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Thomas-Odenthal F, Stein F, Vogelbacher C, Alexander N, Bechdolf A, Bermpohl F, Bröckel K, Brosch K, Correll CU, Evermann U, Falkenberg I, Fallgatter A, Flinkenflügel K, Grotegerd D, Hahn T, Hautzinger M, Jansen A, Juckel G, Krug A, Lambert M, Leicht G, Leopold K, Meinert S, Mikolas P, Mulert C, Nenadić I, Pfarr JK, Reif A, Ringwald K, Ritter P, Stamm T, Straube B, Teutenberg L, Thiel K, Usemann P, Winter A, Wroblewski A, Dannlowski U, Bauer M, Pfennig A, Kircher T. Larger putamen in individuals at risk and with manifest bipolar disorder. Psychol Med 2024:1-11. [PMID: 38801091 DOI: 10.1017/s0033291724001193] [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] [Indexed: 05/29/2024]
Abstract
BACKGROUND Individuals at risk for bipolar disorder (BD) have a wide range of genetic and non-genetic risk factors, like a positive family history of BD or (sub)threshold affective symptoms. Yet, it is unclear whether these individuals at risk and those diagnosed with BD share similar gray matter brain alterations. METHODS In 410 male and female participants aged 17-35 years, we compared gray matter volume (3T MRI) between individuals at risk for BD (as assessed using the EPIbipolar scale; n = 208), patients with a DSM-IV-TR diagnosis of BD (n = 87), and healthy controls (n = 115) using voxel-based morphometry in SPM12/CAT12. We applied conjunction analyses to identify similarities in gray matter volume alterations in individuals at risk and BD patients, relative to healthy controls. We also performed exploratory whole-brain analyses to identify differences in gray matter volume among groups. ComBat was used to harmonize imaging data from seven sites. RESULTS Both individuals at risk and BD patients showed larger volumes in the right putamen than healthy controls. Furthermore, individuals at risk had smaller volumes in the right inferior occipital gyrus, and BD patients had larger volumes in the left precuneus, compared to healthy controls. These findings were independent of course of illness (number of lifetime manic and depressive episodes, number of hospitalizations), comorbid diagnoses (major depressive disorder, attention-deficit hyperactivity disorder, anxiety disorder, eating disorder), familial risk, current disease severity (global functioning, remission status), and current medication intake. CONCLUSIONS Our findings indicate that alterations in the right putamen might constitute a vulnerability marker for BD.
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Affiliation(s)
- Florian Thomas-Odenthal
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
| | - Christoph Vogelbacher
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
- Translational Clinical Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Nina Alexander
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Mitte, Berlin, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Kyra Bröckel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, TUD Dresden University of Technology, Dresden, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Christoph U Correll
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Ulrika Evermann
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
| | - Irina Falkenberg
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
| | - Andreas Fallgatter
- Department of Psychiatry and Psychotherapy, University of Tübingen, Germany; German Center for Mental Health (DZPG), partner site Tübingen, Germany
| | - Kira Flinkenflügel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Martin Hautzinger
- Department of Psychology, Clinical Psychology and Psychotherapy, Eberhard Karls University, Tübingen, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
- Core-Facility BrainImaging, Faculty of Medicine, Philipps-Universität Marburg, Marburg, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, Bochum, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University Hospital of Bonn, Bonn, Germany
| | - Martin Lambert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gregor Leicht
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karolina Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, TUD Dresden University of Technology, Dresden, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Pavol Mikolas
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, TUD Dresden University of Technology, Dresden, Germany
| | - Christoph Mulert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Psychiatry, Justus Liebig University, Giessen, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
| | - Julia-Katharina Pfarr
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Kai Ringwald
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, TUD Dresden University of Technology, Dresden, Germany
| | - Thomas Stamm
- Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Clinical Psychiatry and Psychotherapy Brandenburg Medical School, Neuruppin, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
| | - Lea Teutenberg
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
| | - Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Paula Usemann
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Adrian Wroblewski
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, TUD Dresden University of Technology, Dresden, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, TUD Dresden University of Technology, Dresden, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Universities of Marburg and Gießen, Marburg, Germany
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2
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Thiel K, Lemke H, Winter A, Flinkenflügel K, Waltemate L, Bonnekoh L, Grotegerd D, Dohm K, Hahn T, Förster K, Kanske P, Repple J, Opel N, Redlich R, David F, Forstner AJ, Stein F, Brosch K, Thomas-Odenthal F, Usemann P, Teutenberg L, Straube B, Alexander N, Jamalabadi H, Jansen A, Witt SH, Andlauer TFM, Pfennig A, Bauer M, Nenadić I, Kircher T, Meinert S, Dannlowski U. White and gray matter alterations in bipolar I and bipolar II disorder subtypes compared with healthy controls - exploring associations with disease course and polygenic risk. Neuropsychopharmacology 2024; 49:814-823. [PMID: 38332015 PMCID: PMC10948847 DOI: 10.1038/s41386-024-01812-7] [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: 10/19/2023] [Revised: 12/28/2023] [Accepted: 01/21/2024] [Indexed: 02/10/2024]
Abstract
Patients with bipolar disorder (BD) show alterations in both gray matter volume (GMV) and white matter (WM) integrity compared with healthy controls (HC). However, it remains unclear whether the phenotypically distinct BD subtypes (BD-I and BD-II) also exhibit brain structural differences. This study investigated GMV and WM differences between HC, BD-I, and BD-II, along with clinical and genetic associations. N = 73 BD-I, n = 63 BD-II patients and n = 136 matched HC were included. Using voxel-based morphometry and tract-based spatial statistics, main effects of group in GMV and fractional anisotropy (FA) were analyzed. Associations between clinical and genetic features and GMV or FA were calculated using regression models. For FA but not GMV, we found significant differences between groups. BD-I patients showed lower FA compared with BD-II patients (ptfce-FWE = 0.006), primarily in the anterior corpus callosum. Compared with HC, BD-I patients exhibited lower FA in widespread clusters (ptfce-FWE < 0.001), including almost all major projection, association, and commissural fiber tracts. BD-II patients also demonstrated lower FA compared with HC, although less pronounced (ptfce-FWE = 0.049). The results remained unchanged after controlling for clinical and genetic features, for which no independent associations with FA or GMV emerged. Our findings suggest that, at a neurobiological level, BD subtypes may reflect distinct degrees of disease expression, with increasing WM microstructure disruption from BD-II to BD-I. This differential magnitude of microstructural alterations was not clearly linked to clinical and genetic variables. These findings should be considered when discussing the classification of BD subtypes within the spectrum of affective disorders.
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Affiliation(s)
- Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Kira Flinkenflügel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lena Waltemate
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Translational Psychotherapy, Institute of Psychology, University of Göttingen, Göttingen, Germany
| | - Linda Bonnekoh
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Förster
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
- Department of Psychology, University of Halle, Halle, Germany
- Center for Intervention and Research on adaptive and maladaptive brain circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Halle, Germany
| | - Friederike David
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Florian Thomas-Odenthal
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Paula Usemann
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Lea Teutenberg
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Nina Alexander
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Hamidreza Jamalabadi
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
- Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Stephanie H Witt
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Till F M Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, TU Dresden University of Technology, Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, TU Dresden University of Technology, Dresden, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg, Marburg, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute of Translational Neuroscience, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.
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Shafie M, Shahmohamadi E, Cattarinussi G, Sanjari Moghaddam H, Akhondzadeh S, Sambataro F, Moltrasio C, Delvecchio G. Resting-state functional magnetic resonance imaging alterations in borderline personality disorder: A systematic review. J Affect Disord 2023; 341:335-345. [PMID: 37673288 DOI: 10.1016/j.jad.2023.09.001] [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: 02/20/2023] [Revised: 08/24/2023] [Accepted: 09/01/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Borderline personality disorder (BPD) is a severe psychiatric disorder characterized by emotion dysregulation, impulsivity, and interpersonal disturbances. Several structural and functional neuroimaging abnormalities have been described in BPD. In particular, resting-state functional magnetic resonance imaging (rs-fMRI) studies have recently suggested various connectivity alterations within and between large-scale brain networks in BPD. This review aimed at providing an updated summary of the evidence reported by the available rs-fMRI studies in BPD individuals. METHODS A search on PubMed, Scopus, and Web of Science was performed to identify rs-fMRI alterations in BPD. A total of 15 studies met our inclusion criteria. RESULTS Overall, aberrant resting-state functional connectivity (rs-FC) within and between default mode network (DMN), salience network (SN), and central executive network (CEN) were observed in BPD compared to healthy controls, as well as selective functional impairments in bilateral amygdala, anterior and posterior cingulate cortex, hippocampus, and prefrontal cortex. LIMITATIONS The observational design, small sample size, prevalence of females, high rates of concurrent comorbidities and medications, and heterogeneity across imaging methodologies limit the generalizability of the results. CONCLUSIONS The identification of altered patterns of rs-FC within and between selective brain networks, including DMN, SN, and CEN, could further our knowledge of the clinical symptoms of BPD, and therefore, future studies with multimodal methodologies and longitudinal designs are warranted to further explore the neural correlates of this disorder.
