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Ruiz-Sastre P, Gómez-Sánchez-Lafuente C, Martín-Martín J, Herrera-Imbroda J, Mayoral-Cleries F, Santos-Amaya I, Rodríguez de Fonseca F, Guzmán-Parra J, Rivera P, Suárez J. Pharmacotherapeutic value of inflammatory and neurotrophic biomarkers in bipolar disorder: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2024; 134:111056. [PMID: 38879067 DOI: 10.1016/j.pnpbp.2024.111056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/28/2024] [Accepted: 06/11/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND The various pharmacological interventions, ranging from mood stabilizers and antipsychotics to antidepressants, reflect the diff/iculty of treating depressive/manic symptomatology of bipolar disorder (BD). Among a broad range of mechanisms implicated, immune dysregulation may contribute to the increased inflammation that influences the course of BD. Inflammatory, neurotrophic and oxidative stress factors may be identified as promising peripheral biomarkers in brain functioning, perhaps serving as predictors of an effective response to treatment for BD. The present systematic review aimed to examine the evidence supporting the pharmacotherapeutic value of inflammatory and neurotrophic biomarkers in BD. METHODS PubMed, PsychINFO, Scopus and Web of Science were searched from inception to May 2024 by two independent reviewers. A total of 40 studies with 3371 patients with diagnosis and intervention of BD were selected. RESULTS Inconsistencies in the effects of pharmacological treatments on the connection between the expected anti-inflammatory response and symptomatologic improvement were identified. Mood stabilizers (lithium), antipsychotics (quetiapine), antidepressants (ketamine) or their combination were described to increase both pro-inflammatory (TNFα, IL-6) and anti-inflammatory (IL-4, IL-8) factors. Other medications, such as memantine and dextromethorphan, autoimmune (infliximab) non-steroidal anti-inflammatory (aspirin, celecoxib) drugs, antidiabetics (pioglitazone), and even dietary supplementation (omega-3), or their combination, clearly decrease inflammatory factors (TNFα, IL-6, IL-1β, C-reactive protein) and/or increase the neurotrophic factor BDNF in BD patients. CONCLUSION Inflammation in BD requires further investigation to understand the underlying immunologic mechanism, to identify predictors of treatment response, and to make informed decisions about the use and development of more effective pharmacological interventions for BD.
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Affiliation(s)
- Paloma Ruiz-Sastre
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma BIONAND, Calle Severo Ochoa 35, 29590 Málaga, Spain; Facultad de Medicina, Universidad de Málaga, Andalucia Tech, Campus de Teatinos, 29071 Málaga, Spain; UGC Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Carlos Gómez-Sánchez-Lafuente
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma BIONAND, Calle Severo Ochoa 35, 29590 Málaga, Spain; UGC Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Jaime Martín-Martín
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma BIONAND, Calle Severo Ochoa 35, 29590 Málaga, Spain; Departamento de Anatomía Humana, Medicina Legal e Historia de la Ciencia, Universidad de Málaga, Bulevar Louis Pasteur 32, 29071 Málaga, Spain
| | - Jesús Herrera-Imbroda
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma BIONAND, Calle Severo Ochoa 35, 29590 Málaga, Spain; UGC Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Fermín Mayoral-Cleries
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma BIONAND, Calle Severo Ochoa 35, 29590 Málaga, Spain; UGC Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Ignacio Santos-Amaya
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma BIONAND, Calle Severo Ochoa 35, 29590 Málaga, Spain; Departamento de Anatomía Humana, Medicina Legal e Historia de la Ciencia, Universidad de Málaga, Bulevar Louis Pasteur 32, 29071 Málaga, Spain
| | - Fernando Rodríguez de Fonseca
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma BIONAND, Calle Severo Ochoa 35, 29590 Málaga, Spain; Servicio Neurologia, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - José Guzmán-Parra
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma BIONAND, Calle Severo Ochoa 35, 29590 Málaga, Spain; UGC Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Patricia Rivera
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma BIONAND, Calle Severo Ochoa 35, 29590 Málaga, Spain; UGC Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain.
| | - Juan Suárez
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma BIONAND, Calle Severo Ochoa 35, 29590 Málaga, Spain; Departamento de Anatomía Humana, Medicina Legal e Historia de la Ciencia, Universidad de Málaga, Bulevar Louis Pasteur 32, 29071 Málaga, Spain.
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Gao B, Li C, Qu Y, Cai M, Zhou Q, Zhang Y, Lu H, Tang Y, Li H, Shen H. Progress and trends of research on mineral elements for depression. Heliyon 2024; 10:e35469. [PMID: 39170573 PMCID: PMC11336727 DOI: 10.1016/j.heliyon.2024.e35469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 07/11/2024] [Accepted: 07/29/2024] [Indexed: 08/23/2024] Open
Abstract
Objective To explore the research progress and trends on mineral elements and depression. Methods After querying the MeSH database and referring to the search rules, the search terms were selected and optimized to obtain the target literature collection. We analyzed the general characteristics of the literature, conducted network clustering and co-occurrence analysis, and carried out a narrative review of crucial literature. Results Bipolar disorder was a dominant topic in the retrieved literature, which saw a significant increase in 2010 and 2019-2020. Most studies focused on mineral elements, including lithium, calcium, magnesium, zinc, and copper. The majority of journals and disciplines were in the fields of psychiatry, neuropsychology, neuropharmacology, nutrition, medical informatics, chemistry, and public health. The United States had the highest proportion in terms of paper sources, most-cited articles, high-frequency citations, frontier citations, and high centrality citation. Regarding the influence of academic institutions, the top five were King's College London, the Chinese Academy of Sciences, University of Barcelona, INSERM, and Heidelberg University. Frontier keywords included bipolar disorder, drinking water, (neuro)inflammation, gut microbiota, and systematic analysis. Research on lithium response, magnesium supplementation, and treatment-resistant unipolar depression increased significantly after 2013. Conclusion Global adverse events may have indirectly driven the progress in related research. Although the literature from the United States represents an absolute majority, its influence on academic institutions is relatively weaker. Multiple pieces of evidence support the efficacy of lithium in treating bipolar disorder (BD). A series of key discoveries have led to a paradigm shift in research, leading to increasingly detailed studies on the role of magnesium, calcium, zinc, and copper in the treatment of depression. Most studies on mineral elements remain diverse and inconclusive. The potential toxicity and side effects of some elements warrant careful attention.
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Affiliation(s)
- Biao Gao
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai, 200433, China
- Teaching and Research Support Center, Naval Medical University, Shanghai, 200433, China
| | - Chenqi Li
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai, 200433, China
- Department of Nutrition, The Third Affiliated Hospital of Naval Medical University, Shanghai, 200438, China
| | - Yicui Qu
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai, 200433, China
| | - Mengyu Cai
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai, 200433, China
| | - Qicheng Zhou
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai, 200433, China
| | - Yinyin Zhang
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai, 200433, China
| | - Hongtao Lu
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai, 200433, China
| | - Yuxiao Tang
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai, 200433, China
| | - Hongxia Li
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai, 200433, China
| | - Hui Shen
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai, 200433, China
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Azevedo J, Swales M, Carreiras D, Guiomar R, Macedo A, Castilho P. BI-REAL: A 12-session DBT skills group intervention adapted for bipolar disorder - A feasibility randomised pilot trial. J Affect Disord 2024; 356:394-404. [PMID: 38615843 DOI: 10.1016/j.jad.2024.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 03/21/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Abstract
International guidelines endorse psychological treatment for Bipolar Disorder (BD); however, the absence of a recognised gold-standard intervention requires further research. A Dialectical Behaviour Therapy (DBT) skills group intervention with 12 sessions was developed. This pilot randomised controlled trial (RCT) aims to evaluate the feasibility, acceptability, and outcomes variance of Bi-REAL - Respond Effectively, Assertively, and Live mindfully, tailored for individuals with BD, in preparation for a future RCT. METHODS 52 participants (female = 62.7 %; mean age = 43.2 ± 11.1) with BD were randomised by blocks to either the experimental group (EG; n = 26; Bi-REAL + Treatment as Usual, TAU) receiving 12 weekly 90-minutes sessions, or the control group (CG; n = 26, TAU). Feasibility and acceptability were assessed with a multimethod approach (qualitative interviews, semi-structured clinical interviews and a battery of self-report questionnaires - candidate main outcomes Bipolar Recovery Questionnaire (BRQ) and brief Quality of Life for Bipolar Disorder (QoL.BD)). All participants were evaluated at baseline (T0), post-intervention (T1) and 3-month follow-up (T2). RESULTS Acceptability was supported by participants' positive feedback and ratings of the sessions and programme overall, as well as the treatment attendance (86.25 % of sessions attended). The trial overall retention rate was 74.5 %, with CG having a higher dropout rate across the 3-timepoints (42.31 %). A significant Time × Group interaction effect was found for BRQ and QoL.BD favouring the intervention group (p < .05). LIMITATIONS The assessors were not blind at T1 (only at T2). Recruitment plan was impacted due to COVID-19 restrictions and replication is questionable. High attrition rates in the CG. CONCLUSIONS The acceptability of Bi-REAL was sustained, and subsequent feasibility testing will be necessary to establish whether the retention rates of the overall trial improve and if feasibility is confirmed, before progressing to a definitive trial.
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Affiliation(s)
- Julieta Azevedo
- University of Coimbra, Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Portugal; Bangor University, School of Human and Behavioural Sciences, United Kingdom; Department of Psychology, University of Exeter, Exeter, UK.
| | - Michaela Swales
- Bangor University, School of Human and Behavioural Sciences, United Kingdom
| | - Diogo Carreiras
- University of Coimbra, Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Portugal
| | - Raquel Guiomar
- University of Coimbra, Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Portugal
| | - António Macedo
- University of Coimbra, Faculty of Medicine, Institute of Psychological Medicine (IPM), Portugal; Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Portugal; Centro Hospitalar e Universitário de Coimbra, EPE (CHUC), Coimbra, Portugal
| | - Paula Castilho
- University of Coimbra, Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Portugal
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Pérez-Ramos A, Romero-López-Alberca C, Hidalgo-Figueroa M, Berrocoso E, Pérez-Revuelta JI. A systematic review of the biomarkers associated with cognition and mood state in bipolar disorder. Int J Bipolar Disord 2024; 12:18. [PMID: 38758506 PMCID: PMC11101403 DOI: 10.1186/s40345-024-00340-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a severe psychiatric disorder characterized by changes in mood that alternate between (hypo) mania or depression and mixed states, often associated with functional impairment and cognitive dysfunction. But little is known about biomarkers that contribute to the development and sustainment of cognitive deficits. The aim of this study was to review the association between neurocognition and biomarkers across different mood states. METHOD Search databases were Web of Science, Scopus and PubMed. A systematic review was carried out following the PRISMA guidelines. Risk of bias was assessed with the Newcastle-Ottawa Scale. Studies were selected that focused on the correlation between neuroimaging, physiological, genetic or peripheral biomarkers and cognition in at least two phases of BD: depression, (hypo)mania, euthymia or mixed. PROSPERO Registration No.: CRD42023410782. RESULTS A total of 1824 references were screened, identifying 1023 published articles, of which 336 were considered eligible. Only 16 provided information on the association between biomarkers and cognition in the different affective states of BD. The included studies found: (i) Differences in levels of total cholesterol and C reactive protein depending on mood state; (ii) There is no association found between cognition and peripheral biomarkers; (iii) Neuroimaging biomarkers highlighted hypoactivation of frontal areas as distinctive of acute state of BD; (iv) A deactivation failure has been reported in the ventromedial prefrontal cortex (vmPFC), potentially serving as a trait marker of BD. CONCLUSION Only a few recent articles have investigated biomarker-cognition associations in BD mood phases. Our findings underline that there appear to be central regions involved in BD that are observed in all mood states. However, there appear to be underlying mechanisms of cognitive dysfunction that may vary across different mood states in BD. This review highlights the importance of standardizing the data and the assessment of cognition, as well as the need for biomarkers to help prevent acute symptomatic phases of the disease, and the associated functional and cognitive impairment.
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Affiliation(s)
- Anaid Pérez-Ramos
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, Faculty of Medicine, University of Cadiz, Cadiz, Spain
| | - Cristina Romero-López-Alberca
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain.
- Personality, Evaluation and Psychological Treatment Area, Department of Psychology, University of Cadiz, Cadiz, Spain.
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain.
| | - Maria Hidalgo-Figueroa
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Psychobiology Area, Department of Psychology, University of Cadiz, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain
| | - Esther Berrocoso
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, Faculty of Medicine, University of Cadiz, Cadiz, Spain
| | - Jose I Pérez-Revuelta
- Centre for Biomedical Research in Mental Health (CIBERSAM), ISCI-III, Madrid, Spain
- Clinical Management of Mental Health Unit, University Hospital of Jerez, Andalusian Health Service, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cadiz, Spain
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Farzan F. Transcranial Magnetic Stimulation-Electroencephalography for Biomarker Discovery in Psychiatry. Biol Psychiatry 2024; 95:564-580. [PMID: 38142721 DOI: 10.1016/j.biopsych.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 12/08/2023] [Accepted: 12/15/2023] [Indexed: 12/26/2023]
Abstract
Current diagnosis and treatment of psychiatric illnesses are still based on behavioral observations and self-reports, commonly leading to prolonged untreated illness. Biological markers (biomarkers) may offer an opportunity to revolutionize clinical psychiatry practice by helping provide faster and potentially more effective therapies. Transcranial magnetic stimulation concurrent with electroencephalography (TMS-EEG) is a noninvasive brain mapping methodology that can assess the functions and dynamics of specific brain circuitries in awake humans and aid in biomarker discovery. This article provides an overview of TMS-EEG-based biomarkers that may hold potential in psychiatry. The methodological readiness of the TMS-EEG approach and steps in the validation of TMS-EEG biomarkers for clinical utility are discussed. Biomarker discovery with TMS-EEG is in the early stages, and several validation steps are still required before clinical implementations are realized. Thus far, TMS-EEG predictors of response to magnetic brain stimulation treatments in particular have shown promise for translation to clinical practice. Larger-scale studies can confirm validation followed by biomarker-informed trials to assess added value compared to existing practice.
