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He D, Li L, Zhang H, Liu F, Li S, Xiu X, Fan C, Qi M, Meng M, Ye J, Mort M, Stenson PD, Cooper DN, Zhao H. Accurate identification of genes associated with brain disorders by integrating heterogeneous genomic data into a Bayesian framework. EBioMedicine 2024; 107:105286. [PMID: 39168091 PMCID: PMC11382033 DOI: 10.1016/j.ebiom.2024.105286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/29/2024] [Accepted: 08/01/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Genome-wide association studies (GWAS) have revealed many brain disorder-associated SNPs residing in the noncoding genome, rendering it a challenge to decipher the underlying pathogenic mechanisms. METHODS Here, we present an unsupervised Bayesian framework to identify disease-associated genes by integrating risk SNPs with long-range chromatin interactions (iGOAT), including SNP-SNP interactions extracted from ∼500,000 patients and controls from the UK Biobank, and enhancer-promoter interactions derived from multiple brain cell types at different developmental stages. FINDINGS The application of iGOAT to three psychiatric disorders and three neurodegenerative/neurological diseases predicted sets of high-risk (HRGs) and low-risk (LRGs) genes for each disorder. The HRGs were enriched in drug targets, and exhibited higher expression during prenatal brain developmental stages than postnatal stages, indicating their potential to affect brain development at an early stage. The HRGs associated with Alzheimer's disease were found to share genetic architecture with schizophrenia, bipolar disorder and major depressive disorder according to gene co-expression module analysis and rare variants analysis. Comparisons of this method to the eQTL-based method, the TWAS-based method, and the gene-level GWAS method indicated that the genes identified by our method are more enriched in known brain disorder-related genes, and exhibited higher precision. Finally, the method predicted 205 risk genes not previously reported to be associated with any brain disorder, of which one top-risk gene, MLH1, was experimentally validated as being schizophrenia-associated. INTERPRETATION iGOAT can successfully leverage epigenomic data, phenotype-genotype associations, and protein-protein interactions to advance our understanding of brain disorders, thereby facilitating the development of new therapeutic approaches. FUNDING The work was funded by the National Key Research and Development Program of China (2024YFF1204902), the Natural Science Foundation of China (82371482), Guangzhou Science and Technology Research Plan (2023A03J0659) and Natural Science Foundation of Guangdong (2024A1515011363).
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Affiliation(s)
- Dan He
- Department of Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510006, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, 510006, China
| | - Ling Li
- Department of Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510006, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, 510006, China
| | - Huasong Zhang
- Department of Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510006, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, 510006, China
| | - Feiyi Liu
- Department of Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510006, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, 510006, China
| | - Shaoying Li
- Department of Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510006, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, 510006, China
| | - Xuehao Xiu
- Department of Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510006, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, 510006, China
| | - Cong Fan
- Department of Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510006, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, 510006, China
| | - Mengling Qi
- Department of Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510006, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, 510006, China
| | - Meng Meng
- School of Data and Computer Science, Sun Yat-Sen University, Guangzhou, 510006, China
| | - Junping Ye
- Department of Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510006, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, 510006, China
| | - Matthew Mort
- Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Peter D Stenson
- Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - David N Cooper
- Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK
| | - Huiying Zhao
- Department of Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510006, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, 510006, China.
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Chang CY, Chang HH, Wu CY, Tsai YT, Lu TH, Chang WH, Hsu CF, Chen PS, Tseng HH. Peripheral inflammation is associated with impaired sadness recognition in euthymic bipolar patients. J Psychiatr Res 2024; 173:333-339. [PMID: 38579478 DOI: 10.1016/j.jpsychires.2024.03.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/06/2024] [Accepted: 03/26/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Inflammation impairs cognitive function in healthy individuals and people with psychiatric disorders, such as bipolar disorder (BD). This effect may also impact emotion recognition, a fundamental element of social cognition. Our study aimed to investigate the relationships between pro-inflammatory cytokines and emotion recognition in euthymic BD patients and healthy controls (HCs). METHODS We recruited forty-four euthymic BD patients and forty healthy controls (HCs) and measured their inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and TNF-α. We applied validated cognitive tasks, the Wisconsin Card-Sorting Test (WCST) and Continuous Performance Test (CPT), and a social cognitive task for emotion recognition, Diagnostic Analyses of Nonverbal Accuracy, Taiwanese Version (DANVA-2-TW). We analyzed the relationships between cytokines and cognition and then explored possible predictive factors of sadness recognition accuracy. RESULTS Regarding pro-inflammatory cytokines, TNF-α was elevated in euthymic BD patients relative to HCs. In euthymic BD patients only, higher TNF-α levels were associated with lower accuracy of sadness recognition. Regression analysis revealed that TNF-α was an independent predictive factor of sadness recognition in patients with euthymic BD when neurocognition was controlled for. CONCLUSIONS We demonstrated that enhanced inflammation, indicated by increased TNF-α, was an independent predictive factor of impaired sadness recognition in BD patients but not in HCs. Our findings suggested a direct influence of TNF-α on sadness recognition and indicated vulnerability to depression in euthymic BD patients with chronic inflammation.
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Affiliation(s)
- Chih-Yu Chang
- Department of Medicine, College of Medicine, National Cheng Kung University, Taiwan
| | - Hui Hua Chang
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng University, Tainan, Taiwan; School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pharmacy, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pharmacy, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Cheng Ying Wu
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ying Tsung Tsai
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Hua Lu
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei Hung Chang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Chia-Fen Hsu
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huai-Hsuan Tseng
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Ghafori SS, Yousefi Z, Bakhtiari E, mohammadi mahdiabadi hasani MH, Hassanzadeh G. Neutrophil-to-lymphocyte ratio as a predictive biomarker for early diagnosis of depression: A narrative review. Brain Behav Immun Health 2024; 36:100734. [PMID: 38362135 PMCID: PMC10867583 DOI: 10.1016/j.bbih.2024.100734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/23/2024] [Accepted: 02/04/2024] [Indexed: 02/17/2024] Open
Abstract
Depression is a mood disorder that causes persistent feelings of sadness, hopelessness, loss of interest, and decreased energy. Early diagnosis of depression can improve its negative impacts and be effective in its treatment. Previous studies have indicated that inflammation plays an important role in the initiation and development of depression, hence, various inflammatory biomarkers have been investigated for early diagnosis of depression, the most popular of which are blood biomarkers. The Neutrophil to lymphocyte ratio (NLR) may be more informative in the early diagnosis of depression than other widely used markers, such as other leukocyte characteristics or interleukins. Considering the importance of early diagnosis of depression and the role of NLR in early diagnosis of depression, our paper reviews the literature on NLR as a diagnostic biomarker of depression, which may be effective in its treatment. Various studies have shown that elevated NLR is associated with depression, suggesting that NLR may be a valuable, reproducible, easily accessible, and cost-effective method for the evaluation of depression and it may be used in outpatient clinic settings. Closer follow-up can be performed for these patients who have higher NLR levels. However, it seems that further studies on larger samples, taking into account important confounding factors, and assessing them together with other inflammatory markers are necessary to draw some conclusive statements.
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Affiliation(s)
- Sayed Soran Ghafori
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Yousefi
- School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Elham Bakhtiari
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Gholamreza Hassanzadeh
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Korkmaz ŞA, Kızgın S, Oğuz EF, Neşelioğlu S, Erel Ö. Thiol-disulphide homeostasis, ischemia-modified albumin, complete blood count-derived inflammatory markers and C-reactive protein from acute mania to early remission in bipolar disorder. J Affect Disord 2023; 339:426-434. [PMID: 37459969 DOI: 10.1016/j.jad.2023.07.079] [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: 05/04/2023] [Revised: 06/20/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVES There is much recent evidence that inflammation contributes to the pathophysiology of acute mania in bipolar disorder (BD). However, no study was evaluated in which the change in thiol-disulphide homeostasis, ischemia-modified albumin (IMA), complete blood count-derived inflammatory markers (CBC-IMs) and C-reactive protein (CRP) levels in bipolar patients was followed-up from acute mania to early remission. METHODS Seventy-seven bipolar patients in acute mania and ninety-one HC were enrolled. We measured levels of thiol-disulphide parameters, IMA, and CBC-IMs such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), red-cell-distribution-width (RDW)-to-platelet ratio (RPR), systemic immune-inflammatory index (SII), and systemic inflammatory response index (SIRI), CRP and platelet-to-albumin ratio (PAR), after adjusting for age, gender, body-mass index (BMI) and smoking status, during acute mania to subsequent early remission. The results were compared with HC. RESULTS The levels or ratios of all thiol-disulphide parameters except for disulphide, IMA and CRP of bipolar patients in both acute mania and early remission were significantly different from HC, after adjusting for confounders. The NLR, SII, CRP and PAR values of bipolar patients were significantly higher in only acute mania compared to HC. Significant changes in thiol-disulphide parameters and IMA levels were not found in early remission after acute mania. LIMITATIONS Short follow-up period and lack of drug-naive patients. CONCLUSIONS Our results suggest that thiol-disulphide parameters, IMA level and SIRI value might be a trait biomarkers of inflammation in BD. In addition, NLR, SII and PAR values and CRP level might be a state biomarker of inflammation in bipolar patients in a manic phase.
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Affiliation(s)
- Şükrü Alperen Korkmaz
- Çanakkale Onsekiz Mart University, Faculty of Medicine, Department of Psychiatry, Çanakkale, Turkey.
| | - Sadice Kızgın
- Ankara City Hospital, Department of Psychiatry, Ankara, Turkey
| | - Esra Fırat Oğuz
- Ankara Yıldırım Beyazıt University, Faculty of Medicine, Department of Biochemistry, Ankara/Turkey
| | - Salim Neşelioğlu
- Ankara Yıldırım Beyazıt University, Faculty of Medicine, Department of Biochemistry, Ankara/Turkey
| | - Özcan Erel
- Ankara Yıldırım Beyazıt University, Faculty of Medicine, Department of Biochemistry, Ankara/Turkey
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Xu H, Du Y, Wang Q, Chen L, Huang J, Liu Y, Zhou C, Du B. Comparative efficacy, acceptability, and tolerability of adjunctive anti-inflammatory agents on bipolar disorder: A systemic review and network meta-analysis. Asian J Psychiatr 2023; 80:103394. [PMID: 36525766 DOI: 10.1016/j.ajp.2022.103394] [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: 07/20/2022] [Revised: 09/19/2022] [Accepted: 10/02/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES We performed a network meta-analysis (NMA) with up-to-date evidence to compare different anti-inflammatory agents to improve the treatment of bipolar disorder (BD) patients. METHODS Four databases (i.e., the Cochrane Library, Web of Science, PubMed, and Embase) were searched for randomized controlled trials (RCTs) published between 1995 and 2022 on the use of anti-inflammatory agents in the treatment of BD. A systematic review and NMA were conducted. RESULTS Adjunctive N-acetylcysteine (NAC) was superior to placebo for the treatment of BD according to the endpoint scale score (SMD -0.65, 95% confidence interval (CI): - 0.99 to - 0.31), response rate (odds ratio (OR) 3.42, 95% CI: 1.23-9.52), remission rate (OR 4.94, 95% CI: 1.03-41.38) and surface under the cumulative ranking curve (SUCRA) value of the endpoint scale score (0.84). Adjunctive nonsteroidal anti-inflammatory drugs (NSAIDs) were more favorable than placebo based on the remission rate (OR 3.93, 95% CI: 1.15-13.43) and were significantly more acceptable than other treatments (OR 0.60, 95% CI: 0.36-0.99). Adjunctive coenzyme Q10 (CoQ10) was superior to other agents in terms of the response rate (OR 18.85, 95% CI: 2.63-135.00), with a SUCRA value for the response rate of 0.90 and that for the remission rate of 0.71. CONCLUSION Adjunctive NAC is recommended for the treatment of BD. Adjunctive NSAIDs and CoQ10 are still seen as effective, but more high-quality clinical studies are needed to verify their efficacy. Other anti-inflammatory agents may not be recommended for clinical use at present. All anti-inflammatory agents demonstrated a good safety profile. We call for further research on the combined treatment of BD with different anti-inflammatory agents to be included in future trials.
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Affiliation(s)
- Han Xu
- School of Pharmacy, North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Yang Du
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Qiong Wang
- Department of Pharmacy, Ningxia Medical University, Ningxia 750004, China
| | - Lizhi Chen
- School of Pharmacy, Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Juan Huang
- School of Pharmacy, North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Yin Liu
- School of Pharmacy, North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Chunyang Zhou
- School of Pharmacy, North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Biao Du
- School of Pharmacy, North Sichuan Medical College, Nanchong, Sichuan 637000, China; Department of Pharmacy, Chongqing University Three Gorges Hospital, Chongqing 404000, China.