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Affiliation(s)
- Mahan Shafie
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Hossein Sanjari Moghaddam
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Wang Z, He D, Yang L, Wang P, Zou Z, Xiao J, Min W, He Y, Zhu H. Common and distinct patterns of task-related neural activation abnormalities in patients with remitted and current major depressive disorder: A systematic review and coordinate-based meta-analysis. Neurosci Biobehav Rev 2023; 152:105284. [PMID: 37315658 DOI: 10.1016/j.neubiorev.2023.105284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/20/2023] [Accepted: 06/11/2023] [Indexed: 06/16/2023]
Abstract
Whether remitted major depressive disorder (rMDD) and MDD present common or distinct neuropathological mechanisms remains unclear. We performed a meta-analysis of task-related whole-brain functional magnetic resonance imaging (fMRI) using anisotropic effect-size signed differential mapping software to compare brain activation between rMDD/MDD patients and healthy controls (HCs). We included 18 rMDD studies (458 patients and 476 HCs) and 120 MDD studies (3746 patients and 3863 HCs). The results showed that MDD and rMDD patients shared increased neural activation in the right temporal pole and right superior temporal gyrus. Several brain regions, including the right middle temporal gyrus, left inferior parietal, prefrontal cortex, left superior frontal gyrus and striatum, differed significantly between MDD and rMDD. Meta-regression analyses revealed that the percentage of females with MDD was positively associated with brain activity in the right lenticular nucleus/putamen. Our results provide valuable insights into the underlying neuropathology of brain dysfunction in MDD, developing more targeted and efficacious treatment and intervention strategies, and more importantly, providing potential neuroimaging targets for the early screening of MDD.
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Affiliation(s)
- Zuxing Wang
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Danmei He
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, China
| | - Lin Yang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, China
| | - Peijia Wang
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhili Zou
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jun Xiao
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Wenjiao Min
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Ying He
- Sichuan Provincial Center for Mental Health, The Center of Psychosomatic Medicine of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hongru Zhu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, China.
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5
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Grecucci A, Dadomo H, Salvato G, Lapomarda G, Sorella S, Messina I. Abnormal Brain Circuits Characterize Borderline Personality and Mediate the Relationship between Childhood Traumas and Symptoms: A mCCA+jICA and Random Forest Approach. SENSORS (BASEL, SWITZERLAND) 2023; 23:2862. [PMID: 36905064 PMCID: PMC10006907 DOI: 10.3390/s23052862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
Borderline personality disorder (BPD) is a severe personality disorder whose neural bases are still unclear. Indeed, previous studies reported inconsistent findings concerning alterations in cortical and subcortical areas. In the present study, we applied for the first time a combination of an unsupervised machine learning approach known as multimodal canonical correlation analysis plus joint independent component analysis (mCCA+jICA), in combination with a supervised machine learning approach known as random forest, to possibly find covarying gray matter and white matter (GM-WM) circuits that separate BPD from controls and that are also predictive of this diagnosis. The first analysis was used to decompose the brain into independent circuits of covarying grey and white matter concentrations. The second method was used to develop a predictive model able to correctly classify new unobserved BPD cases based on one or more circuits derived from the first analysis. To this aim, we analyzed the structural images of patients with BPD and matched healthy controls (HCs). The results showed that two GM-WM covarying circuits, including basal ganglia, amygdala, and portions of the temporal lobes and of the orbitofrontal cortex, correctly classified BPD against HC. Notably, these circuits are affected by specific child traumatic experiences (emotional and physical neglect, and physical abuse) and predict symptoms severity in the interpersonal and impulsivity domains. These results support that BPD is characterized by anomalies in both GM and WM circuits related to early traumatic experiences and specific symptoms.
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Affiliation(s)
- Alessandro Grecucci
- Clinical and Affective Neuroscience Lab (CL.I.A.N. Lab), Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, 38068 Rovereto, Italy
- Centre for Medical Sciences (CISMed), University of Trento, 38122 Trento, Italy
| | - Harold Dadomo
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Gerardo Salvato
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
- Cognitive Neuropsychology Centre, ASST “Grande Ospedale Metropolitano” Niguarda, 20162 Milan, Italy
- Milan Centre for Neuroscience (NeuroMI), 20126 Milan, Italy
| | - Gaia Lapomarda
- Department of Psychology, Science Division, New York University of Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates
| | - Sara Sorella
- Clinical and Affective Neuroscience Lab (CL.I.A.N. Lab), Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, 38068 Rovereto, Italy
| | - Irene Messina
- Clinical and Affective Neuroscience Lab (CL.I.A.N. Lab), Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, 38068 Rovereto, Italy
- Universitas Mercatorum, 00186 Rome, Italy
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Wang Z, Zou Z, Xiao J, Wang P, Luo Y, Min W, He Y, Yuan C, Su Y, Yang C, Chang F, Zhu H. Task-related neural activation abnormalities in patients with remitted major depressive disorder: A coordinate-based meta-analysis. Neurosci Biobehav Rev 2022; 143:104929. [DOI: 10.1016/j.neubiorev.2022.104929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
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7
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Common and distinct patterns of gray matter alterations in young adults with borderline personality disorder and major depressive disorder. Eur Arch Psychiatry Clin Neurosci 2022; 272:1569-1582. [PMID: 35419633 DOI: 10.1007/s00406-022-01405-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 03/25/2022] [Indexed: 02/08/2023]
Abstract
Young adults with borderline personality disorder (BPD) and major depressive disorder (MDD) have a relatively high comorbidity rate; however, whether they share a neurobiological basis remains controversial. Although previous studies have reported respective brain alterations, the common and distinct gray matter changes between two disorders are still inconsistent. We conducted a meta-analysis using anisotropic effect size-based algorithms (ASE-SDM) to identify consistent findings from whole-brain voxel-based morphometry (VBM) studies of gray matter volume (GMV) in 274 young adults (< 45 years old) with BPD and 1576 with MDD. Compared with healthy controls, the young adults with BPD showed GMV reduction mainly in the prefrontal cortex including the inferior frontal gyrus and superior frontal gyrus, medial temporal network, and insula, whereas the MDD showed GMV alteration in the visual network (fusiform gyrus and inferior temporal gyrus), sensorimotor network (bilateral postcentral gyrus (PoCG) and right cerebellum) and left caudate nucleus. The GMV differences between these two disorders were concentrated in the left orbitofrontal cortex, cingulate cortex, right insula, and cerebellum. The meta-regression of the MDD group showed a negative association between disease duration and the right middle cingulate gyrus as well as negative associations between depressive symptoms and brain regions of the right cerebellum and the left PoCG. Our results identified common and distinct patterns of GMV alteration between BPD and MDD, which may provide neuroimage evidence for the disorder comorbidity mechanisms and partly indicate the similar and different biological features in emotion regulation of the two disorders. This study was registered with PROSPERO (CRD42020212758).
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8
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Li Y, Cai H, Li X, Qian Y, Zhang C, Zhu J, Yu Y. Functional connectivity of the central autonomic and default mode networks represent neural correlates and predictors of individual personality. J Neurosci Res 2022; 100:2187-2200. [PMID: 36069656 DOI: 10.1002/jnr.25121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/24/2022] [Indexed: 01/07/2023]
Abstract
There is solid evidence for the prominent involvement of the central autonomic and default mode systems in shaping personality. However, whether functional connectivity of these systems can represent neural correlates and predictors of individual variation in personality traits is largely unknown. Resting-state functional magnetic resonance imaging data of 215 healthy young adults were used to construct the sympathetic (SN), parasympathetic (PN), and default mode (DMN) networks, with intra- and internetwork functional connectivity measured. Personality factors were assessed using the five-factor model. We examined the associations between personality factors and functional network connectivity, followed by performance of personality prediction based on functional connectivity using connectome-based predictive modeling (CPM), a recently developed machine learning approach. All personality factors (neuroticism, extraversion, conscientiousness, and agreeableness) other than openness were significantly correlated with intra- and internetwork functional connectivity of the SN, PN, and DMN. Moreover, the CPM models successfully predicted conscientiousness and agreeableness at the individual level using functional network connectivity. Our findings may expand existing knowledge regarding the neural substrates underlying personality.
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Affiliation(s)
- Yating Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Huanhuan Cai
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Xueying Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Yinfeng Qian
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Cun Zhang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
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9
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Xie H, Cao Y, Long X, Xiao H, Wang X, Qiu C, Jia Z. A comparative study of gray matter volumetric alterations in adults with attention deficit hyperactivity disorder and bipolar disorder type I. J Psychiatr Res 2022; 155:410-419. [PMID: 36183596 DOI: 10.1016/j.jpsychires.2022.09.015] [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: 01/16/2022] [Revised: 07/29/2022] [Accepted: 09/16/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) and bipolar disorder type I (BD-Ι) share great overlapping symptoms and are highly comorbid. We aimed to compare and obtain the common and distinct gray matter volume (GMV) patterns in adult patients. METHOD We searched four databases to include whole-brain voxel-based morphometry studies and compared the GMV patterns between ADHD and healthy controls (HCs), between BD-I and HCs, and between ADHD and BD-I using anisotropic effect-size signed differential mapping software. RESULTS We included 677 ADHD and 452 BD-Ι patients. Compared with HCs, ADHD patients showed smaller GMV in the anterior cingulate cortex (ACC) and supramarginal gyrus but a larger caudate nucleus. Compared with HCs, BD-Ι patients showed smaller GMV in the orbitofrontal cortex, parahippocampal gyrus, and amygdala. No common GMV alterations were found, whereas ADHD showed the smaller ACC and larger amygdala relative to BD-Ι. Subgroup analyses revealed the larger insula in manic patients, which was positively associated with the Young Mania Rating Scale. The decreased median cingulate cortex (MCC) was positively associated with the ages in ADHD, whereas the MCC was negatively associated with the ages in BD-Ι. LIMITATIONS All included data were cross-sectional; Potential effects of medication and disease course were not analyzed due to the limited data. CONCLUSIONS ADHD showed altered GMV in the frontal-striatal frontal-parietal circuits, and BD-Ι showed altered GMV in the prefrontal-amygdala circuit. These findings could contribute to a better understanding of the neuropathology of the two disorders.