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Affiliation(s)
- Faranak Farzan
- eBrain Lab, School of Mechatronic Systems Engineering, Simon Fraser University, Surrey, British Columbia, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
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Virtanen M, Törmälehto S, Partonen T, Elovainio M, Ruuhela R, Hakulinen C, Komulainen K, Airaksinen J, Väänänen A, Koskinen A, Sund R. Seasonal patterns of sickness absence due to diagnosed mental disorders: a nationwide 12-year register linkage study. Epidemiol Psychiatr Sci 2023; 32:e64. [PMID: 37941381 PMCID: PMC7615330 DOI: 10.1017/s2045796023000768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 11/10/2023] Open
Abstract
AIMS Although seasonality has been documented for mental disorders, it is unknown whether similar patterns can be observed in employee sickness absence from work due to a wide range of mental disorders with different severity level, and to what extent the rate of change in light exposure plays a role. To address these limitations, we used daily based sickness absence records to examine seasonal patterns in employee sickness absence due to mental disorders. METHODS We used nationwide diagnosis-specific psychiatric sickness absence claims data from 2006 to 2017 for adult individuals aged 16-67 (n = 636,543 sickness absence episodes) in Finland, a high-latitude country with a profound variation in daylength. The smoothed time-series of the ratio of observed and expected (O/E) daily counts of episodes were estimated, adjusted for variation in all-cause sickness absence rates during the year. RESULTS Unipolar depressive disorders peaked in October-November and dipped in July, with similar associations in all forms of depression. Also, anxiety and non-organic sleep disorders peaked in October-November. Anxiety disorders dipped in January-February and in July-August, while non-organic sleep disorders dipped in April-August. Manic episodes reached a peak from March to July and dipped in September-November and in January-February. Seasonality was not dependent on the severity of the depressive disorder. CONCLUSIONS These results suggest a seasonal variation in sickness absence due to common mental disorders and bipolar disorder, with high peaks in depressive, anxiety and sleep disorders towards the end of the year and a peak in manic episodes starting in spring. Rapid changes in light exposure may contribute to sickness absence due to bipolar disorder. The findings can help clinicians and workplaces prepare for seasonal variations in healthcare needs.
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Affiliation(s)
- M. Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - S. Törmälehto
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - T. Partonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - M. Elovainio
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - R. Ruuhela
- Weather and Climate Change Impact Research, Finnish Meteorological Institute, Helsinki, Finland
| | - C. Hakulinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - K. Komulainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - J. Airaksinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - A. Väänänen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - A. Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - R. Sund
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
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Pouchon A, Vinckier F, Dondé C, Gueguen MC, Polosan M, Bastin J. Reward and punishment learning deficits among bipolar disorder subtypes. J Affect Disord 2023; 340:694-702. [PMID: 37591352 DOI: 10.1016/j.jad.2023.08.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 07/24/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Reward sensitivity is an essential dimension related to mood fluctuations in bipolar disorder (BD), but there is currently a debate around hypersensitivity or hyposensitivity hypotheses to reward in BD during remission, probably related to a heterogeneous population within the BD spectrum and a lack of reward bias evaluation. Here, we examine reward maximization vs. punishment avoidance learning within the BD spectrum during remission. METHODS Patients with BD-I (n = 45), BD-II (n = 34) and matched (n = 30) healthy controls (HC) were included. They performed an instrumental learning task designed to dissociate reward-based from punishment-based reinforcement learning. Computational modeling was used to identify the mechanisms underlying reinforcement learning performances. RESULTS Behavioral results showed a significant reward learning deficit across BD subtypes compared to HC, captured at the computational level by a lower sensitivity to rewards compared to punishments in both BD subtypes. Computational modeling also revealed a higher choice randomness in BD-II compared to BD-I that reflected a tendency of BD-I to perform better during punishment avoidance learning than BD-II. LIMITATIONS Our patients were not naive to antipsychotic treatment and were not euthymic (but in syndromic remission) according to the International Society for Bipolar Disorder definition. CONCLUSIONS Our results are consistent with the reward hyposensitivity theory in BD. Computational modeling suggests distinct underlying mechanisms that produce similar observable behaviors, making it a useful tool for distinguishing how symptoms interact in BD versus other disorders. In the long run, a better understanding of these processes could contribute to better prevention and management of BD.
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Affiliation(s)
- Arnaud Pouchon
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000 Grenoble, France; Department of Psychiatry, CHU Grenoble Alpes, 38000 Grenoble, France.
| | - Fabien Vinckier
- Motivation, Brain & Behavior (MBB) lab, Institut du Cerveau (ICM), Hôpital Pitié-Salpêtrière, F-75013 Paris, France; Université Paris Cité, F-75006 Paris, France; Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, F-75014 Paris, France
| | - Clément Dondé
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000 Grenoble, France; Department of Psychiatry, CHU Grenoble Alpes, 38000 Grenoble, France; Department of Psychiatry, CH Alpes-Isère, 38000 Saint-Egrève, France
| | - Maëlle Cm Gueguen
- Department of Psychiatry, University Behavioral Health Care & the Brain Health Institute, Rutgers University-New Brunswick, Piscataway, USA; Laureate Institute for Brain Research, Tulsa, OK 74136 USA
| | - Mircea Polosan
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000 Grenoble, France; Department of Psychiatry, CHU Grenoble Alpes, 38000 Grenoble, France
| | - Julien Bastin
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France.
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Hiller JK, Jangmo A, Tesli MS, Jaholkowski PP, Hoseth EZ, Steen NE, Haram M. Lipid Biomarker Research in Bipolar Disorder: A Scoping Review of Trends, Challenges, and Future Directions. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:594-604. [PMID: 37881590 PMCID: PMC10593953 DOI: 10.1016/j.bpsgos.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 10/27/2023] Open
Abstract
Bipolar disorder (BD) is a disabling disorder with heterogeneous symptom profiles and trajectories. Like many other neuropsychiatric disorders, clinical decision making related to diagnoses and choice of treatment is based on clinical assessments alone, and risk prediction for treatment success or resistance at an individual level remains sparse. An enormous effort to add biological markers to this risk prediction is ongoing. The role of lipids in normal brain functioning is well established, and several hypotheses about the role of lipids in the pathogenesis of neuropsychiatric disorders, including BD, have been made. The frequent comorbidity between neuropsychiatric disorders and cardiovascular disease, the genetic overlap of risk genes for severe mental disorders and genes involved in lipid regulation, and the lipid-altering effects of antipsychotics and mood stabilizers indicate that lipids could hold promise as biomarkers for neuropsychiatric disorders, including BD. To date, reviews of lipid biomarkers in schizophrenia and major depression have noted caveats for future investigations, while reviews of lipid biomarker research in BD is missing. In the current scoping review, we present a comprehensive overview of trends in previous research on lipid biomarkers in BD. The current literature varies greatly in the phenotypes investigated and study designs, leading to divergent findings. Small sample size; potential confounders related to physical activity, nutritional status, and medication use; and cross-sectional designs were frequently reported limitations. Future research may benefit from pivoting toward utilization of newer laboratory techniques such as lipidomics, but consistent use of study methods across cohorts is also needed.
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Affiliation(s)
| | - Andreas Jangmo
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Martin Steen Tesli
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Centre for Research and Education in Forensic Psychiatry, Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Piotr Pawel Jaholkowski
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Eva Zsuzsanna Hoseth
- Clinic of Mental Health and Addiction, Møre and Romsdal Health Trust, Kristiansund, Norway
| | - Nils Eiel Steen
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marit Haram
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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9
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Assessment and Management of Bipolar Disorder. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2023; 21:399-400. [PMID: 38695006 PMCID: PMC11058948 DOI: 10.1176/appi.focus.23021017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
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10
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Saccaro LF, Crokaert J, Perroud N, Piguet C. Structural and functional MRI correlates of inflammation in bipolar disorder: A systematic review. J Affect Disord 2023; 325:83-92. [PMID: 36621677 DOI: 10.1016/j.jad.2022.12.162] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/15/2022] [Accepted: 12/31/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Bipolar disorder (BD) is a common affective disorder characterized by recurrent oscillations between mood states and associated with inflammatory diseases and chronic inflammation. However, data on MRI abnormalities in BD and their relationship with inflammation are heterogeneous and no review has recapitulated them. METHODS In this pre-registered (PROSPERO: CRD42022308461) systematic review we searched Web of Science Core Collection and PubMed for articles correlating functional or structural MRI measures with immune-related markers in BD. RESULTS We included 23 studies (6 on functional, 16 on structural MRI findings, 1 on both, including 1'233 BD patients). Overall, the quality of the studies included was fair, with a low risk of bias. LIMITATIONS Heterogeneity in the methods and results of the studies and small sample sizes limit the generalizability of the conclusions. CONCLUSIONS A qualitative synthesis suggests that the links between immune traits and functional or structural MRI alterations point toward brain areas involved in affective and somatomotor processing, with a trend toward a negative correlation between peripheral inflammatory markers and brain regions volume. We discuss how disentangling the complex relationship between the immune system and MRI alterations in BD may unveil mechanisms underlying symptoms pathophysiology, potentially with quickly translatable diagnostic, prognostic, and therapeutic implications.
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Affiliation(s)
- Luigi F Saccaro
- Psychiatry Department, Faculty of Medicine, University of Geneva, Switzerland; Psychiatry Department, Geneva University Hospital, Switzerland.
| | - Jasper Crokaert
- Psychiatry Department, Faculty of Medicine, University of Geneva, Switzerland; Child and Adolescence Psychiatry Division, Geneva University Hospital, Switzerland
| | - Nader Perroud
- Psychiatry Department, Faculty of Medicine, University of Geneva, Switzerland; Psychiatry Department, Geneva University Hospital, Switzerland
| | - Camille Piguet
- Psychiatry Department, Faculty of Medicine, University of Geneva, Switzerland; Psychiatry Department, Geneva University Hospital, Switzerland; Child and Adolescence Psychiatry Division, Geneva University Hospital, Switzerland
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11
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Grewal S, McKinlay S, Kapczinski F, Pfaffenseller B, Wollenhaupt-Aguiar B. Biomarkers of neuroprogression and late staging in bipolar disorder:
A systematic review. Aust N Z J Psychiatry 2023; 57:328-343. [PMID: 35403455 PMCID: PMC9950598 DOI: 10.1177/00048674221091731] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Bipolar disorder may undertake a progressive course in a subset of patients, and research efforts have been made to understand the biological basis underlying this process. This systematic review examined the literature available on biological markers associated with illness progression in bipolar disorder. METHODS Peer-reviewed articles were assessed using Embase, PsycINFO and PubMed, as well as from external sources. After initial screening, a total of 871 citations from databases and other sources were identified. Participants with a diagnosis of bipolar disorder were included in our systematic review; however, studies with participants younger than 15 or older than 65 were excluded. All studies were assessed using the Newcastle-Ottawa Scale assessment tool, and data pertaining to the results were extracted into tabular form using Google Sheets and Google Documents. The systematic review was registered on PROSPERO international prospective register of systematic reviews (ID Number: CRD42020154305). RESULTS A total of 35 studies were included in the systematic review. Increased ventricular size and reduction of grey matter volume were the most common brain changes associated with illness progression in bipolar disorder. Among the several biomarkers evaluated in this systematic review, findings also indicate a role of peripheral inflammatory markers in this process. DISCUSSION The studies evaluating the biological basis of the illness progression in bipolar disorder are still scarce and heterogeneous. However, current evidence supports the notion of neuroprogression, the pathophysiological process related to progressive brain changes associated with clinical progression in patients with bipolar disorder. The increase in peripheral inflammatory biomarkers and the neuroanatomical changes in bipolar disorder suggest progressive systemic and structural brain alterations, respectively.
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Affiliation(s)
- Sonya Grewal
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Stuart McKinlay
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Flávio Kapczinski
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada,Mood Disorders Program, St. Joseph’s
Healthcare Hamilton, Hamilton, ON, Canada,Instituto Nacional de Ciência e
Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil,Department of Psychiatry, Universidade
Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Bianca Pfaffenseller
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada,Mood Disorders Program, St. Joseph’s
Healthcare Hamilton, Hamilton, ON, Canada
| | - Bianca Wollenhaupt-Aguiar
- Department of Psychiatry and
Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada,Mood Disorders Program, St. Joseph’s
Healthcare Hamilton, Hamilton, ON, Canada,Bianca Wollenhaupt de Aguiar, Department of
Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th
Street, Suite G116, Hamilton, ON L8N 3K7, Canada.
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12
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Li C, Hong L, Zou L, Zhu Y, Ye J, Wu F, Chen C. Variations in olfactory function among bipolar disorder patients with different episodes and subtypes. Front Psychiatry 2023; 14:1080622. [PMID: 37020734 PMCID: PMC10067908 DOI: 10.3389/fpsyt.2023.1080622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/27/2023] [Indexed: 04/07/2023] Open
Abstract
Purpose Most studies on olfactory function in individuals with bipolar disorder (BD) have not distinguished between the different subtypes or between the acute phase (mania or depression) and euthymic state. In this study, we compared olfactory function among BD patients with different subtypes and episodes to explore the potential use of olfactory function as a biomarker for the early identification of BD. Patients and methods The study sample consisted of 117 BD patients who were hospitalized between April 2019 and June 2019, and 47 healthy volunteers as controls. The BD patients were divided into a bipolar I disorder (BD I) (n = 86) and bipolar II disorder (BD II) group (n = 31) according to the different subtypes, and divided into depressive BD (n = 36), manic BD (n = 44), or euthymic BD (n = 37) groups according to the types of episodes they experienced. We assessed olfactory sensitivity (OS) and olfactory identification (OI) via the Sniffin' Sticks test and used the Hamilton Depression Rating Scale (HAMD) and Young Manic Rating Scale (YMRS) to evaluate BD characteristics among all subjects. Results Compared with controls, the participants with BD showed decreased OS and OI. We found statistically significant differences in OS and OI between the BD I group and controls, as well as differences in OS between the BD I and BD II group. Least-significant difference multiple comparisons revealed statistically significant differences in OS between the depressive BD group, manic BD group and controls and also between the manic BD and euthymic BD group. OI was positively correlated with the YMRS score in the BD I group and OS was negatively correlated with the HAMD score in the BD II group. Conclusion This may be the first study to compare olfactory function in patients with BD I vs. BD II via pairwise comparisons. Our findings suggest that OS may have potential as a biomarker for distinguishing the different subtypes of BD and as a state-related biomarker for differentiating the acute phase from the euthymic state of BD. However, further prospective research is warranted.
