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Chen KC, Yang YK, Howes OD, Lee IH, Yeh TL, Chiu NT, Chen PS, David AS, Bramon E. Striatal dopamine D 2/3 receptors in medication-naïve schizophrenia: an [ 123I] IBZM SPECT study. Psychol Med 2022; 52:3251-3259. [PMID: 33682657 PMCID: PMC9693693 DOI: 10.1017/s0033291720005413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 12/10/2020] [Accepted: 12/24/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The hyper-function of the striatal dopamine system has been suggested to underlie key pathophysiological mechanisms in schizophrenia. Moreover, patients have been observed to present a significant elevation of dopamine receptor availability compared to healthy controls. Although it is difficult to measure dopamine levels directly in humans, neurochemical imaging techniques such as single-photon emission computed tomography (SPECT) provide indirect indices of in vivo dopamine synthesis and release, and putative synaptic levels. METHODS We focused on the role of dopamine postsynaptic regulation using [123I] iodobenzamide (IBZM) SPECT. We compared D2/3 receptor availability between 53 healthy controls and 21 medication-naive patients with recent-onset schizophrenia. RESULT The mean specific striatal binding showed no significant difference between patients and controls (estimated difference = 0.001; 95% CI -0.11 to 0.11; F = 0.00, df = 1, 69; p = 0.99). There was a highly significant effect of age whereby IBZM binding declined with advancing age [estimated change per decade of age = -0.01(binding ratio); 95% CI -0.01 to -0.004; F = 11.5, df = 1, 69; p = 0.001]. No significant correlations were found between the mean specific striatal binding and psychopathological or cognitive rating scores. CONCLUSIONS Medication-naïve patients with recent-onset schizophrenia have similar D2/3 receptor availability to healthy controls. We suggest that, rather than focusing exclusively on postsynaptic receptors, future treatments should target the presynaptic control of dopamine synthesis and release.
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Affiliation(s)
- Kao Chin Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Oliver D. Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - I Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzung Lieh Yeh
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nan Tsing Chiu
- Department of Nuclear Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychiatry, National Cheng Kung University, Dou-Liou Branch, Yunlin, Taiwan
| | - Anthony S. David
- Institute of Mental Health, University College London, London, UK
| | - Elvira Bramon
- Mental Health Neurosciences Research Department, Division of Psychiatry, University College London, London, UK
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Tai YC, Lin SH, Chen KC, Lee IH, Chen PS, Lee LT, Tsai HC, Yeh TL, Yang YK. Heart Rate Variability with Deep Breathing in Drug-Naïve Patients with Schizophrenia. Appl Psychophysiol Biofeedback 2020; 45:275-282. [PMID: 32997269 DOI: 10.1007/s10484-020-09489-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 01/03/2023]
Abstract
Abnormal autonomic nervous system (ANS) function may result in poor outcomes in patients with schizophrenia. Altered cardio-respiratory coupling, which indicates suppression of vagal activity, was identified as an important trait in patients with schizophrenia and their unaffected relatives. Heart rate variability (HRV) in standardized bedside reflex tests has been studied, mostly in medicated patients with schizophrenia whose ANS function could be influenced by medication. Our study aimed to explore the autonomic function differences between drug-naïve patients with schizophrenia and healthy individuals during challenge tests combining respiration and HRV analysis. Forty-two drug-naïve patients with schizophrenia were matched with 42 healthy controls in terms of age and gender. Their beat-to-beat blood pressure and heart rate were monitored in the supine position as a survey of ANS function, and the mean heart rate range (MHRR) was measured under deep-breathing challenge. A decreased MHRR, a sensitive sign indicating an impaired parasympathetic response, during the deep-breathing challenge among the drug-naïve patients with schizophrenia was found. Drug-naïve patients with schizophrenia may have a parasympathetic dysfunction in the early stages of schizophrenia before medication is introduced, which could be considered a neurobiological marker in the pathophysiology of schizophrenia.
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Affiliation(s)
- Ying Chun Tai
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan
| | - Shih-Hsien Lin
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kao Chin Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan.
| | - I Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Lan-Ting Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan
| | - Hsin Chun Tsai
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan
| | - Tzung Lieh Yeh
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
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Morandi GN, Lin SH, Lin CW, Yeh TL, Chu CL, Lee IH, Chi MH, Chen KC, Chen PS, Yang YK. Heart Rate Variability is Associated with Memory in Females. Appl Psychophysiol Biofeedback 2020; 44:117-122. [PMID: 30565197 DOI: 10.1007/s10484-018-9425-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Research into the association between heart rate variability (HRV) and cognitive function is scarce, particularly with regard to gender differences. HRV in 182 healthy volunteers was assessed by the root mean square of the successive difference (RMSSD) and spectrum analysis, while the Wechsler Memory Scale-Revised (WMS-R) was used to determine memory function. Robust and significant associations were found to exist between HRV (RMSSD and high-frequency HRV) and domains of the WMS-R in females. Caution should therefore be taken to control for gender when conducting studies on the relationships between HRV and cognitive variables.
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Affiliation(s)
- Gisela Nassralla Morandi
- Department of Medicine, Faculdade de ciências médicas e da saúde (FCMS)-PUC-SP, Sorocaba, São Paulo, Brazil
| | - Shih-Hsien Lin
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 70403, Taiwan. .,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Che-Wei Lin
- Department of BioMedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Tzung Lieh Yeh
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 70403, Taiwan
| | - Ching-Lin Chu
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 70403, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 70403, Taiwan
| | - Mei Hung Chi
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 70403, Taiwan
| | - Kao Chin Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 70403, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 70403, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 70403, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
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Huang CL, Yang YK, Chu CL, Lee IH, Yeh TL, Chen PS, Chiu NT. The association between the Lie scale of the Maudsley personality inventory and striatal dopamine D2/D3 receptor availability of healthy Chinese community subjects. Eur Psychiatry 2020; 21:62-5. [PMID: 16137865 DOI: 10.1016/j.eurpsy.2005.05.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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] [Received: 08/19/2004] [Accepted: 05/17/2005] [Indexed: 11/16/2022] Open
Abstract
AbstractThe present study examined the relationship between the Lie scale scores and striatal D2/D3 receptor availability with respect to the cerebellum in 42 healthy community volunteers in Taiwan using single photon emission computed tomography (SPECT) with [123I]iodo-benzoaminde (IBZM). Even after controlling of age and educational level, subjects' Lie scale scores of the Maudsley personality inventory correlate negatively with D2/D3 receptor availability. Individual with higher Lie scale scores may have higher impulsivity due to lower dopaminergic availability.
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Affiliation(s)
- Chieh Liang Huang
- Department of Psychiatry, China Medical University and Hospital, Taichung, Taiwan, ROC
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Hsiao CY, Tsai HC, Chi MH, Chen KC, Chen PS, Lee IH, Yeh TL, Yang YK. The Association between Baseline Subjective Anxiety Rating and Changes in Cardiac Autonomic Nervous Activity in Response to Tryptophan Depletion in Healthy Volunteers. Medicine (Baltimore) 2016; 95:e3498. [PMID: 27175645 PMCID: PMC4902487 DOI: 10.1097/md.0000000000003498] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The aim of this study was to investigate the influence of serotonin on anxiety and autonomic nervous system (ANS) function; the correlation between subjective anxiety rating and changes of ANS function following tryptophan depletion (TD) in healthy volunteers was examined. Twenty-eight healthy participants, consisting of 15 females and 13 males, with an average age of 33.3 years, were recruited.Baseline Chinese Symptom Checklist-90-Revised and ANS function measurements were taken. TD was carried out on the testing day, and participants provided blood samples right before and 5 hours after TD. ANS function, somatic symptoms, and Visual Analogue Scales (VASs) were determined after TD. Wilcoxon signed rank test and Spearman ρ correlation were adapted for analyses of the results.The TD procedure reduced total and free plasma tryptophan effectively. After TD, the sympathetic nervous activity increased and parasympathetic nervous activity decreased. Baseline anxiety ratings positively correlated with post-TD changes in sympathetic nervous activity, VAS ratings, and physical symptoms. However, a negative correlation with post-TD changes in parasympathetic nervous activity was found.The change in ANS function after TD was associated with the severity of anxiety in healthy volunteers. This supports the fact that the effect of anxiety on heart rate variability is related to serotonin vulnerability. Furthermore, it also shows that the subjective anxiety rating has a biological basis related to serotonin.