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Whitney MS, Scott SL, Perez JA, Barnes S, McVoy MK. Elevation of C-reactive protein in adolescent bipolar disorder vs. anxiety disorders. J Psychiatr Res 2022; 156:308-317. [PMID: 36306709 DOI: 10.1016/j.jpsychires.2022.09.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/28/2022] [Accepted: 09/16/2022] [Indexed: 01/20/2023]
Abstract
Bipolar disorder (BD) largely begins in adolescence, but diagnosis lags for years, causing significant morbidity and mortality, and demonstrating the need for better diagnostic tools. Suggesting an association between BD and immune activity, elevated levels of peripheral inflammatory markers, including C-reactive protein (CRP), have been found in adults with BD. As similar data are extremely limited in adolescents, this study examined CRP levels in adolescents with BD (n = 37) compared to those with anxiety disorders (ADs, n = 157) and healthy controls with no psychiatric diagnoses (HCs, n = 2760). CRP blood levels for patients aged 12-17 years were retrieved from a nationwide repository of deidentified clinical data. After excluding patients with inflammatory conditions, differences in CRP were examined using multivariate and weighted regressions (covariates: demographics and BMI). Mean CRP levels were significantly elevated in adolescents with BD relative to those with ADs and HCs. Mean CRP levels were lower in the ADs cohort versus HCs. Although CRP levels were significantly higher in males and younger patients, the significant between-cohort differences in CRP remained after controlling for multiple confounders. To our knowledge, our study is the first to compare CRP levels between adolescent BD, ADs, and HCs, comprising a novel and essential contribution. Our results suggest the presence of a unique immune process in adolescents with BD and indicate that CRP may represent a biomarker with a crucial role in the diagnostic assessment of adolescent BD.
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Affiliation(s)
| | - Stephen L Scott
- Department of Child and Adolescent Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
| | - Jaime Abraham Perez
- Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
| | - Stephanie Barnes
- Department of Child and Adolescent Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Molly K McVoy
- Department of Child and Adolescent Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
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Kotzaeroglou A, Tsamesidis I. The Role of Equilibrium between Free Radicals and Antioxidants in Depression and Bipolar Disorder. MEDICINES (BASEL, SWITZERLAND) 2022; 9:57. [PMID: 36422118 PMCID: PMC9694953 DOI: 10.3390/medicines9110057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
Background: Increasing evidence suggests that the presence of oxidative stress and disorders of the antioxidant defense system are involved in a wide range of neuropsychiatric disorders, such as bipolar disorder, schizophrenia and major depression, but the exact mechanism remains unknown. This review focuses on a better appreciation of the contribution of oxidative stress to depression and bipolar disorder. Methods: This review was conducted by extracting information from other research and review studies, as well as other meta-analyses, using two search engines, PubMed and Google Scholar. Results: As far as depression is concerned, there is agreement among researchers on the association between oxidative stress and antioxidants. In bipolar disorder, however, most of them observe strong lipid peroxidation in patients, while regarding antioxidant levels, opinions are divided. Nevertheless, in recent years, it seems that on depression, there are mainly meta-analyses and reviews, rather than research studies, unlike on bipolar disorder. Conclusions: Undoubtedly, this review shows that there is an association among oxidative stress, free radicals and antioxidants in both mental disorders, but further research should be performed on the exact role of oxidative stress in the pathophysiology of these diseases.
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Affiliation(s)
- Anastasia Kotzaeroglou
- Department of Biomedical Sciences, Metropolitan College, Campus of Thessaloniki, 54624 Thessaloniki, Greece
| | - Ioannis Tsamesidis
- Department of Biomedical Sciences, Metropolitan College, Campus of Thessaloniki, 54624 Thessaloniki, Greece
- School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Lorkiewicz P, Waszkiewicz N. Is SARS-CoV-2 a Risk Factor of Bipolar Disorder?-A Narrative Review. J Clin Med 2022; 11:6060. [PMID: 36294388 PMCID: PMC9604904 DOI: 10.3390/jcm11206060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
For 2.5 years we have been facing the coronavirus disease (COVID-19) and its health, social and economic effects. One of its known consequences is the development of neuropsychiatric diseases such as anxiety and depression. However, reports of manic episodes related to COVID-19 have emerged. Mania is an integral part of the debilitating illness-bipolar disorder (BD). Due to its devastating effects, it is therefore important to establish whether SARS-CoV-2 infection is a causative agent of this severe mental disorder. In this narrative review, we discuss the similarities between the disorders caused by SARS-CoV-2 and those found in patients with BD, and we also try to answer the question of whether SARS-CoV-2 infection may be a risk factor for the development of this affective disorder. Our observation shows that disorders in COVID-19 showing the greatest similarity to those in BD are cytokine disorders, tryptophan metabolism, sleep disorders and structural changes in the central nervous system (CNS). These changes, especially intensified in severe infections, may be a trigger for the development of BD in particularly vulnerable people, e.g., with family history, or cause an acute episode in patients with a pre-existing BD.
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Affiliation(s)
- Piotr Lorkiewicz
- Department of Psychiatry, Medical University of Bialystok, Wołodyjowskiego 2, 15-272 Białystok, Poland
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Lima DDD, Cyrino LAR, Ferreira GK, Magro DDD, Calegari CR, Cabral H, Cavichioli N, Ramos SA, Ullmann OM, Mayer Y, Pscheidt LC, Schramm MA, Tomasi MC, Stammerjohann FLS, Delmonego L, Packer MH, Fiamoncini H. Neuroinflammation and neuroprogression produced by oxidative stress in euthymic bipolar patients with different onset disease times. Sci Rep 2022; 12:16742. [PMID: 36202963 PMCID: PMC9537234 DOI: 10.1038/s41598-022-21170-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
Bipolar disorder (BD) is associated with systemic toxicity, represented by changes in biomarkers associated with mood episodes, leading to neurological damage, which may reflect cognitive functions and functionality and the progression of the disease. We aimed to analyze the effect of four biomarkers, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and thiobarbituric acid reactive substances (TBA-RS), related to oxidative stress in BD and to correlate them with cognitive functions and functionality. We studied 50 bipolar types I/II patients in the euthymic phase, which was divided into two subgroups with 25 patients each (≤ 3 years and ≥ 10 years of diagnosis, from the first episode of mania) and 25 control patients. To analyze frontal cognitive functions and functionality, we used the Frontal Assessment Battery (FAB) and Functioning Assessment Short Test (FAST) tests, respectively. The scores of the FAST and FAB tests showed an increase and decrease respectively, in both bipolar groups, when compared to the control group, demonstrating impairment in cognitive functions and functionality since the disease onset. In addition, changes occurred in all six domains of the FAST test, and in four domains of the FAB test in bipolar patients when compared to the control group. Regarding oxidative stress biomarkers, we did not find changes in SOD and GSH-Px activities; however, a significant increase in CAT activity and lipid peroxidation was observed in both groups, although the patients were euthymic and medicated. These results allow us to raise the hypothesis that since the beginning of the disease, the euthymic bipolar patient has presented a level of oxidative stress, which gets worse with the evolution of the disease, promoting impairments in the frontal cognitive functions and functionality gradually.
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Affiliation(s)
- Daniela Delwing-de Lima
- Programa de Pós-Graduação Em Saúde E Meio Ambiente, Universidade da Região de Joinville- UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89201-972, Brasil.,Departamento de Medicina, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89201-972, Brasil
| | - Luiz Arthur Rangel Cyrino
- Programa de Pós-Graduação Em Saúde E Meio Ambiente, Universidade da Região de Joinville- UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89201-972, Brasil. .,Departamento de Farmácia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil. .,Departamento de Psicologia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil.
| | - Gabriela Kozuchovski Ferreira
- Programa de Pós-Graduação Em Ciência E Engenharia de Materiais, Universidade Sociedade Educacional de Santa Catarina UNISOCIESC, Joinville, Santa Catarina, Brasil
| | - Débora Delwing Dal Magro
- Departamento de Ciências Naturais, Centro de Ciências Exatas E Naturais, Universidade Regional de Blumenau, Rua Antônio da Veiga, 140, Blumenau, SC, CEP 89012-900, Brasil
| | - Claudia Regina Calegari
- Departamento de Psicologia, Universidad Europea del Atlántico, UNEATLANTICO, Calle Isabel Torres, 21, Santander, Spain
| | - Heloisi Cabral
- Departamento de Ciências Biológicas, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC CEP, CEP 89201-972, Brasil
| | - Natalia Cavichioli
- Departamento de Biomedicina, Centro de Ciências da Saúde, Universidade Regional de Blumenau, Rua Antônio da Veiga, 140, Blumenau, SC, CEP 89012-900, Brasil
| | - Silvia Aparecida Ramos
- Departamento de Farmácia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Oliver Matheus Ullmann
- Departamento de Farmácia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Yasmin Mayer
- Departamento de Farmácia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Luana Carla Pscheidt
- Departamento de Farmácia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Maria Augusta Schramm
- Departamento de Farmácia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Maria Cecília Tomasi
- Departamento de Psicologia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Felipe Luis Schmoller Stammerjohann
- Departamento de Psicologia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Larissa Delmonego
- Departamento de Medicina, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89201-972, Brasil
| | - Maria Helena Packer
- Programa de Pós-Graduação Em Saúde E Meio Ambiente, Universidade da Região de Joinville- UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89201-972, Brasil
| | - Heloiza Fiamoncini
- Programa de Pós-Graduação Em Saúde E Meio Ambiente, Universidade da Região de Joinville- UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89201-972, Brasil
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10
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Zhao Q, Xiang H, Cai Y, Meng SS, Zhang Y, Qiu P. Systematic evaluation of the associations between mental disorders and dementia: An umbrella review of systematic reviews and meta-analyses. J Affect Disord 2022; 307:301-309. [PMID: 35283178 DOI: 10.1016/j.jad.2022.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Increasing evidence support the correlation between mental disorders and the likelihood of developing dementia. We aim to conduct an umbrella review to assess the risk of dementia in patients with eight mental disorders. METHODS We searched PubMed, Embase, Web of science, CNKI, VIP, and Wanfang databases from inception to October 29, 2021. For each included meta-analysis, the effect size with a 95% confidence interval was estimated using either a random effect model or a fixed effect model, and between-study heterogeneity was expressed by I2 and Cochran's Q test. The ROBIS tool was used to assess the risk of bias. RESULTS A total of ten systematic reviews were included. Among these studies, we identified seven risk factors, including anxiety disorder, bipolar disorder, depression, late-life depression, post-traumatic stress disorder, schizophrenia, and sleep disorder. Light to moderate alcohol drinking was identified as a protective factor. The evaluation results of the ROBIS tool showed that nine systematic reviews had high risk of bias and one had low risk of bias. The strength of evidence supporting the associations between late-life depression and all-cause dementia, Alzheimer's disease, and vascular dementia was high; the strength of evidence supporting the association between depression and all-cause dementia was moderate. LIMITATIONS Most associations had low strength of evidence and high risk of bias. CONCLUSIONS This umbrella review shows that high and moderate evidence supports the associations between some mental disorders and dementia. More cohort studies are needed to support the associations between mental disorders and dementia.
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Affiliation(s)
- Qin Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Hongyu Xiang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yan Cai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Steven Siyao Meng
- Department of Psychiatry, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY 14642, USA
| | - Yunyang Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peiyuan Qiu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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11
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Chung JK, Ahn YM, Kim SA, Joo EJ. Differences in mitochondrial DNA copy number between patients with bipolar I and II disorders. J Psychiatr Res 2022; 145:325-333. [PMID: 33190840 DOI: 10.1016/j.jpsychires.2020.11.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/08/2020] [Accepted: 11/05/2020] [Indexed: 02/01/2023]
Abstract
Mitochondria play a critical role in energy metabolism. Genetic, postmortem brain, and brain imaging studies of bipolar disorder (BD) patients indicated that mitochondrial dysfunction might explain BD pathophysiology. Mitochondrial function can be indirectly evaluated by measuring mitochondrial DNA (mtDNA) copy numbers. We recruited 186 bipolar I disorder (BD1) and 95 bipolar II disorder (BD2) patients, and age- and sex-matched controls. MtDNA copy numbers in peripheral blood cells were measured via quantitative polymerase chain reaction. We explored parameters (including age and clinical features) that might affect mtDNA copy numbers. We found that BD1 patients had a lower mtDNA copy number than controls and that mtDNA copy number was negatively associated with the number of mood episodes. BD2 patients had a higher mtDNA copy number than controls. Thus, changes in mitochondrial function may influence BD pathophysiology. The opposite directions of the association with mtDNA copy number in BD1 and BD2 patients suggests that the difference in pathophysiology may be associated with mitochondrial function.
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Affiliation(s)
- Jae Kyung Chung
- Department of Psychiatry, Eumsung-somang Hospital, Eumsung, Republic of Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Soon Ae Kim
- Department of Pharmacology, School of Medicine, Eulji University, Daejeon, Republic of Korea.
| | - Eun-Jeong Joo
- Department of Neuropsychiatry, School of Medicine, Eulji University, Daejeon, Republic of Korea; Department of Psychiatry, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea.
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12
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Avan R, Sahebnasagh A, Hashemi J, Monajati M, Faramarzi F, Henney NC, Montecucco F, Jamialahmadi T, Sahebkar A. Update on Statin Treatment in Patients with Neuropsychiatric Disorders. Life (Basel) 2021; 11:1365. [PMID: 34947895 PMCID: PMC8703562 DOI: 10.3390/life11121365] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/26/2021] [Accepted: 12/04/2021] [Indexed: 02/06/2023] Open
Abstract
Statins are widely accepted as first-choice agents for the prevention of lipid-related cardiovascular diseases. These drugs have both anti-inflammatory and anti-oxidant properties, which may also make them effective as potential treatment marked by perturbations in these pathways, such as some neuropsychiatric disorders. In this narrative review, we have investigated the effects of statin therapy in individuals suffering from major depressive disorder (MDD), schizophrenia, anxiety, obsessive-compulsive disorder (OCD), bipolar disorder (BD), delirium, and autism spectrum disorders using a broad online search of electronic databases. We also explored the adverse effects of these drugs to obtain insights into the benefits and risks associated with their use in the treatment of these disorders. Lipophilic statins (including simvastatin) because of better brain penetrance may have greater protective effects against MDD and schizophrenia. The significant positive effects of statins in the treatment of anxiety disorders without any serious adverse side effects were shown in numerous studies. In OCD, BD, and delirium, limitations, and contradictions in the available data make it difficult to draw conclusions on any positive effect of statins. The positive effects of simvastatin in autism disorders have been evaluated in only a small number of clinical trials. Although some studies showed positive effect of statins in some neuropsychiatric disorders, further prospective studies are needed to confirm this and define the most effective doses and treatment durations.