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Affiliation(s)
- Hongsheng Xie
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China; Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yuan Cao
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China; Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xipeng Long
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China; Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Hongqi Xiao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xiuli Wang
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, 610041, China
| | - Changjian Qiu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, 610041, China.
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China; Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China.
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10
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Chen G, Wang J, Gong J, Qi Z, Fu S, Tang G, Chen P, Huang L, Wang Y. Functional and structural brain differences in bipolar disorder: a multimodal meta-analysis of neuroimaging studies. Psychol Med 2022; 52:2861-2873. [PMID: 36093787 DOI: 10.1017/s0033291722002392] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Numerous studies of resting-state functional imaging and voxel-based morphometry (VBM) have revealed differences in specific brain regions of patients with bipolar disorder (BD), but the results have been inconsistent. METHODS A whole-brain voxel-wise meta-analysis was conducted on resting-state functional imaging and VBM studies that compared differences between patients with BD and healthy controls using Seed-based d Mapping with Permutation of Subject Images software. RESULTS A systematic literature search identified 51 functional imaging studies (1842 BD and 2190 controls) and 83 VBM studies (2790 BD and 3690 controls). Overall, patients with BD displayed increased resting-state functional activity in the left middle frontal gyrus, right inferior frontal gyrus (IFG) extending to the right insula, right superior frontal gyrus and bilateral striatum, as well as decreased resting-state functional activity in the left middle temporal gyrus extending to the left superior temporal gyrus and post-central gyrus, left cerebellum, and bilateral precuneus. The meta-analysis of VBM showed that patients with BD displayed decreased VBM in the right IFG extending to the right insula, temporal pole and superior temporal gyrus, left superior temporal gyrus extending to the left insula, temporal pole, and IFG, anterior cingulate cortex, left superior frontal gyrus (medial prefrontal cortex), left thalamus, and right fusiform gyrus. CONCLUSIONS The multimodal meta-analyses suggested that BD showed similar patterns of aberrant brain activity and structure in the insula extending to the temporal cortex, fronto-striatal-thalamic, and default-mode network regions, which provide useful insights for understanding the underlying pathophysiology of BD.
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Affiliation(s)
- Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Junjing Wang
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, 510006, China
| | - Jiaying Gong
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
- Department of Radiology, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Siying Fu
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
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11
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Choi-Kain LW, Sahin Z, Traynor J. Borderline Personality Disorder: Updates in a Postpandemic World. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:337-352. [PMID: 37200886 PMCID: PMC10187392 DOI: 10.1176/appi.focus.20220057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Progress in understanding borderline personality disorder has unfolded in the last decade, landing in a new COVID-19-influenced world. Borderline personality disorder is now firmly established as a valid diagnosis, distinct from its co-occurring mood, anxiety, trauma-related, and behavioral disorders. Further, it is also understood as a reflection of general personality dysfunction, capturing essential features shared among all personality disorders. Neuroimaging research, representing the vast neurobiological advances made in the last decade, illustrates that the disorder shares frontolimbic dysfunction with many psychiatric diagnoses but has a distinct signature of interpersonal and emotional hypersensitivity. This signature is the conceptual basis of the psychotherapies and clinical management approaches proven effective for the disorder. Medications remain adjunctive and are contraindicated by some guidelines internationally. Less invasive brain-based therapeutics show promise. The most significant change in the treatment landscape is a focus on briefer, less intensive formats of generalist management. Shorter variants of therapies, such as dialectical behavior therapy and mentalization-based treatment, are in the process of being shown to be adequately effective. Earlier intervention and greater emphasis on functional improvement are needed to more effectively curb the disabilities and risks of borderline personality disorder for patients and their families. Remote interventions show promise in broadening access to care.
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Affiliation(s)
- Lois W Choi-Kain
- Gunderson Personality Research Institute, McLean Hospital, Belmont, Massachusetts, and Faculty of Medicine, Harvard Medical School, Boston
| | - Zeynep Sahin
- Gunderson Personality Research Institute, McLean Hospital, Belmont, Massachusetts, and Faculty of Medicine, Harvard Medical School, Boston
| | - Jenna Traynor
- Gunderson Personality Research Institute, McLean Hospital, Belmont, Massachusetts, and Faculty of Medicine, Harvard Medical School, Boston
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12
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Long Y, Pan N, Ji S, Qin K, Chen Y, Zhang X, He M, Suo X, Yu Y, Wang S, Gong Q. Distinct brain structural abnormalities in attention-deficit/hyperactivity disorder and substance use disorders: A comparative meta-analysis. Transl Psychiatry 2022; 12:368. [PMID: 36068207 PMCID: PMC9448791 DOI: 10.1038/s41398-022-02130-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022] Open
Abstract
As two common mental disorders during the period of adolescence that extend to early adulthood, attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) have considerable diagnostic co-occurrence and shared neuropsychological impairments. Our study aimed to identify overlapping and distinct brain structural abnormalities associated with ADHD and SUDs among adolescents and young adults. A systematic literature search on voxel-based morphometry (VBM) studies of ADHD and SUDs was conducted in PubMed and Web of Science. Data were extracted and analyzed to identify brain abnormalities using Seed-based d-Mapping software. Data-driven functional decoding was conducted to identify the psychophysiological functioning associated with brain alterations. 13 and 14 VBM studies for ADHD (619 patients and 483 controls) and SUDs (516 patients and 413 controls), respectively, were included. Patterns of decreased gray matter volume (GMV) were found in the left precentral gyrus, bilateral superior frontal gyri, and left inferior frontal gyrus in the ADHD group compared to the control group. In contrast, individuals with SUDs, relative to controls, were characterized by increased GMV in the left putamen and insula. Comparative analysis indicated larger regional GMV in the right inferior parietal lobule and smaller volumes in the left putamen and left precentral gyrus in the ADHD group than in the SUDs group. Dissociable brain structural abnormalities in adolescents and young adults with ADHD and SUDs potentially implicate different pathogeneses and provide a reference for differential diagnosis and early detection for shared symptomology and comorbidity.
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Affiliation(s)
- Yajing Long
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Nanfang Pan
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Shiyu Ji
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China ,grid.21107.350000 0001 2171 9311Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
| | - Kun Qin
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China ,grid.24827.3b0000 0001 2179 9593Department of Psychiatry, University of Cincinnati, Cincinnati, OH USA
| | - Ying Chen
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Xun Zhang
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Min He
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Xueling Suo
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Yifan Yu
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China. .,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China. .,Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China.
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China. .,Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, China.
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13
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Genetic and environment effects on structural neuroimaging endophenotype for bipolar disorder: a novel molecular approach. Transl Psychiatry 2022; 12:137. [PMID: 35379780 PMCID: PMC8980067 DOI: 10.1038/s41398-022-01892-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 03/03/2022] [Accepted: 03/10/2022] [Indexed: 12/15/2022] Open
Abstract
We investigated gene-environment effects on structural brain endophenotype in bipolar disorder (BD) using a novel method of combining polygenic risk scores with epigenetic signatures since traditional methods of examining the family history and trauma effects have significant limitations. The study enrolled 119 subjects, including 55 BD spectrum (BDS) subjects diagnosed with BD or major depressive disorder (MDD) with subthreshold BD symptoms and 64 non-BDS subjects comprising 32 MDD subjects without BD symptoms and 32 healthy subjects. The blood samples underwent genome-wide genotyping and methylation quantification. We derived polygenic risk score (PRS) and methylation profile score (MPS) as weighted summations of risk single nucleotide polymorphisms and methylation probes, respectively, which were considered as molecular measures of genetic and environmental risks for BD. Linear regression was used to relate PRS, MPS, and their interaction to 44 brain structure measures quantified from magnetic resonance imaging (MRI) on 47 BDS subjects, and the results were compared with those based on family history and childhood trauma. After multiplicity corrections using false discovery rate (FDR), MPS was found to be negatively associated with the volume of the medial geniculate thalamus (FDR = 0.059, partial R2 = 0.208). Family history, trauma scale, and PRS were not associated with any brain measures. PRS and MPS show significant interactions on whole putamen (FDR = 0.09, partial R2 = 0.337). No significant gene-environment interactions were identified for the family history and trauma scale. PRS and MPS generally explained greater proportions of variances of the brain measures (range of partial R2 = [0.008, 0.337]) than the clinical risk factors (range = [0.004, 0.228]).
