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Vai B, Calesella F, Pelucchi A, Riberto M, Poletti S, Bechi M, Cavallaro R, Francesco B. Adverse childhood experiences differently affect Theory of Mind brain networks in schizophrenia and healthy controls. J Psychiatr Res 2024; 172:81-89. [PMID: 38367321 DOI: 10.1016/j.jpsychires.2024.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/13/2024] [Accepted: 02/13/2024] [Indexed: 02/19/2024]
Abstract
Patients with schizophrenia (SZ) show impairments in both affective and cognitive dimensions of theory of mind (ToM). SZ are also particularly vulnerable to detrimental effect of adverse childhood experiences (ACE), influencing the overall course of the disorder and fostering poor social functioning. ACE associate with long-lasting detrimental effects on brain structure, function, and connectivity in regions involved in ToM. Here, we investigated whether ToM networks are differentially affected by ACEs in healthy controls (HC) and SZ, and if these effects can predict the disorder clinical outcome. 26 HC and 33 SZ performed a ToM task during an fMRI session. Whole-brain functional response and connectivity (FC) were extracted, investigating the interaction between ACEs and diagnosis. FC values significantly affected by ACEs were entered in a cross-validated LASSO regression predicting Positive and Negative Syndrome Scale (PANSS), Interpersonal Reactivity Index (IRI), and task performance. ACEs and diagnosis showed a widespread interaction at both affective and cognitive tasks, including connectivity between vmPFC, ACC, precentral and postcentral gyri, insula, PCC, precuneus, parahippocampal gyrus, temporal pole, thalamus, and cerebellum, and functional response in the ACC, thalamus, parahippocampal gyrus and putamen. FC predicted the PANSS score, the fantasy dimension of IRI, and the AToM response latency. Our results highlight the crucial role of early stress in differentially shaping ToM related brain networks in HC and SZ. These effects can also partially explain the clinical and behavioral outcomes of the disorder, extending our knowledge of the effects of ACEs.
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Affiliation(s)
- Benedetta Vai
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy.
| | - Federico Calesella
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Alice Pelucchi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Martina Riberto
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Sara Poletti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Margherita Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Roberto Cavallaro
- Vita-Salute San Raffaele University, Milano, Italy; Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Benedetti Francesco
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
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2
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Vai B, Mazza MG. Clinical and pharmacological implications for a high rate of unrecognized SARS-CoV-2 infected psychiatric patients. Brain Behav Immun 2024; 116:124-125. [PMID: 38070617 DOI: 10.1016/j.bbi.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/04/2023] [Indexed: 01/21/2024] Open
Affiliation(s)
- Benedetta Vai
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy.
| | - Mario Gennaro Mazza
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
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3
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Bruin WB, Abe Y, Alonso P, Anticevic A, Backhausen LL, Balachander S, Bargallo N, Batistuzzo MC, Benedetti F, Bertolin Triquell S, Brem S, Calesella F, Couto B, Denys DAJP, Echevarria MAN, Eng GK, Ferreira S, Feusner JD, Grazioplene RG, Gruner P, Guo JY, Hagen K, Hansen B, Hirano Y, Hoexter MQ, Jahanshad N, Jaspers-Fayer F, Kasprzak S, Kim M, Koch K, Bin Kwak Y, Kwon JS, Lazaro L, Li CSR, Lochner C, Marsh R, Martínez-Zalacaín I, Menchon JM, Moreira PS, Morgado P, Nakagawa A, Nakao T, Narayanaswamy JC, Nurmi EL, Zorrilla JCP, Piacentini J, Picó-Pérez M, Piras F, Piras F, Pittenger C, Reddy JYC, Rodriguez-Manrique D, Sakai Y, Shimizu E, Shivakumar V, Simpson BH, Soriano-Mas C, Sousa N, Spalletta G, Stern ER, Evelyn Stewart S, Szeszko PR, Tang J, Thomopoulos SI, Thorsen AL, Yoshida T, Tomiyama H, Vai B, Veer IM, Venkatasubramanian G, Vetter NC, Vriend C, Walitza S, Waller L, Wang Z, Watanabe A, Wolff N, Yun JY, Zhao Q, van Leeuwen WA, van Marle HJF, van de Mortel LA, van der Straten A, van der Werf YD, Thompson PM, Stein DJ, van den Heuvel OA, van Wingen GA. The functional connectome in obsessive-compulsive disorder: resting-state mega-analysis and machine learning classification for the ENIGMA-OCD consortium. Mol Psychiatry 2023; 28:4307-4319. [PMID: 37131072 PMCID: PMC10827654 DOI: 10.1038/s41380-023-02077-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 05/04/2023]
Abstract
Current knowledge about functional connectivity in obsessive-compulsive disorder (OCD) is based on small-scale studies, limiting the generalizability of results. Moreover, the majority of studies have focused only on predefined regions or functional networks rather than connectivity throughout the entire brain. Here, we investigated differences in resting-state functional connectivity between OCD patients and healthy controls (HC) using mega-analysis of data from 1024 OCD patients and 1028 HC from 28 independent samples of the ENIGMA-OCD consortium. We assessed group differences in whole-brain functional connectivity at both the regional and network level, and investigated whether functional connectivity could serve as biomarker to identify patient status at the individual level using machine learning analysis. The mega-analyses revealed widespread abnormalities in functional connectivity in OCD, with global hypo-connectivity (Cohen's d: -0.27 to -0.13) and few hyper-connections, mainly with the thalamus (Cohen's d: 0.19 to 0.22). Most hypo-connections were located within the sensorimotor network and no fronto-striatal abnormalities were found. Overall, classification performances were poor, with area-under-the-receiver-operating-characteristic curve (AUC) scores ranging between 0.567 and 0.673, with better classification for medicated (AUC = 0.702) than unmedicated (AUC = 0.608) patients versus healthy controls. These findings provide partial support for existing pathophysiological models of OCD and highlight the important role of the sensorimotor network in OCD. However, resting-state connectivity does not so far provide an accurate biomarker for identifying patients at the individual level.
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Grants
- R01 AG058854 NIA NIH HHS
- P41 EB015922 NIBIB NIH HHS
- R01 MH126213 NIMH NIH HHS
- R21 MH101441 NIMH NIH HHS
- R01 MH121520 NIMH NIH HHS
- R21 MH093889 NIMH NIH HHS
- R01 MH116147 NIMH NIH HHS
- R01 MH111794 NIMH NIH HHS
- R01 MH085900 NIMH NIH HHS
- UL1 TR001863 NCATS NIH HHS
- R01 MH081864 NIMH NIH HHS
- R01 MH104648 NIMH NIH HHS
- U54 EB020403 NIBIB NIH HHS
- R01 MH117601 NIMH NIH HHS
- R01 MH116038 NIMH NIH HHS
- R01 MH126981 NIMH NIH HHS
- R01 NS107513 NINDS NIH HHS
- RF1 MH123163 NIMH NIH HHS
- R33 MH107589 NIMH NIH HHS
- K24 MH121571 NIMH NIH HHS
- R01 MH121246 NIMH NIH HHS
- Wellcome Trust
- K23 MH115206 NIMH NIH HHS
- R01 AG059874 NIA NIH HHS
- Funding from Japan Society for the Promotion of Science (KAKENHI Grant No. 18K15523)
- Carlos III Health Institute PI18/00856
- NIMH: 5R01MH116038
- Sara Bertolin was supported by Instituto de Salud Carlos III through the grant CM21/00278 (Co-funded by European Social Fund. ESF investing in your future).
- Hartmann Müller Foundation (no. 1460, principal investigator: S.Brem)
- NIHM: R01MH085900, R01MH121520
- NIH: K23 MH115206 & IOCDF Annual Research Award
- AMED Brain/MINDS Beyond program Grant No. JP22dm0307002, JSPS KAKENHI Grants No. 22H01090, 21K03084, 19K03309, 16K04344
- NIH: R01MH117601, R01AG059874, P41EB015922, R01MH126213, R01MH121246
- Michael Smith Health Research BC
- the Deutsche Forschungsgemeinschaf (KO 3744/11-1)
- This work was supported by the Medical Research Council of South Africa (SAMRC), and the National Research Foundation of South Africa (Christine Lochner), and we acknowledge the contribution of our research assistants.
- NIMH: R21MH093889, R21MH101441 and R01MH104648
- IM-Z was supported by a PFIS grant (FI17/00294) from the Carlos III Health Institute
- This work was supported by National funds, through the Foundation for Science and Technology (project UIDB/50026/2020 and UIDP/50026/2020); by the Norte Portugal Regional Operational Programme (NORTE 2020) under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF) (projects NORTE-01-0145-FEDER-000013 and NORTE-01-0145-FEDER-000023), and by the FLAD Science Award Mental Health 2021.
- JSPS KAKENHI (C)21K07547, 22K07598 and 22K15766
- Government of India grants from Department of Science and Technology (DST INSPIRE faculty grant -IFA12-LSBM-26) & Department of Biotechnology (BT/06/IYBA/2012)
- NIMH: R01MH081864
- MPP was supported by the Spanish Ministry of Universities, with funds from the European Union - NextGenerationEU (MAZ/2021/11).
- Italian Ministry of Health, Ricerca Corrente 2022, 2023
- NIMH: K24MH121571
- Government of India grants to: Prof. Reddy [(SR/S0/HS/0016/2011) & (BT/PR13334/Med/30/259/2009)], Dr. Janardhanan Narayanaswamy (DST INSPIRE faculty grant -IFA12-LSBM-26) & (BT/06/IYBA/2012) and the Wellcome-DBT India Alliance grant to Dr. Ganesan Venkatasubramanian (500236/Z/11/Z)
- the Japan Agency for Medical Research and Development: JP22dm0307008
- DBT-Wellcome Trust India Alliance Early Career Fellowship grant (IA/CPHE/18/1/503956)
- NIMH: R21MH093889 and R01MH104648
- Grant #PI19/01171 from the Carlos III Health Institute, and 2017SGR 1247 from AGAUR-Generalitat de Catalunya.
- Italian Ministry of Health grant RC19-20-21-22/A
- Grants R01MH126981, R01MH111794, and R33MH107589 from the National Institute of Mental Health/National Institute of Health awarded to ERS.
- National Natural Science Foundation of China (Nos. 81871057, 82171495), and Key Technologies Research and Development Program of China (Nos.2022YFE0103700)
- Helse Vest Health Authority (Grant ID 911754 and 911880)
- JSPS KAKENHI (C) JP21K07547, 22K07598 and 22K15766.
- Ganesan Venkatasubramanian acknowledges the support of Department of Biotechnology (DBT) - Wellcome Trust India Alliance CRC grant (IA/CRC/19/1/610005) & senior fellowship grant (500236/Z/11/Z)
- Supported by an grant from Amsterdam Neuroscience CIA-2019-03-A
- Swiss National Science Foundation (no. 320030_130237, principal investigator: S.Walitza)
- The National Natural Science Foundation of China (82071518)
- Else Kröner Fresenius Stiftung (2017_A101)
- ENIGMA World Aging Center, NIA Award No. R01AG058854; ENIGMA Parkinson's Initiative: A Global Initiative for Parkinson's Disease, NINDS award RO1NS107513
- the Obsessive-Compulsive Foundation to Dan J. Stein
- Dutch Organization for Scientific Research (NWO/ZonMW) VENI grant (916-86-038) and Brain & Behavior Research Foundation (NARSAD grant), Netherlands Brain Foundation (2010(1)-50)
- Netherlands Organization for Scientific Research (NWO/ZonMW Vidi Grant No. 165.610.002, 016.156.318, and 917.15.318 G.A. van Wingen)
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Affiliation(s)
- Willem B Bruin
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Amsterdam, The Netherlands.
| | - Yoshinari Abe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain
- Department of Clinical Science, Faculty of Medicine, University of Barcelona, Barcelona, Spain
- IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Alan Anticevic
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Lea L Backhausen
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Srinivas Balachander
- Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Nuria Bargallo
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Radiology Service, Diagnosis Image Center, Hospital Clinic de Barcelona, Barcelona, Spain
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marcelo C Batistuzzo
- Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
- Department of Methods and Techniques in Psychology, Pontifical Catholic University, Sao Paulo, Brazil
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Sara Bertolin Triquell
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Federico Calesella
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Beatriz Couto
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Damiaan A J P Denys
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Marco A N Echevarria
- Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Goi Khia Eng
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Jamie D Feusner
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- General Adult Psychiatry & Health Systems, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Patricia Gruner
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Joyce Y Guo
- University of California, San Diego, CA, USA
| | - Kristen Hagen
- Molde Hospital, Møre og Romsdal Hospital Trust, Molde, Norway
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjarne Hansen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Center for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Marcelo Q Hoexter
- Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Fern Jaspers-Fayer
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Selina Kasprzak
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kathrin Koch
- Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Yoo Bin Kwak
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Luisa Lazaro
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | | | - Christine Lochner
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Rachel Marsh
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Ignacio Martínez-Zalacaín
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Jose M Menchon
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Pedro S Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Tomohiro Nakao
- Graduate School of Medical Sciences, Kyushu University, Fukuoka-shi, Japan
| | - Janardhanan C Narayanaswamy
- National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
- GVAMHS, Goulburn Valley Health, Shepparton, VIC, Australia
| | - Erika L Nurmi
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jose C Pariente Zorrilla
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - John Piacentini
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Federica Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Janardhan Y C Reddy
- Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Daniela Rodriguez-Manrique
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Graduate School of Systemic Neurosciences (GSN), Ludwig-Maximilians-Universität, Munich, Germany
| | - Yuki Sakai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui, Japan
- Department of Cognitive Behavioral Physiology Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Venkataram Shivakumar
- Department of Integrative Medicine, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Blair H Simpson
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Carles Soriano-Mas
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, Universitat de Barcelona-UB, Barcelona, Spain
| | - Nuno Sousa
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Emily R Stern
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - S Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Philip R Szeszko
- Department of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, NY, USA
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Anders L Thorsen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Center for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Tokiko Yoshida
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Hirofumi Tomiyama
- Graduate School of Medical Sciences, Kyushu University, Fukuoka-shi, Japan
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Ilya M Veer
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Nora C Vetter
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Psychology, Faculty of Natural Sciences, MSB Medical School Berlin, Berlin, Germany
| | - Chris Vriend
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging program, Amsterdam, The Netherlands
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Lea Waller
- Department of Psychiatry and Neurosciences CCM, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao, China
| | - Anri Watanabe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nicole Wolff
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Je-Yeon Yun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Qing Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao, China
| | - Wieke A van Leeuwen
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Hein J F van Marle
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood Anxiety Psychosis Stress Sleep, Amsterdam, The Netherlands
| | - Laurens A van de Mortel
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Anouk van der Straten
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Ysbrand D van der Werf
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging program, Amsterdam, The Netherlands
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Dan J Stein
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Odile A van den Heuvel
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
| | - Guido A van Wingen
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Amsterdam, The Netherlands.
