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Porta-Casteràs D, Vicent-Gil M, Serra-Blasco M, Navarra-Ventura G, Solé B, Montejo L, Torrent C, Martinez-Aran A, De la Peña-Arteaga V, Palao D, Vieta E, Cardoner N, Cano M. Increased grey matter volumes in the temporal lobe and its relationship with cognitive functioning in euthymic patients with bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2024; 132:110962. [PMID: 38365103 DOI: 10.1016/j.pnpbp.2024.110962] [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: 10/23/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Bipolar disorder (BD) is characterized by episodic mood dysregulation, although a significant portion of patients suffer persistent cognitive impairment during euthymia. Previous magnetic resonance imaging (MRI) research suggests BD patients may have accelerated brain aging, observed as lower grey matter volumes. How these neurostructural alterations are related to the cognitive profile of BD is unclear. METHODS We aim to explore this relationship in euthymic BD patients with multimodal structural neuroimaging. A sample of 27 euthymic BD patients and 24 healthy controls (HC) underwent structural grey matter MRI and diffusion-weighted imaging (DWI). BD patient's cognition was also assessed. FreeSurfer algorithms were used to obtain estimations of regional grey matter volumes. White matter pathways were reconstructed using TRACULA, and four diffusion metrics were extracted. ANCOVA models were performed to compare BD patients and HC values of regional grey matter volume and diffusion metrics. Global brain measures were also compared. Bivariate Pearson correlations were explored between significant brain results and five cognitive domains. RESULTS Euthymic BD patients showed higher ventricular volume (F(1, 46) = 6.04; p = 0.018) and regional grey matter volumes in the left fusiform (F(1, 46) = 15.03; pFDR = 0.015) and bilateral parahippocampal gyri compared to HC (L: F(1, 46) = 12.79, pFDR = 0.025/ R: F(1, 46) = 15.25, pFDR = 0.015). Higher grey matter volumes were correlated with greater executive function (r = 0.53, p = 0.008). LIMITATIONS We evaluated a modest sample size with concurrent pharmacological treatment. CONCLUSIONS Higher medial temporal volumes in euthymic BD patients may be a potential signature of brain resilience and cognitive adaptation to a putative illness neuroprogression. This knowledge should be integrated into further efforts to implement imaging into BD clinical management.
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Affiliation(s)
- D Porta-Casteràs
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Vicent-Gil
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - M Serra-Blasco
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Programa eHealth ICOnnecta't, Institut Català d'Oncologia, Barcelona, Spain
| | - G Navarra-Ventura
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital (HUSE), Palma (Mallorca), Spain; CIBERES, Carlos III Health Institute, Madrid, Spain
| | - B Solé
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - L Montejo
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - C Torrent
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - A Martinez-Aran
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - V De la Peña-Arteaga
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - D Palao
- Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - E Vieta
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - N Cardoner
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain.
| | - M Cano
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
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2
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Blanken MAJT, Oudega ML, Hoogendoorn AW, Sonnenberg CS, Rhebergen D, Klumpers UMH, Van Diermen L, Birkenhager T, Schrijvers D, Redlich R, Dannlowski U, Heindel W, Coenjaerts M, Nordanskog P, Oltedal L, Kessler U, Frid LM, Takamiya A, Kishimoto T, Jorgensen MB, Jorgensen A, Bolwig T, Emsell L, Sienaert P, Bouckaert F, Abbott CC, Péran P, Arbus C, Yrondi A, Kiebs M, Philipsen A, van Waarde JA, Prinsen E, van Verseveld M, Van Wingen G, Ten Doesschate F, Camprodon JA, Kritzer M, Barbour T, Argyelan M, Cardoner N, Urretavizcaya M, Soriano-Mas C, Narr KL, Espinoza RT, Prudic J, Rowny S, van Eijndhoven P, Tendolkar I, Dols A. Sex-specifics of ECT outcome. J Affect Disord 2023; 326:243-248. [PMID: 36632848 DOI: 10.1016/j.jad.2022.12.144] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Electroconvulsive therapy (ECT) is the most effective treatment for patients with severe major depressive disorder (MDD). Given the known sex differences in MDD, improved knowledge may provide more sex-specific recommendations in clinical guidelines and improve outcome. In the present study we examine sex differences in ECT outcome and its predictors. METHODS Clinical data from 20 independent sites participating in the Global ECT-MRI Research Collaboration (GEMRIC) were obtained for analysis, totaling 500 patients with MDD (58.6 % women) with a mean age of 54.8 years. Severity of depression before and after ECT was assessed with validated depression scales. Remission was defined as a HAM-D score of 7 points or below after ECT. Variables associated with remission were selected based on literature (i.e. depression severity at baseline, age, duration of index episode, and presence of psychotic symptoms). RESULTS Remission rates of ECT were independent of sex, 48.0 % in women and 45.7 % in men (X2(1) = 0.2, p = 0.70). In the logistic regression analyses, a shorter index duration was identified as a sex-specific predictor for ECT outcome in women (X2(1) = 7.05, p = 0.01). The corresponding predictive margins did show overlapping confidence intervals for men and women. CONCLUSION The evidence provided by our study suggests that ECT as a biological treatment for MDD is equally effective in women and men. A shorter duration of index episode was an additional sex- specific predictor for remission in women. Future research should establish whether the confidence intervals for the corresponding predictive margins are overlapping, as we find, or not.
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Affiliation(s)
- M A J T Blanken
- Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands.