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14
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Cui L, Li H, Li JB, Zeng H, Zhang Y, Deng W, Zhou W, Cao L. Altered cerebellar gray matter and cerebellar-cortex resting-state functional connectivity in patients with bipolar disorder Ⅰ. J Affect Disord 2022; 302:50-57. [PMID: 35074460 DOI: 10.1016/j.jad.2022.01.073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Bipolar disorder (BP) is a common psychiatric disorder characterized by extreme fluctuations in mood. Recent studies have indicated the involvement of cerebellum in the pathogenesis of BP. However, no study has focused on the precise role of cerebellum exclusively in patients with bipolar I disorder (BP-I). METHODS Forty-five patients with BP-I and 40 healthy controls were recruited. All subjects underwent clinical evaluation and Magnetic Resonance diffusion Tension Imaging scans. For structural images, we used a spatially unbiased infratentorial template toolbox to isolate the cerebellum and then preformed voxel-based morphometry (VBM) analyses to assess the difference in cerebellar gray matter volume (GMV) between the two groups. For the functional images, we chose the clusters that survived from VBM analysis as seeds and performed functional connectivity (FC) analysis. Between-group differences were assessed using the independent Students t test or the nonparametric Mann-Whitney U Test. For multiple comparisons, the results were further corrected with Gaussian random field (GRF) approach (voxel-level P < 0.001, cluster-level P < 0.05). RESULTS Compared with healthy controls, BP-I patients showed significantly decreased GMV in left lobule V and left lobule VI (P < 0.05, GRF corrected). The FC of cerebellum with bilateral superior temporal gyrus, bilateral insula, bilateral rolandic operculum, right putamen, and left precentral gyrus was disrupted in BP-I patients (P < 0.05, GRF corrected). CONCLUSIONS BP-I patients showed decreased cerebellar GMV and disrupted cerebellar-cortex resting-state FC. This suggests that cerebellar abnormalities may play an important role in the pathogenesis of BP-I.
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Affiliation(s)
- Liqian Cui
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China.
| | - Hao Li
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Jin Biao Li
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Huixing Zeng
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Yizhi Zhang
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
| | - Wenhao Deng
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
| | - Wenjin Zhou
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
| | - Liping Cao
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China.
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15
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Zhu Z, Zhao Y, Wen K, Li Q, Pan N, Fu S, Li F, Radua J, Vieta E, Kemp GJ, Biswa BB, Gong Q. Cortical thickness abnormalities in patients with bipolar disorder: A systematic review and meta-analysis. J Affect Disord 2022; 300:209-218. [PMID: 34971699 DOI: 10.1016/j.jad.2021.12.080] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/10/2021] [Accepted: 12/19/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND An increasing number of neuroimaging studies report alterations of cortical thickness (CT) related to the neuropathology of bipolar disorder (BD). We provide here a whole-brain vertex-wise meta-analysis, which may help improve the spatial precision of these identifications. METHODS A comprehensive meta-analysis was performed to investigate the differences in CT between patients with BD and healthy controls (HCs) by using a newly developed mask for CT analysis in seed-based d mapping (SDM) meta-analytic software. We used meta-regression to explore the effects of demographics and clinical characteristics on CT. This meta-review was conducted in accordance with PRISMA guideline. RESULTS We identified 21 studies meeting criteria for the systematic review, of which 11 were eligible for meta-analysis. The meta-analysis comprising 649 BD patients and 818 HCs showed significant cortical thinning in the left insula extending to left Rolandic operculum and Heschl gyrus, the orbital part of left inferior frontal gyrus (IFG), the medial part of left superior frontal gyrus (SFG) as well as bilateral anterior cingulate cortex (ACC) in BD. In meta-regression analyses, mean patient age was negatively correlated with reduced CT in the left insula. LIMITATIONS All enrolled studies were cross-sectional; we could not explore the potential effects of medication and mood states due to the limited data. CONCLUSIONS Our results suggest that BD patients have significantly thinner frontoinsular cortex than HCs, and the results may be helpful in revealing specific neuroimaging biomarkers of BD patients.
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Affiliation(s)
- Ziyu Zhu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Youjin Zhao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan, China
| | - Keren Wen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qian Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shiqin Fu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan, China
| | - Joaquim Radua
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan, China; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain; Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, Northern Ireland United Kingdom
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain; Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Bharat B Biswa
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA; The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China.
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16
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Grecucci A, Lapomarda G, Messina I, Monachesi B, Sorella S, Siugzdaite R. Structural Features Related to Affective Instability Correctly Classify Patients With Borderline Personality Disorder. A Supervised Machine Learning Approach. Front Psychiatry 2022; 13:804440. [PMID: 35295769 PMCID: PMC8918568 DOI: 10.3389/fpsyt.2022.804440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
Previous morphometric studies of Borderline Personality Disorder (BPD) reported inconsistent alterations in cortical and subcortical areas. However, these studies have investigated the brain at the voxel level using mass univariate methods or region of interest approaches, which are subject to several artifacts and do not enable detection of more complex patterns of structural alterations that may separate BPD from other clinical populations and healthy controls (HC). Multiple Kernel Learning (MKL) is a whole-brain multivariate supervised machine learning method able to classify individuals and predict an objective diagnosis based on structural features. As such, this method can help identifying objective biomarkers related to BPD pathophysiology and predict new cases. To this aim, we applied MKL to structural images of patients with BPD and matched HCs. Moreover, to ensure that results are specific for BPD and not for general psychological disorders, we also applied MKL to BPD against a group of patients with bipolar disorder, for their similarities in affective instability. Results showed that a circuit, including basal ganglia, amygdala, and portions of the temporal lobes and of the orbitofrontal cortex, correctly classified BPD against HC (80%). Notably, this circuit positively correlates with the affective sector of the Zanarini questionnaire, thus indicating an involvement of this circuit with affective disturbances. Moreover, by contrasting BPD with BD, the spurious regions were excluded, and a specific circuit for BPD was outlined. These results support that BPD is characterized by anomalies in a cortico-subcortical circuit related to affective instability and that this circuit discriminates BPD from controls and from other clinical populations.
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Affiliation(s)
- Alessandro Grecucci
- Clinical and Affective Neuroscience Lab, Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, Rovereto, Italy
- Center for Medical Sciences - CISMed, University of Trento, Trento, Italy
| | - Gaia Lapomarda
- Clinical and Affective Neuroscience Lab, Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, Rovereto, Italy
- Department of Psychology, Science Division, New York University of Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Irene Messina
- Clinical and Affective Neuroscience Lab, Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, Rovereto, Italy
- Universitas Mercatorum, Rome, Italy
| | - Bianca Monachesi
- Clinical and Affective Neuroscience Lab, Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, Rovereto, Italy
| | - Sara Sorella
- Clinical and Affective Neuroscience Lab, Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, Rovereto, Italy
| | - Roma Siugzdaite
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
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17
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Dadomo H, Salvato G, Lapomarda G, Ciftci Z, Messina I, Grecucci A. Structural Features Predict Sexual Trauma and Interpersonal Problems in Borderline Personality Disorder but Not in Controls: A Multi-Voxel Pattern Analysis. Front Hum Neurosci 2022; 16:773593. [PMID: 35280205 PMCID: PMC8904389 DOI: 10.3389/fnhum.2022.773593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/17/2022] [Indexed: 12/01/2022] Open
Abstract
Child trauma plays an important role in the etiology of Bordeline Personality Disorder (BPD). Of all traumas, sexual trauma is the most common, severe and most associated with receiving a BPD diagnosis when adult. Etiologic models posit sexual abuse as a prognostic factor in BPD. Here we apply machine learning using Multiple Kernel Regression to the Magnetic Resonance Structural Images of 20 BPD and 13 healthy control (HC) to see whether their brain predicts five sources of traumas: sex abuse, emotion neglect, emotional abuse, physical neglect, physical abuse (Child Trauma Questionnaire; CTQ). We also applied the same analysis to predict symptom severity in five domains: affective, cognitive, impulsivity, interpersonal (Zanarini Rating Scale for Borderline Personality Disorder; Zan-BPD) for BPD patients only. Results indicate that CTQ sexual trauma is predicted by a set of areas including the amygdala, the Heschl area, the Caudate, the Putamen, and portions of the Cerebellum in BPD patients only. Importantly, interpersonal problems only in BPD patients were predicted by a set of areas including temporal lobe and cerebellar regions. Notably, sexual trauma and interpersonal problems were not predicted by structural features in matched healthy controls. This finding may help elucidate the brain circuit affected by traumatic experiences and connected with interpersonal problems BPD suffer from.
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Affiliation(s)
- Harold Dadomo
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy
- *Correspondence: Harold Dadomo,
| | - Gerardo Salvato
- Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
- Cognitive Neuropsychology Centre, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Gaia Lapomarda
- Clinical and Affective Neuroscience Lab – Cli.A.N. Lab, Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Zafer Ciftci
- Clinical and Affective Neuroscience Lab – Cli.A.N. Lab, Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | | | - Alessandro Grecucci
- Clinical and Affective Neuroscience Lab – Cli.A.N. Lab, Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
- Centre for Medical Sciences, CISMed, University of Trento, Trento, Italy
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18
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Association between resting-state functional connectivity of amygdala subregions and peripheral pro-inflammation cytokines levels in bipolar disorder. Brain Imaging Behav 2022; 16:1614-1626. [PMID: 35175549 DOI: 10.1007/s11682-022-00636-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 01/23/2023]
Abstract
The pathophysiological mechanisms of bipolar disorder (BD) are not completely known, and systemic inflammation and immune dysregulation are considered as risk factors. Previous neuroimaging studies have proved metabolic, structural and functional abnormalities of the amygdala in BD, suggesting the vital role of amygdala in BD patients. This study aimed to test the underlying neural mechanism of inflammation-induced functional connectivity (FC) in the amygdala subregions of BD patients. Resting-state functional MRI (rs-fMRI) was used to delineate the amygdala FC from two pairs of amygdala seed regions (the bilateral lateral and medial amygdala) in 51 unmedicated BD patients and 69 healthy controls (HCs). The levels of pro-inflammatory cytokines including interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α were measured in the serum. The correlation between abnormal levels of pro-inflammatory cytokines and FC values were calculated in BD patients. The BD group exhibited decreased FC between the right medial amygdala and bilateral medial frontal cortex (MFC), and decreased FC between the left medial amygdala and the left temporal pole (TP), right orbital inferior frontal gyrus compared with HCs. The BD patients had higher levels of TNF-α than HCs. Correlation analysis showed negative correlation between the TNF-α level and abnormal FC of the right medial amygdala-bilateral MFC; and negative correlation between TNF-α levels and abnormal FC of the left medial amygdala-left TP in BD group. These findings suggest that dysfunctional and immune dysregulation between the amygdala and the frontotemporal circuitry might play a critical role in the pathogenesis of BD.
