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Huang D, Lai S, Zhong S, Zhang Y, He J, Yan S, Huang X, Lu X, Duan M, Song K, Ye K, Chen Y, Ye S, Lai J, Zhong Q, Song X, Jia Y. Sex-differential cognitive performance on MCCB of youth with BD-II depression. BMC Psychiatry 2024; 24:345. [PMID: 38714952 PMCID: PMC11077867 DOI: 10.1186/s12888-024-05701-7] [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: 02/07/2023] [Accepted: 03/20/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Recent evidences have shown sex-differential cognitive deficits in bipolar disorder (BD) and differences in cognitions across BD subtypes. However, the sex-specific effect on cognitive impairment in BD subtype II (BD-II) remains obscure. The aim of the current study was to examine whether cognitive deficits differ by gender in youth with BD-II depression. METHOD This cross-sectional study recruited 125 unmedicated youths with BD-II depression and 140 age-, sex-, and education-matched healthy controls (HCs). The Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) was used to assess cognitive functions. Mood state was assessed using the 24-item Hamilton Depression Rating Scale (24-HDRS) and the Young Mania Rating Scale (YMRS). Multivariate analysis of covariance (MANCOVA) was conducted. RESULT Compared with HCs, patients with BD-II depression had lower scores on MCCB composite and its seven cognitive domains (all p < 0.001). After controlling for age and education, MANCOVA revealed significant gender-by-group interaction on attention/vigilance (F = 6.224, df = 1, p = 0.013), verbal learning (F = 9.847, df = 1, p = 0.002), visual learning (F = 4.242, df = 1, p = 0.040), and composite (F = 8.819, df = 1, p = 0.003). Post hoc analyses suggested that males performed worse in the above-mentioned MCCB tests than females in BD-II depression. CONCLUSION Our study demonstrated generalized cognitive deficits in unmedicated youths with BD-II depression. Male patients performed more serious cognitive impairment on attention/vigilance, verbal learning, and visual learning compared to female patients.
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Affiliation(s)
- Dong Huang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Shuya Yan
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Xiaosi Huang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Xiaodan Lu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Manying Duan
- School of Management, Jinan University, Guangzhou, 510316, China
| | - Kailin Song
- School of Management, Jinan University, Guangzhou, 510316, China
| | - Kaiwei Ye
- School of Management, Jinan University, Guangzhou, 510316, China
| | - Yandi Chen
- School of Management, Jinan University, Guangzhou, 510316, China
| | - Suiyi Ye
- School of Management, Jinan University, Guangzhou, 510316, China
| | - Jiankang Lai
- School of Management, Jinan University, Guangzhou, 510316, China
| | - Qilin Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Xiaodong Song
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
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Wang X, Xia Y, Yan R, Sun H, Huang Y, Xia Q, Sheng J, You W, Hua L, Tang H, Yao Z, Lu Q. Sex differences in anhedonia in bipolar depression: a resting-state fMRI study. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01765-4. [PMID: 38558145 DOI: 10.1007/s00406-024-01765-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/13/2024] [Indexed: 04/04/2024]
Abstract
Previous studies about anhedonia symptoms in bipolar depression (BD) ignored the unique role of gender on brain function. This study aims to explore the regional brain neuroimaging features of BD with anhedonia and the sex differences in these patients. The resting-fMRI by applying fractional amplitude of low-frequency fluctuation (fALFF) method was estimated in 263 patients with BD (174 high anhedonia [HA], 89 low anhedonia [LA]) and 213 healthy controls. The effects of two different factors in patients with BD were analyzed using a 3 (group: HA, LA, HC) × 2 (sex: male, female) ANOVA. The fALFF values were higher in the HA group than in the LA group in the right medial cingulate gyrus and supplementary motor area. For the sex-by-group interaction, the fALFF values of the right hippocampus, left medial occipital gyrus, right insula, and bilateral medial cingulate gyrus were significantly higher in HA males than in LA males but not females. These results suggested that the pattern of high activation could be a marker of anhedonia symptoms in BD males, and the sex differences should be considered in future studies of BD with anhedonia symptoms.
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Affiliation(s)
- Xiaoqin Wang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Yi Xia
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Rui Yan
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Hao Sun
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
- Nanjing Brain Hospital, Medical School of Nanjing University, 22 Hankou Road, Nanjing, 210093, China
| | - Yinghong Huang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
- Nanjing Brain Hospital, Medical School of Nanjing University, 22 Hankou Road, Nanjing, 210093, China
| | - Qiudong Xia
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Junling Sheng
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Wei You
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Lingling Hua
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Hao Tang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China
| | - Zhijian Yao
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, China.
- Nanjing Brain Hospital, Medical School of Nanjing University, 22 Hankou Road, Nanjing, 210093, China.
- School of Biological Sciences and Medical Engineering, Southeast University, 2 sipailou, Nanjing, 210096, China.
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, 2 sipailou, Nanjing, 210096, China.
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, 210096, China.
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3
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Van Rheenen TE, Cotton SM, Dandash O, Cooper RE, Ringin E, Daglas-Georgiou R, Allott K, Chye Y, Suo C, Macneil C, Hasty M, Hallam K, McGorry P, Fornito A, Yücel M, Pantelis C, Berk M. Increased cortical surface area but not altered cortical thickness or gyrification in bipolar disorder following stabilisation from a first episode of mania. Prog Neuropsychopharmacol Biol Psychiatry 2023; 122:110687. [PMID: 36427550 DOI: 10.1016/j.pnpbp.2022.110687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/08/2022] [Accepted: 11/16/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite reports of altered brain morphology in established bipolar disorder (BD), there is limited understanding of when these morphological abnormalities emerge. Assessment of patients during the early course of illness can help to address this gap, but few studies have examined surface-based brain morphology in patients at this illness stage. METHODS We completed a secondary analysis of baseline data from a randomised control trial of BD individuals stabilised after their first episode of mania (FEM). The magnetic resonance imaging scans of n = 35 FEM patients and n = 29 age-matched healthy controls were analysed. Group differences in cortical thickness, surface area and gyrification were assessed at each vertex of the cortical surface using general linear models. Significant results were identified at p < 0.05 using cluster-wise correction. RESULTS The FEM group did not differ from healthy controls with regards to cortical thickness or gyrification. However, there were two clusters of increased surface area in the left hemisphere of FEM patients, with peak coordinates falling within the lateral occipital cortex and pars triangularis. CONCLUSIONS Cortical thickness and gyrification appear to be intact in the aftermath of a first manic episode, whilst cortical surface area in the inferior/middle prefrontal and occipitoparietal cortex is increased compared to age-matched controls. It is possible that increased surface area in the FEM group is the outcome of abnormalities in a premorbidly occurring process. In contrast, the findings raise the hypothesis that cortical thickness reductions seen in past studies of individuals with more established BD may be more attributable to post-onset factors.
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Affiliation(s)
- Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia.
| | - Sue M Cotton
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Orwa Dandash
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Australia
| | - Rebecca E Cooper
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Elysha Ringin
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Rothanthi Daglas-Georgiou
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Kelly Allott
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Yann Chye
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Australia
| | - Chao Suo
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Australia
| | - Craig Macneil
- Orygen Youth Health Clinical Program, Parkville, VIC, Australia
| | - Melissa Hasty
- Orygen Youth Health Clinical Program, Parkville, VIC, Australia
| | - Karen Hallam
- The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia
| | - Patrick McGorry
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Alex Fornito
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Australia
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Clayton, VIC, Australia
| | - Michael Berk
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia; The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia; Barwon Health, PO Box 281, Geelong, Victoria, 3220, Australia
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4
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Ding L, Wu Y, Kong L, Sun J, Qu F, Xin K, Yang A, Yan X, Lu Y, Jiang X, Tang Y, Wu F. Gender differences in plasma glial cell line-derived neurotrophic factor levels of patients with bipolar disorder. J Affect Disord 2023; 320:605-609. [PMID: 36183819 DOI: 10.1016/j.jad.2022.09.123] [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: 05/26/2022] [Revised: 09/11/2022] [Accepted: 09/26/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The glial cell line-derived neurotrophic factor (GDNF) has an important role in neurons and is closely associated with psychiatric disorders. The development of bipolar disorder (BD) may differ between genders. Existing studies have shown that plasma GDNF levels are altered in patients with BD. In this study, we investigate whether the GDNF levels in patients with BD differ in terms of gender. METHODS Participants were divided into the BD group (n = 76, with 26 males and 50 females) and healthy control (HC) group (n = 89, with 35 males and 54 females). Plasma GDNF levels were detected via multifactor assay. Clinical symptoms of patients with BD were collected and assessed using the Hamilton Depression-17 Inventory, Hamilton Anxiety-17 Inventory, Young's Mania Rating Scale, and Brief Psychiatric Rating Scale. RESULTS The GDNF levels were significantly higher in all participants in the HC group (F = 4.262, p < 0.05) compared with those in the BD group. In the HC group, the males (t = 4.814, p < 0.001) presented significantly higher levels than the females. The plasma GDNF levels in males in the BD group (t = 3.022, p < 0.05) were significantly lower than those in males in the HC group. CONCLUSION Differences in plasma GDNF levels are associated with the gender of patients with BD.
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Affiliation(s)
- Luyu Ding
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yifan Wu
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Lingtao Kong
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Jiaze Sun
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Fangru Qu
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Kaiqi Xin
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Anqi Yang
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xintong Yan
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yihui Lu
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaowei Jiang
- Brain Function Research Section, Department of Radiology, The First Hospital of China Medical University, Shenyang, China.
| | - Yanqing Tang
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, Liaoning, China; Department of Geriatric Medicine, The First Hospital of China Medical University, Shenyang, China.
| | - Feng Wu
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, Liaoning, China.
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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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6
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OUP accepted manuscript. Cereb Cortex 2022; 32:4386-4396. [DOI: 10.1093/cercor/bhab490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/15/2022] Open
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7
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Jeong HJ, Lee YM, Park JM, Lee BD, Moon E, Suh H, Kim HJ, Pak K, Choi KU, Chung YI. Reduced Thickness of the Anterior Cingulate Cortex as a Predictor of Amnestic-Mild Cognitive Impairment Conversion to Alzheimer's Disease with Psychosis. J Alzheimers Dis 2021; 84:1709-1717. [PMID: 34719496 DOI: 10.3233/jad-215005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND A long-term follow-up study in patients with amnestic mild cognitive impairment (aMCI) is needed to elucidate the association between regional brain volume and psychopathological mechanisms of Alzheimer's disease with psychosis (AD + P). OBJECTIVE The purpose of this study was to investigate the effect of the thickness of the angular cingulate cortex (ACC) on the risk of AD + P conversion in patients with aMCI. METHODS This was a hospital-based prospective longitudinal study including 174 patients with aMCI. The main outcome measure was time-to-progression from aMCI to AD + P. Subregions of the ACC (rostral ACC, rACC; caudal ACC, cACC) and hippocampus (HC) were measured as regions of interest with magnetic resonance imaging and the Freesurfer analysis at baseline. Survival analysis with time to incident AD + P as an event variable was calculated with Cox proportional hazards models using the subregions of the ACC and HC as a continuous variable. RESULTS Cox proportional hazard analyses showed that the risk of AD + P was associated with sub-regional ACC thickness but not HC volume: reduced cortical thickness of the left cACC (HR [95%CI], 0.224 [0.087-0.575], p = 0.002), right cACC (HR [95%CI], 0.318 [0.132-0.768], p = 0.011). This association of the cACC with the risk of AD also remained significant when adjusted for HC volume. CONCLUSION We found that reduced cortical thickness of the cACC is a predictor of aMCI conversion to AD + P, independent of HC, suggesting that the ACC plays a vital role in the underlying pathogenesis of AD + P.
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Affiliation(s)
- Hee-Jeong Jeong
- Department of Psychiatry, Pusan National University School of Medicine, Busan, Republic of Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Young-Min Lee
- Department of Psychiatry, Pusan National University School of Medicine, Busan, Republic of Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Je-Min Park
- Department of Psychiatry, Pusan National University School of Medicine, Busan, Republic of Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Byung-Dae Lee
- Department of Psychiatry, Pusan National University School of Medicine, Busan, Republic of Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Eunsoo Moon
- Department of Psychiatry, Pusan National University School of Medicine, Busan, Republic of Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hwagyu Suh
- Department of Psychiatry, Pusan National University School of Medicine, Busan, Republic of Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hak-Jin Kim
- Department of Radiology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Kyoungjune Pak
- Department of Nuclear Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Kyung-Un Choi
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.,Department of Pathology, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Young-In Chung
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
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8
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Jiang X, Wu F, Zhang Y, Li H, Kang J, Kong L, Wang F, Tang Y. Gender differences of amplitude of low-frequency fluctuations in bipolar disorder: A resting state fMRI study. J Affect Disord 2021; 280:189-196. [PMID: 33217701 DOI: 10.1016/j.jad.2020.11.087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/27/2020] [Accepted: 11/08/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The clinical and epidemiological features of bipolar disorder (BD) between females and males have many differences. The association between brain function and gender in BD is unknown. This research aimed to investigate the association between brain function and gender in BD by using amplitude of low-frequency fluctuations (ALFFs). METHODS Ninety-eight patients (49 females and 49 males) with BD and 171 matched healthy controls (HCs, 89 females and 82 males) were recruited for resting-state functional magnetic resonance imaging. ALFF was used to estimate brain function. RESULTS A main effect of diagnosis in ALFF was observed in the dorsal lateral prefrontal cortex (DLPFC), ventral prefrontal cortex (VPFC), caudate and occipital lobe. A main effect of gender in ALFF was found in the right VPFC, DLPFC, thalamus, and occipital lobe. A main effect of diagnosis gender interaction in ALFF was observed in the left DLPFC. Analyses of two-sample t-test indicated that male patients with BD had increased ALFF in the right hippocampus, right amygdala, left caudate, and left DLPFC, and decreased ALFF in the occipital lobe compared with male HC. Female patients with BD demonstrated increased ALFF in the right VPFC and right DLPFC compared with female HC. Male patients with BD exhibited increased ALFF in the right VPFC and left DLPFC and decreased ALFF in the occipital lobe compared with female patients with BD. LIMITATIONS This study did not consider the effect of medications and emotional states on brain activity. CONCLUSIONS Results suggested gender differences in the dysfunctions of the cortico-limbic neural system in BD.