| | - M L Oudega
- GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands; Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Psychiatry, Amsterdam Public Health (Research Institute), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands
| | - A W Hoogendoorn
- GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands; Psychiatry, Amsterdam Public Health (Research Institute), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands
| | - C S Sonnenberg
- Psychiatry, Amsterdam Public Health (Research Institute), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; GGZ Parnassia NH, Specialized Mental Health Care, Castricum, the Netherlands
| | - D Rhebergen
- Psychiatry, Amsterdam Public Health (Research Institute), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands; GGZ Centraal, Specialized Mental Health Care, Amersfoort, the Netherlands
| | - U M H Klumpers
- GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands; Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Psychiatry, Amsterdam Public Health (Research Institute), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands
| | - L Van Diermen
- Psychiatric Center Bethanië, Andreas Vesaliuslaan 39, 2980 Zoersel, Belgium; Department of Biomedical Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp. Universiteitsplein 1, 2610 Antwerp, Belgium; University Psychiatric Center (UPC) Duffel, Stationsstraat 22c, 2570 Duffel, Belgium
| | - T Birkenhager
- Department of Biomedical Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp. Universiteitsplein 1, 2610 Antwerp, Belgium; Erasmus MC, Rotterdam, the Netherlands
| | - D Schrijvers
- Department of Biomedical Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp. Universiteitsplein 1, 2610 Antwerp, Belgium; University Psychiatric Center (UPC) Duffel, Stationsstraat 22c, 2570 Duffel, Belgium
| | - R Redlich
- Department of Psychology, University of Halle, Germany; Institute for Translational Psychiatry, University of Münster Germany, Germany
| | - U Dannlowski
- Institute for Translational Psychiatry, University of Münster Germany, Germany
| | - W Heindel
- Department of Radiology, University of Münster Germany, Germany
| | - M Coenjaerts
- Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - P Nordanskog
- Center for Social and Affective Neuroscience (CSAN), Department of Biomedical and Clinical Sciences, Linköping University, Department of Psychiatry, Linköping University Hospital, Sweden
| | - L Oltedal
- Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - U Kessler
- Department of Clinical Medicine, University of Bergen, Bergen, Norway; NORMENT, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - L M Frid
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - A Takamiya
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan; Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Belgium
| | - T Kishimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
| | - M B Jorgensen
- Psychiatric Centre Copenhagen and Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - A Jorgensen
- Psychiatric Centre Copenhagen and Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - T Bolwig
- Psychiatric Centre Copenhagen and Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - L Emsell
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Belgium
| | - P Sienaert
- Academic Center for ECT and Neuromodulation (AcCENT), University Psychiatric Center (UPC) - KU Leuven, Kortenberg, Belgium
| | - F Bouckaert
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Belgium
| | - C C Abbott
- University of New Mexico Department of Psychiatry, 87131, United States of America
| | - P Péran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - C Arbus
- Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante FondaMental, CHU Toulouse, Hospital Purpan, ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - A Yrondi
- Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante FondaMental, CHU Toulouse, Hospital Purpan, ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - M Kiebs
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany; Section of Medical Psychology, University of Bonn, Bonn, Germany; School of Medicine & Health Sciences University Hospital Oldenburg at the Karl-Jaspers Clinic, Germany
| | - A Philipsen
- Section of Medical Psychology, University of Bonn, Bonn, Germany
| | | | | | | | - G Van Wingen
- Amsterdam UMC, location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - F Ten Doesschate
- Rijnstate Arnhem, the Netherlands; Amsterdam UMC, location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, the Netherlands
| | - J A Camprodon
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - M Kritzer
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - T Barbour
- Massachusetts General Hospital, United States of America
| | - M Argyelan
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, United States of America
| | - N Cardoner
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - M Urretavizcaya
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, Universitat de Barcelona-UB, Barcelona, Spain
| | - C Soriano-Mas
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Social Psychology and Quantitative Psychology, Universitat de Barcelona-UB, Barcelona, Spain
| | - K L Narr
- Department of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, United States of America
| | - R T Espinoza
- Department of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, United States of America
| | - J Prudic
- Columbia University Irving Medical Center, United States of America
| | - S Rowny
- Columbia University Irving Medical Center, United States of America
| | | | - I Tendolkar
- Radboud University, Nijmegen, the Netherlands
| | - A Dols
- Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
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3
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Porta-Casteràs D, Cano M, Navarra-Ventura G, Serra-Blasco M, Vicent-Gil M, Solé B, Montejo L, Torrent C, Martinez-Aran A, Harrison BJ, Palao D, Vieta E, Cardoner N. Disrupted network switching in euthymic bipolar disorder: Working memory and self-referential paradigms. J Affect Disord 2023; 320:552-560. [PMID: 36202301 DOI: 10.1016/j.jad.2022.09.152] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patients with bipolar disorder (BD) frequently suffer from neurocognitive deficits that can persist during periods of clinical stability. Specifically, impairments in executive functioning such as working memory and in self-processing have been identified as the main components of the neurocognitive profile observed in euthymic BD patients. The study of the neurobiological correlates of these state-independent alterations may be a prerequisite to develop reliable biomarkers in BD. METHODS A sample of 27 euthymic BD patients and 25 healthy participants (HC) completed working memory and self-referential functional Magnetic Resonance Imaging (fMRI) tasks. Activation maps obtained for each group and contrast images (i.e., 2-back > 1-back/self > control) were used for comparisons between patients and HC. RESULTS Euthymic BD patients, in comparison to HC, showed a higher ventromedial prefrontal cortex activation during working memory, a result driven by the lack of deactivation in BD patients. In addition, euthymic BD patients displayed a greater dorsomedial and dorsolateral prefrontal cortex activation during self-reference processing. LIMITATIONS Pharmacotherapy was described but not included as a confounder in our models. Sample size was modest. CONCLUSION Our findings revealed a lack of deactivation in the anterior default mode network (aDMN) during a working memory task, a finding consistent with prior research in BD patients, but also a higher activation in frontal regions within the central executive network (CEN) during self-processing. These results suggest that an imbalance of neural network dynamics underlying external/internal oriented cognition (the CEN and the aDMN, respectively) may be one of the first reliable biomarkers in euthymic bipolar patients.
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Affiliation(s)
- D Porta-Casteràs
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Cano
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain.
| | - G Navarra-Ventura
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma, Spain; Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Universitat de les Illes Balears, Palma, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - M Serra-Blasco
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Programa eHealth ICOnnecta't, Institut Català d'Oncologia, Barcelona, Spain
| | - M Vicent-Gil
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - B Solé
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - L Montejo
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - C Torrent
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - A Martinez-Aran
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - B J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | - D Palao
- Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - E Vieta
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive disorders Unit, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - N Cardoner
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
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4
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Giménez M, Cano M, Martínez-Zalacaín I, Real E, Alonso P, Segalàs C, Munuera J, Kegeles LS, Weinstein JJ, Xu X, Menchón JM, Cardoner N, Soriano-Mas C, Fullana MA. Is glutamate associated with fear extinction and cognitive behavior therapy outcome in OCD? A pilot study. Eur Arch Psychiatry Clin Neurosci 2020; 270:1003-1014. [PMID: 31432262 DOI: 10.1007/s00406-019-01056-3] [Citation(s) in RCA: 5] [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: 10/11/2018] [Accepted: 08/07/2019] [Indexed: 12/15/2022]
Abstract
Cognitive behavioral therapy (CBT) including exposure and response prevention is a well-established treatment for obsessive-compulsive disorder (OCD) and is based on the principles of fear extinction. Fear extinction is linked to structural and functional variability in the ventromedial prefrontal cortex (vmPFC) and has been consistently associated with glutamate neurotransmission. The relationship between vmPFC glutamate and fear extinction and its effects on CBT outcome have not yet been explored in adults with OCD. We assessed glutamate levels in the vmPFC using 3T magnetic resonance spectroscopy, and fear extinction (learning and recall) using skin conductance responses during a 2-day experimental paradigm in OCD patients (n = 17) and in healthy controls (HC; n = 13). Obsessive-compulsive patients (n = 12) then received manualized CBT. Glutamate in the vmPFC was negatively associated with fear extinction recall and positively associated with CBT outcome (with higher glutamate levels predicting a better outcome) in OCD patients. Glutamate levels in the vmPFC in OCD patients were not significantly different from those in HC, and were not associated with OCD severity. Our results suggest that glutamate in the vmPFC is associated with fear extinction recall and CBT outcome in adult OCD patients.
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Affiliation(s)
- M Giménez
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain
| | - M Cano
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - E Real
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain
| | - P Alonso
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - C Segalàs
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain
| | - J Munuera
- Diagnostic Imaging Department, Fundació de Recerca Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, Esplugues de Llobregat, 08950, Barcelona, Spain
| | - L S Kegeles
- Department of Psychiatry and Radiology, Columbia University, 622 W 168th St, New York, 10032, USA.,New York State Psychiatric Institute, 1051 Riverside Dr, New York, 10032, USA
| | - J J Weinstein
- Department of Psychiatry and Radiology, Columbia University, 622 W 168th St, New York, 10032, USA.,New York State Psychiatric Institute, 1051 Riverside Dr, New York, 10032, USA.,Department of Psychiatry, Stony Brook University, Stony Brook, 101 Nicolls Rd, Stony Brook, New York, 11794, USA
| | - X Xu
- Department of Psychiatry and Radiology, Columbia University, 622 W 168th St, New York, 10032, USA.,New York State Psychiatric Institute, 1051 Riverside Dr, New York, 10032, USA
| | - J M Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - N Cardoner
- Depression and Anxiety Program, Department of Mental Health, Parc Taulí Sabadell, Hospital Universitari, Parc Taulí 1, 08208, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Av. de Can Domènech, 737, 08193, Cerdanyola Del Vallès Barcelona, Barcelona, Spain
| | - C Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain.,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Building B1, Ca n'Altayó, s/n, Bellaterra, 08193, Barcelona, Spain
| | - M A Fullana
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain. .,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Av. de Can Domènech, 737, 08193, Cerdanyola Del Vallès Barcelona, Barcelona, Spain. .,Psychiatry Department, Hospital Clínic-Institute of Neurosciences, CIBERSAM, C/Rosselló 140, 08036, Barcelona, Spain.