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Affiliation(s)
- Chunyang Li
- Department of Psychiatry, Shunde Wu Zhongpei Hospital, Foshan, Guangdong, China
- *Correspondence: Chunyang Li,
| | - Liu Hong
- Department of Psychiatry, Shunde Wu Zhongpei Hospital, Foshan, Guangdong, China
| | - Laiquan Zou
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yiping Zhu
- Department of Psychiatry, Shunde Wu Zhongpei Hospital, Foshan, Guangdong, China
| | - Jianfu Ye
- Department of Psychiatry, Shunde Wu Zhongpei Hospital, Foshan, Guangdong, China
| | - Fenlan Wu
- Department of Psychiatry, Shunde Wu Zhongpei Hospital, Foshan, Guangdong, China
| | - Chao Chen
- Department of Psychiatry, Shunde Wu Zhongpei Hospital, Foshan, Guangdong, China
- Chao Chen,
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13
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Bertschy G, Martz E, Weibel S, Weiner L. Psychopathological Dissection of Bipolar Disorder and ADHD: Focussing on Racing Thoughts and Verbal Fluency . Neuropsychiatr Dis Treat 2023; 19:1153-1168. [PMID: 37197328 PMCID: PMC10184890 DOI: 10.2147/ndt.s401330] [Citation(s) in RCA: 1] [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: 12/18/2022] [Accepted: 04/27/2023] [Indexed: 05/19/2023] Open
Abstract
In the present study, we propose a review and a synthesis of the work of our group about the phenomenology and the cognitive mechanisms of racing thoughts in bipolar disorder (BD) and ADHD. Contrary to the mainstream idea according to which racing thoughts are pathognomonic of BD, our work suggests that racing thoughts are enhanced in ADHD compared to hypomanic episodes of BD, whereas in euthymic episodes of BD self-reported racing thoughts are similar to the rates reported by healthy controls. Using verbal fluency tasks, we found many similarities between bipolar and ADHD subjects with one clear difference: lexical search strategy in hypomania is based on phonemic similarities rather than semantic-relatedness. However, this distinction observed in this cognitive task is certainly difficult to grasp during a clinical interview aiming to differentiate mild hypomania from combined ADHD presentation. The main landmark to distinguish them remains the episodic nature of bipolar disorders as opposed to the lifelong presentation of ADHD symptoms, a dichotomous view that is not so clear-cut in clinical practice.
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Affiliation(s)
- Gilles Bertschy
- Pôle de Psychiatrie, santé mentale & addictologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, F-67000, France
- INSERM U1114, Strasbourg, F-67000, France
- Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, F-67000, France
- Correspondence: Gilles Bertschy, Pôle de Psychiatrie, santé mentale & addictologie des Hôpitaux Universitaires de Strasbourg, 1 Place de L’hôpital, BP 426, Strasbourg Cedex, F-67091, France, Tel +33 388 11 65 48, Fax +33 388 11 54 23, Email
| | | | - Sebastien Weibel
- Pôle de Psychiatrie, santé mentale & addictologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, F-67000, France
- INSERM U1114, Strasbourg, F-67000, France
| | - Luisa Weiner
- Pôle de Psychiatrie, santé mentale & addictologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, F-67000, France
- Laboratoire de Psychologie des Cognitions, Strasbourg, F-67000, France
- Faculté de Psychologie, Université de Strasbourg, Strasbourg, F-67000, France
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14
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Zou Y, Grigorian A, Kennedy KG, Zai CC, Shao S, Kennedy JL, Andreazza AC, Ameis SH, Heyn C, Maclntosh BJ, Goldstein BI. Differential association of antioxidative defense genes with white matter integrity in youth bipolar disorder. Transl Psychiatry 2022; 12:504. [PMID: 36476443 PMCID: PMC9729619 DOI: 10.1038/s41398-022-02261-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 11/03/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Oxidative stress is associated with white matter diffusion metrics in adults with bipolar disorder (BD). We examined the association of single-nucleotide polymorphisms in the oxidative stress system, superoxide dismutase-2 (SOD2) rs4880 and glutathione peroxidase-3 (GPX3) rs3792797 with fractional anisotropy (FA) and radial diffusivity (RD) in youth with BD. Participants included 104 youth (age 17.5 ± 1.7 years; 58 BD, 46 healthy controls). Saliva samples were obtained for genotyping, and diffusion tensor imaging was acquired. Voxel-wise whole-brain white matter diffusion analyses controlled for age, sex, and race. There were significant diagnosis-by-SOD2 rs4880 interaction effects for FA and RD in major white matter tracts. Within BD, the group with two copies of the G-allele (GG) showed lower FA and higher RD than A-allele carriers. Whereas within the control group, the GG group showed higher FA and lower RD than A-allele carriers. Additionally, FA was higher and RD was lower within the control GG group compared to the BD GG group. No significant findings were observed for GPX3 rs3793797. The current study revealed that, within matter tracts known to differ in BD, associations of SOD2 rs4880 GG genotype with both FA and RD differed between BD vs healthy control youth. The SOD2 enzyme encoded by the G-allele, has higher antioxidant capacity than the enzyme encoded by the A-allele. We speculate that the current findings of lower FA and higher RD of the BD GG group compared to the other groups reflects attenuation of the salutary antioxidant effects of GG genotype on white matter integrity in youth with BD, in part due to predisposition to oxidative stress. Future studies incorporating other genetic markers and oxidative stress biomarkers are warranted.
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Affiliation(s)
- Yi Zou
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Anahit Grigorian
- grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Kody G. Kennedy
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Clement C. Zai
- grid.155956.b0000 0000 8793 5925Psychiatric Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Suyi Shao
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - James L. Kennedy
- grid.155956.b0000 0000 8793 5925Psychiatric Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Ana C. Andreazza
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
| | - Stephanie H. Ameis
- grid.155956.b0000 0000 8793 5925Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada ,grid.42327.300000 0004 0473 9646Department of Psychiatry, The Hospital for Sick Children, Toronto, ON Canada
| | - Chinthaka Heyn
- grid.413104.30000 0000 9743 1587Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON Canada
| | - Bradley J. Maclntosh
- grid.17063.330000 0001 2157 2938Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Medical Biophysics, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada
| | - Benjamin I. Goldstein
- grid.17063.330000 0001 2157 2938Department of Pharmacology, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8 Canada
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15
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Whitney MS, Scott SL, Perez JA, Barnes S, McVoy MK. Elevation of C-reactive protein in adolescent bipolar disorder vs. anxiety disorders. J Psychiatr Res 2022; 156:308-317. [PMID: 36306709 DOI: 10.1016/j.jpsychires.2022.09.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/28/2022] [Accepted: 09/16/2022] [Indexed: 01/20/2023]
Abstract
Bipolar disorder (BD) largely begins in adolescence, but diagnosis lags for years, causing significant morbidity and mortality, and demonstrating the need for better diagnostic tools. Suggesting an association between BD and immune activity, elevated levels of peripheral inflammatory markers, including C-reactive protein (CRP), have been found in adults with BD. As similar data are extremely limited in adolescents, this study examined CRP levels in adolescents with BD (n = 37) compared to those with anxiety disorders (ADs, n = 157) and healthy controls with no psychiatric diagnoses (HCs, n = 2760). CRP blood levels for patients aged 12-17 years were retrieved from a nationwide repository of deidentified clinical data. After excluding patients with inflammatory conditions, differences in CRP were examined using multivariate and weighted regressions (covariates: demographics and BMI). Mean CRP levels were significantly elevated in adolescents with BD relative to those with ADs and HCs. Mean CRP levels were lower in the ADs cohort versus HCs. Although CRP levels were significantly higher in males and younger patients, the significant between-cohort differences in CRP remained after controlling for multiple confounders. To our knowledge, our study is the first to compare CRP levels between adolescent BD, ADs, and HCs, comprising a novel and essential contribution. Our results suggest the presence of a unique immune process in adolescents with BD and indicate that CRP may represent a biomarker with a crucial role in the diagnostic assessment of adolescent BD.
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Affiliation(s)
| | - Stephen L Scott
- Department of Child and Adolescent Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
| | - Jaime Abraham Perez
- Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
| | - Stephanie Barnes
- Department of Child and Adolescent Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Molly K McVoy
- Department of Child and Adolescent Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
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16
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Guidara W, Messedi M, Naifar M, Charfi N, Grayaa S, Maalej M, Maalej M, Ayadi F. Predictive value of oxidative stress biomarkers in drug-free patients with bipolar disorder. Nord J Psychiatry 2022; 76:539-550. [PMID: 34965843 DOI: 10.1080/08039488.2021.2016954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Oxidative stress is one of the primary etiological mechanisms of bipolar disorder (BD). METHODS The present study was conducted over a period of 24 months on Tunisian on 34 drug‑free male patients with BD (mean age: 34.5 years) and 101 age and gender matched controls (mean age: 34.20 years) were enrolled in the study. RESULTS Plasma reduced glutathione (GSH) and total thiols levels were significantly decreased in patients compared to controls (respectively p < .001; p = .009). In addition, malondialdehyde (MDA), advanced oxidation protein products (AOPP), protein carbonyls (PC) and homocysteine (Hcys) concentrations and glutathione peroxidase (GSH-Px) activity were significantly increased in patients compared to controls (p = .002; p < .001; p = .001; p < .001 and p = .016, respectively). The binary logistic regression analysis revealed that MDA, AOPP and Hcys could be considered as independent risk factors for BD. When using CombiROC analysis, a remarkable increase in the area under the curve (AUC) with higher sensitivity (Se) and specificity (Sp) for MDA, AOPP, PC, GSH-Px and Hcys combined markers was observed. CONCLUSIONS Overall, the identification of the predictive value of these five selected biomarkers related to oxidative stress in drug free patients should lead to a better identification of the etiological mechanism of BD.
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Affiliation(s)
- Wassim Guidara
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Meriam Messedi
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Manel Naifar
- Laboratory of Biochemistry, University of Sfax & Habib Bourguiba Hospital, Sfax, Tunisia
| | - Nada Charfi
- Psychiatry C- department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Sahar Grayaa
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Mohamed Maalej
- Psychiatry C- department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Manel Maalej
- Psychiatry C- department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Fatma Ayadi
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia.,Laboratory of Biochemistry, University of Sfax & Habib Bourguiba Hospital, Sfax, Tunisia
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17
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Hu X, Yu C, Dong T, Yang Z, Fang Y, Jiang Z. Biomarkers and detection methods of bipolar disorder. Biosens Bioelectron 2022; 220:114842. [DOI: 10.1016/j.bios.2022.114842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 09/16/2022] [Accepted: 10/19/2022] [Indexed: 12/01/2022]
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18
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The Mediation Effect of Peripheral Biomarkers of Calcium Metabolism and Chronotypes in Bipolar Disorder Psychopathology. Metabolites 2022; 12:metabo12090827. [PMID: 36144231 PMCID: PMC9505716 DOI: 10.3390/metabo12090827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
Calcium (Ca++) metabolism may be impaired in several psychiatric diseases. We hypothesize that calcium imbalance might also correlate with a specific chronotype and could be recognized as a marker of illness severity in bipolar disorder (BD). We aimed to (1) identify the association between calcium imbalance and a specific chronotype in a cohort of BD patients, and (2) test the mediation role of high parathyroid hormone (PTH) levels towards a specific chronotype and illness severity in BD patients. Patients’ socio-demographic and clinical characteristics were collected with an ad-hoc schedule. We administered the Hamilton Depression Rating Scale (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), the Young Mania Rating Scale (YMRS), and the Morningness Eveningness Questionnaire (MEQ). 100 patients affected by BD were recruited. The Kruskal-Wallis test showed a significant difference between the three MEQ groups in PTH levels (p < 0.001) and vitamin D levels (p = 0.048) but not in Ca++ levels (p = 0.426). Dwass-Steel-Critchlow-Fligner Pairwise analyses performed concerning three MEQ groups revealed significantly higher scores on PTH levels in MEQ-E subjects compared to MEQ-M and MEQ-I (in both cases, p < 0.001). No differences emerged between calcium levels among the three chronotypes. The mediation analysis has shown that elevated PTH levels are directly influenced by more severe HAM-A, HAM-D, and YMRS scores. MEQ-E could be a marker related to BD and predispose to various factors influencing mood symptoms. The combination of vitamin D therapy in MEQ-E may help to improve prognosis in this subtype of patients affected by BD.
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19
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Niu Z, Wu X, Zhu Y, Yang L, Shi Y, Wang Y, Qiu H, Gu W, Wu Y, Long X, Lu Z, Hu S, Yao Z, Yang H, Liu T, Xia Y, Chen Z, Chen J, Fang Y. Early Diagnosis of Bipolar Disorder Coming Soon: Application of an Oxidative Stress Injury Biomarker (BIOS) Model. Neurosci Bull 2022; 38:979-991. [PMID: 35590012 PMCID: PMC9468206 DOI: 10.1007/s12264-022-00871-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/10/2022] [Indexed: 11/26/2022] Open
Abstract
Early distinction of bipolar disorder (BD) from major depressive disorder (MDD) is difficult since no tools are available to estimate the risk of BD. In this study, we aimed to develop and validate a model of oxidative stress injury for predicting BD. Data were collected from 1252 BD and 1359 MDD patients, including 64 MDD patients identified as converting to BD from 2009 through 2018. 30 variables from a randomly-selected subsample of 1827 (70%) patients were used to develop the model, including age, sex, oxidative stress markers (uric acid, bilirubin, albumin, and prealbumin), sex hormones, cytokines, thyroid and liver function, and glycolipid metabolism. Univariate analyses and the Least Absolute Shrinkage and Selection Operator were applied for data dimension reduction and variable selection. Multivariable logistic regression was used to construct a model for predicting bipolar disorder by oxidative stress biomarkers (BIOS) on a nomogram. Internal validation was assessed in the remaining 784 patients (30%), and independent external validation was done with data from 3797 matched patients from five other hospitals in China. 10 predictors, mainly oxidative stress markers, were shown on the nomogram. The BIOS model showed good discrimination in the training sample, with an AUC of 75.1% (95% CI: 72.9%-77.3%), sensitivity of 0.66, and specificity of 0.73. The discrimination was good both in internal validation (AUC 72.1%, 68.6%-75.6%) and external validation (AUC 65.7%, 63.9%-67.5%). In this study, we developed a nomogram centered on oxidative stress injury, which could help in the individualized prediction of BD. For better real-world practice, a set of measurements, especially on oxidative stress markers, should be emphasized using big data in psychiatry.
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Affiliation(s)
- Zhiang Niu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Xiaohui Wu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Yuncheng Zhu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
- Division of Mood Disorders, Shanghai Hongkou Mental Health Center, Shanghai, 200083, China
| | - Lu Yang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Yifan Shi
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Yun Wang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Hong Qiu
- Information and Statistics Department, Shanghai Mental Health Center, Shanghai, 200030, China
| | - Wenjie Gu
- Information and Statistics Department, Shanghai Mental Health Center, Shanghai, 200030, China
| | - Yina Wu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Xiangyun Long
- Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200333, China
| | - Zheng Lu
- Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200333, China
| | - Shaohua Hu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Zhijian Yao
- Nanjing Brain Hospital, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Haichen Yang
- Shenzhen Mental Health Center, Shenzhen, 518003, China
| | - Tiebang Liu
- Shenzhen Mental Health Center, Shenzhen, 518003, China
| | - Yong Xia
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
| | - Zhiyu Chen
- Affiliated Mental Health Center, Zhejiang University School of Medicine, Hangzhou Seventh People's Hospital, Hangzhou, 310013, China
| | - Jun Chen
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
| | - Yiru Fang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, 200031, China.