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4
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Bruin WB, Abe Y, Alonso P, Anticevic A, Backhausen LL, Balachander S, Bargallo N, Batistuzzo MC, Benedetti F, Bertolin Triquell S, Brem S, Calesella F, Couto B, Denys DAJP, Echevarria MAN, Eng GK, Ferreira S, Feusner JD, Grazioplene RG, Gruner P, Guo JY, Hagen K, Hansen B, Hirano Y, Hoexter MQ, Jahanshad N, Jaspers-Fayer F, Kasprzak S, Kim M, Koch K, Bin Kwak Y, Kwon JS, Lazaro L, Li CSR, Lochner C, Marsh R, Martínez-Zalacaín I, Menchon JM, Moreira PS, Morgado P, Nakagawa A, Nakao T, Narayanaswamy JC, Nurmi EL, Zorrilla JCP, Piacentini J, Picó-Pérez M, Piras F, Piras F, Pittenger C, Reddy JYC, Rodriguez-Manrique D, Sakai Y, Shimizu E, Shivakumar V, Simpson BH, Soriano-Mas C, Sousa N, Spalletta G, Stern ER, Evelyn Stewart S, Szeszko PR, Tang J, Thomopoulos SI, Thorsen AL, Yoshida T, Tomiyama H, Vai B, Veer IM, Venkatasubramanian G, Vetter NC, Vriend C, Walitza S, Waller L, Wang Z, Watanabe A, Wolff N, Yun JY, Zhao Q, van Leeuwen WA, van Marle HJF, van de Mortel LA, van der Straten A, van der Werf YD, Thompson PM, Stein DJ, van den Heuvel OA, van Wingen GA. Correction: The functional connectome in obsessive-compulsive disorder: resting-state mega-analysis and machine learning classification for the ENIGMA-OCD consortium. Mol Psychiatry 2023; 28:4320. [PMID: 37582859 PMCID: PMC10827652 DOI: 10.1038/s41380-023-02211-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Affiliation(s)
- Willem B Bruin
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Amsterdam, The Netherlands.
| | - Yoshinari Abe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain
- Department of Clinical Science, Faculty of Medicine, University of Barcelona, Barcelona, Spain
- IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Alan Anticevic
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Lea L Backhausen
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Srinivas Balachander
- Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Nuria Bargallo
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Radiology Service, Diagnosis Image Center, Hospital Clinic de Barcelona, Barcelona, Spain
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marcelo C Batistuzzo
- Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
- Department of Methods and Techniques in Psychology, Pontifical Catholic University, Sao Paulo, Brazil
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Sara Bertolin Triquell
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Federico Calesella
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Beatriz Couto
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Damiaan A J P Denys
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Marco A N Echevarria
- Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Goi Khia Eng
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Jamie D Feusner
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- General Adult Psychiatry & Health Systems, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Patricia Gruner
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Joyce Y Guo
- University of California, San Diego, CA, USA
| | - Kristen Hagen
- Molde Hospital, Møre og Romsdal Hospital Trust, Molde, Norway
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjarne Hansen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Center for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Marcelo Q Hoexter
- Department of Psychiatry, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Fern Jaspers-Fayer
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Selina Kasprzak
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kathrin Koch
- Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Yoo Bin Kwak
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Luisa Lazaro
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | | | - Christine Lochner
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Rachel Marsh
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Ignacio Martínez-Zalacaín
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Jose M Menchon
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Pedro S Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Tomohiro Nakao
- Graduate School of Medical Sciences, Kyushu University, Fukuoka-shi, Japan
| | - Janardhanan C Narayanaswamy
- National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
- GVAMHS, Goulburn Valley Health, Shepparton, VIC, Australia
| | - Erika L Nurmi
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jose C Pariente Zorrilla
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - John Piacentini
- Division of Child and Adolescent Psychiatry,, UCLA Semel Institute for Neuroscience, Los Angeles, CA, USA
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Federica Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Janardhan Y C Reddy
- Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Daniela Rodriguez-Manrique
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Graduate School of Systemic Neurosciences (GSN), Ludwig-Maximilians-Universität, Munich, Germany
| | - Yuki Sakai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui, Japan
- Department of Cognitive Behavioral Physiology Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Venkataram Shivakumar
- Department of Integrative Medicine, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Blair H Simpson
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Carles Soriano-Mas
- CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, Universitat de Barcelona-UB, Barcelona, Spain
| | - Nuno Sousa
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Emily R Stern
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - S Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Philip R Szeszko
- Department of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, NY, USA
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Anders L Thorsen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Center for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Tokiko Yoshida
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Hirofumi Tomiyama
- Graduate School of Medical Sciences, Kyushu University, Fukuoka-shi, Japan
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Ilya M Veer
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Nora C Vetter
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Psychology, Faculty of Natural Sciences, MSB Medical School Berlin, Berlin, Germany
| | - Chris Vriend
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging program, Amsterdam, The Netherlands
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Lea Waller
- Department of Psychiatry and Neurosciences CCM, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao, China
| | - Anri Watanabe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nicole Wolff
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Je-Yeon Yun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Qing Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao, China
| | - Wieke A van Leeuwen
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Hein J F van Marle
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood Anxiety Psychosis Stress Sleep, Amsterdam, The Netherlands
| | - Laurens A van de Mortel
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Anouk van der Straten
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Ysbrand D van der Werf
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging program, Amsterdam, The Netherlands
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Dan J Stein
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Odile A van den Heuvel
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
| | - Guido A van Wingen
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Amsterdam, The Netherlands.
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5
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Vai B, Calesella F, Lenti C, Fortaner-Uyà L, Caselani E, Fiore P, Breit S, Poletti S, Colombo C, Zanardi R, Benedetti F. Reduced corticolimbic habituation to negative stimuli characterizes bipolar depressed suicide attempters. Psychiatry Res Neuroimaging 2023; 331:111627. [PMID: 36924742 DOI: 10.1016/j.pscychresns.2023.111627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/10/2023] [Accepted: 03/07/2023] [Indexed: 03/18/2023]
Abstract
Suicide attempts in Bipolar Disorder are characterized by high levels of lethality and impulsivity. Reduced rates of amygdala and cortico-limbic habituation can identify a fMRI phenotype of suicidality in the disorder related to internal over-arousing states. Hence, we investigated if reduced amygdala and whole-brain habituation may differentiate bipolar suicide attempters (SA, n = 17) from non-suicide attempters (nSA, n = 57), and healthy controls (HC, n = 32). Habituation was assessed during a fMRI task including facial expressions of anger and fear and a control condition. Associations with suicidality and current depressive symptomatology were assessed, including machine learning procedure to estimate the potentiality of habituation as biomarker for suicidality. SA showed lower habituation compared to HC and nSA in several cortico-limbic areas, including amygdalae, cingulate and parietal cortex, insula, hippocampus, para-hippocampus, cerebellar vermis, thalamus, and striatum, while nSA displayed intermediate rates between SA and HC. Lower habituation rates in the amygdalae were also associated with higher depressive and suicidal current symptomatology. Machine learning on whole-brain and amygdala habituation differentiated SA vs. nSA with 94% and 69% of accuracy, respectively. Reduced habituation in cortico-limbic system can identify a candidate biomarker for attempting suicide, helping in detecting at-risk bipolar patients, and in developing new therapeutic interventions.
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Affiliation(s)
- Benedetta Vai
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy.
| | - Federico Calesella
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Claudia Lenti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Lidia Fortaner-Uyà
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Elisa Caselani
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Paola Fiore
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Sigrid Breit
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern Switzerland
| | - Sara Poletti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Cristina Colombo
- University Vita-Salute San Raffaele, Milano, Italy; Unit of Mood Disorders, IRCCS Ospedale San Raffaele Turro, Milano, Italy
| | - Raffaella Zanardi
- University Vita-Salute San Raffaele, Milano, Italy; Unit of Mood Disorders, IRCCS Ospedale San Raffaele Turro, Milano, Italy
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
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6
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Yoshiike T, Benedetti F, Moriguchi Y, Vai B, Aggio V, Asano K, Ito M, Ikeda H, Ohmura H, Honma M, Yamada N, Kim Y, Nakajima S, Kuriyama K. Exploring the role of empathy in prolonged grief reactions to bereavement. Sci Rep 2023; 13:7596. [PMID: 37165097 PMCID: PMC10172345 DOI: 10.1038/s41598-023-34755-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/06/2023] [Indexed: 05/12/2023] Open
Abstract
Grief reactions to the bereavement of a close individual could involve empathy for pain, which is fundamental to social interaction. To explore whether grief symptoms interact with social relatedness to a person to whom one directs empathy to modulate the expression of empathy, we administered an empathy task to 28 bereaved adults during functional magnetic resonance imaging, in which participants were subliminally primed with facial stimuli (e.g., faces of their deceased or living relative, or a stranger), each immediately followed by a visual pain stimulus. Individuals' grief severity promoted empathy for the pain stimulus primed with the deceased's face, while it diminished the neural response to the pain stimulus primed with the face of either their living relative or a stranger in the medial frontal cortex (e.g., the right dorsal anterior cingulate cortex). Moreover, preliminary analyses showed that while the behavioral empathic response was promoted by the component of "longing" in the deceased priming condition, the neural empathic response was diminished by the component of "avoidance" in the stranger priming condition. Our results suggest an association between grief reactions to bereavement and empathy, in which grief symptoms interact with interpersonal factors to promote or diminish empathic responses to others' pain.
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Affiliation(s)
- Takuya Yoshiike
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-8553, Japan.
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Yoshiya Moriguchi
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Benedetta Vai
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Veronica Aggio
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Keiko Asano
- Department of Human Sciences, Faculty of Human Sciences, Musashino University, Tokyo, Japan
| | - Masaya Ito
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Hiroki Ikeda
- National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Kawasaki, Japan
| | - Hidefumi Ohmura
- Department of Information Sciences, Faculty of Science and Technology, Tokyo University of Science, Noda, Japan
| | - Motoyasu Honma
- Department of Physiology, Showa University School of Medicine, Tokyo, Japan
| | - Naoto Yamada
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Yoshiharu Kim
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Satomi Nakajima
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Human Sciences, Faculty of Human Sciences, Musashino University, Tokyo, Japan
| | - Kenichi Kuriyama
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-8553, Japan
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
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7
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Paolini M, Palladini M, Mazza MG, Colombo F, Vai B, Rovere-Querini P, Falini A, Poletti S, Benedetti F. Brain correlates of subjective cognitive complaints in COVID-19 survivors: A multimodal magnetic resonance imaging study. Eur Neuropsychopharmacol 2023; 68:1-10. [PMID: 36640728 PMCID: PMC9742225 DOI: 10.1016/j.euroneuro.2022.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/09/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
Cognitive impairment represents a leading residual symptom of COVID-19 infection, which lasts for months after the virus clearance. Up-to-date scientific reports documented a wide spectrum of brain changes in COVID-19 survivors following the illness's resolution, mainly related to neurological and neuropsychiatric consequences. Preliminary insights suggest abnormal brain metabolism, microstructure, and functionality as neural under-layer of post-acute cognitive dysfunction. While previous works focused on brain correlates of impaired cognition as objectively assessed, herein we investigated long-term neural correlates of subjective cognitive decline in a sample of 58 COVID-19 survivors with a multimodal imaging approach. Diffusion Tensor Imaging (DTI) analyses revealed widespread white matter disruption in the sub-group of cognitive complainers compared to the non-complainer one, as indexed by increased axial, radial, and mean diffusivity in several commissural, projection and associative fibres. Likewise, the Multivoxel Pattern Connectivity analysis (MVPA) revealed highly discriminant patterns of functional connectivity in resting-state among the two groups in the right frontal pole and in the middle temporal gyrus, suggestive of inefficient dynamic modulation of frontal brain activity and possible metacognitive dysfunction at rest. Beyond COVID-19 actual pathophysiological brain processes, our findings point toward brain connectome disruption conceivably translating into clinical post-COVID cognitive symptomatology. Our results could pave the way for a potential brain signature of cognitive complaints experienced by COVID-19 survivors, possibly leading to identify early therapeutic targets and thus mitigating its detrimental long-term impact on quality of life in the post-COVID-19 stages.
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Affiliation(s)
- Marco Paolini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; PhD Program in Molecular Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Mariagrazia Palladini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy.
| | - Mario Gennaro Mazza
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
| | - Federica Colombo
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milan, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Andrea Falini
- Vita-Salute San Raffaele University, Milan, Italy; Department of Neuroradiology, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
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8
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Vai B, Palladini M, Lorenzi C, Zanardi R, Poletti S, Aggio V, Benedetti F. Interleukin 6 associates with reduced grey matter volume and resting-state connectivity in the anterior cingulate cortex in bipolar patients. Brain Behav Immun Health 2022; 26:100522. [PMID: 36187407 PMCID: PMC9523275 DOI: 10.1016/j.bbih.2022.100522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Benedetta Vai
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
- University Vita-Salute San Raffaele, Milano, Italy
- Corresponding author. Unit of Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, San Raffaele Turro, Via Stamira d’Ancona 20, Milano, Italy.
| | - Mariagrazia Palladini
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
- University Vita-Salute San Raffaele, Milano, Italy
| | - Cristina Lorenzi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Raffaella Zanardi
- Unit of Mood Disorders, IRCCS Ospedale San Raffaele- Turro, Milano, Italy
| | - Sara Poletti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
- University Vita-Salute San Raffaele, Milano, Italy
| | - Veronica Aggio
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
- University Vita-Salute San Raffaele, Milano, Italy
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9
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Asperti C, Benanti G, Ramirez GA, Russo M, Vai B, Bramé B, Viapiana N, Nannipieri S, Cilona MB, Mazzetti M, Zuffada S, Di Mattei VE, Benedetti F, Dagna L, Yacoub MR. Interactions between Severe Allergy and Anxiety in Anti-SARS-CoV-2 Vaccinees. Vaccines (Basel) 2022; 10:vaccines10122047. [PMID: 36560457 PMCID: PMC9783305 DOI: 10.3390/vaccines10122047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022] Open
Abstract
Severe drug allergy affects patient hesitancy to new treatments, posing unprecedented challenges to anti-SARS-CoV-2 vaccination campaigns. We aimed to analyze the psychological profile of vaccinees with a history of severe allergy in comparison to subjects with a milder allergy history. Patients attending a dedicated vaccination setting were administered an anonymized questionnaire including clinical data and the State-Trait Anxiety Inventory (STAI) scale (score range 20−80). Patients were also asked whether being in a protected setting affected their attitude toward vaccination. Data are expressed as median (interquartile range). We enrolled 116 patients (78% women), of whom 79% had a history of drug anaphylaxis. The median state anxiety score was 36.5 (30−47.2), while the trait anxiety score was 37 (32−48). State anxiety was higher in those with severe than mild allergy [39 (32−50) vs. 30 (25−37); p < 0.001], with the highest score found in a patient with previous drug anaphylaxis (42.5 [32−51.7]). More than 50% of patients reported that being in a protected setting had lowered their anxiety. Severe allergy is associated with a higher burden of situational anxiety in the setting of vaccination without affecting patient constitutional (trait) levels of anxiety. Vaccination in dedicated facilities might overcome issues related to hesitancy and improve patients’ quality of life.