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Porta-Casteràs D, Fullana MA, Tinoco D, Martínez-Zalacaín I, Pujol J, Palao DJ, Soriano-Mas C, Harrison BJ, Via E, Cardoner N. Prefrontal-amygdala connectivity in trait anxiety and generalized anxiety disorder: Testing the boundaries between healthy and pathological worries. J Affect Disord 2020; 267:211-219. [PMID: 32217221 DOI: 10.1016/j.jad.2020.02.029] [Citation(s) in RCA: 14] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 01/17/2020] [Accepted: 02/08/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Current brain-based theoretical models of generalized anxiety disorder (GAD) suggest a dysfunction of amygdala-ventromedial prefrontal cortex emotional regulatory mechanisms. These alterations might be reflected by an altered resting state functional connectivity between both areas and could extend to vulnerable non-clinical samples such as high worriers without a GAD diagnosis. However, there is a lack of information in this regard. METHODS We investigated differences in resting state functional connectivity between the basolateral amygdala and the ventromedial prefrontal cortex (amygdala-vmPFC) in 28 unmedicated participants with GAD, 28 high-worriers and 28 low-worriers. We additionally explored selected clinical variables as predictors of amygdala-vmPFC connectivity, including anxiety sensitivity. RESULTS GAD participants presented higher left amygdala-vmPFC connectivity compared to both groups of non-GAD participants, and there were no differences between the latter two groups. In our exploratory analyses, concerns about the cognitive consequences of anxiety (the cognitive dimension of anxiety sensitivity) were found to be a significant predictor of the left amygdala-vmPFC connectivity. LIMITATIONS The cross-sectional nature of our study preclude us from assessing if functional connectivity measures and anxiety sensitivity scores entail an increased risk of GAD. CONCLUSIONS These results suggest a neurobiological qualitative distinction at the level of the amygdala-vmPFC emotional-regulatory system in GAD compared to non-GAD participants, either high- or low-worriers. At this neural level, they question previous hypotheses of continuity between high worries and GAD development. Instead, other anxiety traits such as anxiety sensitivity might confer a greater proneness to the amygdala-vmPFC connectivity alterations observed in GAD.
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Affiliation(s)
- D Porta-Casteràs
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - M A Fullana
- Institute of Neurosciences, Hospital Clinic, CIBERSAM, Barcelona, Spain
| | - D Tinoco
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital -IDIBELL, CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - J Pujol
- MRI Research Unit,Hospital del Mar, CIBERSAM G21, Barcelona,Spain
| | - D J Palao
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - C Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital -IDIBELL, CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Department of Psychobiology and Methodology of Health Sciences. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - B J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia
| | - E Via
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain; Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
| | - N Cardoner
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Cavero M, Monreal J, Cardoner N, Moreno M, Solá VP, Palao D. Efficacy of an active implementation process of a computerized CPG of major depression disorder in primary care. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2017.01.763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionThe application of scientific evidence in clinical practice management of Major Depressive Disorder (MDD) is complex. Generally, the usual dissemination process and implementation of Clinical Practice Guidelines (CPG) induce modest changes. A computerized version of a Clinical Practice Guideline for Major Depression (e-CPG-MD) has been integrated in Electronic Clinical Records of Primary Care in Catalonia (Spain). It offers an opportunity to improve clinical results. The design allows access to precise help in the visit itself, improving diagnosis, treatment and follow-up.ObjectivesTo evaluate the effects of a multifaceted implementation process of e-CPG-MD, analysing their use and changes in MDD diagnosis.MethodsA cluster randomized clinical trial was performed in 10 primary care centers (PCC) in Barcelona. In five of ten centers, a multifaceted implementation process of the e-CPG-MD was developed during 6 month. The active process includes: interactive training program, regular feedback audit, educational outreach visits and periodic reminders.ResultsThe multifaceted implementation of e-CPG-MD was associated with a significant increase in use during the first 6 months (4.1% + 3.1% vs. 52.7% + 7.3%, P < 0.001). In the active centers, the MD diagnosis increased significantly (rate quotient = 1.56, P < 0.001) and the proportion of moderate and severe MD increased (13.6% vs 41.1%, P = 0.002).ConclusionsA multifaceted implementation method of e-CPG-MD increased significantly its use in active centers at 6 months. Diagnosis of MDD and the proportion of moderate and severe cases also increased significantly.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Picó-Pérez M, Alemany-Navarro M, Dunsmoor J, Radua J, Albajes-Eizagirre A, Vervliet B, Cardoner N, Benet O, Harrison B, Soriano-Mas C, Fullana M. Common and distinct neural correlates of fear extinction and cognitive reappraisal: A meta-analysis of fMRI studies. Neurosci Biobehav Rev 2019; 104:102-115. [DOI: 10.1016/j.neubiorev.2019.06.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/22/2019] [Accepted: 06/20/2019] [Indexed: 12/25/2022]
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Via E, Fullana MA, Goldberg X, Tinoco-González D, Martínez-Zalacaín I, Soriano-Mas C, Davey CG, Menchón JM, Straube B, Kircher T, Pujol J, Cardoner N, Harrison BJ. Ventromedial prefrontal cortex activity and pathological worry in generalised anxiety disorder. Br J Psychiatry 2018; 213:437-443. [PMID: 29739481 DOI: 10.1192/bjp.2018.65] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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] [Indexed: 11/23/2022]
Abstract
BACKGROUND Pathological worry is a hallmark feature of generalised anxiety disorder (GAD), associated with dysfunctional emotional processing. The ventromedial prefrontal cortex (vmPFC) is involved in the regulation of such processes, but the link between vmPFC emotional responses and pathological v. adaptive worry has not yet been examined.AimsTo study the association between worry and vmPFC activity evoked by the processing of learned safety and threat signals. METHOD In total, 27 unmedicated patients with GAD and 56 healthy controls (HC) underwent a differential fear conditioning paradigm during functional magnetic resonance imaging. RESULTS Compared to HC, the GAD group demonstrated reduced vmPFC activation to safety signals and no safety-threat processing differentiation. This response was positively correlated with worry severity in GAD, whereas the same variables showed a negative and weak correlation in HC. CONCLUSIONS Poor vmPFC safety-threat differentiation might characterise GAD, and its distinctive association with GAD worries suggests a neural-based qualitative difference between healthy and pathological worries.Declaration of interestNone.
