048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/22/2020] [Accepted: 01/21/2021] [Indexed: 11/30/2022]
Affiliation(s)
- LiQin Sheng
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, PR China
| | - HaiRong Ma
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, PR China
| | - ZhenYu Dai
- Department of Radiology, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, PR China
| | - LiZheng Yao
- Department of Radiology, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, PR China
| | - JianBin Hu
- Department of Radiology, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, PR China
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Keramatian K, Chakrabarty T, Saraf G, Pinto JV, Yatham LN. Grey matter abnormalities in first-episode mania: A systematic review and meta-analysis of voxel-based morphometry studies. Bipolar Disord 2021; 23:228-240. [PMID: 32961005 DOI: 10.1111/bdi.12995] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES It has been proposed that different stages of bipolar disorder may be underpinned by distinct neurobiological substrates. However, structural neuroimaging studies in early stages of the illness are limited by small sample sizes yielding inconsistent findings. The purpose of this systematic review and meta-analysis, therefore, was to identify regional grey matter volume (GMV) changes that are consistently associated with first episode of mania (FEM). METHODS Following PRISMA guidelines, we conducted a systematic search of the literature to identify Voxel-Based Morphometry (VBM) studies in FEM patients compared with healthy individuals. We then conducted a voxel-wise meta-analysis using Seed-based d-Mapping technique. Finally, we performed univariate meta-regression analyses to explore the potential effects of moderator variables including age, gender, and percentage of lithium users on GMV alterations. RESULTS We identified 15 VBM studies and included 12 studies in the meta-analysis. Four studies found no regional differences in GM volumes while other 11 studies reported volume changes in frontal and temporal regions as well as anterior cingulate cortex (ACC), cerebellum and basal ganglia. The meta-analysis revealed a single cluster of GMV reduction in bilateral pregenual ACC in patients with FEM compared to healthy individuals (P < .001). The Egger's test showed no evidence of publication bias at peak voxel level (P = .447). Meta-regression analyses revealed no significant effects of moderators evaluated. CONCLUSIONS Structural brain changes are evident in the early stages of bipolar disorder. GMV reduction in bilateral pregenual ACC is the most consistent finding in VBM studies of FEM.
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Affiliation(s)
- Kamyar Keramatian
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Trisha Chakrabarty
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Gayatri Saraf
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Jairo V Pinto
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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fNIRS study of prefrontal activation during emotion recognition-A Potential endophenotype for bipolar I disorder? J Affect Disord 2021; 282:869-875. [PMID: 33601730 DOI: 10.1016/j.jad.2020.12.153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 11/26/2020] [Accepted: 12/23/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Facial emotion recognition (FER) deficit is documented in many psychiatric disorders, including bipolar disorder (BD). However, its role as a risk-marker in BD is not well researched. In the present study, we investigated the role of FER and the corresponding prefrontal neurohemodynamic changes (PNHC) with functional near infra-red spectroscopy (fNIRS) in patients with BD and subjects at high risk for BD compared to healthy subject. METHODS Using a cross-sectional case-control design we compared 14 patients with first episode mania (FEM) in remission (BD group), 14 healthy siblings of BD patients (HR group), and 13 matched healthy subjects (HC group). FER was assessed using a computer-based task called Tool for Recognition of Emotions in Neuropsychiatric Disorders (TRENDS). Simultaneously, the corresponding PNHC was recorded with fNIRS. Kruskal Wallis H test was used to analyze between-group differences and Spearman's rho for correlation analysis. RESULTS The three groups were comparable on socio-demographics (all p>0.09) except education (p = 0.03). HR group had the most hyper-activation in the bilateral DLPFC during the TRENDS task (all p<0.05). There was no significant between-group differences in the FER performance and no significant correlation between the FER performance and the PNHC in the HR and BD groups (all p>0.35). LIMITATIONS The potential confounding effect of medications in the BD group. CONCLUSIONS The hyper-activation of the DLPCF in HR group during FER could indicate an increased risk for BD. However, the lack of similar findings in the BD group might reflect a possible normalizing effect of medications. It is equally likely that differences in the PNHC are detectable earlier than the differences in FER task performance during the course of the illness. This requires further exploration.
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Zhang YN, Li H, Shen ZW, Xu C, Huang YJ, Wu RH. Healthy individuals vs patients with bipolar or unipolar depression in gray matter volume. World J Clin Cases 2021; 9:1304-1317. [PMID: 33644197 PMCID: PMC7896697 DOI: 10.12998/wjcc.v9.i6.1304] [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: 09/10/2020] [Revised: 12/14/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Previous studies using voxel-based morphometry (VBM) revealed changes in gray matter volume (GMV) of patients with depression, but the differences between patients with bipolar disorder (BD) and unipolar depression (UD) are less known.
AIM To analyze the whole-brain GMV data of patients with untreated UD and BD compared with healthy controls.
METHODS Fourteen patients with BD and 20 with UD were recruited from the Mental Health Center of Shantou University between August 2014 and July 2015, and 20 non-depressive controls were recruited. After routine three-plane positioning, axial T2WI scanning was performed. The connecting line between the anterior and posterior commissures was used as the scanning baseline. The scanning range extended from the cranial apex to the foramen magnum. Categorical data are presented as frequencies and were analyzed using the Fisher exact test.
RESULTS There were no significant intergroup differences in gender, age, or years of education. Disease course, age at the first episode, and Hamilton depression rating scale scores were similar between patients with UD and those with BD. Compared with the non-depressive controls, patients with BD showed smaller GMVs in the right inferior temporal gyrus, left middle temporal gyrus, right middle occipital gyrus, and right superior parietal gyrus and larger GMVs in the midbrain, left superior frontal gyrus, and right cerebellum. In contrast, UD patients showed smaller GMVs than the controls in the right fusiform gyrus, left inferior occipital gyrus, left paracentral lobule, right superior and inferior temporal gyri, and the right posterior lobe of the cerebellum, and larger GMVs than the controls in the left posterior central gyrus and left middle frontal gyrus. There was no difference in GMV between patients with BD and UD.
CONCLUSION Using VBM, the present study revealed that patients with UD and BD have different patterns of changes in GMV when compared with healthy controls.
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Affiliation(s)
- Yin-Nan Zhang
- Department of Rehabilitation Medicine, Mental Health Center of Shantou University, Shantou 515000, Guangdong Province, China
| | - Hui Li
- Mental Health Center of Shantou University, Shantou 515000, Guangdong Province, China
| | | | - Chang Xu
- Mental Health Center of Shantou University, Shantou 515000, Guangdong Province, China
| | - Yue-Jun Huang
- Department of Pediatrics, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515000, Guangdong Province, China
| | - Ren-Hua Wu
- Department of Medical Imaging, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
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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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Jiang X, Wang X, Jia L, Sun T, Kang J, Zhou Y, Wei S, Wu F, Kong L, Wang F, Tang Y. Structural and functional alterations in untreated patients with major depressive disorder and bipolar disorder experiencing first depressive episode: A magnetic resonance imaging study combined with follow-up. J Affect Disord 2021; 279:324-333. [PMID: 33096331 DOI: 10.1016/j.jad.2020.09.133] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 09/16/2020] [Accepted: 09/28/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) could assist in identifying objective biomarkers and follow-up study could effectively improve subjective diagnostic accuracy. By combining MRI with follow-up, this study aims to determine the shared and distinct alterations between major depressive disorder (MDD) and bipolar disorder (BD). METHODS Untreated patients with MDD experiencing the first episode were subjected to MRI and subsequent follow-up. Fifteen patients with mania or hypomania were regrouped into BD group. Twenty patients were still grouped as MDD after an average of 37.95 months follow-up. Thirty healthy controls (HCs) were recruited to match the patients. Gray matter volume (GMV) and amygdala-seed functional connectivity (FC) in the whole brain were detected and compared among the three groups. RESULTS GMV analysis revealed that the MDD and BD groups presented reduced GMV predominantly in the parietal, occipital, and frontal regions in the bilateral cerebrum compared with the HCs. The BD group had reduced GMV predominantly in the parietal, temporal, insular regions and the Rolandic operculum in the right-side cerebrum compared with MDD and HC groups. FC analysis revealed that the MDD and BD patients displayed increased FC values mainly in the bilateral parietal, and left occipital regions. Only the BD group displayed increased FC values in the temporal, occipital, parietal and limbic regions in the right-side cerebrum relative to HCs. LIMITATIONS The main limitation is the relatively small sample size. CONCLUSIONS Alterations in the cortical regions and cortico-limbic neural system may provide the scientific basis for differential diagnosis in affective disorders.
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Affiliation(s)
- Xiaowei Jiang
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China; Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Xinrui Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Linna Jia
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Ting Sun
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Jiahui Kang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Yifang Zhou
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China; Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Shengnan Wei
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Feng Wu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Lingtao Kong
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China
| | - Fei Wang
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China; Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China.
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China; Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, PR China.
