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Prunas C, Delvecchio G, Perlini C, Barillari M, Ruggeri M, Altamura AC, Bellani M, Brambilla P. Diffusion imaging study of the Corpus Callosum in bipolar disorder. Psychiatry Res Neuroimaging 2018; 271:75-81. [PMID: 29129544 DOI: 10.1016/j.pscychresns.2017.11.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 09/06/2017] [Accepted: 11/02/2017] [Indexed: 01/28/2023]
Abstract
Structural and diffusion imaging studies have provided some evidence of abnormal organization of Corpus Callosum (CC) in Bipolar Disorder (BD). Therefore, by using Diffusion Weighted Imaging (DWI), which allows to build subtle prediction models of fiber integrity for white matter (WM) tracts, this study aims to further explore the microstructure integrity of CC in BD patients compared to matched healthy controls. Twenty-four chronic patients with BD and 35 healthy controls were included in the study. Circular regions of interest were placed, on diffusion images, in the left and right side of callosal regions (i.e. rostrum/genu, anterior body, posterior body, splenium) and the Apparent Diffusion Coefficient (ADC) was then calculated. Significantly increased ADC values were found in right anterior body and in right splenium in BD patients compared to healthy controls (all p < 0.05, Bonferroni corrected). In this study, we found abnormally increased ADC callosal values in BD suggesting microstructural anomalies specifically in the right hemisphere. Interestingly, this finding further supports the presence of an altered inter-hemispheric communication between frontal and temporo-parietal association areas in patients with BD, which may ultimately result in clinical symptoms and cognitive deficits.
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Affiliation(s)
- Cecilia Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy; InterUniversity Centre for Behavioural Neurosciences, University of Verona, Verona, Italy
| | - Marco Barillari
- Section of Neurology, Department of Neurological and Movement Sciences, University Hospital of Verona, Verona, Italy
| | | | - A Carlo Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Marcella Bellani
- InterUniversity Centre for Behavioural Neurosciences, University of Verona, Verona, Italy; Section of Psychiatry, AOUI Verona, Verona, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, TX, USA.
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Teicher MH, Samson JA. Annual Research Review: Enduring neurobiological effects of childhood abuse and neglect. J Child Psychol Psychiatry 2016; 57:241-66. [PMID: 26831814 PMCID: PMC4760853 DOI: 10.1111/jcpp.12507] [Citation(s) in RCA: 645] [Impact Index Per Article: 80.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Childhood maltreatment is the most important preventable cause of psychopathology accounting for about 45% of the population attributable risk for childhood onset psychiatric disorders. A key breakthrough has been the discovery that maltreatment alters trajectories of brain development. METHODS This review aims to synthesize neuroimaging findings in children who experienced caregiver neglect as well as from studies in children, adolescents and adults who experienced physical, sexual and emotional abuse. In doing so, we provide preliminary answers to questions regarding the importance of type and timing of exposure, gender differences, reversibility and the relationship between brain changes and psychopathology. We also discuss whether these changes represent adaptive modifications or stress-induced damage. RESULTS Parental verbal abuse, witnessing domestic violence and sexual abuse appear to specifically target brain regions (auditory, visual and somatosensory cortex) and pathways that process and convey the aversive experience. Maltreatment is associated with reliable morphological alterations in anterior cingulate, dorsal lateral prefrontal and orbitofrontal cortex, corpus callosum and adult hippocampus, and with enhanced amygdala response to emotional faces and diminished striatal response to anticipated rewards. Evidence is emerging that these regions and interconnecting pathways have sensitive exposure periods when they are most vulnerable. CONCLUSIONS Early deprivation and later abuse may have opposite effects on amygdala volume. Structural and functional abnormalities initially attributed to psychiatric illness may be a more direct consequence of abuse. Childhood maltreatment exerts a prepotent influence on brain development and has been an unrecognized confound in almost all psychiatric neuroimaging studies. These brain changes may be best understood as adaptive responses to facilitate survival and reproduction in the face of adversity. Their relationship to psychopathology is complex as they are discernible in both susceptible and resilient individuals with maltreatment histories. Mechanisms fostering resilience will need to be a primary focus of future studies.