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Affiliation(s)
- E Via
- Department of Mental Health,Corporació Sanitaria Parc Taulí-i3PT,CIBERSAM,Sabadell,Spain
| | - M A Fullana
- Anxiety Unit,Institute of Neuropsychiatry and Addictions,Hospital del Mar,CIBERSAM,Barcelona,Spain
| | - X Goldberg
- Department of Mental Health,Corporació Sanitaria Parc Taulí-i3PT,CIBERSAM,Sabadell,Spain
| | | | - I Martínez-Zalacaín
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL,CIBERSAM,Barcelona,Spain
| | - C Soriano-Mas
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL,CIBERSAM,Barcelona,Spain
| | - C G Davey
- Melbourne Neuropsychiatry Centre,Department of Psychiatry,The University of Melbourne and Melbourne Health,Victoria,Australia
| | - J M Menchón
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL,CIBERSAM,Barcelona,Spain
| | - B Straube
- Department of Psychiatry and Psychotherapy,Philipps-University Marburg,Marburg,Germany
| | - T Kircher
- Department of Psychiatry and Psychotherapy,Philipps-University Marburg,Marburg,Germany
| | - J Pujol
- MRI Research Unit,Hospital del Mar,CIBERSAM G21,Barcelona,Spain
| | - N Cardoner
- Department of Mental Health,Corporació Sanitaria Parc Taulí-i3PT,CIBERSAM,Sabadell,Spain
| | - B J Harrison
- Melbourne Neuropsychiatry Centre,Department of Psychiatry,The University of Melbourne and Melbourne Health,Victoria,Australia
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Vicent-Gil M, Keymer-Gausset A, Serra-Blasco M, Carceller-Sindreu M, de Diego-Adeliño J, Trujols J, Mur M, Pérez V, Alvarez E, Cardoner N, Portella MJ. Cognitive predictors of illness course at 12 months after first-episode of depression. Eur Neuropsychopharmacol 2018; 28:529-537. [PMID: 29482974 DOI: 10.1016/j.euroneuro.2018.02.001] [Citation(s) in RCA: 18] [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: 09/14/2017] [Revised: 02/01/2018] [Accepted: 02/07/2018] [Indexed: 10/17/2022]
Abstract
Major Depressive Disorder (MDD) entails cognitive dysfunction in many cognitive domains, but it is still uncertain whether such deficits are present in the early stages. The purpose of the study is to determine the cognitive performance in first episode depression (FED) exploring the presence of different cognitive profiles, and the role of cognition in FED at baseline and long-term. Ninety subjects (18-50 years) were included, 50 patients with a FED and 40 healthy controls. Participants were assessed with a neuropsychological battery, covering language, attention, verbal memory, processing speed and executive domains. Neuropsychological group comparisons were performed with MANOVAs. A hierarchical cluster analysis was run to identify clusters of patients with similar neuropsychological performance. Two generalized linear models were built to predict baseline HDRS-17 and changes at 12 months. Patients performed significantly worse than healthy controls in language, attention/working memory, verbal memory, processing speed and executive functioning, with moderate to large effect sizes (0.5 - 1). Two clusters were found: cognitively preserved patients (n=37) and cognitively impaired patients (n=13). Large effect sizes of cognitive impairment in FED were observed between the two cognitive clusters (preserved and impaired). Depressive symptoms at baseline were predicted by verbal memory (p=0.003), while 12-month changes were predicted by executive function (p=0.041) and language (p=0.037). Cognitive performance predicted depressive symptoms at baseline and at follow-up, pointing to the usefulness of cognitive assessment even at the commencement of the illness.
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Affiliation(s)
- M Vicent-Gil
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau)- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Biomedical Research Networking Center Consortium on Mental Health, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain; Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT), CIBERSAM, Biomedical Research Networking Center Consortium on Mental Health, Sabadell, Spain
| | - A Keymer-Gausset
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau)- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Biomedical Research Networking Center Consortium on Mental Health, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain
| | - M Serra-Blasco
- Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT), CIBERSAM, Biomedical Research Networking Center Consortium on Mental Health, Sabadell, Spain
| | - M Carceller-Sindreu
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau)- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Biomedical Research Networking Center Consortium on Mental Health, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain
| | - J de Diego-Adeliño
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau)- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Biomedical Research Networking Center Consortium on Mental Health, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain
| | - J Trujols
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau)- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Biomedical Research Networking Center Consortium on Mental Health, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain
| | - M Mur
- Psychiatric Service, Hospital Universitari Santa Maria, University of Lleida, IRB Lleida (Biomedicine Research Institute), Lleida, Catalonia, Spain
| | - V Pérez
- Hospital del Mar, Institut Hospital del Mar d'Investigacions Biomèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), CIBERSAM, Biomedical Research Networking Center Consortium on Mental Health, Barcelona, Spain
| | - E Alvarez
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau)- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Biomedical Research Networking Center Consortium on Mental Health, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain
| | - N Cardoner
- Mental Health, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT), CIBERSAM, Biomedical Research Networking Center Consortium on Mental Health, Sabadell, Spain
| | - M J Portella
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau)- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Biomedical Research Networking Center Consortium on Mental Health, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain.
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10
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Cano M, Alonso P, Martínez-Zalacaín I, Subirà M, Real E, Segalàs C, Pujol J, Cardoner N, Menchón JM, Soriano-Mas C. Altered functional connectivity of the subthalamus and the bed nucleus of the stria terminalis in obsessive-compulsive disorder. Psychol Med 2018; 48:919-928. [PMID: 28826410 DOI: 10.1017/s0033291717002288] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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] [Indexed: 12/17/2022]
Abstract
BACKGROUND The assessment of inter-regional functional connectivity (FC) has allowed for the description of the putative mechanism of action of treatments such as deep brain stimulation (DBS) of the nucleus accumbens in patients with obsessive-compulsive disorder (OCD). Nevertheless, the possible FC alterations of other clinically-effective DBS targets have not been explored. Here we evaluated the FC patterns of the subthalamic nucleus (STN) and the bed nucleus of the stria terminalis (BNST) in patients with OCD, as well as their association with symptom severity. METHODS Eighty-six patients with OCD and 104 healthy participants were recruited. A resting-state image was acquired for each participant and a seed-based analysis focused on our two regions of interest was performed using statistical parametric mapping software (SPM8). Between-group differences in FC patterns were assessed with two-sample t test models, while the association between symptom severity and FC patterns was assessed with multiple regression analyses. RESULTS In comparison with controls, patients with OCD showed: (1) increased FC between the left STN and the right pre-motor cortex, (2) decreased FC between the right STN and the lenticular nuclei, and (3) increased FC between the left BNST and the right frontopolar cortex. Multiple regression analyses revealed a negative association between clinical severity and FC between the right STN and lenticular nucleus. CONCLUSIONS This study provides a neurobiological framework to understand the mechanism of action of DBS on the STN and the BNST, which seems to involve brain circuits related with motor response inhibition and anxiety control, respectively.