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Affiliation(s)
- Razieh Avan
- Department of Clinical Pharmacy, Medical Toxicology and Drug Abuse Research Center (MTDRC), School of Pharmacy, Birjand University of Medical Sciences, Birjand 9717853577, Iran;
| | - Adeleh Sahebnasagh
- Clinical Research Center, Department of Internal Medicine, North Khorasan University of Medical Sciences, Bojnurd 9453155166, Iran;
| | - Javad Hashemi
- Department of Pathobiology and Laboratory Sciences, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd 9453155166, Iran;
| | - Mahila Monajati
- Department of Internal Medicine, Golestan University of Medical Sciences, Gorgan 4934174515, Iran;
| | - Fatemeh Faramarzi
- Clinical Pharmacy Research Center, Iran University of Medical Sciences, Tehran 1445613131, Iran;
| | - Neil C. Henney
- Pharmacy & Biomolecular Sciences, Liverpool John Moores University, Liverpool L3 5UX, UK;
| | - Fabrizio Montecucco
- IRCCS Ospedale Policlinico San Martino Genoa-Italian Cardiovascular Network, 10 Largo Benzi, 16132 Genoa, Italy;
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132 Genoa, Italy
| | - Tannaz Jamialahmadi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran;
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad 9177948954, Iran
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad 9177948954, Iran
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13
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Cyrino LAR, Delwing-de Lima D, Ullmann OM, Maia TP. Concepts of Neuroinflammation and Their Relationship With Impaired Mitochondrial Functions in Bipolar Disorder. Front Behav Neurosci 2021; 15:609487. [PMID: 33732117 PMCID: PMC7959852 DOI: 10.3389/fnbeh.2021.609487] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/18/2021] [Indexed: 12/24/2022] Open
Abstract
Bipolar disorder (BD) is a chronic psychiatric disease, characterized by frequent behavioral episodes of depression and mania, and neurologically by dysregulated neurotransmission, neuroplasticity, growth factor signaling, and metabolism, as well as oxidative stress, and neuronal apoptosis, contributing to chronic neuroinflammation. These abnormalities result from complex interactions between multiple susceptibility genes and environmental factors such as stress. The neurocellular abnormalities of BD can result in gross morphological changes, such as reduced prefrontal and hippocampal volume, and circuit reorganization resulting in cognitive and emotional deficits. The term "neuroprogression" is used to denote the progressive changes from early to late stages, as BD severity and loss of treatment response correlate with the number of past episodes. In addition to circuit and cellular abnormalities, BD is associated with dysfunctional mitochondria, leading to severe metabolic disruption in high energy-demanding neurons and glia. Indeed, mitochondrial dysfunction involving electron transport chain (ETC) disruption is considered the primary cause of chronic oxidative stress in BD. The ensuing damage to membrane lipids, proteins, and DNA further perpetuates oxidative stress and neuroinflammation, creating a perpetuating pathogenic cycle. A deeper understanding of BD pathophysiology and identification of associated biomarkers of neuroinflammation are needed to facilitate early diagnosis and treatment of this debilitating disorder.
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Affiliation(s)
- Luiz Arthur Rangel Cyrino
- Programa de Pós-Graduação em Saúde e Meio Ambiente, Laboratório de Práticas Farmacêuticas of Department of Pharmacy, University of Joinville Region—UNIVILLE, Joinville, Brazil
- Department of Psychology, University of Joinville—UNIVILLE, Joinville, Brazil
- Department of Pharmacy, University of Joinville—UNIVILLE, Joinville, Brazil
| | - Daniela Delwing-de Lima
- Programa de Pós-Graduação em Saúde e Meio Ambiente, Laboratório de Práticas Farmacêuticas of Department of Pharmacy, University of Joinville Region—UNIVILLE, Joinville, Brazil
- Department of Pharmacy, University of Joinville—UNIVILLE, Joinville, Brazil
- Department of Medicine, University of Joinville—UNIVILLE, Joinville, Brazil
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14
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Wollenhaupt-Aguiar B, Kapczinski F, Pfaffenseller B. Biological Pathways Associated with Neuroprogression in Bipolar Disorder. Brain Sci 2021; 11:brainsci11020228. [PMID: 33673277 PMCID: PMC7918818 DOI: 10.3390/brainsci11020228] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 02/06/2023] Open
Abstract
There is evidence suggesting clinical progression in a subset of patients with bipolar disorder (BD). This progression is associated with worse clinical outcomes and biological changes. Molecular pathways and biological markers of clinical progression have been identified and may explain the progressive changes associated with this disorder. The biological basis for clinical progression in BD is called neuroprogression. We propose that the following intertwined pathways provide the biological basis of neuroprogression: inflammation, oxidative stress, impaired calcium signaling, endoplasmic reticulum and mitochondrial dysfunction, and impaired neuroplasticity and cellular resilience. The nonlinear interaction of these pathways may worsen clinical outcomes, cognition, and functioning. Understanding neuroprogression in BD is crucial for identifying novel therapeutic targets, preventing illness progression, and ultimately promoting better outcomes.
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Affiliation(s)
- Bianca Wollenhaupt-Aguiar
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON L8N 3K7, Canada; (B.W.-A.); (F.K.)
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON L8N 3K7, Canada; (B.W.-A.); (F.K.)
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada
- Neuroscience Graduate Program, McMaster University, Hamilton, ON L8S 4L8, Canada
- Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-903, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90035-003, Brazil
| | - Bianca Pfaffenseller
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON L8N 3K7, Canada; (B.W.-A.); (F.K.)
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON L8N 3K7, Canada
- Correspondence:
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15
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Fusar-Poli L, Natale A, Amerio A, Cimpoesu P, Grimaldi Filioli P, Aguglia E, Amore M, Serafini G, Aguglia A. Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte and Monocyte-to-Lymphocyte Ratio in Bipolar Disorder. Brain Sci 2021; 11:brainsci11010058. [PMID: 33418881 PMCID: PMC7825034 DOI: 10.3390/brainsci11010058] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Several inflammatory hypotheses have been suggested to explain the etiopathogenesis of bipolar disorder (BD) and its different phases. Neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), and monocyte-to-lymphocyte (MLR) ratios have been proposed as potential peripheral biomarkers of mood episodes. Methods: We recruited 294 patients affected by BD, of which 143 were experiencing a (hypo)manic episode and 151 were in a depressive phase. A blood sample was drawn to perform a complete blood count. NLR, PLR, and MLR were subsequently calculated. A t-test was performed to evaluate differences in blood cell counts between depressed and (hypo)manic patients and a regression model was then computed. Results: Mean values of neutrophils, platelets, mean platelet volume, NLR, PLR, and MLR were significantly higher in (hypo)manic than depressed individuals. Logistic regression showed that PLR may represent an independent predictor of (hypo)mania. Conclusions: Altered inflammatory indexes, particularly PLR, may explain the onset and recurrence of (hypo)manic episodes in patients with BD. As inflammatory ratios represent economical and accessible markers of inflammation, further studies should be implemented to better elucidate their role as peripheral biomarkers of BD mood episodes.
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Affiliation(s)
- Laura Fusar-Poli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (L.F.-P.); (A.N.); (E.A.)
| | - Antimo Natale
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (L.F.-P.); (A.N.); (E.A.)
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Department of Psychiatry, Tufts University, Boston, MA 02110, USA
| | - Patriciu Cimpoesu
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Pietro Grimaldi Filioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Eugenio Aguglia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (L.F.-P.); (A.N.); (E.A.)
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Correspondence:
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16
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Interleukin-6 and total antioxidant capacity levels following N-acetylcysteine and a combination nutraceutical intervention in a randomised controlled trial for bipolar disorder. Acta Neuropsychiatr 2020; 32:313-320. [PMID: 32600481 DOI: 10.1017/neu.2020.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aims of this study were to evaluate changes in inflammatory and oxidative stress levels following treatment with N-acetylcysteine (NAC) or mitochondrial-enhancing agents (CT), and to assess the how these changes may predict and/or moderate clinical outcomes primarily the Montgomery-Åsberg Depression Rating Scale (MADRS). METHODS This study involved secondary analysis of a placebo-controlled randomised trial (n = 163). Serum samples were collected at baseline and week 16 of the clinical trial to determine changes in Interleukin-6 (IL-6) and total antioxidant capacity (TAC) following adjunctive CT and/or NAC treatment, and to explore the predictability of the outcome or moderator effects of these markers. RESULTS In the NAC-treated group, no difference was observed in serum IL-6 and TAC levels after 16 weeks of treatment with NAC or CT. However, results from a moderator analysis showed that in the CT group, lower IL-6 levels at baseline was a significant moderator of MADRS χ2 (df) = 4.90, p = 0.027) and Clinical Global Impression-Improvement (CGI-I, χ2 (df) = 6.28 p = 0.012). In addition, IL-6 was a non-specific but significant predictor of functioning (based on the Social and Occupational Functioning Assessment Scale (SOFAS)), indicating that individuals with higher IL-6 levels at baseline had a greater improvement on SOFAS regardless of their treatment (p = 0.023). CONCLUSION Participants with lower IL-6 levels at baseline had a better response to the adjunctive treatment with the mitochondrial-enhancing agents in terms of improvements in MADRS and CGI-I outcomes.
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17
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You X, Zhang Y, Long Q, Liu Z, Feng Z, Zhang W, Teng Z, Zeng Y. Does single gene expression omnibus data mining analysis apply for only tumors and not mental illness? A preliminary study on bipolar disorder based on bioinformatics methodology. Medicine (Baltimore) 2020; 99:e21989. [PMID: 32871949 PMCID: PMC7458177 DOI: 10.1097/md.0000000000021989] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Bipolar disorder (BD), a common kind of mood disorder with frequent recurrence, high rates of additional comorbid conditions and poor compliance, has an unclear pathogenesis. The Gene Expression Omnibus (GEO) database is a gene expression database created and maintained by the National Center for Biotechnology Information. Researchers can download expression data online for bioinformatics analysis, especially for cancer research. However, there is little research on the use of such bioinformatics analysis methodologies for mental illness by downloading differential expression data from the GEO database. METHODS Publicly available data were downloaded from the GEO database (GSE12649, GSE5388 and GSE5389), and differentially expressed genes (DEGs) were extracted by using the online tool GEO2R. A Venn diagram was used to screen out common DEGs between postmortem brain tissues and normal tissues. Functional annotation and pathway enrichment analysis of DEGs were performed by using Gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses, respectively. Furthermore, a protein-protein interaction network was constructed to identify hub genes. RESULTS A total of 289 DEGs were found, among which 5 of 10 hub genes [HSP90AA1, HSP90AB 1, UBE2N, UBE3A, and CUL1] were identified as susceptibility genes whose expression was downregulated. Gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses showed that variations in these 5 hub genes were obviously enriched in protein folding, protein polyubiquitination, apoptotic process, protein binding, the ubiquitin-mediated proteolysis pathway, and protein processing in the endoplasmic reticulum pathway. These findings strongly suggested that HSP90AA1, UBE3A, and CUL 1, which had large areas under the curve in receiver operator curves (P < .05), were potential diagnostic markers for BD. CONCLUSION Although there are 3 hub genes [HSP90AA1, UBE3A, and CUL 1] that are tightly correlated with the occurrence of BD, mainly based on routine bioinformatics methods for cancer-related disease, the feasibility of applying this single GEO bioinformatics approach for mental illness is questionable, given the significant differences between mental illness and cancer-related diseases.
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18
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Velosa J, Delgado A, Finger E, Berk M, Kapczinski F, de Azevedo Cardoso T. Risk of dementia in bipolar disorder and the interplay of lithium: a systematic review and meta-analyses. Acta Psychiatr Scand 2020; 141:510-521. [PMID: 31954065 DOI: 10.1111/acps.13153] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To assess whether bipolar disorder (BD) increases the rate of dementia and whether lithium is related to a lower risk of dementia in BD. METHODS A total of 10 studies (6859 BD; 487 966 controls) were included in the meta-analysis to test whether BD is a risk factor for dementia. In addition, five studies (6483 lithium; 43 496 non-lithium) were included in the meta-analysis about the potential protective effect of lithium in BD. RESULTS BD increases the risk of dementia (odds ratio (OR): 2.96 [95% CI: 2.09-4.18], P < 0.001), and treatment with lithium decreases the risk of dementia in BD (OR: 0.51 [95% CI: 0.36-0.72], P < 0.0001). In addition, secondary findings from our systematic review showed that the risk of progression to dementia is higher in BD than in major depressive disorder (MDD). Moreover, the number of mood episodes predicted the development of dementia in BD. CONCLUSION Individuals with BD are at higher risk of dementia than both the general population or those with MDD. Lithium appears to reduce the risk of developing dementia in BD.