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9
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Qiu Y, Yang M, Li S, Teng Z, Jin K, Wu C, Xu X, Chen J, Tang H, Huang J, Xiang H, Guo W, Wang B, Wu H. Altered Fractional Amplitude of Low-Frequency Fluctuation in Major Depressive Disorder and Bipolar Disorder. Front Psychiatry 2021; 12:739210. [PMID: 34721109 PMCID: PMC8548428 DOI: 10.3389/fpsyt.2021.739210] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Discriminating between major depressive disorder (MDD) and bipolar disorder (BD) remains challenging and cognitive deficits in MDD and BD are generally recognized. In this study, the fractional amplitude of low-frequency fluctuation (fALFF) approach was performed to explore neural activity and cognition in first-episode, drug-naïve BD and MDD patients, as well as the relationship between altered fALFF values and clinical or psychometric variables. Methods: A total of 21 BD patients, 25 MDD patients, and 41 healthy controls (HCs) completed clinical assessments and resting-state functional magnetic resonance imaging (rs-fMRI) scans in this study. The rs-fMRI data were analyzed by fALFF method and Pearson correlation analyses were performed between altered fALFF values and clinical variables or cognition. Support vector machine (SVM) was adopted to identify the three groups from each other with abnormal fALFF values in the brain regions obtained by group comparisons. Results: (1) The fALFF values were significantly different in the frontal lobe, temporal lobe, and left precuneus among three groups. In comparison to HCs, BD showed increased fALFF values in the right inferior temporal gyrus (ITG) and decreased fALFF values in the right middle temporal gyrus, while MDD showed decreased fALFF values in the right cerebellar lobule IV/V. In comparison to MDD, BD showed decreased fALFF values in bilateral posterior cingulate gyrus and the right cerebellar lobule VIII/IX. (2) In the BD group, a negative correlation was found between increased fALFF values in the right ITG and years of education, and a positive correlation was found between decreased fALFF values in the right cerebellar lobule VIII/IX and visuospatial abilities. (3) The fALFF values in the right cerebellar lobule VIII/IX may have the ability to discriminate BD patients from MDD patients, with sensitivity, specificity, and accuracy all over 0.70. Conclusions: Abnormal brain activities were observed in BD and MDD and were related with cognition in BD patients. The abnormality in the cerebellum can be potentially used to identify BD from MDD patients.
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Affiliation(s)
- Yan Qiu
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Min Yang
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Sujuan Li
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ziwei Teng
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Kun Jin
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chujun Wu
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xuelei Xu
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jindong Chen
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hui Tang
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jing Huang
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hui Xiang
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenbin Guo
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Bolun Wang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Haishan Wu
- Department of Psychiatry, China National Technology Institute on Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
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10
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Zhang L, Verwer RWH, Lucassen PJ, Huitinga I, Swaab DF. Sex difference in glia gene expression in the dorsolateral prefrontal cortex in bipolar disorder: Relation to psychotic features. J Psychiatr Res 2020; 125:66-74. [PMID: 32208195 DOI: 10.1016/j.jpsychires.2020.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/16/2020] [Accepted: 03/09/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Suicide, psychotic features and gender influence the epidemiology and clinical prognosis of bipolar disorder (BD). Differences in glial function between the genders might contribute to these clinical variables. Here we studied expression of glial genes in human post-mortem prefrontal cortex of BD and control subjects in relation to suicide, psychotic features and sex. METHODS Real time PCR was used to detect transcriptional alterations of 16 glia-related genes in two brain areas, the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC), from 30 patients with BD subdivided by suicide and psychotic features, and from 34 well-matched control cases. RESULTS We found no evidence of immune activation in BD. Instead, we found three microglial genes to be downregulated in the DLPFC of non-suicidal individuals with BD, i.e. CD68, triggering receptor expressed on myeloid cells 2 (TREM2) and purinergic receptor 12 (P2RY12). A remarkable sex difference was observed in the DLPFC of patients with BD: 14 glia-related genes were expressed at significantly higher levels in males, including all three glial cell types. A subset analysis showed that the sex differences were closely associated with the presence of psychotic features. CONCLUSIONS No evidence of immune activation was found in these two brain regions in BD. The sex-specific differences in glial gene expression in BD, found particularly in patients with psychotic features, may be associated with the potential co-existence of mania and psychotic features and could potentially contribute to the gender-biased characteristics in BD.
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Affiliation(s)
- Lin Zhang
- Neuropsychiatric Disorders Group, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Ronald W H Verwer
- Neuropsychiatric Disorders Group, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Paul J Lucassen
- Brain Plasticity Group, Faculty of Science, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Inge Huitinga
- Brain Plasticity Group, Faculty of Science, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, the Netherlands; Neuroimmunology Group, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Dick F Swaab
- Neuropsychiatric Disorders Group, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands.
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11
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Matsuo K, Harada K, Fujita Y, Okamoto Y, Ota M, Narita H, Mwangi B, Gutierrez CA, Okada G, Takamura M, Yamagata H, Kusumi I, Kunugi H, Inoue T, Soares JC, Yamawaki S, Watanabe Y. Distinctive Neuroanatomical Substrates for Depression in Bipolar Disorder versus Major Depressive Disorder. Cereb Cortex 2020; 29:202-214. [PMID: 29202177 DOI: 10.1093/cercor/bhx319] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 11/02/2017] [Indexed: 12/20/2022] Open
Abstract
No neuroanatomical substrates for distinguishing between depression of bipolar disorder (dBD) and major depressive disorder (dMDD) are currently known. The aim of the current multicenter study was to identify neuroanatomical patterns distinct to depressed patients with the two disorders. Further analysis was conducted on an independent sample to enable generalization of results. We directly compared MR images of these subjects using voxel-based morphometry (VBM) and a support vector machine (SVM) algorithm using 1531 participants. The VBM analysis showed significantly reduced gray matter volumes in the bilateral dorsolateral prefrontal (DLPFC) and anterior cingulate cortices (ACC) in patients with dBD compared with those with dMDD. Patients with the two disorders shared small gray matter volumes for the right ACC and left inferior frontal gyrus when compared with healthy subjects. Voxel signals in these regions during SVM analysis contributed to an accurate classification of the two diagnoses. The VBM and SVM results in the second cohort also supported these results. The current findings provide new evidence that gray matter volumes in the DLPFC and ACC are core regions in displaying shared and distinct neuroanatomical substrates and can shed light on elucidation of neural mechanism for depression within the bipolar/major depressive disorder continuum.
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Affiliation(s)
- Koji Matsuo
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, Japan
| | - Kenichiro Harada
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, Japan
| | - Yusuke Fujita
- Division of Electrical, Electronic and Information Engineering, Graduate School of Sciences and Technology for Innovation, Yamaguchi University, Tokiwadai 2-16-1, Ube, Yamaguchi, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neurosciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, Japan
| | - Hisashi Narita
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Japan
| | - Benson Mwangi
- Department of Psychiatry, The University of Texas Health Science Center at Houston, TX, USA
| | - Carlos A Gutierrez
- Department of Psychiatry, The University of Texas Health Science Center at Houston, TX, USA
| | - Go Okada
- Department of Psychiatry and Neurosciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Masahiro Takamura
- Department of Psychiatry and Neurosciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Hirotaka Yamagata
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Japan.,Department of Psychiatry, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo, Japan
| | - Jair C Soares
- Department of Psychiatry, The University of Texas Health Science Center at Houston, TX, USA
| | - Shigeto Yamawaki
- Department of Psychiatry and Neurosciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Yoshifumi Watanabe
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, Japan
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12
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Lu X, Zhong Y, Ma Z, Wu Y, Fox PT, Zhang N, Wang C. Structural imaging biomarkers for bipolar disorder: Meta-analyses of whole-brain voxel-based morphometry studies. Depress Anxiety 2019; 36:353-364. [PMID: 30475436 DOI: 10.1002/da.22866] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 10/20/2018] [Accepted: 11/06/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a common and destructive psychiatric illness worldwide. Although it is known that BD is associated with morphological abnormalities of the brain, the regions implicated in BD remain unclear. Therefore, we aimed to update current knowledge on potential structural imaging biomarkers of BD. METHODS Studies published up to January 31, 2018, were identified by a comprehensive literature search of PubMed, EBSCO, and BrainMap voxel-based morphometry (VBM) database. Whole-brain VBM studies that examined gray matter (GM) abnormalities of group comparisons between BD and healthy controls (HC) and reported results as coordinates in a standard reference space were included. Different meta-analyses were performed by activation likelihood estimation (ALE) algorithm. RESULTS A total of 46 studies with 56 experiments, including 1720 subjects and 268 foci were included. Seven different meta-analyses were calculated separately across experiments reporting decreased or increased GM volume among BD, BDΙ, BD-adults, and BD-youths groups. Fifteen regions of significantly different GM volume between four groups and HC were identified. There were extensive GM deficits in the prefrontal and temporal cortex, and enlargements in the putamen, cingulate cortex, and precuneus. CONCLUSIONS The results revealed that the thinning of prefrontal cortex was a key region in the pathophysiology of BD. The enlargement of the cingulate cortex may be implicated in a compensatory mechanism. It underscored important differences between BD-adults and BD-youths and specific biomarkers of three subgroups.