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Affiliation(s)
- M Cano
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - P Alonso
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - M Subirà
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - E Real
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - C Segalàs
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - J Pujol
- CIBERSAM, Carlos III Health Institute, Madrid,Spain
| | - N Cardoner
- CIBERSAM, Carlos III Health Institute, Madrid,Spain
| | - J M Menchón
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - C Soriano-Mas
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
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11
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Wise T, Radua J, Via E, Cardoner N, Abe O, Adams TM, Amico F, Cheng Y, Cole JH, de Azevedo Marques Périco C, Dickstein DP, Farrow TFD, Frodl T, Wagner G, Gotlib IH, Gruber O, Ham BJ, Job DE, Kempton MJ, Kim MJ, Koolschijn PCMP, Malhi GS, Mataix-Cols D, McIntosh AM, Nugent AC, O'Brien JT, Pezzoli S, Phillips ML, Sachdev PS, Salvadore G, Selvaraj S, Stanfield AC, Thomas AJ, van Tol MJ, van der Wee NJA, Veltman DJ, Young AH, Fu CH, Cleare AJ, Arnone D. Common and distinct patterns of grey-matter volume alteration in major depression and bipolar disorder: evidence from voxel-based meta-analysis. Mol Psychiatry 2017; 22:1455-1463. [PMID: 27217146 PMCID: PMC5622121 DOI: 10.1038/mp.2016.72] [Citation(s) in RCA: 357] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 03/01/2016] [Accepted: 03/23/2016] [Indexed: 12/11/2022]
Abstract
Finding robust brain substrates of mood disorders is an important target for research. The degree to which major depression (MDD) and bipolar disorder (BD) are associated with common and/or distinct patterns of volumetric changes is nevertheless unclear. Furthermore, the extant literature is heterogeneous with respect to the nature of these changes. We report a meta-analysis of voxel-based morphometry (VBM) studies in MDD and BD. We identified studies published up to January 2015 that compared grey matter in MDD (50 data sets including 4101 individuals) and BD (36 data sets including 2407 individuals) using whole-brain VBM. We used statistical maps from the studies included where available and reported peak coordinates otherwise. Group comparisons and conjunction analyses identified regions in which the disorders showed common and distinct patterns of volumetric alteration. Both disorders were associated with lower grey-matter volume relative to healthy individuals in a number of areas. Conjunction analysis showed smaller volumes in both disorders in clusters in the dorsomedial and ventromedial prefrontal cortex, including the anterior cingulate cortex and bilateral insula. Group comparisons indicated that findings of smaller grey-matter volumes relative to controls in the right dorsolateral prefrontal cortex and left hippocampus, along with cerebellar, temporal and parietal regions were more substantial in major depression. These results suggest that MDD and BD are characterised by both common and distinct patterns of grey-matter volume changes. This combination of differences and similarities has the potential to inform the development of diagnostic biomarkers for these conditions.
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Affiliation(s)
- T Wise
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - J Radua
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Research Unit, FIDMAG Germanes Hospitalàries – CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - E Via
- Mental Health, Parc Taulí Sabadell-CIBERSAM, University Hospital, Sabadell, Barcelona, Spain
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - N Cardoner
- Mental Health, Parc Taulí Sabadell-CIBERSAM, University Hospital, Sabadell, Barcelona, Spain
| | - O Abe
- Department of Radiology, Nihon University School of Medicine, Tokyo, Japan
| | - T M Adams
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - F Amico
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - Y Cheng
- Department of Psychiatry, The 1st Affiliated Hospital of Kunming Medical University, Kunming, PR China
| | - J H Cole
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Department of Medicine, Imperial College London, London, UK
| | - C de Azevedo Marques Périco
- Department of Neuroscience, Medical School, Fundação do ABC, Santo André, SP, Brazil
- ABC Center of Studies on Mental Health, Santo André, SP, Brazil
| | - D P Dickstein
- PediMIND Program, Bradley Hospital, Department of Psychiatry, Brown University, East Providence, RI, USA
| | - T F D Farrow
- Academic Clinical Neurology, Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - T Frodl
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
- Department of Psychiatry, University of Dublin, Trinity College, Dublin, Ireland
| | - G Wagner
- Psychiatric Brain and Body Research Group Jena, Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - I H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - O Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - B J Ham
- Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea
| | - D E Job
- Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK
- Scottish Imaging Network–A Platform for Scientific Excellence (SINAPSE), Giffnock, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - M J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - M J Kim
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - P C M P Koolschijn
- Department of Psychology, Dutch Autism and ADHD Research Center, Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - G S Malhi
- CADE Clinic, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - D Mataix-Cols
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - A C Nugent
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - J T O'Brien
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - S Pezzoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Neuroscience, Medical School, University of Sheffield, Sheffield, UK
| | - M L Phillips
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA
| | - P S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - G Salvadore
- Janssen Research and Development, Titusville, NJ, USA
| | - S Selvaraj
- Department of Psychiatry and Behavioral Sciences, Center of Excellence on Mood Disorders, Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - A C Stanfield
- The Patrick Wild Centre, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - A J Thomas
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - M J van Tol
- NeuroImaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - N J A van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - D J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - A H Young
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - C H Fu
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- School of Psychology, University of East London, London, UK
| | - A J Cleare
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - D Arnone
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Serra-Blasco M, Aguilar E, Vicent M, Navarra G, Portella M, Figuereo I, Crivillés S, Martínez-Amorós E, Lahera G, Monreal J, Cardoner N. Cognitive dysfunction in depression. Is it well detected? Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.02.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionMajor depression cognitive impairments lasts in remission periods, have an impact on treatment outcome and hamper psychosocial functioning. Thus, its accurate detection and specific treatment has become a crucial step.ObjectivesIn order to assess objective cognitive functioning (OCF), a neuropsychological battery was administered. For subjective cognitive functioning (SCF), cognitive perception was evaluated by clinicians and patients.AimsTo determine the concordance between OCF and SCF.MethodsOne hundred and two patients were grouped according to Hamilton Depressive Rating Scale (HDRS−17): 18 remitters (RE < 7), 40 partly remitters (PR, 7–18) and 44 acutely depressed (AD > 18). OCF was computed combining T-scores of digit symbol substitution test (WAIS-IV) with two RAVLT subtests (learning and memory). SCF was assessed with a CGI adaptation for cognitive disturbances severity.ResultsThe OFC was 41.21(8.49) for all patients and 45.54(6.8), 41.93(6.8) and 38.7 (9.7) for RE, PR, and AD, respectively. Psychiatrist and patients’ SCF had a poor agreement (α=0.518), with Cronbach's alpha for RE, PR and AD of −0.607, 0.518 and 0.404. Concordance between OCF and SCF was calculated for all patients (psychiatrist, r = −0.317, P = 0.002; patient, r = −0.310, P = 0.002), for RE (r = −0.535, P = 0.022; r = 0.395, P = 0.105) for PR (r = −0.013, P = 0.94; r = −0.328, P = 0.045) and for AD (r = −0.252, P = 0.122; r = −0.333, P = 0.033). Patients rated their SFC as more impaired than did clinicians.ConclusionsConcordance between clinicians and patients regarding SCF is very poor, worsening in AD group and being null in remission. This study also points out that CF is best detected by patients in acute episodes and by psychiatrists when patients are in clinical remission.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Cardoner N, Cebria A, Lopez-Sola C, Serra-Blasco M, Massons C, Muriel V, Navarra G, Via E, Cobo J, Golberg X. Neuropersonaltrainer-mh: A New Computerized Platform for the Cognitive Remediation in Schizophrenia and Bipolar Disorders. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Schizophrenia and mood disorders -including unipolar depression and bipolar disorder-, are severe mental diseases with a highly heterogeneous symptomatology, among which cognitive dysfunction has progressively emerged as a key cornerstone. Patients suffering from these illnesses show significant deficits in different neurocognitive and social cognition domains. These deficits are evident during acute episodes, and in a high percentage of patients persist in periods of recovery, playing a decisive role on functional and clinical outcome. Nowadays, different pharmacological therapies have been tested, obtaining non-conclusive results. In this context, non-pharmacological strategies, such as neurocognitive remediation, have emerged as promising therapeutic intervention. Neurocognitive remediation comprises a program to rehabilitate cognitively impaired subjects, aiming either to restore their cognitive functioning or to compensate them in specific cognitive domains. One evolving approach, beginning to receive attention for its initial promising results, is computerized cognitive training. This technique employs tasks or games that exercise a particular brain function which target specific neural networks in order to improve cognitive functioning through neuroplasticity in a given neural circuit. In this scenario, we report our recent results with neuropersonaltrainer®-MH; a module for neurocognitive remediation consisting in a computerized telerehabilitation platform that enables cognitive remediation programs to be carried out in an intensive and personalized manner. Our group has applied NPTMH® in a pilot study treating patients with early onset psychotic disorder with positive and promising results, involving an improvement in functionality, neurocognition, and social cognition performance. Furthermore, new trials in bipolar disorder and major depressive disorder have been recently started.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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14