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Affiliation(s)
- Xuejun Jiang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China; Department of Gerontology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Feng Wu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yifan Zhang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Huizi Li
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jiahui Kang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Lingtao Kong
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China; Department of Gerontology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
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9
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Madre M, Canales-Rodríguez EJ, Fuentes-Claramonte P, Alonso-Lana S, Salgado-Pineda P, Guerrero-Pedraza A, Moro N, Bosque C, Gomar JJ, Ortíz-Gil J, Goikolea JM, Bonnin CM, Vieta E, Sarró S, Maristany T, McKenna PJ, Salvador R, Pomarol-Clotet E. Structural abnormality in schizophrenia versus bipolar disorder: A whole brain cortical thickness, surface area, volume and gyrification analyses. Neuroimage Clin 2019; 25:102131. [PMID: 31911343 PMCID: PMC6948361 DOI: 10.1016/j.nicl.2019.102131] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 11/19/2019] [Accepted: 12/13/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The profiles of cortical abnormalities in schizophrenia and bipolar disorder, and how far they resemble each other, have only been studied to a limited extent. The aim of this study was to identify and compare the changes in cortical morphology associated with these pathologies. METHODS A total of 384 subjects, including 128 patients with schizophrenia, 128 patients with bipolar disorder and 127 sex-age-matched healthy subjects, were examined using cortical surface-based morphology. Four cortical structural measures were studied: cortical volume (CV), cortical thickness (CT), surface area (SA) and gyrification index (GI). Group comparisons for each separate cortical measure were conducted. RESULTS At a threshold of P = 0.05 corrected, both patient groups showed significant widespread CV and CT reductions in similar areas compared to healthy subjects. However, the changes in schizophrenia were more pronounced. While CV decrease in bipolar disorder was exclusively explained by cortical thinning, in schizophrenia it was driven by changes in CT and partially by SA. Reduced GI was only found in schizophrenia. The direct comparison between both disorders showed significant reductions in all measures in patients with schizophrenia. CONCLUSIONS Cortical volume and cortical thickness deficits are shared between patients with schizophrenia and bipolar disorder, suggesting that both pathologies may be affected by similar environmental and neurodegenerative factors. However, the exclusive alteration in schizophrenia of metrics related to the geometry and curvature of the brain cortical surface (SA, GI) suggests that this group is influenced by additional neurodevelopmental and genetic factors.
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Affiliation(s)
- Mercè Madre
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain.
| | - Erick J Canales-Rodríguez
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - Paola Fuentes-Claramonte
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Silvia Alonso-Lana
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Pilar Salgado-Pineda
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | | | - Noemí Moro
- Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain
| | - Clara Bosque
- Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain
| | - Jesús J Gomar
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; The Litwin-Zucker Alzheimer's Research Center, NY, USA
| | - Jordi Ortíz-Gil
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Hospital General de Granollers, Granollers, Catalonia, Spain
| | - José M Goikolea
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Bipolar Disorder Program, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Caterina M Bonnin
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Bipolar Disorder Program, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Bipolar Disorder Program, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Teresa Maristany
- Diagnostic Imaging Department, Fundació de Recerca Hospital Sant Joan de Déu, Barcelona, Spain
| | - Peter J McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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10
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Delvecchio G, Ciappolino V, Perlini C, Barillari M, Ruggeri M, Altamura AC, Bellani M, Brambilla P. Cingulate abnormalities in bipolar disorder relate to gender and outcome: a region-based morphometry study [corrected]. Eur Arch Psychiatry Clin Neurosci 2019; 269:777-784. [PMID: 29594394 DOI: 10.1007/s00406-018-0887-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 03/16/2018] [Indexed: 12/22/2022]
Abstract
Structural magnetic resonance imaging (MRI) studies reported gray matter (GM) loss in bipolar disorder (BD) in cingulate cortices, key regions subserving emotional regulation and cognitive functions in humans. The aim of this study was to further explore cingulate GM volumes in a sizeable group of BD patients with respect to healthy controls, particularly investigating the impact of gender and clinical variables. 39 BD patients (mean Age = 48.6 ± 9.7, 15 males and 24 females) and 39 demographically matched healthy subjects (mean Age = 47.9 ± 9.1, 15 males and 24 females) underwent a 1.5T MRI scan. GM volumes within the cingulate cortex were manually detected, including anterior and posterior regions. BD patients had decreased left anterior cingulate volumes compared with healthy controls (F = 6.7, p = 0.01). Additionally, a significant gender effect was observed, with male patients showing reduced left anterior cingulate cortex (ACC) volumes compared to healthy controls (F = 5.1, p = 0.03). Furthermore, a significant inverse correlation between right ACC volumes and number of hospitalizations were found in the whole group of BD patients (r = - 0.51, p = 0.04) and in male BD patients (r = - 0.88, p = 0.04). Finally, no statistically significant correlations were observed in female BD patients. Our findings further confirm the putative role of the ACC in the pathophysiology of BD. Interestingly, this study also suggested the presence of gender-specific GM volume reductions in ACC in BD, which may also be associated to poor outcome.
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Affiliation(s)
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
| | - Cinzia Perlini
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy
| | - Marco Barillari
- Section of Radiology, Department of Neurological and Movement Sciences, University Hospital of Verona, Verona, Italy
| | - Mirella Ruggeri
- Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy.,Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - A Carlo Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy
| | - Marcella Bellani
- Interuniversity Centre for Behavioural Neurosciences, AOUI Verona, Verona, Italy.,Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, via F. Sforza 35, 20122, Milan, Italy. .,Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA.
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11
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Hirjak D, Kubera KM, Northoff G, Fritze S, Bertolino AL, Topor CE, Schmitgen MM, Wolf RC. Cortical Contributions to Distinct Symptom Dimensions of Catatonia. Schizophr Bull 2019; 45:1184-1194. [PMID: 30753720 PMCID: PMC6811823 DOI: 10.1093/schbul/sby192] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Catatonia is a central aspect of schizophrenia spectrum disorders (SSD) and most likely associated with abnormalities in affective, motor, and sensorimotor brain regions. However, contributions of different cortical features to the pathophysiology of catatonia in SSD are poorly understood. Here, T1-weighted structural magnetic resonance imaging data at 3 T were obtained from 56 right-handed patients with SSD. Using FreeSurfer version 6.0, we calculated cortical thickness, area, and local gyrification index (LGI). Catatonic symptoms were examined on the Northoff catatonia rating scale (NCRS). Patients with catatonia (NCRS total score ≥3; n = 25) showed reduced surface area in the parietal and medial orbitofrontal gyrus and LGI in the temporal gyrus (P < .05, corrected for cluster-wise probability [CWP]) as well as hypergyrification in rostral cingulate and medial orbitofrontal gyrus when compared with patients without catatonia (n = 22; P < .05, corrected for CWP). Following a dimensional approach, a negative association between NCRS motor and behavior scores and cortical thickness in superior frontal, insular, and precentral cortex was found (34 patients with at least 1 motor and at least 1 other affective or behavioral symptom; P < .05, corrected for CWP). Positive associations were found between NCRS motor and behavior scores and surface area and LGI in superior frontal, posterior cingulate, precentral, and pericalcarine gyrus (P < .05, corrected for CWP). The data support the notion that cortical features of distinct evolutionary and genetic origin differently contribute to catatonia in SSD. Catatonia in SSD may be essentially driven by cortex variations in frontoparietal regions including regions implicated in the coordination and goal-orientation of behavior.
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Affiliation(s)
- Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany,To whom correspondence should be addressed; tel: 49-621-1703-0, fax: 0049-621-1703-2305, e-mail:
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Stefan Fritze
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Alina L Bertolino
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Cristina E Topor
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
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12
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Wen Y, Zhang F, Ma X, Fan Q, Wang W, Xu J, Zhu F, Hao J, He A, Liu L, Liang X, Du Y, Li P, Wu C, Wang S, Wang X, Ning Y, Guo X. eQTLs Weighted Genetic Correlation Analysis Detected Brain Region Differences in Genetic Correlations for Complex Psychiatric Disorders. Schizophr Bull 2019; 45:709-715. [PMID: 29912442 PMCID: PMC6483588 DOI: 10.1093/schbul/sby080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Psychiatric disorders are usually caused by the dysfunction of various brain regions. Incorporating the genetic information of brain regions into correlation analysis can provide novel clues for pathogenetic and therapeutic studies of psychiatric disorders. METHODS The latest genome-wide association study (GWAS) summary data of schizophrenia (SCZ), bipolar disorder (BIP), autism spectrum disorder (AUT), major depression disorder (MDD), and attention-deficit/hyperactivity disorder (ADHD) were obtained from the Psychiatric GWAS Consortium (PGC). The expression quantitative trait loci (eQTLs) datasets of 10 brain regions were driven from the genotype-tissue expression (GTEx) database. The PGC GWAS summaries were first weighted by the GTEx eQTLs summaries for each brain region. Linkage disequilibrium score regression was applied to the weighted GWAS summary data to detect genetic correlation for each pair of 5 disorders. RESULTS Without considering brain region difference, significant genetic correlations were observed for BIP vs SCZ (P = 1.68 × 10-63), MDD vs SCZ (P = 5.08 × 10-45), ADHD vs MDD (P = 1.93 × 10-44), BIP vs MDD (P = 6.39 × 10-9), AUT vs SCZ (P = .0002), and ADHD vs SCZ (P = .0002). Utilizing brain region related eQTLs weighted LD score regression, different strengths of genetic correlations were observed within various brain regions for BIP vs SCZ, MDD vs SCZ, ADHD vs MDD, and SCZ vs ADHD. For example, the most significant genetic correlations were observed at anterior cingulate cortex (P = 1.13 × 10-34) for BIP vs SCZ. CONCLUSIONS This study provides new clues for elucidating the mechanism of genetic correlations among various psychiatric disorders.
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Affiliation(s)
- Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Xiancang Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P. R. China
| | - Qianrui Fan
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Wenyu Wang
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Jiawen Xu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Feng Zhu
- Center for Translational Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P. R. China
| | - Jingcan Hao
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Awen He
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Xiao Liang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Yanan Du
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Ping Li
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Cuiyan Wu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Sen Wang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Xi Wang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Yujie Ning
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
| | - Xiong Guo
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, P. R. China
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13
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Wang X, Tian F, Wang S, Cheng B, Qiu L, He M, Wang H, Duan M, Dai J, Jia Z. Gray matter bases of psychotic features in adult bipolar disorder: A systematic review and voxel-based meta-analysis of neuroimaging studies. Hum Brain Mapp 2018; 39:4707-4723. [PMID: 30096212 DOI: 10.1002/hbm.24316] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 07/05/2018] [Indexed: 02/05/2023] Open
Abstract
Psychotic bipolar disorder (P-BD) is a specific subset that presents greater risk of relapse and worse outcomes than nonpsychotic bipolar disorder (NP-BD). To explore the neuroanatomical bases of psychotic dimension in bipolar disorder (BD), a systematic review was carried out based on the gray matter volume (GMV) among P-BD and NP-BD patients and healthy controls (HC). Further, we conducted a meta-analysis of GMV differences between P-BD patients and HC using a whole-brain imaging approach. Our review revealed that P-BD patients exhibited smaller GMVs mainly in the prefronto-temporal and cingulate cortices, the precentral gyrus, and insula relative to HC both qualitatively and quantitatively. Qualitatively the comparison between P-BD and NP-BD patients suggested inconsistent GMV alterations mainly involving the prefrontal cortex, while NP-BD patients showed GMV deficits in local regions compared with HC. The higher proportions of female patients and patients taking psychotropic medication in P-BD and P-BD type I were associated with smaller GMV in the right precentral gyrus, and the right insula, respectively. In conclusions, psychosis in BD might be associated with specific cortical GMV deficits. Gender and psychotropic medication might have effects on the regional GMVs in P-BD patients. It is necessary to distinguish psychotic dimension in neuroimaging studies of BD.
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Affiliation(s)
- Xiuli Wang
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Fangfang Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Song Wang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Lihua Qiu
- Department of Radiology, The Second People's Hospital of Yibin, Yibin, China
| | - Manxi He
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Hongming Wang
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Mingjun Duan
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Jing Dai
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
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14
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Godwin D, Alpert KI, Wang L, Mamah D. Regional cortical thinning in young adults with schizophrenia but not psychotic or non-psychotic bipolar I disorder. Int J Bipolar Disord 2018; 6:16. [PMID: 29992455 PMCID: PMC6161965 DOI: 10.1186/s40345-018-0124-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/06/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Schizophrenia shares some genetic risk and clinical symptoms with bipolar disorder. Clinical heterogeneity across subjects is thought to contribute to variable structural imaging findings across studies. The current study investigates cortical thickness in young adults diagnosed with schizophrenia or bipolar I disorder with a history of hyperthymic mania. We hypothesize that cortical thickness will be most similar between SCZ and the psychotic bipolar 1 disorder subtype. METHODS Patients with schizophrenia (n = 52), psychotic bipolar I disorder (PBD; n = 49) and non-psychotic bipolar I disorder (NPBD; n = 24) and healthy controls (n = 40) were scanned in a 3T Trio MRI. The thickness of 34 cortical regions was estimated with FreeSurfer, and analyzed using univariate analyses of variance. Relationships to psychotic (SAPS) and negative (SANS) symptoms were investigated using linear regression. RESULTS Cortical thickness showed significant group effects, after covarying for sex, age, and intracranial volume (p = 0.001). SCZ subjects had thinner paracentral, inferior parietal, supramarginal and fusiform cortices compared to CON. Caudal anterior cingulate cortical thickness was increased in SCZ, PBD and NPBD. Cortical thickness in PBD and NPBD were not significantly different from controls. Significant partial correlations were observed for SAPS severity with middle temporal (r = - 0.26; p = 0.001) and fusiform (- 0.26; p = 0.001) cortical thickness. CONCLUSIONS Individuals with SCZ displayed significantly reduced cortical thickness in several cortical regions compared to both CON and bipolar. We found that SCZ participants had significant cortical thinning relative to CON and bipolar disorder most significantly in the frontal (i.e. paracentral), parietal (i.e. inferior parietal, supramarginal), and temporal (i.e. middle temporal, fusiform) cortices.