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Affiliation(s)
- Martin H. Teicher
- Department of Psychiatry, Harvard Medical School, Boston, MA,Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | - Jacqueline A. Samson
- Department of Psychiatry, Harvard Medical School, Boston, MA,Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
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Bücker J, Muralidharan K, Torres IJ, Su W, Kozicky J, Silveira LE, Bond DJ, Honer WG, Kauer-Sant'anna M, Lam RW, Yatham LN. Childhood maltreatment and corpus callosum volume in recently diagnosed patients with bipolar I disorder: data from the Systematic Treatment Optimization Program for Early Mania (STOP-EM). J Psychiatr Res 2014; 48:65-72. [PMID: 24183241 DOI: 10.1016/j.jpsychires.2013.10.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 08/29/2013] [Accepted: 10/10/2013] [Indexed: 01/11/2023]
Abstract
Childhood trauma (CT) has been associated with abnormalities in the corpus callosum (CC). Decreased CC volumes have been reported in children and adolescents with trauma as well as adults with CT compared to healthy controls. CC morphology is potentially susceptible to the effects of Bipolar Disorder (BD) itself. Therefore, we evaluated the relationship between CT and CC morphology in BD. We using magnetic resonance imaging in 53 adults with BD recently recovered from their first manic episode, with (n = 23) and without (n = 30) CT, defined using the Childhood Trauma Questionnaire (CTQ) and 16 healthy controls without trauma. ANCOVA was performed with age, gender and intracranial volume as covariates in order to evaluate group differences in CC volume. The total CC volume was found to be smaller in BD patients with trauma compared to BD patients without trauma (p < .05). The differences were more pronounced in the anterior region of the CC. There was a significant negative correlation between CTQ scores and total CC volume in BD patients with trauma (p = .01). We did not find significant differences in the CC volume of patients with/without trauma compared to the healthy subjects. Our sample consists of patients recovered from a first episode of mania and are early in the course of illness and reductions in CC volume may occur late in the course of BD. It might mean there may be two sources of CC volume reduction in these patients: the reduction due to trauma, and the further reduction due to the illness.
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Affiliation(s)
- J Bücker
- Department of Psychiatry, University of British Columbia, Vancouver, Canada; Bipolar Disorder Program and Laboratory of Molecular Psychiatry, National Institute for Translational Medicine, INCT-TM, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Brambilla P, Como G, Isola M, Taboga F, Zuliani R, Goljevscek S, Ragogna M, Brondani G, Baiano M, Perini L, Ferro A, Bazzocchi M, Zuiani C, Balestrieri M. White-matter abnormalities in the right posterior hemisphere in generalized anxiety disorder: a diffusion imaging study. Psychol Med 2012; 42:427-434. [PMID: 21781374 DOI: 10.1017/s0033291711001255] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Prior imaging studies have shown structural, functional and biochemical impairments in patients with generalized anxiety disorder (GAD), particularly in the right hemisphere. In this study we investigated, for the first time to the best of our knowledge, the white-matter microstructure organization in GAD. METHOD A total of 12 patients with DSM-IV GAD and 15 matched healthy controls underwent a magnetic resonance imaging session of diffusion weighted imaging, exploring white-matter water molecules by the means of apparent diffusion coefficients (ADCs). Regions of interests were placed in the frontal, parietal, temporal and occipital lobes and in the splenium and genu of the corpus callosum, bilaterally. RESULTS ADC measures were significantly greater in patients with GAD in the right splenium and right parietal cortex compared with healthy controls (p⩽0.002). No significant correlations between ADCs and age or clinical variables were found. CONCLUSIONS We provide evidence that GAD is associated with disrupted white-matter coherence of posterior right hemisphere regions, which may partly sustain the impaired cognitive regulation of anxiety. Future diffusion imaging investigations are expected to better elucidate the communication between the parietal cortex and other right hemisphere regions in sustaining the cognitive processing of social and emotional stimuli in patients with GAD.