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Cano M, Alonso P, Martínez-Zalacaín I, Subirà M, Real E, Segalàs C, Pujol J, Cardoner N, Menchón J, Soriano-Mas C. Altered functional connectivity of the subthalamus and the bed nucleus of the stria terminalis in obsessive-compulsive disorder. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.075] [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: 11/30/2022] Open
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15
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Cano M, Martínez-Zalacaín I, Bernabéu-Sanz Á, Contreras-Rodríguez O, Hernández-Ribas R, Via E, de Arriba-Arnau A, Gálvez V, Urretavizcaya M, Pujol J, Menchón JM, Cardoner N, Soriano-Mas C. Brain volumetric and metabolic correlates of electroconvulsive therapy for treatment-resistant depression: a longitudinal neuroimaging study. Transl Psychiatry 2017; 7:e1023. [PMID: 28170003 PMCID: PMC5438019 DOI: 10.1038/tp.2016.267] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/12/2016] [Accepted: 11/13/2016] [Indexed: 02/08/2023] Open
Abstract
Recent research suggests that neuroplastic and neuroinflammatory changes may account for the mode of action of electroconvulsive therapy (ECT), although extant data do not allow for a clear disambiguation between these two hypotheses. Multimodal neuroimaging approaches (for example, combining structural and metabolic information) may help in clarifying this issue. Here we aimed to assess longitudinal changes in (i) regional gray matter (GM) volumes and (ii) hippocampal metabolite concentrations throughout an acute course of bitemporal ECT, as well as (iii) to determine the association between imaging changes and clinical improvement. We assessed 12 patients with treatment-resistant depression (TRD) at four time points (pre-treatment, after the first ECT session, after the ninth ECT session and 15 days after ECT course completion) and 10 healthy participants at two time points, 5 weeks apart. Patients with TRD showed bilateral medial temporal lobe (MTL) and perigenual anterior cingulate cortex volume increases. Left MTL volume increase was associated with (i) a hippocampal N-acetylaspartate concentration decrease, (ii) a hippocampal Glutamate+Glutamine concentration increase and (iii) significant clinical improvement. The observed findings are, in part, compatible with both neuroplastic and neuroinflammatory changes induced by ECT. We postulate that such phenomena may be interrelated, therefore reconciling the neuroplasticity and neuroinflammatory hypotheses of ECT action.
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Affiliation(s)
- M Cano
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Á Bernabéu-Sanz
- Magnetic Resonance Department, Inscanner SL, Alicante, Spain
| | - O Contreras-Rodríguez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Carlos III Health Institute, CIBERSAM, Madrid, Spain
| | - R Hernández-Ribas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Carlos III Health Institute, CIBERSAM, Madrid, Spain
| | - E Via
- Mental Health Department, Parc Taulí Sabadell, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A de Arriba-Arnau
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - V Gálvez
- School of Psychiatry, University of New South Wales (UNSW) and Black Dog Institute, Randwick, Sydney, NSW, Australia
| | - M Urretavizcaya
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Carlos III Health Institute, CIBERSAM, Madrid, Spain
| | - J Pujol
- Carlos III Health Institute, CIBERSAM, Madrid, Spain,MRI Research Unit, Radiology Department, Hospital del Mar, Barcelona, Spain
| | - J M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Carlos III Health Institute, CIBERSAM, Madrid, Spain,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain E-mail:
| | - N Cardoner
- Mental Health Department, Parc Taulí Sabadell, Universitat Autònoma de Barcelona, Barcelona, Spain,Mental Health Department, Parc Taulí Sabadell, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell, 08208 Barcelona, Spain. E-mail:
| | - C Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Carlos III Health Institute, CIBERSAM, Madrid, Spain,Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
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16
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Real E, Subirà M, Alonso P, Segalàs C, Labad J, Orfila C, López-Solà C, Martínez-Zalacaín I, Via E, Cardoner N, Jiménez-Murcia S, Soriano-Mas C, Menchón JM. Brain structural correlates of obsessive-compulsive disorder with and without preceding stressful life events. World J Biol Psychiatry 2016; 17:366-77. [PMID: 26784523 DOI: 10.3109/15622975.2016.1142606] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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] [Indexed: 11/13/2022]
Abstract
Objectives There is growing evidence supporting a role for stressful life events (SLEs) at obsessive-compulsive disorder (OCD) onset, but neurobiological correlates of such effect are not known. We evaluated regional grey matter (GM) changes associated with the presence/absence of SLEs at OCD onset. Methods One hundred and twenty-four OCD patients and 112 healthy controls were recruited. Patients were split into two groups according to the presence (n = 56) or absence (n = 68) of SLEs at disorder's onset. A structural magnetic resonance image was acquired for each participant and pre-processed with Statistical Parametric Mapping software (SPM8) to obtain a volume-modulated GM map. Between-group differences in sociodemographic, clinical and whole-brain regional GM volumes were assessed. Results SLEs were associated with female sex, later age at disorder's onset, more contamination/cleaning and less hoarding symptoms. In comparison with controls, patients without SLEs showed GM volume increases in bilateral dorsal putamen and the central tegmental tract of the brainstem. By contrast, patients with SLEs showed specific GM volume increases in the right anterior cerebellum. Conclusions Our findings support the idea that neuroanatomical alterations of OCD patients partially depend on the presence of SLEs at disorder's onset.
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Affiliation(s)
- E Real
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain
| | - M Subirà
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain ;,c Department of Clinical Sciences, School of Medicine , University of Barcelona , Barcelona , Spain
| | - P Alonso
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain ;,c Department of Clinical Sciences, School of Medicine , University of Barcelona , Barcelona , Spain
| | - C Segalàs
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain
| | - J Labad
- d Mental Health Department , Corporació Sanitària Parc Taulí , Sabadell , Spain ;,e Department of Psychiatry and Forensic Medicine , Universitat Autònoma De Barcelona , Barcelona , Spain
| | - C Orfila
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain
| | - C López-Solà
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain ;,c Department of Clinical Sciences, School of Medicine , University of Barcelona , Barcelona , Spain
| | - I Martínez-Zalacaín
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain
| | - E Via
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,c Department of Clinical Sciences, School of Medicine , University of Barcelona , Barcelona , Spain
| | - N Cardoner
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,d Mental Health Department , Corporació Sanitària Parc Taulí , Sabadell , Spain ;,e Department of Psychiatry and Forensic Medicine , Universitat Autònoma De Barcelona , Barcelona , Spain
| | - S Jiménez-Murcia
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,f Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBERobn) , Carlos III Health Institute , Madrid , Spain
| | - C Soriano-Mas
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain ;,g Department of Psychobiology and Methodology in Health Sciences , Universitat Autònoma de Barcelona , Barcelona , Spain
| | - J M Menchón
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain ;,c Department of Clinical Sciences, School of Medicine , University of Barcelona , Barcelona , Spain
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17
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Fullana MA, Cardoner N, Alonso P, Subirà M, López-Solà C, Pujol J, Segalàs C, Real E, Bossa M, Zacur E, Martínez-Zalacaín I, Bulbena A, Menchón JM, Olmos S, Soriano-Mas C. Brain regions related to fear extinction in obsessive-compulsive disorder and its relation to exposure therapy outcome: a morphometric study. Psychol Med 2014; 44:845-856. [PMID: 23773479 DOI: 10.1017/s0033291713001128] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The size of particular sub-regions within the ventromedial prefrontal cortex (vmPFC) has been associated with fear extinction in humans. Exposure therapy is a form of extinction learning widely used in the treatment of obsessive-compulsive disorder (OCD). Here we investigated the relationship between morphometric measurements of different sub-regions of the vmPFC and exposure therapy outcome in OCD. METHOD A total of 74 OCD patients and 86 healthy controls underwent magnetic resonance imaging (MRI). Cortical thickness and volumetric measurements were obtained for the rostral anterior cingulate cortex (rACC), the medial orbital frontal cortex and the subcallosal cortex. After MRI acquisition, patients were enrolled in an exposure therapy protocol, and we assessed the relationship between MRI-derived measurements and treatment outcome. Baseline between-group differences for such measurements were also assessed. RESULTS Compared with healthy controls, OCD patients showed a thinner left rACC (p = 0.008). Also, left rACC thickness was inversely associated with exposure therapy outcome (r - 0.32, p = 0.008), and this region was significantly thinner in OCD patients who responded to exposure therapy than in those who did not (p = 0.006). Analyses based on regional volumetry did not yield any significant results. CONCLUSIONS OCD patients showed cortical thickness reductions in the left rACC, and these alterations were related to exposure therapy outcome. The precise characterization of neuroimaging predictors of treatment response derived from the study of the brain areas involved in fear extinction may optimize exposure therapy planning in OCD and other anxiety disorders.