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Affiliation(s)
- Douglass Godwin
- Department of Psychiatry, Washington University Medical School, St. Louis, USA
| | - Kathryn I. Alpert
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, USA
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15
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Hibar DP, Westlye LT, Doan NT, Jahanshad N, Cheung JW, Ching CRK, Versace A, Bilderbeck AC, Uhlmann A, Mwangi B, Krämer B, Overs B, Hartberg CB, Abé C, Dima D, Grotegerd D, Sprooten E, Bøen E, Jimenez E, Howells FM, Delvecchio G, Temmingh H, Starke J, Almeida JRC, Goikolea JM, Houenou J, Beard LM, Rauer L, Abramovic L, Bonnin M, Ponteduro MF, Keil M, Rive MM, Yao N, Yalin N, Najt P, Rosa PG, Redlich R, Trost S, Hagenaars S, Fears SC, Alonso-Lana S, van Erp TGM, Nickson T, Chaim-Avancini TM, Meier TB, Elvsåshagen T, Haukvik UK, Lee WH, Schene AH, Lloyd AJ, Young AH, Nugent A, Dale AM, Pfennig A, McIntosh AM, Lafer B, Baune BT, Ekman CJ, Zarate CA, Bearden CE, Henry C, Simhandl C, McDonald C, Bourne C, Stein DJ, Wolf DH, Cannon DM, Glahn DC, Veltman DJ, Pomarol-Clotet E, Vieta E, Canales-Rodriguez EJ, Nery FG, Duran FLS, Busatto GF, Roberts G, Pearlson GD, Goodwin GM, Kugel H, Whalley HC, Ruhe HG, Soares JC, Fullerton JM, Rybakowski JK, Savitz J, Chaim KT, Fatjó-Vilas M, Soeiro-de-Souza MG, Boks MP, Zanetti MV, Otaduy MCG, Schaufelberger MS, Alda M, Ingvar M, Phillips ML, Kempton MJ, Bauer M, Landén M, Lawrence NS, van Haren NEM, Horn NR, Freimer NB, Gruber O, Schofield PR, Mitchell PB, Kahn RS, Lenroot R, Machado-Vieira R, Ophoff RA, Sarró S, Frangou S, Satterthwaite TD, Hajek T, Dannlowski U, Malt UF, Arolt V, Gattaz WF, Drevets WC, Caseras X, Agartz I, Thompson PM, Andreassen OA. Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group. Mol Psychiatry 2018; 23:932-942. [PMID: 28461699 PMCID: PMC5668195 DOI: 10.1038/mp.2017.73] [Citation(s) in RCA: 445] [Impact Index Per Article: 74.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 02/04/2017] [Accepted: 02/10/2017] [Indexed: 12/13/2022]
Abstract
Despite decades of research, the pathophysiology of bipolar disorder (BD) is still not well understood. Structural brain differences have been associated with BD, but results from neuroimaging studies have been inconsistent. To address this, we performed the largest study to date of cortical gray matter thickness and surface area measures from brain magnetic resonance imaging scans of 6503 individuals including 1837 unrelated adults with BD and 2582 unrelated healthy controls for group differences while also examining the effects of commonly prescribed medications, age of illness onset, history of psychosis, mood state, age and sex differences on cortical regions. In BD, cortical gray matter was thinner in frontal, temporal and parietal regions of both brain hemispheres. BD had the strongest effects on left pars opercularis (Cohen's d=-0.293; P=1.71 × 10-21), left fusiform gyrus (d=-0.288; P=8.25 × 10-21) and left rostral middle frontal cortex (d=-0.276; P=2.99 × 10-19). Longer duration of illness (after accounting for age at the time of scanning) was associated with reduced cortical thickness in frontal, medial parietal and occipital regions. We found that several commonly prescribed medications, including lithium, antiepileptic and antipsychotic treatment showed significant associations with cortical thickness and surface area, even after accounting for patients who received multiple medications. We found evidence of reduced cortical surface area associated with a history of psychosis but no associations with mood state at the time of scanning. Our analysis revealed previously undetected associations and provides an extensive analysis of potential confounding variables in neuroimaging studies of BD.
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Affiliation(s)
- D P Hibar
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA,Janssen Research & Development, San Diego, CA, USA
| | - L T Westlye
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,Department of Psychology, University of Oslo, Oslo, Norway
| | - N T Doan
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - N Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - J W Cheung
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - C R K Ching
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA,Neuroscience Interdepartmental Graduate Program, University of California, Los Angeles, Los Angeles, CA, USA
| | - A Versace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - A C Bilderbeck
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - A Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,MRC Unit on Anxiety and Stress Disorders, Groote Schuur Hospital (J-2), University of Cape Town, Cape Town, South Africa
| | - B Mwangi
- UT Center of Excellence on Mood Disorders, Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - B Krämer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - B Overs
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - C B Hartberg
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - C Abé
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden
| | - D Dima
- Department of Psychology, City University London, London, UK,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - D Grotegerd
- Department of Psychiatry, University of Münster, Münster, Germany
| | - E Sprooten
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E Bøen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - E Jimenez
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - F M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - G Delvecchio
- IRCCS "E. Medea" Scientific Institute, San Vito al Tagliamento, Italy
| | - H Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - J Starke
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - J R C Almeida
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - J M Goikolea
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - J Houenou
- INSERM U955 Team 15 ‘Translational Psychiatry’, University Paris East, APHP, CHU Mondor, Fondation FondaMental, Créteil, France,NeuroSpin, UNIACT Lab, Psychiatry Team, CEA Saclay, Gif Sur Yvette, France
| | - L M Beard
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - L Rauer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - L Abramovic
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Bonnin
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - M F Ponteduro
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - M Keil
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - M M Rive
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - N Yao
- Department of Psychiatry, Yale University, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - N Yalin
- Centre for Affective Disorders, King’s College London, London, UK
| | - P Najt
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - P G Rosa
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - R Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | - S Trost
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - S Hagenaars
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - S C Fears
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA,West Los Angeles Veterans Administration, Los Angeles, CA, USA
| | - S Alonso-Lana
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - T Nickson
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - T M Chaim-Avancini
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - T B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA,Laureate Institute for Brain Research, Tulsa, OK, USA
| | - T Elvsåshagen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - U K Haukvik
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Adult Psychiatry, University of Oslo, Oslo, Norway
| | - W H Lee
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A H Schene
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - A J Lloyd
- Academic Psychiatry and Northern Centre for Mood Disorders, Newcastle University/Northumberland Tyne & Wear NHS Foundation Trust, Newcastle, UK
| | - A H Young
- Centre for Affective Disorders, King’s College London, London, UK
| | - A Nugent
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - A M Dale
- MMIL, Department of Radiology, University of California San Diego, San Diego, CA, USA,Department of Cognitive Science, Neurosciences and Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - A Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - B Lafer
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - B T Baune
- Department of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - C J Ekman
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden
| | - C A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - C E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA,Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - C Henry
- INSERM U955 Team 15 ‘Translational Psychiatry’, University Paris East, APHP, CHU Mondor, Fondation FondaMental, Créteil, France,Institut Pasteur, Unité Perception et Mémoire, Paris, France
| | - C Simhandl
- Bipolar Center Wiener Neustadt, Wiener Neustadt, Austria
| | - C McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - C Bourne
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK,Department of Psychology & Counselling, Newman University, Birmingham, UK
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,MRC Unit on Anxiety and Stress Disorders, Groote Schuur Hospital (J-2), University of Cape Town, Cape Town, South Africa
| | - D H Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - D M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - D C Glahn
- Department of Psychiatry, Yale University, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - D J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - E Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - E Vieta
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - E J Canales-Rodriguez
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - F G Nery
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - F L S Duran
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - G F Busatto
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - G Roberts
- School of Psychiatry and Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - G D Pearlson
- Department of Psychiatry, Yale University, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - G M Goodwin
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - H Kugel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - H G Ruhe
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK,Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands,Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J C Soares
- UT Center of Excellence on Mood Disorders, Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J M Fullerton
- Neuroscience Research Australia, Sydney, NSW, Australia,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - J K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - J Savitz
- Laureate Institute for Brain Research, Tulsa, OK, USA,Faculty of Community Medicine, The University of Tulsa, Tulsa, OK, USA
| | - K T Chaim
- Department of Radiology, University of São Paulo, São Paulo, Brazil,LIM44-Laboratory of Magnetic Resonance in Neuroradiology, University of São Paulo, São Paulo, Brazil
| | - M Fatjó-Vilas
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - M G Soeiro-de-Souza
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - M P Boks
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M V Zanetti
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - M C G Otaduy
- Department of Radiology, University of São Paulo, São Paulo, Brazil,LIM44-Laboratory of Magnetic Resonance in Neuroradiology, University of São Paulo, São Paulo, Brazil
| | - M S Schaufelberger
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - M Ingvar
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden,Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - M L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - M J Kempton
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - M Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Landén
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden,Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the Gothenburg University, Goteborg, Sweden
| | - N S Lawrence
- Department of Psychology, University of Exeter, Exeter, UK
| | - N E M van Haren
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - N R Horn
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - N B Freimer
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - O Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - P R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - P B Mitchell
- School of Psychiatry and Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - R S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R Lenroot
- Neuroscience Research Australia, Sydney, NSW, Australia,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - R Machado-Vieira
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - R A Ophoff
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands,Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - S Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - S Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - T Hajek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,National Institute of Mental Health, Klecany, Czech Republic
| | - U Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - U F Malt
- Division of Clinical Neuroscience, Department of Research and Education, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - V Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - W F Gattaz
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - W C Drevets
- Janssen Research & Development, Titusville, NJ, USA
| | - X Caseras
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - I Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - P M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - O A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,NORMENT, KG Jebsen Centre for Psychosis Research—TOP Study, Oslo University Hospital, Ullevål, Building 49, Kirkeveien 166, PO Box 4956, Nydalen, 0424, Oslo, Norway. E-mail:
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Altamura AC, Delvecchio G, Marotta G, Oldani L, Pigoni A, Ciappolino V, Caletti E, Rovera C, Dobrea C, Arici C, Benatti B, Camuri G, Prunas C, Paoli RA, Dell'osso B, Cinnante C, Triulzi FM, Brambilla P. Structural and metabolic differentiation between bipolar disorder with psychosis and substance-induced psychosis: An integrated MRI/PET study. Eur Psychiatry 2016; 41:85-94. [PMID: 28049086 DOI: 10.1016/j.eurpsy.2016.09.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/20/2016] [Accepted: 09/24/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) may be characterized by the presence of psychotic symptoms and comorbid substance abuse. In this context, structural and metabolic dysfunctions have been reported in both BD with psychosis and addiction, separately. In this study, we aimed at identifying neural substrates differentiating psychotic BD, with or without substance abuse, versus substance-induced psychosis (SIP) by coupling, for the first time, magnetic resonance imaging (MRI) and positron emission tomography (PET). METHODS Twenty-seven BD type I psychotic patients with (n=10) or without (n=17) substance abuse, 16 SIP patients and 54 healthy controls were enrolled in this study. 3T MRI and 18-FDG-PET scanning were acquired. RESULTS Gray matter (GM) volume and cerebral metabolism reductions in temporal cortices were observed in all patients compared to healthy controls. Moreover, a distinct pattern of fronto-limbic alterations were found in patients with substance abuse. Specifically, BD patients with substance abuse showed volume reductions in ventrolateral prefrontal cortex, anterior cingulate, insula and thalamus, whereas SIP patients in dorsolateral prefrontal cortex and posterior cingulate. Common alterations in cerebellum, parahippocampus and posterior cingulate were found in both BD with substance abuse and SIP. Finally, a unique pattern of GM volumes reduction, with concomitant increased of striatal metabolism, were observed in SIP patients. CONCLUSIONS These findings contribute to shed light on the identification of common and distinct neural markers associated with bipolar psychosis and substance abuse. Future longitudinal studies should explore the effect of single substances of abuse in patients at the first-episode of BD and substance-induced psychosis.
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Affiliation(s)
- A C Altamura
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - G Delvecchio
- Scientific Institute IRCCS "E. Medea", San Vito al Tagliamento (PN), Italy
| | - G Marotta
- Department of Services, Neuroradiology Unit, Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - L Oldani
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - A Pigoni
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - V Ciappolino
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - E Caletti
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - C Rovera
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - C Dobrea
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - C Arici
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - B Benatti
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - G Camuri
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - C Prunas
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - R A Paoli
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - B Dell'osso
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry, Bipolar Disorders Clinic, Stanford University, CA, USA
| | - C Cinnante
- Department of Services, Neuroradiology Unit, Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F M Triulzi
- Department of Services, Neuroradiology Unit, Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Brambilla
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA.
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18
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Makovac E, Serra L, Spanò B, Giulietti G, Torso M, Cercignani M, Caltagirone C, Bozzali M. Different Patterns of Correlation between Grey and White Matter Integrity Account for Behavioral and Psychological Symptoms in Alzheimer's Disease. J Alzheimers Dis 2016; 50:591-604. [PMID: 26836635 DOI: 10.3233/jad-150612] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Behavioral disorders and psychological symptoms (BPSD) in Alzheimer's disease (AD) are known to correlate with grey matter (GM) atrophy and, as shown recently, also with white matter (WM) damage. WM damage and its relationship with GM atrophy are reported in AD, reinforcing the interpretation of the AD pathology in light of a disconnection syndrome. It remains uncertain whether this disconnection might account also for different BPSD observable in AD. Here, we tested the hypothesis of different patterns of association between WM damage of the corpus callosum (CC) and GM atrophy in AD patients exhibiting one of the following BPSD clusters: Mood (i.e., anxiety and depression; ADmood), Frontal (i.e., dishinibition and elation; ADfrontal), and Psychotic (delusions and hallucinations; ADpsychotic) related symptoms, as well as AD patients without BPSD. Overall, this study brings to light the strict relationship between WM alterations in different parts of the CC and GM atrophy in AD patients exhibiting BPSD, supporting the hypothesis that such symptoms are likely to be caused by characteristic patterns of neurodegeneration of WM and GM, rather than being a reactive response to accumulation of cognitive disabilities, and should therefore be regarded as potential markers of diagnostic and prognostic value in AD.