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Affiliation(s)
- P Brambilla
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
| | - G Como
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - M Isola
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - F Taboga
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
| | - R Zuliani
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
| | - S Goljevscek
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
| | - M Ragogna
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
| | - G Brondani
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - M Baiano
- Centre for Weight and Eating Disorders, Portogruaro, Venice, Italy
| | - L Perini
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
| | - A Ferro
- Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, Inter-University Centre for Behavioural Neurosciences, University of Verona, Verona, Italy
| | - M Bazzocchi
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - C Zuiani
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - M Balestrieri
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
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James A, Hough M, James S, Burge L, Winmill L, Nijhawan S, Matthews PM, Zarei M. Structural brain and neuropsychometric changes associated with pediatric bipolar disorder with psychosis. Bipolar Disord 2011; 13:16-27. [PMID: 21320249 DOI: 10.1111/j.1399-5618.2011.00891.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To identify neuropsychological and structural brain changes using a combination of high-resolution structural and diffusion tensor imaging in pediatric bipolar disorder (PBD) with psychosis (presence of delusions and or hallucinations). METHODS We recruited 15 patients and 20 euthymic age- and gender-matched healthy controls. All subjects underwent high-resolution structural and diffusion tensor imaging. Voxel-based morphometry (VBM), tract-based spatial statistics (TBSS), and probabilistic tractography were used to analyse magnetic resonance imaging data. RESULTS The PBD subjects had normal overall intelligence with specific impairments in working memory, executive function, language function, and verbal memory. Reduced gray matter (GM) density was found in the left orbitofrontal cortex, left pars triangularis, right premotor cortex, occipital cortex, right occipital fusiform gyrus, and right crus of the cerebellum. TBSS analysis showed reduced fractional anisotropy (FA) in the anterior corpus callosum. Probabilistic tractography from this cluster showed that this region of the corpus callosum is connected with the prefrontal cortices, including those regions whose density is decreased in PBD. In addition, FA change was correlated with verbal memory and working memory, while more widespread reductions in GM density correlated with working memory, executive function, language function, and verbal memory. CONCLUSIONS The findings suggest widespread cortical changes as well as specific involvement of interhemispheric prefrontal tracts in PBD, which may reflect delayed myelination in these tracts.
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Affiliation(s)
- Anthony James
- Highfield Family and Adolescent Unit, Warneford Hospital Oxford Centre for Functional MRI of the Brain (FMRIB), John Radcliffe Hospital, Oxford GSK Clinical Imaging Centre, Imperial College London, London, UK.
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Hale TS, Smalley SL, Walshaw PD, Hanada G, Macion J, McCracken JT, McGough JJ, Loo SK. Atypical EEG beta asymmetry in adults with ADHD. Neuropsychologia 2010; 48:3532-9. [PMID: 20705076 DOI: 10.1016/j.neuropsychologia.2010.08.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 06/22/2010] [Accepted: 08/04/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Abnormal brain laterality (ABL) is well established in ADHD. However, its clinical specificity and association to cognitive and clinical symptoms is not yet understood. Previous studies indicate increased right hemisphere (RH) contribution in both ADHD and reading impaired samples. The current study investigates whether this ABL characteristic occurs in adults with ADHD absent comorbid language impairment. METHODS EEG beta asymmetry was compared in 35 adult ADHD subjects and 104 controls during rest and active cognition. Group differences in beta asymmetry were then further evaluated for association to linguistic and attentional abilities, as well as association to beta asymmetry measures across different brain regions. RESULTS Adults with ADHD showed pronounced rightward beta asymmetry (p=.00001) in inferior parietal regions (P8-P7) during a continuous performance task (CPT) that could not be attributed to linguistic ability. Among ADHD subjects only, greater rightward beta asymmetry at this measure was correlated with better CPT performance. Furthermore, this measure showed a lack of normal association (i.e., observed in controls) to left-biased processing in temporal-parietal (TP8-TP7) brain regions important for higher order language functions. CONCLUSION Adult ADHD involves abnormally increased right-biased contribution to CPT processing that could not be attributed to poor language ability. This appears to also involve abnormal recruitment of LH linguistic processing regions and represents an alternative, albeit less effective, CPT processing strategy. These findings suggest different pathophysiologic mechanisms likely underlie RH biased processing in ADHD and reading impaired samples.
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Affiliation(s)
- T Sigi Hale
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90024, USA.
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