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Affiliation(s)
- Chiara Asperti
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Giovanni Benanti
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Giuseppe A. Ramirez
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Marco Russo
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Benedetta Vai
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Barbara Bramé
- Nuovo Ospedale di Legnano, Uoc Medicina Generale, 20025 Legnano, Italy
| | - Naomi Viapiana
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Serena Nannipieri
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Maria Bernadette Cilona
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Martina Mazzetti
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Simone Zuffada
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Valentina Elisabetta Di Mattei
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Francesco Benedetti
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Lorenzo Dagna
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Mona-Rita Yacoub
- Unit of Immunology Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
- Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
- Correspondence:
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10
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Poletti S, Paolini M, Ernst J, Bollettini I, Melloni E, Vai B, Harrington Y, Bravi B, Calesella F, Lorenzi C, Zanardi R, Benedetti F. Long-term effect of childhood trauma: Role of inflammation and white matter in mood disorders. Brain Behav Immun Health 2022; 26:100529. [PMID: 36237478 PMCID: PMC9550612 DOI: 10.1016/j.bbih.2022.100529] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 10/27/2022] Open
Abstract
Bipolar disorder (BD) and major depressive disorder (MDD) are severe psychiatric illnesses that share among their environmental risk factors the exposure to adverse childhood experiences (ACE). Exposure to ACE has been associated with long-term changes in brain structure and the immune response. In the lasts decades, brain abnormalities including alterations of white matter (WM) microstructure and higher levels of peripheral immune/inflammatory markers have been reported in BD and MDD and an association between inflammation and WM microstructure has been shown. However, differences in these measures have been reported by comparing the two diagnostic groups. The aim of the present study was to investigate the interplay between ACE, inflammation, and WM in BD and MDD. We hypothesize that inflammation will mediate the association between ACE and WM and that this will be different in the two groups. A sample of 200 patients (100 BD, 100 MDD) underwent 3T MRI scan and ACE assessment through Childhood Trauma Questionnaire. A subgroup of 130 patients (75 MDD and 55 BD) underwent blood sampling for the assessment of immune/inflammatory markers. We observed that ACE associated with higher peripheral levels of IL-2, IL-17, bFGF, IFN-γ, TNF-α, CCL3, CCL4, CCL5, and PDGF-BB only in the BD group. Further, higher levels of CCL3 and IL-2 associated with lower FA in BD. ACE were found to differently affect WM microstructure in the two diagnostic groups and to be negatively associated with FA and AD in BD patients. Mediation analyses showed a significant indirect effect of ACE on WM microstructure mediated by IL-2. Our findings suggest that inflammation may mediate the detrimental effect of early experiences on brain structure and different mechanisms underlying brain alterations in BD and MDD.
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Affiliation(s)
- Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy,Corresponding author. San Raffaele Turro, Via Stamira d’Ancona 20, 20127, Milano, Italy.
| | - Marco Paolini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
| | - Julia Ernst
- Vita-Salute San Raffaele University, Milano, Italy
| | - Irene Bollettini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Elisa Melloni
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
| | - Yasmin Harrington
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
| | - Beatrice Bravi
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
| | - Federico Calesella
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
| | - Cristina Lorenzi
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
| | - Raffaella Zanardi
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
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11
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Delli Colli C, Borgi M, Poggini S, Chiarotti F, Cirulli F, Penninx BWJH, Benedetti F, Vai B, Branchi I. Time moderates the interplay between 5-HTTLPR and stress on depression risk: gene x environment interaction as a dynamic process. Transl Psychiatry 2022; 12:274. [PMID: 35821204 PMCID: PMC9276704 DOI: 10.1038/s41398-022-02035-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/13/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
The serotonin-transporter-linked promoter region (5-HTTLPR) has been widely investigated as contributing to depression vulnerability. Nevertheless, empirical research provides wide contrasting findings regarding its involvement in the etiopathogenesis of the disorder. Our hypothesis was that such discrepancy can be explained considering time as moderating factor. We explored this hypothesis, exploiting a meta analytic approach. We searched PubMed, PsychoINFO, Scopus and EMBASE databases and 1096 studies were identified and screened, resulting in 22 studies to be included in the meta-analyses. The effect of the 5-HTTLPR x stress interaction on depression risk was found to be moderated by the following temporal factors: the duration of stress (i.e. chronic vs. acute) and the time interval between end of stress and assessment of depression (i.e. within 1 year vs. more than 1 year). When stratifying for the duration of stress, the effect of the 5-HTTLPR x stress interaction emerged only in the case of chronic stress, with a significant subgroup difference (p = 0.004). The stratification according to time interval revealed a significant interaction only for intervals within 1 year, though no difference between subgroups was found. The critical role of time interval clearly emerged when considering only chronic stress: a significant effect of the 5-HTTLPR and stress interaction was confirmed exclusively within 1 year and a significant subgroup difference was found (p = 0.01). These results show that the 5-HTTLPR x stress interaction is a dynamic process, producing different effects at different time points, and indirectly confirm that s-allele carriers are both at higher risk and more capable to recover from depression. Overall, these findings expand the current view of the interplay between 5-HTTLPR and stress adding the temporal dimension, that results in a three-way interaction: gene x environment x time.
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Affiliation(s)
- Claudia Delli Colli
- grid.416651.10000 0000 9120 6856Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy ,grid.7841.aPhD program in Pharmacology and Toxicology, Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, Rome, Italy
| | - Marta Borgi
- grid.416651.10000 0000 9120 6856Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Silvia Poggini
- grid.416651.10000 0000 9120 6856Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Chiarotti
- grid.416651.10000 0000 9120 6856Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Francesca Cirulli
- grid.416651.10000 0000 9120 6856Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Brenda W. J. H. Penninx
- grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Francesco Benedetti
- grid.18887.3e0000000417581884Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy ,grid.15496.3f0000 0001 0439 0892Università Vita-Salute San Raffaele, Milan, Italy
| | - Benedetta Vai
- grid.18887.3e0000000417581884Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy ,grid.15496.3f0000 0001 0439 0892Università Vita-Salute San Raffaele, Milan, Italy
| | - Igor Branchi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy.
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12
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Vai B, Mazza MG. Antipsychotics and COVID-19 Outcomes-The Potential Role of the Clinical Setting? JAMA Netw Open 2022; 5:e2210749. [PMID: 35522287 DOI: 10.1001/jamanetworkopen.2022.10749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Benedetta Vai
- Unit of Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Mario Gennaro Mazza
- Unit of Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
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13
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Mazza MG, Vai B, De Picker L, Benedetti F, Zanardi R. Comment on: "Fluvoxamine for the Early Treatment of SARS-CoV-2 Infection: A Review of Current Evidence". Drugs 2022; 82:349-351. [PMID: 35150437 PMCID: PMC8853053 DOI: 10.1007/s40265-022-01682-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Mario Gennaro Mazza
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Dipartimento di Neuroscienze Cliniche, IRCCS Scientific Institute Ospedale San Raffaele, San Raffaele Turro, Via Stamira d'Ancona 20, 20127, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy.
| | - Benedetta Vai
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Dipartimento di Neuroscienze Cliniche, IRCCS Scientific Institute Ospedale San Raffaele, San Raffaele Turro, Via Stamira d'Ancona 20, 20127, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Livia De Picker
- University Psychiatric Hospital Campus Duffel, Duffel, Belgium.,Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Dipartimento di Neuroscienze Cliniche, IRCCS Scientific Institute Ospedale San Raffaele, San Raffaele Turro, Via Stamira d'Ancona 20, 20127, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Raffaella Zanardi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Dipartimento di Neuroscienze Cliniche, IRCCS Scientific Institute Ospedale San Raffaele, San Raffaele Turro, Via Stamira d'Ancona 20, 20127, Milan, Italy.,Mood Disorders Unit, Scientific Institute IRCCS Ospedale San Raffaele, Milan, Italy
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14
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Comai S, Melloni E, Lorenzi C, Bollettini I, Vai B, Zanardi R, Colombo C, Valtorta F, Benedetti F, Poletti S. Selective association of cytokine levels and kynurenine/tryptophan ratio with alterations in white matter microstructure in bipolar but not in unipolar depression. Eur Neuropsychopharmacol 2022; 55:96-109. [PMID: 34847455 DOI: 10.1016/j.euroneuro.2021.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/03/2021] [Accepted: 11/08/2021] [Indexed: 02/07/2023]
Abstract
Bipolar (BD) and major depression (MDD) disorders are severe mental illnesses characterised by altered levels of immune/inflammatory markers and disrupted white matter (WM) microstructure. A pro-inflammatory state was suggested to activate indoleamine 2,3-dioxygenase which, in turn, increases the amount of tryptophan (Trp) converted into kynurenine (Kyn). We investigated whether plasma levels of Trp, Kyn and Kyn/Trp ratio are associated with peripheral levels of immune/inflammatory markers and whether they are related to WM integrity in 100 MDD and 66 BD patients. Patients also underwent MRI, and fractional anisotropy (FA) was estimated as a measure of WM microstructure. BD patients showed higher Kyn levels and Kyn/Trp ratio than MDD patients, and lower FA in several WM tracts, including the corpus callosum and the inferior fronto-occipital fasciculus (IFO). Lower Trp levels associated with a more severe depressive symptomatology irrespective of diagnosis and with lower FA in the corpus callosum (CC) and external capsule (EC). We found an association of immune/inflammatory markers with Kyn/Trp ratio selectively in BD patients: IL-1β and TNF-α showed a positive relationship and IL-2 and IL-9 a negative relationship; in addition, higher IL-4 correlated with lower Kyn levels; higher Kyn/Trp ratio and IL-1β correlated with lower FA in the CC and IFO. Notably, the detrimental effect of IL-1β on the IFO was moderated by the Kyn/Trp ratio. These data suggest that in BD, cytokines and the conversion of Trp into Kyn may affect WM microstructure and support the idea that distinct mechanisms underlie the pathophysiology of BD and MDD.
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Affiliation(s)
- Stefano Comai
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy; Department of Biomedical Sciences, University of Padua, Padua, Italy; Department of Psychiatry, McGill University, Montreal, Canada.
| | - Elisa Melloni
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Lorenzi
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Irene Bollettini
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Benedetta Vai
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Raffaella Zanardi
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Colombo
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Flavia Valtorta
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Benedetti
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Sara Poletti
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
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15
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Vai B, Mazza MG, Marisa CD, Beezhold J, Kärkkäinen H, Saunders J, Samochowiec J, Benedetti F, Leboyer M, Fusar-Poli P, De Picker L. Joint European policy on the COVID-19 risks for people with mental disorders: An umbrella review and evidence- and consensus-based recommendations for mental and public health. Eur Psychiatry 2022; 65:e47. [PMID: 35971656 PMCID: PMC9486830 DOI: 10.1192/j.eurpsy.2022.2307] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Abstract
As COVID-19 becomes endemic, identifying vulnerable population groups for severe infection outcomes and defining rapid and effective preventive and therapeutic strategies remains a public health priority. We performed an umbrella review, including comprehensive studies (meta-analyses and systematic reviews) investigating COVID-19 risk for infection, hospitalization, intensive care unit (ICU) admission, and mortality in people with psychiatric disorders, and outlined evidence- and consensus-based recommendations for overcoming potential barriers that psychiatric patients may experience in preventing and managing COVID-19, and defining optimal therapeutic options and current research priorities in psychiatry. We searched Web of Science, PubMed, and Ovid/PsycINFO databases up to 17 January 2022 for the umbrella review. We synthesized evidence, extracting when available pooled odd ratio estimates for the categories “any mental disorder” and “severe mental disorders.” The quality of each study was assessed using the AMSTAR-2 approach and ranking evidence quality. We identified four systematic review/meta-analysis combinations, one meta-analysis, and three systematic reviews, each including up to 28 original studies. Although we rated the quality of studies from moderate to low and the evidence ranged from highly suggestive to non-significant, we found consistent evidence that people with mental illness are at increased risk of COVID-19 infection, hospitalization, and most importantly mortality, but not of ICU admission. The risk and the burden of COVID-19 in people with mental disorders, in particular those with severe mental illness, can no longer be ignored but demands urgent targeted and persistent action. Twenty-two recommendations are proposed to facilitate this process.