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Affiliation(s)
- Chih Yin Hsiao
- From the Department of Psychiatry, National Cheng Kung University Hospital (CYH, HCT, MHC, KCC, PSC, IHL, TLY, YKY), College of Medicine; Addiction Research Center (CYH, KCC, PSC, IHL, TLY, YKY), National Cheng Kung University, Tainan; Department of Psychiatry (HCT, KCC, YKY), National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin; and Institute of Behavioral Medicine (YKY), College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Lin SH, Chen KC, Lee SY, Chiu NT, Lee IH, Chen PS, Yeh TL, Lu RB, Chen CC, Liao MH, Yang YK. The association between heroin expenditure and dopamine transporter availability--a single-photon emission computed tomography study. Psychiatry Res 2015; 231:292-7. [PMID: 25659472 DOI: 10.1016/j.pscychresns.2015.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 12/04/2013] [Revised: 05/16/2014] [Accepted: 01/11/2015] [Indexed: 11/25/2022]
Abstract
One of the consequences of heroin dependency is a huge expenditure on drugs. This underlying economic expense may be a grave burden for heroin users and may lead to criminal behavior, which is a huge cost to society. The neuropsychological mechanism related to heroin purchase remains unclear. Based on recent findings and the established dopamine hypothesis of addiction, we speculated that expenditure on heroin and central dopamine activity may be associated. A total of 21 heroin users were enrolled in this study. The annual expenditure on heroin was assessed, and the availability of the dopamine transporter (DAT) was assessed by single-photon emission computed tomography (SPECT) using [(99m)TC]TRODAT-1. Parametric and nonparametric correlation analyses indicated that annual expenditure on heroin was significantly and negatively correlated with the availability of striatal DAT. After adjustment for potential confounders, the predictive power of DAT availability was significant. Striatal dopamine function may be associated with opioid purchasing behavior among heroin users, and the cycle of spiraling dysfunction in the dopamine reward system could play a role in this association.
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Affiliation(s)
- Shih-Hsien Lin
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Kao Chin Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Sheng-Yu Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Nan Tsing Chiu
- Department of Nuclear Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Tzung Lieh Yeh
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Ru-Band Lu
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Chieh Chen
- Institute of Nuclear Energy Research, Atomic Energy Council, Executive Yuan, Taoyuan, Taiwan
| | - Mei-Hsiu Liao
- Institute of Nuclear Energy Research, Atomic Energy Council, Executive Yuan, Taoyuan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan.
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Tsai HC, Lin SH, Chen PS, Chang HH, Lee IH, Yeh TL, Chen KC, Chiu NT, Yao WJ, Liao MH, Yang YK. Quantifying midbrain serotonin transporter in depression: a preliminary study of diagnosis and naturalistic treatment outcome. Pharmacopsychiatry 2015; 48:58-64. [PMID: 25626060 DOI: 10.1055/s-0034-1396800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Serotonin may play an important role in the pathology of major depressive disorder (MDD). However, the relationship between serotonin transporter (SERT) availability and the medical outcome of antidepressant treatment is uncertain. METHODS In this naturalistic study, SERT availability (expressed as the specific uptake ratio, SUR) in the midbrain of 17 drug-free patients with MDD and 17 controls matched for age and gender was measured using SPECT with [(123)I]ADAM. The severity of MDD was measured by the Hamilton Depression Rating Scale before, and after 6 weeks of non-standardized antidepressant treatment. RESULTS A total of 12 patients completed the study. The SUR of the patients with MDD was significantly lower than that of the healthy controls. The SUR of SERT was not found to have a linear relationship with the treatment outcome; however, supplemental analysis found a curvilinear relationship between treatment outcome and the SUR of SERT. DISCUSSION The findings indicate that the SUR of SERT is lower in patients with MDD; however it did not predict treatment outcome in a linear fashion. Studies with larger sample sizes are required.
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Affiliation(s)
- H C Tsai
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - S-H Lin
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - P S Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - H H Chang
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I H Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - T L Yeh
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - K C Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - N T Chiu
- Department of Nuclear Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - W J Yao
- Department of Nuclear Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - M-H Liao
- Institute of Nuclear Energy Research, Atomic Energy Council, Executive Yuan, Taoyuan, Taiwan
| | - Y K Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Lee SY, Chen SL, Chang YH, Chen PS, Huang SY, Tzeng NS, Wang YS, Wang LJ, Lee IH, Wang TY, Yeh TL, Yang YK, Hong JS, Lu RB. The effects of add-on low-dose memantine on cytokine levels in bipolar II depression: a 12-week double-blind, randomized controlled trial. J Clin Psychopharmacol 2014; 34:337-43. [PMID: 24717258 DOI: 10.1097/jcp.0000000000000109] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [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: 12/11/2022]
Abstract
Memantine, a noncompetitive N-methyl-d-aspartate receptor antagonist with a mood-stabilizing effect, and an association between bipolar disorder and proinflammatory cytokine levels have been reported. Whether adding-on memantine would reduce cytokine levels and is more effective than valproic acid (VPA) alone in bipolar II disorder was investigated. A randomized, double-blind, controlled, 12-week study was conducted. Patients undergoing regular VPA treatments were randomly assigned to a group: VPA + memantine (5 mg/d) (n = 106) or VPA + placebo (n = 108). The Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) were used to evaluate clinical response. Symptom severity, plasma tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), IL-8, and IL-1 levels were examined during weeks 0, 1, 2, 4, 8, and 12. To adjust within-subject dependence over repeated assessments, multiple linear regressions with generalized estimating equation methods were used to examine the therapeutic effect. Tumor necrosis factor α levels were significantly lower in the VPA + memantine group than in the VPA + placebo group (P = 0.013). Posttreatment HDRS and YMRS scores decreased significantly in both groups, but not significant, nor was the other between-group cytokine level difference pretreatment and posttreatment. The HDRS score changes were significantly associated with IL-6 (P = 0.012) and IL-1 (P = 0.005) level changes and changes in YMRS score changes with TNF-α (P = 0.005) level changes. Treating bipolar II depression with VPA + memantine may improve the plasma TNF-α level. However, adding-on memantine may not improve clinical symptoms or cytokine levels other than TNF-α. Clinical symptoms may be correlated with certain cytokines.