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Affiliation(s)
- Xin Lu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.,Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.,Jiangsu Key Laboratory of Mental Health and Cognitive Science, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Zijuan Ma
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yun Wu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.,Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Peter T Fox
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,South Texas Veterans Healthcare System, University of Texas Health San Antonio, San Antonio, United States.,Research Imaging Institute, University of Texas Health San Antonio, San Antonio, United States
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chun Wang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
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13
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Goikolea JM, Dima D, Landín-Romero R, Torres I, DelVecchio G, Valentí M, Amann BL, Bonnín CM, McKenna PJ, Pomarol-Clotet E, Frangou S, Vieta E. Multimodal Brain Changes in First-Episode Mania: A Voxel-Based Morphometry, Functional Magnetic Resonance Imaging, and Connectivity Study. Schizophr Bull 2019; 45:464-473. [PMID: 29672741 PMCID: PMC6403052 DOI: 10.1093/schbul/sby047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Brain structural and functional changes in bipolar disorder (BD) are well-established findings, but it is uncertain whether these changes are already present in first episode mania (FEM). METHODS We compared 31 FEM subjects, with 31 healthy individuals matched for age, sex, and premorbid IQ. Whole-brain voxel-wise morphometry, functional magnetic resonance imaging during the n-back task, and a functional connectivity analysis were performed. RESULTS There were no volumetric differences between the 2 groups. During the 2-back task, FEM patients did not perform differently from controls and activated similar regions, but they showed less deactivation in the ventromedial prefrontal cortex (vmPFC), the anterior hub of the default mode network (DMN). They showed preserved functional connectivity between the vmPFC and other regions of the DMN, but increased connectivity with the superior frontal gyrus. CONCLUSIONS The absence of volumetric changes in FEM patients suggests that these changes could be related to progression of the illness. On the other hand, the failure of deactivation of the anterior hub of the DMN is present from the onset of the illness and may represent a core pathophysiological feature of BD.
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Affiliation(s)
- José M Goikolea
- Barcelona Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Danai Dima
- Department of Psychology, School of Arts and Social Sciences, City University London, London, UK,Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Ramón Landín-Romero
- FIDMAG Germanes Hospitalàries Research Foundation, Benito Menni Complex Assistencial en Salut Mental, CIBERSAM, Barcelona, Catalonia, Spain
| | - Imma Torres
- Barcelona Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | | | - Marc Valentí
- Barcelona Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Benedikt L Amann
- FIDMAG Germanes Hospitalàries Research Foundation, Benito Menni Complex Assistencial en Salut Mental, CIBERSAM, Barcelona, Catalonia, Spain
| | - Caterina Mar Bonnín
- Barcelona Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Peter J McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Benito Menni Complex Assistencial en Salut Mental, CIBERSAM, Barcelona, Catalonia, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Benito Menni Complex Assistencial en Salut Mental, CIBERSAM, Barcelona, Catalonia, Spain
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Eduard Vieta
- Barcelona Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain,To whom correspondence should be addressed; Bipolar Disorder Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, Villarroel, 170, 08036 Barcelona, Spain; tel: +34-93-227-5401; fax: +34-93-227-9228, e-mail:
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14
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Wang X, Tian F, Wang S, Cheng B, Qiu L, He M, Wang H, Duan M, Dai J, Jia Z. Gray matter bases of psychotic features in adult bipolar disorder: A systematic review and voxel-based meta-analysis of neuroimaging studies. Hum Brain Mapp 2018; 39:4707-4723. [PMID: 30096212 DOI: 10.1002/hbm.24316] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 07/05/2018] [Indexed: 02/05/2023] Open
Abstract
Psychotic bipolar disorder (P-BD) is a specific subset that presents greater risk of relapse and worse outcomes than nonpsychotic bipolar disorder (NP-BD). To explore the neuroanatomical bases of psychotic dimension in bipolar disorder (BD), a systematic review was carried out based on the gray matter volume (GMV) among P-BD and NP-BD patients and healthy controls (HC). Further, we conducted a meta-analysis of GMV differences between P-BD patients and HC using a whole-brain imaging approach. Our review revealed that P-BD patients exhibited smaller GMVs mainly in the prefronto-temporal and cingulate cortices, the precentral gyrus, and insula relative to HC both qualitatively and quantitatively. Qualitatively the comparison between P-BD and NP-BD patients suggested inconsistent GMV alterations mainly involving the prefrontal cortex, while NP-BD patients showed GMV deficits in local regions compared with HC. The higher proportions of female patients and patients taking psychotropic medication in P-BD and P-BD type I were associated with smaller GMV in the right precentral gyrus, and the right insula, respectively. In conclusions, psychosis in BD might be associated with specific cortical GMV deficits. Gender and psychotropic medication might have effects on the regional GMVs in P-BD patients. It is necessary to distinguish psychotic dimension in neuroimaging studies of BD.
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Affiliation(s)
- Xiuli Wang
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Fangfang Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Song Wang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Lihua Qiu
- Department of Radiology, The Second People's Hospital of Yibin, Yibin, China
| | - Manxi He
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Hongming Wang
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Mingjun Duan
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Jing Dai
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
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15
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Chen L, Wang Y, Niu C, Zhong S, Hu H, Chen P, Zhang S, Chen G, Deng F, Lai S, Wang J, Huang L, Huang R. Common and distinct abnormal frontal-limbic system structural and functional patterns in patients with major depression and bipolar disorder. NEUROIMAGE-CLINICAL 2018; 20:42-50. [PMID: 30069426 PMCID: PMC6067086 DOI: 10.1016/j.nicl.2018.07.002] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/02/2018] [Accepted: 07/03/2018] [Indexed: 12/16/2022]
Abstract
Major depressive disorder (MDD) and bipolar disorder (BD) are common severe affective diseases. Although previous neuroimaging studies have investigated brain abnormalities in MDD or BD, the structural and functional differences between these two disorders remain unclear. In this study, we adopted a multimodal approach, combining voxel-based morphometry (VBM) and functional connectivity (FC), to study the common and distinct structural and functional alterations in unmedicated MDD and BD patients. The VBM analysis revealed that both the MDD and BD patients showed decreased gray matter volume (GMV) in the left anterior cingulate cortex (ACC_L) and right hippocampus (HIP_R) compared with the healthy controls, and the MDD patients showed decreased GMV in the left superior frontal gyrus (SFG_L) and ACC_L compared with the BD patients. Furthermore, we took these clusters as seed regions to analyze the abnormal resting-state functional connectivity (RSFC) in the patients. We found that both the MDD and BD groups had decreased RSFC between the ACC_L and the left orbitofrontal cortex (OFC_L) and that the MDD group had decreased RSFC between the SFG_L and the HIP_L, compared with the healthy controls. Our results revealed that the MDD and BD patients were more similar than different in GMV and RSFC. These findings indicate that investigating the frontal-limbic system could be useful for understanding the underlying mechanisms of these two disorders. Both MDD and BD patients had reduced GMV in the ACC_L and HIP_R compared with HC. MDD patients had decreased GMV in the ACC_L and SFG_L compared with BD patients. Both BD and MDD patients had decreased ACC-OFC RSFC compared with HC. The MDD and BD patients were more similar than different in GMV and RSFC.
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Key Words
- ACC, anterior cingulate cortex
- Affective disorder
- CSF, cerebrospinal fluid
- DLPFC, dorsolateral prefrontal cortex
- Functional connectivity
- GM, gray matter
- GMV, gray matter volume
- HDRS, Hamilton Depression Rating Scale
- HIP, hippocampus
- Multimodal
- OFC, orbitofrontal cortex
- ORBmid, orbital part middle frontal gyrus
- ORBsup, orbital part superior frontal gyrus
- R-fMRI, Resting-state fMRI
- RSFC, resting-state functional connectivity
- SFG, superior frontal gyrus
- THA, thalamus
- VBM, voxel-based morphometry
- VLPFC, ventrolateral prefrontal cortex
- Voxel-based morphometry
- WM, white matter
- YMRS, Young Mania Rating Scale
- dmPFC, dorsomedial prefrontal cortex
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Affiliation(s)
- Lixiang Chen
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, 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.
| | - Chen Niu
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Huiqing Hu
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Ping Chen
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Shufei Zhang
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Feng Deng
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Sunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Junjing Wang
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou 510006, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Ruiwang Huang
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China.
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16
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Liu H, Zhao K, Shi J, Chen Y, Yao Z, Lu Q. Topological Properties of Brain Structural Networks Represent Early Predictive Characteristics for the Occurrence of Bipolar Disorder in Patients With Major Depressive Disorder: A 7-Year Prospective Longitudinal Study. Front Psychiatry 2018; 9:704. [PMID: 30618875 PMCID: PMC6307456 DOI: 10.3389/fpsyt.2018.00704] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 12/03/2018] [Indexed: 11/13/2022] Open
Abstract
Bipolar disorder (BD) and major depressive disorder (MDD) are associated with different brain functional and structural abnormalities, but BD is hard to distinguish from MDD until the first manic or hypomanic episode. The aim of this study was to examine whether the topological properties of the brain structural network could be used to differentiate BD from MDD patients before their first manic/hypomanic episode. Diffusion tensor images were collected from 80 MDD patients and 53 healthy controls (HCs); 78 patients completed the follow-up study lasting 7 years. Among them, 12 patients were converted to BD and 64 patients remained MDD. Topological properties of the brain structural networks at baseline were compared among patients who converted to BD, patients who did not develop BD, and HCs. Patients who converted to BD displayed reduced nodal local efficiency in the left inferior frontal gyrus(IFG) compared with HCs and patients who did not convert to BD. There was no significant difference in the nodal global efficiency among the three groups. The findings suggest that the nodal local efficiency in the left IFG could serve as a potential biomarker to predict the conversion of MDD to BD before the occurrence of the first manic or hypomanic episode.