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 201108, China.
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20
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Scott J, Hennion V, Meyrel M, Bellivier F, Etain B. An ecological study of objective rest-activity markers of lithium response in bipolar-I-disorder. Psychol Med 2022; 52:2281-2289. [PMID: 33183364 DOI: 10.1017/s0033291720004171] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Despite its pivotal role in prophylaxis for bipolar-I-disorders (BD-I), variability in lithium (Li) response is poorly understood and only a third of patients show a good outcome. Converging research strands indicate that rest-activity rhythms can help characterize BD-I and might differentiate good responders (GR) and non-responders (NR). METHODS Seventy outpatients with BD-I receiving Li prophylaxis were categorized as GR or NR according to the ratings on the retrospective assessment of response to lithium scale (Alda scale). Participants undertook 21 consecutive days of actigraphy monitoring of sleep quantity (SQ), sleep variability (SV) and circadian rhythmicity (CR). RESULTS Twenty-five individuals were categorized as GR (36%). After correcting statistical analysis to minimize false discoveries, four variables (intra-daily variability; median activity level; amplitude; and relative amplitude of activity) significantly differentiated GR from NR. The odds of being classified as a GR case were greatest for individuals showing more regular/stable CR (1.41; 95% confidence interval (CI) 1.08, 2.05; p < 0.04). Also, there was a trend for lower SV to be associated with GR (odds ratio: 0.56; 95% CI 0.31, 1.01; p < 0.06). CONCLUSIONS To our knowledge, this is the largest actigraphy study of rest-activity rhythms and Li response. Circadian markers associated with fragmentation, variability, amount and/or amplitude of day and night-time activity best-identified GR. However, associations were modest and future research must determine whether these objectively measured parameters, singly or together, represent robust treatment response biomarkers. Actigraphy may offer an adjunct to multi-platform approaches aimed at developing personalized treatments or stratification of individuals with BD-I into treatment-relevant subgroups.
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Affiliation(s)
- Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- Centre for Affective Disorders, IoPPN, Kings College, London, UK
- Université de Paris, Paris, France
| | - Vincent Hennion
- Université de Paris, Paris, France
- AP-HP.Nord, DMU Neurosciences, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Manon Meyrel
- Université de Paris, Paris, France
- AP-HP.Nord, DMU Neurosciences, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Frank Bellivier
- Université de Paris, Paris, France
- AP-HP.Nord, DMU Neurosciences, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
- INSERM, UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
| | - Bruno Etain
- Centre for Affective Disorders, IoPPN, Kings College, London, UK
- Université de Paris, Paris, France
- AP-HP.Nord, DMU Neurosciences, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
- INSERM, UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
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21
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Mao M, Chen G, Feng K, Xu D, Hua X, Shan C, Liu P. Characteristics of prefrontal activity during emotional and cognitive processing in patients with bipolar disorder: A multi-channel functional near-infrared spectroscopy study. Front Neurosci 2022; 16:946543. [PMID: 35958997 PMCID: PMC9360599 DOI: 10.3389/fnins.2022.946543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/28/2022] [Indexed: 01/10/2023] Open
Abstract
Bipolar disorder (BD) is a recurrent chronic mental disorder with a broad profile of functional deficits including disturbed emotional processing and cognitive impairments. The goal of the current study was to further explore the underlying neural mechanism of dysfunction in patients with BD from a comprehensive perspective of both cognition and emotion. Forty-six clinical patients with BD and forty-five healthy controls performed emotion induction task and verbal fluency task (VFT), with frontal activity measured by functional near-infrared spectroscopy (fNIRS). Our results show distinct hemodynamic activity in the prefrontal region during emotional and cognitive processing between patients with BD and healthy controls. Patients with BD exhibit valence-dependent prefrontal cortex (PFC) hemodynamic response to emotional stimuli, with bilateral frontal hypoactivity indicating decreased positive reactivity and left frontal hyperactivity indicating increased negative reactivity. On the other hand, patients with BD showed impaired performance with bilateral frontal hypoactivity during VFT. Taken together, frontal dysfunction of cognition and emotionality in patients with BD probed by fNIRS would be a potential biomarker in clinical assessment.
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Affiliation(s)
- Mengchai Mao
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guifang Chen
- YuQuan Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
- Affiliated Hospital of Zunyi Medical University, Guizhou, China
- *Correspondence: Guifang Chen,
| | - Kun Feng
- YuQuan Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Dongsheng Xu
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xuyun Hua
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chunlei Shan
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Chunlei Shan,
| | - Pozi Liu
- YuQuan Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
- Pozi Liu,
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22
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Ziani PR, Feiten JG, Goularte JF, Colombo R, Antqueviezc B, Géa LP, Rosa AR. Potential Candidates for Biomarkers in Bipolar Disorder: A Proteomic Approach through Systems Biology. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2022; 20:211-227. [PMID: 35466093 PMCID: PMC9048014 DOI: 10.9758/cpn.2022.20.2.211] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Paola Rampelotto Ziani
- Laboratory of Molecular Psychiatry, Hospital Clinic of Porto Alegre, Porto Alegre, Brasil
- Postgraduate Program in Biological Sciences: Pharmacology and Therapeutics - Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brasil
| | - Jacson Gabriel Feiten
- Laboratory of Molecular Psychiatry, Hospital Clinic of Porto Alegre, Porto Alegre, Brasil
- Postgraduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brasil
| | | | - Rafael Colombo
- Laboratory of Molecular Psychiatry, Hospital Clinic of Porto Alegre, Porto Alegre, Brasil
- University of Caxias do Sul, Caxias do Sul, Brasil
| | - Bárbara Antqueviezc
- Laboratory of Molecular Psychiatry, Hospital Clinic of Porto Alegre, Porto Alegre, Brasil
| | - Luiza Paul Géa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Adriane Ribeiro Rosa
- Laboratory of Molecular Psychiatry, Hospital Clinic of Porto Alegre, Porto Alegre, Brasil
- Postgraduate Program in Biological Sciences: Pharmacology and Therapeutics - Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brasil
- Postgraduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brasil
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23
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Zou Y, Grigorian A, Karthikeyan S, Goldstein BI. Elevated C-reactive protein among symptomatic youth with bipolar disorder. J Psychopharmacol 2022; 36:645-652. [PMID: 35574908 PMCID: PMC9127784 DOI: 10.1177/02698811221093796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
RATIONALE AND OBJECTIVES Increased levels of high-sensitivity C-reactive protein (CRP) are associated with mood symptoms in adults with bipolar disorder (BD). The few studies on this topic in youth with BD have not included controls. We, therefore, examined CRP levels in relation to symptomatic status in youth with and without BD. METHODS Participants included 154 youth (mean age 17 years; 48 asymptomatic BD, 39 symptomatic BD, 67 healthy controls (HC)). Rank analysis of covariance test examined group differences in CRP, controlling for age and sex. Correlation between CRP and mood symptom severity was examined using Spearman's correlation within the BD group. RESULTS There were significant group differences in CRP levels (F(2,151) = 5.06, p = 0.007, ηp2=0.06); post hoc analyses showed higher CRP levels in the symptomatic BD group compared with HC (p = 0.01). In sensitivity analyses, this finding was no longer significant after controlling for body mass index (BMI). CRP was not significantly associated with symptomatic severity. CONCLUSIONS CRP levels are elevated among symptomatic youth with BD, partly related to BMI. As elevated BMI is associated with mood symptom burden, prospective studies are warranted to parse the associations among mood symptoms, BMI, and inflammation. Given the proportion of time that youth with BD are symptomatic, present findings raise concern about the long-term impact of elevated CRP on blood vessels, brain, and related clinical outcomes.
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Affiliation(s)
- Yi Zou
- Department of Pharmacology &
Toxicology, University of Toronto, Toronto, ON, Canada,Centre for Youth Bipolar Disorder,
Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Anahit Grigorian
- Centre for Youth Bipolar Disorder,
Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sudhir Karthikeyan
- Centre for Youth Bipolar Disorder,
Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Benjamin I Goldstein
- Department of Pharmacology &
Toxicology, University of Toronto, Toronto, ON, Canada,Centre for Youth Bipolar Disorder,
Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of
Toronto, Toronto, ON, Canada,Benjamin I Goldstein, Centre for Youth
Bipolar Disorder, Centre for Addiction and Mental Health, 80 Workman Way,
Toronto, ON M6J 1H4, Canada.
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24
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Which Actigraphy Dimensions Predict Longitudinal Outcomes in Bipolar Disorders? J Clin Med 2022; 11:jcm11082204. [PMID: 35456294 PMCID: PMC9027161 DOI: 10.3390/jcm11082204] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 02/04/2023] Open
Abstract
Bipolar disorder (BD) is characterized by recurrent mood episodes. It is increasingly suggested that disturbances in sleep–wake cycles and/or circadian rhythms could represent valuable predictors of recurrence, but few studies have addressed this question. Euthymic individuals with BD (n = 69) undertook 3 weeks of actigraphy recording and were then followed up for a median duration of 3.5 years. Principal component analyses were used to identify core dimensions of sleep quantity/variability and circadian rhythmicity. Associations between clinical variables and actigraphy dimensions and time to first recurrence were explored using survival analyses, and then using area under the curve (AUC) analyses (early vs. late recurrence). Most participants (64%) experienced a recurrence during follow-up (median survival time: 18 months). After adjusting for potential confounding factors, an actigraphy dimension comprising amplitude and variability/stability of circadian rhythms was a significant predictor of time to recurrence (p = 0.009). The AUC for correct classification of early vs. late recurrence subgroups was only 0.64 for clinical predictors, but combining these variables with objectively measured intra-day variability improved the AUC to 0.82 (p = 0.04). Actigraphy estimates of circadian rhythms, particularly variability/stability and amplitude, may represent valid predictive markers of future BD recurrences and could be putative targets for future psychosocial interventions.
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25
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Ünler M, Ekmekçi Ertek İ, Afandiyeva N, Kavutçu M, Yüksel N. The role of neuropeptide Y, orexin-A, and ghrelin in differentiating unipolar and bipolar depression: a preliminary study. Nord J Psychiatry 2022; 76:162-169. [PMID: 35282777 DOI: 10.1080/08039488.2022.2048887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND When depressive symptoms in bipolar and unipolar patients were compared, a number of studies reported that atypical vegetative features such as hypersomnia and hyperphagia were more common in bipolar patients. Moreover, neuropeptides such as orexin-A (ORX-A), ghrelin (GRL), and neuropeptide Y (NPY) are involved in the regulation of these vegetative functions. MATERIALS AND METHODS A total of 45 unipolar and 24 bipolar depressive patients, and 36 euthymic healthy controls were included in the study. The groups were compared in terms of peripheral blood samples of ORX-A, GRL, and NPY levels, as well as HAM-D, Epworth Sleepiness Scale, Three-Factor Eating Questionnaire-Revised, and Suicide Probability Scale scores. RESULTS Both unipolar and bipolar patients had lower ORX-A, GRL, and NPY levels compared to the controls, whereas NPY levels of bipolar patients were lower than unipolar patients. There was a negative correlation between NPY levels and emotional eating in the bipolar group. CONCLUSION While lower ORX-A, GRL, and NPY levels are associated with depressive episodes regardless of the diagnosis; NPY levels also differ in bipolar and unipolar depression patients.
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Affiliation(s)
- Mehmet Ünler
- Gaziantep 25 Aralık State Hospital, Psychiatry Clinic, Gaziantep, Turkey
| | - İrem Ekmekçi Ertek
- Department of Psychiatry, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nigar Afandiyeva
- Department of Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mustafa Kavutçu
- Department of Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nevzat Yüksel
- Department of Psychiatry, Faculty of Medicine, Gazi University, Ankara, Turkey
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26
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Soto-Vega JG, Valencia JG, Vargas C, López-Jaramillo C. Resting-state functional nuclear magnetic resonance imaging in patients with bipolar disorder: Beyond euthymia. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:153-157. [PMID: 35778347 DOI: 10.1016/j.rcpeng.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/05/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Functional nuclear magnetic resonance imaging in the resting state (R-fMRI) allows the identification of complete functional connectivity networks and the possible neuronal correlations of psychiatric disorders. The literature on R-fMRI and bipolar disorder (BD) will be reviewed, emphasising the findings in the phases of mania, hypomania and depression. METHODS It is a narrative review of the literature in which articles were searched in PubMed and Embase, with the key words in English "bipolar disorder" AND "resting state", without limit on the date of publication. RESULTS The studies of BD patients in the mania and hypomania phases who underwent R-fMRI show concordant results in terms of decreased functional cerebral connectivity between the amygdala and some cortical regions, which indicates that this functional connection would have some implication in the normal affect regulation. Patients in the depressive phase show a decrease in functional brain connectivity, but as there are several anatomical structures involved and neural networks reported in the studies, it is not possible to compare them. CONCLUSIONS There is a decrease in functional connectivity in patients with BD, but current evidence does not allow establishing specific changes in specific functional brain connectivity networks. However, there are already some findings that show correlation with the patients' symptoms.
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Affiliation(s)
| | - Jenny García Valencia
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Cristian Vargas
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - Carlos López-Jaramillo
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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27
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Madireddy S, Madireddy S. Therapeutic Interventions to Mitigate Mitochondrial Dysfunction and Oxidative Stress–Induced Damage in Patients with Bipolar Disorder. Int J Mol Sci 2022; 23:ijms23031844. [PMID: 35163764 PMCID: PMC8836876 DOI: 10.3390/ijms23031844] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/26/2021] [Accepted: 12/30/2021] [Indexed: 01/10/2023] Open
Abstract
Bipolar disorder (BD) is characterized by mood changes, including recurrent manic, hypomanic, and depressive episodes, which may involve mixed symptoms. Despite the progress in neurobiological research, the pathophysiology of BD has not been extensively described to date. Progress in the understanding of the neurobiology driving BD could help facilitate the discovery of therapeutic targets and biomarkers for its early detection. Oxidative stress (OS), which damages biomolecules and causes mitochondrial and dopamine system dysfunctions, is a persistent finding in patients with BD. Inflammation and immune dysfunction might also play a role in BD pathophysiology. Specific nutrient supplements (nutraceuticals) may target neurobiological pathways suggested to be perturbed in BD, such as inflammation, mitochondrial dysfunction, and OS. Consequently, nutraceuticals may be used in the adjunctive treatment of BD. This paper summarizes the possible roles of OS, mitochondrial dysfunction, and immune system dysregulation in the onset of BD. It then discusses OS-mitigating strategies that may serve as therapeutic interventions for BD. It also analyzes the relationship between diet and BD as well as the use of nutritional interventions in the treatment of BD. In addition, it addresses the use of lithium therapy; novel antipsychotic agents, including clozapine, olanzapine, risperidone, cariprazine, and quetiapine; and anti-inflammatory agents to treat BD. Furthermore, it reviews the efficacy of the most used therapies for BD, such as cognitive–behavioral therapy, bright light therapy, imagery-focused cognitive therapy, and electroconvulsive therapy. A better understanding of the roles of OS, mitochondrial dysfunction, and inflammation in the pathogenesis of bipolar disorder, along with a stronger elucidation of the therapeutic functions of antioxidants, antipsychotics, anti-inflammatory agents, lithium therapy, and light therapies, may lead to improved strategies for the treatment and prevention of bipolar disorder.