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Affiliation(s)
- Sheng-Yu Lee
- From the *Department of Psychiatry, †Institute of Behavioral Medicine, and ‡Institute of Allied Health Sciences, College of Medicine and Hospital, National Cheng Kung University, Tainan; §Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei; ∥Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung; ¶Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan; #Addiction Research Center, National Cheng Kung University, Tainan, Taiwan; and **Laboratory of Toxicology and Pharmacology, NIH/NIEHS, Research Triangle Park, NC
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Hsieh PC, Chen KC, Yeh TL, Lee IH, Chen PS, Yao WJ, Chiu NT, Chen CC, Liao MH, Yang YK. Lower availability of midbrain serotonin transporter between healthy subjects with and without a family history of major depressive disorder - a preliminary two-ligand SPECT study. Eur Psychiatry 2014; 29:414-8. [PMID: 24439516 DOI: 10.1016/j.eurpsy.2013.11.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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: 08/12/2013] [Revised: 11/28/2013] [Accepted: 11/29/2013] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Serotonin transporter (SERT) and dopamine transporter (DAT) levels differ in patients with major depressive disorder (MDD) who are in a depressed state in comparison with healthy controls. In addition, a family history of depression is a potent risk factor for developing depression, and inherited vulnerability to serotonergic and dopaminergic dysfunction is suspected in this. The aim of this study was to examine the availabilities of midbrain SERT and striatal DAT in healthy subjects with and without a first-degree family history of MDD. METHODS Eight healthy subjects with first-degree relatives with MDD and 16 sex- and age-matched healthy controls were recruited. The availabilities of SERT and DAT were approximated using SPECT, employing [¹²³I] 2-((2-((dimethylamino) methyl) phenyl)thio)-5-iodophenylamine (ADAM) and [(⁹⁹m)Tc] TRODAT-1 as the ligands, respectively. There are missing data for one participant with a first-degree family history of MDD from the ADAM study, due to a lack of the radio-ligand at the time of experiment. RESULTS SERT availability in the midbrain was significantly lower in subjects with a first-degree family history of MDD than in healthy subjects. However, DAT availability was no different between two groups. CONCLUSIONS The results with regard to the midbrain SERT level suggest the heritability of MDD.
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Affiliation(s)
- P C Hsieh
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li road, North Dist., 70403 Tainan, Taiwan
| | - K C Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li road, North Dist., 70403 Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - T L Yeh
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li road, North Dist., 70403 Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - I H Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li road, North Dist., 70403 Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - P S Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li road, North Dist., 70403 Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - W J Yao
- Department of Nuclear Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - N-T Chiu
- Department of Nuclear Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - C-C Chen
- Institute of Nuclear Energy Research, Atomic Energy Council, Executive Yuan, Taoyuan, Taiwan
| | - M-H Liao
- Institute of Nuclear Energy Research, Atomic Energy Council, Executive Yuan, Taoyuan, Taiwan
| | - Y K Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138, Sheng Li road, North Dist., 70403 Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Wu JS, Yang YC, Lu FH, Lin TS, Chen JJ, Huang YH, Yeh TL, Chang CJ. Cardiac autonomic function and insulin resistance for the development of hypertension: a six-year epidemiological follow-up study. Nutr Metab Cardiovasc Dis 2013; 23:1216-1222. [PMID: 23419733 DOI: 10.1016/j.numecd.2013.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 12/27/2012] [Accepted: 01/04/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS To explore the impact of cardiac autonomic function (CAF) and insulin resistance (IR) on incident hypertension. METHODS AND RESULTS In 1996, 1638 subjects finished baseline examination, which included anthropometry, blood pressures, CAF, blood biochemistry, plasma insulin, urine examination and electrocardiogram. CAF included standard deviation of normal-to-normal intervals or RR intervals (SDNN), low- and high-frequency power spectrum (LF and HF), and LF/HF ratio at supine for 5 min, the RR interval changes during lying-to-standing maneuver, and the ratio between the longest RR interval during expiration and the shortest RR interval during inspiration (E/I ratio). We used homeostasis model assessment to define beta cell function (HOMA-B) and insulin resistance (HOMA-IR). In total, 992 non-hypertensive participants completed the follow-up assessment in 2003 and 959 participants were included for the final analysis. Incident hypertension was determined by blood pressure status at follow-up. In unadjusted model, both square root of HOMA-IR (OR:3.37, 95%CI: 2.10-6.64) and HOMA-B (OR:0.996, 95%CI: 0.992-0.999) were related to incident hypertension. In multivariate model, square root of HOMA-IR (OR:1.97, 95%CI: 1.05-3.70), but not HOMA-B, was associated with incident hypertension. After further adjustment for baseline CAF, the positive relationship between the square root of HOMA-IR and incident hypertension disappeared. In contrast, LF/HF ratio (OR:1.18, 95%CI: 1.01-1.37), HF power (OR:0.98, 95%CI: 0.96-0.999), and E/I ratio (OR:0.71, 95%CI: 0.54-0.95) were each independently associated with incident hypertension after further adjustment for HOMA measures. CONCLUSION Sympathovagal imbalance with an apparently decreased parasympathetic tone is an important predictor of incident hypertension independent of IR.
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Affiliation(s)
- J S Wu
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Taiwan, ROC; Department of Family Medicine, National Cheng Kung University Hospital, Taiwan, ROC
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Huang HY, Lee IH, Chen KC, Lin SH, Yeh TL, Chen PS, Chiu NT, Yao WJ, Chen CC, Liao MH, Yang YK. Serotonin transporter availability in the midbrain and perceived social support in healthy volunteers. J Psychosom Res 2013; 75:577-81. [PMID: 24290049 DOI: 10.1016/j.jpsychores.2013.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 12/28/2012] [Revised: 09/17/2013] [Accepted: 09/17/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Serotonin modulates human behavior and emotion. Recent evidence implies that a higher level of serotonergic activity could be associated with a higher level of perceived social support. This study aimed to examine the correlation between serotonin transporter (SERT) availability and perceived social support scores in healthy volunteers. METHODS 111 healthy participants, 50 males and 61 females, were enrolled from the community and completed the Measurement of Support Function questionnaire. Single photon emission computed tomography (SPECT) with [(123)I] ADAM was performed to examine SERT availability. RESULTS Perceived social support was positively correlated with SERT availability (Spearman's ρ=0.29, p<0.01; χ(2)=7.57, p<0.01), particularly in males (Spearman's ρ=0.37, p<0 .01; χ(2)=11.77, p<0.01). Censored regressions indicated that these associations are not influenced by a ceiling effect and remained significant after controlling the effect of age. CONCLUSIONS This result confirmed the correlation between perceived social support and central serotonergic activity. However, this correlation was present only in males.
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Affiliation(s)
- Hsiang Yu Huang
- Department of Psychiatry, Tainan Municipal Hospital, Tainan, Taiwan
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12
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Tsai HC, Lin SH, Lee IH, Chen PS, Chen KC, Yeh TL, Yao WJ, Chiu NT, Lu RB, Yang YK. Probing the association between dexamethasone-induced cortisol suppression and serotonin transporter availability among drug-free patients with major depressive disorder--a small-sample SPECT study with [¹²³I]ADAM. Psychoneuroendocrinology 2013; 38:2805-9. [PMID: 23816429 DOI: 10.1016/j.psyneuen.2013.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 07/11/2012] [Revised: 05/30/2013] [Accepted: 06/03/2013] [Indexed: 11/26/2022]
Abstract
The association between hypothalamo-pituitary-adrenal (HPA) axis function and the serotonergic system could be involved in the mechanism of depression. However, neuroimaging evidence is scarce. The aim of the present study was to probe the association between dexamethasone suppression test response and serotonin transporter (SERT) availability in drug-free patients with major depressive disorder (MDD). Seventeen MDD patients (five males and twelve females) were recruited. SPECT with [(123)I] ADAM was used to measure the midbrain SERT availability, and HPA axis function was measured by the dexamethasone suppression test (DST). The association was significant when considering all participants (ρ=0.69, p=0.002). This association may have clinical implications for the treatment of MDD.