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Affiliation(s)
- Elena Makovac
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Laura Serra
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Barbara Spanò
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Mario Torso
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Mara Cercignani
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.,Brighton and Sussex Medical School, Clinical Imaging Sciences Centre, University of Sussex, Brighton, Falmer, UK
| | - Carlo Caltagirone
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Neuroscience, University of Rome 'Tor Vergata', Rome, Italy
| | - Marco Bozzali
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
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19
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Abstract
Bipolar disorder is associated with subtle neuroanatomical deficits including lateral
ventricular enlargement, grey matter deficits incorporating limbic system structures, and distributed
white matter pathophysiology. Substantial heterogeneity has been identified by structural neuroimaging
studies to date and differential psychotropic medication use is potentially a substantial contributor to
this. This selective review of structural neuroimaging and diffusion tensor imaging studies considers
evidence that lithium, mood stabilisers, antipsychotic medication and antidepressant medications are
associated with neuroanatomical variation. Most studies are negative and suffer from methodological
weaknesses in terms of directly assessing medication effects on neuroanatomy, since they commonly
comprise posthoc assessments of medication associations with neuroimaging metrics in small heterogenous patient
groups. However the studies which report positive findings tend to form a relatively consistent picture whereby lithium
and antiepileptic mood stabiliser use is associated with increased regional grey matter volume, especially in limbic
structures. These findings are further supported by the more methodologically robust studies which include large numbers of
patients or repeated intra-individual scanning in longitudinal designs. Some similar findings of an apparently ameliorative
effect of lithium on white matter microstructure are also emerging. There is less support for an effect of antipsychotic or
antidepressant medication on brain structure in bipolar disorder, but these studies are further limited by methodological
difficulties. In general the literature to date supports a normalising effect of lithium and mood stabilisers on brain structure
in bipolar disorder, which is consistent with the neuroprotective characteristics of these medications identified by
preclinical studies.
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Affiliation(s)
- Colm McDonald
- National University of Ireland Galway, Galway, Ireland.
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20
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Bootsman F, Brouwer RM, Schnack HG, Kemner SM, Hillegers MHJ, Sarkisyan G, van der Schot AC, Vonk R, Hulshoff Pol HE, Nolen WA, Kahn RS, van Haren NEM. A study of genetic and environmental contributions to structural brain changes over time in twins concordant and discordant for bipolar disorder. J Psychiatr Res 2016; 79:116-124. [PMID: 27218817 DOI: 10.1016/j.jpsychires.2016.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 04/13/2016] [Accepted: 04/29/2016] [Indexed: 01/02/2023]
Abstract
This is the first longitudinal twin study examining genetic and environmental contributions to the association between liability to bipolar disorder (BD) and changes over time in global brain volumes, and global and regional measures of cortical surface area, cortical thickness and cortical volume. A total of 50 twins from pairs discordant or concordant for BD (monozygotic: 8 discordant and 3 concordant pairs, and 1 patient and 3 co-twins from incomplete pairs; dizygotic: 6 discordant and 2 concordant pairs, and 1 patient and 7 co-twins from incomplete pairs) underwent magnetic resonance imaging twice. In addition, 57 twins from healthy twin pairs (15 monozygotic and 10 dizygotic pairs, and 4 monozygotic and 3 dizygotic subjects from incomplete pairs) were also scanned twice. Mean follow-up duration for all twins was 7.5 years (standard deviation: 1.5 years). Data were analyzed using structural equation modeling software OpenMx. The liability to BD was not associated with global or regional structural brain changes over time. Although we observed a subtle increase in cerebral white matter in BD patients, this effect disappeared after correction for multiple comparisons. Heritability of brain changes over time was generally low to moderate. Structural brain changes appear to follow similar trajectories in BD patients and healthy controls. Existing brain abnormalities in BD do not appear to progressively change over time, but this requires additional confirmation. Further study with large cohorts is recommended to assess genetic and environmental influences on structural brain abnormalities in BD, while taking into account the influence of lithium on the brain.
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Affiliation(s)
- F Bootsman
- University Medical Center Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands.
| | - R M Brouwer
- University Medical Center Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - H G Schnack
- University Medical Center Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - S M Kemner
- University Medical Center Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - M H J Hillegers
- University Medical Center Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - G Sarkisyan
- University Medical Center Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | | | - R Vonk
- Reinier van Arkel, 's-Hertogenbosch, The Netherlands
| | - H E Hulshoff Pol
- University Medical Center Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - W A Nolen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - R S Kahn
- University Medical Center Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - N E M van Haren
- University Medical Center Utrecht Brain Center Rudolf Magnus, Utrecht, The Netherlands
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21
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Liberg B, Rahm C, Panayiotou A, Pantelis C. Brain change trajectories that differentiate the major psychoses. Eur J Clin Invest 2016; 46:658-74. [PMID: 27208657 DOI: 10.1111/eci.12641] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 05/18/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Bipolar disorder and schizophrenia are highly heritable, often chronic and debilitating psychotic disorders that can be difficult to differentiate clinically. Their brain phenotypes appear to overlap in both cross-sectional and longitudinal structural neuroimaging studies, with some evidence to suggest areas of differentiation with differing trajectories. The aim of this review was to investigate the notion that longitudinal trajectories of alterations in brain structure could differentiate the two disorders. DESIGN Narrative review. We searched MEDLINE and Web of Science databases in May 2016 for studies that used structural magnetic resonance imaging to investigate longitudinal between-group differences in bipolar disorder and schizophrenia. Ten studies met inclusion criteria, namely longitudinal structural magnetic resonance studies comparing bipolar disorder (or affective psychosis) and schizophrenia within the same study. RESULTS Our review of these studies implicates illness-specific trajectories of morphological change in total grey matter volume, and in regions of the frontal, temporal and cingulate cortices. The findings in schizophrenia suggest a trajectory involving progressive grey matter loss confined to fronto-temporal cortical regions. Preliminary findings identify a similar but less severely impacted trajectory in a number of regions in bipolar disorder, however, bipolar disorder is also characterized by differential involvement across cingulate subregions. CONCLUSION The small number of available studies must be interpreted with caution but provide initial evidence supporting the notion that bipolar disorder and schizophrenia have differential longitudinal trajectories that are influenced by brain maturation.
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Affiliation(s)
- Benny Liberg
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Vic., Australia.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Christoffer Rahm
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Vic., Australia.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Anita Panayiotou
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Vic., Australia.,Western Centre for Health Research & Education, Sunshine Hospital, University of Melbourne, St Albans, Vic., Australia.,Sunshine Hospital, Western Health, St Albans, Vic., Australia
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Vic., Australia.,Western Centre for Health Research & Education, Sunshine Hospital, University of Melbourne, St Albans, Vic., Australia.,Florey Institute for Neuroscience and Mental Health, Parkville, Vic., Australia.,Department of Electrical and Electronic Engineering, Centre for Neural Engineering, University of Melbourne, Parkville, Vic., Australia
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22
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Buoli M, Caldiroli A, Cumerlato Melter C, Serati M, de Nijs J, Altamura AC. Biological aspects and candidate biomarkers for psychotic bipolar disorder: A systematic review. Psychiatry Clin Neurosci 2016; 70:227-44. [PMID: 26969211 DOI: 10.1111/pcn.12386] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/24/2016] [Accepted: 03/06/2016] [Indexed: 12/23/2022]
Abstract
AIM We carried out a systematic review of the available literature about potential biomarkers of psychotic bipolar disorder (BD-P), a specific subset presenting worse outcome and greater risk of relapse than non-psychotic bipolar disorder (BD-NP). METHODS We searched the main psychiatric databases (PubMed, ISI Web of Knowledge, PsychInfo). Only original articles with the main topic of BD-P compared to schizophrenia/BD-NP/healthy controls (HC) written in English from 1994 to 2015 were included. RESULTS BD-P patients presented higher kynurenic acid levels in the cerebrospinal fluid, elevated anti- S accharomyces cerevisiae antibodies levels, and lower serum levels of dehydroepiandrosterone sulfate and progesterone than BD-NP/HC. Event-related potentials abnormalities have been identified in BD-P with respect to BD-NP. BD-P patients also presented bigger ventricles but similar hippocampal volumes compared to BD-NP/HC. Although the results are contrasting, some cognitive deficits seemed to be related to the psychotic dimension of bipolar affective disorder, such as impairment in verbal/logical memory, working memory, verbal and semantic fluency and executive functioning. Finally, polymorphisms of genes, such as NRG1, 5HTTLPR (s), COMT, DAOA and some chromosome regions (16p12 and 13q), were positively associated with BD-P. CONCLUSION Data about the identification of specific biomarkers for BD-P are promising, but most of them have not yet been replicated. They could lead the clinicians to an early diagnosis and proper treatment, thus ameliorating outcome of BD-P and reducing the biological changes associated with a long duration of illness. Further studies with bigger samples are needed to detect more specific biological markers of the psychotic dimension of bipolar affective disorder.
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Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Psychiatry, University Medical Center Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - Alice Caldiroli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Cumerlato Melter
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Jessica de Nijs
- Department of Psychiatry, University Medical Center Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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23
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Knöchel C, Reuter J, Reinke B, Stäblein M, Marbach K, Feddern R, Kuhlmann K, Alves G, Prvulovic D, Wenzler S, Linden DEJ, Oertel-Knöchel V. Cortical thinning in bipolar disorder and schizophrenia. Schizophr Res 2016; 172:78-85. [PMID: 26876312 DOI: 10.1016/j.schres.2016.02.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 02/02/2016] [Accepted: 02/03/2016] [Indexed: 01/08/2023]
Abstract
Although schizophrenia (SZ) and bipolar disorder (BD) share some clinical features such as psychotic symptoms and cognitive dysfunctions, little is known about possible pathophysiological similarities between both diseases. Therefore, we investigated the potential topographical overlap and segregation of cortical thickness abnormalities in SZ and BD patients. We analyzed 3D-anatomical magnetic resonance imaging datasets with the FreeSurfer 5.1.0 software to examine cortical thickness and volumes in three groups of participants: n=34 BD patients, n=32 SZ patients and n=38 healthy controls. We observed similar bilateral cortical thickness reductions in BD and SZ patients predominantly in the pars opercularis of the inferior frontal gyrus and in the anterior and posterior cingulate. We also found disease-specific cortical reductions in the orbitofrontal cortex for BD patients and in dorsal frontal and temporal areas for SZ. Furthermore, inferior frontal gyrus cortical thinning was associated with deficits in psychomotor speed and executive functioning in SZ patients and with age at onset in both groups. Our findings support the hypothesis that thinning of the frontal cortex may represent a biological feature shared by both disease groups. The associations between cognitive deficits and the reported findings in SZ and to a lesser degree in BD patients add to the functional relevance of our results. However, further studies are needed to corroborate a model of shared pathophysiological disease features across BD and SZ.
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Affiliation(s)
- Christian Knöchel
- Laboratory for Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt/Main, Germany.
| | - Johanna Reuter
- Laboratory for Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt/Main, Germany
| | - Britta Reinke
- Laboratory for Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt/Main, Germany; Brain Imaging Center (BIC), Goethe-University, Frankfurt/Main, Germany
| | - Michael Stäblein
- Laboratory for Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt/Main, Germany; Brain Imaging Center (BIC), Goethe-University, Frankfurt/Main, Germany
| | - Katharina Marbach
- Laboratory for Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt/Main, Germany
| | - Richard Feddern
- Laboratory for Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt/Main, Germany; Brain Imaging Center (BIC), Goethe-University, Frankfurt/Main, Germany
| | - Kristina Kuhlmann
- Laboratory for Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt/Main, Germany
| | - Gilberto Alves
- Center for Alzheimer's Disease and Related Disorders, Universidade Federal do Rio de Janeiro, Brazil
| | - David Prvulovic
- Laboratory for Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt/Main, Germany
| | - Sofia Wenzler
- Laboratory for Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt/Main, Germany
| | - David E J Linden
- MRC Centre for Neuropsychiatric Genetics & Genomics, Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, United Kingdom
| | - Viola Oertel-Knöchel
- Laboratory for Neuroimaging, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt/Main, Germany; Brain Imaging Center (BIC), Goethe-University, Frankfurt/Main, Germany
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24
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Hanford LC, Nazarov A, Hall GB, Sassi RB. Cortical thickness in bipolar disorder: a systematic review. Bipolar Disord 2016; 18:4-18. [PMID: 26851067 DOI: 10.1111/bdi.12362] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 10/19/2015] [Accepted: 11/16/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Bipolar disorder (BD) is a debilitating illness, the psychopathology of which is associated with aberrant structural and functional differences in the brain. Despite the many advances in psychiatric research, our understanding of the complex neurobiological underpinnings of BD remains incomplete. The aim of this review was to critically examine all available published magnetic resonance imaging (MRI) research reporting cortical thickness in BD with respect to a healthy population and/or other psychiatric samples. METHODS The systematic search encompassed all relevant studies published until November 2014. Relevant papers were identified through an online search of select databases (MEDLINE and EMBASE) using key terms bipolar disorder or mania, and cortical thickness. Two independent raters determined the eligibility of papers and performed separate data extraction to ensure quality and accuracy of reporting. RESULTS A total of 17 papers met the criteria and were included in this review. Compared to a healthy population, the majority of studies reported decreased cortical thickness in the left anterior cingulate/paracingulate and the left superior temporal gyrus, as well as several prefrontal regions bilaterally in patients with BD. Studies also show consistency of cortical thinning in individuals with BD and schizophrenia in frontal and temporal regions, suggesting some common neuropathology. CONCLUSIONS This systematic review further supports a link between specific structural brain abnormalities and BD. Future studies should investigate cortical thickness with respect to at-risk populations to determine whether these neuropathologies develop before or after the onset of BD.