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Affiliation(s)
- M A Fullana
- Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar and Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain
| | - N Cardoner
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - P Alonso
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - M Subirà
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - C López-Solà
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - J Pujol
- CRC Mar, Hospital del Mar, Barcelona, Spain
| | - C Segalàs
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - E Real
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - M Bossa
- Aragon Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain
| | - E Zacur
- Aragon Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - A Bulbena
- Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar and Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain
| | - J M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - S Olmos
- Aragon Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain
| | - C Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
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Pujol J, Giménez M, Ortiz H, Soriano-Mas C, López-Solà M, Farré M, Deus J, Merlo-Pich E, Harrison BJ, Cardoner N, Navinés R, Martín-Santos R. Neural response to the observable self in social anxiety disorder. Psychol Med 2013; 43:721-731. [PMID: 22895096 DOI: 10.1017/s0033291712001857] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Distorted images of the observable self are considered crucial in the development and maintenance of social anxiety. We generated an experimental situation in which participants viewed themselves from an observer's perspective when exposed to scrutiny and evaluation by others. Method Twenty patients with social anxiety disorder (SAD) and 20 control subjects were assessed using functional magnetic resonance imaging (fMRI) during the public exposure of pre-recorded videos in which they were each shown performing a verbal task. The examiners acted as the audience in the experiment and rated performance. Whole-brain functional maps were computed using Statistical Parametric Mapping. RESULTS Robust activation was observed in regions related to self-face recognition, emotional response and general arousal in both study groups. Patients showed significantly greater activation only in the primary visual cortex. By contrast, they showed significant deactivation or smaller activation in dorsal frontoparietal and anterior cingulate cortices relevant to the cognitive control of negative emotion. Task-related anxiety ratings revealed a pattern of negative correlation with activation in this frontoparietal/cingulate network. Importantly, the relationship between social anxiety scores and neural response showed an inverted-U function with positive correlations in the lower score range and negative correlations in the higher range. CONCLUSIONS Our findings suggest that exposure to scrutiny and evaluation in SAD may be associated with changes in cortical systems mediating the cognitive components of anxiety. Disorder severity seems to be relevant in shaping the neural response pattern, which is distinctively characterized by a reduced cortical response in the most severe cases.
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Affiliation(s)
- J Pujol
- Institut d'Alta Tecnologia-PRBB, CRC Mar, Hospital de Mar, Barcelona, Spain.
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Radua J, Mataix-Cols D, Phillips ML, El-Hage W, Kronhaus DM, Cardoner N, Surguladze S. A new meta-analytic method for neuroimaging studies that combines reported peak coordinates and statistical parametric maps. Eur Psychiatry 2011; 27:605-11. [PMID: 21658917 DOI: 10.1016/j.eurpsy.2011.04.001] [Citation(s) in RCA: 507] [Impact Index Per Article: 39.0] [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: 03/14/2011] [Accepted: 04/03/2011] [Indexed: 12/11/2022] Open
Abstract
Meta-analyses are essential to summarize the results of the growing number of neuroimaging studies in psychiatry, neurology and allied disciplines. Image-based meta-analyses use full image information (i.e. the statistical parametric maps) and well-established statistics, but images are rarely available making them highly unfeasible. Peak-probability meta-analyses such as activation likelihood estimation (ALE) or multilevel kernel density analysis (MKDA) are more feasible as they only need reported peak coordinates. Signed-differences methods, such as signed differential mapping (SDM) build upon the positive features of existing peak-probability methods and enable meta-analyses of studies comparing patients with controls. In this paper we present a new version of SDM, named Effect Size SDM (ES-SDM), which enables the combination of statistical parametric maps and peak coordinates and uses well-established statistics. We validated the new method by comparing the results of an ES-SDM meta-analysis of studies on the brain response to fearful faces with the results of a pooled analysis of the original individual data. The results showed that ES-SDM is a valid and reliable coordinate-based method, whose performance might be additionally increased by including statistical parametric maps. We anticipate that ES-SDM will be a helpful tool for researchers in the fields of psychiatry, neurology and allied disciplines.
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Affiliation(s)
- J Radua
- Department of psychosis Studies, institute of psychiatry, King's College London, P.O. 69, London, SE5 8AF, UK.
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Soriano-Mas C, Harrison BJ, Ortiz H, Lopez-Sola M, Deus J, Cardoner N, Hernandez-Ribas R, Pujol J. Structural correlations of the neostriatum with regional gray matter volumes. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71896-8] [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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21
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Lopez-Sola M, Pujol J, Hernandez-Ribas R, Deus J, Harrison BJ, Ortiz H, Soriano C, Vallejo J, Menchon JM, Cardoner N. Dynamics of the right frontal cortex response to painful stimulation. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70292-7] [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: 11/28/2022] Open
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22
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Pujol J, Harrison BJ, Ortiz H, Deus J, Soriano-Mas C, López-Solà M, Yücel M, Perich X, Cardoner N. Influence of the fusiform gyrus on amygdala response to emotional faces in the non-clinical range of social anxiety. Psychol Med 2009; 39:1177-1187. [PMID: 19154647 DOI: 10.1017/s003329170800500x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Social anxiety often involves a combination of hypervigilance and avoidance to potentially warning signals including the facial expression of emotions. Functional imaging has demonstrated an increase in amygdala response to emotional faces in subjects with social anxiety. Nevertheless, it is unclear to what extent visual areas processing faces influence amygdala reactivity in different socially anxious individuals. We assessed the influence of the fusiform gyrus activation on amygdala response to emotional faces in the non-clinical range of social anxiety. METHOD Twenty-two normal subjects showing a wide range in social anxiety scores were examined using functional magnetic resonance imaging (fMRI) during the processing of happy and fearful faces. A dimensional analysis approach was used involving voxel-wise mapping of the correlation between subjects' social anxiety scores and amygdala activation, before and after controlling for fusiform gyrus activation. RESULTS We observed that only after controlling for subjects' level of activation of the fusiform gyrus was there an association between social anxiety ratings and amygdala response to both happy and fearful faces. The fusiform gyrus influence was more robust during the fear condition. Of note, fusiform gyrus response to fearful faces showed a negative correlation with additional behavioral assessments related to avoidance, including social anxiety scores, harm avoidance and sensitivity to punishment. CONCLUSIONS Relevant interactions among the emotional face-processing stages exist in the non-clinical range of social anxiety that may ultimately attenuate amygdala responses. Future research will help to establish the role of this effect in a clinical context.