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Affiliation(s)
- Hsin Chun Tsai
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Douliou Branch, Yunlin, Taiwan
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Lin SH, Chen KC, Lee SY, Hsiao CY, Lee IH, Yeh TL, Chen PS, Lu RB, Yang YK. The economic cost of heroin dependency and quality of life among heroin users in Taiwan. Psychiatry Res 2013; 209:512-7. [PMID: 23477899 DOI: 10.1016/j.psychres.2013.01.014] [Citation(s) in RCA: 14] [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: 09/30/2011] [Revised: 08/22/2012] [Accepted: 01/13/2013] [Indexed: 11/25/2022]
Abstract
Heroin dependence may cause an economic burden and has an impact on quality of life (QOL). However, assessments of economic cost are scarce and the relationship between economic cost and QOL is unclear in the Asian population. In the present study, an established questionnaire was modified to assess the economic cost and its association with QOL. A total of 121 volunteer subjects in a methadone maintenance therapy programme and 157 normal controls were enrolled. The total economic cost of heroin dependency is US$ 18,310 per person-year. The direct cost is US$ 11,791 per person-year (64% of the total cost), mostly consisting of the cost of heroin and other illegal drugs. The indirect cost is US$ 6519 (36% of the total cost) per person-year, most of which arises from productivity loss caused by unemployment and incarceration. The QOL of heroin-dependent patients is poorer than that of healthy controls in all domains. The overall QOL is negatively related to direct cost and total cost. The economic cost of heroin dependency is huge, equal to 1.07 times the average gross domestic product per capita. Reduction of the economic cost to society and the economic burden for heroin users is important.
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Affiliation(s)
- Shih-Hsien Lin
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
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14
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Wang TY, Lee SY, Chen SL, Huang SY, Chang YH, Tzeng NS, Wang CL, Hui Lee I, Yeh TL, Yang YK, Lu RB. Association between DRD2, 5-HTTLPR, and ALDH2 genes and specific personality traits in alcohol- and opiate-dependent patients. Behav Brain Res 2013; 250:285-92. [DOI: 10.1016/j.bbr.2013.05.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 05/03/2013] [Accepted: 05/07/2013] [Indexed: 10/26/2022]
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Wang TY, Lee SY, Chen SL, Chang YH, Chen SH, Chu CH, Huang SY, Tzeng NS, Wang CL, Yeh PH, Lee IH, Yeh TL, Yang YK, Lu RB. The ADH1B and DRD2 gene polymorphism may modify the protective effect of the ALDH2 gene against heroin dependence. Prog Neuropsychopharmacol Biol Psychiatry 2013; 43:134-9. [PMID: 23266708 DOI: 10.1016/j.pnpbp.2012.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 12/10/2012] [Accepted: 12/15/2012] [Indexed: 10/27/2022]
Abstract
Understanding the influences of genes involved in dopamine and serotonin metabolism, such as the aldehyde dehydrogenase 2 (ALDH2) and alcohol dehydrogenase 1B (ADH1B) genes, is critical for understanding addictive behavior. In addition, dopamine D2 receptor (DRD2) gene may also interact with the dopamine metabolizing genes and link to addiction. Therefore, we investigated the association between the ALDH2, ADH1B and DRD2 polymorphisms and heroin dependence. Heroin-dependent Han Chinese patients (n=304) and healthy controls (n=335) were recruited. Genotypes of ALDH2, ADH1B and DRD2 polymorphisms were analyzed using a polymerase chain reaction with restriction fragment length polymorphism. The frequency of the ALDH2*1/*1 genotype was significantly lower in heroin-dependent patients than in controls, but the frequency of ADH1B and DRD2 genotypes was not significantly different. Further stratification of the ALDH2 gene with the ADH1B gene showed that the protective effect of ALDH2*1/*1 existed only in patients who also carried the ADH1B*1/*1 and ADH1B*1/*2 genotype. Logistic regression analysis showed a significant interaction between ALDH2 and ADH1B (P=0.022) and DRD2, ALDH2 and ADH1B in patients (P=0.037). The ALDH2*1/*1, ADH1B*1/*1, and ADH1B*1/*2 genotypes may interact and protect their carriers against heroin dependence and the protective effect may be varied by the DRD2 gene polymorphism. We conclude that the protective effect of the ALDH2 polymorphism against heroin dependence may be modified by the ADH1B and DRD2 polymorphism.
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Affiliation(s)
- Tzu-Yun Wang
- Department of Psychiatry, National Cheng Kung University Hospital, Tainan, Taiwan
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Abstract
Various clinical issues are involved in the appropriate diagnosis and proper treatment interventions for patients with major depressive disorder (MDD). Despite a number of diverse antidepressants for treating MDD now, response and remission rates following adequate trials of antidepressant intervention are still not satisfactory. Furthermore, a significant proportion of MDD patients have residual symptoms, which are associated with increased relapse and recurrence of MDD, leading to negative impacts on the clinical course and outcomes of MDD. Timely and appropriate decision-making regarding the proper management of such cases is required in our routine daily practice. These issues are illustrated and also framed by one MDD case with a complicated clinical course. This review paper may give physicians clinical insight into how we can effectively and properly evaluate and manage such patients in clinical practice.
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Affiliation(s)
- Changsu Han
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
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Abstract
Major depressive disorder (MDD) is frequently unrecognized and underdiagnosed by clinicians and thus remains untreated or inappropriately treated in routine clinical practice. Although the symptoms of MDD are widely acknowledged and recognized by clinicians, numerous epidemiological studies have reported that this disorder is more prevalent than had previously been thought, and that it is challenging to diagnose and treat, particularly because somatic symptoms and comorbid conditions are common in real clinical situations. MDD is associated with increased morbidity and mortality as well as with higher healthcare costs and more severe functional impairment. Therefore, optimal treatment for MDD should include collaboration focussed on comorbid physical diseases, rehabilitation aimed at restoring social functioning, and pharmacotherapy designed to ensure complete remission including psychological and physical symptoms, as well as functional recovery.
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Affiliation(s)
- Soichiro Sato
- Zikei Hospital/Zikei Institute of Psychiatry, 100-2 Urayasuhonmachi, Southern Ward, Okayama City, Okayama, Japan.
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18
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Chen KC, Yang YK, Howes O, Lee IH, Landau S, Yeh TL, Chiu NT, Chen PS, Lu RB, David AS, Bramon E. Striatal dopamine transporter availability in drug-naive patients with schizophrenia: a case-control SPECT study with [(99m)Tc]-TRODAT-1 and a meta-analysis. Schizophr Bull 2013; 39:378-86. [PMID: 22156764 PMCID: PMC3576153 DOI: 10.1093/schbul/sbr163] [Citation(s) in RCA: 33] [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] [Indexed: 01/20/2023]
Abstract
Central dopaminergic hyperactivity has been one of the main hypotheses of the pathophysiology of schizophrenia since the 1970s. Excess dopamine (DA) neurotransmission in the striatum is hypothesized to alter the processing of information and result in psychotic symptoms in schizophrenia. Single photon emission computerized tomography (SPECT) provides in vivo indices of DA neurotransmission. Our study aimed to compare dopamine transporter (DAT) availability between drug-naive patients with schizophrenia and controls using SPECT. DAT availability through [(99m)Tc]-TRODAT-1 SPECT was compared between 47 drug-naive patients with recent-onset schizophrenia and 112 healthy controls. We also conducted a random-effects meta-analysis of the available literature synthesizing the results of 6 comparable published articles as well as our current data. The mean specific striatal binding showed a statistical trend for a reduction among the patients compared with controls (estimated difference = 0.071; 95% CI -0.01, 0.15; P = .08). There was an effect of gender, whereby females had a higher ratio of specific striatal binding than males. Age was negatively correlated with the ratio of specific striatal binding, both in patients and controls. The meta-analysis provided a pooled standardized effect size (Cohen's d) of -0.07 (95% CI -0.31, 0.18; P = .60) for the patient vs control comparison in TRODAT binding, with no evidence of heterogeneity between studies or publication bias. Our findings suggest that striatal DAT levels are not altered in the early stages of schizophrenia before medication is introduced. We identified gender differences and aging effects that could have significance for future studies.