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Affiliation(s)
- J Velosa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Department of Psychiatry and Mental Health, Hospital Beatriz Angelo, Loures, Portugal
| | - A Delgado
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Department of Psychiatry and Mental Health, Hospital Beatriz Angelo, Loures, Portugal
| | - E Finger
- Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
| | - M Berk
- Barwon Health, School of Medicine, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - F Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - T de Azevedo Cardoso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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19
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Wollenhaupt-Aguiar B, Librenza-Garcia D, Bristot G, Przybylski L, Stertz L, Kubiachi Burque R, Ceresér KM, Spanemberg L, Caldieraro MA, Frey BN, Fleck MP, Kauer-Sant'Anna M, Passos IC, Kapczinski F. Differential biomarker signatures in unipolar and bipolar depression: A machine learning approach. Aust N Z J Psychiatry 2020; 54:393-401. [PMID: 31789053 DOI: 10.1177/0004867419888027] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study used machine learning techniques combined with peripheral biomarker measurements to build signatures to help differentiating (1) patients with bipolar depression from patients with unipolar depression, and (2) patients with bipolar depression or unipolar depression from healthy controls. METHODS We assessed serum levels of interleukin-2, interleukin-4, interleukin-6, interleukin-10, tumor necrosis factor-α, interferon-γ, interleukin-17A, brain-derived neurotrophic factor, lipid peroxidation and oxidative protein damage in 54 outpatients with bipolar depression, 54 outpatients with unipolar depression and 54 healthy controls, matched by sex and age. Depressive symptoms were assessed using the Hamilton Depression Rating Scale. Variable selection was performed with recursive feature elimination with a linear support vector machine kernel, and the leave-one-out cross-validation method was used to test and validate our model. RESULTS Bipolar vs unipolar depression classification achieved an area under the receiver operating characteristics (ROC) curve (AUC) of 0.69, with 0.62 sensitivity and 0.66 specificity using three selected biomarkers (interleukin-4, thiobarbituric acid reactive substances and interleukin-10). For the comparison of bipolar depression vs healthy controls, the model retained five variables (interleukin-6, interleukin-4, thiobarbituric acid reactive substances, carbonyl and interleukin-17A), with an AUC of 0.70, 0.62 sensitivity and 0.7 specificity. Finally, unipolar depression vs healthy controls comparison retained seven variables (interleukin-6, Carbonyl, brain-derived neurotrophic factor, interleukin-10, interleukin-17A, interleukin-4 and tumor necrosis factor-α), with an AUC of 0.74, a sensitivity of 0.68 and 0.70 specificity. CONCLUSION Our findings show the potential of machine learning models to aid in clinical practice, leading to more objective assessment. Future studies will examine the possibility of combining peripheral blood biomarker data with other biological data to develop more accurate signatures.
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Affiliation(s)
- Bianca Wollenhaupt-Aguiar
- Department of Psychiatry and Behavioural Neurosciences, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Diego Librenza-Garcia
- Department of Psychiatry and Behavioural Neurosciences, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Graduation Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Giovana Bristot
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Laura Przybylski
- Graduation Program in Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Laura Stertz
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Renan Kubiachi Burque
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Keila Mendes Ceresér
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Graduation Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Lucas Spanemberg
- Graduation Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Neuroscience Training Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Section of Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Marco Antônio Caldieraro
- Graduation Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Marcelo P Fleck
- Graduation Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Legal Medicine and Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Marcia Kauer-Sant'Anna
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Graduation Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Department of Legal Medicine and Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Ives Cavalcante Passos
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Graduation Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Department of Legal Medicine and Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University and St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Graduation Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Department of Legal Medicine and Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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20
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Mora E, Portella MJ, Piñol-Ripoll G, López R, Cuadras D, Forcada I, Teres M, Vieta E, Mur M. High BDNF serum levels are associated to good cognitive functioning in bipolar disorder. Eur Psychiatry 2020; 60:97-107. [DOI: 10.1016/j.eurpsy.2019.02.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/18/2019] [Accepted: 02/18/2019] [Indexed: 01/08/2023] Open
Abstract
AbstractBackground:Neurotrophins such as brain-derived neurotrophic factor (BDNF), inflammation and oxidative damage may contribute to the pathophysiology of bipolar disorder (BD) in terms of illness activity. To date, there is a lack of studies linking the cognitive impairment observed in BD with these neurobiological mechanisms. This study aimed to investigate the role of these neurobiological factors in clinical and cognitive outcomes in a sample of bipolar individuals.Methods:We measured serum BDNF, cytokines and oxidative stress markers in a sample of 133 individuals: 52 euthymic bipolar patients, 32 manic patients and 49 healthy controls. They were all assessed with a comprehensive cognitive battery. Sociodemographic and clinical data were collected. Multiple linear regression models were built to study associations of neurotrophins and inflammatory and oxidative measures with cognitive functioning.Results:BDNF levels were decreased in euthymic (p = 0.039) and manic (p < 0.001) individuals. Conversely, inflammatory (interleukin 6 (IL-6)) (p = 0.019) and oxidative stress (p = 0.003) measures were increased in bipolar individuals compared to controls. BDNF levels were associated with executive functioning (β = 0.01, p = 0.02) and verbal memory (β = 0.013, p = 0.005), together with other demographic variables. In particular, verbal memory was also associated with obesity (β=-0.04, p = 0.005). Neither inflammatory markers, oxidative stress markers nor other relevant clinical variables showed any association with cognitive outcome.Conclusions:Of all the peripheral neurobiological factors analysed, BDNF was the only one significantly associated with cognitive dysfunction in bipolar disorder individuals. This study emphasizes the role of BDNF not only across mood phases but also in cognitive functioning.
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21
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Lv Q, Guo Y, Zhu M, Geng R, Cheng X, Bao C, Wang Y, Huang X, Zhang C, Hao Y, Li Z, Yi Z. Predicting individual responses to lithium with oxidative stress markers in drug-free bipolar disorder. World J Biol Psychiatry 2019; 20:778-789. [PMID: 31595816 DOI: 10.1080/15622975.2019.1663929] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: This is the first study to investigate the oxidative stress (OxS) levels in drug-free bipolar disorder (BD) patients and their association with lithium response.Methods: A total of 61 drug-free BD patients and 49 controls were included. Patients treated with lithium were followed-up for 6 weeks. The levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT) and malondialdehyde (MDA) were measured at baseline and at the end of the sixth week.Results: Compared to controls, the SOD levels were lower, whereas the MDA were higher in the BD-depression (BD-D) group (both P < 0.001). GSH-Px levels were higher in both the BD-D and the BD-mania (BD-M) group (both P < 0.001). Both GSH-Px and MDA levels in the BD (P = 0.009, P < 0.001) and the BD-D subgroup (P = 0.006, P = 0.001) decreased significantly after the 6-week treatment with lithium. Interestingly, both GSH-Px and MDA levels decreased in responders (P = 0.03, P = 0.002) but not in the non-responders of BD-D (both p > 0.05). Moreover, the reduction in the MDA levels were associated with lithium response (B = 1.47, Wald statistic = 5.94, P = 0.015, odds ratio = 4.35, 95% confidence interval 1.33-14.20).Conclusions: Our study demonstrates an imbalance of OxS in drug-free BD, especially BD-D. Lithium reduces the GSH-Px and MDA levels in BD patients. The reduction in MDA levels may predict individual responsiveness to lithium.
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Affiliation(s)
- Qinyu Lv
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanhong Guo
- Qingdao Mental Health Center, Qingdao, China
| | - Minghuan Zhu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruijie Geng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyan Cheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenxi Bao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingyi Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinxin Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Hao
- Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zezhi Li
- Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenghui Yi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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22
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Munkholm K, Vinberg M, Pedersen BK, Poulsen HE, Ekstrøm CT, Kessing LV. A multisystem composite biomarker as a preliminary diagnostic test in bipolar disorder. Acta Psychiatr Scand 2019; 139:227-236. [PMID: 30383306 DOI: 10.1111/acps.12983] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/29/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Diagnosis and management of bipolar disorder (BD) are limited by the absence of available laboratory tests. We aimed to combine data from different molecular levels and tissues into a composite diagnostic and state biomarker. METHODS Expression levels of 19 candidate genes in peripheral blood, plasma levels of BDNF, NT-3, IL-6 and IL-18, leukocyte counts, and urinary markers of oxidative damage to DNA and RNA were measured in 37 adult rapid-cycling patients with BD in different affective states during a 6- to 12-month period and in 40 age- and gender-matched healthy individuals in a longitudinal, repeated measures design comprising a total of 211 samples. A composite biomarker was constructed using data-driven variable selection. RESULTS The composite biomarker discriminated between patients with BD and healthy control individuals with an area under the receiver operating characteristic curve (AUC) of 0.83 and a sensitivity of 73% and specificity of 71% corresponding with a moderately accurate test. Discrimination between manic and depressive states had a moderate accuracy, with an AUC of 0.82 and a sensitivity of 92% and a specificity of 40%. CONCLUSION Combining individual biomarkers across tissues and molecular systems could be a promising avenue for research in biomarker models in BD.
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Affiliation(s)
- K Munkholm
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - M Vinberg
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - B K Pedersen
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - H E Poulsen
- Department of Clinical Pharmacology, Bispebjerg Frederiksberg Hospital, Copenhagen, Denmark
| | - C T Ekstrøm
- Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - L V Kessing
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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23
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Watts D, Pfaffenseller B, Wollenhaupt-Aguiar B, Paul Géa L, Cardoso TDA, Kapczinski F. Agmatine as a potential therapeutic intervention in bipolar depression: the preclinical landscape. Expert Opin Ther Targets 2019; 23:327-339. [DOI: 10.1080/14728222.2019.1581764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Devon Watts
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Bianca Pfaffenseller
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | | | - Luiza Paul Géa
- Graduate Program in Biological Sciences, Pharmacology and Therapeutics, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | | | - Flavio Kapczinski
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
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24
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Duarte JA, Massuda R, Goi PD, Vianna-Sulzbach M, Colombo R, Kapczinski F, Gama CS. White matter volume is decreased in bipolar disorder at early and late stages. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2018; 40:277-284. [DOI: 10.1590/2237-6089-2017-0025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 01/11/2018] [Indexed: 11/21/2022]
Abstract
Abstract Introduction: Bipolar disorder (BD) is a debilitating mood condition that affects approximately 1.3% of people worldwide, although some studies report up to 3.9% lifetime prevalence and 4-6% in adults when broad diagnostic criteria are applied. Objective: To compare differences in total white matter (WM), corpus callosum (CC) and total gray matter (GM) volumes in patients with type I BD at early and late stages compared with controls. Methods: Fifty-five subjects were enrolled in this study protocol. The double case-control design included 14 patients with BD at early stage; 15 patients at late stage; and their respective matched controls (14 and 12 subjects). Results: CC and total WM volumes were significantly smaller in patients with BD at early and late stages vs. controls. There was no difference for total GM volume in the early stage group, but in patients at late stage total GM volume was significantly smaller than in controls. The total GM volume reduction in patients at late stage is in agreement with the neuroprogression theory of BD. The reduction of WM volumes in total WM and in the CC at early and late stages supports the possibility that an early demyelination process could occur underlying the clinical manifestation of BD. Conclusion: Our findings may direct to the investigation of WM abnormalities in populations at high risk to develop BD, perhaps as early biomarkers before the overt syndrome.
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Affiliation(s)
- Juliana A. Duarte
- Hospital de Clínicas de Porto Alegre, Brazil; Tomoclínica, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
| | - Raffael Massuda
- Universidade Federal do Rio Grande do Sul, Brazil; Universidade Federal do Paraná, Brazil
| | - Pedro D. Goi
- Universidade Federal do Rio Grande do Sul, Brazil
| | | | - Rafael Colombo
- Universidade Federal do Rio Grande do Sul, Brazil; Universidade Federal do Paraná, Brazil; Universidade de Caxias do Sul, Brazil
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25
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Wang D, Li Z, Liu W, Zhou J, Ma X, Tang J, Chen X. Differential mitochondrial DNA copy number in three mood states of bipolar disorder. BMC Psychiatry 2018; 18:149. [PMID: 29801445 PMCID: PMC5970444 DOI: 10.1186/s12888-018-1717-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 05/02/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Accumulating evidences indicated that mitochondrial abnormalities were associated with bipolar disorder. As a sensitive index of mitochondrial function and biogenesis, Mitochondrial DNA copy number (mtDNAcn) may be involved in the pathophysiology of bipolar disorder. METHODS Leukocyte relative mtDNAcn was measured by quantitative polymerase chain reaction in subjects with BD (n = 131) in manic, depressive, and euthymic symptoms. Thirty-four healthy individuals were used as comparison control. BD clinical symptomatology was evaluated by Young Mania Rating Scale (YMRS), Hamilton Depression Scale (HAM-D), Clinical Global Impression-Bipolar Disorder-Severity of Illness Scale (CGI-BD-S), and the Positive and Negative Syndrome Scale (PANSS). RESULTS Compared to healthy controls, BD patients with manic and depressive symptoms presented significantly decreased mtDNAcn levels (p-value = 0.009 and 0.041, respectively). No significant differences were detected in mtDNAcn between euthymic patients and healthy controls. The mtDNAcn was negatively correlated with the number of relapses in manic patients (β = - 0.341, p = 0.044). CONCLUSIONS Our study described the first evidence of (1) a significant decline of mtDNAcn in manic BD patients, (2) a similar decreased level of mtDNAcn between manic and depressed BD patients, (3) a negative correlation of mtDNAcn with number of relapses in patients suffering from manic states. Alterations of mtDNAcn in manic and depressed patients, which may reflect disturbances of energy metabolism, supported the role of mitochondrial abnormalities in the pathophysiology of BD.