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19
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Qi Z, Wang J, Gong J, Su T, Fu S, Huang L, Wang Y. Common and specific patterns of functional and structural brain alterations in schizophrenia and bipolar disorder: a multimodal voxel-based meta-analysis. J Psychiatry Neurosci 2022; 47:E32-E47. [PMID: 35105667 PMCID: PMC8812718 DOI: 10.1503/jpn.210111] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/12/2021] [Accepted: 11/16/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Schizophrenia and bipolar disorder have been linked to alterations in the functional activity and grey matter volume of some brain areas, reflected in impaired regional homogeneity and aberrant voxel-based morphometry. However, because of variable findings and methods used across studies, identifying patterns of brain alteration in schizophrenia and bipolar disorder has been difficult. METHODS We conducted a meta-analysis of differences in regional homogeneity and voxel-based morphometry between patients and healthy controls for schizophrenia and bipolar disorder separately, using seed-based d mapping. RESULTS We included 45 publications on regional homogeneity (26 in schizophrenia and 19 in bipolar disorder) and 190 publications on voxel-based morphometry (120 in schizophrenia and 70 in bipolar disorder). Patients with schizophrenia showed increased regional homogeneity in the frontal cortex and striatum and the supplementary motor area; they showed decreased regional homogeneity in the insula, primary sensory cortex (visual and auditory cortices) and sensorimotor cortex. Patients with bipolar disorder showed increased regional homogeneity in the frontal cortex and striatum; they showed decreased regional homogeneity in the insula. Patients with schizophrenia showed decreased grey matter volume in the superior temporal gyrus, inferior frontal gyrus, cingulate cortex and cerebellum. Patients with bipolar disorder showed decreased grey matter volume in the insula, cingulate cortex, frontal cortex and thalamus. Overlap analysis showed that patients with schizophrenia displayed decreased regional homogeneity and grey matter volume in the left insula and left superior temporal gyrus; patients with bipolar disorder displayed decreased regional homogeneity and grey matter volume in the left insula. LIMITATIONS The small sample size for our subgroup analysis (unmedicated versus medicated patients and substantial heterogeneity in the results for some regions could limit the interpretability and generalizability of the results. CONCLUSION Patients with schizophrenia and bipolar disorder shared a common pattern of regional functional and structural alterations in the insula and frontal cortex. Patients with schizophrenia showed more widespread functional and structural impairment, most prominently in the primary sensory motor areas.
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Affiliation(s)
| | - Junjing Wang
- From the Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China (Qi, Su, Fu, Huang, Y. Wang); the Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China (Qi, Su, Fu, Huang, Y. Wang); the Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, China (J. Wang); and the Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (Gong)
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20
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Li L, Yu H, Zhong M, Liu S, Wei W, Meng Y, Li ML, Li T, Wang Q. Gray matter volume alterations in subjects with overweight and obesity: Evidence from a voxel-based meta-analysis. Front Psychiatry 2022; 13:955741. [PMID: 36226110 PMCID: PMC9548618 DOI: 10.3389/fpsyt.2022.955741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/05/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Obesity is a multi-systemic disease with complex etiology. And consistent evidence indicated obesity or overweight subjects render brain structure changes. Increasing evidence indicates these subjects have shown widespread structural brain gray matter volume (GMV) changes. However, results from other neuroimaging studies have been inconsistent. Consequently, the question remains whether body mass index (BMI), a gold standard to define obesity/overweight, is associated with brain structural changes. METHODS This study will apply an updated meta-analysis of voxel-based GMV studies to compare GMV changes in overweight and obese subjects. Online databases were used to build on relevant studies published before May 2022. The updated Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) explores GMV changes in individuals with overweight and obesity and further examines the correlation between GMV and obesity-related variables, specifically body mass index (BMI). RESULTS This research included fourteen studies and provided a whole-brain analysis of GMV distribution in overweight and obese individuals. It revealed lower GMV in brain regions, including the left putamen and right precentral gyrus, in individuals with overweight and obesity compared to lean controls. Further, meta-regression analyses revealed GMV in the left middle occipital gyrus was negatively correlated with the BMI of the whole sample. CONCLUSION GMV decreased was reported in reward circuit processing areas and sensorimotor processing areas of individuals with overweight and obesity diagnoses, suggesting an underlying structural basis for reward processing and sensorimotor processing dysregulation in overweight and obese subjects. Our results also suggest that GMV in occipital gyrus, a key region for food visual and gustatory encoding, is negatively associated with BMI. These results provide further evidence for the dysregulated reward circuit in individuals with overweight and obesity.
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Affiliation(s)
- Lei Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Hua Yu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Ming Zhong
- Department of Sport and Health Science, University of Exeter, Exeter, United Kingdom
| | - Siyi Liu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Wei Wei
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Yajing Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Ming-Li Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Tao Li
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qiang Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
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21
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Lithium effects on Hippocampus volumes in patients with bipolar disorder. J Affect Disord 2021; 294:521-526. [PMID: 34330048 DOI: 10.1016/j.jad.2021.07.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/11/2021] [Accepted: 07/11/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Lithium is one of the most effective medications for bipolar disorder episode prevention, but its mechanism of action is still largely unknown. The hippocampus is a subcortical cerebral structure involved in the formation of emotional responses, cognition and various primitive functions, altered during affective episodes. Deviations in the anatomy or physiology of the hippocampus would partially explain the symptomatology of bipolar subjects, and restoration may reflect treatment response. METHODS In this mini review, we summarize the studies which have investigated the effect of lithium intake on the volume of hippocampus, measured using magnetic resonance imaging (MRI). We performed a bibliographic search on PubMed, using the terms terms "hippocampus", "lithium", "bipolar disorder", "volume" and "MRI". Only original studies were considered. RESULTS Thirteen studies met the inclusion criteria. Nine studies demonstrated increased total hippocampal volume or hippocampal subfield volumes in BD patients on lithium treatment (Li BD) compared to those not taking lithium (non-Li BD), while four failed to show significant differences between groups. When healthy controls were compared to either the Li subjects or the non-Li ones, the findings were more heterogeneous. LIMITATIONS Heterogeneity in the methodology and definition of groups limits the comparison of study results. CONCLUSIONS Lithium may be associated with increased hippocampal volume in BD, potentially due to its putative neurotrophic action, but further research is needed better define the morphological alterations of hippocampus in BD and the longitudinal effects of lithium in the short and long-term.
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22
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Shared and specific patterns of structural and functional thalamo-frontal disturbances in manic and euthymic pediatric bipolar disorder. Brain Imaging Behav 2021; 15:2671-2680. [PMID: 34432228 PMCID: PMC8500876 DOI: 10.1007/s11682-021-00539-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 01/05/2023]
Abstract
Bipolar disorder (BD) is clinically defined by alternating depressive and manic episodes with a separated period of euthymia. Thalamo-frontal loop plays vital role in psychotic symptoms, altered motor control and executive difficulties in BD. It remains unclear that structural and functional alterations of thalamo-frontal loop among the different mood states in BD, especially in pediatric BD(PBD). Twenty manic PBD (mPBD), 20 euthymic PBD (ePBD) and 19 healthy controls (HCs) were included in the study. By analyzing the T1 images and fMRI signals, thalamus volume and frontal grey matter cortical thickness were tested, and functional connectivity (FC) between bilateral thalamus and frontal cortex was calculated. Relationship between clinical indices and thalamo-frontal FC was also evaluated in mPBD and ePBD adolescents. Compared to HCs, the cortical thickness of left middle frontal gyrus (MFG), bilateral superior frontal gyrus (SFG) was significantly decreased in both mPBD and ePBD patients, and volume of left thalamus and cortical thickness of right MFG significantly decreased in mPBD patients. Compared to that of the HCs and ePBD subjects, thalamo-frontal hyperconnectivity with MFG was found in mPBD, and compared with that of HCs, thalamo-frontal hypoconnectivity with precentral gyrus/SFG was found in ePBD. In ePBD patients, episode times positively correlated with FC values between thalamus and precentral gyrus. The findings of the present study demonstrate detailed knowledge regarding shared and specific structural and functional disruption in thalamo-frontal loop in mPBD and ePBD subjects. Thalamo-frontal abnormalities reported in adult BD subjects were also observed in adolescent BD patients, and thalamo-frontal dysfunction may be a crucial treatment target in BD.