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Affiliation(s)
- Haiyan Liu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Ke Zhao
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jiabo Shi
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Chen
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China
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17
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Wise T, Radua J, Via E, Cardoner N, Abe O, Adams TM, Amico F, Cheng Y, Cole JH, de Azevedo Marques Périco C, Dickstein DP, Farrow TFD, Frodl T, Wagner G, Gotlib IH, Gruber O, Ham BJ, Job DE, Kempton MJ, Kim MJ, Koolschijn PCMP, Malhi GS, Mataix-Cols D, McIntosh AM, Nugent AC, O'Brien JT, Pezzoli S, Phillips ML, Sachdev PS, Salvadore G, Selvaraj S, Stanfield AC, Thomas AJ, van Tol MJ, van der Wee NJA, Veltman DJ, Young AH, Fu CH, Cleare AJ, Arnone D. Common and distinct patterns of grey-matter volume alteration in major depression and bipolar disorder: evidence from voxel-based meta-analysis. Mol Psychiatry 2017; 22:1455-1463. [PMID: 27217146 PMCID: PMC5622121 DOI: 10.1038/mp.2016.72] [Citation(s) in RCA: 368] [Impact Index Per Article: 52.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 03/01/2016] [Accepted: 03/23/2016] [Indexed: 12/11/2022]
Abstract
Finding robust brain substrates of mood disorders is an important target for research. The degree to which major depression (MDD) and bipolar disorder (BD) are associated with common and/or distinct patterns of volumetric changes is nevertheless unclear. Furthermore, the extant literature is heterogeneous with respect to the nature of these changes. We report a meta-analysis of voxel-based morphometry (VBM) studies in MDD and BD. We identified studies published up to January 2015 that compared grey matter in MDD (50 data sets including 4101 individuals) and BD (36 data sets including 2407 individuals) using whole-brain VBM. We used statistical maps from the studies included where available and reported peak coordinates otherwise. Group comparisons and conjunction analyses identified regions in which the disorders showed common and distinct patterns of volumetric alteration. Both disorders were associated with lower grey-matter volume relative to healthy individuals in a number of areas. Conjunction analysis showed smaller volumes in both disorders in clusters in the dorsomedial and ventromedial prefrontal cortex, including the anterior cingulate cortex and bilateral insula. Group comparisons indicated that findings of smaller grey-matter volumes relative to controls in the right dorsolateral prefrontal cortex and left hippocampus, along with cerebellar, temporal and parietal regions were more substantial in major depression. These results suggest that MDD and BD are characterised by both common and distinct patterns of grey-matter volume changes. This combination of differences and similarities has the potential to inform the development of diagnostic biomarkers for these conditions.
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Affiliation(s)
- T Wise
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - J Radua
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Research Unit, FIDMAG Germanes Hospitalàries – CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - E Via
- Mental Health, Parc Taulí Sabadell-CIBERSAM, University Hospital, Sabadell, Barcelona, Spain
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - N Cardoner
- Mental Health, Parc Taulí Sabadell-CIBERSAM, University Hospital, Sabadell, Barcelona, Spain
| | - O Abe
- Department of Radiology, Nihon University School of Medicine, Tokyo, Japan
| | - T M Adams
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - F Amico
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - Y Cheng
- Department of Psychiatry, The 1st Affiliated Hospital of Kunming Medical University, Kunming, PR China
| | - J H Cole
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Department of Medicine, Imperial College London, London, UK
| | - C de Azevedo Marques Périco
- Department of Neuroscience, Medical School, Fundação do ABC, Santo André, SP, Brazil
- ABC Center of Studies on Mental Health, Santo André, SP, Brazil
| | - D P Dickstein
- PediMIND Program, Bradley Hospital, Department of Psychiatry, Brown University, East Providence, RI, USA
| | - T F D Farrow
- Academic Clinical Neurology, Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - T Frodl
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
- Department of Psychiatry, University of Dublin, Trinity College, Dublin, Ireland
| | - G Wagner
- Psychiatric Brain and Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - I H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - O Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - B J Ham
- Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea
| | - D E Job
- Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK
- Scottish Imaging Network–A Platform for Scientific Excellence (SINAPSE), Giffnock, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - M J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - M J Kim
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - P C M P Koolschijn
- Department of Psychology, Dutch Autism and ADHD Research Center, Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - G S Malhi
- CADE Clinic, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - D Mataix-Cols
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - A C Nugent
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - J T O'Brien
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - S Pezzoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Neuroscience, Medical School, University of Sheffield, Sheffield, UK
| | - M L Phillips
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - P S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - G Salvadore
- Janssen Research and Development, Titusville, NJ, USA
| | - S Selvaraj
- Department of Psychiatry and Behavioral Sciences, Center of Excellence on Mood Disorders, Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - A C Stanfield
- The Patrick Wild Centre, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - A J Thomas
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - M J van Tol
- NeuroImaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - N J A van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - D J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - A H Young
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - C H Fu
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- School of Psychology, University of East London, London, UK
| | - A J Cleare
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - D Arnone
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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18
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Duarte DGG, Neves MDCL, Albuquerque MR, Turecki G, Ding Y, de Souza-Duran FL, Busatto G, Correa H. Structural brain abnormalities in patients with type I bipolar disorder and suicidal behavior. Psychiatry Res Neuroimaging 2017; 265:9-17. [PMID: 28494347 DOI: 10.1016/j.pscychresns.2017.04.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 04/24/2017] [Accepted: 04/28/2017] [Indexed: 12/20/2022]
Abstract
Some studies have identified brain morphological changes in the frontolimbic network (FLN) in bipolar subjects who attempt suicide (SA). The present study investigated neuroanatomical abnormalities in the FLN to find a possible neural signature for suicidal behavior in patients with bipolar disorder type I (BD-I). We used voxel-based morphometry to compare euthymic patients with BD-I who had attempted suicide (n=20), who had not attempted suicide (n=19) and healthy controls (HCs) (n=20). We also assessed the highest medical lethality of their previous SA. Compared to the participants who had not attempted suicide, the patients with BD-I who had attempted suicide exhibited significantly increased gray matter volume (GMV) in the right rostral anterior cingulate cortex (ACC), which was more pronounced and extended further to the left ACC in the high-lethality subgroup (p<0.05, with family-wise error (FWE) correction for multiple comparisons using small-volume correction). GMV in the insula and orbitofrontal cortex was also related to suicide lethality (p<0.05, FWE-corrected). The current findings suggest that morphological changes in the FLN could be a signature of previous etiopathogenic processes affecting regions related to suicidality and its severity in BD-I patients.
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Affiliation(s)
- Dante G G Duarte
- Mental Health Department, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil.
| | - Maila de Castro L Neves
- Mental Health Department, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil.
| | | | - Gustavo Turecki
- McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Montreal, Canada.
| | - Yang Ding
- McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Montreal, Canada.
| | - Fabio Luis de Souza-Duran
- Laboratory of Neuroimaging in Psychiatry (LIM-21), Research in Applied Neuroscience, Support Care of the University of São Paulo (NAPNA-USP), São Paulo, Brazil.
| | - Geraldo Busatto
- Laboratory of Neuroimaging in Psychiatry (LIM-21), Research in Applied Neuroscience, Support Care of the University of São Paulo (NAPNA-USP), São Paulo, Brazil.
| | - Humberto Correa
- Mental Health Department, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil.
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19
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Ganzola R, Duchesne S. Voxel-based morphometry meta-analysis of gray and white matter finds significant areas of differences in bipolar patients from healthy controls. Bipolar Disord 2017; 19:74-83. [PMID: 28444949 DOI: 10.1111/bdi.12488] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 03/06/2017] [Accepted: 03/12/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We present a retrospective meta-analysis of voxel-based morphometry (VBM) of gray (GM) and white matter (WM) differences between patients with bipolar disorder (BD) and behaviorally healthy controls. METHODS We used the activation likelihood estimation and Sleuth software for our meta-analysis, considering P-value maps at the cluster level inference of .05 with uncorrected P<.001. Results were visualized with the software MANGO. RESULTS We included twenty-five articles in the analysis, and separated the comparisons where BD patients had lower GM or WM concentrations than controls (573 subjects, 21 experiments, and 117 locations/180 subjects, five experiments, and 15 locations, respectively) and the comparisons where BD patients had greater GM concentrations than controls (217 subjects, nine experiments, and 49 locations). Higher WM concentrations in BD patients were not detected. We observed for BD reduced GM concentrations in the left medial frontal gyrus and right inferior/precentral gyri encompassing the insular cortex, and greater GM concentrations in the left putamen. Further, lower WM concentrations were detected in the left inferior longitudinal fasciculus, left superior corona radiata, and left posterior cingulum. CONCLUSIONS This meta-analysis confirms deterioration of frontal and insular regions as already found in previous meta-analysis. GM reductions in these regions could be related to emotional processing and decision making, which are typically impaired in BD. Moreover, we found abnormalities in precentral frontal areas and putamen that have been linked to more basic functions, which could point to sensory and specific cognitive deficits. Finally, WM reductions involved circuitry that may contribute to emotional dysregulation in BD.