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Affiliation(s)
- Dong Wang
- 0000 0004 1803 0208grid.452708.cDepartment of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan China ,0000 0004 1803 0208grid.452708.cMental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Zongchang Li
- 0000 0004 1803 0208grid.452708.cDepartment of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan China ,0000 0001 0379 7164grid.216417.7Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan China
| | - Weiqing Liu
- grid.414902.aDepartment of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan China
| | - Jun Zhou
- 0000 0004 1803 0208grid.452708.cDepartment of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan China ,0000 0004 1803 0208grid.452708.cMental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Xiaoqian Ma
- 0000 0004 1803 0208grid.452708.cDepartment of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan China ,0000 0004 1803 0208grid.452708.cMental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Jinsong Tang
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China. .,Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China. .,National Clinical Research Center on Mental Disorders, Changsha, Hunan, China. .,National Technology Institute on Mental Disorders, Changsha, Hunan, China. .,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China.
| | - Xiaogang Chen
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China. .,Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China. .,National Clinical Research Center on Mental Disorders, Changsha, Hunan, China. .,National Technology Institute on Mental Disorders, Changsha, Hunan, China. .,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China.
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26
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Colpo GD, Stertz L, Diniz BS, Teixeira AL. Potential Use of Stem Cells in Mood Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1089:87-96. [DOI: 10.1007/5584_2018_250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Valvassori SS, Resende WR, Varela RB, Arent CO, Gava FF, Peterle BR, Dal-Pont GC, Carvalho AF, Andersen ML, Quevedo J. The Effects of Histone Deacetylase Inhibition on the Levels of Cerebral Cytokines in an Animal Model of Mania Induced by Dextroamphetamine. Mol Neurobiol 2017; 55:1430-1439. [PMID: 28168425 DOI: 10.1007/s12035-017-0384-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/04/2017] [Indexed: 01/12/2023]
Abstract
Studies have suggested the involvement of inflammatory processes in the physiopathology of bipolar disorder. Preclinical evidences have shown that histone deacetylase inhibitors may act as mood-stabilizing agents and protect the brain in models of mania and depression. The aim of the present study was to evaluate the effects of sodium butyrate (SB) and valproate (VPA) on behavioral changes, histone deacetylase activity, and the levels of cytokines in an animal model of mania induced by dextroamphetamine (d-AMPH). Wistar rats were first given d-AMPH or saline (Sal) for a period of 14 days, and then, between the 8th and 14th days, the rats were treated with SB, VPA, or Sal. The activity of histone deacetylase and the levels of cytokines (interleukin (IL) IL-4, IL-6, and IL-10 and tumor necrosis factor-alpha (TNF-α)) were evaluated in the frontal cortex and striatum of the rats. The administration of d-AMPH increased the activity of histone deacetylase in the frontal cortex. Administration of SB or VPA decreased the levels of histone deacetylase activity in the frontal cortex and striatum of rats. SB per se increased the levels of cytokines in both of the brain structures evaluated. AMPH increased the levels of cytokines in both of the brain structures evaluated, and VPA reversed this alteration. The effects of SB on d-AMPH-induced cytokine alterations were dependent on the brain structure and the cytokine evaluated. Despite VPA and SB having a similar mechanism of action, both being histone deacetylase inhibitors, they showed different effects on the levels of cytokines. The present study reinforces the need for more research into histone deacetylase inhibitors being used as a possible target for new medications in the treatment of bipolar disorder.
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Affiliation(s)
- Samira S Valvassori
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC University), Criciúma, SC, Brazil. .,Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.
| | - Wilson R Resende
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC University), Criciúma, SC, Brazil.,Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Roger B Varela
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC University), Criciúma, SC, Brazil.,Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Camila O Arent
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC University), Criciúma, SC, Brazil
| | - Fernanda F Gava
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC University), Criciúma, SC, Brazil
| | - Bruna R Peterle
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC University), Criciúma, SC, Brazil.,Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Gustavo C Dal-Pont
- Laboratory of Neuronal Signaling and Psychopharmacology, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC University), Criciúma, SC, Brazil
| | - André F Carvalho
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - João Quevedo
- Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.,Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) Medical School, Houston, TX, USA.,Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) Medical School, Houston, TX, USA.,Neuroscience Graduate Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA
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Vasconcelos-Moreno MP, Fries GR, Gubert C, dos Santos BTMQ, Fijtman A, Sartori J, Ferrari P, Grun LK, Parisi MM, Guma FTCR, Barbé-Tuana FM, Kapczinski F, Rosa AR, Yatham LN, Kauer-Sant’Anna M. Telomere Length, Oxidative Stress, Inflammation and BDNF Levels in Siblings of Patients with Bipolar Disorder: Implications for Accelerated Cellular Aging. Int J Neuropsychopharmacol 2017; 20:445-454. [PMID: 28339618 PMCID: PMC5458375 DOI: 10.1093/ijnp/pyx001] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 01/19/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Growing evidence supports the existence of neurobiological trait abnormalities in individuals at genetic risk for bipolar disorder. The aim of this study was to examine potential differences in brain-derived neurotrophic factor, cytokines, oxidative stress, and telomere length markers between patients with bipolar disorder, their siblings, and healthy controls. METHODS Thirty-six patients with bipolar disorder type I, 39 siblings, and 44 healthy controls were assessed. Serum levels of brain-derived neurotrophic factor, interleukin-6, interleukin-10, tumor necrosis factor-α, C-C motif chemokine 11, C-C motif chemokine 24, and 3-nitrotyrosine were measured, as were the activities of glutathione peroxidase, glutathione reductase, and glutathione S-transferase. Telomere length (T/S ratio) was measured using quantitative polymerase chain reaction. RESULTS Telomere length was different between the 3 groups (P = .041) with both patients and siblings showing a shorter T/S ratio compared with healthy controls. Patients showed increased levels of interleukin-6 (P = .005) and interleukin-10 (P = .002) compared with controls as well as increased levels of interleukin-6 (p = 0.014) and CCL24 (P = .016) compared with their siblings. C-C motif chemokine 11 levels were increased in siblings compared with controls (P = .015), and a similar tendency was found in patients compared with controls (P = .045). Glutathione peroxidase activity was decreased in patients compared with controls (P = .006) and siblings (P = .025). No differences were found for the other markers. CONCLUSIONS The present results suggest that unaffected siblings may present accelerated aging features. These neurobiological findings may be considered as endophenotypic traits. Further prospective studies are warranted.
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Affiliation(s)
- Mirela Paiva Vasconcelos-Moreno
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Gabriel Rodrigo Fries
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Carolina Gubert
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Bárbara Tietböhl Martins Quadros dos Santos
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Adam Fijtman
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Juliana Sartori
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Pamela Ferrari
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Lucas Kich Grun
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Mariana Migliorini Parisi
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Fátima Theresinha Costa Rodrigues Guma
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Florencia Maria Barbé-Tuana
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Flávio Kapczinski
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Adriane Ribeiro Rosa
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Lakshmi N. Yatham
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Marcia Kauer-Sant’Anna
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
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Frye MA, Ryu E, Nassan M, Jenkins GD, Andreazza AC, Evans JM, McElroy SL, Oglesbee D, Highsmith WE, Biernacka JM. Mitochondrial DNA sequence data reveals association of haplogroup U with psychosis in bipolar disorder. J Psychiatr Res 2017; 84:221-226. [PMID: 27770741 DOI: 10.1016/j.jpsychires.2016.09.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 08/15/2016] [Accepted: 09/29/2016] [Indexed: 12/22/2022]
Abstract
Converging genetic, postmortem gene-expression, cellular, and neuroimaging data implicate mitochondrial dysfunction in bipolar disorder. This study was conducted to investigate whether mitochondrial DNA (mtDNA) haplogroups and single nucleotide variants (SNVs) are associated with sub-phenotypes of bipolar disorder. MtDNA from 224 patients with Bipolar I disorder (BPI) was sequenced, and association of sequence variations with 3 sub-phenotypes (psychosis, rapid cycling, and adolescent illness onset) was evaluated. Gene-level tests were performed to evaluate overall burden of minor alleles for each phenotype. The haplogroup U was associated with a higher risk of psychosis. Secondary analyses of SNVs provided nominal evidence for association of psychosis with variants in the tRNA, ND4 and ND5 genes. The association of psychosis with ND4 (gene that encodes NADH dehydrogenase 4) was further supported by gene-level analysis. Preliminary analysis of mtDNA sequence data suggests a higher risk of psychosis with the U haplogroup and variation in the ND4 gene implicated in electron transport chain energy regulation. Further investigation of the functional consequences of this mtDNA variation is encouraged.
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Affiliation(s)
- Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Malik Nassan
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Gregory D Jenkins
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Ana C Andreazza
- Department of Psychiatry & Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Jared M Evans
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Devin Oglesbee
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - W Edward Highsmith
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Joanna M Biernacka
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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Gubert C, Jacintho Moritz CE, Vasconcelos-Moreno MP, Quadros Dos Santos BTM, Sartori J, Fijtman A, Kauer-Sant'Anna M, Kapczinski F, Battastini AMO, Magalhães PVDS. Peripheral adenosine levels in euthymic patients with bipolar disorder. Psychiatry Res 2016; 246:421-426. [PMID: 27788463 DOI: 10.1016/j.psychres.2016.10.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/23/2016] [Accepted: 10/05/2016] [Indexed: 12/19/2022]
Abstract
Recent evidence points to the involvement of the purinergic signaling in the pathophysiology of bipolar disorder. The aim of this study was to assess the serum levels of adenosine and to evaluate its relation to functioning in 24 euthymic patients with bipolar disorder type I and in 25 matched healthy controls. Subjects were evaluated using the functioning assessment short test. Serum purine levels were measured by high pressure liquid chromatography. Our results show a decrease in serum adenosine levels in bipolar disorder patients compared with controls (t= -4.8, df= 43.96, p<0.001). Moreover, a significant negative correlation was found between patient adenosine levels and depression scale scores (r= -0.642, p= 0.001). Higher functional impairment was linked to lower levels of adenosine in patients (rho= -0.551, p= 0.008). Taken together, our results provide evidence for a purinergic imbalance in bipolar disorder, specifically an adenosinergic dysfunction. Our results also indicate a relation between adenosine levels and the functional impairment caused by the disorder, which could demonstrate a potential relation of adenosine levels in worsening of symptoms.
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Affiliation(s)
- Carolina Gubert
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, RS, Brazil
| | - Cesar Eduardo Jacintho Moritz
- Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, 90035-903, Porto Alegre, RS, Brazil
| | - Mirela Paiva Vasconcelos-Moreno
- Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, 90035-003, Porto Alegre, RS, Brazil
| | | | - Juliana Sartori
- Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, 90035-003, Porto Alegre, RS, Brazil
| | - Adam Fijtman
- Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, 90035-003, Porto Alegre, RS, Brazil
| | - Márcia Kauer-Sant'Anna
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, RS, Brazil; Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, 90035-003, Porto Alegre, RS, Brazil; INCT of Translational Medicine, Hospital de Clínicas de Porto Alegre, 90035-903 RS, Brazil; Departamento de Psiquiatria, Universidade Federal Rio Grande do Sul, 90035-903 RS, Brazil
| | - Flávio Kapczinski
- Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, 90035-003, Porto Alegre, RS, Brazil; INCT of Translational Medicine, Hospital de Clínicas de Porto Alegre, 90035-903 RS, Brazil; Departamento de Psiquiatria, Universidade Federal Rio Grande do Sul, 90035-903 RS, Brazil
| | - Ana Maria Oliveira Battastini
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, 90035-903, Porto Alegre, RS, Brazil.
| | - Pedro Vieira da Silva Magalhães
- Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, 90035-003, Porto Alegre, RS, Brazil; INCT of Translational Medicine, Hospital de Clínicas de Porto Alegre, 90035-903 RS, Brazil; Departamento de Psiquiatria, Universidade Federal Rio Grande do Sul, 90035-903 RS, Brazil.
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Elvsåshagen T, Zuzarte P, Westlye LT, Bøen E, Josefsen D, Boye B, Hol PK, Malt UF, Young LT, Andreazza AC. Dentate gyrus-cornu ammonis (CA) 4 volume is decreased and associated with depressive episodes and lipid peroxidation in bipolar II disorder: Longitudinal and cross-sectional analyses. Bipolar Disord 2016; 18:657-668. [PMID: 27995733 DOI: 10.1111/bdi.12457] [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: 04/17/2016] [Accepted: 11/09/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Reduced dentate gyrus volume and increased oxidative stress have emerged as potential pathophysiological mechanisms in bipolar disorder. However, the relationship between dentate gyrus volume and peripheral oxidative stress markers remains unknown. Here, we examined dentate gyrus-cornu ammonis (CA) 4 volume longitudinally in patients with bipolar II disorder (BD-II) and healthy controls and investigated whether BD-II is associated with elevated peripheral levels of oxidative stress. METHODS We acquired high-resolution structural 3T-magnetic resonance imaging (MRI) images and quantified hippocampal subfield volumes using an automated segmentation algorithm in individuals with BD-II (n=29) and controls (n=33). The participants were scanned twice, at study inclusion and on average 2.4 years later. In addition, we measured peripheral levels of two lipid peroxidation markers (4-hydroxy-2-nonenal [4-HNE] and lipid hydroperoxides [LPH]). RESULTS First, we demonstrated that the automated hippocampal subfield segmentation technique employed in this work reliably measured dentate gyrus-CA4 volume. Second, we found a decreased left dentate gyrus-CA4 volume in patients and that a larger number of depressive episodes between T1 and T2 predicted greater volume decline. Finally, we showed that 4-HNE was elevated in BD-II and that 4-HNE was negatively associated with left and right dentate gyrus-CA4 volumes in patients. CONCLUSIONS These results are consistent with a role for the dentate gyrus in the pathophysiology of bipolar disorder and suggest that depressive episodes and elevated oxidative stress might contribute to hippocampal volume decreases. In addition, these findings provide further support for the hypothesis that peripheral lipid peroxidation markers may reflect brain alterations in bipolar disorders.