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23
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Vatheuer CC, Dzionsko I, Maier S, Näher T, van Zutphen L, Sprenger A, Jacob GA, Arntz A, Domes G. Looking at the bigger picture: Cortical volume, thickness and surface area characteristics in borderline personality disorder with and without posttraumatic stress disorder. Psychiatry Res Neuroimaging 2021; 311:111283. [PMID: 33812313 DOI: 10.1016/j.pscychresns.2021.111283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/05/2021] [Accepted: 03/19/2021] [Indexed: 11/21/2022]
Abstract
Borderline personality disorder (BPD) is a severe psychiatric disorder accompanied by multiple comorbidities. Neuroimaging studies have identified structural abnormalities in BPD with most findings pointing to gray matter volume reductions in the fronto-limbic network, although results remain inconsistent. Similar alterations were found in posttraumatic stress disorder (PTSD), a common comorbidity of BPD. Only a small number of studies have investigated structural differences in BPD patients regarding comorbid PTSD specifically and studies conducting additional surface analyses are scarce. We investigated structural differences in women with BPD with and without PTSD and non-patient controls. Automated voxel-based and region-based volumetric analyses were applied. Additionally, four surface-based measures were analyzed: cortical thickness, gyrification index, fractal dimension, and sulcus depth. Analyses did not identify cortical volume alterations in the fronto-limbic network. Instead, hypergyrification was detected in the right superior parietal cortex in BPD patients compared to non-patient controls. No distinction was revealed between BPD patients with and without PTSD. These findings underline the importance of a holistic investigation examining volumetric and surface measures as these might enhance the understanding of structural alterations in BPD.
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Affiliation(s)
- C Carolyn Vatheuer
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer 15, 54290 Trier, Germany
| | - Inga Dzionsko
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer 15, 54290 Trier, Germany
| | - Simon Maier
- Department of Psychiatry and Psychotherapy, Section for Experimental Neuropsychiatry, Medical Center, University of Freiburg, Freiburg, Germany
| | - Tim Näher
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer 15, 54290 Trier, Germany
| | - Linda van Zutphen
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | | | - Gitta A Jacob
- Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Gregor Domes
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer 15, 54290 Trier, Germany; Institute of Psychobiology, University of Trier, Trier, Germany.
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24
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Husain SF, Tang TB, Tam WW, Tran BX, Ho CS, Ho RC. Cortical haemodynamic response during the verbal fluency task in patients with bipolar disorder and borderline personality disorder: a preliminary functional near-infrared spectroscopy study. BMC Psychiatry 2021; 21:201. [PMID: 33879125 PMCID: PMC8056702 DOI: 10.1186/s12888-021-03195-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 04/02/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Functional near-infrared spectroscopy (fNIRS) is an emerging neuroimaging modality that provides a direct and quantitative assessment of cortical haemodynamic response during a cognitive task. It may be used to identify neurophysiological differences between psychiatric disorders with overlapping symptoms, such as bipolar disorder (BD) and borderline personality disorder (BPD). Hence, this preliminary study aimed to compare the cerebral haemodynamic function of healthy controls (HC), patients with BD and patients with BPD. METHODS Twenty-seven participants (9 HCs, 9 patients with BD and 9 patients with BPD) matched for age, gender, ethnicity and education were recruited. Relative oxy-haemoglobin and deoxy-haemoglobin changes in the frontotemporal cortex was monitored with a 52-channel fNIRS system during a verbal fluency task (VFT). VFT performance, clinical history and symptom severity were also noted. RESULTS Compared to HCs, both patient groups had lower mean oxy-haemoglobin in the frontotemporal cortex during the VFT. Moreover, mean oxy-haemoglobin in the left inferior frontal region is markedly lower in patients with BPD compared to patients with BD. Task performance, clinical history and symptom severity were not associated with mean oxy-haemoglobin levels. CONCLUSIONS Prefrontal cortex activity is disrupted in patients with BD and BPD, but it is more extensive in BPD. These results provide further neurophysiological evidence for the separation of BPD from the bipolar spectrum. fNIRS could be a potential tool for assessing the frontal lobe function of patients who present with symptoms that are common to BD and BPD.
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Affiliation(s)
- Syeda Fabeha Husain
- grid.4280.e0000 0001 2180 6431Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 117599 Singapore ,grid.4280.e0000 0001 2180 6431Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228 Singapore
| | - Tong-Boon Tang
- grid.444487.f0000 0004 0634 0540Centre for Intelligent Signal and Imaging Research (CISIR), University Teknologi PETRONAS, Darul Ridzuan, 32610 Seri Iskandar, Perak Malaysia
| | - Wilson W. Tam
- grid.4280.e0000 0001 2180 6431Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597 Singapore
| | - Bach X. Tran
- grid.21107.350000 0001 2171 9311Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205 USA ,grid.56046.310000 0004 0642 8489Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 116001 Vietnam ,grid.473736.20000 0004 4659 3737Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, 70000 Vietnam
| | - Cyrus S. Ho
- grid.4280.e0000 0001 2180 6431Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228 Singapore
| | - Roger C. Ho
- grid.4280.e0000 0001 2180 6431Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 117599 Singapore ,grid.4280.e0000 0001 2180 6431Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228 Singapore
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25
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Lapomarda G, Grecucci A, Messina I, Pappaianni E, Dadomo H. Common and different gray and white matter alterations in bipolar and borderline personality disorder: A source-based morphometry study. Brain Res 2021; 1762:147401. [PMID: 33675742 DOI: 10.1016/j.brainres.2021.147401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 02/15/2021] [Accepted: 02/25/2021] [Indexed: 12/21/2022]
Abstract
According to the nosological classification, Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) are different syndromes. However, these pathological conditions share a number of affective symptoms that make the diagnosis difficult. Affective symptoms range from abnormal mood swings, characterizing both BD and BPD, to regulation dysfunctions, more specific to BPD. To shed light on the neural bases of these aspects, and to better understand differences and similarities between the two disorders, we analysed for the first time gray and white matter features of both BD and BPD. Structural T1 images from 30 patients with BD, 20 with BPD, and 45 controls were analysed by capitalizing on an innovative whole-brain multivariate method known as Source-based Morphometry. Compared to controls, BD patients showed increased gray matter concentration (p = .003) in a network involving mostly subcortical structures and cerebellar areas, possibly related to abnormal mood experiences. Notably, BPD patients showed milder alterations in the same circuit, standing in the middle of a continuum between BD and controls. In addition to this, we found an altered white matter network specific to BPD (p = .018), including frontal-parietal and temporal regions possibly associated with dysfunctional top-down emotion regulation. These findings may shed light on a better understanding of affective disturbances behind the two disorders, with BD patients more characterized by abnormalities in neural structures involved in mood oscillations, and BPD by deficits in the cognitive regulation of emotions. These results may help developing better treatments tailored to the specific affective disturbances displayed by these patients.
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Affiliation(s)
- Gaia Lapomarda
- Clinical and Affective Neuroscience Lab, Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy.
| | - Alessandro Grecucci
- Clinical and Affective Neuroscience Lab, Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy
| | | | - Edoardo Pappaianni
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Harold Dadomo
- Department of Neuroscience, University of Parma, Parma, Italy
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Epidemiology of knife carrying among young British men. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1555-1563. [PMID: 33502562 PMCID: PMC8429363 DOI: 10.1007/s00127-021-02031-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Knife carrying has caused considerable public concern in the UK. But little is known of the epidemiology and characteristics of men who carry knives. We investigated associations with socioeconomic deprivation, area-level factors, and psychiatric morbidity. METHODS Cross-sectional surveys of 5005 British men, 18-34 years, oversampling Black and Minority Ethnic (BME) men, lower social grades, and in London Borough of Hackney and Glasgow East. Participants completed questionnaires covering violent behaviour and psychiatric morbidity using standardised self-report instruments. Socioeconomic deprivation measured at small area level. RESULTS Prevalence of knife carrying was 5.5% (4.8-6.9) and similar among white and BME subgroups. However, prevalence was twice the national rate in Glasgow East, and four times higher among Black men in Hackney, both areas with high levels of background violence and gang activity. Knife carrying was associated with multiple social problems, attitudes encouraging violence, and psychiatric morbidity, including antisocial personality disorder (AOR 9.94 95% CI 7.28-13.56), drug dependence (AOR 2.96 95% CI 1.90-4.66), and paranoid ideation (AOR 6.05 95% CI 4.47-8.19). There was no evidence of a linear relationship with socioeconomic deprivation. CONCLUSION Men who carry knives represent an important public health problem with high levels of health service use. It is not solely a criminal justice issue. Rates are increased in areas where street gangs are active. Contact with the criminal justice system provides opportunity for targeted violence prevention interventions involving engagement with integrated psychiatric, substance misuse, and criminal justice agencies.