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Affiliation(s)
| | - Yen Kuang Yang
- To whom correspondence should be addressed; tel: +886-6-2353535 ext. 5213, fax: +886-6-2759259, e-mail:
| | - Oliver Howes
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | | | - Sabine Landau
- Department of Biostatistics, Institute of Psychiatry, King’s College London, London, UK
| | | | - Nan Tsing Chiu
- Department of Nuclear Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National ChengKung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Ru Band Lu
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Anthony S. David
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Elvira Bramon
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
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Chang CT, Chang YH, Yung-Wei Wu J, Lee SY, Chen SL, Chen SH, Chu CH, See Chen P, Hui Lee I, Lieh Yeh T, Tzeng NS, Huang SY, Yang YK, Yang HF, Lu RB. Neuropsychological functions impairment in different subtypes of bipolar disorder with or without comorbid anxiety disorders. Psychiatry Res 2012; 200:246-51. [PMID: 22748188 DOI: 10.1016/j.psychres.2012.06.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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] [Received: 08/30/2011] [Revised: 06/01/2012] [Accepted: 06/10/2012] [Indexed: 01/27/2023]
Abstract
Bipolar disorder (BP) patients with comorbid anxiety disorders (ADs) showed more severe clinical characteristics and psychosocial function impairment, worse response to treatment, and more substance use than those without AD. However, few studies focus on differences in neuropsychological function between BP-I and BP-II and patients with and without AD. Seventy-nine BP patients in their interepisode state classified into four groups-BP-I without AD (BP-I(-AD)) (n=22), BP-I with AD (BP-I(+AD)) (n=20), BP-II without AD (BP-II(-AD)) (n=18), BP-II with AD (BP-II(+AD)) (n=19), and healthy controls (HC) (n=30)-were given neuropsychological tests. BP-I(+AD) patients did less well than BP-I(-AD) patients, but only in working memory. BP-II(+AD) patients did less well than the BP-II(-AD) patients in visual immediate memory, visual delayed memory, working memory, and psychomotor speed. BP-I(+AD) has limited effects on neuropsychological performance. However, significant effects were found only in BP-II(+AD) patients compared with BPII(-AD) patients. We hypothesized that comorbid AD worsens neuropsychological performance more in BP-II than in BP-I patients.
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Lee SY, Chen SL, Chen SH, Chu CH, Chang YH, Lin SH, Huang SY, Tzeng NS, Kuo PH, Lee IH, Yeh TL, Yang YK, Lu RB. Interaction of the DRD3 and BDNF gene variants in subtyped bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39:382-7. [PMID: 22877924 DOI: 10.1016/j.pnpbp.2012.07.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 07/19/2012] [Accepted: 07/25/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Bipolar disorder is a severe mental disorder with prominent genetic etiologic factors. Dopaminergic dysfunction has been implicated in the pathogenesis of bipolar disorder, which suggests that the dopamine D3 receptor gene (DRD3) is a strong candidate gene. The brain-derived neurotrophic factor (BDNF) gene has been implicated in the etiology of bipolar disorder. We examined the association between the BDNF Val66Met and DRD3 Ser9Gly polymorphisms with two subtypes of bipolar disorder: bipolar-I and -II. Because BDNF regulates DRD3 expression (1), we also examined possible interactions between these genes. METHODS We recruited 964 participants: 268 with bipolar-I, 436 with bipolar-II, and 260 healthy controls. The genotypes of the BDNF Val66Met and DRD3 Ser9Gly polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. RESULTS Logistic regression analysis showed a significant main effect for the Val/Val genotype of the BDNF Val66Met polymorphism (P=0.020), which predicted bipolar-II patients. Significant interaction effects for the BDNF Val66Met Val/Val genotype and both DRD3 Ser9Gly Ser/Ser and Ser/Gly genotypes were found only in bipolar-II patients (P=0.027 and 0.006, respectively). CONCLUSION We provide initial evidence that the BDNF Val66Met and DRD3 Ser9Gly genotypes interact only in bipolar-II disorder and that bipolar-I and bipolar-II may be genetically distinct.
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Affiliation(s)
- Sheng-Yu Lee
- Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan
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21
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Chen WT, Yeh TL, Lehti V, Cheng SH, Chu CL, Chen KC, Lee IH, Chen PS, Yang YK. Daily life events influence the results of the Dexamethasone Suppression Test in healthy women. Behav Med 2012; 38:49-53. [PMID: 22676630 DOI: 10.1080/08964289.2012.679327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 10/28/2022]
Abstract
Although the Dexamethasone Suppression Test (DST) plays an important role in psychosomatic research, confounding factors limit the sensitivity and specificity of the DST. The aim of this study was to investigate the relationship between the intensity of daily life stressors and DST results in healthy participants after controlling the confounding factors. The subjects of this study consisted of 75 healthy volunteers. The intensity of daily life events was assessed using the Taiwanese version of the Recent Life Change Questionnaire (RLCQ). Neuroticism was assessed using the Maudsley Personality Inventory (MPI). The Dexamethasone Suppression Test (DST) was also performed. The regression model showed that daily life events (RLCQ score) were correlated significantly with cortisol level on day 1 and D% only in women. This finding implies that daily life events should be considered as an independent variable in women in further studies when the DST is applied.
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Lee SY, Chen SL, Wang YS, Chang YH, Huang SY, Tzeng NS, Lee IH, Yeh TL, Yang YK, Lu RB. COMT and BDNF interacted in bipolar II disorder not comorbid with anxiety disorder. Behav Brain Res 2012; 237:243-8. [PMID: 23026378 DOI: 10.1016/j.bbr.2012.09.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 09/18/2012] [Accepted: 09/20/2012] [Indexed: 12/14/2022]
Abstract
Bipolar disorder (BP), especially bipolar II disorder (BP-II), is highly comorbid with anxiety disorder (AD). Monoaminergic dysfunction has been implicated in the pathogenesis of BP, it may be important to investigate genes such as the catechol-O-methyltransferase (COMT), involved in monoamine metabolism and brain-derived neurotrophic factor (BDNF) genes, modulating the monoamine system. We therefore examined the association of the COMT Val158Met and BDNF Val66Met polymorphisms with BP-II with and without comorbidity of AD, and possible interactions between these genes. Seven hundred and seventy-one participants were recruited: 314 with bipolar-II without AD, 117 with bipolar-II with AD, and 340 healthy controls. The genotypes of the COMT and BDNF polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. Logistic regression analysis showed a significant effect of the COMT and the BDNF polymorphisms, and a significant interaction effect for the Val/Val genotypes of the BDNF Val66Met polymorphism and the COMsT Val158Met Val/Met and Met/Met genotypes (P=0.007, 0.048) discriminated between BP-II without AD patients and controls. Our findings provide initial evidence that the COMT and BDNF genes interact in bipolar-II without AD. Our findings suggest the involvement of dopaminergic pathway in the pathogenesis of bipolar-II.