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Affiliation(s)
- J Pujol
- Institut d'Alta Tecnologia-PRBB, Department of Magnetic Resonance, CRC Corporació Sanitària, Barcelona, Spain.
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Hernández-Ribas R, Soriano-Mas C, Pujol J, Deus J, Segalàs C, López-Solà M, Ortiz H, Harrison B, Menchón JM, Cardoner N. The modulating effect of repetitive transcranial magnetic stimulation (rTMS) on brain activity evoked by word generation in depressive patients. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70430-6] [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: 10/20/2022] Open
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Cardoner N, ópez-Sola M, Pujol J, Hernández-Ribas R, Deus J, Ortiz H, Martinez-Amoros E, Soriano-Mas C, Menchón JM, Harrison BJ. DULOXETINE MODULATES PAIN-RELATED BRAIN RESPONSE IN PATIENTS WITH MAJOR DEPRESSIVE DISORDER. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70098-9] [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: 10/20/2022] Open
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Urretavizcaya M, Moreno I, Benlloch L, Cardoner N, Serrallonga J, Menchón JM, Vallejo J. Auditory event-related potentials in 50 melancholic patients: increased N100, N200 and P300 latencies and diminished P300 amplitude. J Affect Disord 2003; 74:293-7. [PMID: 12738049 DOI: 10.1016/s0165-0327(02)00016-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND To investigate whether there are some differences in Event-Related Potentials (ERP) between melancholic patients and healthy controls. To establish whether there is a relationship between abnormalities of ERP and severity of depression and psychomotor retardation. METHOD Melancholic depressed patients (N=50) and normal comparison subjects (N=31) were assessed for latencies and interlatencies of N100, N200, N400, latency and amplitude of P300. The ERPs were studied with an 'oddball paradigm' in the auditory modality. Severity of depression was measured by the Hamilton Depression Rating Scale (HDRS) and psychomotor retardation with the Depressive Retardation Rating Scale (DRRS). RESULTS The melancholic group showed a significantly higher latency in N100 (P<0.001), N200 (P<0.001) and P300 (P<0.001) and a significantly lower P300 amplitude (P<0.001) than healthy controls. No other differences were found either in the latencies of the N400 or in their interlatencies. HDRS and DRRS do not have any significant correlations with amplitude or latency measures. LIMITATIONS The subjects of this study are inpatients, with a severe subcategory of depression and high average age. It is difficult to generalize these findings. CONCLUSIONS The principal finding of this study is the increase in three of the four latencies measured (N100, N200 and P300) and in the decreased P300 amplitude in melancholic patients compared to normal controls. There is no association between these abnormalities and clinical variables.
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Affiliation(s)
- M Urretavizcaya
- Department of Psychiatry, Prínceps d'Espanya University Hospital, Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
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Alonso P, Pujol J, Cardoner N, Benlloch L, Deus J, Menchón JM, Capdevila A, Vallejo J. Right prefrontal repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: a double-blind, placebo-controlled study. Am J Psychiatry 2001; 158:1143-5. [PMID: 11431238 DOI: 10.1176/appi.ajp.158.7.1143] [Citation(s) in RCA: 118] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The efficacy of repetitive transcranial magnetic stimulation (rTMS) of the right prefrontal cortex for patients with obsessive-compulsive disorder (OCD) was studied under double-blind, placebo-controlled conditions. METHOD Patients were randomly assigned to 18 sessions of real (N=10) or sham (N=8) rTMS. Treatments lasted 20 minutes, and the frequency was 1 Hz for both conditions, but the intensity was 110% of motor threshold for real rTMS and 20% for the sham condition. RESULTS No significant changes in OCD were detected in either group after treatment. Two patients who received real rTMS, with checking compulsions, and one receiving sham treatment, with sexual/religious obsessions, were considered responders. CONCLUSIONS Low-frequency rTMS of the right prefrontal cortex failed to produce significant improvement of OCD and was not significantly different from sham treatment. Further studies are indicated to assess the efficacy of rTMS in OCD and to clarify the optimal stimulation characteristics.
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Affiliation(s)
- P Alonso
- Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain
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Pujol J, Bello J, Deus J, Cardoner N, Martí-Vilalta JL, Capdevila A. Beck Depression Inventory factors related to demyelinating lesions of the left arcuate fasciculus region. Psychiatry Res 2000; 99:151-9. [PMID: 11068196 DOI: 10.1016/s0925-4927(00)00061-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This study was conducted to further establish the significance of the previously reported association between depressive symptoms and demyelinating lesions in the region of the left arcuate fasciculus in multiple sclerosis patients. The Beck Depression Inventory (BDI) was broken down into its main symptom categories on the basis of well-established factor analyses from the literature, and the correlation pattern between the resulting BDI subscores and lesion measurements was analyzed. We found that lesions of the left arcuate fasciculus region were selectively associated with BDI items expressing patients' Affective Symptoms and Somatic Complaints. Specifically, lesion measurements from this brain location accounted for 26% of symptom score variance of the BDI part that includes only these two factors. Performance Difficulties and Cognitive Distortions were not consistently associated with the lesion measurement. Performance Difficulties, however, showed a high correlation with the neurologic deficit detected in the physical examination. These results show that lesions in the left arcuate fasciculus region are associated with the core of the depressive syndrome rather than marginal symptoms and, thus, further suggest that this left suprainsular brain region involves white matter tracts relevant to mood regulation.
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Affiliation(s)
- J Pujol
- Magnetic Resonance Center of Pedralbes, Monestir, 3, 08034, Barcelona, Spain.
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Pujol J, Torres L, Deus J, Cardoner N, Pifarré J, Capdevila A, Vallejo J. Functional magnetic resonance imaging study of frontal lobe activation during word generation in obsessive-compulsive disorder. Biol Psychiatry 1999; 45:891-7. [PMID: 10202577 DOI: 10.1016/s0006-3223(98)00099-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Functional imaging studies have demonstrated abnormal patterns of brain activity in obsessive-compulsive disorder, which consistently suggest the alteration of frontal lobe functioning. We performed a brain activation study in obsessive-compulsive disorder using a cognitive task involving the frontal lobes. METHODS Twenty patients and 20 healthy control subjects were assessed with functional magnetic resonance imaging during a phonologically guided word generation task. The study analysis was based on the comparison of group average time-course functional changes occurring at the site of largest frontal cortex activation during alternating rest and task periods. RESULTS In terms of relative signal changes, patients showed a significantly greater activation during word generation and a defective suppression of this activation during the following rest period. Both abnormal imaging findings significantly correlated with the severity of the clinical process assessed by the Yale-Brown Obsessive-Compulsive Scale. CONCLUSIONS The results indicate that functional magnetic resonance imaging during cognitive challenge may be useful to reveal distinctive features of latent brain dysfunction in obsessive-compulsive disorder.
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Affiliation(s)
- J Pujol
- Magnetic Resonance Center of Pedralbes, Barcelona, Spain
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