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Vai B, Mazza MG, Cazzetta S, Calesella F, Aggio V, Lorenzi C, Zanardi R, Poletti S, Colombo C, Benedetti F. Higher Interleukin 13 differentiates patients with a positive history of suicide attempts in major depressive disorder. Journal of Affective Disorders Reports 2021. [DOI: 10.1016/j.jadr.2021.100254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Benedetti F, Palladini M, Paolini M, Melloni E, Vai B, De Lorenzo R, Furlan R, Rovere-Querini P, Falini A, Mazza MG. Brain correlates of depression, post-traumatic distress, and inflammatory biomarkers in COVID-19 survivors: A multimodal magnetic resonance imaging study. Brain Behav Immun Health 2021; 18:100387. [PMID: 34746876 PMCID: PMC8562046 DOI: 10.1016/j.bbih.2021.100387] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 10/31/2021] [Indexed: 01/08/2023] Open
Abstract
Psychiatric sequelae substantially contribute to the post-acute burden of disease associated with COVID-19, persisting months after clearance of the virus. Brain imaging shows white matter (WM) hypodensities/hyperintensities, and the involvement of grey matter (GM) in prefrontal, anterior cingulate (ACC) and insular cortex after COVID, but little is known about brain correlates of persistent psychopathology. With a multimodal approach, we studied whole brain voxel-based morphometry, diffusion-tensor imaging, and resting-state connectivity, to correlate MRI measures with depression and post-traumatic distress (PTSD) in 42 COVID-19 survivors without brain lesions, at 90.59 ± 54.66 days after COVID. Systemic immune-inflammation index (SII) measured in the emergency department, which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, predicted worse self-rated depression and PTSD, widespread lower diffusivity along the main axis of WM tracts, and abnormal functional connectivity (FC) among resting state networks. Self-rated depression and PTSD inversely correlated with GM volumes in ACC and insula, axial diffusivity, and associated with FC. We observed overlapping associations between severity of inflammation during acute COVID-19, brain structure and function, and severity of depression and post-traumatic distress in survivors, thus warranting interest for further study of brain correlates of the post-acute COVID-19 syndrome. Beyond COVID-19, these findings support the hypothesis that regional GM, WM microstructure, and FC could mediate the relationship between a medical illness and its psychopathological sequelae, and are in agreement with current perspectives on the brain structural and functional underpinnings of depressive psychopathology.
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Affiliation(s)
- Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Mariagrazia Palladini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Marco Paolini
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
- PhD Program in Molecular Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Elisa Melloni
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Benedetta Vai
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Rebecca De Lorenzo
- Vita-Salute San Raffaele University, Milano, Italy
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Roberto Furlan
- Clinical Neuroimmunology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milano, Italy
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Andrea Falini
- Vita-Salute San Raffaele University, Milano, Italy
- Department of Neuroradiology, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Mario Gennaro Mazza
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
- PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
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Affiliation(s)
- Livia De Picker
- University Psychiatric Hospital Campus Duffel, 2570 Duffel, Belgium; Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium.
| | - Mario Gennaro Mazza
- Psychiatry & Clinical Psychology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Benedetta Vai
- Psychiatry & Clinical Psychology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Fondazione Centro San Raffaele, Milan, Italy
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Vai B, Mazza MG, Delli Colli C, Foiselle M, Allen B, Benedetti F, Borsini A, Casanova Dias M, Tamouza R, Leboyer M, Benros ME, Branchi I, Fusar-Poli P, De Picker LJ. Mental disorders and risk of COVID-19-related mortality, hospitalisation, and intensive care unit admission: a systematic review and meta-analysis. Lancet Psychiatry 2021; 8:797-812. [PMID: 34274033 PMCID: PMC8285121 DOI: 10.1016/s2215-0366(21)00232-7] [Citation(s) in RCA: 180] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Mental disorders might be a risk factor for severe COVID-19. We aimed to assess the specific risks of COVID-19-related mortality, hospitalisation, and intensive care unit (ICU) admission associated with any pre-existing mental disorder, and specific diagnostic categories of mental disorders, and exposure to psychopharmacological drug classes. METHODS In this systematic review and meta-analysis, we searched Web of Science, Cochrane, PubMed, and PsycINFO databases between Jan 1, 2020, and March 5, 2021, for original studies reporting data on COVID-19 outcomes in patients with psychiatric disorders compared with controls. We excluded studies with overlapping samples, studies that were not peer-reviewed, and studies written in languages other than English, Danish, Dutch, French, German, Italian, and Portuguese. We modelled random-effects meta-analyses to estimate crude odds ratios (OR) for mortality after SARS-CoV-2 infection as the primary outcome, and hospitalisation and ICU admission as secondary outcomes. We calculated adjusted ORs for available data. Heterogeneity was assessed using the I2 statistic, and publication bias was tested with Egger regression and visual inspection of funnel plots. We used the GRADE approach to assess the overall strength of the evidence and the Newcastle Ottawa Scale to assess study quality. We also did subgroup analyses and meta-regressions to assess the effects of baseline COVID-19 treatment setting, patient age, country, pandemic phase, quality assessment score, sample sizes, and adjustment for confounders. This study is registered with PROSPERO, CRD42021233984. FINDINGS 841 studies were identified by the systematic search, of which 33 studies were included in the systematic review and 23 studies in the meta-analysis, comprising 1 469 731 patients with COVID-19, of whom 43 938 had mental disorders. The sample included 130 807 females (8·9% of the whole sample) and 130 373 males (8·8%). Nine studies provided data on patient race and ethnicity, and 22 studies were rated as high quality. The presence of any mental disorder was associated with an increased risk of COVID-19 mortality (OR 2·00 [95% CI 1·58-2·54]; I2=92·66%). This association was also observed for psychotic disorders (2·05 [1·37-3·06]; I2=80·81%), mood disorders (1·99 [1·46-2·71]; I2=68·32%), substance use disorders (1·76 [1·27-2·44]; I2=47·90%), and intellectual disabilities and developmental disorders (1·73 [1·29-2·31]; I2=90·15%) but not for anxiety disorders (1·07 [0·73-1·56]; I2=11·05%). COVID-19 mortality was associated with exposure to antipsychotics (3·71 [1·74-7·91]; I2=90·31%), anxiolytics (2·58 [1·22-5·44]; I2=96·42%), and antidepressants (2·23 [1·06-4·71]; I2=95·45%). For psychotic disorders, mood disorders, antipsychotics, and anxiolytics, the association remained significant after adjustment for age, sex, and other confounders. Mental disorders were associated with increased risk of hospitalisation (2·24 [1·70-2·94]; I2=88·80%). No significant associations with mortality were identified for ICU admission. Subgroup analyses and meta-regressions showed significant associations of baseline COVID-19 treatment setting (p=0·013) and country (p<0·0001) with mortality. No significant associations with mortality were identified for other covariates. No evidence of publication bias was found. GRADE assessment indicated high certainty for crude mortality and hospitalisation, and moderate certainty for crude ICU admission. INTERPRETATION Pre-existing mental disorders, in particular psychotic and mood disorders, and exposure to antipsychotics and anxiolytics were associated with COVID-19 mortality in both crude and adjusted models. Although further research is required to determine the underlying mechanisms, our findings highlight the need for targeted approaches to manage and prevent COVID-19 in at-risk patient groups identified in this study. FUNDING None. TRANSLATIONS For the Italian, French and Portuguese translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Benedetta Vai
- Psychiatry & Clinical Psychology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Fondazione Centro San Raffaele, Milan, Italy
| | - Mario Gennaro Mazza
- Psychiatry & Clinical Psychology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Claudia Delli Colli
- Center for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marianne Foiselle
- Université Paris Est Creteil, Inserm U955, IMRB Translational Neuropsychiatry Laboratory, Creteil, France; AP-HP, Hôpitaux Universitaires H Mondor, DMU IMPACT, FHU ADAPT, Créteil, France; Fondation FondaMental, Creteil, France
| | - Bennett Allen
- Center for Opioid Epidemiology and Policy, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Francesco Benedetti
- Psychiatry & Clinical Psychology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Alessandra Borsini
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marisa Casanova Dias
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Ryad Tamouza
- Université Paris Est Creteil, Inserm U955, IMRB Translational Neuropsychiatry Laboratory, Creteil, France; AP-HP, Hôpitaux Universitaires H Mondor, DMU IMPACT, FHU ADAPT, Créteil, France; Fondation FondaMental, Creteil, France
| | - Marion Leboyer
- Université Paris Est Creteil, Inserm U955, IMRB Translational Neuropsychiatry Laboratory, Creteil, France; AP-HP, Hôpitaux Universitaires H Mondor, DMU IMPACT, FHU ADAPT, Créteil, France; Fondation FondaMental, Creteil, France
| | - Michael E Benros
- Copenhagen Research Centre for Mental Health, Copenhagen University Hospital, Copenhagen, Denmark; Department of Immunology & Microbiology, Faculty of Health and Medical Sciences, Copenhagen University Hospital, Copenhagen, Denmark
| | - Igor Branchi
- Center for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Livia J De Picker
- University Psychiatric Hospital Campus Duffel, Duffel, Belgium; Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium.
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Poletti S, Mazza MG, Calesella F, Vai B, Lorenzi C, Manfredi E, Colombo C, Zanardi R, Benedetti F. Circulating inflammatory markers impact cognitive functions in bipolar depression. J Psychiatr Res 2021; 140:110-116. [PMID: 34107379 DOI: 10.1016/j.jpsychires.2021.05.071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/05/2021] [Accepted: 05/29/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cognitive impairment is a core feature of bipolar disorder, with a prevalence of about 64.4% during episodes and 57.1% in euthymia. Recent evidences suggest that cognitive deficits in BD may follow immune dysfunction and elevated levels of inflammatory cytokines have been reported during periods of depression, mania and euthymia, suggesting the presence of a chronic, low-grade inflammatory state. The aim of the study is to investigate if immune/inflammatory markers and especially chemokines associate to cognitive performances. METHODS Seventy-six consecutively admitted inpatients with a depressive episode in course of bipolar disorder performed a neuropsychological evaluation with the Brief Assessment of Cognition in Schizophrenia and plasma blood levels of cytokines, chemokines and growth factors were analyzed with Luminex technology. RESULTS Higher levels of IL-1β, IL-6, CCL2, CCL4, CCL5, CXCL10, and bFGF are associated with the likelihood of having a poor cognitive performance. LIMITATIONS Limitation include the lack of a group of healthy controls and the lack of information regarding previous psychopharmacological treatments, alcohol and tobacco use. CONCLUSIONS Our results confirm the importance of chemokines in bipolar disorder and suggest that inflammatory markers suggestive of a low-grade inflammatory state could contribute to the neurocognitive deficits observed in depressed patients.
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Affiliation(s)
- Sara Poletti
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy.
| | - Mario Gennaio Mazza
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Federico Calesella
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Benedetta Vai
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Cristina Lorenzi
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Elena Manfredi
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Cristina Colombo
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Raffaella Zanardi
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
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21
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Cavicchioli M, Calesella F, Cazzetta S, Mariagrazia M, Ogliari A, Maffei C, Vai B. Investigating predictive factors of dialectical behavior therapy skills training efficacy for alcohol and concurrent substance use disorders: A machine learning study. Drug Alcohol Depend 2021; 224:108723. [PMID: 33965687 DOI: 10.1016/j.drugalcdep.2021.108723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/22/2021] [Accepted: 03/17/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Dialectical Behavior Therapy Skills Training (DBT-ST) as stand-alone treatment has demonstrated promising outcomes for the treatment of alcohol use disorder (AUD) and concurrent substance use disorders (SUDs). However, no studies have so far empirically investigated factors that might predict efficacy of this therapeutic model. METHODS 275 treatment-seeking individuals with AUD and other SUDs were consecutively admitted to a 3-month DBT-ST program (in- + outpatient; outpatient settings). The machine learning routine applied (i.e. penalized regression combined with a nested cross-validation procedure) was conducted in order to estimate predictive values of a wide panel of clinical variables in a single statistical framework on drop-out and substance-use behaviors, dealing with related multicollinearity, and eliminating redundant variables. RESULTS The cross-validated elastic net model significantly predicted the drop-out. The bootstrap analysis revealed that subjects who showed substance-use behaviors during the intervention and who were treated with the mixed setting (i.e., in- and outpatient) program, together with higher ASI alcohol scores were associated with an higher probability of drop-out. On the contrary, older subjects, higher levels of education, together with higher scores of DERS awareness subscale were negatively associated to drop-out. Similarly, lifetime co-diagnoses of anxiety, bipolar, and gambling disorders, together with bulimia nervosa negatively predicted the drop-out. The machine learning model did not identify predictive variables of substance-use behaviors during the treatment. CONCLUSIONS The DBT-ST program could be considered a valid therapeutic approach especially when AUD and other SUDs co-occur with other psychiatric conditions and, it is carried out as a full outpatient intervention.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona, 20127, Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Via Stamira d'Ancona, 20127, Milan, Italy.
| | - Federico Calesella
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona, 20127, Milan, Italy; Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Silvia Cazzetta
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona, 20127, Milan, Italy; Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
| | - Movalli Mariagrazia
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona, 20127, Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Via Stamira d'Ancona, 20127, Milan, Italy
| | - Anna Ogliari
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona, 20127, Milan, Italy; Child in Mind Lab, University "Vita-Salute San Raffaele", Via Stamira d'Ancona, 20127, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona, 20127, Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Via Stamira d'Ancona, 20127, Milan, Italy
| | - Benedetta Vai
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona, 20127, Milan, Italy; Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy; Fondazione Centro San Raffaele, Via Olgettina, 60, 20132 Milan, Italy
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De Picker LJ, Yolken R, Benedetti F, Borsini A, Branchi I, Fusar-Poli P, Carlos Leza J, Pariante C, Pollak T, Tamouza R, Vai B, Vernon AC, Benros ME, Leboyer M. Viewpoint | European COVID-19 exit strategy for people with severe mental disorders: Too little, but not yet too late. Brain Behav Immun 2021; 94:15-17. [PMID: 33493625 PMCID: PMC9761870 DOI: 10.1016/j.bbi.2021.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 10/22/2022] Open
Affiliation(s)
- Livia J. De Picker
- University Psychiatric Hospital Campus Duffel, Duffel, Belgium,Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium,Corresponding author at: Wetenschappelijk Onderzoek t.a.v. Livia De Picker, UPC Duffel, Stationsstraat 22c, 2570 Duffel Belgium
| | - Robert Yolken
- The Stanley Neurovirology Laboratory, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy.
| | - Alessandra Borsini
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Igor Branchi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy.
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Juan Carlos Leza
- Department of Pharmacology & Toxicology, Faculty of Medicine, Universidad Complutense Madrid, CIBERSAM, Imas12, IUINQ, Madrid, Spain.
| | - Carmine Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Thomas Pollak
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Ryad Tamouza
- Translational Neuropsychiatry Lab, Université Paris Est Creteil (UPEC), INSERM U955, IMRB, F-94010 Creteil, France; Département Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), AP-HP, Hopital Henri Mondor, F-94010 Creteil, France; Fondation FondaMental, Creteil, France.