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Affiliation(s)
- Sahithi Madireddy
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Correspondence:
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28
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Karthikeyan S, Dimick MK, Fiksenbaum L, Jeong H, Birmaher B, Kennedy JL, Lanctôt K, Levitt AJ, Miller GE, Schaffer A, Young LT, Youngstrom EA, Andreazza AC, Goldstein BI. Inflammatory markers, brain-derived neurotrophic factor, and the symptomatic course of adolescent bipolar disorder: A prospective repeated-measures study. Brain Behav Immun 2022; 100:278-286. [PMID: 34896179 DOI: 10.1016/j.bbi.2021.11.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/15/2021] [Accepted: 11/29/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Numerous studies have found elevated pro-inflammatory markers and reduced brain-derived neurotrophic factor (BDNF) during symptomatic episodes of bipolar disorder (BD) in adults. There is a paucity of research examining these markers in youth with BD, or longitudinally in any BD age group. METHODS 79 adolescents, ages 13-19 years, were enrolled, including 43 symptomatic adolescents with BD and 36 age-matched healthy controls (HC). Blood samples were collected from all participants at intake, and repeatedly from BD participants at pre-specified intervals over the course of two years. Serum was assayed for levels of pro-inflammatory markers (c-reactive protein [CRP], interleukin [IL]-6, tumor necrosis factor alpha [TNF-α]), BDNF and the anti-inflammatory marker, IL-10. Week-by-week severity of mood symptoms was assessed using semi-structured interviews. RESULTS Adolescents with BD provided an average of 4.6 blood samples, on average every 5.0 months. During the most severe symptomatic interval (i.e., highest sum of mood symptom scores) among BD adolescents, levels of CRP (p = 0.01) and pro- to anti-inflammatory ratios (CRP/IL-10; p < 0.001 and IL-6/IL-10; p = 0.046) were significantly greater, and IL-10 levels (p = 0.004) were significantly lower, vs. HC. There were no differences between BD and HC in IL-6, TNF-α or BDNF. Within BD participants, higher BDNF (p = 0.01) and IL-10 levels (p = 0.001) significantly predicted greater burden of mood symptoms over the subsequent epoch. Moreover, higher CRP levels (p = 0.009) at intake predicted greater time to recovery from the index symptomatic episode. CONCLUSIONS In the first repeated-measures study on this topic in adolescents with BD, we found evidence that CRP, an inexpensive and ubiquitous blood test, may be useful in predicting the prospective course of BD symptoms. Future larger studies are warranted.
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Affiliation(s)
- Sudhir Karthikeyan
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada
| | - Mikaela K Dimick
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | | | - Hyunjin Jeong
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - James L Kennedy
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Krista Lanctôt
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Anthony J Levitt
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Gregory E Miller
- Institute for Policy Research & Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Ayal Schaffer
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - L Trevor Young
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Eric A Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ana C Andreazza
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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29
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Zazula R, Dodd S, Dean OM, Berk M, Bortolasci CC, Verri WA, Vargas HO, Nunes SOV. Cognition-immune interactions between executive function and working memory, tumour necrosis factor-alpha (TNF-alpha) and soluble TNF receptors (sTNFR1 and sTNFR2) in bipolar disorder. World J Biol Psychiatry 2022; 23:67-77. [PMID: 33949291 DOI: 10.1080/15622975.2021.1925152] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study examined cognition-immune interactions, specifically executive function, working memory, peripheral levels of tumour necrosis factor-alpha (TNF-α), and soluble tumour necrosis factor receptors-1 and -2 (sTNFR1 and 2) levels in bipolar disorder (BD) patients in comparison with controls. METHODS Thirty-one BD participants and twenty-seven controls participated in the study. The neurocognitive assessment was performed through three of CogState Research BatteryTM tasks for executive function and working memory. Plasma levels of TNF-α, sTNFR1, and sTNFR2 were measured after overnight fasting. Sociodemographic data and symptom severity of depression and mania were assessed. RESULTS BD presented a significantly worse performance in the working memory task (p = .005) and higher levels of TNF-α (p = .043) in comparison to controls. A trend level of significance was found for sTNFR1 between groups (p = .082). Among BD participants, there were significant correlations between sTNFR2 and neurocognitive tasks (Groton Maze Learning Task: ρ = .54, p = .002; Set-Shifting Task: ρ = .37, p = .042; and the Two-Back Task: ρ = -.49, p = .005), and between sTNFR1 and mania, depression and anxiety symptoms (respectively ρ = .37, p = .038; ρ = -.38, p = .037; and ρ = .42, p = .002). CONCLUSION TNF-α and its receptors might be an important variable in cognitive impairment in BD. Future studies might focus on the development of anti-inflammatory therapeutic targets for cognitive dysfunction in BD.
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Affiliation(s)
- Robson Zazula
- Federal University for Latin American Integration, Foz do Iguacu, Brazil.,Londrina State University, Health Sciences Graduate Program, Londrina, Brazil.,Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia
| | - Seetal Dodd
- Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia.,Centre of Youth Mental Health, University of Melbourne, Parkville, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Olivia M Dean
- Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia.,Centre of Youth Mental Health, University of Melbourne, Parkville, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia.,Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Michael Berk
- Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia.,Centre of Youth Mental Health, University of Melbourne, Parkville, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.,Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Chiara C Bortolasci
- Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia
| | - Waldiceu A Verri
- Department of Pathology, Londrina State University, Londrina, Brazil
| | - Heber O Vargas
- Londrina State University, Health Sciences Graduate Program, Londrina, Brazil
| | - Sandra O V Nunes
- Londrina State University, Health Sciences Graduate Program, Londrina, Brazil
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Wu X, Chen Z, Liao Y, Yang Z, Liang X, Guan N, Gan Z. Are serum levels of inflammatory markers associated with the severity of symptoms of bipolar disorder? Front Psychiatry 2022; 13:1063479. [PMID: 36741577 PMCID: PMC9894870 DOI: 10.3389/fpsyt.2022.1063479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/28/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND To explore the relationship between serum levels of inflammatory markers and symptomatic severity of bipolar disorder (BD). MATERIALS AND METHODS A cross-sectional study was conducted on 126 BD patients with current depressive episode (BDD), 102 BD patients with current mixed or (hypo)manic episode (BDM) and 94 healthy controls (HC). All participants were drug-naïve and had no current active physical illness associated with inflammatory response or history of substance abuse. Fasting serum levels of CRP, leptin (LEP), adiponectin (ADP), visfatin (VIS), TNF-α, IL-2, IL-6, IL-10, IL-17), and monocyte chemoattractant protein-1 (MCP-1) were measured with enzyme-linked immunosorbent assay (ELISA). Symptomatic severity of BD was assessed with HAMD-17 and YMRS. Generalized linear model was used to determine the association between the serum levels of inflammatory markers and symptomatic severity of BD. RESULTS The serum levels of IL-6, IL-10 and IL-17, and the IL-6/IL-10 ratio were significantly lower in mild BDD than in HC. In moderate BDD, the serum levels of MCP, IL-6 and IL-17 were significantly lower than in HC. In severe BDD, the serum level of ADP, MCP-1, IL-10 and IL-17and the IL-17/IL-10 ratio were significantly lower than in HC. The serum levels of TNF-α and the IL-6/IL-10 ratio were significantly higher in mild BDM than in HC. In moderate BDM, the serum level of VIS, IL-2, and IL-17 were significantly higher than in HC, but the IL-6/IL-10 ratio was significantly lower than in control. In severe BDM, the serum levels of IL-6 and IL-17 and the ratios of IL-6/IL-10 and IL-17/IL-10 were significantly lower than in HC, but the neutrophil/lymphocyte ratio was significantly higher than in HC. CONCLUSION In BDD, immune-inhibition is persistently predominant, while in mild-to-moderate BDM, immune system is activated but inhibited in severe BDM. The dynamic change of serum inflammatory markers suggests that alteration of peripheral inflammatory markers in BD is state-dependent instead of trait-marked.
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Affiliation(s)
- Xiuhua Wu
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhongcheng Chen
- Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yingtao Liao
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhihua Yang
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaolin Liang
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Nianhong Guan
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhaoyu Gan
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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Carta MG, Kalcev G, Fornaro M, Nardi AE. Novel experimental and early investigational drugs for the treatment of bipolar disorder. Expert Opin Investig Drugs 2021; 30:1081-1087. [PMID: 34844484 DOI: 10.1080/13543784.2021.2000965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The quest toward more effective treatments for bipolar disorder (BD) solicits novel drugs and further research on the underpinning neurobiology. The present review aims to critically appraise the existing evidence about the pharmacological treatment of BD toward the development of novel treatment avenues. AREAS COVERED The present review appraises animal and human studies concerning both the currently available psychotropic drugs, and the general medicine drugs which may represent a path toward the development of novel drugs for BD. PubMed and Scopus were last accessed on February 20th, 2021 for records indexed upon inception relevant to the pharmacological treatment of BD. Immune-modulating agents, anti-inflammatory agents, and glutamate antagonists represent the most intriguing potential targets for the development of new drugs for BD, thus receiving critical appraisal in the present text. EXPERT OPINION Regardless of the neurobiological pathways worthy of investigation toward the development of experimental drugs for BD, several unmet needs need to be addressed first. In particular, several biomarkers are altered in BD. However, it is the opinion herein expressed by the authors that it remains uncertain what comes first, that is peripheral changes or the disease.
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Affiliation(s)
- Mauro Giovanni Carta
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari Italy
| | - Goce Kalcev
- Department of Mechanical, Chemical and Materials Engineering, International Ph.D. In Innovation Sciences and Technologies, University of Cagliari, Cagliari Italy
| | - Michele Fornaro
- Department of Psychiatry, University of Federico II of Naples, Italy
| | - Antonio Egidio Nardi
- Laboratory Panic and Respiration, Institute of Psychiatry (Ipub), Federal University of Rio De Janeiro (Ufrj), Rio De Janeiro, Brazil
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Kupka R, Duffy A, Scott J, Almeida J, Balanzá‐Martínez V, Birmaher B, Bond DJ, Brietzke E, Chendo I, Frey BN, Grande I, Hafeman D, Hajek T, Hillegers M, Kauer‐Sant’Anna M, Mansur RB, van der Markt A, Post R, Tohen M, Tremain H, Vazquez G, Vieta E, Yatham LN, Berk M, Alda M, Kapczinski F. Consensus on nomenclature for clinical staging models in bipolar disorder: A narrative review from the International Society for Bipolar Disorders (ISBD) Staging Task Force. Bipolar Disord 2021; 23:659-678. [PMID: 34174130 PMCID: PMC9290926 DOI: 10.1111/bdi.13105] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Clinical staging is widely used in medicine to map disease progression, inform prognosis, and guide treatment decisions; in psychiatry, however, staging remains a hypothetical construct. To facilitate future research in bipolar disorders (BD), a well-defined nomenclature is needed, especially since diagnosis is often imprecise with blurred boundaries, and a full understanding of pathophysiology is lacking. METHODS Under the auspices of the International Society of Bipolar Disorders, a Task Force of international experts was convened to review, discuss, and integrate findings from the scientific literature relevant to the development of a consensus staging model and standardize a terminology that could be used to advance future research including staging of BD and related disorders. RESULTS Consensus opinion and areas of uncertainty or difference were identified in regard to terms referring to staging as it may apply to BD, to at-risk status and subthreshold stages, and to various clinical stages of BD as it is currently diagnosed. CONCLUSION The use of a standardized nomenclature about the clinical stages of BD will facilitate communication about research on clinical and pathological components of this heterogeneous group of disorders. The concepts presented are based on current evidence, but the template provided allows for further refinements as etiological advances come to light.