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Affiliation(s)
- Sheng-Yu Lee
- Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan
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Chen SL, Lee SY, Tao PL, Chang YH, Chen SH, Chu CH, Chen PS, Lee IH, Yeh TL, Yang YK, Hong JS, Lu RB. Dextromethorphan Attenuated Inflammation and Combined Opioid Use in Humans Undergoing Methadone Maintenance Treatment. J Neuroimmune Pharmacol 2012; 7:1025-33. [DOI: 10.1007/s11481-012-9400-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 09/03/2012] [Indexed: 01/28/2023]
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Chen SL, Lee SY, Chang YH, Chen SH, Chu CH, Tzeng NS, Lee IH, Chen PS, Yeh TL, Huang SY, Yang YK, Lu RB, Hong JS. Inflammation in patients with schizophrenia: the therapeutic benefits of risperidone plus add-on dextromethorphan. J Neuroimmune Pharmacol 2012; 7:656-64. [PMID: 22730040 PMCID: PMC3611097 DOI: 10.1007/s11481-012-9382-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 06/11/2012] [Indexed: 12/30/2022]
Abstract
UNLABELLED Increasing evidence suggests that inflammation contributes to the etiology and progression of schizophrenia. Molecules that initiate inflammation, such as virus- and toxin-induced cytokines, are implicated in neuronal degeneration and schizophrenia-like behavior. Using therapeutic agents with anti-inflammatory or neurotrophic effects may be beneficial for treating schizophrenia. One hundred healthy controls and 95 Han Chinese patients with schizophrenia were tested in this double-blind study. Their PANSS scores, plasma interleukin (IL)-1β, tumor necrosis factor-α (TNF-α) and brain-derived neurotrophic factor (BDNF) levels were measured before and after pharmacological treatment. Pretreatment, plasma levels of IL-1β and TNF-α were significantly higher in patients with schizophrenia than in controls, but plasma BDNF levels were significantly lower. Patients were treated with the atypical antipsychotic risperidone (Risp) only or with Risp+ dextromethorphan (DM). PANSS scores and plasma IL-1β levels significantly decreased, but plasma TNF-α and BDNF levels significantly increased after 11 weeks of Risp treatment. Patients in the Risp+ DM group showed a greater and earlier reduction of symptoms than did those in the Risp-only group. Moreover, Risp+ DM treatment attenuated Risp-induced plasma increases in TNF-α. Patients with schizophrenia had a high level of peripheral inflammation and a low level of peripheral BDNF. Long-term Risp treatment attenuated inflammation and potentiated the neurotrophic function but also produced a certain degree of toxicity. Risp+ DM was more beneficial and less toxic than Risp-only treatment. CLINICAL TRIAL REGISTRATION Protocol Record: HR-93-50; TRIAL REGISTRATION NUMBER NCT01189006; URL: http://www.clinicaltrials.gov.
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Affiliation(s)
- Shiou-Lan Chen
- Institute of Behavioral Medicine, University Hospital
- Department of Psychiatry, National Cheng Kung University Hospital
- Addiction Research Center, National Cheng Kung University
| | - Sheng-Yu Lee
- Department of Psychiatry, National Cheng Kung University Hospital
- Addiction Research Center, National Cheng Kung University
- Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan
| | - Yun-Hsuan Chang
- Institute of Behavioral Medicine, University Hospital
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University
| | - Shih-Heng Chen
- Department of Psychiatry, National Cheng Kung University Hospital
- Addiction Research Center, National Cheng Kung University
| | - Chun-Hsieh Chu
- Department of Psychiatry, National Cheng Kung University Hospital
- Addiction Research Center, National Cheng Kung University
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - I-Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital
- Addiction Research Center, National Cheng Kung University
| | - Po-See Chen
- Department of Psychiatry, National Cheng Kung University Hospital
- Addiction Research Center, National Cheng Kung University
| | - Tzung Lieh Yeh
- Department of Psychiatry, National Cheng Kung University Hospital
- Addiction Research Center, National Cheng Kung University
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yen-Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital
- Addiction Research Center, National Cheng Kung University
- Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan
| | - Ru-Band Lu
- Institute of Behavioral Medicine, University Hospital
- Department of Psychiatry, National Cheng Kung University Hospital
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University
- Addiction Research Center, National Cheng Kung University
- Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan
| | - Jau-Shyong Hong
- Neuropharmacology Section, Laboratory of Pharmacology and Chemistry, National Institute of Environmental Health Sciences/National Institutes of Health, Research Triangle Park, North Carolina, USA
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Lin SH, Chen KC, Lee SY, Yao WJ, Chiu NT, Lee IH, Chen PS, Yeh TL, Liao MH, Lu RB, Yang YK. The association between availability of serotonin transporters and time to relapse in heroin users: a two-isotope SPECT small sample pilot study. Eur Neuropsychopharmacol 2012; 22:647-50. [PMID: 22335891 DOI: 10.1016/j.euroneuro.2012.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 12/29/2011] [Accepted: 01/12/2012] [Indexed: 10/28/2022]
Abstract
Neuroimaging evidence supporting an association between either dopamine or serotonin and time to relapse of heroin users is limited. In this two-isotope SPECT small sample (N=9) pilot study, the relationship between the availability of serotonin transporter (SERT) and dopamine transporter (DAT) and the relapse of heroin users was investigated. A significant negative association between SERT availability and time to relapse among those who relapsed (N=7) was found.
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Affiliation(s)
- Shih-Hsien Lin
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Lee SY, Chen SL, Chang YH, Chu CH, Huang SY, Tzeng NS, Wang CL, Lin SH, Lee IH, Yeh TL, Yang YK, Lu RB. The ALDH2 and 5-HT2A genes interacted in bipolar-I but not bipolar-II disorder. Prog Neuropsychopharmacol Biol Psychiatry 2012; 38:247-51. [PMID: 22564712 DOI: 10.1016/j.pnpbp.2012.04.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [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: 02/14/2012] [Revised: 04/05/2012] [Accepted: 04/06/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Clarifying the similarities and differences between the two most common subtypes of bipolar disorder, bipolar-I and bipolar-II, is essential for improving our understanding of them. Because the serotonergic system has been implicated in the pathogenesis of bipolar disorder, it may be important to investigate genes such as the aldehyde dehydrogenase 2 (ALDH2) and serotonin 2A receptor genes, which are involved in metabolizing serotonin and encoding serotonin receptors. We examined the association of the ALDH2 and 5-HT2A-A1438G polymorphisms with bipolar I and II and possible interactions between these genes. METHODS One thousand forty-nine participants were recruited: 249 with bipolar-I, 456 with bipolar-II, and 344 healthy controls. The genotypes of the ALDH2 and 5HT2A-A1438G polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. RESULTS Logistic regression analysis showed a significant effect of the ALDH2 and the 5-HT2A-A1438G polymorphisms, and a significant interaction effect for the A/G genotypes of the 5-HT2A-A1438G polymorphism and the ALDH2*1*1 genotypes (p=0.004) discriminated between bipolar-I patients and controls without bipolar disorder. These polymorphisms, however, were not associated with bipolar-II disorder. LIMITATIONS The significant differences of age and gender between patients and controls limit the comparison, although statistical adjustments were made for them. CONCLUSION Our findings provide initial evidence that the ALDH2 and 5-HT2A genes interact in bipolar-I but not in bipolar-II disorder. Our findings suggest a unique genetic distinction between bipolar-I and bipolar-II.
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Affiliation(s)
- Sheng-Yu Lee
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Lu RB, Chen SL, Lee SY, Chang YH, Chen SH, Chu CH, Tzeng NS, Lee IH, Chen PS, Yeh TL, Huang SY, Yang YK, Hong JS. Neuroprotective and neurogenesis agent for treating bipolar II disorder: add-on memantine to mood stabilizer works. Med Hypotheses 2012; 79:280-3. [PMID: 22677298 PMCID: PMC3622707 DOI: 10.1016/j.mehy.2012.04.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 04/18/2012] [Accepted: 04/27/2012] [Indexed: 12/29/2022]
Abstract
Bipolar disorder, characterized by a dysregulation of mood, impulsivity, risky behavior and interpersonal problems, is a recurrent and often becomes chronic psychiatric illness. However, bipolar subtypes are not often recognized in psychiatric settings, especially bipolar II subtype, until Akiskal and Angst made clear definition to bipolar I (BP-I) and bipolar II (BP-II) disorder in 1999. More and more studies, not only on family inheritance, diagnosis, but also on disease process have been reported that BP-I and BP-II are two different disorders with distinct pathological mechanisms. In general, patients with BP-II express less symptoms and have shorter hypomania stages than BP-I. According to a longitudinal research, patients with BP-II have poor recovery than do BP-I patients. Memantine used to be recognized as a noncompetitive N-methyl-d-aspartate receptor antagonist. However, it was found to have neuroprotective and neurogenesis effect in several neurodegenerative diseases in the past years. We found that memantine could inhibit brain inflammatory response through its action on neuroglial cells and provide neurotrophic effect. The above evidences of benefit on auto-immune system with memantine would support that memantine as add-on therapy to valproate might be more effective than valproate alone on improvement of the neuron degeneration in bipolar disorders. Review articles indicate that not only the mood stabilizers provide with good neuroprotection, but the memantine also have conspicuous anti-autoimmune and neurogenesis effect. Therefore, we propose that drugs with neuroprotective effect and neurotrophic effect may treat neurodegenerative diseases including BP-II. The combination treatment of mood stabilizers memantine may not only augment and improve the remedy for bipolar disorders, but also repair the damaged neurons and neurogenesis through activation of astroglial cell and release of neurotrophic factors.