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Affiliation(s)
- Lindsay C Hanford
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Anthony Nazarov
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Geoffrey B Hall
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Roberto B Sassi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Mood Disorders Outpatient Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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25
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Savitz J, Morris HM, Drevets WC. Neuroimaging Studies of Bipolar Depression: Therapeutic Implications. BIPOLAR DEPRESSION: MOLECULAR NEUROBIOLOGY, CLINICAL DIAGNOSIS, AND PHARMACOTHERAPY 2016. [DOI: 10.1007/978-3-319-31689-5_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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26
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Peeters SCT, Gronenschild EHBM, van de Ven V, Habets P, Goebel R, van Os J, Marcelis M. Altered mesocorticolimbic functional connectivity in psychotic disorder: an analysis of proxy genetic and environmental effects. Psychol Med 2015; 45:2157-2169. [PMID: 25804977 DOI: 10.1017/s0033291715000161] [Citation(s) in RCA: 6] [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] [Indexed: 12/27/2022]
Abstract
BACKGROUND Altered dopaminergic neurotransmission in the mesocorticolimbic (MCL) system may mediate psychotic symptoms. In addition, pharmacological dopaminergic manipulation may coincide with altered functional connectivity (fc) 'in rest'. We set out to test whether MCL-fc is conditional on (familial risk for) psychotic disorder and/or interactions with environmental exposures. METHOD Resting-state functional magnetic resonance imaging data were obtained from 63 patients with psychotic disorder, 73 non-psychotic siblings of patients with psychotic disorder and 59 healthy controls. With the nucleus accumbens (NAcc) as seed region, fc within the MCL system was estimated. Regression analyses adjusting for a priori hypothesized confounders were used to assess group differences in MCL connectivity as well as gene (group) × environmental exposure interactions (G × E) (i.e., to cannabis, developmental trauma and urbanicity). RESULTS Compared with controls, patients and siblings had decreased fc between the right NAcc seed and the right orbitofrontal cortex (OFC) as well as the left middle cingulate cortex (MCC). Siblings showed decreased connectivity between the NAcc seed and lentiform nucleus compared with patients and controls. In addition, patients had decreased left NAcc connectivity compared with siblings in the left middle frontal gyrus. There was no evidence for a significant interaction between group and the three environmental exposures in the model of MCL-fc. CONCLUSIONS Reduced NAcc-OFC/MCC connectivity was seen in patients and siblings, suggesting that altered OFC connectivity and MCC connectivity are vulnerability markers for psychotic disorder. Differential exposure to environmental risk factors did not make an impact on the association between familial risk and MCL connectivity.
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Affiliation(s)
- S C T Peeters
- Department of Psychiatry and Psychology,South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University,Maastricht,the Netherlands
| | - E H B M Gronenschild
- Department of Psychiatry and Psychology,South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University,Maastricht,the Netherlands
| | - V van de Ven
- Department of Cognitive Neuroscience,Maastricht University,Maastricht,the Netherlands
| | - P Habets
- Department of Psychiatry and Psychology,South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University,Maastricht,the Netherlands
| | - R Goebel
- Department of Cognitive Neuroscience,Maastricht University,Maastricht,the Netherlands
| | - J van Os
- Department of Psychiatry and Psychology,South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University,Maastricht,the Netherlands
| | - M Marcelis
- Department of Psychiatry and Psychology,South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University,Maastricht,the Netherlands
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27
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Jørgensen KN, Psychol C, Skjærvø I, Mørch-Johnsen L, Haukvik UK, Lange EH, Melle I, Andreassen OA, Agartz I. Cigarette smoking is associated with thinner cingulate and insular cortices in patients with severe mental illness. J Psychiatry Neurosci 2015; 40:241-9. [PMID: 25672482 PMCID: PMC4478057 DOI: 10.1503/jpn.140163] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 10/07/2014] [Accepted: 11/28/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI) studies show reduced cortical thickness in patients with schizophrenia and bipolar disorder. These subtle brain abnormalities may provide insight into illness mechanisms. However, environmental and lifestyle-related factors, such as cigarette smoking, may contribute to brain structure changes. Cigarette smoking is highly prevalent in patients with severe mental illness. In nonpsychiatric samples, smoking has been associated with reduced thickness in the anterior (ACC) and posterior cingulate cortices, the insular cortex (INS), the dorsolateral prefrontal cortex and the orbitofrontal cortex. METHODS We examined MRI scans from patients with schizophrenia, other psychotic disorders or bipolar disorder and healthy controls using FreeSurfer. RESULTS We included 506 patients (49% smokers) and 237 controls (20% smokers) in our study. We found reduced cortical thickness in the left rostral ACC and the left INS in smoking patients compared with nonsmoking patients, but this difference was not found among healthy controls. No dose-response relationship was found between amount of smoking and cortical thickness in these regions. Among patients, maps of thickness along the whole cortical surface revealed reduced insular thickness but no effects in other regions. Among healthy controls, similar analyses revealed increased age-related cortical thinning in the left occipital lobe among smokers compared with nonsmokers. LIMITATIONS The causal direction could not be determined owing to the cross-sectional design and lack of detailed data on smoking addiction and smoking history. CONCLUSION The effect of cigarette smoking should be considered in MRI studies of patients with severe mental illness.
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Affiliation(s)
- Kjetil Nordbø Jørgensen
- Department of Psychiatric Research, Diakonhjemmet Hospital, (Jørgensen, Skjærvø, Mørch-Johnsen, Haukvik, Lange, Agartz); NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo (Jørgensen, Mørch-Johnsen, Haukvik, Lange, Melle, Andreassen, Agartz); the Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo (Skjærvø); and the Division of Mental Health and Addiction, Oslo University Hospital (Melle, Andreassen), Oslo, Norway
| | | | | | - Lynn Mørch-Johnsen
- Department of Psychiatric Research, Diakonhjemmet Hospital, (Jørgensen, Skjærvø, Mørch-Johnsen, Haukvik, Lange, Agartz); NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo (Jørgensen, Mørch-Johnsen, Haukvik, Lange, Melle, Andreassen, Agartz); the Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo (Skjærvø); and the Division of Mental Health and Addiction, Oslo University Hospital (Melle, Andreassen), Oslo, Norway
| | - Unn Kristin Haukvik
- Department of Psychiatric Research, Diakonhjemmet Hospital, (Jørgensen, Skjærvø, Mørch-Johnsen, Haukvik, Lange, Agartz); NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo (Jørgensen, Mørch-Johnsen, Haukvik, Lange, Melle, Andreassen, Agartz); the Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo (Skjærvø); and the Division of Mental Health and Addiction, Oslo University Hospital (Melle, Andreassen), Oslo, Norway
| | - Elisabeth Heffermehl Lange
- Department of Psychiatric Research, Diakonhjemmet Hospital, (Jørgensen, Skjærvø, Mørch-Johnsen, Haukvik, Lange, Agartz); NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo (Jørgensen, Mørch-Johnsen, Haukvik, Lange, Melle, Andreassen, Agartz); the Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo (Skjærvø); and the Division of Mental Health and Addiction, Oslo University Hospital (Melle, Andreassen), Oslo, Norway
| | - Ingrid Melle
- Department of Psychiatric Research, Diakonhjemmet Hospital, (Jørgensen, Skjærvø, Mørch-Johnsen, Haukvik, Lange, Agartz); NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo (Jørgensen, Mørch-Johnsen, Haukvik, Lange, Melle, Andreassen, Agartz); the Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo (Skjærvø); and the Division of Mental Health and Addiction, Oslo University Hospital (Melle, Andreassen), Oslo, Norway
| | - Ole Andreas Andreassen
- Department of Psychiatric Research, Diakonhjemmet Hospital, (Jørgensen, Skjærvø, Mørch-Johnsen, Haukvik, Lange, Agartz); NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo (Jørgensen, Mørch-Johnsen, Haukvik, Lange, Melle, Andreassen, Agartz); the Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo (Skjærvø); and the Division of Mental Health and Addiction, Oslo University Hospital (Melle, Andreassen), Oslo, Norway
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, (Jørgensen, Skjærvø, Mørch-Johnsen, Haukvik, Lange, Agartz); NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo (Jørgensen, Mørch-Johnsen, Haukvik, Lange, Melle, Andreassen, Agartz); the Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo (Skjærvø); and the Division of Mental Health and Addiction, Oslo University Hospital (Melle, Andreassen), Oslo, Norway
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28
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Functional organization of human subgenual cortical areas: Relationship between architectonical segregation and connectional heterogeneity. Neuroimage 2015; 115:177-90. [PMID: 25937490 DOI: 10.1016/j.neuroimage.2015.04.053] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 04/24/2015] [Accepted: 04/27/2015] [Indexed: 01/02/2023] Open
Abstract
Human subgenual anterior cingulate cortex (sACC) is involved in affective experiences and fear processing. Functional neuroimaging studies view it as a homogeneous cortical entity. However, sACC comprises several distinct cyto- and receptorarchitectonical areas: 25, s24, s32, and the ventral portion of area 33. Thus, we hypothesized that the areas may also be connectionally and functionally distinct. We performed structural post mortem and functional in vivo analyses. We computed probabilistic maps of each area based on cytoarchitectonical analysis of ten post mortem brains. Maps, publicly available via the JuBrain atlas and the Anatomy Toolbox, were used to define seed regions of task-dependent functional connectivity profiles and quantitative functional decoding. sACC areas presented distinct co-activation patterns within widespread networks encompassing cortical and subcortical regions. They shared common functional domains related to emotion, perception and cognition. A more specific analysis of these domains revealed an association of s24 with sadness, and of s32 with fear processing. Both areas were activated during taste evaluation, and co-activated with the amygdala, a key node of the affective network. s32 co-activated with areas of the executive control network, and was associated with tasks probing cognition in which stimuli did not have an emotional component. Area 33 was activated by painful stimuli, and co-activated with areas of the sensorimotor network. These results support the concept of a connectional and functional specificity of the cyto- and receptorarchitectonically defined areas within the sACC, which can no longer be seen as a structurally and functionally homogeneous brain region.
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Oertel-Knöchel V, Reuter J, Reinke B, Marbach K, Feddern R, Alves G, Prvulovic D, Linden DEJ, Knöchel C. Association between age of disease-onset, cognitive performance and cortical thickness in bipolar disorders. J Affect Disord 2015; 174:627-35. [PMID: 25577157 DOI: 10.1016/j.jad.2014.10.060] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 10/29/2014] [Accepted: 10/31/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Neuroimaging studies in patients with bipolar disorder (BD) have indicated a number of structural brain changes, including reduced cortical thickness. However, the effects of the course of illness, clinical and cognitive variables on cortical thickness in BD patients have not yet been evaluated. METHODS A total of 67 individuals (32 patients with euthymic BD and 35 healthy and age-matched controls) underwent 3D-anatomical magnetic resonance imaging (MRI). Whole-brain cortical thickness and group differences were assessed using the Freesurfer software. Course of disease variables, clinical and cognitive parameters were correlated with cortical thickness measures. RESULTS We found reduced cortical thickness in BD patients compared with controls in the frontal and temporal lobes and in several limbic areas. We also report significant associations between cortical thickness and age of disease-onset, speed of cognitive processing, executive function and depression severity in BD patients. CONCLUSIONS Cortical thickness reduction across frontal and limbic areas is a structural correlate of affective symptom severity and cognitive impairments in BD as well of age of disease-onset. We may assume that frontal lobe structural abnormalities are present in bipolar disorder, and might lead to dysfunctional cognitive functioning. The causality and functional relevance beyond mere correlation, however, is yet to be established. Our findings encourage further longitudinal studies in BD patients and in healthy at-risk subjects in order to discern the temporal order and development of morphological changes and clinical symptoms.
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Affiliation(s)
- Viola Oertel-Knöchel
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany.
| | - Johanna Reuter
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Britta Reinke
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany; Brain Imaging Center (BIC), Goethe-University, Frankfurt/Main, Germany
| | - Katharina Marbach
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Richard Feddern
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Gilberto Alves
- Center for Alzheimer׳s Disease and Related Disorders, Universidade Federal do Rio de Janeiro, Brazil
| | - David Prvulovic
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - David E J Linden
- School of Psychology, Cardiff University, United Kingdom; MRC Centre for Neuropsychiatric Genetics & Genomics, Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, United Kingdom
| | - Christian Knöchel
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
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30
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Brennan AM, Hainsworth C, Starling J, Korgaonkar MS, Harris AWF, Williams LM. Emotion circuits differentiate symptoms of psychosis versus mania in adolescents. Neurocase 2015; 21:592-600. [PMID: 25265277 DOI: 10.1080/13554794.2014.960426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The diagnostic boundary between schizophrenia and bipolar disorder can be unclear, particularly with early onset. We assessed if emotion brain circuits differentiate psychosis versus mania symptoms in a series of six early onset patients. Symptoms were dissociated by direction, awareness condition, and brain regions. Greater psychosis symptoms were correlated with greater prefrontal, anterior cingulate, amygdala, and fusiform face area activation during masked fear processing. By contrast, greater mania symptoms were correlated with less amygdala activation during unmasked fear and happy processing. This suggests emotion dysfunction in schizophrenia versus bipolar disorder may arise from partially distinct neural mechanisms of susceptibility.
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Affiliation(s)
- Annie M Brennan
- a Brain Dynamics Centre, Sydney Medical School and Westmead Millennium Institute , University of Sydney at Westmead , Sydney , NSW , Australia
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31
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Bootsman F, Brouwer RM, Schnack HG, van Baal GCM, van der Schot AC, Vonk R, Hulshoff Pol HE, Nolen WA, Kahn RS, van Haren NEM. Genetic and environmental influences on cortical surface area and cortical thickness in bipolar disorder. Psychol Med 2015; 45:193-204. [PMID: 25065711 DOI: 10.1017/s0033291714001251] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The risk of developing bipolar disorder (BD) has been linked to structural brain abnormalities. The degree to which genes and environment influence the association of BD with cortical surface area remains to be elucidated. In this twin study, genetic and environmental contributions to the association between liability to develop BD and surface area, thickness and volume of the cortex were examined. METHOD The study cohort included 44 affected monozygotic (nine concordant, 12 discordant) and dizygotic (four concordant, 19 discordant) twin pairs, and seven twins from incomplete discordant monozygotic and dizygotic discordant twin pairs. In addition, 37 monozygotic and 24 dizygotic healthy control twin pairs, and six twins from incomplete monozygotic and dizygotic control pairs were included. RESULTS Genetic liability to develop BD was associated with a larger cortical surface in limbic and parietal regions, and a thicker cortex in central and parietal regions. Environmental factors related to BD were associated with larger medial frontal, parietal and limbic, and smaller orbitofrontal surfaces. Furthermore, thinner frontal, limbic and occipital cortex, and larger frontal and parietal, and smaller orbitofrontal volumes were also associated with environmental factors related to BD. CONCLUSIONS Our results suggest that unique environmental factors play a prominent role in driving the associations between liability to develop BD and cortical measures, particularly those involving cortical thickness. Further evaluation of their influence on the surface and thickness of the cortical mantle is recommended. In addition, cortical volume appeared to be primarily dependent on surface and not thickness.