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Affiliation(s)
- Ralph Kupka
- Department of PsychiatryAmsterdam Public Mental Health Research InsituteAmsterdam UMCVrije UniversiteitAmsterdamThe Netherlands
| | - Anne Duffy
- Department of PsychiatryDivision of Student Mental HealthQueen's UniversityCote Sharp Student Wellness CentreKingstonONCanada,Department of PsychiatryUniversity of OxfordOxfordUK
| | - Jan Scott
- Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneUK,Brain and Mind CentreThe University of SydneySydneyNSWAustralia
| | - Jorge Almeida
- Department of Psychiatry and Behavior SciencesDell Medical SchoolUniversity of Texas at AustinAustinTXUSA
| | - Vicent Balanzá‐Martínez
- Teaching Unit of Psychiatry and Psychological MedicineDepartment of MedicineUniversity of ValenciaCIBERSAMValenciaSpain
| | | | - David J. Bond
- Department of Psychiatry and Behavioral SciencesUniversity of Minnesota Medical SchoolMinneapolisMNUSA
| | - Elisa Brietzke
- Department of PsychiatryQueen's University School of MedicineKingstonONCanada,Centre for Neuroscience StudiesQueen’s UniversityKingstonONCanada
| | - Ines Chendo
- Psychiatry DepartmentDepartment of NeurosciencesHospital Santa MariaLisbonPortugal,Clínica Universitária de PsiquiatriaFaculty of MedicineUniversity of LisbonLisbonPortugal
| | - Benicio N. Frey
- Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada,Mood Disorders Program and Women's Health Concerns ClinicSt. Joseph's Healthcare HamiltonHamiltonONCanada
| | - Iria Grande
- Barcelona Bipolar Disorders and Depressive UnitHospital ClinicInstitute of NeurosciencesUniversity of BarcelonaIDIBAPSCIBERSAMBarcelonaSpain
| | - Danella Hafeman
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Tomas Hajek
- Department of PsychiatryDalhousie UniversityHalifaxNSCanada
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical Center‐Sophia Children’s HospitalRotterdamThe Netherlands
| | - Marcia Kauer‐Sant’Anna
- Department of PsychiatryFaculty of MedicineUniversidade Federal do Rio Grande do Sul (UFRGSHospital de Clínicas de Porto Alegre (HCPAPorto AlegreBrazil
| | - Rodrigo B. Mansur
- Mood Disorders Psychopharmacology UnitUniversity Health NetworkTorontoONCanada,Department of PsychiatryUniversity of TorontoTorontoONCanada
| | - Afra van der Markt
- Department of PsychiatryAmsterdam Public Mental Health Research InsituteAmsterdam UMCVrije UniversiteitAmsterdamThe Netherlands
| | - Robert Post
- George Washington University School of MedicineWashingtonDCUSA,Bipolar Collaborative NetworkBethesdaMDUSA
| | - Mauricio Tohen
- Department of Psychiatry and Behavioral SciencesUniversity of New Mexico Health Sciences CenterAlbuquerqueNMUSA
| | - Hailey Tremain
- Centre for Mental HealthFaculty of Health Arts and DesignSwinburne UniversityMelbourneVicAustralia,OrygenThe National Centre of Excellence in Youth Mental HealthParkvilleVicAustralia
| | | | - Eduard Vieta
- Hospital ClinicInstitute of NeuroscienceUniversity of BarcelonaIDIBAPSCIBERSAMBarcelonaSpain
| | - Lakshmi N. Yatham
- Department of PsychiatryUniversity of British ColumbiaVancouverBCCanada
| | - Michael Berk
- IMPACT – the Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineBarwon HealthDeakin UniversityGeelongVicAustralia,OrygenThe National Centre of Excellence in Youth Mental HealthCentre for Youth Mental HealthFlorey Institute for Neuroscience and Mental HealthDepartment of PsychiatryThe University of MelbourneMelbourneVicAustralia
| | - Martin Alda
- Department of PsychiatryMood Disorders ClinicDalhousie UniversityHalifaxNCCanada
| | - Flávio Kapczinski
- St. Joseph’s Healthcare Hamilton McMaster UniversityHamiltonONCanada,Universidade Federal do Rio Grande do SulUFRGSPorto AlegreBrazil
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A Comparison of Different Approaches to Clinical Phenotyping of Lithium Response: A Proof of Principle Study Employing Genetic Variants of Three Candidate Circadian Genes. Pharmaceuticals (Basel) 2021; 14:ph14111072. [PMID: 34832854 PMCID: PMC8625673 DOI: 10.3390/ph14111072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022] Open
Abstract
Optimal classification of the response to lithium (Li) is crucial in genetic and biomarker research. This proof of concept study aims at exploring whether different approaches to phenotyping the response to Li may influence the likelihood of detecting associations between the response and genetic markers. We operationalized Li response phenotypes using the Retrospective Assessment of Response to Lithium Scale (i.e., the Alda scale) in a sample of 164 cases with bipolar disorder (BD). Three phenotypes were defined using the established approaches, whilst two phenotypes were generated by machine learning algorithms. We examined whether these five different Li response phenotypes showed different levels of statistically significant associations with polymorphisms of three candidate circadian genes (RORA, TIMELESS and PPARGC1A), which were selected for this study because they were plausibly linked with the response to Li. The three original and two revised Alda ratings showed low levels of discordance (misclassification rates: 8–12%). However, the significance of associations with circadian genes differed when examining previously recommended categorical and continuous phenotypes versus machine-learning derived phenotypes. Findings using machine learning approaches identified more putative signals of the Li response. Established approaches to Li response phenotyping are easy to use but may lead to a significant loss of data (excluding partial responders) due to recent attempts to improve the reliability of the original rating system. While machine learning approaches require additional modeling to generate Li response phenotypes, they may offer a more nuanced approach, which, in turn, would enhance the probability of identifying significant signals in genetic studies.
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Rahmani N, Hatch J, Dimick M, Naiberg MR, Fiksenbaum L, Andreazza AC, Bowie CR, Dickstein DP, Goldstein BI. Lower pro- to anti-inflammatory ratios associated with reduced neurocognitive flexibility in symptomatic adolescents with bipolar disorder. J Affect Disord 2021; 292:430-438. [PMID: 34144368 DOI: 10.1016/j.jad.2021.05.062] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 04/11/2021] [Accepted: 05/30/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Peripheral inflammatory markers, such as C-reactive protein (CRP), are elevated among adolescents and adults with bipolar disorder (BD), particularly during symptomatic episodes. Neurocognition, predominantly in the domain of executive function, is also impaired among adults and youth with BD. In adults with BD, CRP is negatively associated with neurocognitive functioning. We aim to investigate this relationship in BD adolescents. METHODS Serum levels of CRP and five other inflammatory markers (interleukin (IL)-1β, IL-6, IL-10, IL-4 and tumor necrosis factor α (TNF)) were examined in 60 adolescents with BD (34 symptomatic, 26 asymptomatic) age- and sex-matched to 51 healthy controls (HC). Diagnoses were confirmed using semi-structured interviews. Pro- to anti-inflammatory marker ratios were also examined. Neurocognitive flexibility was assessed via the intra/extradimensional shift (IED) task from the CANTAB battery. Multivariate linear regression controlled for age, sex and race. RESULTS Within symptomatic BD adolescents, but not asymptomatic BD or HC adolescents, lower IL-6/IL-10 and lower CRP/IL-10 ratios were significantly associated with worse performance on the neurocognitive flexibility task (p = 0.03 and p = 0.04, respectively). Both models accounted for 13.3% of variance in neurocognitive flexibility. No significant CRP by diagnosis interaction effects were observed on neurocognitive flexibility. LIMITATIONS Limited sample-size restricted ability to separate the symptomatic BD adolescents into varying mood states. CONCLUSION More balanced pro- to anti-inflammatory ratios were associated with better neurocognitive flexibility in symptomatic BD adolescents. Prospective studies are warranted to assess the direction of these findings.
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Affiliation(s)
- Noreen Rahmani
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON M5R 0A3, Canada.
| | - Jessica Hatch
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON M5R 0A3, Canada
| | - Mikaela Dimick
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON M5R 0A3, Canada; Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
| | - Melanie R Naiberg
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON M5R 0A3, Canada
| | - Lisa Fiksenbaum
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON M5R 0A3, Canada; Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
| | - Ana C Andreazza
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON M5R 0A3, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Christopher R Bowie
- Centre for Neuroscience Studies, Department of Psychology & Department of Psychiatry, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Daniel P Dickstein
- PediMIND Program, Department of Psychiatry and Human Behaviour, Bradley Hospital and Alpert Medical School of Brown University, Rhode Island, East Providence 02915, USA
| | - Benjamin I Goldstein
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON M5R 0A3, Canada; Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada.
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Vošahlíková M, Roubalová L, Brejchová J, Alda M, Svoboda P. Therapeutic lithium alters polar head-group region of lipid bilayer and prevents lipid peroxidation in forebrain cortex of sleep-deprived rats. Biochim Biophys Acta Mol Cell Biol Lipids 2021; 1866:158962. [PMID: 33991653 DOI: 10.1016/j.bbalip.2021.158962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/22/2021] [Accepted: 04/27/2021] [Indexed: 02/07/2023]
Abstract
Lithium is regarded as a unique therapeutic agent for the management of bipolar disorder (BD). In efforts to explain the favourable effects of lithium in BD, a wide range of mechanisms was suggested. Among those, the effect of clinically relevant concentrations of lithium on the plasma membrane was extensively studied. However, the biophysical properties of brain membranes isolated from experimental animals exposed to acute, short-term and chronic lithium have not been performed to-date. In this study, we compared the biophysical parameters and level of lipid peroxidation in membranes isolated from forebrain cortex (FBC) of therapeutic lithium-treated and/or sleep-deprived rats. Lithium interaction with FBC membranes was characterized by appropriate fluorescent probes. DPH (1,6-diphenyl-1,3,5-hexatriene) and TMA-DPH (1-(4-trimethylammoniumphenyl)-6-phenyl-1,3,5-hexatriene p-toluenesulphonate) were used for characterization of the hydrophobic lipid core and Laurdan (6-dodecanoyl-2-dimethylaminonaphthalene) for the membrane-water interface. Lipid peroxidation was determined by immunoblot analysis of 4-HNE-(4-hydroxynonenal)-protein adducts. The organization of polar head-group region of FBC membranes, measured by Laurdan generalized polarization, was substantially altered by sleep deprivation and augmented by lithium treatment. Hydrophobic membrane interior characterized by steady-state anisotropy of DPH and TMA-DPH fluorescence was unchanged. Chronic lithium had a protective effect against peroxidative damage of membrane lipids in FBC. In summary, lithium administration at a therapeutic level and/or sleep deprivation as an animal model of mania resulted in changes in rat FBC membrane properties.
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Affiliation(s)
- Miroslava Vošahlíková
- Laboratory of Neurochemistry, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic.
| | - Lenka Roubalová
- Laboratory of Neurochemistry, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Jana Brejchová
- Laboratory of Neurochemistry, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; National Institute of Mental Health, Klecany, Czech Republic
| | - Petr Svoboda
- Laboratory of Neurochemistry, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
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Zou Y, Kennedy KG, Grigorian A, Fiksenbaum L, Freeman N, Zai CC, Kennedy JL, MacIntosh BJ, Goldstein BI. Antioxidative Defense Genes and Brain Structure in Youth Bipolar Disorder. Int J Neuropsychopharmacol 2021; 25:89-98. [PMID: 34387669 PMCID: PMC8832218 DOI: 10.1093/ijnp/pyab056] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/27/2021] [Accepted: 08/20/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Oxidative stress is implicated in the neuropathology of bipolar disorder (BD). We investigated the association of single-nucleotide polymorphisms (SNPs) in the antioxidative genes superoxide dismutase 2 (SOD2) and glutathione peroxidase 3 (GPX3) with structural neuroimaging phenotypes in youth BD. METHODS SOD2 rs4880 and GPX3 rs3792797 SNP genotypes, along with structural magnetic resonance imaging, were obtained from 147 youth (BD = 75; healthy controls = 72). Images were processed using FreeSurfer, yielding surface area, volume, and thickness values for regions of interest (prefrontal cortex [PFC], caudal anterior cingulate cortex, hippocampus) and for vertex-wise whole-brain analysis. Analyses controlled for age, sex, race, and intracranial volume for volume, area, and thickness analyses. RESULT Regions of interest analyses revealed diagnosis-by-SOD2 rs4880 interaction effects for caudal anterior cingulate cortex volume and surface area as well as PFC volume; in each case, there was lower volume/area in the BD GG genotype group vs the healthy controls GG genotype group. There was a significant BD diagnosis × GPX3 rs3793797 interaction effect for PFC surface area, where area was lower in the BD A-allele carrier group vs the other genotype groups. Vertex-wise analyses revealed significant interaction effects in frontal, temporal, and parietal regions related to smaller brain structure in the BD SOD2 rs4880 GG group and BD GPX3 rs3793797 A-allele carrier group. CONCLUSION We found preliminary evidence that SOD2 rs4880 and GPX3 rs3792797 are differentially associated with brain structures in youth with BD in regions that are relevant to BD. Further studies incorporating additional neuroimaging phenotypes and blood levels of oxidative stress markers are warranted.
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Affiliation(s)
- Yi Zou
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada,Correspondence: Benjamin I. Goldstein, MD, PhD, FRCPC, Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Centre for Addiction and Mental Health, 100 Stokes St, Toronto, ON M6J 1H4, Canada ()
| | - Kody G Kennedy
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Anahit Grigorian
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Lisa Fiksenbaum
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Natalie Freeman
- Psychiatric Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Clement C Zai
- Psychiatric Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - James L Kennedy
- Psychiatric Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Bradley J MacIntosh
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, ON, Canada,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Benjamin I Goldstein
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada,Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Tang G, Chen P, Chen G, Zhong S, Gong J, Zhong H, Ye T, Chen F, Wang J, Luo Z, Qi Z, Jia Y, Wang Y, Huang L. Inflammation is correlated with abnormal functional connectivity in unmedicated bipolar depression: an independent component analysis study of resting-state fMRI. Psychol Med 2021; 52:1-11. [PMID: 33602352 DOI: 10.1017/s003329172100009x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Inflammation might play a role in bipolar disorder (BD), but it remains unclear the relationship between inflammation and brain structural and functional abnormalities in patients with BD. In this study, we focused on the alterations of functional connectivity (FC), peripheral pro-inflammatory cytokines and their correlations to investigate the role of inflammation in FC in BD depression. METHODS In this study, 42 unmedicated patients with BD II depression and 62 healthy controls (HCs) were enrolled. Resting-state-functional magnetic resonance imaging was performed in all participants and independent component analysis was used. Serum levels of Interleukin-6 (IL-6) and Interleukin-8 (IL-8) were measured in all participants. Correlation between FC values and IL-6 and IL-8 levels in BD was calculated. RESULTS Compared with the HCs, BD II patients showed decreased FC in the left orbitofrontal cortex (OFC) implicating the limbic network and the right precentral gyrus implicating the somatomotor network. BD II showed increased IL-6 (p = 0.039), IL-8 (p = 0.002) levels. Moreover, abnormal FC in the right precentral gyrus were inversely correlated with the IL-8 (r = -0.458, p = 0.004) levels in BD II. No significant correlation was found between FC in the left OFC and cytokines levels. CONCLUSIONS Our findings that serum IL-8 levels are associated with impaired FC in the right precentral gyrus in BD II patients suggest that inflammation might play a crucial role in brain functional abnormalities in BD.
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Affiliation(s)
- Guixian Tang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou510630, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou510630, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou510630, China
| | - JiaYing Gong
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou510630, China
- Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou510655, China
| | - Hui Zhong
- Biomedical Translational Research Institute, Jinan University, Guangzhou510630, China
| | - Tao Ye
- Clinical Laboratory Center, First Affiliated Hospital of Jinan University, Guangzhou510630, China
| | - Feng Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou510630, China
| | - Jurong Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou510630, China
| | - Zhenye Luo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou510630, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou510630, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou510630, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou510630, China
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38
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Wollenhaupt-Aguiar B, Kapczinski F, Pfaffenseller B. Biological Pathways Associated with Neuroprogression in Bipolar Disorder. Brain Sci 2021; 11:brainsci11020228. [PMID: 33673277 PMCID: PMC7918818 DOI: 10.3390/brainsci11020228] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 02/06/2023] Open
Abstract
There is evidence suggesting clinical progression in a subset of patients with bipolar disorder (BD). This progression is associated with worse clinical outcomes and biological changes. Molecular pathways and biological markers of clinical progression have been identified and may explain the progressive changes associated with this disorder. The biological basis for clinical progression in BD is called neuroprogression. We propose that the following intertwined pathways provide the biological basis of neuroprogression: inflammation, oxidative stress, impaired calcium signaling, endoplasmic reticulum and mitochondrial dysfunction, and impaired neuroplasticity and cellular resilience. The nonlinear interaction of these pathways may worsen clinical outcomes, cognition, and functioning. Understanding neuroprogression in BD is crucial for identifying novel therapeutic targets, preventing illness progression, and ultimately promoting better outcomes.