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Affiliation(s)
- Rossana Ganzola
- Institut universitaire en santé mentale de Québec, Québec City, Québec, Canada
| | - Simon Duchesne
- Institut universitaire en santé mentale de Québec, Québec City, Québec, Canada.,Départment de Radiologie, Faculté de Médecine, Université Laval, Québec City, Québec, Canada
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20
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Arnone D, Job D, Selvaraj S, Abe O, Amico F, Cheng Y, Colloby SJ, O'Brien JT, Frodl T, Gotlib IH, Ham BJ, Kim MJ, Koolschijn PCMP, Périco CAM, Salvadore G, Thomas AJ, Van Tol MJ, van der Wee NJA, Veltman DJ, Wagner G, McIntosh AM. Computational meta-analysis of statistical parametric maps in major depression. Hum Brain Mapp 2016; 37:1393-404. [PMID: 26854015 DOI: 10.1002/hbm.23108] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 12/17/2015] [Accepted: 12/19/2015] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Several neuroimaging meta-analyses have summarized structural brain changes in major depression using coordinate-based methods. These methods might be biased toward brain regions where significant differences were found in the original studies. In this study, a novel voxel-based technique is implemented that estimates and meta-analyses between-group differences in grey matter from individual MRI studies, which are then applied to the study of major depression. METHODS A systematic review and meta-analysis of voxel-based morphometry studies were conducted comparing participants with major depression and healthy controls by using statistical parametric maps. Summary effect sizes were computed correcting for multiple comparisons at the voxel level. Publication bias and heterogeneity were also estimated and the excess of heterogeneity was investigated with metaregression analyses. RESULTS Patients with major depression were characterized by diffuse bilateral grey matter loss in ventrolateral and ventromedial frontal systems extending into temporal gyri compared to healthy controls. Grey matter reduction was also detected in the right parahippocampal and fusiform gyri, hippocampus, and bilateral thalamus. Other areas included parietal lobes and cerebellum. There was no evidence of statistically significant publication bias or heterogeneity. CONCLUSIONS The novel computational meta-analytic approach used in this study identified extensive grey matter loss in key brain regions implicated in emotion generation and regulation. Results are not biased toward the findings of the original studies because they include all available imaging data, irrespective of statistically significant regions, resulting in enhanced detection of additional areas of grey matter loss.
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Affiliation(s)
- Danilo Arnone
- Centre for Affective Disorders, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Dominic Job
- Neuroimaging Sciences, the University of Edinburgh, Edinburgh, United Kingdom
| | - Sudhakar Selvaraj
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Osamu Abe
- Department of Radiology, Nihon University School of Medicine, Itabashi-Ku, Tokyo, Japan
| | - Francesco Amico
- Trinity College School of Medicine, Department of Psychiatry, Neuroimaging Group, Trinity College Dublin, Ireland
| | - Yuqi Cheng
- Department of Psychiatry, the 1st Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Sean J Colloby
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - John T O'Brien
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Thomas Frodl
- Trinity College School of Medicine, Department of Psychiatry, Neuroimaging Group, Trinity College Dublin, Ireland.,Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, California
| | - Byung-Joo Ham
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea
| | - M Justin Kim
- Department of Psychological & Brain Sciences, Dartmouth College, Hanover, New Hampshire
| | - P Cédric M P Koolschijn
- Dutch Autism & ADHD Research Center Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - Cintia A-M Périco
- Disciplinas De Psiquiatria E Psicologia Médica Da Faculdade De Medicina Do ABC Coordenadora Da Enfermaria De Psiquiatria Do Hospital Estadual Mário Covas, San Paolo, Brazil
| | - Giacomo Salvadore
- Neuroscience Experimental Medicine, Janssen Research & Development, Raritan, New Jersey
| | - Alan J Thomas
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Marie-José Van Tol
- Neuroimaging Centre, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Nic J A van der Wee
- Leiden Institute for Brain and Cognition/Psychiatric Neuroimaging, Leiden University and Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
| | - Andrew M McIntosh
- Division of Psychiatry, the University of Edinburgh, Edinburgh, United Kingdom
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21
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Neves MDC, Duarte DG, Albuquerque MR, Nicolato R, Neves FS, Souza-Duran FLD, Busatto G, Corrêa H. Neural correlates of hallucinations in bipolar disorder. ACTA ACUST UNITED AC 2016; 38:1-5. [PMID: 26785108 PMCID: PMC7115474 DOI: 10.1590/1516-4446-2014-1640] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 02/24/2015] [Indexed: 01/10/2023]
Abstract
Objective: Approximately one-half of all patients affected by bipolar disorder present with psychotic features on at least one occasion. Several studies have found that alterations in the activity of mesolimbic and prefrontal regions are related to aberrant salience in psychotic patients. The aim of the present study was to investigate the structural correlates of a history of hallucinations in a sample of euthymic patients with bipolar I disorder (BD-I). Methods: The sample consisted of 21 euthymic patients with BD-I and no comorbid axis I DSM-IV-TR disorders. Voxel based morphometry (VBM) was used to compare patients with and without a lifetime history of hallucinations. Preprocessing was performed using the Diffeomorphic Anatomical Registration through Exponentiated Lie Algebra (DARTEL) algorithm for VBM in SPM8. Images were processed using optimized VBM. Results: The main finding of the present study was a reduction in gray matter volume in the right posterior insular cortex of patients with BD-I and a lifetime history of hallucinations, as compared to subjects with the same diagnosis but no history of hallucinations. Conclusions: This finding supports the presence of abnormalities in the salience network in BD patients with a lifetime history of hallucinations. These alterations may be associated with an aberrant assignment of salience to the elements of one’s own experience, which could result in psychotic symptoms.
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Affiliation(s)
- Maila de C Neves
- Departamento de Sa�de Mental, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Dante G Duarte
- Departamento de Sa�de Mental, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Rodrigo Nicolato
- Departamento de Sa�de Mental, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Fernando S Neves
- Departamento de Sa�de Mental, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Fábio L de Souza-Duran
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Geraldo Busatto
- Department of Psychiatry, School of Medicine, Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, São Paulo, SP, Brazil
| | - Humberto Corrêa
- Departamento de Sa�de Mental, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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22
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Gupta S, Goren A, Dong P, Liu D. Prevalence, awareness, and burden of major depressive disorder in urban China. Expert Rev Pharmacoecon Outcomes Res 2015; 16:393-407. [PMID: 26495800 DOI: 10.1586/14737167.2016.1102062] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES This cross-sectional study examined the prevalence and burden of major depressive disorder (MDD) among adults in urban China. METHODS Data were included from the 2012 China National Health and Wellness Survey. Respondents self-reporting physician diagnosis of depression and screening positive for MDD (Patient Health Questionnaire-9), plus those screening positive for MDD, but undiagnosed and not experiencing depression, were compared with non-depressed controls. Outcomes included health-related quality of life (HRQoL), productivity loss, and resource utilization. Multivariable models assessed outcomes as a function of MDD, controlling for covariates. RESULTS MDD prevalence was 6.0%; only 8.3% of these respondents were diagnosed, among whom 51.5% currently used prescription medication for depression. Adults with MDD (diagnosed or undiagnosed) reported significantly poorer HRQoL and greater productivity loss and resource utilization than controls. CONCLUSIONS MDD in urban China may be under-diagnosed and undertreated. Awareness and better access to treatments may help alleviate the burden of MDD.
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Affiliation(s)
- Shaloo Gupta
- a Health Outcomes Practice , Kantar Health , Princeton , NJ , USA
| | - Amir Goren
- b Health Outcomes Practice, Kantar Health , New York , NY , USA
| | - Peng Dong
- c Health Economics & Outcomes Research , Pfizer Investment Co., Ltd , Beijing , China
| | - Dongdong Liu
- c Health Economics & Outcomes Research , Pfizer Investment Co., Ltd , Beijing , China
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23
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A voxel-based morphometry study of gray matter correlates of facial emotion recognition in bipolar disorder. Psychiatry Res 2015; 233:158-64. [PMID: 26123449 DOI: 10.1016/j.pscychresns.2015.05.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 11/07/2014] [Accepted: 05/17/2015] [Indexed: 01/23/2023]
Abstract
Facial emotion recognition (FER) is one of the many cognitive deficits reported in bipolar disorder (BD) patients. The aim of this study was to investigate neuroanatomical correlates of FER impairments in BD type I (BD-I). Participants comprised 21 euthymic BD-I patients without Axis I DSM IV-TR comorbidities and 21 healthy controls who were assessed using magnetic resonance imaging and the Penn Emotion Recognition Test (ER40). Preprocessing of images used DARTEL (diffeomorphic anatomical registration through exponentiated Lie algebra) for optimized voxel-based morphometry in SPM8. Compared with healthy subjects, BD-I patients performed poorly in on the ER40 and had reduced gray matter volume (GMV) in the left orbitofrontal cortex, superior portion of the temporal pole and insula. In the BD-I group, the statistical maps indicated a direct correlation between FER on the ER40 and right middle cingulate gyrus GMV. Our findings are consistent with the previous studies regarding the overlap of multiple brain networks of social cognition and BD neurobiology, particularly components of the anterior-limbic neural network.
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24
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Wei X, Shen H, Ren J, Liu W, Yang R, Liu J, Wu H, Xu X, Lai L, Hu J, Pan X, Jiang X. Alteration of spontaneous neuronal activity in young adults with non-clinical depressive symptoms. Psychiatry Res 2015; 233:36-42. [PMID: 26004037 DOI: 10.1016/j.pscychresns.2015.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 09/26/2014] [Accepted: 04/27/2015] [Indexed: 12/18/2022]
Abstract
Non-clinical depressive symptoms (nCDSs) are highly prevalent in young adults and may be associated with the risk of developing full-fledged depressive disorders. However, the neural basis underlying nCDSs remains unknown. To explore the alteration of spontaneous brain activity in individuals with nCDSs compared with healthy controls (HCs), we investigated resting-state brain activity using the amplitude of low-frequency fluctuations (ALFF) in subjects with nCDSs (n=17) and HCs (n=20). All subjects were drawn from a sample of 1105 college students participating in a survey assessing depressive symptoms. We determined that nCDSs can lead to reduced ALFF in the right ventral lateral prefrontal cortex (VLPFC) and right dorsolateral prefrontal cortex (DLPFC) and to increased ALFF in the left fusiform, left posterior cerebellum, right cuneus, left inferior parietal lobule, right supramarginal gyrus and bilateral precuneus. In addition, with respect to Beck Depression Inventory (BDI) scores and ALFF values in subjects with nCDSs, a positive correlation was discovered in the right DLPFC, while a negative correlation was identified in left posterior cerebellum and bilateral precuneus after correction. These results indicate that nCDSs are characterized by altered spontaneous activity in several important functional regions. We suggest that altered ALFFs in the right DLPFC, left posterior cerebellum and bilateral precuneus may be biomarkers that are related to the pathophysiology of nCDSs in young adults.