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Affiliation(s)
- F Bootsman
- Brain Center Rudolf Magnus, University Medical Center Utrecht,Utrecht,The Netherlands
| | - R M Brouwer
- Brain Center Rudolf Magnus, University Medical Center Utrecht,Utrecht,The Netherlands
| | - H G Schnack
- Brain Center Rudolf Magnus, University Medical Center Utrecht,Utrecht,The Netherlands
| | - G C M van Baal
- Julius Center, University Medical Center Utrecht,Utrecht,The Netherlands
| | - A C van der Schot
- Brain Center Rudolf Magnus, University Medical Center Utrecht,Utrecht,The Netherlands
| | - R Vonk
- Reinier van Arkel Group, 's-Hertogenbosch,The Netherlands
| | - H E Hulshoff Pol
- Brain Center Rudolf Magnus, University Medical Center Utrecht,Utrecht,The Netherlands
| | - W A Nolen
- Department of Psychiatry,University Medical Center Groningen,Groningen,The Netherlands
| | - R S Kahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht,Utrecht,The Netherlands
| | - N E M van Haren
- Brain Center Rudolf Magnus, University Medical Center Utrecht,Utrecht,The Netherlands
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Nanda P, Tandon N, Mathew IT, Giakoumatos CI, Abhishekh HA, Clementz B, Pearlson G, Sweeney J, Tamminga C, Keshavan MS. Local gyrification index in probands with psychotic disorders and their first-degree relatives. Biol Psychiatry 2014; 76:447-55. [PMID: 24369266 PMCID: PMC4032376 DOI: 10.1016/j.biopsych.2013.11.018] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 11/12/2013] [Accepted: 11/14/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Psychotic disorders are characterized by aberrant neural connectivity. Alterations in gyrification, the pattern and degree of cortical folding, may be related to the early development of connectivity. Past gyrification studies have relatively small sample sizes, yield mixed results for schizophrenia, and are scant for psychotic bipolar and schizoaffective (SZA) disorders and for relatives of these conditions. Here, we examine gyrification in psychotic disorder patients and their first-degree relatives as a possible endophenotype. METHODS Regional local gyrification index (LGI) values, as measured by FreeSurfer software, were compared between 243 control subjects, 388 psychotic disorder probands, and 300 of their first-degree relatives. For patients, LGI values were examined grouped across psychotic diagnoses and then separately for schizophrenia, SZA, and bipolar disorder. Familiality (heritability) values and correlations with clinical measures were also calculated for regional LGI values. RESULTS Probands exhibited significant hypogyria compared with control subjects in three brain regions and relatives with Axis II cluster A disorders showed nearly significant hypogyria in these same regions. Local gyrification index values in these locations were significantly heritable and uncorrelated with any clinical measure. Observations of significant hypogyria were most widespread in SZA. CONCLUSIONS Psychotic disorders appear to be characterized by significant regionally localized hypogyria, particularly in cingulate cortex. This abnormality may be a structural endophenotype marking risk for psychotic illness and it may help elucidate etiological underpinnings of psychotic disorders.
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Affiliation(s)
- Pranav Nanda
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, Columbia University College of Physicians & Surgeons, New York, NY
| | - Neeraj Tandon
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, Baylor College ofMedicine, Houston, TX
| | - Ian T Mathew
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA
| | | | | | - Brett Clementz
- Department of Psychology, BioImaging Research Center, University of Georgia, Athens, Georgia, Department of Neuroscience, BioImaging Research Center, University of Georgia, Athens, Georgia
| | - Godfrey Pearlson
- Olin Neuropsychiatry Research Center, Institute ofLiving, Hartford, Connecticut, Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, Connecticut
| | - John Sweeney
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Carol Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
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Fischer AS, Whitfield-Gabrieli S, Roth RM, Brunette MF, Green AI. Impaired functional connectivity of brain reward circuitry in patients with schizophrenia and cannabis use disorder: Effects of cannabis and THC. Schizophr Res 2014; 158:176-82. [PMID: 25037524 PMCID: PMC4778557 DOI: 10.1016/j.schres.2014.04.033] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 04/21/2014] [Accepted: 04/23/2014] [Indexed: 01/21/2023]
Abstract
Cannabis use disorder (CUD) occurs in up to 42% of patients with schizophrenia and substantially worsens disease progression. The basis of CUD in schizophrenia is unclear and available treatments are rarely successful at limiting cannabis use. We have proposed that a dysregulated brain reward circuit (BRC) may underpin cannabis use in these patients. In the present pilot study, we used whole-brain seed-to-voxel resting state functional connectivity (rs-fc) to examine the BRC of patients with schizophrenia and CUD, and to explore the effects of smoked cannabis and orally administered delta-9-tetrahydrocannabinol (THC) on the BRC. 12 patients with schizophrenia and CUD and 12 control subjects each completed two fMRI resting scans, with patients administered either a 3.6% THC cannabis cigarette (n=6) or a 15 mg THC capsule (n=6) prior to their second scan. Results revealed significantly reduced connectivity at baseline in patients relative to controls, with most pronounced hypoconnectivity found between the nucleus accumbens and prefrontal cortical BRC regions (i.e., anterior prefrontal cortex, orbitofrontal cortex, and anterior cingulate cortex). Both cannabis and THC administration increased connectivity between these regions, in direct correlation with increases in plasma THC levels. This study is the first to investigate interregional connectivity of the BRC and the effects of cannabis and THC on this circuit in patients with schizophrenia and CUD. The findings from this pilot study support the use of rs-fc as a means of measuring the integrity of the BRC and the effects of pharmacologic agents acting on this circuit in patients with schizophrenia and CUD.
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Affiliation(s)
- Adina S Fischer
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Susan Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Robert M Roth
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Mary F Brunette
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Alan I Green
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA; Department of Pharmacology and Toxicology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
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Hegarty CE, Foland-Ross LC, Narr KL, Sugar CA, McGough JJ, Thompson PM, Altshuler LL. ADHD comorbidity can matter when assessing cortical thickness abnormalities in patients with bipolar disorder. Bipolar Disord 2012; 14:843-55. [PMID: 23167934 PMCID: PMC3506177 DOI: 10.1111/bdi.12024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Attention-deficit hyperactivity disorder (ADHD) is prevalent in patients with bipolar disorder (BP), but very few studies consider this when interpreting magnetic resonance imaging findings. No studies, to our knowledge, have screened for or controlled for the presence of ADHD when examining cortical thickness in patients with BP. We used a 2 × 2 design to evaluate the joint effects of BP and ADHD on cortical thickness and uncover the importance of ADHD comorbidity in BP subjects. METHODS The study included 85 subjects: 31 healthy controls, 17 BP-only, 19 ADHD-only, and 18 BP/ADHD. All patients with BP were subtype I, euthymic, and not taking lithium. Groups did not differ significantly in age or gender distribution. We used cortical thickness measuring tools combined with cortical pattern matching methods to align sulcal/gyral anatomy across participants. Significance maps were used to check for both main effects of BP and ADHD and their interaction. Post-hoc comparisons assessed how the effects of BP on cortical thickness varied as a function of the presence or absence of ADHD. RESULTS Interactions of BP and ADHD diagnoses were found in the left subgenual cingulate and right orbitofrontal cortex, demonstrating that the effect of BP on cortical thickness depends on ADHD status. CONCLUSIONS Some brain abnormalities attributed to BP may result from the presence of ADHD. Diagnostic interactions were found in regions previously implicated in the pathophysiology of BP, making it vital to control for an ADHD comorbid diagnosis when attempting to isolate neural or genetic abnormalities specific to BP.
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Affiliation(s)
- Catherine E Hegarty
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California at Los Angeles (UCLA), Los Angeles
| | - Lara C Foland-Ross
- Mood and Anxiety Disorders Laboratory, Department of Psychology, Stanford University, Stanford
| | - Katherine L Narr
- Laboratory of Neuro Imaging, Department of Neurology, David Geffen School of Medicine, UCLA
| | - Catherine A Sugar
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California at Los Angeles (UCLA), Los Angeles,Department of Biostatistics, School of Public Health, UCLA,Department of Psychiatry, VA Greater Los Angeles Healthcare System, West Los Angeles Healthcare Center, UCLA, Los Angeles, USA
| | - James J McGough
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California at Los Angeles (UCLA), Los Angeles,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | - Paul M Thompson
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California at Los Angeles (UCLA), Los Angeles,Laboratory of Neuro Imaging, Department of Neurology, David Geffen School of Medicine, UCLA
| | - Lori L Altshuler
- Jane and Terry Semel Institute of Neuroscience and Human Behavior, University of California at Los Angeles (UCLA), Los Angeles,Department of Psychiatry, VA Greater Los Angeles Healthcare System, West Los Angeles Healthcare Center, UCLA, Los Angeles, USA,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, USA
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35
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Singh MK, Chang KD, Chen MC, Kelley RG, Garrett A, Mitsunaga MM, Bararpour L, Howe M, Reiss AL, Gotlib IH. Volumetric reductions in the subgenual anterior cingulate cortex in adolescents with bipolar I disorder. Bipolar Disord 2012; 14:585-96. [PMID: 22938166 PMCID: PMC3433284 DOI: 10.1111/j.1399-5618.2012.01043.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES A range of prefrontal and subcortical volumetric abnormalities have been found in adults and adolescents with bipolar disorder. It is unclear, however, if these deficits are present early in the onset of mania or are a consequence of multiple mood episodes or prolonged exposure to medication. The goal of this study was to examine whether youth with bipolar I disorder who recently experienced their first episode of mania are characterized by brain volumetric abnormalities. METHODS Anatomical images from magnetic resonance imaging of 26 13- to 18-year-old adolescents with bipolar I disorder and 24 age-comparable healthy controls with no personal or family history of psychopathology were analyzed using whole-brain voxel-based morphometry (VBM). RESULTS Compared with healthy controls, adolescents with bipolar I disorder had significantly less gray matter volume in the left subgenual cingulate cortex [p<0.05, family-wise error (FWE)-corrected]. CONCLUSIONS Adolescents with a recent single episode of mania have smaller subgenual cingulate cortex volume than do their healthy counterparts, suggesting that this anomaly occurs early in the onset of, or may predate the disorder. Longitudinal studies are needed to examine the impact of this volumetric reduction on the course and outcome of this disorder.
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Affiliation(s)
- Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305-5719, USA.
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Jogia J, Dima D, Frangou S. Sex differences in bipolar disorder: a review of neuroimaging findings and new evidence. Bipolar Disord 2012; 14:461-71. [PMID: 22631625 DOI: 10.1111/j.1399-5618.2012.01014.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES The sex of an individual is known to modulate the clinical presentation of bipolar disorder (BD), but little is known as to whether there are significant sex-by-diagnosis interactions on the brain structural and functional correlates of BD. METHODS We conducted a literature review of magnetic resonance imaging (MRI) studies in BD, published between January 1990 and December 2010, reporting on the effects of sex and diagnosis. In the absence of any functional MRI (fMRI) studies, this review was supplemented by original data analyses focusing on sex-by-diagnosis interactions on patterns of brain activation obtained during tasks of working memory, incentive decision-making, and facial affect processing. RESULTS We found no support for a sex-by-diagnosis interaction in global gray or white matter volume. Evidence regarding regional volumetric measures is limited, but points to complex interactions between sex and diagnosis with developmental and temperamental factors within limbic and prefrontal regions. Sex-by-diagnosis interactions were noted in the pattern of activation within the basal ganglia during incentive decision-making and within ventral prefrontal regions during facial affect processing. CONCLUSIONS Potential sex-by-diagnosis interactions influencing the brain structural and functional correlates of disease expression in BD have received limited attention. Our data suggest that the sex of an individual modulates structure and function within subcortical and cortical regions implicated in disease expression.
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Affiliation(s)
- Jigar Jogia
- Department of Psychosis Studies, Section of Neurobiology of Psychosis, Institute of Psychiatry, King's College London, London, UK
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37
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Hafeman DM, Chang KD, Garrett AS, Sanders EM, Phillips ML. Effects of medication on neuroimaging findings in bipolar disorder: an updated review. Bipolar Disord 2012; 14:375-410. [PMID: 22631621 DOI: 10.1111/j.1399-5618.2012.01023.x] [Citation(s) in RCA: 258] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Neuroimaging is an important tool for better understanding the neurobiological underpinnings of bipolar disorder (BD). However, potential study participants are often receiving psychotropic medications which can possibly confound imaging data. To better interpret the results of neuroimaging studies in BD, it is important to understand the impact of medications on structural magnetic resonance imaging (sMRI), functional MRI (fMRI), and diffusion tensor imaging (DTI). METHODS To better understand the impact of medications on imaging data, we conducted a literature review and searched MEDLINE for papers that included the key words bipolar disorder and fMRI, sMRI, or DTI. The search was limited to papers that assessed medication effects and had not been included in a previous review by Phillips et al. (Medication effects in neuroimaging studies of bipolar disorder. Am J Psychiatry 2008; 165: 313-320). This search yielded 74 sMRI studies, 46 fMRI studies, and 15 DTI studies. RESULTS Medication appeared to influence many sMRI studies, but had limited impact on fMRI and DTI findings. From the structural studies, the most robust finding (20/45 studies) was that lithium was associated with increased volumes in areas important for mood regulation, while antipsychotic agents and anticonvulsants were generally not. Regarding secondary analysis of the medication effects of fMRI and DTI studies, few showed significant effects of medication, although rigorous analyses were typically not possible when the majority of subjects were medicated. Medication effects were more frequently observed in longitudinal studies designed to assess the impact of particular medications on the blood oxygen level-dependent (BOLD) signal. With a few exceptions, the observed effects were normalizing, meaning that the medicated individuals with BD were more similar than their unmedicated counterparts to healthy subjects. CONCLUSIONS The effects of psychotropic medications, when present, are predominantly normalizing and thus do not seem to provide an alternative explanation for differences in volume, white matter tracts, or BOLD signal between BD participants and healthy subjects. However, the normalizing effects of medication could obfuscate differences between BD and healthy subjects, and thus might lead to type II errors.