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Fondazione Centro San Raffaele, Italy.
| | - Anthony C. Vernon
- MRC Centre for Neurodevelopmental Disorders, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Michael E. Benros
- Copenhagen Research Centre for Mental Health, Copenhagen University Hospital, Denmark,Department of Immunology & Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Marion Leboyer
- Translational Neuropsychiatry Lab, Université Paris Est Creteil (UPEC), INSERM U955, IMRB, F-94010 Creteil, France; Département Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), AP-HP, Hopital Henri Mondor, F-94010 Creteil, France; Fondation FondaMental, Creteil, France.
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23
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De Picker LJ, Dias MC, Benros ME, Vai B, Branchi I, Benedetti F, Borsini A, Leza JC, Kärkkäinen H, Männikkö M, Pariante CM, Güngör ES, Szczegielniak A, Tamouza R, van der Markt A, Fusar-Poli P, Beezhold J, Leboyer M. Severe mental illness and European COVID-19 vaccination strategies. Lancet Psychiatry 2021; 8:356-359. [PMID: 33609450 PMCID: PMC7906735 DOI: 10.1016/s2215-0366(21)00046-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 01/28/2021] [Accepted: 01/28/2021] [Indexed: 01/20/2023]
Affiliation(s)
- Livia J De Picker
- Scientific Initiative for Neuropsychiatric and Pyschopharmacological Studies, University Psychiatric Hospital Campus Duffel, Duffel, Belgium; Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium.
| | - Marisa Casanova Dias
- National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK; Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Michael E Benros
- Copenhagen Research Centre for Mental Health, Copenhagen University Hospital, Copenhagen, Denmark; Department of Immunology & Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Benedetta Vai
- Psychiatry & Clinical Psychology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Fondazione Centro San Raffaele, Milan, Italy
| | - Igor Branchi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Psychiatry and Clinical Psychobiology Unit, University Vita-Salute San Raffaele, Milan, Italy
| | - Alessandra Borsini
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Juan Carlos Leza
- Department of Pharmacology & Toxicology, Faculty of Medicine, Universidad Complutense Madrid, CIBERSAM, Madrid, Spain
| | - Hilkka Kärkkäinen
- Global Alliance of Mental Illness Advocacy Networks-Europe, Brussels, Belgium
| | - Miia Männikkö
- European Federation of Associations of Families of People with Mental Illness, Leuven, Belgium
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Ekin Sönmez Güngör
- University of Health Sciences, Erenköy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
| | - Anna Szczegielniak
- Department of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Ryad Tamouza
- IMRB Translational Neuropsychiatry Lab, Université Paris Est Creteil, Creteil, France; Department of Psychiatry and Addictology, Hôpitaux Universitaires Henri Mondor, Créteil, France; Fondation FondaMental, Creteil, France
| | - Afra van der Markt
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, The Netherlands
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Julian Beezhold
- Norwich Medical School, University of East Anglia, Norwich, UK; Mental Health Liaison Service, Norfolk and Norwich University Hospital, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Marion Leboyer
- IMRB Translational Neuropsychiatry Lab, Université Paris Est Creteil, Creteil, France; Department of Psychiatry and Addictology, Hôpitaux Universitaires Henri Mondor, Créteil, France; Fondation FondaMental, Creteil, France
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Vai B, Cazzetta S, Scalisi R, Donati A, Bechi M, Poletti S, Sforzini L, Visintini R, Maffei C, Benedetti F. Neuropsychological deficits correlate with symptoms severity and cortical thickness in Borderline Personality Disorder. J Affect Disord 2021; 278:181-188. [PMID: 32961414 DOI: 10.1016/j.jad.2020.09.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/15/2020] [Accepted: 09/11/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Neuropsychological abnormalities have been proposed to contribute to the development and maintenance of Borderline Personality Disorder (BPD). Previous meta-analyses and reviews confirmed deficits in a broad range of cognitive domains, including attention, cognitive flexibility, memory, executive functions, planning, information processing, and visuospatial abilities, often suggested to underlie brain abnormalities. However, no study directly explored the structural neural correlates of these deficits in BPD, also accounting for the possible confounding effect of pharmacological treatments, often used as adjunctive symptom-targeted therapy in clinical setting. METHODS In this study we compared the performance of 24 BPD patients to 24 healthy controls obtained at the neuropsychological battery "Brief Assessment and Cognition in Schizophrenia", exploring the relationship between the cognitive impairments and current symptomatology, brain grey matter volumes and cortical thickness, controlling for medications load. RESULTS Data revealed deficits in verbal memory and fluency, working memory, attention and speed of information processing and psychomotor speed and coordination when medication load was not in the model. Correcting for this variable, only the impairment in psychomotor abilities remained significant. A multiple regression confirmed the effect of this neuropsychological domain on the severity of BPD symptomatology (Borderline Evaluation of Severity Over Time). In BPD, the performance at psychomotor speed and coordination was also directly associated to cortical thickness in postcentral gyrus. LIMITATIONS Relatively small sample size, especially for neuroimaging. CONCLUSIONS Our study highlighted an influence of BPD neuropsychological impairments on symptomatology, and cortical thickness, prompting the potential clinical utility of a cognitive remediation program in BPD.
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Affiliation(s)
- Benedetta Vai
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; Fondazione Centro San Raffaele, Milan, Italy.
| | - Silvia Cazzetta
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Rosalia Scalisi
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessia Donati
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Margherita Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Poletti
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Laura Sforzini
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Raffaele Visintini
- Division of Neuroscience, Clinical Psychology and Psychotherapy Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, Clinical Psychology and Psychotherapy Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Francesco Benedetti
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
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Benedetti F, Poletti S, Vai B, Mazza MG, Lorenzi C, Brioschi S, Aggio V, Branchi I, Colombo C, Furlan R, Zanardi R. Higher baseline interleukin-1β and TNF-α hamper antidepressant response in major depressive disorder. Eur Neuropsychopharmacol 2021; 42:35-44. [PMID: 33191075 DOI: 10.1016/j.euroneuro.2020.11.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/18/2020] [Accepted: 11/06/2020] [Indexed: 01/06/2023]
Abstract
Raised pro-inflammatory immune/inflammatory setpoints, leading to an increased production of peripheral cytokines, have been associated with Major Depressive Disorder (MDD) and with failure to respond to first-line antidepressant drugs. However, the usefulness of these biomarkers in clinical psychopharmacology has been questioned because single findings did not translate into the clinical practice, where patients are prescribed treatments upon clinical need. We studied a panel of 27 inflammatory biomarkers in a sample of 108 inpatients with MDD, treated with antidepressant monotherapy for 4 weeks upon clinical need in a specialized hospital setting, and assessed the predictive effect of baseline peripheral measures of inflammation on antidepressing efficacy (response rates and time-lagged pattern of decrease of depression severity) using a machine-learning approach with elastic net penalized regression, and multivariate analyses in the context of the general linear model. When considering both categorical and continuous measures of response, baseline levels of IL-1β predicted non-response to antidepressants, with the predicted probability to respond being highly dispersed at low levels of IL-1β, and stratifying toward non-response when IL-1β is high. Significant negative effects were also detected for TNF-α, while IL-12 weakly predicted response. These findings support the usefulness of inflammatory biomarkers in the clinical psychopharmacology of depression, and add to ongoing research efforts aiming at defining reliable cutoff values to identify depressed patients in clinical settings with high inflammation, and low probability to respond.
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Affiliation(s)
- Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy.
| | - Sara Poletti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Benedetta Vai
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy; Fondazione Centro San Raffaele, Milano, Italy
| | - Mario Gennaro Mazza
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Cristina Lorenzi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Silvia Brioschi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Veronica Aggio
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Igor Branchi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Cristina Colombo
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Roberto Furlan
- Vita-Salute San Raffaele University, Milano, Italy; Clinical Neuroimmunology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Raffaella Zanardi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
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26
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Caletti E, Pagliari C, Vai B, Delvecchio G, Brambilla P. Which are the best questionnaires to longitudinally evaluate mindfulness skills in personality disorders? J Affect Disord 2020; 277:169-174. [PMID: 32829192 DOI: 10.1016/j.jad.2020.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Personality disorders (PDs) are severe mental illnesses, characterized by inflexible and enduring response patterns in a broad range of personal and social situations. With the aim of identifying effective and evidence-based interventions, in the last decades we observed a flourishing of the so-called "thirdwave" cognitive-behavioural therapies, where mindfulness appears as relevant factor in promoting individual well-being and treatment response. In this regard, several authors tried to develop new instruments that enable to measure mindfulness skills, such as the Kentucky Inventory of Mindfulness Skills (KIMS), the Five Facet Mindfulness Questionnaire (FFMQ) and the Philadelphia Mindfulness Scale (PHLMS). The aim of this review is to provide new insights about the mindfulness questionnaires currently used in longitudinal studies in PDs by providing a benchmark for future studies evaluating mindfulness changes associated to therapeutic interventions. METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search in PubMed was performed. Three reviewers conducted the data extraction. Longitudinal studies on PDs evaluating mindfulness skills through a validated questionnaire were selected. Ten studies met the selection criteria. RESULTS The majority of the studies reviewed (N=7) detected an increase in mindfulness skills (4 rated with FFMQ, 2 KIMS, and 1 Philadelphia Mindfulness Scale). Finally, from the selected studies mindfulness changes were also associated with clinical amelioration. LIMITATIONS Few studies evaluate male patients and PDs other than borderline personality disorder. CONCLUSION Although mindfulness is a complex construct to operationalize, the considered questionnaires emerged as useful instruments for clinicians to detect changes in mindfulness abilities. In particular, currently the FFMQ appears as the most suitable measure.
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Affiliation(s)
- Elisabetta Caletti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy
| | | | - Benedetta Vai
- Division of Neuroscience, Psychiatry and Clinical Psychobiology, IRCCS Ospedale San Raffaele, Fondazione Centro San Raffaele, Milano, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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27
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Vai B, Cazzetta S, Ghiglino D, Parenti L, Saibene G, Toti M, Verga C, Wykowska A, Benedetti F. Risk Perception and Media in Shaping Protective Behaviors: Insights From the Early Phase of COVID-19 Italian Outbreak. Front Psychol 2020; 11:563426. [PMID: 33250809 PMCID: PMC7674945 DOI: 10.3389/fpsyg.2020.563426] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/07/2020] [Indexed: 12/14/2022] Open
Abstract
In the absence of target treatments or vaccination, the SARS-CoV-2 pandemic can be impeded by effectively implementing containment measures and behaviors. This relies on individuals’ adoption of protective behaviors, their perceived risk, and the use and trust of information sources. During a health emergency, receiving timely and accurate information enables individuals to take appropriate actions to protect themselves, shaping their risk perception. Italy was the first western country plagued by COVID-19 and one of the most affected in the early phase. During this period, we surveyed 2,223 Italians before the national lockdown. A quarter of the sample perceived COVID-19 less threatening than flu and would not vaccinate, if a vaccine was available. Besides, most people perceived containment measures, based on social distancing or wearing masks, not useful. This perceived utility was related to COVID-19 threat perception and efficacy beliefs. All these measures were associated with the use of media and their truthfulness: participants declared to mainly use the Internet, while health organizations’ websites were the most trusted. Although social networks were frequently used, they were rated lower for trustfulness. Our data differ from those obtained in other community samples, suggesting the relevance to explore changes across different countries and during the different phases of the pandemic. Understanding these phenomena, and how people access the media, may contribute to improve the efficacy of containment measures, tailoring specific policies and health communications.
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Affiliation(s)
- Benedetta Vai
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Fondazione Centro San Raffaele, Milan, Italy
| | - Silvia Cazzetta
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | - Michelle Toti
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Chiara Verga
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
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28
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Scalabrini A, Vai B, Poletti S, Damiani S, Mucci C, Colombo C, Zanardi R, Benedetti F, Northoff G. All roads lead to the default-mode network-global source of DMN abnormalities in major depressive disorder. Neuropsychopharmacology 2020; 45:2058-2069. [PMID: 32740651 PMCID: PMC7547732 DOI: 10.1038/s41386-020-0785-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 12/18/2022]
Abstract
Major depressive disorder (MDD) is a psychiatric disorder characterized by abnormal resting state functional connectivity (rsFC) in various neural networks and especially in default-mode network (DMN). However, inconsistent findings, i.e., increased and decreased DMN rsFC, have been reported, which raise the question for the source of DMN changes in MDD. Testing whether the DMN abnormalities in MDD can be traced to either a local, i.e., intra-network, or a global, i.e., inter-network, source, we conducted a novel sequence of rsFC analyses, i.e., global FC, intra-network FC, and inter-network FC. Moreover, all analyses were conducted without global signal regression (non-GSR) and with GSR in order to identify the impact of specifically the global component of functional connectivity on within-network functional connectivity within specifically the DMN. In MDD our findings demonstrate (i) increased representation of global signal correlation (GSCORR) in DMN regions, as confirmed independently by degree of centrality (DC) and by an independent DMN template, (ii) increased within-network DMN rsFC, (iii) highly increased inter-network rsFC of both lower- and higher order non-DMN networks with DMN, (iv) high accuracy in classifying MDD vs. healthy subjects by using GSCORR as predictor. Further supporting the global, i.e., non-DMN source of within-network rsFC of the DMN, all results were obtained only when including the global signal, i.e., non-GSR, but not when conducting GSR. Together, we show for the first time increased global signal representation within rsFC of DMN as stemming from inter-network sources as distinguished from local sources, i.e., within- or intra-DMN.