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Affiliation(s)
- Bianca Wollenhaupt-Aguiar
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON L8N 3K7, Canada; (B.W.-A.); (F.K.)
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON L8N 3K7, Canada; (B.W.-A.); (F.K.)
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada
- Neuroscience Graduate Program, McMaster University, Hamilton, ON L8S 4L8, Canada
- Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-003, Brazil
| | - Bianca Pfaffenseller
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON L8N 3K7, Canada; (B.W.-A.); (F.K.)
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada
- Correspondence:
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Shonibare DO, Patel RR, Islam AH, Metcalfe AWS, Fiksenbaum L, Freeman N, MacIntosh BJ, Kennedy JL, Goldstein BI. Neurostructural phenotypes of CACNA1C rs1006737 in adolescents with bipolar disorder and healthy controls. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110071. [PMID: 32800865 DOI: 10.1016/j.pnpbp.2020.110071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/05/2020] [Accepted: 08/09/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Investigate the effects of CACNA1C rs1006737 on cortical and subcortical neurostructural phenotypes in Caucasian bipolar disorder (BD) and healthy control (HC) adolescents. METHODS Seventy-one adolescents (14-20 years; 38BD, 33HC) underwent 3-Tesla Magnetic Resonance Imaging (MRI). Region of interest (ROI) and vertex-wise analyses examined cortical volume, surface area (SA), and thickness, as well as subcortical volume. ROIs included the ventromedial prefrontal cortex (vmPFC), ventrolateral prefrontal cortex (vlPFC), anterior cingulate cortex (ACC), putamen, and amygdala. General linear models included main effects of diagnosis and rs1006737, and an interaction term, controlling for age, sex, and total intracranial volume. RESULTS Vertex-wise analysis found significant BD-by-rs1006737 interactions for prefrontal and occipital regions such that BD A-carriers were found to have greater SA relative to BD non-carriers, while HC A-carriers had reduced SA relative to HC non-carriers. ROI analysis found an interaction in the ACC such that BD A-carriers were found to have greater SA relative to BD non-carriers, while no significant difference was found in HCs. Main effects of rs1006737 were also found on ACC SA from ROI analysis, and occipital SA from vertex-wise analysis, such that A-carriers had larger SA relative to non-carriers in both of these regions. CONCLUSIONS The current study identified neurostructural intermediate phenotypes relevant to the impact of CACNA1C rs1006737 on adolescent BD. Further investigation is warranted into the neurofunctional and neurocognitive relevance of rs1006737 associations with BD-specific elevations in regional SA.
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Affiliation(s)
- Daniel O Shonibare
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Ronak R Patel
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Alvi H Islam
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Arron W S Metcalfe
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada; Hurvitz Brain Sciences, Sunnybrook Research Institute, Toronto, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada
| | - Lisa Fiksenbaum
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Natalie Freeman
- Tanenbaum Centre for Pharmacogenetics, Centre for Addiction and Mental Health, Toronto, Canada
| | - Bradley J MacIntosh
- Hurvitz Brain Sciences, Sunnybrook Research Institute, Toronto, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada; Department of Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - James L Kennedy
- Institute of Medical Science, University of Toronto, Toronto, Canada; Tanenbaum Centre for Pharmacogenetics, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
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Soto-Vega JG, Valencia JG, Vargas C, López-Jaramillo C. Resting-state functional nuclear magnetic resonance imaging in patients with bipolar disorder: beyond euthymia. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 51:S0034-7450(20)30088-3. [PMID: 33735024 DOI: 10.1016/j.rcp.2020.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/05/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Functional nuclear magnetic resonance imaging in the resting state (R-fMRI) allows the identification of complete functional connectivity networks and the possible neuronal correlations of psychiatric disorders. The literature on R-fMRI and bipolar disorder (BD) will be reviewed, emphasising the findings in the phases of mania, hypomania and depression. METHODS It is a narrative review of the literature in which articles were searched in PubMed and Embase, with the key words in English "bipolar disorder" AND "resting state", without limit on the date of publication. RESULTS The studies of BD patients in the mania and hypomania phases who underwent R-fMRI show concordant results in terms of decreased functional cerebral connectivity between the amygdala and some cortical regions, which indicates that this functional connection would have some implication in the normal affect regulation. Patients in the depressive phase show a decrease in functional brain connectivity, but as there are several anatomical structures involved and neural networks reported in the studies, it is not possible to compare them. CONCLUSIONS There is a decrease in functional connectivity in patients with BD, but current evidence does not allow establishing specific changes in specific functional brain connectivity networks. However, there are already some findings that show correlation with the patients' symptoms.
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Affiliation(s)
| | - Jenny García Valencia
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Cristian Vargas
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - Carlos López-Jaramillo
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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Scott J, Colom F, Young A, Bellivier F, Etain B. An evidence map of actigraphy studies exploring longitudinal associations between rest-activity rhythms and course and outcome of bipolar disorders. Int J Bipolar Disord 2020; 8:37. [PMID: 33258017 PMCID: PMC7704984 DOI: 10.1186/s40345-020-00200-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/25/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Evidence mapping is a structured approach used to synthesize the state-of-the-art in an emerging field of research when systematic reviews or meta-analyses are deemed inappropriate. We employed this strategy to summarise knowledge regarding longitudinal ecological monitoring of rest-activity rhythms (RAR) and disease modifiers, course of illness, treatment response or outcome in bipolar disorders (BD). STRUCTURE We had two key aims: (1) to determine the number and type of actigraphy studies of in BD that explored data regarding: outcome over time (e.g. relapse/recurrence according to polarity, or recovery/remission), treatment response or illness trajectories and (2) to examine the range of actigraphy metrics that can be used to estimate disruptions of RAR and describe which individual circadian rhythm or sleep-wake cycle parameters are most consistently associated with outcome over time in BD. The mapping process incorporated four steps: clarifying the project focus, describing boundaries and 'coordinates' for mapping, searching the literature and producing a brief synopsis with summary charts of the key outputs. Twenty-seven independent studies (reported in 29 publications) were eligible for inclusion in the map. Most were small-scale, with the median sample size being 15 per study and median duration of actigraphy being about 7 days (range 1-210). Interestingly, 17 studies comprised wholly or partly of inpatients (63%). The available evidence indicated that a discrete number of RAR metrics are more consistently associated with transition between different phases of BD and/or may be predictive of longitudinal course of illness or treatment response. The metrics that show the most frequent associations represent markers of the amount, timing, or variability of RAR rather than the sleep quality metrics that are frequently targeted in contemporary studies of BD. CONCLUSIONS Despite 50 years of research, use of actigraphy to assess RAR in longitudinal studies and examination of these metrics and treatment response, course and outcome of BD is under-investigated. This is in marked contrast to the extensive literature on case-control or cross-sectional studies of actigraphy, especially typical sleep analysis metrics in BD. However, given the encouraging findings on putative RAR markers, we recommend increased study of putative circadian phenotypes of BD.
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Affiliation(s)
- Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, 75013, Paris, France
| | - Francesc Colom
- IMIM-Hospital del Mar-CIBERSAM, Barcelona, Catalonia, Spain
- Universitat Autònoma de Barcelona Barcelona-Catalonia, Barcelona, Spain
| | - Allan Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Kent, UK
| | - Frank Bellivier
- Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, 75013, Paris, France
- Département de Psychiatrie Et de Médecine Addictologique, AP-HP, GH Saint-Louis - Lariboisière - F. Widal, 75475, Paris, France
- Inserm U114475006, Paris, France
| | - Bruno Etain
- Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, 75013, Paris, France.
- Département de Psychiatrie Et de Médecine Addictologique, AP-HP, GH Saint-Louis - Lariboisière - F. Widal, 75475, Paris, France.
- Inserm U114475006, Paris, France.
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Vosahlikova M, Roubalova L, Cechova K, Kaufman J, Musil S, Miksik I, Alda M, Svoboda P. Na +/K +-ATPase and lipid peroxidation in forebrain cortex and hippocampus of sleep-deprived rats treated with therapeutic lithium concentration for different periods of time. Prog Neuropsychopharmacol Biol Psychiatry 2020; 102:109953. [PMID: 32360816 DOI: 10.1016/j.pnpbp.2020.109953] [Citation(s) in RCA: 12] [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: 10/31/2019] [Revised: 04/22/2020] [Accepted: 04/27/2020] [Indexed: 12/18/2022]
Abstract
Lithium (Li) is a typical mood stabilizer and the first choice for treatment of bipolar disorder (BD). Despite an extensive clinical use of Li, its mechanisms of action remain widely different and debated. In this work, we studied the time-course of the therapeutic Li effects on ouabain-sensitive Na+/K+-ATPase in forebrain cortex and hippocampus of rats exposed to 3-day sleep deprivation (SD). We also monitored lipid peroxidation as malondialdehyde (MDA) production. In samples of plasma collected from all experimental groups of animals, Li concentrations were followed by ICP-MS. The acute (1 day), short-term (7 days) and chronic (28 days) treatment of rats with Li resulted in large decrease of Na+/K+-ATPase activity in both brain parts. At the same time, SD of control, Li-untreated rats increased Na+/K+-ATPase along with increased production of MDA. The SD-induced increase of Na+/K+-ATPase and MDA was attenuated in Li-treated rats. While SD results in a positive change of Na+/K+-ATPase, the inhibitory effect of Li treatment may be interpreted as a pharmacological mechanism causing a normalization of the stress-induced shift and return the Na+/K+-ATPase back to control level. We conclude that SD alone up-regulates Na+/K+-ATPase together with increased peroxidative damage of lipids. Chronic treatment of rats with Li before SD, protects the brain tissue against this type of damage and decreases Na+/K+-ATPase level back to control level.
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Affiliation(s)
- Miroslava Vosahlikova
- Laboratory of Biomathematics, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Lenka Roubalova
- Laboratory of Biomathematics, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic.
| | - Kristina Cechova
- Laboratory of Biomathematics, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic; Department of Biochemistry, Faculty of Science, Charles University, Prague, Czech Republic
| | - Jonas Kaufman
- Laboratory of Biomathematics, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Stanislav Musil
- Department of Trace Element Analysis, Institute of Analytical Chemistry of the Czech Academy of Sciences, Brno, Czech Republic
| | - Ivan Miksik
- Laboratory of Translation Metabolism, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; National Institute of Mental Health, Klecany, Czech Republic
| | - Petr Svoboda
- Laboratory of Biomathematics, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
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Kashaninasab F, Panahi Dashdebi R, Ghalehbandi MF. Comorbidity of Coronavirus disease (COVID-19) and the first episode of bipolar disorder and its treatment challenges: A case report. Med J Islam Repub Iran 2020; 34:103. [PMID: 33315969 PMCID: PMC7722969 DOI: 10.34171/mjiri.34.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Indexed: 01/07/2023] Open
Abstract
This study attempted to diagnose and examine the treatment challenges of a 25-year-old patient with the first episode of bipolar I disorder (BD-I) who also had Coronavirus disease 2019 (COVID-19) at the same time. This patient was admitted to the general ward of the hospital, along with other COVID-19 patients, and was treated with electroconvulsive therapy (ECT). Our results showed that it is important to pay attention to the comorbidity of psychiatric disorders in patients with COVID-19 to evaluate and treat them completely and avoid drug interactions.
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Affiliation(s)
- Fatemeh Kashaninasab
- Mental Health Research Center, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Panahi Dashdebi
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Mir Farhad Ghalehbandi
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
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Goldstein BI, Baune BT, Bond DJ, Chen P, Eyler L, Fagiolini A, Gomes F, Hajek T, Hatch J, McElroy SL, McIntyre RS, Prieto M, Sylvia LG, Tsai S, Kcomt A, Fiedorowicz JG. Call to action regarding the vascular-bipolar link: A report from the Vascular Task Force of the International Society for Bipolar Disorders. Bipolar Disord 2020; 22:440-460. [PMID: 32356562 PMCID: PMC7522687 DOI: 10.1111/bdi.12921] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The association of bipolar disorder with early and excessive cardiovascular disease was identified over a century ago. Nonetheless, the vascular-bipolar link remains underrecognized, particularly with regard to how this link can contribute to our understanding of pathogenesis and treatment. METHODS An international group of experts completed a selective review of the literature, distilling core themes, identifying limitations and gaps in the literature, and highlighting future directions to bridge these gaps. RESULTS The association between bipolar disorder and vascular disease is large in magnitude, consistent across studies, and independent of confounding variables where assessed. The vascular-bipolar link is multifactorial and is difficult to study given the latency between the onset of bipolar disorder, often in adolescence or early adulthood, and subsequent vascular disease, which usually occurs decades later. As a result, studies have often focused on risk factors for vascular disease or intermediate phenotypes, such as structural and functional vascular imaging measures. There is interest in identifying the most relevant mediators of this relationship, including lifestyle (eg, smoking, diet, exercise), medications, and systemic biological mediators (eg, inflammation). Nonetheless, there is a paucity of treatment studies that deliberately engage these mediators, and thus far no treatment studies have focused on engaging vascular imaging targets. CONCLUSIONS Further research focused on the vascular-bipolar link holds promise for gleaning insights regarding the underlying causes of bipolar disorder, identifying novel treatment approaches, and mitigating disparities in cardiovascular outcomes for people with bipolar disorder.