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Affiliation(s)
- Danella M Hafeman
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
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38
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Ong D, Walterfang M, Malhi GS, Styner M, Velakoulis D, Pantelis C. Size and shape of the caudate nucleus in individuals with bipolar affective disorder. Aust N Z J Psychiatry 2012; 46:340-51. [PMID: 22368240 PMCID: PMC3328643 DOI: 10.1177/0004867412440191] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The caudate nucleus (CN) is a crucial component of the ventral striatum, which is part of a prefrontal-striatal-thalamic circuit that is modulated by limbic structures to subserve emotional processing. Bipolar disorder is thought to be underpinned by dysfunctional anterior limbic networks, although MRI studies examining the CN have shown equivocal results. As gross volumetric analyses may not detect subtle regional change, we aimed to clarify the role of the CN in bipolar disorder by undertaking shape analysis to detect regional reductions. METHODS The CN was manually traced on MRI scans from 27 patients with bipolar-I disorder and 24 matched controls. A non-parametric spherical harmonic shape analysis was undertaken using the SPHARM toolkit. RESULTS Whilst the left CN volume was consistently larger in the sample, there was no effect of group or gender or significant interactions between these variables. Volume did not correlate with illness duration or lithium dosage, but was larger in those with a history of psychosis at trend level. However, left caudate shape differed significantly between groups, with deflation in an area along the ventromedial surface (connecting to dorsolateral prefrontal regions) in bipolar patients. Psychotic patients showed increases in the dorsal head and body at trend level overall, in regions connecting to medial and orbitofrontal regions. CONCLUSIONS These findings suggest that subtle rather than gross structural changes occur in the CN, which may not be detectable by volumetric analysis alone, and reflect alterations in specific frontostriatal circuitry in the disorder.
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Affiliation(s)
- Daniel Ong
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
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Rimol LM, Nesvåg R, Hagler DJ, Bergmann O, Fennema-Notestine C, Hartberg CB, Haukvik UK, Lange E, Pung CJ, Server A, Melle I, Andreassen OA, Agartz I, Dale AM. Cortical volume, surface area, and thickness in schizophrenia and bipolar disorder. Biol Psychiatry 2012; 71:552-60. [PMID: 22281121 DOI: 10.1016/j.biopsych.2011.11.026] [Citation(s) in RCA: 242] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Revised: 11/22/2011] [Accepted: 11/22/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND Magnetic resonance imaging studies have shown that structural brain abnormalities are present in both schizophrenia and bipolar disorder. Most previous studies have focused on brain tissue volumes, but advances in neuroimaging data processing have made it possible to separate cortical area and cortical thickness. The purpose of the present study was to provide a more complete picture of cortical morphometric differences in schizophrenia and bipolar disorder, decomposing cortical volume into its constituent parts, cortical thickness and cortical area. METHODS We analyzed magnetic resonance imaging images from a sample of 173 patients with schizophrenia, 139 patients with bipolar disorder, and 207 healthy control subjects. Maps of cortical volume, area, and thickness across the continuous cortical surface were generated within groups and compared between the groups. RESULTS There were widespread reductions in cortical volume in schizophrenia relative to healthy control subjects and patients with bipolar disorder type I. These reductions were mainly driven by cortical thinning, but there were also cortical area reductions in more circumscribed regions, which contributed to the observed volume reductions. CONCLUSIONS The current surface-based methodology allows for a distinction between cortical thinning and reduction in cortical area and reveals that cortical thinning is the most important factor in volume reduction in schizophrenia. Cortical area reduction was not observed in bipolar disorder type I and may be unique to schizophrenia.
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Affiliation(s)
- Lars M Rimol
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway.
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Cousins DA, Grunze H. Interpreting magnetic resonance imaging findings in bipolar disorder. CNS Neurosci Ther 2012; 18:201-7. [PMID: 22449107 PMCID: PMC6493435 DOI: 10.1111/j.1755-5949.2011.00280.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 06/13/2011] [Accepted: 08/04/2011] [Indexed: 02/05/2023] Open
Abstract
The episodic nature of bipolar disorder together with the ostensibly polar extremes of mania and depression have favored the acceptance of a functional model postulating regionally disturbed brain activity returning to normal with time or treatment. Seemingly contrary to that view, anatomical imaging studies have demonstrated abnormalities in brain structure which could reflect neurodegeneration or represent disturbed neuronal development. Resolution may come from an appreciation of adult neurogenesis, especially given the neuroprotective properties of drugs, such as lithium and their effects on brain volume. The brain regions vulnerable to structural changes also show evidence of dysfunction, giving rise to corticolimbic dysregulation interpretations of bipolar disorder. This article reviews the structural and functional magnetic resonance imaging data in bipolar disorder. Its focus is on the interpretation of findings in light of recent developments in the fields of neurobiology and image analysis, with particular attention paid to both the confounding effects of medication and the baseline energy state of the brain.
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Affiliation(s)
- David A Cousins
- Newcastle Magnetic Resonance Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK.
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Bao AM, Ruhé HG, Gao SF, Swaab DF. Neurotransmitters and neuropeptides in depression. HANDBOOK OF CLINICAL NEUROLOGY 2012; 106:107-36. [PMID: 22608619 DOI: 10.1016/b978-0-444-52002-9.00008-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- A-M Bao
- Department of Neurobiology, Zhejiang University School of Medicine, Hangzhou, China.
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42
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Foland-Ross LC, Thompson PM, Sugar CA, Madsen SK, Shen JK, Penfold C, Ahlf K, Rasser PE, Fischer J, Yang Y, Townsend J, Bookheimer SY, Altshuler LL. Investigation of cortical thickness abnormalities in lithium-free adults with bipolar I disorder using cortical pattern matching. Am J Psychiatry 2011; 168:530-9. [PMID: 21285139 PMCID: PMC3640313 DOI: 10.1176/appi.ajp.2010.10060896] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Although several lines of evidence implicate gray matter abnormalities in the prefrontal cortex and anterior cingulate cortex in patients with bipolar disorder, findings have been largely inconsistent across studies. Differences in patients' medication status or mood state or the application of traditional volumetric methods that are insensitive to subtle neuroanatomical differences may have contributed to variations in findings. The authors used MRI in conjunction with cortical pattern matching methods to assess cortical thickness abnormalities in euthymic bipolar patients who were not receiving lithium treatment. METHOD Thirty-four lithium-free euthymic patients with bipolar I disorder and 31 healthy comparison subjects underwent MRI scanning. Data were processed to measure cortical gray matter thickness. Thickness maps were spatially normalized using cortical pattern matching and were analyzed to assess illness effects and associations with clinical variables. RESULTS Relative to healthy comparison subjects, euthymic bipolar patients had significantly thinner gray matter in the left and right prefrontal cortex (Brodmann's areas 11, 10, 8, and 44) and the left anterior cingulate cortex (Brodmann's areas 24/32). Thinning in these regions was more pronounced in patients with a history of psychosis. No areas of thicker cortex were detected in bipolar patients relative to healthy comparison subjects. CONCLUSIONS Using a technique that is highly sensitive to subtle neuroanatomical differences, significant regional cortical thinning was found in lithium-free euthymic patients with bipolar disorder.
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Affiliation(s)
- Lara C. Foland-Ross
- Laboratory of NeuroImaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA
| | - Paul M. Thompson
- Laboratory of NeuroImaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA
| | - Catherine A. Sugar
- Department of Biostatistics, UCLA, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA
| | - Sarah K. Madsen
- Laboratory of NeuroImaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA
| | - Jim K. Shen
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA
| | | | - Kyle Ahlf
- Department of Biostatistics, UCLA, Los Angeles, CA
| | - Paul E. Rasser
- Schizophrenia Research Institute; and Priority Centre for Brain & Mental Health Research, University of Newcastle, Callaghan, New South Wales 2308, Australia
| | | | - Yilan Yang
- Laboratory of NeuroImaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA
| | | | | | - Lori L. Altshuler
- Department of Biostatistics, UCLA, Los Angeles, CA,Department of Psychiatry, VA Greater Los Angeles Healthcare System, West Los Angeles Healthcare Center, Los Angeles, CA
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de Azevedo-Marques Périco C, Duran FLS, Zanetti MV, Santos LC, Murray RM, Scazufca M, Menezes PR, Busatto GF, Schaufelberger MS. A population-based morphometric MRI study in patients with first-episode psychotic bipolar disorder: comparison with geographically matched healthy controls and major depressive disorder subjects. Bipolar Disord 2011; 13:28-40. [PMID: 21320250 DOI: 10.1111/j.1399-5618.2011.00896.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Many morphometric magnetic resonance imaging (MRI) studies that have investigated the presence of gray matter (GM) volume abnormalities associated with the diagnosis of bipolar disorder (BD) have reported conflicting findings. None of these studies has compared patients with recent-onset psychotic BD with asymptomatic controls selected from exactly the same environment using epidemiological methods, or has directly contrasted BD patients against subjects with first-onset psychotic major depressive disorder (MDD). We examined structural brain differences between (i) BD (type I) subjects and MDD subjects with psychotic features in their first contact with the healthcare system in Brazil, and (ii) these two mood disorder groups relative to a sample of geographically matched asymptomatic controls. METHODS A total of 26 BD subjects, 20 subjects with MDD, and 94 healthy controls were examined using either of two identical MRI scanners and acquisition protocols. Diagnoses were based on DSM-IV criteria and confirmed one year after brain scanning. Image processing was conducted using voxel-based morphometry. RESULTS The BD group showed increased volume of the right dorsal anterior cingulate cortex relative to controls, while the MDD subjects exhibited bilateral foci GM deficits in the dorsolateral prefrontal cortex (p < 0.05, corrected for multiple comparisons). Direct comparison between BD and MDD patients showed a focus of GM reduction in the right-sided dorsolateral prefrontal cortex (p < 0.05, corrected for multiple comparisons) and a trend (p < 0.10, corrected) toward left-sided GM deficits in the dorsolateral prefrontal cortex of MDD patients. When analyses were repeated with scanner site as a confounding covariate the finding of increased right anterior cingulate volumes in BD patients relative to controls remained statistically significant (p=0.01, corrected for multiple comparisons). CONCLUSIONS These findings reinforce the view that there are important pathophysiological distinctions between BD and MDD, and indicate that subtle dorsal anterior cingulate abnormalities may be relevant to the pathophysiology of BD.
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Affiliation(s)
- Cintia de Azevedo-Marques Périco
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
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Baharnoori M, Bartholomeusz C, Boucher AA, Buchy L, Chaddock C, Chiliza B, Föcking M, Fornito A, Gallego JA, Hori H, Huf G, Jabbar GA, Kang SH, El Kissi Y, Merchán-Naranjo J, Modinos G, Abdel-Fadeel NA, Neubeck AK, Ng HP, Novak G, Owolabi O, Prata DP, Rao NP, Riecansky I, Smith DC, Souza RP, Thienel R, Trotman HD, Uchida H, Woodberry KA, O'Shea A, DeLisi LE. The 2nd Schizophrenia International Research Society Conference, 10-14 April 2010, Florence, Italy: summaries of oral sessions. Schizophr Res 2010; 124:e1-62. [PMID: 20934307 PMCID: PMC4182935 DOI: 10.1016/j.schres.2010.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 08/30/2010] [Accepted: 09/01/2010] [Indexed: 01/06/2023]
Abstract
The 2nd Schizophrenia International Research Society Conference, was held in Florence, Italy, April 10-15, 2010. Student travel awardees served as rapporteurs of each oral session and focused their summaries on the most significant findings that emerged from each session and the discussions that followed. The following report is a composite of these reviews. It is hoped that it will provide an overview for those who were present, but could not participate in all sessions, and those who did not have the opportunity to attend, but who would be interested in an update on current investigations ongoing in the field of schizophrenia research.