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Affiliation(s)
- Andrea Scalabrini
- Department of Psychological, Health and Territorial Sciences (DiSPuTer), G. d'Annunzio University of Chieti-Pescara, Via dei Vestini 33, 66100, Chieti (CH), Italy. .,Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Benedetta Vai
- grid.18887.3e0000000417581884Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy ,grid.15496.3fDepartment of Clinical Neurosciences, University Vita-Salute San Raffaele, Milan, Italy
| | - Sara Poletti
- grid.18887.3e0000000417581884Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy ,grid.15496.3fDepartment of Clinical Neurosciences, University Vita-Salute San Raffaele, Milan, Italy
| | - Stefano Damiani
- grid.8982.b0000 0004 1762 5736Department of Brain and Behavioral Science, University of Pavia, 27100 Pavia, Italy
| | - Clara Mucci
- grid.412451.70000 0001 2181 4941Department of Psychological, Health and Territorial Sciences (DiSPuTer), G. d’Annunzio University of Chieti-Pescara, Via dei Vestini 33, 66100 Chieti (CH), Italy
| | - Cristina Colombo
- grid.15496.3fDepartment of Clinical Neurosciences, University Vita-Salute San Raffaele, Milan, Italy ,grid.18887.3e0000000417581884Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy ,grid.28046.380000 0001 2182 2255The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa, 145 Carling Avenue, Rm. 6435, Ottawa, ON K1Z 7K4 Canada
| | - Raffaella Zanardi
- grid.18887.3e0000000417581884Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy ,grid.28046.380000 0001 2182 2255The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa, 145 Carling Avenue, Rm. 6435, Ottawa, ON K1Z 7K4 Canada
| | - Francesco Benedetti
- grid.18887.3e0000000417581884Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy ,grid.15496.3fDepartment of Clinical Neurosciences, University Vita-Salute San Raffaele, Milan, Italy
| | - Georg Northoff
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy. .,The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada. .,Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa, 145 Carling Avenue, Rm. 6435, Ottawa, ON, K1Z 7K4, Canada. .,Mental Health Centre, Zhejiang University School of Medicine, Tianmu Road 305, Hangzhou, 310013, Zhejiang Province, China. .,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Tianmu Road 305, Hangzhou, 310013, Zhejiang Province, China.
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Mazza MG, De Lorenzo R, Conte C, Poletti S, Vai B, Bollettini I, Melloni EMT, Furlan R, Ciceri F, Rovere-Querini P, Benedetti F. Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain Behav Immun 2020; 89:594-600. [PMID: 32738287 PMCID: PMC7390748 DOI: 10.1016/j.bbi.2020.07.037] [Citation(s) in RCA: 832] [Impact Index Per Article: 208.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
Infection-triggered perturbation of the immune system could induce psychopathology, and psychiatric sequelae were observed after previous coronavirus outbreaks. The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. We investigated the psychopathological impact of COVID-19 in survivors, also considering the effect of clinical and inflammatory predictors. We screened for psychiatric symptoms 402 adults surviving COVID-19 (265 male, mean age 58), at one month follow-up after hospital treatment. A clinical interview and a battery of self-report questionnaires were used to investigate post-traumatic stress disorder (PTSD), depression, anxiety, insomnia, and obsessive-compulsive (OC) symptomatology. We collected sociodemographic information, clinical data, baseline inflammatory markers and follow-up oxygen saturation levels. A significant proportion of patients self-rated in the psychopathological range: 28% for PTSD, 31% for depression, 42% for anxiety, 20% for OC symptoms, and 40% for insomnia. Overall, 56% scored in the pathological range in at least one clinical dimension. Despite significantly lower levels of baseline inflammatory markers, females suffered more for both anxiety and depression. Patients with a positive previous psychiatric diagnosis showed increased scores on most psychopathological measures, with similar baseline inflammation. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, positively associated with scores of depression and anxiety at follow-up. PTSD, major depression, and anxiety, are all high-burden non-communicable conditions associated with years of life lived with disability. Considering the alarming impact of COVID-19 infection on mental health, the current insights on inflammation in psychiatry, and the present observation of worse inflammation leading to worse depression, we recommend to assess psychopathology of COVID-19 survivors and to deepen research on inflammatory biomarkers, in order to diagnose and treat emergent psychiatric conditions.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Anxiety/epidemiology
- Anxiety/immunology
- Anxiety/psychology
- Anxiety Disorders/epidemiology
- Anxiety Disorders/immunology
- Anxiety Disorders/psychology
- Betacoronavirus
- C-Reactive Protein/immunology
- COVID-19
- Coronavirus Infections/epidemiology
- Coronavirus Infections/immunology
- Coronavirus Infections/psychology
- Depression/epidemiology
- Depression/immunology
- Depression/psychology
- Depressive Disorder/epidemiology
- Depressive Disorder/immunology
- Depressive Disorder/psychology
- Depressive Disorder, Major/epidemiology
- Depressive Disorder, Major/immunology
- Depressive Disorder, Major/psychology
- Emergency Service, Hospital
- Female
- Humans
- Inflammation
- Italy/epidemiology
- Length of Stay/statistics & numerical data
- Leukocyte Count
- Lymphocyte Count
- Male
- Mental Disorders/epidemiology
- Mental Disorders/immunology
- Mental Disorders/psychology
- Middle Aged
- Monocytes
- Neutrophils
- Obsessive-Compulsive Disorder/epidemiology
- Obsessive-Compulsive Disorder/immunology
- Obsessive-Compulsive Disorder/psychology
- Pandemics
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/immunology
- Pneumonia, Viral/psychology
- SARS-CoV-2
- Severity of Illness Index
- Sex Factors
- Sleep Initiation and Maintenance Disorders/epidemiology
- Sleep Initiation and Maintenance Disorders/immunology
- Sleep Initiation and Maintenance Disorders/psychology
- Stress Disorders, Post-Traumatic/epidemiology
- Stress Disorders, Post-Traumatic/immunology
- Stress Disorders, Post-Traumatic/psychology
- Suicidal Ideation
- Survivors/psychology
- Survivors/statistics & numerical data
- Young Adult
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Affiliation(s)
- Mario Gennaro Mazza
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy.
| | - Rebecca De Lorenzo
- Vita-Salute San Raffaele University, Milano, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Caterina Conte
- Vita-Salute San Raffaele University, Milano, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Irene Bollettini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Elisa Maria Teresa Melloni
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Roberto Furlan
- Vita-Salute San Raffaele University, Milano, Italy; Clinical Neuroimmunology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milano, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milano, Italy; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
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30
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Melloni EMT, Poletti S, Dallaspezia S, Bollettini I, Vai B, Barbini B, Zanardi R, Colombo C, Benedetti F. Changes of white matter microstructure after successful treatment of bipolar depression. J Affect Disord 2020; 274:1049-1056. [PMID: 32663931 DOI: 10.1016/j.jad.2020.05.146] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/22/2020] [Accepted: 05/27/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) measures suggest a widespread alteration of white matter (WM) microstructure in patients with bipolar disorder (BD). The chronotherapeutic combination of repeated total sleep deprivation and morning light therapy (TSD+LT) can acutely reverse depressive symptoms in approximately 60% of patients, and it has been confirmed as a model antidepressant treatment to investigate the neurobiological correlates of rapid antidepressant response. METHODS We tested if changes in DTI measures of WM microstructure could parallel antidepressant response in a sample of 44 patients with a major depressive episode in course of BD, treated with chronoterapeutics for one week. We used both a tract-wise and a voxel-wise approach for the whole-brain extraction of DTI measures of WM microstructure: axial (AD), radial (RD), and mean diffusivity (MD), and fractional anisotropy (FA). RESULTS Compared to baseline level, at one-week follow up we observed a significant increase in average FA measures paralleled by a significant decrease in MD measures of several WM tracts including cingulum, corpus callosum, corona radiata, cortico-spinal tract, internal capsule, fornix and uncinate fasciculus. The degree of change was associated to clinical response. CONCLUSIONS This is the first study to show changes of individual DTI measures of WM microstructure in response to antidepressant treatment in BD. Our results add new evidence to warrant a role for chronotherapeutics as a first-line treatment for bipolar depression and contribute identifying generalizable neuroimaging-based biomarkers of antidepressant response.
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Affiliation(s)
- Elisa M T Melloni
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy.
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Sara Dallaspezia
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Irene Bollettini
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy; Fondazione Centro San Raffaele, Milano, Italy
| | - Barbara Barbini
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Raffaella Zanardi
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Cristina Colombo
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
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Vai B, Parenti L, Bollettini I, Cara C, Verga C, Melloni E, Mazza E, Poletti S, Colombo C, Benedetti F. Predicting differential diagnosis between bipolar and unipolar depression with multiple kernel learning on multimodal structural neuroimaging. Eur Neuropsychopharmacol 2020; 34:28-38. [PMID: 32238313 DOI: 10.1016/j.euroneuro.2020.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/24/2020] [Accepted: 03/06/2020] [Indexed: 01/10/2023]
Abstract
One of the greatest challenges in providing early effective treatment in mood disorders is the early differential diagnosis between major depression (MDD) and bipolar disorder (BD). A remarkable need exists to identify reliable biomarkers for these disorders. We integrate structural neuroimaging techniques (i.e. Tract-based Spatial Statistics, TBSS, and Voxel-based morphometry) in a multiple kernel learning procedure in order to define a predictive function of BD against MDD diagnosis in a sample of 148 patients. We achieved a balanced accuracy of 73.65% with a sensitivity for BD of 74.32% and specificity for MDD of 72.97%. Mass-univariates analyses showed reduced grey matter volume in right hippocampus, amygdala, parahippocampal, fusiform gyrus, insula, rolandic and frontal operculum and cerebellum, in BD compared to MDD. Volumes in these regions and in anterior cingulate cortex were also reduced in BD compared to healthy controls (n = 74). TBSS analyses revealed widespread significant effects of diagnosis on fractional anisotropy, axial, radial, and mean diffusivity in several white matter tracts, suggesting disruption of white matter microstructure in depressed patients compared to healthy controls, with worse pattern for MDD. To best of our knowledge, this is the first study combining grey matter and diffusion tensor imaging in predicting BD and MDD diagnosis. Our results prompt brain quantitative biomarkers and multiple kernel learning as promising tool for personalized treatment in mood disorders.
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Affiliation(s)
- Benedetta Vai
- Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy; Fondazione Centro San Raffaele, Milano, Italy.
| | - Lorenzo Parenti
- Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Irene Bollettini
- Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Cristina Cara
- Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Chiara Verga
- Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Elisa Melloni
- Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Elena Mazza
- Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Sara Poletti
- Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Cristina Colombo
- Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Division of Neuroscience, Psychiatry and Clinical Psychobiology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
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Seghi F, Vai B, Barbini B, Attanasio F, Benedetti F, Colombo C. P82 Neurobiologic and clinical correlates of low-frequency TMS over the left DorsoLateral Prefrontal Cortex in Manic Episode. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vai B, Serretti A, Poletti S, Mascia M, Lorenzi C, Colombo C, Benedetti F. Cortico-limbic functional connectivity mediates the effect of early life stress on suicidality in bipolar depressed 5-HTTLPR*s carriers. J Affect Disord 2020; 263:420-427. [PMID: 31969273 DOI: 10.1016/j.jad.2019.11.142] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 11/05/2019] [Accepted: 11/29/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND In bipolar disorder (BD) the risk of suicide in adult life can be influenced by the interaction of adverse childhood experiences with the serotonin transporter polymorphism (5-HTTLPR). The cortico-limbic connectivity is a candidate endophenotype for the disorder, also related to suicidality and affected by the 5-HT system. METHODS In 64 (*s carriers = 41; l/l = 23) depressed BD patients, we explored the effect of 5-HTTLPR on corticolimbic functional connectivity (FC) during emotional processing, and the role of FC in moderating/mediating the effect of early stressful events on suicidality among 5-HTTLPR groups, by implementing Generalized Structural Equation Model. RESULTS 5-HTTLPR affects FC between amygdala (Amy) and anterior cingulate cortex (ACC), temporal pole, putamen/thalamus, and precuneus. The short allele was associated to a more inefficient corticolimbic connectivity. In 5-HTTLPR*s carriers, but not in l/l, the Amy-ACC functional coupling mediated the relationship between stress load and current suicidality. LIMITATIONS Patients were not drug-naive, and the recruitment took place in a single center, thus raising the possibility of population stratifications. The sample size is relatively small, but our findings can provide the background for replication study in independent and larger datasets. CONCLUSIONS Our results confirm the link between the 5-HTT promoter polymorphism and susceptibility to stress in BD, and suggest that cortico-limbic functional connectivity mediates these effects. This pattern could identify a vulnerability factor for the exacerbation of mood episodes after stressful life events particularly relevant in *s carriers.
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Affiliation(s)
- Benedetta Vai
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy; Fondazione Centro San Raffaele, Milano, Italy.
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Sara Poletti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Mattia Mascia
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Cristina Lorenzi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Cristina Colombo
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
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Poletti S, Mazza MG, Vai B, Lorenzi C, Colombo C, Benedetti F. Proinflammatory Cytokines Predict Brain Metabolite Concentrations in the Anterior Cingulate Cortex of Patients With Bipolar Disorder. Front Psychiatry 2020; 11:590095. [PMID: 33363485 PMCID: PMC7753118 DOI: 10.3389/fpsyt.2020.590095] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/06/2020] [Indexed: 12/12/2022] Open
Abstract
Bipolar disorder (BD) is a severe psychiatric illness characterized by abnormalities in the immune/inflammatory function and in brain metabolism. Evidences suggest that inflammation may affect the levels of brain metabolites as measured by single-proton magnetic resonance spectroscopy (1H-MRS). The aim of the study was to investigate whether a wide panel of inflammatory markers (i.e., cytokines, chemokines, and growth factors) can predict brain metabolite concentrations of glutamate, myo-inositol, N-acetylaspartate, and glutathione in a sample of 63 bipolar patients and 49 healthy controls. Three cytokines influenced brain metabolite concentrations: IL-9 positively predicts glutamate, IL-1β positively predicts Myo-inositol, and CCL5 positively predicts N-acetylaspartate concentrations. Furthermore, patients showed higher concentrations of glutamate, Myo-inositol, and glutathione and lower concentrations of N-acetylaspartate in respect to healthy controls. Our results confirm that inflammation in BD alters brain metabolism, through mechanisms possibly including the production of reactive oxygen species and glia activation.