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Affiliation(s)
- Torbjørn Elvsåshagen
- Department of Neurology, Oslo University Hospital, Oslo, Norway.,Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pedro Zuzarte
- Department of Psychiatry, Santa Maria's University Hospital, University of Lisbon, Lisbon, Portugal.,Department of Pharmacology and Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Lars T Westlye
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Erlend Bøen
- Department of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
| | - Dag Josefsen
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Birgitte Boye
- Section of Psychosocial Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.,Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
| | - Per K Hol
- The Intervention Centre, Oslo University Hospital, Oslo, Norway
| | - Ulrik F Malt
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Research and Education, Oslo University Hospital, Oslo, Norway
| | - L Trevor Young
- Department of Pharmacology and Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Ana C Andreazza
- Department of Pharmacology and Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
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Brain-Derived Neurotrophic Factor (Bdnf) and Gray Matter Volume in Bipolar Disorder. Eur Psychiatry 2016; 40:33-37. [DOI: 10.1016/j.eurpsy.2016.06.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/20/2016] [Accepted: 06/22/2016] [Indexed: 11/19/2022] Open
Abstract
AbstractIntroductionBipolar Disorder (BD) is a severe psychiatric condition characterized by grey matter (GM) volumes reduction. Neurotrophic factors have been suggested to play a role in the neuroprogressive changes during the illness course. In particular peripheral brain-derived neurotrophic factor (BDNF) has been proposed as a potential biomarker related to disease activity and neuroprogression in BD. The aim of our study was to investigate if serum levels of BDNF are associated with GM volumes in BD patients and healthy controls (HC).MethodsWe studied 36 inpatients affected by a major depressive episode in course of BD type I and 17 HC. Analysis of variance was performed to investigate the effect of diagnosis on GM volumes in the whole brain. Threshold for significance was P < 0.05, Family Wise Error (FWE) corrected for multiple comparisons. All the analyses were controlled for the effect of nuisance covariates known to influence GM volumes, such as age, gender and lithium treatment.ResultsBD patients showed significantly higher serum BDNF levels compared with HC. Reduced GM volumes in BD patients compared to HC were observed in several brain areas, encompassing the caudate head, superior temporal gyrus, insula, fusiform gyrus, parahippocampal gyrus, and anterior cingulate cortex. The interaction analysis between BDNF levels and diagnosis showed a significant effect in the middle frontal gyrus. HC reported higher BDNF levels associated with higher GM volumes, whereas no association between BDNF and GM volumes was observed in BD.DiscussionOur study seems to suggest that although the production of BDNF is increased in BD possibly to prevent and repair neural damage, its effects could be hampered by underlying neuroinflammatory processes interfering with the neurodevelopmental role of BDNF.
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Mansur RB, Cunha GR, Asevedo E, Zugman A, Zeni-Graiff M, Rios AC, Sethi S, Maurya PK, Levandowski ML, Gadelha A, Pan PM, Stertz L, Belangero SI, Kauer-Sant' Anna M, Teixeira AL, Mari JJ, Rohde LA, Miguel EC, McIntyre RS, Grassi-Oliveira R, Bressan RA, Brietzke E. Socioeconomic Disadvantage Moderates the Association between Peripheral Biomarkers and Childhood Psychopathology. PLoS One 2016; 11:e0160455. [PMID: 27489945 PMCID: PMC4973983 DOI: 10.1371/journal.pone.0160455] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/19/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Socioeconomic disadvantage (SED) has been consistently associated with early life mental health problems. SED has been shown to impact multiple biological systems, including the regulation of neurotrophic proteins, immune-inflammatory and oxidative stress markers, which, conversely, have been reported to be relevant to physiological and pathological neurodevelopment This study investigated the relationship between SED, different domains of psychopathology, serum levels of interleukin-6 (IL6), thiobarbituric acid-reactive substance (TBARS) and brain-derived neurotrophic factor (BDNF). We hypothesized that a composite of socioeconomic risk would be associated with psychopathology and altered levels of peripheral biomarkers. In addition, we hypothesized that SED would moderate the associations between mental health problems, IL6, TBARS and BDNF. METHODS AND FINDINGS Using a cross-sectional design, we measured the serum levels of IL6, TBARS and BDNF in 495 children aged 6 to 12. We also investigated socio-demographic characteristics and mental health problems using the Child Behaviour Checklist (CBCL) DSM-oriented scales. SED was evaluated using a cumulative risk model. Generalized linear models were used to assess associations between SED, biomarkers levels and psychopathology. SED was significantly associated with serum levels of IL6 (RR = 1.026, 95% CI 1.004; 1.049, p = 0.020) and TBARS (RR = 1.077, 95% CI 1.028; 1.127, p = 0.002). The association between SED and BDNF was not statistically significant (RR = 1.031, 95% CI 0.997; 1.066, p = 0.077). SED was also significantly associated with all CBCL DSM-oriented scales (all p < 0.05), whereas serum biomarkers (i.e. IL6, TBARS, BDNF) were associated with specific subscales. Moreover, the associations between serum biomarkers and domains of psychopathology were moderated by SED, with stronger correlations between mental health problems, IL6, TBARS, and BDNF being observed in children with high SED. CONCLUSIONS In children, SED is highly associated with mental health problems. Our findings suggest that this association may be moderated via effects on multiple interacting neurobiological systems.
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Affiliation(s)
- Rodrigo B. Mansur
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada
- * E-mail:
| | - Graccielle R. Cunha
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Elson Asevedo
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - André Zugman
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Maiara Zeni-Graiff
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Adiel C. Rios
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Sumit Sethi
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Pawan K. Maurya
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Mateus L. Levandowski
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Pedro M. Pan
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Laura Stertz
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Center for Translational Psychiatry, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, United States of America
| | - Síntia I. Belangero
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Márcia Kauer-Sant' Anna
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Antônio L. Teixeira
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Interdisciplinary Laboratory of Medical Investigation, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jair J. Mari
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Luis A. Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Euripedes C. Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Department of Psychiatry, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada
| | - Rodrigo Grassi-Oliveira
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rodrigo A. Bressan
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Elisa Brietzke
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, São Paulo, Brazil
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
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State-dependent increase in the levels of neurotrophin-3 and neurotrophin-4/5 in patients with bipolar disorder: A meta-analysis. J Psychiatr Res 2016; 79:86-92. [PMID: 27214525 DOI: 10.1016/j.jpsychires.2016.05.009] [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: 02/24/2016] [Revised: 05/08/2016] [Accepted: 05/10/2016] [Indexed: 12/29/2022]
Abstract
Bipolar disorder (BD) is one of the most serious psychiatric disorders in the world, but its pathophysiology is still unclear. Regulation of neurotrophic factors have been thought to play a role in this process. There have been inconsistent findings regarding the differences in blood neurotrophin-3 (NT-3) and neurotrophin-4/5 (NT-4/5) between patients with BD and healthy controls (HCs). The aim of the current meta-analysis is to examine the changes in the levels of NT-3 and NT-4/5 in BD patients at different affective states. Eight articles (including 465 BD patients and 353 HCs) were included in the analysis, and their results were pooled by using a random effects model. We found the levels of both NT-3 (p = 0.0046) and NT-4/5 (p = 0.0003) were significantly increased in BD patients, compared to HCs. Through subgroup analysis, this increase persisted only in patients in depressed state (p = 0.0038 for NT-3 and p = 0.0001 for NT-4/5), but not in manic or euthymic state. In addition, we found the differences in NT-3 and NT-4/5 were significantly associated with the duration of illness, but not by the mean age or female proportion. Our results suggest a state-dependent increase in NT-3 and NT-4/5 levels in patients with BD. Further studies are needed to examine dynamic changes of these neurotrophins in BD patients along the disease course.
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Wang Y, McDermott S, Mann JR, Hardin JW. Preventing intellectual disability during pregnancy: what are the potentially high yield targets? J Perinat Med 2016; 44:421-32. [PMID: 26352060 DOI: 10.1515/jpm-2015-0059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 06/17/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To identify risk factors among children with unknown cause intellectual disability (ID) and to estimate the population-attributable risk (PAR) associated with these factors. METHODS This was a retrospective cohort study of maternal and child pairs born between 2004 and 2010 in South Carolina, and information was obtained from Medicaid billing records, birth certificates, and other administrative data. The data included 123,922 children and logistic generalized estimating equations (GEE) regression models were used to estimate the association of maternal risk factors and ID. We estimated models with and without birth weight as a covariate, since low birth weight is known to be a mediator of the association between some risk factors and ID in children. RESULTS The prevalence of ID in the children was 3.85% and the associations between risk factors and ID were similar for female and male children. We found that the odds of having ID were increased if a child's mother had a diagnosis of major depression; for male children, the odds ratio (OR) was 1.34 (95% confidence interval [CI] 1.14-1.59, PAR 2.17%); and for females, the OR was 1.59 (95% CI 1.30-1.95, PAR 4.70%). The odds of having ID were also increased for children of women with bipolar disorder (males - OR 1.95, 95% CI 1.53-2.48, PAR 2.85%; females - OR 1.63, 95% CI 1.20-2.22, PAR 2.05%). CONCLUSIONS Major maternal depression and bipolar disorder were each significantly associated with the odds of ID in children, each accounting for approximately 2-5% of the PAR, when controlling for covariates.
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Muneer A. Staging Models in Bipolar Disorder: A Systematic Review of the Literature. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2016; 14:117-30. [PMID: 27121423 PMCID: PMC4857867 DOI: 10.9758/cpn.2016.14.2.117] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 01/23/2023]
Abstract
Bipolar disorder is manifested as severe dysregulation of mood with recurrent manic and major depressive episodes. It is associated with psychiatric and medical comorbidities, inadequate response to currently available pharmacological agents and a progressively deteriorating course in many patients. The index episode is often depressive in nature, while the first manic or hypomanic episode may occur several years later in the course of the disorder causing delay in diagnosis and use of inappropriate treatment strategies. Staging has been used to great advantage in other branches of medicine like cardiology and oncology. There is growing realization that major mental disorders are fundamentally progressive, with simpler treatment requirements and better prognosis during initial stages of the illness. Defining these conditions into clinically applicable stages not only helps in better understanding the trajectory of a particular disorder, but also assists in management. Patients with a chronic, recalcitrant condition like bipolar disorder are likely to greatly benefit from this approach. If the illness is correctly identified early in its course, proper treatment can be instigated arresting progression to latter phases which are associated with myriad complications in the biopsychosocial realm. With these considerations, a search of the MEDLINE data base was conducted to seek out literature pertaining to staging models in bipolar disorder. A thorough scrutiny of the existing research work revealed that a number of investigators have endeavored to stage define bipolar disorder. This paper outlines staging proposals for bipolar disorder which have the greatest supporting evidence in the literature.
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Affiliation(s)
- Ather Muneer
- Department of Psychiatry, Islamic International Medical College, Riphah International University, Rawalpindi, Pakistan
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Cunha GR, Asevedo E, Mansur RB, Zugman A, Pan PM, Gadelha A, Belangero SI, Rizzo LB, Coelho R, Stertz L, Cogo-Moreira H, Grassi-Oliveira R, Teixeira AL, Kauer-Sant'Anna M, Mari JJ, Miguel EC, Bressan RA, Brietzke E. Inflammation, neurotrophism and oxidative stress and childhood psychopathology in a large community sample. Acta Psychiatr Scand 2016; 133:122-132. [PMID: 26139469 DOI: 10.1111/acps.12453] [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] [Accepted: 05/11/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate the association between peripheral biomarkers and child psychopathology in a large community sample. METHOD A total of 625 aged 6- to 13-year old subjects were recruited from a community school-based study. Psychopathology was assessed using the Child Behaviour Checklist (CBCL). Psychiatric diagnosis was evaluated using the Development and Well-Being Assessment. The following biomarkers were examined in peripheral blood: brain-derived neurotrophic factor, cytokines (IL-2, IL-4, IL-6, IL-10, IL-17, IFN-g, and TNF-α), chemokines (eotaxin/CCL11, IP-10, MCP-1), cytokine receptors (sTNFR1 and sTNFR2), and the oxidative stress marker TBARS. RESULTS We found significant associations between sTNFR2, eotaxin/CCL11 and CBCL total score, as well as with specific dimensions of psychopathology. There were different patterns of association between these biomarkers and psychological and behavioural symptoms in children with and without a mental disorder. TBARS, IL-6 and MCP-1 were more specific to some clusters of symptoms in children with a psychiatric diagnosis. CONCLUSION Our data support the potential use of biomarkers, especially those involved in immune-inflammatory pathways, in investigating neurodevelopmental psychopathology. Their association with different dimensions of symptoms might be of useful when analyzing illness severity and clusters of symptoms within specific disorders.