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Affiliation(s)
- Ru-Band Lu
- Department of Psychiatry, National Cheng Kung University Hospital & College of Medicine, National Cheng Kung University
- Institute of Behavioral Medicine, National Cheng Kung University
- Division of Clinical Psychology, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University
| | - Shiou-Lan Chen
- Department of Psychiatry, National Cheng Kung University Hospital & College of Medicine, National Cheng Kung University
- Institute of Behavioral Medicine, National Cheng Kung University
| | - Sheng-Yu Lee
- Institute of Behavioral Medicine, National Cheng Kung University
| | - Yun-Hsuan Chang
- Department of Psychiatry, National Cheng Kung University Hospital & College of Medicine, National Cheng Kung University
- Division of Clinical Psychology, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University
| | - Shih-Heng Chen
- Department of Psychiatry, National Cheng Kung University Hospital & College of Medicine, National Cheng Kung University
- Institute of Behavioral Medicine, National Cheng Kung University
| | - Chun-Hsieh Chu
- Department of Psychiatry, National Cheng Kung University Hospital & College of Medicine, National Cheng Kung University
- Institute of Behavioral Medicine, National Cheng Kung University
| | | | - I Hui Lee
- Institute of Behavioral Medicine, National Cheng Kung University
| | - Po See Chen
- Institute of Behavioral Medicine, National Cheng Kung University
| | - Tzung Lieh Yeh
- Department of Psychiatry, National Cheng Kung University Hospital & College of Medicine, National Cheng Kung University
- Institute of Behavioral Medicine, National Cheng Kung University
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, NIEHS/NIH, USA
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital & College of Medicine, National Cheng Kung University
- Institute of Behavioral Medicine, National Cheng Kung University
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Chen SL, Lee SY, Chang YH, Chen SH, Chu CH, Tzeng NS, Lee IH, Chen PS, Yeh TL, Huang SY, Yang YK, Lu RB, Hong JS. Erratum to: Inflammation in Patients with Schizophrenia: The Therapeutic Benefits of Risperidone Plus Add-On Dextromethorphan. J Neuroimmune Pharmacol 2012. [DOI: 10.1007/s11481-012-9389-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Wang TY, Lee SY, Chen SL, Chang YH, Chen SH, Chu CH, Huang SY, Tzeng NS, Wang CL, Lee IH, Yeh TL, Yang YK, Lu RB. Interaction between serotonin transporter and serotonin receptor 1 B genes polymorphisms may be associated with antisocial alcoholism. Behav Brain Funct 2012; 8:18. [PMID: 22550993 PMCID: PMC3583294 DOI: 10.1186/1744-9081-8-18] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Accepted: 05/02/2012] [Indexed: 11/29/2022] Open
Abstract
Background Several studies have hypothesized that genes regulating the components of the serotonin system, including serotonin transporter (5-HTTLPR) and serotonin 1 B receptor (5-HT1B), may be associated with alcoholism, but their results are contradictory because of alcoholism’s heterogeneity. Therefore, we examined whether the 5-HTTLPR gene and 5-HT1B gene G861C polymorphism are susceptibility factors for a specific subtype of alcoholism, antisocial alcoholism in Han Chinese in Taiwan. Methods We recruited 273 Han Chinese male inmates with antisocial personality disorder (ASPD) [antisocial alcoholism (AS-ALC) group (n = 120) and antisocial non-alcoholism (AS-N-ALC) group (n = 153)] and 191 healthy male controls from the community. Genotyping was done using PCR-RFLP. Results There were no significant differences in the genotypic frequency of the 5-HT1B G861C polymorphism between the 3 groups. Although AS-ALC group members more frequently carried the 5-HTTLPR S/S, S/LG, and LG/LG genotypes than controls, the difference became non-significant after controlling for the covarying effects of age. However, the 5-HTTLPR S/S, S/LG, and LG/LG genotypes may have interacted with the 5-HT1B G861C C/C polymorphism and increased the risk of becoming antisocial alcoholism. Conclusion Our study suggests that neither the 5-HTTLPR gene nor the 5-HT1B G861C polymorphism alone is a risk factor for antisocial alcoholism in Taiwan’s Han Chinese population, but that the interaction between both genes may increase susceptibility to antisocial alcoholism.
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Affiliation(s)
- Tzu-Yun Wang
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Huang CC, Chang YH, Lee SY, Chen SL, Chen SH, Chu CH, Huang SY, Tzeng NS, Lee IH, Yeh TL, Yang YK, Lu RB. The interaction between BDNF and DRD2 in bipolar II disorder but not in bipolar I disorder. Am J Med Genet B Neuropsychiatr Genet 2012; 159B:501-7. [PMID: 22514151 DOI: 10.1002/ajmg.b.32055] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 04/04/2012] [Indexed: 12/17/2022]
Abstract
Bipolar I (BP-I) and bipolar II (BP-II) disorders are the two most common subtypes of bipolar disorder. However, most studies have not differentiated bipolar disorder into BP-I and BP-II groups, for which the underlying etiology differentiating these two subtypes remains unclear. The genetic association between both subtypes is essential for improving our understanding. The dopamine D2 receptor/ankyrin repeat and kinase domain containing 1 (DRD2/ANKK1), one of the dopaminergic pathways, as well as the brain-derived neurotrophic factor (BDNF) gene, were reported as candidate genes in the etiology of bipolar disorder. Therefore, we examined the contribution of the BDNF and DRD2/ANKK1 genes and their interaction to the differentiation of BP-I and BP-II. Seven hundred ninety-two participants were recruited: 208 with BP-I, 329 with BP-II, and 255 healthy controls. The genotypes of the BDNF and DRD2/ANKK1 Taq1A polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. A significant main effect for the Val/Val genotype of the BDNF Val66Met polymorphism predicted BP-II patients. The significant interaction effect for the Val/Val genotype of the BDNF Val66Met polymorphism and A1/A2 genotype of DRD2/ANKK1 Taq1A polymorphism was found only in BP-II patients. We provide initial evidence that the BDNF Val66Me and DRD2/ANKK1 Taq1A polymorphisms interact only in BP-II disorder and that BP-I and BP-II are genetically distinct.