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Affiliation(s)
- Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Mario Gennaro Mazza
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Cristina Lorenzi
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Colombo
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
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Abstract
Stress is a powerful moderator of brain plasticity and may affect several physiological functions such as the endocrine and the immune system. The impact of stress can be protective or detrimental according to several factors such as level of the stressor and age of occurrence. Also, the impact may differ in males and females. We aim to analyze the effect of mild levels of early and recent stress on white matter microstructure in healthy volunteers. MRI acquisition of diffusion tensor images with a 3.0 T scanner was performed on 130 healthy subjects (71 males and 59 females). Severity of early and recent stress was rated, respectively, on the Risky Families Questionnaire and on the Schedule of Recent Experiences; subjects were divided into low stress and mild stress groups. Mild early stress associated with lower fractional anisotropy (FA) in the cingulate gyrus compared to low early stress. Females reported reduced FA compared to males in the low-stress group in the internal capsule, posterior corona radiata, posterior thalamic radiation, superior longitudinal fasciculus, and sagittal stratum whereas no difference was observed in the mild stress group. An additive effect of early and recent stress was observed in posterior corona radiata, retrolenticular part of the internal capsule, and superior longitudinal fasciculus. The impact of early stress on WM microstructure in healthy subjects is different in males and females. While males seem to be more sensitive to early stress, an additive effect of early and recent stress manifests itself in females.Layman summaryMild levels of early stress associate with lower white matter integrity measured by fractional anisotropy.Females and males show differences in white matter integrity when exposed to low levels of early stress with females showing lower white matter integrity compared to males.No difference in white matter integrity was observed for males and females exposed to mild levels of stress.Mild stress in females is associated with higher white matter integrity.Males seem to be more sensitive to early stress while females are more affected when early stress is followed by stress in adult life.
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Affiliation(s)
- Sara Poletti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Elisa Melloni
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Elena Mazza
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Benedetta Vai
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Benedetti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
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Furlan R, Melloni E, Finardi A, Vai B, Di Toro S, Aggio V, Battistini L, Borsellino G, Manfredi E, Falini A, Colombo C, Poletti S, Benedetti F. Natural killer cells protect white matter integrity in bipolar disorder. Brain Behav Immun 2019; 81:410-421. [PMID: 31254622 DOI: 10.1016/j.bbi.2019.06.037] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 06/08/2019] [Accepted: 06/25/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Bipolar Disorder (BD) associates with disrupted white matter (WM) microstructure and functional connectivity, and with a perturbation of the immune system. Higher cytokines, and reduced T cells, correlated with WM disruption and fMRI responses. A core component of the innate immune system, natural killer (NK) cells were detected in brain parenchyma, but never studied in BD. METHODS We studied Diffusion Tensor Imaging (DTI) measures of water diffusion, fMRI corticolimbic functional response and connectivity, and multi-parameter cytofluorometry analysis of NK (CD56+) subpopulations, in 30 inpatients with active Bipolar Disorder type I. NK cells were also obtained in 36 healthy controls. RESULTS Patients had significantly higher circulating counts of CD56+GMCSF+, CD56+INFγ+, and CD56+IL17+. NK cell levels positively associated to fractional anisotropy (FA) measures. CD56+TNFα+, CD56+INFγ+, and CD56+GMCSF+ directly correlated with FA, and inversely with radial (RD) and mean (MD) diffusivity. Duration of lithium treatment associated with higher CD56+TNFα+, CD56+IL2+, and CD56+IL4+, and positively associated with FA in tracts were NKs had significant effects. A mediation model suggested a partial mediation of CD56+TNFα+ cells, higher in patients on lithium, on the effects of lithium on FA. Frequencies of the same cytokine-producing NK cells also influenced fMRI cortico-limbic functional connectivity during processing of both, emotional and non-emotional stimuli. DISCUSSION Higher circulating cytokine-producing NK cells associated with lithium treatment, and with DTI measures of WM integrity, partially mediating the effect of lithium on WM. The same cells associated with fMRI responses and connectivity, thus suggesting an effect on structural and functional connectomics in BD.
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Affiliation(s)
- Roberto Furlan
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milano, Italy
| | - Elisa Melloni
- University Vita-Salute San Raffaele, Italy; Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, San Raffaele Scientific Institute, Milano, Italy
| | - Annamaria Finardi
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milano, Italy
| | - Benedetta Vai
- University Vita-Salute San Raffaele, Italy; Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, San Raffaele Scientific Institute, Milano, Italy
| | - Sara Di Toro
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milano, Italy
| | - Veronica Aggio
- University Vita-Salute San Raffaele, Italy; Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, San Raffaele Scientific Institute, Milano, Italy
| | | | | | | | - Andrea Falini
- University Vita-Salute San Raffaele, Italy; Department of Neuroradiology, San Raffaele Scientific Institute, Milano, Italy
| | - Cristina Colombo
- University Vita-Salute San Raffaele, Italy; Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, San Raffaele Scientific Institute, Milano, Italy
| | - Sara Poletti
- University Vita-Salute San Raffaele, Italy; Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, San Raffaele Scientific Institute, Milano, Italy
| | - Francesco Benedetti
- University Vita-Salute San Raffaele, Italy; Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, San Raffaele Scientific Institute, Milano, Italy.
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Melloni EMT, Poletti S, Vai B, Bollettini I, Colombo C, Benedetti F. Effects of illness duration on cognitive performances in bipolar depression are mediated by white matter microstructure. J Affect Disord 2019; 249:175-182. [PMID: 30772745 DOI: 10.1016/j.jad.2019.02.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/31/2019] [Accepted: 02/05/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cognitive deficits are a core feature of bipolar disorder (BD), and persist during the euthymic phase. White matter (WM) microstructural abnormalities are widely considered a structural marker of BD. Features of illness chronicity, such as illness duration and number of mood episodes, have been associated with worsening of both clinical profile and brain structural alterations. This study examined the role of WM integrity as a possible mediator between illness duration and cognitive performances in a sample of BD patients. METHODS We assessed 88 inpatients affected by a depressive episode in course of type I BD for verbal memory, visual memory, working memory, visuospatial constructional abilities, psychomotor coordination, executive functions, processing speed, and verbal fluency. White matter integrity was evaluated through FA measurements derived using the Enhancing Neuro Imaging Genetics Through Meta-Analysis (ENIGMA)-DTI protocol. RESULTS The effect of illness duration on processing speed, verbal memory, and visual memory was mediated by the FA values of bilateral anterior corona radiata, bilateral corona radiata, genu of corpus callosum, and fornix, adjusting for age, sex, education and lithium treatment (p < 0.05). LIMITATIONS Potential interaction factors were not examined in this study. CONCLUSIONS This is the first study to show the role of WM integrity as a mediator of the negative effect of illness duration on cognitive performances. Our data provide new insight into the neuroprogressive hypothesis of BD.
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Affiliation(s)
| | - Sara Poletti
- University Vita-Salute San Raffaele, Milano, Italy
| | - Benedetta Vai
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Irene Bollettini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
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Poletti S, Leone G, Hoogenboezem TA, Ghiglino D, Vai B, de Wit H, Wijkhuijs AJM, Locatelli C, Colombo C, Drexhage HA, Benedetti F. Markers of neuroinflammation influence measures of cortical thickness in bipolar depression. Psychiatry Res Neuroimaging 2019; 285:64-66. [PMID: 30785023 DOI: 10.1016/j.pscychresns.2019.01.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 12/05/2018] [Accepted: 01/27/2019] [Indexed: 12/15/2022]
Abstract
We tested if peripheral levels of cytokines and chemokines associate to grey matter volumes, cortical thickness and fMRI neural responses to a moral valence decision task in bipolar patients. ICAM1 and CCL4 negatively correlated with cortical thickness in Inferior Temporal Gyrus, and sCD25 in Parahippocampal Gyrus. TNF-α, Interleukine-8, and CCL2 correlated positively with cortical thickness in the Anterior Cingulate Cortex, and with lower BOLD responses to negative stimuli. Markers of immune activation are associated with measures of brain structural and functional integrity in bipolar depression.
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Affiliation(s)
- Sara Poletti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy.
| | - Giovanni Leone
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Thomas A Hoogenboezem
- Department of Immunology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Davide Ghiglino
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Benedetta Vai
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Harm de Wit
- Department of Immunology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | | | - Clara Locatelli
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Cristina Colombo
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Hemmo A Drexhage
- Department of Immunology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Francesco Benedetti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milano, Italy
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Abstract
INTRODUCTION The fronto-limbic network has been suggested as a key circuitry in the pathophysiology and maintenance of bipolar disorder. In the past decade, a disrupted connectivity within prefrontal-limbic structures was identified as a promising candidate biomarker for the disorder. Areas Covered: In this review, the authors examine current literature in terms of the structural, functional and effective connectivity in bipolar disorder, integrating recent findings of imaging genetics and machine learning. This paper profiles the current knowledge and identifies future perspectives to provide reliable and usable neuroimaging biomarkers for bipolar psychopathology in clinical practice. Expert Opinion: The replication and the translation of acquired knowledge into useful and usable tools represents one of the current greatest challenges in biomarker research applied to psychiatry.
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Affiliation(s)
- Benedetta Vai
- a Psychiatry & Clinical Psychobiology , Division of Neuroscience, Scientific Institute Ospedale San Raffaele , Milano , Italy.,b University Vita-Salute San Raffaele , Milano , Italy
| | - Carlotta Bertocchi
- a Psychiatry & Clinical Psychobiology , Division of Neuroscience, Scientific Institute Ospedale San Raffaele , Milano , Italy
| | - Francesco Benedetti
- a Psychiatry & Clinical Psychobiology , Division of Neuroscience, Scientific Institute Ospedale San Raffaele , Milano , Italy.,b University Vita-Salute San Raffaele , Milano , Italy
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Vai B, Sforzini L, Visintini R, Riberto M, Bulgarelli C, Ghiglino D, Melloni E, Bollettini I, Poletti S, Maffei C, Benedetti F. Corticolimbic Connectivity Mediates the Relationship between Adverse Childhood Experiences and Symptom Severity in Borderline Personality Disorder. Neuropsychobiology 2018; 76:105-115. [PMID: 29860262 DOI: 10.1159/000487961] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 04/15/2018] [Indexed: 01/13/2023]
Abstract
The interaction between biological and environmental factors (especially adverse childhood experiences, ACEs) plays a crucial role in the development and maintenance of borderline personality disorder (BPD). These factors act influencing BPD core features such as pervasive instability in affect regulation, impulse control, social cognition, and interpersonal relationships. In line with this perspective, abnormalities in social cognition and related neurobiological underpinnings could mediate the relationship between ACEs and psychopathological manifestations in adulthood. In a sample of 14 females, functional connectivity (FC) analyses were performed modeling the interaction between ACEs and corticolimbic dysregulation during emotional processing and its relationship with BPD symptom severity. ACEs were associated with a dampening of the negative FC between (1) the right amygdala (Amy) and right dorsolateral prefrontal cortex (DLPFC) and between (2) the left Amy and bilateral DLPFC, right precuneus, left cerebellum and left dorsomedial prefrontal cortex during emotional processing. The connectivity between right Amy and DLPFC mediates the relationship between childhood adversities and BPD symptomatology. Furthermore, the negative FC between Amy and DLPFC, postcentral gyrus, the vermis of cerebellum and precuneus was also associated with BPD symptom severity, with a weaker negative coupling between Amy and these regions being related to a worse BPD psychopathology. Our results confirm the role of ACEs in contributing to social cognition impairments in BPD and related symptomatology from a neurobiological perspective.
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Affiliation(s)
- Benedetta Vai
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy.,Department of Human Studies, Libera Università Maria Ss. Assunta, Rome, Italy.,Centro di Eccellenza Risonanza Magnetica ad Alto Campo (CERMAC), Università Vita-Salute San Raffaele, Milan, Italy
| | - Laura Sforzini
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Raffaele Visintini
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Martina Riberto
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Chiara Bulgarelli
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy.,Centre for Brain and Cognitive Development, Birkbeck College, London, United Kingdom
| | - Davide Ghiglino
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Elisa Melloni
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Irene Bollettini
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Sara Poletti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy.,Centro di Eccellenza Risonanza Magnetica ad Alto Campo (CERMAC), Università Vita-Salute San Raffaele, Milan, Italy
| | - Cesare Maffei
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Francesco Benedetti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy.,Centro di Eccellenza Risonanza Magnetica ad Alto Campo (CERMAC), Università Vita-Salute San Raffaele, Milan, Italy
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Poletti S, Riberto M, Vai B, Ghiglino D, Lorenzi C, Vitali A, Brioschi S, Locatelli C, Serretti A, Colombo C, Benedetti F. A Glutamate Transporter EAAT1 Gene Variant Influences Amygdala Functional Connectivity in Bipolar Disorder. J Mol Neurosci 2018; 65:536-545. [PMID: 30073554 DOI: 10.1007/s12031-018-1138-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 07/23/2018] [Indexed: 12/27/2022]
Abstract
Bipolar disorder (BD) is a severe illness characterized by recurrent depressive and manic episodes and by emotional dysregulation. Altered cortico-limbic connectivity could account for typical symptoms of the disorder such as mood instability, emotional dysregulation, and cognitive deficits. Functional connectivity positively associated with glutamatergic neurotransmission. The inactivation of glutamate is handled by a series of glutamate transporters, among them, the excitatory amino acid transporter 1 (EAAT1) which is modulated by a SNP rs2731880 (C/T) where the C allele leads to increased EAAT1 expression and glutamate uptake. We hypothesized that rs2731880 would affect cortico-limbic functional connectivity during an implicit affective processing task. Sixty-eight BD patients underwent fMRI scanning during implicit processing of fearful and angry faces. We explored the effect of rs2731880 on the strength of functional connectivity from the amygdalae to the whole brain. A significant activation in response to emotional processing was observed in two main clusters encompassing the right and left amygdala. Amygdalae to whole-brain functional connectivity analyses revealed a significant interaction between rs2731880 and the task (emotional stimuli vs geometric shapes) for the functional connections between the right amygdala and right subgenual anterior cingulate cortex. Post-hoc analyses revealed that T/T patients showed a significant negative connectivity between the amygdala and anterior cingulate cortex compared to C carriers. T/T subjects also performed significantly better in the face-matching task than rs2731880*C carriers. Our findings reveal an EAAT1 genotype-associated difference in cortico-limbic connectivity during affective regulation, possibly identifying a neurobiological underpinning of emotional dysfunction in BD.