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Vai B, Cazzetta S, Scalisi R, Donati A, Bechi M, Poletti S, Sforzini L, Visintini R, Maffei C, Benedetti F. Neuropsychological deficits correlate with symptoms severity and cortical thickness in Borderline Personality Disorder. J Affect Disord 2021; 278:181-188. [PMID: 32961414 DOI: 10.1016/j.jad.2020.09.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/15/2020] [Accepted: 09/11/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Neuropsychological abnormalities have been proposed to contribute to the development and maintenance of Borderline Personality Disorder (BPD). Previous meta-analyses and reviews confirmed deficits in a broad range of cognitive domains, including attention, cognitive flexibility, memory, executive functions, planning, information processing, and visuospatial abilities, often suggested to underlie brain abnormalities. However, no study directly explored the structural neural correlates of these deficits in BPD, also accounting for the possible confounding effect of pharmacological treatments, often used as adjunctive symptom-targeted therapy in clinical setting. METHODS In this study we compared the performance of 24 BPD patients to 24 healthy controls obtained at the neuropsychological battery "Brief Assessment and Cognition in Schizophrenia", exploring the relationship between the cognitive impairments and current symptomatology, brain grey matter volumes and cortical thickness, controlling for medications load. RESULTS Data revealed deficits in verbal memory and fluency, working memory, attention and speed of information processing and psychomotor speed and coordination when medication load was not in the model. Correcting for this variable, only the impairment in psychomotor abilities remained significant. A multiple regression confirmed the effect of this neuropsychological domain on the severity of BPD symptomatology (Borderline Evaluation of Severity Over Time). In BPD, the performance at psychomotor speed and coordination was also directly associated to cortical thickness in postcentral gyrus. LIMITATIONS Relatively small sample size, especially for neuroimaging. CONCLUSIONS Our study highlighted an influence of BPD neuropsychological impairments on symptomatology, and cortical thickness, prompting the potential clinical utility of a cognitive remediation program in BPD.
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Affiliation(s)
- Benedetta Vai
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; Fondazione Centro San Raffaele, Milan, Italy.
| | - Silvia Cazzetta
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Rosalia Scalisi
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessia Donati
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Margherita Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Poletti
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Laura Sforzini
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Raffaele Visintini
- Division of Neuroscience, Clinical Psychology and Psychotherapy Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, Clinical Psychology and Psychotherapy Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Francesco Benedetti
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
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Lou J, Sun Y, Cui Z, Gong L. Common and distinct patterns of gray matter alterations in borderline personality disorder and posttraumatic stress disorder: A dual meta-analysis. Neurosci Lett 2020; 741:135376. [PMID: 33221476 DOI: 10.1016/j.neulet.2020.135376] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/31/2020] [Accepted: 09/07/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) are severe psychiatric disorders and often co-occur, either of the two will seriously threaten to public health. However, we lack ample evidences to understand the potential pathophysiologic mechanisms of gray matter (GM) alterations in the two disorders. METHODS We performed a meta-analysis in both BPD (15 datasets including 442 BPD subjects versus 441 healthy controls) and PTSD (11 datasets including 214 PTSD subjects versus 258 healthy controls) applying anisotropic effect-size-based algorithms (AES-SDM) method. RESULTS Conjunction analysis found relative GM volume reductions in both disorders in the orbitofrontal gyrus and anterior cingulate cortex, contrarily, differences were predominantly observed that GM volume increased in the posterior cingulate gyrus and precuneus in BPD subjects, and GM volume decreased in the amygdala-hippocampal fear circuit, fusiform gyrus in PTSD subjects. CONCLUSIONS Group comparisons and conjunction analyses in BPD and PTSD identified same regions of GM volume reductions in the orbitofrontal gyrus and anterior cingulate cortex, which may provide clues for the neurobiological mechanisms and clinical diagnosis underpinning two disorders.
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Affiliation(s)
- Jing Lou
- Dalian Medical University, Neuropsychological Department, Liaoning Province, China
| | - Yueji Sun
- Dalian Medical University, Neuropsychological Department, Liaoning Province, China.
| | - Zhixi Cui
- Dalian Medical University, Neuropsychological Department, Liaoning Province, China
| | - Lei Gong
- Dalian Medical University, Neuropsychological Department, Liaoning Province, China
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Lorefice L, Fenu G, Carta E, Frau J, Coghe G, Contu F, Barracciu MA, Carta MG, Cocco E. Bipolar disorders and deep grey matter in multiple sclerosis: A preliminary quantitative MRI study. Mult Scler Relat Disord 2020; 46:102564. [PMID: 33172832 DOI: 10.1016/j.msard.2020.102564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is frequently observed in patients affected by multiple sclerosis (MS), presenting a lifetime estimate of around 8%. However, uncertainty exists on the brain damage associated with this psychiatric comorbidity. This study aimed to investigate the effect of brain atrophy, particularly that of the subcortical grey matter (scGM) structures that notoriously regulate the affective functioning, on the co-occurrence of BD in patients with MS. METHODS A group of patients with MS affected by BD and a control group of patients with MS without any mood/psychiatric disorder, as defined using standardised diagnostic tools (Advanced Neuropsychiatric Tools and Assessment Schedule), were recruited. The patients underwent brain MRI, and the volumes of the whole brain (WB), white matter (WM), and grey matter (GM) were estimated using SIENAX. Thus, the scGM volumes of the putamen, caudate, thalamus, hippocampus, amygdala, nucleus accumbens, and pallidus were estimated using the FIRST tool. RESULTS The sample included 61 patients with MS, amongst whom 15 (24.6%) had BD. No differences in the WB, WM, and cortical GM volumes were observed between the patients with MS with and without BD. Conversely, the multiple regression analysis revealed a significant association of BD with lower volumes of the putamen (p = 0.032), nucleus accumbens (p = 0.029), and pallidus (p = 0.061; with a trend towards significance), independently from the demographic and MS clinical features. CONCLUSIONS Our preliminary results indicated that the nucleus accumbens and putamen are smaller in MS patients with BD. Further investigations in larger cohorts of MS patients with affective disorders are necessary to confirm these data and understand the structural brain damage underlying this psychiatric comorbidity.
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Affiliation(s)
- L Lorefice
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, ASSL Cagliari, Italy.
| | - G Fenu
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, ASSL Cagliari, Italy
| | - E Carta
- Multiple Sclerosis Centre, Dpt of Medical Sciences and Public Health, University of Cagliari, Italy
| | - J Frau
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, ASSL Cagliari, Italy
| | - G Coghe
- Multiple Sclerosis Centre, Binaghi Hospital, ATS Sardegna, ASSL Cagliari, Italy
| | - F Contu
- Radiology Unit, Binaghi Hospital, ATS Sardegna, ASSL Cagliari, Italy
| | - M A Barracciu
- Radiology Unit, Binaghi Hospital, ATS Sardegna, ASSL Cagliari, Italy
| | - M G Carta
- Dpt of Medical Sciences and Public Health, University of Cagliari, Italy
| | - E Cocco
- Multiple Sclerosis Centre, Dpt of Medical Sciences and Public Health, University of Cagliari, Italy
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Chen P, Chen F, Chen G, Zhong S, Gong J, Zhong H, Ye T, Tang G, Wang J, Luo Z, Qi Z, Jia Y, Yang H, Yin Z, Huang L, Wang Y. Inflammation is associated with decreased functional connectivity of insula in unmedicated bipolar disorder. Brain Behav Immun 2020; 89:615-622. [PMID: 32688026 DOI: 10.1016/j.bbi.2020.07.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/17/2020] [Accepted: 07/08/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Systemic inflammation and immune dysregulation have been considered as risk factors in the pathophysiology of mood disorders including bipolar disorder (BD). Previous neuroimaging studies have demonstrated metabolic, structural and functional abnormalities in the insula in BD, proposed that the insula played an important role in BD. We herein aimed to explore neural mechanisms underlying inflammation-induced in the insular subregions functional connectivity (FC) in patients with BD. METHODS Brain resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from 41 patients with unmedicated BD II (current episode depressed), 68 healthy controls (HCs). Three pairs of insular seed regions were selected: the bilateral anterior insula (AI), the bilateral middle insula (MI) and the bilateral posterior insula (PI), and calculated the whole-brain FC for each subregion. Additionally, the serum levels of pro-inflammatory cytokines in patients and HCs, including IL-6 and TNF-α, were detected. Then the partial correlation coefficients between the abnormal insular subregions FC values and pro-inflammatory cytokines levels in patients with BD II depression were calculated. RESULTS The BD II depression group exhibited decreased FC between the right PI and the left postcentral gyrus, and increased FC between the left AI and the bilateral insula (extended to the right putamen) when compared with the HC group. Moreover, the patients with BD II depression showed higher IL-6 and TNF-α levels than HCs, and IL-6 level was negatively correlated with FC of the right PI to the left postcentral gyrus. CONCLUSIONS Our results demonstrated that abnormal FC between the bilateral insula, and between the insula and sensorimotor areas in BD. Moreover, disrupted FC between the insula and sensorimotor areas was associated with elevated pro-inflammatory cytokine levels of IL-6 in BD.
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Affiliation(s)
- Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Feng Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - JiaYing Gong
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China; Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
| | - Hui Zhong
- Biomedical Translational Research Institute, Jinan University, Guangzhou 510630, China
| | - Tao Ye
- Clinical Laboratory Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Jurong Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Zhenye Luo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hengwen Yang
- Biomedical Translational Research Institute, Jinan University, Guangzhou 510630, China; Zhuhai Precision Medical Center, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Jinan University, Zhuhai 519000, China
| | - Zhinan Yin
- Biomedical Translational Research Institute, Jinan University, Guangzhou 510630, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China.