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Affiliation(s)
- G R Cunha
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - E Asevedo
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - R B Mansur
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - A Zugman
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - P M Pan
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - A Gadelha
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - S I Belangero
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - L B Rizzo
- Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - R Coelho
- Post-Graduation Program in Psychology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Developmental Cognitive Neuroscience Research Group (GNCD), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - L Stertz
- Molecular Psychiatry Unit and National Science and Technology Institute for Translational Medicine (INCT-TM), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Department of Psychiatry and Behavioral Sciences, UT Center for Molecular Psychiatry, University of Texas Health Science Center, Houston, TX, USA
| | - H Cogo-Moreira
- Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - R Grassi-Oliveira
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Post-Graduation Program in Psychology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Developmental Cognitive Neuroscience Research Group (GNCD), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - A L Teixeira
- Translational Psychoneuroimmunology Group, Federal University of Minas Gerais (UFMG), Belo Horizonte
| | - M Kauer-Sant'Anna
- Molecular Psychiatry Unit and National Science and Technology Institute for Translational Medicine (INCT-TM), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - J J Mari
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - E C Miguel
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Department of Psychiatry, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil
| | - R A Bressan
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - E Brietzke
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
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Effects of a single bout of maximal aerobic exercise on BDNF in bipolar disorder: A gender-based response. Psychiatry Res 2015; 229:57-62. [PMID: 26239767 DOI: 10.1016/j.psychres.2015.07.072] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 07/06/2015] [Accepted: 07/26/2015] [Indexed: 01/08/2023]
Abstract
Acute exercise increases brain-derived neurotrophic factor (BDNF) serum levels in majorly depressed and anxious patients. However, to the best of our knowledge, no study has evaluated the acute effects of exercise on BDNF serum levels in Bipolar Disorder (BD). The objective of the present study was to evaluate the peripheral BDNF serum response to a single maximum session of exercise in BD participants and age- and gender-matched healthy participants. BD participants (n=18) and age- and gender-matched healthy participants (n=18) were recruited to perform a single bout of maximal exercise on a cycle ergometer. Blood samples were collected prior to and immediately after the exercise protocol. There was a significant group effect and a significant group x time x gender interaction. BD participants presented significantly higher BDNF serum levels when compared to their healthy control counterparts. Exercise increases the BDNF levels of BD women, but not men.
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Oliveira J, Debnath M, Etain B, Bennabi M, Hamdani N, Lajnef M, Bengoufa D, Fortier C, Boukouaci W, Bellivier F, Kahn JP, Henry C, Charron D, Krishnamoorthy R, Leboyer M, Tamouza R. Violent suicidal behaviour in bipolar disorder is associated with nitric oxide synthase 3 gene polymorphism. Acta Psychiatr Scand 2015; 132:218-25. [PMID: 25939888 DOI: 10.1111/acps.12433] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Given the importance of nitric oxide system in oxidative stress, inflammation, neurotransmission and cerebrovascular tone regulation, we postulated its potential dysfunction in bipolar disorder (BD) and suicide. By simultaneously analysing variants of three isoforms of nitric oxide synthase (NOS) genes, we explored interindividual genetic liability to suicidal behaviour in BD. METHOD A total of 536 patients with BD (DSM-IV) and 160 healthy controls were genotyped for functionally relevant NOS1, NOS2 and NOS3 polymorphisms. History of suicidal behaviour and violent suicide attempt was documented for 511 patients with BD. Chi-squared test was used to perform genetic association analyses and logistic regression to test for gene-gene interactions. RESULTS NOS3 rs1799983 T homozygous state was associated with violent suicide attempts (26.4% vs. 10.8%, in patients and controls, P = 0.002, corrected P (Pc) = 0.004, OR: 2.96, 95% CI = 1.33-6.34), and this association was restricted to the early-onset BD subgroup (37.9% vs. 10.8%, in early-onset BD and controls, P = 0.0003, Pc = 0.0006 OR: 5.05, 95% CI: 1.95-12.45), while we found no association with BD per se and no gene-gene interactions. CONCLUSION Our results bring further evidence for the potential involvement of endothelial NOS gene variants in susceptibility to suicidal behaviour. Future exploration of this pathway on larger cohort of suicidal behaviour is warranted.
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Affiliation(s)
- J Oliveira
- INSERM, U1160, Hôpital Saint Louis, Paris, France.,Fondation FondaMental, Créteil, France
| | - M Debnath
- INSERM, U1160, Hôpital Saint Louis, Paris, France.,Fondation FondaMental, Créteil, France
| | - B Etain
- Fondation FondaMental, Créteil, France.,INSERM, U955, Psychopathologie et Génétique des maladies psychiatriques, Créteil, France.,Faculté de Médecine, Université Paris-Est, Créteil, France.,AP-HP, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - M Bennabi
- INSERM, U1160, Hôpital Saint Louis, Paris, France.,Fondation FondaMental, Créteil, France
| | - N Hamdani
- Fondation FondaMental, Créteil, France.,INSERM, U955, Psychopathologie et Génétique des maladies psychiatriques, Créteil, France.,Faculté de Médecine, Université Paris-Est, Créteil, France.,AP-HP, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - M Lajnef
- Fondation FondaMental, Créteil, France.,INSERM, U955, Psychopathologie et Génétique des maladies psychiatriques, Créteil, France.,Faculté de Médecine, Université Paris-Est, Créteil, France
| | - D Bengoufa
- Laboratoire Jean Dausset and LabEx Transplantex, Hôpital Saint Louis, Paris, France
| | - C Fortier
- Laboratoire Jean Dausset and LabEx Transplantex, Hôpital Saint Louis, Paris, France
| | - W Boukouaci
- INSERM, U1160, Hôpital Saint Louis, Paris, France
| | - F Bellivier
- Fondation FondaMental, Créteil, France.,INSERM, U955, Psychopathologie et Génétique des maladies psychiatriques, Créteil, France.,Faculté de Médecine, Université Paris-Est, Créteil, France.,AP-HP, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - J-P Kahn
- Fondation FondaMental, Créteil, France.,Service de Psychiatrie et Psychologie Clinique, CHU de Nancy, Hôpitaux de Brabois, Vandoeuvre Les Nancy, France
| | - C Henry
- Fondation FondaMental, Créteil, France.,INSERM, U955, Psychopathologie et Génétique des maladies psychiatriques, Créteil, France.,Faculté de Médecine, Université Paris-Est, Créteil, France.,AP-HP, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - D Charron
- INSERM, U1160, Hôpital Saint Louis, Paris, France.,Fondation FondaMental, Créteil, France.,Laboratoire Jean Dausset and LabEx Transplantex, Hôpital Saint Louis, Paris, France.,Sorbonne Paris-Cité, Université Paris Diderot, Paris, France
| | | | - M Leboyer
- Fondation FondaMental, Créteil, France.,INSERM, U955, Psychopathologie et Génétique des maladies psychiatriques, Créteil, France.,Faculté de Médecine, Université Paris-Est, Créteil, France.,AP-HP, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - R Tamouza
- INSERM, U1160, Hôpital Saint Louis, Paris, France.,Fondation FondaMental, Créteil, France.,Laboratoire Jean Dausset and LabEx Transplantex, Hôpital Saint Louis, Paris, France.,Sorbonne Paris-Cité, Université Paris Diderot, Paris, France
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Panizzutti B, Gubert C, Schuh AL, Ferrari P, Bristot G, Fries GR, Massuda R, Walz J, Rocha NP, Berk M, Teixeira AL, Gama CS. Increased serum levels of eotaxin/CCL11 in late-stage patients with bipolar disorder: An accelerated aging biomarker? J Affect Disord 2015; 182:64-9. [PMID: 25973785 DOI: 10.1016/j.jad.2014.12.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 12/04/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is commonly comorbid with many medical disorders including atopy, and appears characterized by progressive social, neurobiological, and functional impairment associated with increasing number of episodes and illness duration. Early and late stages of BD may present different biological features and may therefore require different treatment strategies. Consequently, the aim of this study was to evaluate serum levels of eotaxin/CCL11, eotaxin-2/CCL24, IL-2, IL-4, IL-6, IL-10, IL-17, TNF-α, IFNγ, BDNF, TBARS, carbonyl, and GPx in a sample of euthymic patients with BD at early and late stages compared to controls. METHODS Early-stage BD patients, 12 late-stage patients, and 25 controls matched for sex and age were selected. 10mL of peripheral blood was drawn from all subjects by venipuncture. Serum levels of BDNF, TBARS, carbonyl content, glutathione-peroxidase activity (GPx), cytokines (IL-2, IL-4, IL-6, IL-10, IL-17, TNF-α and IFNγ), and chemokines (eotaxin/CCL11 and eotaxin-2/CCL24) were measured. RESULTS There were no demographic differences between patients and controls. No significant differences were found for any of the biomarkers, except chemokine eotaxin/CCL11, whose serum levels were higher in late-stage patients with BD when compared to controls (p=0.022; Mann-Whitney U test). LIMITATIONS Small number of subjects and use of medication may have influenced in our results. CONCLUSION The present study suggests a link between biomarkers of atopy and eosinophil function and bipolar disorder. These findings are also in line with progressive biological changes partially mediated by inflammatory imbalance, a process referred to as neuroprogression.
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Affiliation(s)
- B Panizzutti
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Programa de Pós-Graduação em Medicina: Psiquiatria, UFRGS, Porto Alegre, Brazil.
| | - C Gubert
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Programa de Pós-Graduação Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde, UFRGS, Brazil
| | - A L Schuh
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - P Ferrari
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Programa de Pós-Graduação em Medicina: Psiquiatria, UFRGS, Porto Alegre, Brazil
| | - G Bristot
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - G R Fries
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Programa de Pós-Graduação Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde, UFRGS, Brazil
| | - R Massuda
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Programa de Pós-Graduação em Medicina: Psiquiatria, UFRGS, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | - J Walz
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Programa de Pós-Graduação em Medicina: Psiquiatria, UFRGS, Porto Alegre, Brazil; Centro Universitário UNILASALLE, Canoas, Brazil
| | - N P Rocha
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil
| | - M Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Department of Psychiatry and The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia
| | - A L Teixeira
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Brazil
| | - C S Gama
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Programa de Pós-Graduação em Medicina: Psiquiatria, UFRGS, Porto Alegre, Brazil
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Staging bipolar disorder: what data and what models are needed? Lancet Psychiatry 2015; 2:564-70. [PMID: 26360452 DOI: 10.1016/s2215-0366(15)00096-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 02/11/2015] [Accepted: 02/20/2015] [Indexed: 01/02/2023]
Abstract
Although bipolar disorder is increasingly recognised as a spectrum of multisystem disorders (ie, bipolar disorders), proposed staging models and theories of bipolar disease progression often fail to incorporate longitudinal data or data from multiple domains of dysfunction. We propose that bipolar disorders are best thought of as syndromes, with different trajectories of development and progression for various symptoms and demographic groups. This inherent complexity might be better suited to non-traditional modelling techniques, potentially derived from chaos theory. In this Personal View, we propose an allostatic load framework to account for biomarkers of physiological symptom progression. We then suggest integration of two potential domains of biobehavioural markers: sleep and wake and circadian rhythm regulation and the behavioural activation system. A satisfactory model should account for the effects of developmental stage as well as demographic characteristics, including but not limited to sex, culture, ethnicity, and socioeconomic status. The ultimate goal of a staging model has to be to inform the development of targeted, stage-appropriate interventions to reduce the substantial burden of bipolar disorders on individuals and societies.
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Effects of Mood Stabilizers on Brain Energy Metabolism in Mice Submitted to an Animal Model of Mania Induced by Paradoxical Sleep Deprivation. Neurochem Res 2015; 40:1144-52. [PMID: 25894682 DOI: 10.1007/s11064-015-1575-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 03/23/2015] [Accepted: 04/06/2015] [Indexed: 12/17/2022]
Abstract
There is a body of evidence suggesting that mitochondrial dysfunction is involved in bipolar disorder (BD) pathogenesis. Studies suggest that abnormalities in circadian cycles are involved in the pathophysiology of affective disorders; paradoxical sleep deprivation (PSD) induces hyperlocomotion in mice. Thus, the present study aims to investigate the effects of lithium (Li) and valproate (VPA) in an animal model of mania induced by PSD for 96 h. PSD increased exploratory activity, and mood stabilizers prevented PSD-induced behavioral effects. PSD also induced a significant decrease in the activity of complex II-III in hippocampus and striatum; complex IV activity was decreased in prefrontal cortex, cerebellum, hippocampus, striatum and cerebral cortex. Additionally, VPA administration was able to prevent PSD-induced inhibition of complex II-III and IV activities in prefrontal cortex, cerebellum, hippocampus, striatum and cerebral cortex, whereas Li administration prevented PSD-induced inhibition only in prefrontal cortex and hippocampus. Regarding the enzymes of Krebs cycle, only citrate synthase activity was increased by PSD in prefrontal cortex. We also found a similar effect in creatine kinase, an important enzyme that acts in the buffering of ATP levels in brain; its activity was increased in prefrontal cortex, hippocampus and cerebral cortex. These results are consistent with the connection of mitochondrial dysfunction and hyperactivity in BD and suggest that the present model fulfills adequate face, construct and predictive validity as an animal model of mania.