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Affiliation(s)
- Sara Poletti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy.
| | - Martina Riberto
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Benedetta Vai
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Davide Ghiglino
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Cristina Lorenzi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Alice Vitali
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Silvia Brioschi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Clara Locatelli
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Cristina Colombo
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
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Bollettini I, Mazza MG, Muzzarelli L, Dallaspezia S, Poletti S, Vai B, Smeraldi E, Benedetti F. White matter alterations associate with onset symptom dimension in obsessive-compulsive disorder. Psychiatry Clin Neurosci 2018; 72:13-27. [PMID: 28815874 DOI: 10.1111/pcn.12563] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 08/01/2017] [Accepted: 08/07/2017] [Indexed: 01/25/2023]
Abstract
AIM The high heterogeneity of obsessive-compulsive disorder (OCD) is best described by a multidimensional model involving symptom dimensions. We aimed to investigate white matter alterations associated with OCD, focusing on the impact of long-lasting effect of symptom dimensions assessed at onset of illness. Furthermore, we investigated white matter alterations associated with this disorder, controlling for the impact of medications and for the prevailing current symptom dimension. METHODS We studied 58 patients affected by OCD and 58 age- and sex-matched healthy controls. We divided patients according to symptom dimension at onset of illness, assessed with the five-factor model. T-tests were performed in order to investigate differences between subgroups. Similar analyses were performed considering the prevailing current symptom dimension. Analyses were conducted with tract-based spatial statistics on diffusion tensor imaging. RESULTS Doubt/checking and rituals/superstition symptom dimensions at onset and symmetry/perfectionism current symptom dimensions were characterized by significant alterations in diffusion tensor imaging measures. An association of white matter alterations and symmetry/perfectionism current dimension was found only when controlling for the effect of doubt/checking dimension at onset. Finally, results pointed out that the observed differences between patients and healthy controls were carried by the effect of previous and current medications. CONCLUSION Our findings evidenced that onset symptom dimensions are associated with enduring alterations of white matter microstructure. Onset symptom dimensions may reflect underlying endophenotypes. In addition, present results confirm the effect of medications on white matter in OCD, showing a large effect of current treatment on myelination.
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Affiliation(s)
- Irene Bollettini
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.,C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), Vita-Salute San Raffaele University, Milan, Italy
| | - Mario G Mazza
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Muzzarelli
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Dallaspezia
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Poletti
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.,C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), Vita-Salute San Raffaele University, Milan, Italy
| | - Benedetta Vai
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.,C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), Vita-Salute San Raffaele University, Milan, Italy
| | - Enrico Smeraldi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.,C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Benedetti
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.,C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), Vita-Salute San Raffaele University, Milan, Italy
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Abstract
Adverse childhood experiences (ACEs) affect the development of social cognition (and identify a risk factor for several physical and mental disorders). Theory of Mind (ToM) is a key predictor of social functioning, mental health, and quality of life. No previous study explored the effect of mild ACEs on the neural correlates of ToM in healthy humans. In 23 healthy participants, we used brain blood oxygen level-dependent fMRI to study the effect of ACEs on the neural responses to tasks targeting affective and cognitive ToM. Results pointed out an association between ACEs and a lower neural response in the vermis of the cerebellum (r = -.85), precentral gyrus, and inferior frontal operculum (putative Mirror Neural System, r = -.78) during affective ToM. A lower recruitment of these brain regions, paralleled by the same performance, could express an increased neural efficacy in inferring affective mental states driven by previous experience, in this case, ACEs.
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Affiliation(s)
- Benedetta Vai
- a Department of Clinical Neurosciences , Psychiatry and Clinical Psychobiology, IRCCS Ospedale San Raffaele , Milan , Italy
- b Department of Human Studies , Libera Università Maria Ss. Assunta , Roma , Italy
- c C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo) , Università Vita-Salute San Raffaele , Milan , Italy
| | - Martina Riberto
- a Department of Clinical Neurosciences , Psychiatry and Clinical Psychobiology, IRCCS Ospedale San Raffaele , Milan , Italy
| | - Davide Ghiglino
- a Department of Clinical Neurosciences , Psychiatry and Clinical Psychobiology, IRCCS Ospedale San Raffaele , Milan , Italy
| | - Irene Bollettini
- a Department of Clinical Neurosciences , Psychiatry and Clinical Psychobiology, IRCCS Ospedale San Raffaele , Milan , Italy
- c C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo) , Università Vita-Salute San Raffaele , Milan , Italy
| | - Andrea Falini
- c C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo) , Università Vita-Salute San Raffaele , Milan , Italy
- d Department of Neuroradiology , San Raffaele Scientific Institute, Vita-Salute San Raffaele University , Milan , Italy
| | - Francesco Benedetti
- a Department of Clinical Neurosciences , Psychiatry and Clinical Psychobiology, IRCCS Ospedale San Raffaele , Milan , Italy
- c C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo) , Università Vita-Salute San Raffaele , Milan , Italy
| | - Sara Poletti
- a Department of Clinical Neurosciences , Psychiatry and Clinical Psychobiology, IRCCS Ospedale San Raffaele , Milan , Italy
- c C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo) , Università Vita-Salute San Raffaele , Milan , Italy
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Vai B, Riberto M, Ghiglino D, Poletti S, Bollettini I, Lorenzi C, Colombo C, Benedetti F. A 5-HT 1Areceptor promoter polymorphism influences fronto-limbic functional connectivity and depression severity in bipolar disorder. Psychiatry Res Neuroimaging 2017; 270:1-7. [PMID: 28985530 DOI: 10.1016/j.pscychresns.2017.09.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 09/18/2017] [Accepted: 09/18/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Benedetta Vai
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy.
| | - Martina Riberto
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy
| | - Davide Ghiglino
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy
| | - Sara Poletti
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Irene Bollettini
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Cristina Lorenzi
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy
| | - Cristina Colombo
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy
| | - Francesco Benedetti
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
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Vai B, Riberto M, Poletti S, Bollettini I, Lorenzi C, Colombo C, Benedetti F. Catechol-O-methyltransferase Val(108/158)Met polymorphism affects fronto-limbic connectivity during emotional processing in bipolar disorder. Eur Psychiatry 2017; 41:53-59. [PMID: 28049082 DOI: 10.1016/j.eurpsy.2016.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 10/03/2016] [Accepted: 10/05/2016] [Indexed: 12/23/2022] Open
Abstract
Catechol-O-methyltransferase (COMT) inactivates catecholamines, Val/Val genotype was associated to an increased amygdala (Amy) response to negative stimuli and can influence the symptoms severity and the outcome of bipolar disorder, probably mediated by the COMT polymorphism (rs4680) interaction between cortical and subcortical dopaminergic neurotransmission. The aim of this study is to explore how rs4680 and implicit emotional processing of negative emotional stimuli could interact in affecting the Amy connectivity in bipolar depression. Forty-five BD patients (34 Met carriers vs. 11 Val/Val) underwent fMRI scanning during implicit processing of fearful and angry faces. We explore the effect of rs4680 on the strength of functional connectivity from the amygdalae to whole brain. Val/Val and Met carriers significantly differed for the connectivity between Amy and dorsolateral prefrontal cortex (DLPFC) and supramarginal gyrus. Val/Val patients showed a significant positive connectivity for all of these areas, where Met carriers presented a significant negative one for the connection between DLPFC and Amy. Our findings reveal a COMT genotype-dependent difference in corticolimbic connectivity during affective regulation, possibly identifying a neurobiological underpinning of clinical and prognostic outcome of BD. Specifically, a worse antidepressant recovery and clinical outcome previously detected in Val/Val patients could be associated to a specific increased sensitivity to negative emotional stimuli.
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Affiliation(s)
- B Vai
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy; CERMAC (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy; Department of Human Studies, Libera Università Maria Ss. Assunta, Roma, Italy.
| | - M Riberto
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy
| | - S Poletti
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy; CERMAC (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - I Bollettini
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy; CERMAC (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - C Lorenzi
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy
| | - C Colombo
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy
| | - F Benedetti
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy; CERMAC (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
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Ratti MM, Delli Zotti GB, Sangiovanni E, Vai B, Limido A, Bertoli S, Sarno L, Spotti D. [Quality of life, anxiety and distress in patients suffering from chronic kidney disease: pre-dialysis and start of dialytic treatment]. G Ital Nefrol 2017; 34:gin/00250.13. [PMID: 28177103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The psychological impact of the Chronic Kidney Disease is well known and several factors contribute to a reduction of quality of life, increase of anxiety levels and psychological distress for affected patients. Psychological intervention is becoming ever more consolidating within the Departments of Nephrology. Nevertheless, literature is lacking about the psychological intervention specificity, especially concerning the dialysis and pre-dialysis phase. The purpose of the study is to identify the mainly critical periods for the dialysed patients in terms of anxiety and distress and to examine the impact of medical management in pre-dialysis period on life quality. In this multi-centre study the sample was collected in three Dialysis Centres: the IRCCS San Raffaele, the IRCCS Multimedica and the A.O. Fatebenefratelli. The instruments used were KDQOL-SF, specific for the dialysed patient's quality of life, PDI, for the distress evaluation and STAI, for anxiety evaluation. The data showed the presence of a more severe psychological unease at the beginning of haemodialysis therapy and a better perception of the life quality for those who have received the medical adoption during the pre-dialysis phase than who did not have it. From a psychological point of view, these results highlight the importance of taking charge the patients in a pre-dialysis phase and of structuring specific psychological interventions during the initial period of substitution therapy.
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Bollettini I, Melloni EMT, Aggio V, Poletti S, Lorenzi C, Pirovano A, Vai B, Dallaspezia S, Colombo C, Benedetti F. Clock genes associate with white matter integrity in depressed bipolar patients. Chronobiol Int 2016; 34:212-224. [DOI: 10.1080/07420528.2016.1260026] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Irene Bollettini
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
- PhD program in Philosophy and Sciences of Mind, University Vita-Salute San Raffaele, Milan, Italy
| | - Elisa Maria Teresa Melloni
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
- PhD program in Molecular Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Veronica Aggio
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Sara Poletti
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Cristina Lorenzi
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Adele Pirovano
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Benedetta Vai
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
- PhD program in Evolutionary Psychopathology, Libera Università Maria SS. Assunta, Rome, Italy
| | - Sara Dallaspezia
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Cristina Colombo
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Benedetti
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
- C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
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Vai B, Bulgarelli C, Godlewska BR, Cowen PJ, Benedetti F, Harmer CJ. Fronto-limbic effective connectivity as possible predictor of antidepressant response to SSRI administration. Eur Neuropsychopharmacol 2016; 26:2000-2010. [PMID: 27756525 DOI: 10.1016/j.euroneuro.2016.09.640] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 09/21/2016] [Accepted: 09/24/2016] [Indexed: 12/24/2022]
Abstract
The timely selection of the optimal treatment for depressed patients is critical to improve remission rates. The detection of pre-treatment variables able to predict differential treatment response may provide novel approaches for treatment selection. Selective serotonin reuptake inhibitors (SSRIs) modulate the fronto-limbic functional response and connectivity, an effect preceding the overt clinical antidepressant effects. Here we investigated whether the cortico-limbic connectivity associated with emotional bias measured before SSRI administration predicts the efficacy of antidepressant treatment in MDD patients. fMRI and Dynamic Causal Modeling (DCM) were combined to study if effective connectivity might differentiate healthy controls (HC) and patients affected by major depression who later responded (RMDD, n=21), or failed to respond (nRMDD, n=12), to 6 weeks of escitalopram administration. Sixteen DCMs exploring connectivity between anterior cingulate cortex (ACC), ventrolateral prefrontal cortex (VLPFC), Amygdala (Amy), and fusiform gyrus (FG) were constructed. Analyses revealed that nRMDD had reduced endogenous connectivity from Amy to VLPFC and to ACC, with an increased connectivity and modulation of the ACC to Amy connectivity when processing of fearful emotional stimuli compared to HC. RMDD and HC did not significantly differ among themselves. Pre-treatment effective connectivity in fronto-limbic circuitry could be an important factor affecting antidepressant response, and highlight the mechanisms which may be involved in recovery from depression. These results suggest that fronto-limbic connectivity might provide a neural biomarker to predict the clinical outcome to SSRIs administration in major depression.
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Affiliation(s)
- Benedetta Vai
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy; Department of Human Studies, Libera Università Maria Ss. Assunta, Roma, Italy.
| | - Chiara Bulgarelli
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy
| | | | - Philip J Cowen
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Francesco Benedetti
- IRCCS Ospedale San Raffaele, Department of Clinical Neurosciences, Milan, Italy
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Benedetti F, Poletti S, Hoogenboezem TA, Locatelli C, Ambrée O, de Wit H, Wijkhuijs AJM, Mazza E, Bulgarelli C, Vai B, Colombo C, Smeraldi E, Arolt V, Drexhage HA. Stem Cell Factor (SCF) is a putative biomarker of antidepressant response. J Neuroimmune Pharmacol 2016; 11:248-58. [DOI: 10.1007/s11481-016-9672-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 04/14/2016] [Indexed: 02/06/2023]
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Poletti S, Vai B, Smeraldi E, Cavallaro R, Colombo C, Benedetti F. Adverse childhood experiences influence the detrimental effect of bipolar disorder and schizophrenia on cortico-limbic grey matter volumes. J Affect Disord 2016; 189:290-7. [PMID: 26454335 DOI: 10.1016/j.jad.2015.09.049] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/09/2015] [Accepted: 09/26/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACE) can lead to several negative consequences in adult life, are highly prevalent in psychiatric disorders where they associate with clinical and brain morphological features. Grey matter volume loss is a central characteristic of bipolar disorder (BD) and schizophrenia (SCZ). The aim of this study is to measure the effect of diagnosis and ACE on GM volume in a sample of patients with BD or SCZ compared with healthy controls (HC). METHODS We studied 206 depressed BD patients, 96 SCZ patients and 136 healthy subjects. GM volumes were estimated with 3.0 Tesla MRI and analyzed with VBM technique. The effect of diagnosis was investigated in the whole sample and separately exposed to high and low ACE subjects. RESULTS An effect of diagnosis was observed in orbitofrontal cortex encompassing BA 47 and insula, and in the thalamus. HC had the highest volume and SCZ patients the lowest with BD patients showing an intermediate volume. This pattern persisted only in subjects with high ACE. No differences were observed for low ACE subjects. LIMITATIONS The three diagnostic groups differ for age and education, previous and current medications, and treatment periods. CONCLUSIONS Our results underline the importance of ACE on the neural underpinnings of psychiatric psychopathology and suggest a major role of exposure to ACE for the GM deficits to reveal in clinical populations. Exposure to early stress is a crucial factor that must be taken in to account when searching for biomarkers of BD and SCZ.
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Affiliation(s)
- Sara Poletti
- Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy.
| | - Benedetta Vai
- Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Enrico Smeraldi
- Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Roberto Cavallaro
- Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Milan, Italy
| | - Cristina Colombo
- Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Milan, Italy
| | - Francesco Benedetti
- Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
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