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31
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Baranger DAA, Few LR, Sheinbein DH, Agrawal A, Oltmanns TF, Knodt AR, Barch DM, Hariri AR, Bogdan R. Borderline Personality Traits Are Not Correlated With Brain Structure in Two Large Samples. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:669-677. [PMID: 32312691 PMCID: PMC7360105 DOI: 10.1016/j.bpsc.2020.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/06/2020] [Accepted: 02/15/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Borderline personality disorder is associated with severe psychiatric presentations and has been linked to variability in brain structure. Dimensional models of borderline personality traits (BPTs) have become influential; however, associations between BPTs and brain structure remain poorly understood. METHODS We tested whether BPTs are associated with regional cortical thickness, cortical surface area, and subcortical volumes (n = 152 brain structure metrics) in data from the Duke Neurogenetics Study (n = 1299) and Human Connectome Project (n = 1099). Positive control analyses tested whether BPTs are associated with related behaviors (e.g., suicidal thoughts and behaviors, psychiatric diagnoses) and experiences (e.g., adverse childhood experiences). RESULTS While BPTs were robustly associated with all positive control measures, they were not significantly associated with any brain structure metrics in the Duke Neurogenetics Study or Human Connectome Project, or in a meta-analysis of both samples. The strongest findings from the meta-analysis showed a positive association between BPTs and volumes of the left ventral diencephalon and thalamus (p values < .005 uncorrected, p values > .1 false discovery rate-corrected). Contrasting high and low BPT decile groups (n = 552) revealed no false discovery rate-significant associations with brain structure. CONCLUSIONS We find replicable evidence that BPTs are not associated with brain structure despite being correlated with independent behavioral measures. Prior reports linking brain morphology to borderline personality disorder may be driven by factors other than traits (e.g., severe presentations, comorbid conditions, severe childhood adversity, or medication) or reflect false positives. The etiology or consequences of BPTs may not be attributable to brain structure measured via magnetic resonance imaging. Future studies of BPTs will require much larger sample sizes to detect these very small effects.
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Affiliation(s)
- David A A Baranger
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Lauren R Few
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Daniel H Sheinbein
- Department of Psychological and Brain Sciences, Washington University, St. Louis, Missouri
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Thomas F Oltmanns
- Department of Psychological and Brain Sciences, Washington University, St. Louis, Missouri
| | - Annchen R Knodt
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Department of Psychological and Brain Sciences, Washington University, St. Louis, Missouri
| | - Ahmad R Hariri
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Ryan Bogdan
- Department of Psychological and Brain Sciences, Washington University, St. Louis, Missouri.
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Aerobic exercise impacts the anterior cingulate cortex in adolescents with subthreshold mood syndromes: a randomized controlled trial study. Transl Psychiatry 2020; 10:155. [PMID: 32424169 PMCID: PMC7235232 DOI: 10.1038/s41398-020-0840-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/23/2020] [Accepted: 04/30/2020] [Indexed: 12/11/2022] Open
Abstract
Aerobic exercise is effective in alleviating mood symptoms while the mechanism is poorly understood. There are limited clinical trials that investigated the effect of exercise on the anterior cingulate cortex (ACC), a key brain region involved in mood regulations, in adolescents with subthreshold mood syndromes. This randomized controlled trial (RCT) of aerobic exercise was undertaken in a middle school in Guangzhou, China. Participants were adolescents aged 12-14 with subthreshold mood syndromes including depressive and manic symptoms and were randomly assigned to an aerobic exercise intervention or a psychoeducation control group. Participants in the exercise group received moderate-intensity exercise intervention, consisting of 30 mins running, 4 days per week for 3 months. The primary outcome in this study was structural changes in the ACC from baseline to post intervention. The trial was registered with ClinicalTrial.gov (NCT03300778). Of 56 participants who met the criteria for subthreshold mood syndromes, 39 (41.03% males) had complete MRI data, with 20 and 19 subjects in the exercise and control group, respectively. At baseline, demographic information (e.g., age and sex), clinical symptoms, and the gray matter volume and cortical thickness of ACC were matched between the two groups. After 12 weeks of treatment, participants in the exercise group displayed increased gray matter volume of the left rostral ACC (F1,30 = 5.73, p = 0.02) and increased cortical thickness of the right rostral ACC (F1,30 = 7.83, p = 0.01) when compared with the control group. No significant differences were found for caudal ACC cortical thickness and gray matter volume. Our data demonstrate that 12-week, moderate-intensity aerobic exercise can induce structural changes in the rostral ACC in adolescents with subthreshold mood syndromes.
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Yaxu Y, Ren Z, Ward J, Jiang Q. Atypical Brain Structures as a Function of Gray Matter Volume (GMV) and Gray Matter Density (GMD) in Young Adults Relating to Autism Spectrum Traits. Front Psychol 2020; 11:523. [PMID: 32322224 PMCID: PMC7158890 DOI: 10.3389/fpsyg.2020.00523] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 03/05/2020] [Indexed: 12/03/2022] Open
Abstract
Individuals with autistic traits are those who present in the normal population with characteristics of social, communication, personality, and cognitive impairments but do not meet the clinical threshold for autism spectrum disorder (ASD). Most studies have focused on the abnormalities in ASD patients rather than on individuals with autistic traits. In this study, we focused on the behaviors of a large sample (N = 401) of Chinese individuals with different levels of autistic traits, measured using the Autism Spectrum Quotient, and applied voxel-based morphometry (VBM) to determine their association to differences in brain structure. The results mainly showed that the correlation between gray matter volume (GMV) and gray matter density of the brain and the Autism Spectrum Quotient was significant in these regions: the right middle frontal gyrus, which are involved in social processing and social reasoning; the left parahippocampal gyrus, which is involved in socioemotional behaviors and unconscious relational memory encoding; and the right superior parietal lobule, which are involved in cognitive control and the ability to show attention to detail. These findings reveal that people with autistic traits in the normal population have atypical development in GMV and gray matter density, which may affect their social functioning and communication ability.
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Affiliation(s)
- Yu Yaxu
- School of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing, China
| | - Zhiting Ren
- School of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing, China
| | - Jamie Ward
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
| | - Qiu Jiang
- School of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing, China
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Husain SF, Tang TB, Yu R, Tam WW, Tran B, Quek TT, Hwang SH, Chang CW, Ho CS, Ho RC. Cortical haemodynamic response measured by functional near infrared spectroscopy during a verbal fluency task in patients with major depression and borderline personality disorder. EBioMedicine 2020; 51:102586. [PMID: 31877417 PMCID: PMC6938854 DOI: 10.1016/j.ebiom.2019.11.047] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/15/2019] [Accepted: 11/25/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Functional near infrared spectroscopy (fNIRS) provides a direct and quantitative assessment of cortical haemodynamic function during a cognitive task. This functional neuroimaging modality may be used to elucidate the pathophysiology of psychiatric disorders, and identify neurophysiological differences between co-occurring psychiatric disorders. However, fNIRS research on borderline personality disorder (BPD) has been limited. Hence, this study aimed to compare cerebral haemodynamic function in healthy controls (HC), patients with major depressive disorder (MDD) and patients with BPD. METHODS fNIRS signals during a verbal fluency task designed for clinical assessment was recorded for all participants. Demographics, clinical history and symptom severity were also noted. FINDINGS Compared to HCs (n = 31), both patient groups (MDD, n = 31; BPD, n = 31) displayed diminished haemodynamic response in the frontal, temporal and parietal cortices. Moreover, haemodynamic response in the right frontal cortex is markedly lower in patients with MDD compared to patients with BPD. INTERPRETATION Normal cortical function in patients with BPD is disrupted, but not as extensively as in patients with MDD. These results provide further neurophysiological evidence for the distinction of patients with MDD from patients with BPD.
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Affiliation(s)
- Syeda F Husain
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tong-Boon Tang
- Centre for Intelligent Signal and Imaging Research (CISIR), University Teknologi PETRONAS, Perak, Malaysia
| | - Rongjun Yu
- Department of Psychology, Faculty of Arts and Social Science, National University of Singapore, Singapore
| | - Wilson W Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Bach Tran
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States; Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam; Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Travis T Quek
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shi-Hui Hwang
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cheryl W Chang
- Department of Psychological Medicine, National University Health System, Singapore
| | - Cyrus S Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Roger C Ho
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Li B, Valles NL, Saunders J, Vyas A, Naqvi M, Shah AA. Can We Differentiate Borderline Personality Disorder from Bipolar Disorder? Psychiatr Ann 2020. [DOI: 10.3928/00485713-20191126-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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36
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Bayes A, Parker G, Paris J. Differential Diagnosis of Bipolar II Disorder and Borderline Personality Disorder. Curr Psychiatry Rep 2019; 21:125. [PMID: 31749106 DOI: 10.1007/s11920-019-1120-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
PURPOSE OF REVIEW Differentiating bipolar (BP) disorders (in particular BP II) from borderline personality disorder (BPD) is a common diagnostic dilemma. We sought to critically examine recent studies that considered clinical differences between BP II and BPD, which might advance their delineation. RECENT FINDINGS Recent studies focused on differentiating biological parameters-genetics, epigenetics, diurnal rhythms, structural and functional neuroimaging-with indicative differences not yet sufficient to guide diagnosis. Key differentiating factors include family history, developmental antecedents, illness course, phenomenological differences in mood states, personality style and relationship factors. Less differentiating factors include impulsivity, neuropsychological profiles, gender distribution, comorbidity and treatment response. This review details parameters offering differentiation of BP II from BPD and should assist in resolving a frequent diagnostic dilemma. Future studies should specifically examine the BP II subtype directly with BPD, which would aid in sharpening the distinction between the disorders.
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Affiliation(s)
- Adam Bayes
- School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia. .,Black Dog Institute, Sydney, NSW, Australia.
| | - Gordon Parker
- School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia.,Black Dog Institute, Sydney, NSW, Australia
| | - Joel Paris
- Institute of Community and Family Psychiatry, SMBD-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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