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Affiliation(s)
- Moogeh Baharnoori
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, 6875 LaSalle Blvd, Montreal, Quebec, Canada H4H 1R3, phone (514) 761-6131 ext 3346,
| | - Cali Bartholomeusz
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Level 2-3, Alan Gilbert Building, 161 Barry St, Carlton South, Victoria 3053, Australia, phone +61 3 8344 1878, fax +61 3 9348 0469,
| | - Aurelie A. Boucher
- Brain and Mind Research Institute, 100 Mallett Street, Camperdown NSW 2050, Australia, phone +61 (0)2 9351 0948, fax +61 (0)2 9351 0652,
| | - Lisa Buchy
- Douglas Hospital Research Centre, 6875 LaSalle Blvd, Verdun, Québec, Canada, H4H 1R3 phone: 514-761-6131 x 3386, fax: 514-888-4064,
| | - Christopher Chaddock
- PO67, Section of Neuroimaging, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, phone 020 7848 0919, mobile 07734 867854 fax 020 7848 0976,
| | - Bonga Chiliza
- Department of Psychiatry, University of Stellenbosch, Tygerberg, 7505, South Africa, phone: +27 (0)21 9389227, fax +27 (0)21 9389738,
| | - Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland, phone +353 1 809 3857, fax +353 1 809 3741,
| | - Alex Fornito
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Downing Site, Downing St, Cambridge, UK, CB2 3EB, phone +44 (0) 1223 764670, fax +44 (0) 1223 336581,
| | - Juan A. Gallego
- The Zucker Hillside Hospital, Psychiatry Research, 75-59 263rd St, Glen Oaks, NY 11004, phone 718-470-8177, fax 718-343-1659,
| | - Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, NCNP, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, JAPAN, phone: +81 42 341 2711; fax: +81 42 346 1744,
| | - Gisele Huf
- National Institute of Quality Control in Health - Oswaldo Cruz Foundation.Av. Brasil 4365 Manguinhos Rio de Janeiro RJ BRAZIL 21045-900, phone + 55 21 38655112, fax + 55 21 38655139,
| | - Gul A. Jabbar
- Clinical Research Coordinator, Harvard Medical School Department of Psychiatry, 940 Belmont Street 2-B, Brockton, MA 02301, office (774) 826-1624, cell (845) 981-9514, fax (774) 286-1076,
| | - Shi Hyun Kang
- Seoul National Hospital, 30-1 Junggok3-dong Gwangjin-gu, Seoul, 143-711, Korea, phone +82-2-2204-0326, fax +82-2-2204-0394,
| | - Yousri El Kissi
- Psychiatry department, Farhat Hached Hospital. Ibn Jazzar Street, 4002 Sousse. Tunisia. phone + 216 98468626, fax + 216 73226702,
| | - Jessica Merchán-Naranjo
- Adolescent Unit. Department of Psychiatry. Hospital General Universitario Gregorio Marañón. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain. C/Ibiza 43, C.P:28009, phone +34 914265005, fax +34 914265004,
| | - Gemma Modinos
- Department of Psychosis Studies (PO67), Institute of Psychiatry, King's College London, King's Health Partners, De Crespigny Park, SE5 8AF London, United Kingdo, phone +44 (0)20 78480917, fax +44 (0)20 78480976,
| | - Nashaat A.M. Abdel-Fadeel
- Minia University, Egypt, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, phone 617 953 0414, fax 617-998-5007, ,
| | - Anna-Karin Neubeck
- Project Manager at Karolinska Institute, Skinnarviksringen 12, 117 27 Stockholm, Sweden, phone +46708777908,
| | - Hsiao Piau Ng
- Singapore Bioimaging Consortium, A*STAR, Singapore; Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, phone 857-544-0192, fax 617-525-6150,
| | - Gabriela Novak
- University of Toronto, Medical Sciences Building, Room 4345, 1 King's College Circle, Toronto, Ontario, M5S 1A8, phone (416) 946-8219, fax (416) 971-2868,
| | - Olasunmbo.O. Owolabi
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Science University of Ilorin, Ilorin, Nigeria, phone +2348030764811,
| | - Diana P. Prata
- Department of Psychosis Studies, King’s College London, King’s Health Partners, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, UK, phone +44(0)2078480917, fax +44(0)2078480976,
| | - Naren P. Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, 560029 Karnataka, India, phone +91 9448342379,
| | - Igor Riecansky
- Address: Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Sienkiewiczova 1, 813 71 Bratislava, Slovakia, phone +421-2-52 92 62 76, fax +421-2-52 96 85 16,
| | - Darryl C. Smith
- 3336 Mt Pleasant St. NW #2, Washington, DC 20010, phone 202.494.3892,
| | - Renan P. Souza
- Centre for Addiction and Mental Health 250 College St R31 Toronto - Ontario - Canada M5T1R8, phone +14165358501 x4883, fax +14169794666,
| | - Renate Thienel
- Postdoctoral Research Fellow, PRC Brain and Mental Health, University of Newcastle, Mc Auley Centre Level 5, Mater Hospital, Edith Street, Waratah NSW 2298, phone +61 (2) 40335636,
| | - Hanan D. Trotman
- 36 Eagle Row, Atlanta, GA 30322, phone 404-727-8384, fax 404-727-1284,
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Psychopharmacology Research Program, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan, phone +81.3.3353.1211(x62454), fax +81.3.5379.0187,
| | - Kristen A. Woodberry
- Landmark Center 2 East, 401 Park Drive, Boston, MA 02215, phone 617-998-5022, fax 617-998-5007,
| | - Anne O'Shea
- Coordinator of reports. Harvard Medical School, VA Boston Healthcare System, 940 Belmont Street, Brockton, MA 02301, phone 774-826-1374, anne_o’
| | - Lynn E. DeLisi
- VA Boston Healthcare System and Harvard Medical School, 940 Belmont Street, Brockton, MA 02301, phone 774-826-1355, fax 774-826-2721
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Berk M, Kapczinski F, Andreazza AC, Dean OM, Giorlando F, Maes M, Yücel M, Gama CS, Dodd S, Dean B, Magalhães PVS, Amminger P, McGorry P, Malhi GS. Pathways underlying neuroprogression in bipolar disorder: focus on inflammation, oxidative stress and neurotrophic factors. Neurosci Biobehav Rev 2010; 35:804-17. [PMID: 20934453 DOI: 10.1016/j.neubiorev.2010.10.001] [Citation(s) in RCA: 856] [Impact Index Per Article: 61.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 09/29/2010] [Accepted: 10/01/2010] [Indexed: 12/11/2022]
Abstract
There is now strong evidence of progressive neuropathological processes in bipolar disorder (BD). On this basis, the current understanding of the neurobiology of BD has shifted from an initial focus on monoamines, subsequently including evidence of changes in intracellular second messenger systems and more recently to, incorporating changes in inflammatory cytokines, corticosteroids, neurotrophins, mitochondrial energy generation, oxidative stress and neurogenesis into a more comprehensive model capable of explaining some of the clinical features of BD. These features include progressive shortening of the inter-episode interval with each recurrence, occurring in consort with reduced probability of treatment response as the illness progresses. To this end, emerging data shows that these biomarkers may differ between early and late stages of BD in parallel with stage-related structural and neurocognitive alterations. This understanding facilitates identification of rational therapeutic targets, and the development of novel treatment classes. Additionally, these pathways provide a cogent explanation for the efficacy of seemingly diverse therapies used in BD, that appear to share common effects on oxidative, inflammatory and neurotrophic pathways.
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Affiliation(s)
- M Berk
- Department of Clinical and Biomedical Sciences, University of Melbourne, Victoria 3010, Australia.
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Rimol LM, Hartberg CB, Nesvåg R, Fennema-Notestine C, Hagler DJ, Pung CJ, Jennings RG, Haukvik UK, Lange E, Nakstad PH, Melle I, Andreassen OA, Dale AM, Agartz I. Cortical thickness and subcortical volumes in schizophrenia and bipolar disorder. Biol Psychiatry 2010; 68:41-50. [PMID: 20609836 DOI: 10.1016/j.biopsych.2010.03.036] [Citation(s) in RCA: 353] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Revised: 03/05/2010] [Accepted: 03/25/2010] [Indexed: 01/12/2023]
Abstract
BACKGROUND Schizophrenia and bipolar disorder are severe psychiatric diseases with overlapping symptomatology. Widespread brain morphologic abnormalities, including cortical thinning and subcortical volume reductions, have been demonstrated in schizophrenia but it is unclear whether similar abnormalities are present in bipolar disorder. The purpose of this study was to compare cortical thickness and subcortical volumes in schizophrenia and bipolar disorder, to assess differences and similarities in cortical and subcortical brain structure. METHODS We analyzed magnetic resonance images from a sample of 173 patients with schizophrenia spectrum disorder, 139 patients with bipolar disorder, and 207 healthy control subjects. Cortical thickness was compared between the groups in multiple locations across the continuous cortical surface. Subcortical volumes were compared on a structure-by-structure basis. RESULTS There was widespread cortical thinning in schizophrenia compared with control subjects, in frontal, temporal, occipital, and smaller parietal regions. There was no cortical thinning in bipolar disorder compared with control subjects or in schizophrenia compared with bipolar disorder. However, the subgroup of patients with bipolar disorder Type 1 showed cortical thinning, primarily in the frontal lobes and superior temporal and temporoparietal regions. Both patient groups showed substantial subcortical volume reductions bilaterally in the hippocampus, the left thalamus, the right nucleus accumbens, the left cerebellar cortex, and the brainstem, along with substantial ventricular enlargements. CONCLUSIONS We found substantial overlap in the underlying brain morphologic abnormalities in schizophrenia and bipolar disorder in subcortical structures, and between schizophrenia and bipolar disorder Type 1 in the cerebral cortex.
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Affiliation(s)
- Lars M Rimol
- Department of Psychiatry, Section Vinderen, University of Oslo, Oslo, Norway.
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Chan WY, Yang GL, Chia MY, Woon PS, Lee J, Keefe R, Sitoh YY, Nowinski WL, Sim K. Cortical and subcortical white matter abnormalities in adults with remitted first-episode mania revealed by Tract-Based Spatial Statistics. Bipolar Disord 2010; 12:383-9. [PMID: 20636635 DOI: 10.1111/j.1399-5618.2010.00829.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Abnormalities of brain white matter have been noted in structural magnetic resonance imaging and diffusion tensor imaging (DTI) studies of bipolar disorder, but there are fewer investigations specifically examining white matter integrity early in the course of illness. In this study, we employed DTI to elucidate white matter changes in adult patients with remitted first-episode mania and hypothesized that first-episode mania was associated with decreased fractional anisotropy in cortical (frontal) and subcortical (thalamus, striatum) white matter as well as white matter tracts (cingulum, corpus callosum). METHODS Diffusion tensor images were acquired from 16 patients with remitted first-episode mania and 16 healthy controls matched for age, gender, handedness, and years of education. Fractional anisotropy and radial and axial diffusivities were analyzed using Tract-Based Spatial Statistics. RESULTS Patients had lower fractional anisotropy and higher radial diffusivity in the left anterior frontal white matter, right posterior thalamic radiation, left cingulum, and bilateral sagittal striatum. In addition, increased radial diffusivity was found in the left corpus callosum. CONCLUSION Our findings highlighted that white matter abnormalities were present by the time of remission of first-episode mania. The widespread occurrence of these white matter abnormalities both in first-episode mania and chronic bipolar disorder suggested that disruption of white matter cortical-subcortical networks as well as projection, associative, and commissural tracts is a hallmark of the illness.
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Affiliation(s)
- Wai-Yen Chan
- Research Division, Institute of Mental Health, Singapore
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Ellison-Wright I, Bullmore E. Anatomy of bipolar disorder and schizophrenia: a meta-analysis. Schizophr Res 2010; 117:1-12. [PMID: 20071149 DOI: 10.1016/j.schres.2009.12.022] [Citation(s) in RCA: 400] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Revised: 11/27/2009] [Accepted: 12/19/2009] [Indexed: 01/14/2023]
Abstract
BACKGROUND Recent genetic results have indicated that the two major, classically distinct forms of psychosis - schizophrenia and bipolar disorder - may share causative factors in common. However it is not clear to what extent they may also have similar profiles of brain abnormality. We used meta-analytic techniques to generate and compare maps of brain structural abnormality in the large samples of patients with both disorders that have been studied using magnetic resonance imaging. METHOD A systematic search was conducted for voxel-based morphometry studies examining gray matter in patients with schizophrenia or bipolar disorder. The anatomical distribution of the co-ordinates of gray matter differences was meta-analysed using Anatomical Likelihood Estimation. RESULTS Forty-two schizophrenia studies including 2058 patients with schizophrenia and 2131 comparison subjects were compared with fourteen bipolar studies including 366 patients with bipolar disorder and 497 comparison subjects. In schizophrenia, there were extensive gray matter deficits in frontal, temporal, cingulate and insular cortex and thalamus, and increased gray matter in the basal ganglia. In bipolar disorder, gray matter reductions were present in the anterior cingulate and bilateral insula. These substantially overlapped with areas of gray matter reduction in schizophrenia, except for a region of anterior cingulate where gray matter reduction was specific to bipolar disorder. IMPLICATIONS In bipolar disorder studies there were consistent regional gray matter reductions in paralimbic regions (anterior cingulate and insula) implicated in emotional processing. Gray matter reductions in schizophrenia studies were more extensive and involved limbic and neocortical structures as well as the paralimbic regions affected in bipolar disorder.
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Abstract
Bipolar disorder (BPD) is increasingly recognized as a neuropathological disorder characterized by reductions in grey matter (GM) volume, as measured by magnetic resonance imaging (MRI) and neuronal and postmortem glial cell changes. Here, we use an anatomical framework to discuss the neurobiology of BPD, focusing on individual components of the "visceromotor network" that regulates bodily homeostasis along with neurophysiological and neuroendocrine responses to stress. MRI-defined reductions in GM volume, combined with neuronal changes, are observed in the perigenual anterior cingulate cortex (ACC) of individuals with BPD, while postmortem glial cell loss is also a characteristic of Brodmann's Area 9. Both postmortem neuronal loss and reduced GM volume have been reported in the amygdala and hippocampus. These structural changes to components of the visceromotor network are associated with increased regional cerebral blood flow (rCBF) or blood oxygenated level-dependent (BOLD) activity in response to affective or rewarding stimuli, raising the possibility that the BPD-associated structural changes are secondary to a glutamate-driven excitotoxic process.
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Corpus callosum size and shape in first-episode affective and schizophrenia-spectrum psychosis. Psychiatry Res 2009; 173:77-82. [PMID: 19447585 DOI: 10.1016/j.pscychresns.2008.09.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Revised: 08/20/2008] [Accepted: 09/17/2008] [Indexed: 11/23/2022]
Abstract
Reductions in the size of the anterior callosum have been described for both first-episode and established schizophrenia and bipolar affective disorder, but never in individuals with psychotic bipolar disorder. We recruited 110 first-episode psychosis subjects (74 schizophrenia spectrum and 36 affective psychosis) and 36 age- and gender-matched controls. The callosum was extracted from a mid-sagittal slice from T1-weighted magnetic resonance images, and total area, length and curvature of the callosum were compared. The schizophrenia-spectrum group showed reductions in thickness of the genu across schizophreniform and schizoaffective disorder and schizophrenia, and the schizoaffective disorder group also showed an increase in thickness in the splenium and isthmus. None of these changes were seen in the affective disorder group, although a non-significant increase in the region of the isthmus and splenium was seen, particularly in the depressed group. Psychotic affective disorders do not show the anterior callosal reductions that are seen in the schizophrenia-spectrum group at first episode. The schizoaffective patients show additional posterior callosal expansions that may be a marker of an affective diathesis. This suggests that schizoaffective disorder may represent two interacting illness processes or be mid-way along a continuum of these two broad categories of illness at first psychosis.
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