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Affiliation(s)
- Benjamin I. Goldstein
- Centre for Youth Bipolar DisorderSunnybrook Health Sciences CentreTorontoONCanada,Departments of Psychiatry & PharmacologyFaculty of MedicineUniversity of TorontoTorontoONCanada
| | - Bernhard T. Baune
- Department of Psychiatry and PsychotherapyUniversity of MünsterMünsterGermany,Department of PsychiatryMelbourne Medical SchoolThe University of MelbourneMelbourneVICAustralia,The Florey Institute of Neuroscience and Mental HealthThe University of MelbourneParkvilleVICAustralia
| | - David J. Bond
- Department of Psychiatry and Behavioral ScienceUniversity of Minnesota Medical SchoolMinneapolisMNUSA
| | - Pao‐Huan Chen
- Department of PsychiatryTaipei Medical University HospitalTaipeiTaiwan,Department of PsychiatrySchool of MedicineCollege of MedicineTaipei Medical UniversityTaipeiTaiwan
| | - Lisa Eyler
- Department of PsychiatryUniversity of California San DiegoSan DiegoCAUSA
| | | | - Fabiano Gomes
- Department of PsychiatryQueen’s University School of MedicineKingstonONCanada
| | - Tomas Hajek
- Department of PsychiatryDalhousie UniversityHalifaxNSCanada,National Institute of Mental HealthKlecanyCzech Republic
| | - Jessica Hatch
- Centre for Youth Bipolar DisorderSunnybrook Health Sciences CentreTorontoONCanada,Departments of Psychiatry & PharmacologyFaculty of MedicineUniversity of TorontoTorontoONCanada
| | - Susan L. McElroy
- Department of Psychiatry and Behavioral NeuroscienceUniversity of Cincinnati College of MedicineCincinnatiOHUSA,Lindner Center of HOPEMasonOHUSA
| | - Roger S. McIntyre
- Departments of Psychiatry & PharmacologyFaculty of MedicineUniversity of TorontoTorontoONCanada,Mood Disorders Psychopharmacology UnitUniversity Health NetworkTorontoONCanada
| | - Miguel Prieto
- Department of PsychiatryFaculty of MedicineUniversidad de los AndesSantiagoChile,Mental Health ServiceClínica Universidad de los AndesSantiagoChile,Department of Psychiatry and PsychologyMayo Clinic College of Medicine and ScienceRochesterMNUSA
| | - Louisa G. Sylvia
- Department of PsychiatryMassachusetts General HospitalBostonMAUSA,Department of PsychiatryHarvard Medical SchoolCambridgeMAUSA
| | - Shang‐Ying Tsai
- Department of PsychiatryTaipei Medical University HospitalTaipeiTaiwan,Department of PsychiatrySchool of MedicineCollege of MedicineTaipei Medical UniversityTaipeiTaiwan
| | - Andrew Kcomt
- Hope+Me—Mood Disorders Association of OntarioTorontoONCanada
| | - Jess G. Fiedorowicz
- Departments of Psychiatry, Internal Medicine, & EpidemiologyCarver College of MedicineUniversity of IowaIowa CityIAUSA
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Chang KH, Hsu YC, Chiu IM, Chen LC, Hsu CC, Lee CY, Fan HC, Chen HJ, Chou RH. Association between periodontitis and bipolar disorder: A nationwide cohort study. Medicine (Baltimore) 2020; 99:e21423. [PMID: 32756145 PMCID: PMC7402799 DOI: 10.1097/md.0000000000021423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Whether periodontitis is a risk factor for developing bipolar disorders (BD) has not been investigated. We aimed to determine whether periodontitis is associated with the subsequent development of BD and examine the risk factors for BD among patients with periodontitis.Using ambulatory and inpatient claims data from the National Health Insurance Research Database (NHIRD), we identified 12,337 patients who were aged at least 20 years and newly diagnosed with periodontitis between 2000 and 2004. The date of the first claim with a periodontitis diagnosis was set as the index date. For each patient with periodontitis, 4 subjects without a history of periodontitis were randomly selected from the NHIRD and frequency-matched with the patients with periodontitis according to sex, age (in 5-year bands), and index year.The periodontitis group had a mean age of 44.0 ± 13.7 years and slight predominance of men (51.3%). Compared with the subjects without periodontitis, the patients with periodontitis had higher prevalence of diabetes mellitus, hyperlipidemia, hypertension, ischemic heart disease, stroke, head injury, major depressive disorder, chronic obstructive pulmonary disease (COPD), and asthma (P < .001). The incidence rate of BD was higher in the periodontitis group than in the non-periodontitis group (2.74 vs 1.46 per 1000 person-year), with an adjusted hazard ratio of 1.82 (95% confidence interval = 1.59-2.08) after adjustment for sex, age, and comorbidities.The patients with periodontitis exhibited a significantly higher risk of developing BD. Keep the better oral hygiene to reduce periodontitis might be a preventive strategy for BD.
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Affiliation(s)
- Kuang-Hsi Chang
- Department of Medical Research
- Graduate Institute of Biomedical Sciences, China Medical University
- General Education Center
| | | | - Ing-Ming Chiu
- Institute of Cellular and System Medicine, National Health Research Institutes
| | - Lih-Chyang Chen
- Department of Medicine, Mackay Medical College, New Taipei City
| | - Chih-Chao Hsu
- Division of Psychiatry, Taitung Branch, Taipei Veterans General Hospital, Taitung
| | - Chang-Yin Lee
- College of Medicine, The School of Chinese Medicine for Post Baccalaureate, I-Shou University (Yancho Campus)
- Department of Chinese Medicine, E-DA Hospital
- Department of Chinese Medicine, E-DA Cancer Hospital, Kaohsiung
| | - Hueng-Chuen Fan
- Department of Medical Research
- Department of Pediatrics, Tungs’ Taichung Metroharbor Hospital
- Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli
| | | | - Ruey-Hwang Chou
- Graduate Institute of Biomedical Sciences, China Medical University
- Center for Molecular Medicine, China Medical University Hospital
- Department of Biotechnology, Asia University, Taichung, Taiwan
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Cuéllar-Barboza AB, McElroy SL, Veldic M, Singh B, Kung S, Romo-Nava F, Nunez NA, Cabello-Arreola A, Coombes BJ, Prieto M, Betcher HK, Moore KM, Winham SJ, Biernacka JM, Frye MA. Potential pharmacogenomic targets in bipolar disorder: considerations for current testing and the development of decision support tools to individualize treatment selection. Int J Bipolar Disord 2020; 8:23. [PMID: 32632502 PMCID: PMC7338319 DOI: 10.1186/s40345-020-00184-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 03/07/2020] [Indexed: 12/13/2022] Open
Abstract
Background Treatment in bipolar disorder (BD) is commonly applied as a multimodal therapy based on decision algorithms that lack an integrative understanding of molecular mechanisms or a biomarker associated clinical outcome measure. Pharmacogenetics/genomics study the individual genetic variation associated with drug response. This selective review of pharmacogenomics and pharmacogenomic testing (PGT) in BD will focus on candidate genes and genome wide association studies of pharmacokinetic drug metabolism and pharmacodynamic drug response/adverse event, and the potential role of decision support tools that incorporate multiple genotype/phenotype drug recommendations. Main body We searched PubMed from January 2013 to May 2019, to identify studies reporting on BD and pharmacogenetics, pharmacogenomics and PGT. Studies were selected considering their contribution to the field. We summarize our findings in: targeted candidate genes of pharmacokinetic and pharmacodynamic pathways, genome-wide association studies and, PGT platforms, related to BD treatment. This field has grown from studies of metabolizing enzymes (i.e., pharmacokinetics) and drug transporters (i.e., pharmacodynamics), to untargeted investigations across the entire genome with the potential to merge genomic data with additional biological information. Conclusions The complexity of BD genetics and, the heterogeneity in BD drug-related phenotypes, are important considerations for the design and interpretation of BD PGT. The clinical applicability of PGT in psychiatry is in its infancy and is far from reaching the robust impact it has in other medical disciplines. Nonetheless, promising findings are discovered with increasing frequency with remarkable relevance in neuroscience, pharmacology and biology.
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Affiliation(s)
- Alfredo B Cuéllar-Barboza
- Department of Psychiatry, University Hospital, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.,Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Susan L McElroy
- Lindner Center of HOPE and Department of Psychiatry, University of Cincinnati, Cincinnati, OH, USA
| | - Marin Veldic
- Department of Psychiatry, University Hospital, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Balwinder Singh
- Department of Psychiatry, University Hospital, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Simon Kung
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Francisco Romo-Nava
- Lindner Center of HOPE and Department of Psychiatry, University of Cincinnati, Cincinnati, OH, USA
| | - Nicolas A Nunez
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Alejandra Cabello-Arreola
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | | | - Miguel Prieto
- Department of Psychiatry, Universidad de los Andes, Santiago, Chile
| | - Hannah K Betcher
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Katherine M Moore
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Stacey J Winham
- Department of Health Sciences Research, Mayo Clinic, Rochester, USA
| | - Joanna M Biernacka
- Department of Psychiatry, University Hospital, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.,Department of Health Sciences Research, Mayo Clinic, Rochester, USA
| | - Mark A Frye
- Department of Psychiatry, University Hospital, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico. .,Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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Achalia R, Sinha A, Jacob A, Achalia G, Kaginalkar V, Venkatasubramanian G, Rao NP. A proof of concept machine learning analysis using multimodal neuroimaging and neurocognitive measures as predictive biomarker in bipolar disorder. Asian J Psychiatr 2020; 50:101984. [PMID: 32143176 DOI: 10.1016/j.ajp.2020.101984] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Concomitant use of complementary, multimodal imaging measures and neurocognitive measures is reported to have higher accuracy as a biomarker in Alzheimer's dementia. However, such an approach has not been examined to differentiate healthy individuals from Bipolar disorder. In this study, we examined the utility of support vector machine (SVM) technique to differentiate bipolar disorder patients and healthy using structural, functional and diffusion tensor images of brain and neurocognitive measures. METHODS 30 patients with Bipolar disorder-I and 30 age, sex matched individuals participated in the study. Structural MRI, resting state functional MRI and diffusion tensor images were obtained using a 1.5 T scanner. All participants were administered neuropsychological tests to measure executive functions. SVM, a supervised machine learning technique was applied to differentiate patients and healthy individuals with k-fold cross validation over 10 trials. RESULTS The composite marker consisting of both neuroimaging and neuropsychological measures, had an accuracy of 87.60 %, sensitivity of 82.3 % and specificity of 92.7 %. The performance of composite marker was better compared to that of individual markers on classificatory. CONCLUSIONS We were able to achieve a high accuracy for machine learning technique in distinguishing BD from HV using a combination of multimodal neuroimaging and neurocognitive measures. Findings of this proof of concept study, if replicated in larger samples, could have potential clinical applications.
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Affiliation(s)
| | - Anannya Sinha
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arpitha Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Garimaa Achalia
- Achalia Neuropsychiatry Hospital, Aurangabad, Maharashtra, India
| | | | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, India.
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Delvecchio G, Maggioni E, Squarcina L, Arighi A, Galimberti D, Scarpini E, Bellani M, Brambilla P. A Critical Review on Structural Neuroimaging Studies in BD: a Transdiagnostic Perspective from Psychosis to Fronto-Temporal Dementia. Curr Behav Neurosci Rep 2020. [DOI: 10.1007/s40473-020-00204-7] [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] [Indexed: 11/30/2022]
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Salagre E, Vizuete A, Leite M, Brownstein D, McGuinness A, Jacka F, Dodd S, Stubbs B, Köhler C, Vieta E, Carvalho A, Berk M, Fernandes B. Homocysteine as a peripheral biomarker in bipolar disorder: A meta-analysis. Eur Psychiatry 2020; 43:81-91. [DOI: 10.1016/j.eurpsy.2017.02.482] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/13/2017] [Accepted: 02/14/2017] [Indexed: 12/13/2022] Open
Abstract
AbstractBackground:Bipolar disorder (BD) is a psychiatric disorder with an uncertain aetiology. Recently, special attention has been given to homocysteine (Hcy), as it has been suggested that alterations in 1-carbon metabolism might be implicated in diverse psychiatric disorders. However, there is uncertainty regarding possible alterations in peripheral Hcy levels in BD.Methods:This study comprises a meta-analysis comparing serum and plasma Hcy levels in persons with BD and healthy controls. We conducted a systematic search for all eligible English and non-English peer-reviewed articles.Results:Nine cross-sectional studies were included in the meta-analyses, providing data on 1547 participants. Random-effects meta-analysis showed that serum and plasma levels of Hcy were increased in subjects with BD in either mania or euthymia when compared to healthy controls, with a large effect size in the mania group (g= 0.98, 95% CI: 0.8–1.17,P< 0.001,n= 495) and a small effect in the euthymia group (g= 0.3, 95% CI: 0.11–0.48,P= 0.002,n= 1052).Conclusions:Our meta-analysis provides evidence that Hcy levels are elevated in persons with BD during mania and euthymia. Peripheral Hcy could be considered as a potential biomarker in BD, both of trait (since it is increased in euthymia), and also of state (since its increase is more accentuated in mania). Longitudinal studies are needed to clarify the relationship between bipolar disorder and Hcy, as well as the usefulness of peripheral Hcy as both a trait and state biomarker in BD.
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Shonibare DO, Patel R, Islam AH, Metcalfe AWS, Fiksenbaum L, Kennedy JL, Freeman N, MacIntosh BJ, Goldstein BI. Preliminary study of structural magnetic resonance imaging phenotypes related to genetic variation in Interleukin-1β rs16944 in adolescents with Bipolar Disorder. J Psychiatr Res 2020; 122:33-41. [PMID: 31918351 DOI: 10.1016/j.jpsychires.2019.12.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 12/13/2019] [Accepted: 12/30/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bipolar disorder (BD), among the most heritable psychiatric conditions, is associated with increased pro-inflammatory blood markers and pro-inflammatory gene expression in post-mortem brain. We therefore examined the effects of pro-inflammatory single nucleotide polymorphism interleukin-1β (IL-1β) rs16944 on brain structure in adolescents with BD and healthy control (HC) adolescents. METHODS T1-weighted 3-T magnetic resonance imaging data were acquired for 38 adolescents with BD and 32 HC adolescents (14-20 years). Using FreeSurfer, a priori regions of interest analyses, examining hippocampus, amygdala, dorsolateral prefrontal cortex (DLPFC), and caudal anterior cingulate cortex, were complemented by exploratory whole-brain vertex-wise analyses. General linear models assessed the association between IL-1β rs16944 and the ROIs, controlling for sex, age, and intracranial volume. RESULTS There was an IL-1β rs16944 polymorphism-by-diagnosis interaction effect on the DLPFC; T-carriers with BD had greater surface area compared to non-carriers with BD. Whereas, HC T-carriers had smaller DLPFC volume compared to HC non-carriers. In vertex-wise analyses, similar interactions were evident in a pars triangularis surface area cluster and a lateral occipital cortex volume cluster. Whole-brain analyses also yielded a main effect of IL-1β rs16944 polymorphism, whereby T-carriers had greater lateral occipital cortex surface area and volume. CONCLUSIONS The IL-1β rs16944 polymorphism is associated with neurostructural phenotypes in cognitive and visual regions that subserve functions, including facial recognition and response inhibition, which are known to be aberrant in BD. Future studies are warranted to evaluate whether the observed rs16944-related structural differences are relevant to neurocognitive function, functional neuroimaging phenotypes and IL-1β protein levels.
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Affiliation(s)
- Daniel O Shonibare
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Ronak Patel
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Alvi H Islam
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Arron W S Metcalfe
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada
| | - Lisa Fiksenbaum
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - James L Kennedy
- Department of Psychiatry, University of Toronto, Toronto, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Natalie Freeman
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Bradley J MacIntosh
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Canada; Physical Sciences Research Platform, Sunnybrook Research Institute, Toronto, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada.
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