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Affiliation(s)
- Xinhua Wei
- Department of Radiology, the Affiliated Guangzhou First Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong, China.
| | - Huicong Shen
- Department of Neuroradiology, Tiantan Hospital, Capital Medical University, Beijing 100050, China.
| | - Jiliang Ren
- Department of Radiology, the Affiliated Guangzhou First Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong, China.
| | - Wenhua Liu
- Faculty of Health Management, Guangzhou Medical University, Guangzhou 510180, China.
| | - Ruimeng Yang
- Department of Radiology, the Affiliated Guangzhou First Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong, China.
| | - Jun Liu
- Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Hongzhen Wu
- Department of Radiology, the Affiliated Guangzhou First Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong, China.
| | - Xiangdong Xu
- Department of Radiology, the Affiliated Guangzhou First Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong, China.
| | - Lisha Lai
- Department of Radiology, the Affiliated Guangzhou First Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong, China.
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, MI 48202, United States.
| | - Xiaoping Pan
- Department of Neurology, the Affiliated Guangzhou First Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong, China.
| | - Xinqing Jiang
- Department of Radiology, the Affiliated Guangzhou First Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong, China.
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25
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Mehraban A, Samimi SM, Entezari M, Seifi MH, Nazari M, Yaseri M. Peripapillary retinal nerve fiber layer thickness in bipolar disorder. Graefes Arch Clin Exp Ophthalmol 2015; 254:365-71. [PMID: 25808660 DOI: 10.1007/s00417-015-2981-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 12/12/2014] [Accepted: 03/02/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To compare peripapillary retinal nerve fiber layer thickness (RNFLT) between patients with bipolar disorder and a control group by optical coherence tomography (OCT). METHODS This prospective comparative case series included 60 eyes of 30 patients with bipolar disorder and 60 eyes of 30 age-matched healthy control subjects. Using OCT, peripapillary RNFLT of the 4 quadrants and the mean of them was compared between the two groups. Variables such as age of onset, duration, smoking, psychosis, mania and depression episodes in the case group and their relationships with RNFLT were evaluated by OCT. RESULTS Mean RNFLT was 99 ± 8 in the case group, significantly less than the 106 ± 8 mμ in the control group (p = 0.001). The inferior, superior, and nasal quadrants in the case and control groups showed significant difference in RNFLT (p < 0.001) (p = 0.040) (p = 0.005); however, the temporal quadrant was not reduced significantly, compared to the control value (p = 0.907). Moreover, the only variable showing significant relation with RNFLT was duration of bipolar disorder (p = 0.040). CONCLUSION Reduction of peripapilary RNFLT occurs in patients with bipolar disorder, and is related to the duration of disease. RNFLT can be a beneficial value for studying neurodegenerative changes over time towards detecting the severity and duration of disorder.
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Affiliation(s)
- Ali Mehraban
- Psychiatry Research Center, Department of Psychiatry, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mehdi Samimi
- Psychiatry Research Center, Department of Psychiatry, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Entezari
- Ophthalmic Research Center, Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Shahid Madani Ave., 1617763141, Tehran, Iran.
| | - Mohammad Hassan Seifi
- Ophthalmic Research Center, Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Shahid Madani Ave., 1617763141, Tehran, Iran
| | - Maryam Nazari
- Department of Neurology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
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26
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Rosa PGP, Zanetti MV, Duran FLS, Santos LC, Menezes PR, Scazufca M, Murray RM, Busatto GF, Schaufelberger MS. What determines continuing grey matter changes in first-episode schizophrenia and affective psychosis? Psychol Med 2015; 45:817-828. [PMID: 25180801 DOI: 10.1017/s0033291714001895] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) studies have shown that brain abnormalities in psychosis might be progressive during the first years of illness. We sought to determine whether first-episode psychosis (FEP) subjects show progressive regional grey matter (GM) changes compared with controls, and whether those changes are associated with diagnosis, illness course or antipsychotic (AP) use. METHOD Thirty-two subjects with first-episode schizophrenia-spectrum disorders (FESZ), 24 patients with first-episode affective psychoses (FEAP) and 34 controls recruited using a population-based design underwent structural MRI scanning at baseline and at a 5-year follow-up. Regional GM volumes were assessed with voxel-based morphometry (VBM). Patients were treated at community settings, and about half of them remained mainly untreated. RESULTS No significant progressive changes in GM regional volumes were observed in either the FESZ or FEAP group overall. However, FESZ subjects with a non-remitting course showed GM decrements in the left superior temporal gyrus (STG) and insula relative to remitted FESZ subjects. Non-remitted FEAP subjects exhibited a GM decrease in the dorsolateral prefrontal cortex (DLPFC) bilaterally in comparison to remitted FEAP subjects. Among FESZ subjects, AP use was associated with regional GM decrements in the right insula and increments in the cerebellum. CONCLUSIONS Our results suggest that the progression of brain abnormalities in FEP subjects is restricted to those with a poor outcome and differs between diagnosis subgroups. AP intake is associated with a different pattern of GM reductions over time.
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Affiliation(s)
- P G P Rosa
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine,University of São Paulo,Brazil
| | - M V Zanetti
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine,University of São Paulo,Brazil
| | - F L S Duran
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine,University of São Paulo,Brazil
| | - L C Santos
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine,University of São Paulo,Brazil
| | - P R Menezes
- Department of Preventive Medicine, Faculty of Medicine,University of São Paulo,Brazil
| | - M Scazufca
- Laboratory of Psychopharmacology and Clinical Psychophysiology (LIM-23), Faculty of Medicine,Institute of Psychiatry, University of São Paulo,Brazil
| | - R M Murray
- Department of Psychosis Studies,Institute of Psychiatry, King's College London,UK
| | - G F Busatto
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine,University of São Paulo,Brazil
| | - M S Schaufelberger
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine,University of São Paulo,Brazil
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27
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Serafini G, Pompili M, Borgwardt S, Houenou J, Geoffroy PA, Jardri R, Girardi P, Amore M. Brain changes in early-onset bipolar and unipolar depressive disorders: a systematic review in children and adolescents. Eur Child Adolesc Psychiatry 2014; 23:1023-41. [PMID: 25212880 DOI: 10.1007/s00787-014-0614-z] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 08/29/2014] [Indexed: 01/09/2023]
Abstract
Pediatric bipolar disorder (BD) and unipolar disorder (UD) share common symptomatic and functional impairments. Various brain imaging techniques have been used to investigate the integrity of brain white matter (WM) and gray matter (GM) in these disorders. Despite promising preliminary findings, it is still unclear whether these alterations may be considered as common trait markers or may be used to distinguish BD from UD. A systematic literature search of studies between 1980 and September 2013 which reported WM/GM changes in pediatric and adolescent BD/UD, as detected by diffusion tensor imaging and voxel-based analysis was conducted. Of the 34 articles judged as eligible, 17 fulfilled our inclusion criteria and were finally retained in this review. More abnormalities have been documented in the brains of children and adolescents with BD than UD. Reductions in the volume of basal ganglia and the hippocampus appeared more specific for pediatric UD, whereas reduced corpus callosum volume and increased rates of deep WM hyperintensities were more specific for pediatric BD. Seminal papers failed to address the possibility that the differences between unipolar and bipolar samples might be related to illness severity, medication status, comorbidity or diagnosis. UD and BD present both shared and distinctive impairments in the WM and GM compartments. More WM abnormalities have been reported in children and adolescents with bipolar disease than in those with unipolar disease, maybe as a result of a low number of DTI studies in pediatric UD. Future longitudinal studies should investigate whether neurodevelopmental changes are diagnosis-specific.
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Affiliation(s)
- Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, IRCCS San Martino, Largo Rosanna Benzi 10, 16100, Genoa, Italy,
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Insular and hippocampal gray matter volume reductions in patients with major depressive disorder. PLoS One 2014; 9:e102692. [PMID: 25051163 PMCID: PMC4106847 DOI: 10.1371/journal.pone.0102692] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 06/20/2014] [Indexed: 01/17/2023] Open
Abstract
Background Major depressive disorder is a serious psychiatric illness with a highly variable and heterogeneous clinical course. Due to the lack of consistent data from previous studies, the study of morphometric changes in major depressive disorder is still a major point of research requiring additional studies. The aim of the study presented here was to characterize and quantify regional gray matter abnormalities in a large sample of clinically well-characterized patients with major depressive disorder. Methods For this study one-hundred thirty two patients with major depressive disorder and 132 age- and gender-matched healthy control participants were included, 35 with their first episode and 97 with recurrent depression. To analyse gray matter abnormalities, voxel-based morphometry (VBM8) was employed on T1 weighted MRI data. We performed whole-brain analyses as well as a region-of-interest approach on the hippocampal formation, anterior cingulate cortex and amygdala, correlating the number of depressive episodes. Results Compared to healthy control persons, patients showed a strong gray-matter reduction in the right anterior insula. In addition, region-of-interest analyses revealed significant gray-matter reductions in the hippocampal formation. The observed alterations were more severe in patients with recurrent depressive episodes than in patients with a first episode. The number of depressive episodes was negatively correlated with gray-matter volume in the right hippocampus and right amygdala. Conclusions The anterior insula gray matter structure appears to be strongly affected in major depressive disorder and might play an important role in the neurobiology of depression. The hippocampal and amygdala volume loss cumulating with the number of episodes might be explained either by repeated neurotoxic stress or alternatively by higher relapse rates in patients showing hippocampal atrophy.