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Morris G, Berk M, Galecki P, Walder K, Maes M. The Neuro-Immune Pathophysiology of Central and Peripheral Fatigue in Systemic Immune-Inflammatory and Neuro-Immune Diseases. Mol Neurobiol 2015; 53:1195-1219. [PMID: 25598355 DOI: 10.1007/s12035-015-9090-9] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 01/05/2015] [Indexed: 01/18/2023]
Abstract
Many patients with systemic immune-inflammatory and neuro-inflammatory disorders, including depression, rheumatoid arthritis, systemic lupus erythematosus, Sjögren's disease, cancer, cardiovascular disorder, Parkinson's disease, multiple sclerosis, stroke, and chronic fatigue syndrome/myalgic encephalomyelitis, endure pathological levels of fatigue. The aim of this narrative review is to delineate the wide array of pathways that may underpin the incapacitating fatigue occurring in systemic and neuro-inflammatory disorders. A wide array of immune, inflammatory, oxidative and nitrosative stress (O&NS), bioenergetic, and neurophysiological abnormalities are involved in the etiopathology of these disease states and may underpin the incapacitating fatigue that accompanies these disorders. This range of abnormalities comprises: increased levels of pro-inflammatory cytokines, e.g., interleukin-1 (IL-1), IL-6, tumor necrosis factor (TNF) α and interferon (IFN) α; O&NS-induced muscle fatigue; activation of the Toll-Like Receptor Cycle through pathogen-associated (PAMPs) and damage-associated (DAMPs) molecular patterns, including heat shock proteins; altered glutaminergic and dopaminergic neurotransmission; mitochondrial dysfunctions; and O&NS-induced defects in the sodium-potassium pump. Fatigue is also associated with altered activities in specific brain regions and muscle pathology, such as reductions in maximum voluntary muscle force, downregulation of the mitochondrial biogenesis master gene peroxisome proliferator-activated receptor gamma coactivator 1-alpha, a shift to glycolysis and buildup of toxic metabolites within myocytes. As such, both mental and physical fatigue, which frequently accompany immune-inflammatory and neuro-inflammatory disorders, are the consequence of interactions between multiple systemic and central pathways.
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Affiliation(s)
- Gerwyn Morris
- Tir Na Nog, Bryn Road seaside 87, Llanelli, SA152LW, Wales, UK
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, P.O. Box 291, Geelong, 3220, Australia.,Orygen Youth Health Research Centre and the Centre of Youth Mental Health, Poplar Road 35, Parkville, 3052, Australia.,The Florey Institute for Neuroscience and Mental Health, University of Melbourne, Kenneth Myer Building, Royal Parade 30, Parkville, 3052, Australia.,Department of Psychiatry, University of Melbourne, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville, 3052, Australia
| | - Piotr Galecki
- Department of Adult Psychiatry, Medical University of Lodz, Lodz, Poland
| | - Ken Walder
- Metabolic Research Unit, Deakin University, Geelong, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, P.O. Box 291, Geelong, 3220, Australia. .,Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina, Brazil. .,Impact Strategic Research Center, Deakin University, Geelong, Australia.
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Mansur RB, Brietzke E, McIntyre RS. Is there a "metabolic-mood syndrome"? A review of the relationship between obesity and mood disorders. Neurosci Biobehav Rev 2015; 52:89-104. [PMID: 25579847 DOI: 10.1016/j.neubiorev.2014.12.017] [Citation(s) in RCA: 202] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 12/19/2014] [Accepted: 12/31/2014] [Indexed: 12/12/2022]
Abstract
Obesity and mood disorders are highly prevalent and co-morbid. Epidemiological studies have highlighted the public health relevance of this association, insofar as both conditions and its co-occurrence are associated with a staggering illness-associated burden. Accumulating evidence indicates that obesity and mood disorders are intrinsically linked and share a series of clinical, neurobiological, genetic and environmental factors. The relationship of these conditions has been described as convergent and bidirectional; and some authors have attempted to describe a specific subtype of mood disorders characterized by a higher incidence of obesity and metabolic problems. However, the nature of this association remains poorly understood. There are significant inconsistencies in the studies evaluating metabolic and mood disorders; and, as a result, several questions persist about the validity and the generalizability of the findings. An important limitation in this area of research is the noteworthy phenotypic and pathophysiological heterogeneity of metabolic and mood disorders. Although clinically useful, categorical classifications in both conditions have limited heuristic value and its use hinders a more comprehensive understanding of the association between metabolic and mood disorders. A recent trend in psychiatry is to move toward a domain specific approach, wherein psychopathology constructs are agnostic to DSM-defined diagnostic categories and, instead, there is an effort to categorize domains based on pathogenic substrates, as proposed by the National Institute of Mental Health (NIMH) Research Domain Criteria Project (RDoC). Moreover, the substrates subserving psychopathology seems to be unspecific and extend into other medical illnesses that share in common brain consequences, which includes metabolic disorders. Overall, accumulating evidence indicates that there is a consistent association of multiple abnormalities in neuropsychological constructs, as well as correspondent brain abnormalities, with broad-based metabolic dysfunction, suggesting, therefore, that the existence of a "metabolic-mood syndrome" is possible. Nonetheless, empirical evidence is necessary to support and develop this concept. Future research should focus on dimensional constructs and employ integrative, multidisciplinary and multimodal approaches.
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Affiliation(s)
- Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.
| | - Elisa Brietzke
- Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada
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Roda Â, Chendo I, Kunz M. Biomarkers and staging of bipolar disorder: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2014; 37:3-11. [PMID: 25860561 DOI: 10.1590/2237-6089-2014-0002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 07/22/2014] [Indexed: 01/09/2023]
Abstract
INTRODUCTION A growing body of evidence suggests that bipolar disorder (BD) is a progressive disease according to clinical, biochemical and neuroimaging findings. This study reviewed the literature on the relationship between specific biomarkers and BD stages. METHODS A comprehensive literature search of MEDLINE and PubMed was conducted to identify studies in English and Portuguese using the keywords biomarker, neurotrophic factors, inflammation, oxidative stress, neuroprogression and staging models cross-referenced with bipolar disorder. RESULTS Morphometric studies of patients with BD found neuroanatomic abnormalities, such as ventricular enlargement, grey matter loss in the hippocampus and cerebellum, volume decreases in the prefrontal cortex and variations in the size of the amygdala. Other studies demonstrated that serum concentrations of neurotrophic factors, inflammatory mediators and oxidative stress may be used as BD biomarkers. CONCLUSIONS The analysis of neurobiological changes associated with BD progression and activity may confirm the existence of BD biomarkers, which may be then included in staging models that will lead to improvements in treatment algorithms and more effective, individually tailored treatment regimens. Biomarkers may also be used to define early interventions to control disease progression.
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Affiliation(s)
- Ângela Roda
- Faculdade de Medicina de Lisboa, Lisbon, Portugal
| | - Inês Chendo
- Faculdade de Medicina de Lisboa, University Clinic, Lisboa, Portugal
| | - Mauricio Kunz
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Brown JA, Sherrod SD, Goodwin CR, Brewer B, Yang L, Garbett KA, Li D, McLean JA, Wikswo JP, Mirnics K. Metabolic consequences of interleukin-6 challenge in developing neurons and astroglia. J Neuroinflammation 2014; 11:183. [PMID: 25374324 PMCID: PMC4233071 DOI: 10.1186/s12974-014-0183-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 10/11/2014] [Indexed: 02/02/2023] Open
Abstract
Background Maternal immune activation and subsequent interleukin-6 (IL-6) induction disrupt normal brain development and predispose the offspring to developing autism and schizophrenia. While several proteins have been identified as having some link to these developmental disorders, their prevalence is still small and their causative role, if any, is not well understood. However, understanding the metabolic consequences of environmental predisposing factors could shed light on disorders such as autism and schizophrenia. Methods To gain a better understanding of the metabolic consequences of IL-6 exposure on developing central nervous system (CNS) cells, we separately exposed developing neuron and astroglia cultures to IL-6 for 2 hours while collecting effluent from our gravity-fed microfluidic chambers. By coupling microfluidic technologies to ultra-performance liquid chromatography-ion mobility-mass spectrometry (UPLC-IM-MS), we were able to characterize the metabolic response of these CNS cells to a narrow window of IL-6 exposure. Results Our results revealed that 1) the use of this technology, due to its superb media volume:cell volume ratio, is ideally suited for analysis of cell-type-specific exometabolome signatures; 2) developing neurons have low secretory activity at baseline, while astroglia show strong metabolic activity; 3) both neurons and astroglia respond to IL-6 exposure in a cell type-specific fashion; 4) the astroglial response to IL-6 stimulation is predominantly characterized by increased levels of metabolites, while neurons mostly depress their metabolic activity; and 5) disturbances in glycerophospholipid metabolism and tryptophan/kynurenine metabolite secretion are two putative mechanisms by which IL-6 affects the developing nervous system. Conclusions Our findings are potentially critical for understanding the mechanism by which IL-6 disrupts brain function, and they provide information about the molecular cascade that links maternal immune activation to developmental brain disorders. Electronic supplementary material The online version of this article (doi:10.1186/s12974-014-0183-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jacquelyn A Brown
- Department of Psychiatry, 465 21st Avenue South, Vanderbilt University, Nashville, TN, 37232, USA. .,Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA.
| | - Stacy D Sherrod
- Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Department of Physics and Astronomy, 6301 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA.
| | - Cody R Goodwin
- Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Department of Chemistry, 5421 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA.
| | - Bryson Brewer
- Department of Mechanical Engineering, 333 Olin Hall, Vanderbilt University, Nashville, TN, 37235, USA.
| | - Lijie Yang
- Department of Mechanical Engineering, 333 Olin Hall, Vanderbilt University, Nashville, TN, 37235, USA.
| | - Krassimira A Garbett
- Department of Psychiatry, 465 21st Avenue South, Vanderbilt University, Nashville, TN, 37232, USA.
| | - Deyu Li
- Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Department of Mechanical Engineering, 333 Olin Hall, Vanderbilt University, Nashville, TN, 37235, USA.
| | - John A McLean
- Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Department of Chemistry, 5421 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA.
| | - John P Wikswo
- Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Department of Physics and Astronomy, 6301 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Department of Biomedical Engineering, 5824 Stevenson Center, Vanderbilt University, Nashville, 37235, TN, USA. .,Department of Molecular Physiology and Biophysics, 702 Light Hall, Vanderbilt University, Nashville, TN, 37232, USA.
| | - Károly Mirnics
- Department of Psychiatry, 465 21st Avenue South, Vanderbilt University, Nashville, TN, 37232, USA. .,Vanderbilt Institute for Integrative Biosystems Research and Education, 6809 Stevenson Center, Vanderbilt University, Nashville, TN, 37235, USA. .,Vanderbilt Kennedy Center for Research on Human Development, 110 Magnolia Circle, Vanderbilt University, Nashville, TN, 37203, USA. .,Department of Psychiatry, University of Szeged, 6725, Szeged, Hungary.
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Barbosa IG, Morato IB, Huguet RB, Rocha FL, Machado-Vieira R, Teixeira AL. Decreased plasma neurotrophin-4/5 levels in bipolar disorder patients in mania. REVISTA BRASILEIRA DE PSIQUIATRIA 2014; 36:340-3. [DOI: 10.1590/1516-4446-2014-1380] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 04/07/2014] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - Rodrigo B. Huguet
- Instituto de Previdência dos Servidores do Estado de Minas Gerais (IPSEMG), Brazil
| | - Fabio L. Rocha
- Instituto de Previdência dos Servidores do Estado de Minas Gerais (IPSEMG), Brazil
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Lovastatin as an adjuvant to lithium for treating manic phase of bipolar disorder: a 4-week, randomized, double-blind, placebo-controlled clinical trial. DEPRESSION RESEARCH AND TREATMENT 2014; 2014:730505. [PMID: 25132988 PMCID: PMC4123509 DOI: 10.1155/2014/730505] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 06/04/2014] [Accepted: 06/05/2014] [Indexed: 12/22/2022]
Abstract
Objectives. Many patients with bipolar disorder suffer from metabolic disorder. Lovastatin is effective for treating major depression. This double-blind randomized placebo controlled clinical trial investigates whether lovastatin is a useful adjuvant to lithium for treating mania. Methods. Fifty-four patients with bipolar disorder-manic phase were randomly allocated into lovastatin or placebo group. The clinical symptoms were assessed at baseline, week 2, and week 4 using Young Mania Rating Scale. Adverse effects were checked. Results. Forty-six out of 54 patients completed this trial. The mania score in the lovastatin group decreased from 40.6 (11.1) at baseline to 12.9 (8.7) and 4.1 (5.4) at weeks 2 and 4, respectively. The score in the placebo group decreased from 41.0 (11.2) at baseline to 12.8 (8.07) and 5.8 (4.6) at weeks 2 and 4, respectively. However, there was no significant difference between groups at week 2 and week 4. The adverse effects rates were comparable between the two groups. No serious adverse effect was found. Tremor and nausea were the most common adverse effects. Conclusions. Lovastatin neither exacerbated nor decreased the symptoms of mania in patients with bipolar disorder. Current results support that the combination of lovastatin with lithium is tolerated well in bipolar disorder. The trial was registered with the Iranian Clinical Trials Registry (IRCT201302203930N18).
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