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Kozicky JM, Ha TH, Torres IJ, Bond DJ, Honer WG, Lam RW, Yatham LN. Relationship between frontostriatal morphology and executive function deficits in bipolar I disorder following a first manic episode: data from the Systematic Treatment Optimization Program for Early Mania (STOP-EM). Bipolar Disord 2013; 15:657-68. [PMID: 23919287 DOI: 10.1111/bdi.12103] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 02/24/2013] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Executive function impairments are a core feature of bipolar I disorder (BD-I), not only present during acute episodes but also persisting following remission of mood symptoms. Despite advances in knowledge regarding the neural basis of executive functions in healthy subjects, research into morphological abnormalities underlying the deficits in BD-I is lacking. METHODS Patients with BD-I within three months of sustained remission from their first manic episode (n = 41) underwent neuropsychological testing and a 3T magnetic resonance imaging scan and were compared to healthy subjects matched for age, sex, and premorbid IQ (n = 30). Group dorsolateral prefrontal cortex (DLPFC; Brodmann areas 9 and 46) and caudate volumes were examined and analyzed for relationships with the average score from three computerized tests of executive function: Spatial Working Memory, Stockings of Cambridge, and Intradimensional/Extradimensional Shift. RESULTS Right caudate volumes were enlarged in patients (z = 3.57, p < 0.05 corrected). No differences in DLPFC volumes were found. Patients showed large deficits in executive function relative to healthy subjects (d = -0.92, p < 0.001). While in healthy subjects, a larger right (r = +0.39, p < 0.05) and left (r = +0.44, p < 0.05) caudate was associated with better executive function score, in patients, larger right (r = -0.36, p < 0.05) and left (r = -0.34, p < 0.05) volumes correlated with poorer performance. CONCLUSIONS Although the etiology of gray matter changes is unknown, volume increases in the right caudate may be an important factor underlying executive function impairments during remission in patients with BD-I.
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Affiliation(s)
- Jan-Marie Kozicky
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Busatto GF. Structural and functional neuroimaging studies in major depressive disorder with psychotic features: a critical review. Schizophr Bull 2013; 39:776-86. [PMID: 23615813 PMCID: PMC3686460 DOI: 10.1093/schbul/sbt054] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The relationship between major depressive disorder with psychotic (MDDP) features and schizophrenia has long been recognized, and the neurobiological boundaries between these disorders can nowadays be investigated using neuroimaging techniques. This article provides a critical review of such studies, addressing how they support a dimensional approach to the nosology and pathophysiology of psychotic disorders. A proportion of neuroimaging studies carried out to date indicate that MDDP subjects display structural and functional abnormalities in some brain regions specifically implicated in the pathophysiology of mood disorders, such as the subgenual cingulate cortex. This reinforces the validity of the classification of MDDP in proximity to major depression without psychosis. There is some neuroimaging evidence that MDDP may be associated with additional brain abnormalities relative to nonpsychotic major depression although less prominently in comparison with findings from the neuroimaging literature on schizophrenia. Brain regions seen as critical both to emotional processing and to models of psychotic symptoms, such as the hippocampus, insula, and lateral prefrontal cortex, have been implicated in separate neuroimaging investigations of either schizophrenia or major depression, as well as in some studies that directly compared depressed patients with and without psychotic features. These brain regions are key targets for future studies designed to validate imaging phenotypes more firmly associated with MDDP, as well as to investigate the relationship between these phenotypes and possible etiological influences for MDDP.
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Affiliation(s)
- Geraldo F. Busatto
- Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; ,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Universidade de São Paulo, São Paulo, Brazil,*To whom correspondence should be addressed; Rua Ovidio Pires Campos s/n, CEP 05403-010, São Paulo–SP, Brasil; tel: -55-11-26618132, fax: -55-11-30821015, e-mail:
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Cunha PJ, Rosa PGP, Ayres ADM, Duran FLS, Santos LC, Scazufca M, Menezes PR, dos Santos B, Murray RM, Crippa JAS, Busatto GF, Schaufelberger MS. Cannabis use, cognition and brain structure in first-episode psychosis. Schizophr Res 2013; 147:209-15. [PMID: 23672820 DOI: 10.1016/j.schres.2013.04.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Revised: 04/08/2013] [Accepted: 04/10/2013] [Indexed: 11/16/2022]
Abstract
Cannabis use is highly prevalent worldwide and it is associated with psychosis, but its effects on brain structure and cognition are still controversial. The aim of this paper is to investigate cognitive functioning and brain structure in patients with their first episode of psychosis who used Cannabis. We examined gray matter and lateral ventricle volumes in 28 patients with first-episode psychosis and a history of Cannabis use, 78 patients without a history of Cannabis use and 80 healthy controls who had not used Cannabis. Cognition was assessed using forward and backwards digit span tests, from the Wechsler Memory Scale-Third Edition (WMS-III) and the Controlled Oral Word Association Test (COWAT). Patients with a history of Cannabis use had less brain abnormalities, characterized by gray matter and lateral ventricle volume preservation, as well as less attentional and executive impairments compared to patients without a history of Cannabis use. Cannabis-using patients who develop psychosis have less neurodevelopmental impairment and better cognitive reserve than other psychotic patients; perhaps reflecting different etiological processes.
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Affiliation(s)
- Paulo Jannuzzi Cunha
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department of Psychiatry, Faculty of Medicine, University of São Paulo, Rua Dr Ovídio Pires de Campos, s/n, 05403-010 São Paulo, SP, Brazil.
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Valente KDR, Busatto Filho G. Depression and temporal lobe epilepsy represent an epiphenomenon sharing similar neural networks: clinical and brain structural evidences. ARQUIVOS DE NEURO-PSIQUIATRIA 2013; 71:183-90. [DOI: 10.1590/s0004-282x2013000300011] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Indexed: 11/22/2022]
Abstract
The relationship between depression and epilepsy has been known since ancient times, however, to date, it is not fully understood. The prevalence of psychiatric disorders in persons with epilepsy is high compared to general population. It is assumed that the rate of depression ranges from 20 to 55% in patients with refractory epilepsy, especially considering those with temporal lobe epilepsy caused by mesial temporal sclerosis. Temporal lobe epilepsy is a good biological model to understand the common structural basis between depression and epilepsy. Interestingly, mesial temporal lobe epilepsy and depression share a similar neurocircuitry involving: temporal lobes with hippocampus, amygdala and entorhinal and neocortical cortex; the frontal lobes with cingulate gyrus; subcortical structures, such as basal ganglia and thalamus; and the connecting pathways. We provide clinical and brain structural evidences that depression and epilepsy represent an epiphenomenon sharing similar neural networks.
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Distinguishing between unipolar depression and bipolar depression: current and future clinical and neuroimaging perspectives. Biol Psychiatry 2013; 73:111-8. [PMID: 22784485 PMCID: PMC3494754 DOI: 10.1016/j.biopsych.2012.06.010] [Citation(s) in RCA: 174] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 06/13/2012] [Accepted: 06/14/2012] [Indexed: 12/16/2022]
Abstract
Differentiating bipolar disorder (BD) from recurrent unipolar depression (UD) is a major clinical challenge. Main reasons for this include the higher prevalence of depressive relative to hypo/manic symptoms during the course of BD illness and the high prevalence of subthreshold manic symptoms in both BD and UD depression. Identifying objective markers of BD might help improve accuracy in differentiating between BD and UD depression, to ultimately optimize clinical and functional outcome for all depressed individuals. Yet, only eight neuroimaging studies to date have directly compared UD and BD depressed individuals. Findings from these studies suggest more widespread abnormalities in white matter connectivity and white matter hyperintensities in BD than UD depression, habenula volume reductions in BD but not UD depression, and differential patterns of functional abnormalities in emotion regulation and attentional control neural circuitry in the two depression types. These findings suggest different pathophysiologic processes, especially in emotion regulation, reward, and attentional control neural circuitry in BD versus UD depression. This review thereby serves as a call to action to highlight the pressing need for more neuroimaging studies, using larger samples sizes, comparing BD and UD depressed individuals. These future studies should also include dimensional approaches, studies of at-risk individuals, and more novel neuroimaging approaches, such as connectivity analysis and machine learning. Ultimately, these approaches might provide biomarkers to identify individuals at future risk for BD versus UD and biological targets for more personalized treatment and new treatment developments for BD and UD depression.
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Colombo RRDC, Schaufelberger MS, Santos LC, Duran FLDS, Menezes PR, Scazufca M, Busatto GF, Zanetti MV. Voxelwise evaluation of white matter volumes in first-episode psychosis. Psychiatry Res 2012; 202:198-205. [PMID: 22804969 DOI: 10.1016/j.pscychresns.2011.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2011] [Revised: 07/22/2011] [Accepted: 09/07/2011] [Indexed: 10/28/2022]
Abstract
The occurrence of white matter (WM) abnormalities in psychotic disorders has been suggested by several studies investigating brain pathology and diffusion tensor measures, but evidence assessing regional WM morphometry is still scarce and conflicting. In the present study, 122 individuals with first-episode psychosis (FEP) (62 fulfilling criteria for schizophrenia/schizophreniform disorder, 26 psychotic bipolar I disorder, and 20 psychotic major depressive disorder) underwent magnetic resonance imaging, as well as 94 epidemiologically recruited controls. Images were processed with the Statistical Parametric Mapping (SPM2) package, and voxel-based morphometry was used to compare groups (t-test) and subgroups (ANOVA). Initially, no regional WM abnormalities were observed when both groups (overall FEP group versus controls) and subgroups (i.e., schizophrenia/schizophreniform, psychotic bipolar I disorder, psychotic depression, and controls) were compared. However, when the voxelwise analyses were repeated excluding subjects with comorbid substance abuse or dependence, the resulting statistical maps revealed a focal volumetric reduction in right frontal WM, corresponding to the right middle frontal gyral WM/third subcomponent of the superior longitudinal fasciculus, in subjects with schizophrenia/schizophreniform disorder (n=40) relative to controls (n=89). Our results suggest that schizophrenia/schizophreniform disorder is associated with right frontal WM volume decrease at an early course of the illness.
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Affiliation(s)
- Renata Rodrigues da Cunha Colombo
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
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Hafeman DM, Chang KD, Garrett AS, Sanders EM, Phillips ML. Effects of medication on neuroimaging findings in bipolar disorder: an updated review. Bipolar Disord 2012; 14:375-410. [PMID: 22631621 DOI: 10.1111/j.1399-5618.2012.01023.x] [Citation(s) in RCA: 258] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Neuroimaging is an important tool for better understanding the neurobiological underpinnings of bipolar disorder (BD). However, potential study participants are often receiving psychotropic medications which can possibly confound imaging data. To better interpret the results of neuroimaging studies in BD, it is important to understand the impact of medications on structural magnetic resonance imaging (sMRI), functional MRI (fMRI), and diffusion tensor imaging (DTI). METHODS To better understand the impact of medications on imaging data, we conducted a literature review and searched MEDLINE for papers that included the key words bipolar disorder and fMRI, sMRI, or DTI. The search was limited to papers that assessed medication effects and had not been included in a previous review by Phillips et al. (Medication effects in neuroimaging studies of bipolar disorder. Am J Psychiatry 2008; 165: 313-320). This search yielded 74 sMRI studies, 46 fMRI studies, and 15 DTI studies. RESULTS Medication appeared to influence many sMRI studies, but had limited impact on fMRI and DTI findings. From the structural studies, the most robust finding (20/45 studies) was that lithium was associated with increased volumes in areas important for mood regulation, while antipsychotic agents and anticonvulsants were generally not. Regarding secondary analysis of the medication effects of fMRI and DTI studies, few showed significant effects of medication, although rigorous analyses were typically not possible when the majority of subjects were medicated. Medication effects were more frequently observed in longitudinal studies designed to assess the impact of particular medications on the blood oxygen level-dependent (BOLD) signal. With a few exceptions, the observed effects were normalizing, meaning that the medicated individuals with BD were more similar than their unmedicated counterparts to healthy subjects. CONCLUSIONS The effects of psychotropic medications, when present, are predominantly normalizing and thus do not seem to provide an alternative explanation for differences in volume, white matter tracts, or BOLD signal between BD participants and healthy subjects. However, the normalizing effects of medication could obfuscate differences between BD and healthy subjects, and thus might lead to type II errors.
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Affiliation(s)
- Danella M Hafeman
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
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Liu CH, Ma X, Wu X, Li F, Zhang Y, Zhou FC, Wang YJ, Tie CL, Zhou Z, Zhang D, Dong J, Yao L, Wang CY. Resting-state abnormal baseline brain activity in unipolar and bipolar depression. Neurosci Lett 2012; 516:202-6. [DOI: 10.1016/j.neulet.2012.03.083] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Revised: 03/21/2012] [Accepted: 03/27/2012] [Indexed: 12/31/2022]
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Ong D, Walterfang M, Malhi GS, Styner M, Velakoulis D, Pantelis C. Size and shape of the caudate nucleus in individuals with bipolar affective disorder. Aust N Z J Psychiatry 2012; 46:340-51. [PMID: 22368240 PMCID: PMC3328643 DOI: 10.1177/0004867412440191] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The caudate nucleus (CN) is a crucial component of the ventral striatum, which is part of a prefrontal-striatal-thalamic circuit that is modulated by limbic structures to subserve emotional processing. Bipolar disorder is thought to be underpinned by dysfunctional anterior limbic networks, although MRI studies examining the CN have shown equivocal results. As gross volumetric analyses may not detect subtle regional change, we aimed to clarify the role of the CN in bipolar disorder by undertaking shape analysis to detect regional reductions. METHODS The CN was manually traced on MRI scans from 27 patients with bipolar-I disorder and 24 matched controls. A non-parametric spherical harmonic shape analysis was undertaken using the SPHARM toolkit. RESULTS Whilst the left CN volume was consistently larger in the sample, there was no effect of group or gender or significant interactions between these variables. Volume did not correlate with illness duration or lithium dosage, but was larger in those with a history of psychosis at trend level. However, left caudate shape differed significantly between groups, with deflation in an area along the ventromedial surface (connecting to dorsolateral prefrontal regions) in bipolar patients. Psychotic patients showed increases in the dorsal head and body at trend level overall, in regions connecting to medial and orbitofrontal regions. CONCLUSIONS These findings suggest that subtle rather than gross structural changes occur in the CN, which may not be detectable by volumetric analysis alone, and reflect alterations in specific frontostriatal circuitry in the disorder.
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Affiliation(s)
- Daniel Ong
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
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Neuropsychological performance in bipolar I, bipolar II and unipolar depression patients: a longitudinal, naturalistic study. J Affect Disord 2012; 136:328-39. [PMID: 22169253 DOI: 10.1016/j.jad.2011.11.029] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 10/23/2011] [Accepted: 11/14/2011] [Indexed: 12/11/2022]
Abstract
BACKGROUND It has been suggested that cognitive deficits existed in mood disorders. Nevertheless, whether neuropsychological profiles differ three main subtypes of mood disorder (Bipolar I, Bipolar II and UP) remain understudied because most current studies include either mixed samples of bipolar I and bipolar II patients or mixed samples of different states of the illness. The main aim of the present study is to determine whether, or to some extent, specific cognitive domains could differentiate the main subtypes of mood disorders in the depressed and clinically remitted status. METHOD Three groups of bipolar I (n=92), bipolar II (n=131) and unipolar depression (UP) patients (n=293) were tested with a battery of neuropsychological tests both at baseline (during a depressive episode) and after 6 weeks of treatment, contrasting with 202 healthy controls on cognitive performance. The cognitive domains include processing speed, attention, memory, verbal fluency and executive function. RESULTS At the acute depressive state, the three patient groups (bipolar I, bipolar II and UP) showed cognitive dysfunction in processing speed, memory, verbal fluency and executive function but not in attention compared with controls. Post comparisons revealed that bipolar I depressed patients performed significantly worse in verbal fluency and executive function than bipolar II and UP depressed patients. No difference was found between bipolar II and UP depressed patients except for the visual memory. After 6 weeks of treatment, clinically remitted bipolar I and bipolar II patients only displayed cognitive impairment in processing speed and visual memory. Remitted UP patients showed cognitive impairment in executive function in addition to processing speed and visual memory. The three remitted patient groups scored similarly in processing speed and visual memory. LIMITATION Clinically remitted patients were just recovered from a major depressive episode after 6 weeks of treatment and in relatively unstable state. CONCLUSION Bipolar I, bipolar II and UP patients have a similar pattern of cognitive impairment during the state of acute depressive episode, but bipolar I patients experience greater impairment than bipolar II and UP patients. In clinical remission, both bipolar and UP patients show cognitive deficits in processing speed and visual memory, and executive dysfunction might be a status-maker for bipolar disorder, but a trait-marker for UP.
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Du MY, Wu QZ, Yue Q, Li J, Liao Y, Kuang WH, Huang XQ, Chan RCK, Mechelli A, Gong QY. Voxelwise meta-analysis of gray matter reduction in major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2012; 36:11-6. [PMID: 22001316 DOI: 10.1016/j.pnpbp.2011.09.014] [Citation(s) in RCA: 176] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 09/13/2011] [Accepted: 09/29/2011] [Indexed: 02/05/2023]
Abstract
BACKGROUND Voxel-based morphometry (VBM) has been widely used in studies of major depressive disorder (MDD) and has provided cumulative evidence of gray matter abnormalities in patients relative to controls. Thus we performed a meta-analysis to integrate the reported studies to determine the consistent gray matter alterations in MDD. METHODS A systematic search was conducted to identify VBM studies which contrasted MDD patients against a comparison group. The coordinates of gray matter change across studies were meta-analyzed using the activation likelihood estimation (ALE) method hybridized with the rank-based Genome Scan Meta-Analysis (GSMA) to quantitatively estimate regional gray matter reductions in MDD. RESULTS A total of 20 VBM studies comparing 543 major depressive patients with 750 healthy control subjects were included. Consistent gray matter reductions in all MDD patients relative to healthy controls were identified in the bilateral anterior cingulate cortex (ACC), right middle and inferior frontal gyrus, right hippocampus and left thalamus. CONCLUSIONS Meta-analysis of all primary VBM studies indicates that significant gray matter reductions in MDD are localized in a distributed neural network which includes frontal, limbic and thalamic regions. Future studies will benefit from the use of a longitudinal approach to examine anatomical and functional abnormalities within this network and their relationship to clinical profile, particularly in first-episode and drug-naive MDD patients.
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Affiliation(s)
- Ming-Ying Du
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
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