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Affiliation(s)
- Chih-Chun Huang
- Department of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
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Chang YH, Chen SL, Lee SY, Hsu YW, Wu JYW, Chen SH, Chu CH, Lee IH, Yeh TL, Tzeng NS, Huang SY, Yang YK, Lu RB. Neuropsychological functions in bipolar disorders I and II with and without comorbid alcohol dependence. Prog Neuropsychopharmacol Biol Psychiatry 2012; 37:211-6. [PMID: 22366071 DOI: 10.1016/j.pnpbp.2012.01.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [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: 06/20/2011] [Revised: 01/15/2012] [Accepted: 01/28/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Bipolar disorder (BP) is a mental disorder most likely to co-occur with substance dependence and abuse, especially alcohol dependence (ALD). Whether the effect of comorbid alcoholism is different between the BP-I and BP-II subtypes remains unclear. We aimed to identify the neuropsychological performance of BP patients with and without comorbid ALD in partial remission from depression or mania, and compare it with that of healthy controls (HCs). METHODS We recruited 29 HCs and 94 BP patients, whom we categorized into four groups: (1) BP-I without a history of alcohol abuse or dependence (BP-I(-ALD); n=22), (2) BP-II without a history of alcohol abuse and dependence (BP-II(-ALD); n=38), (3) BP-I with comorbid ALD (BP-I(+ALD); n=16), and (4) BP-II with comorbid ALD (BP-II(+ALD); n=18). Only males were recruited in this study. RESULTS When patients comorbid with ALD were not excluded, there were no significant differences on neuropsychological tests between the BP-I and BP-II groups. However, when patients with comorbid ALD were excluded, there were significant differences between the two BP(-ALD) groups. The BP-I(-ALD) group had lower scores on memory subtests (p≤0.01) than the HC and BP-II(-ALD) groups, but the BP-II(-ALD) and HC groups had similar scores. CONCLUSION We found it important to exclude ALD comorbidity when evaluating neuropsychological functions due to our finding that ALD affected the cognitive performance in BP-I more severely than in the BP-II group. ALD not only impairs neuropsychological function, but also worsen the clinical course and leads to a more pernicious status and negative cycle.
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Affiliation(s)
- Yun-Hsuan Chang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Chou CC, Lee IH, Yeh TL, Chen KC, Chen PS, Chen WT, Lu RB, Yang YK. Comparison of the validity of the Chinese versions of the Hypomania Symptom Checklist-32 (HCL-32) and Mood Disorder Questionnaire (MDQ) for the detection of bipolar disorder in medicated patients with major depressive disorder. Int J Psychiatry Clin Pract 2012; 16:132-7. [PMID: 22208673 DOI: 10.3109/13651501.2011.644563] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [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: 11/13/2022]
Abstract
OBJECTIVE The sensitivity and specificity of the Chinese versions of the Hypomania Symptom Checklist-32 (HCL-32) and Mood Disorder Questionnaire (MDQ) for detecting bipolar disorder in Taiwan were explored in this study. METHODS In total, 59 participants who were initially diagnosed with unipolar depression were recruited from an outpatient clinic and were screened for bipolar disorder using the HCL-32 and MDQ; each participant also underwent a diagnostic interview based on the Structured Clinical Interview for DSM-IV Axis disorder patients (SCID). RESULTS The results showed that the HCL-32 yielded the best combination of sensitivity (100%) and specificity (46.2%) at a cut-off point of 7/8, and the MDQ yielded the best combination of sensitivity (71.4%) and specificity (76.9%) at a cut-off point of 6/7. CONCLUSION The results of our study demonstrate that the HCL-32 and MDQ are of reasonable validity to distinguish between bipolar disorder and major depressive disorder. However small sample size may limit generalization of the results.
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Affiliation(s)
- Chia Chi Chou
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Lee SY, Chen SL, Chang YH, Chen SH, Chu CH, Huang SY, Tzeng NS, Wang CL, Lee IH, Yeh TL, Yang YK, Lu RB. The DRD2/ANKK1 gene is associated with response to add-on dextromethorphan treatment in bipolar disorder. J Affect Disord 2012; 138:295-300. [PMID: 22326841 DOI: 10.1016/j.jad.2012.01.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 01/18/2012] [Accepted: 01/18/2012] [Indexed: 11/30/2022]
Abstract
Dextromethorphan (DM) is a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist that may be neuroprotective for monoamine neurons. We hypothesized that adding DM to valproate (VPA) treatment would attenuate bipolar disorder (BP) symptoms. We evaluated in BP patients the association between the DRD2/ANKK1 TaqIA polymorphism with treatment response to VPA+add-on DM and to VPA+placebo. This double-blind, stratified, randomized study ran from January 2007 through December 2010. BP patients undergoing regular VPA treatments were randomly assigned to groups given either add-on DM (60 mg/day) (n=167) or placebo (n=83) for 12 weeks. The Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS) were used to evaluate clinical response. The genotypes of the DRD2/ANKK1 TaqIA polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. To adjust within-subject dependence over repeated assessments, multiple linear regression with generalized estimating equation methods was used to analyze the effects of the DRD2/ANKK1 TaqIA polymorphism on clinical performance. Both groups showed significantly decreased YMRS and HDRS scores after 12 weeks of treatment; the differences between groups were non-significant. Decreases in YMRS scores were greater in patients with the A1A1 (P=0.004) genotypes than with the A2A2 genotype. We conclude that the DRD2/ANKK1 TaqIA polymorphism influenced responses to DM by decreasing manic symptoms in BP patients.
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Affiliation(s)
- Sheng-Yu Lee
- Department of Psychiatry, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
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Chen KC, Lee IH, Yeh TL, Chiu NT, Chen PS, Yang YK, Lu RB, Chen CC. Schizotypy trait and striatal dopamine receptors in healthy volunteers. Psychiatry Res 2012; 201:218-21. [PMID: 22429746 DOI: 10.1016/j.pscychresns.2011.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [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: 09/29/2010] [Revised: 05/10/2011] [Accepted: 07/09/2011] [Indexed: 11/30/2022]
Abstract
Individuals with schizotypal features exhibit cognitive, perceptual and social deficits that are similar to but less prominent than those seen in patients with schizophrenia. Dopaminergic hyperactivity in the striatum has been related to the positive symptoms of schizophrenia, and brain-imaging studies of dopamine uptake in the striatum are thought to be linked to the pathophysiological mechanisms underlying schizophrenia. The aim of this study was to investigate whether the increased availability of striatal dopamine (DA) D(2/3) receptors is related to elevated levels of schizotypal features in healthy individuals. The Schizotypal Personality Questionnaire (SPQ) was administered to 55 healthy volunteers. The availability of their striatal DA D(2/3) receptors was analysed using [(123)I] iodobenzamide single photon emission computed tomography (SPECT). Although the SPQ total scores showed no correlation with the availability of total (left and right) striatal DA D(2) receptors, the SPQ disorganised subscale scores were positively correlated with the availability of right striatal DA D(2/3) receptors. Our findings demonstrated that the availability of striatal DA D(2/3) receptors may be associated with schizotypal features in healthy volunteers.
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Affiliation(s)
- Kao Chin Chen
- Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan
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Chiu NT, Lee BF, Yeh TL, Chen PS, Lee IH, Chen KC, Yang YK. Relationship between striatal dopamine transporter availability and sleep quality in healthy adults. Mol Imaging Biol 2012; 13:1267-71. [PMID: 20953736 DOI: 10.1007/s11307-010-0442-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Our previous study using (123)I-iodo-benzamide single photon emission computed tomography (SPECT) showed a positive relationship in healthy adults between striatal postsynaptic D(2)/D(3) receptor availability and sleep duration in good sleepers. To further investigate the role of dopamine (DA) in the sleep-wake cycle, we explored the correlation between presynaptic dopamine transporter (DAT) availability and sleep quality in healthy volunteers. METHODS A total of 83 healthy volunteers (33 males, 50 females; mean age, 34.62 years), including 39 good sleepers and 44 poor sleepers, were recruited. The sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Striatal DAT availability was determined by (99m)Tc-TRODAT-1 SPECT, and the DAT availability in the good and poor sleepers was compared. Furthermore, the correlation between PSQI and DAT availability was analyzed. RESULTS There was no significant difference in DAT availability between the good and poor sleepers. No significant relationship was found between the global score or individual-component PSQI scores and DAT availability in the good sleepers. However, the sleep duration component score in the poor sleepers negatively correlated with DAT availability in the caudate (ρ = -0.31, P = 0.049). CONCLUSIONS The study demonstrates that healthy poor sleepers, with a lower DAT availability in the caudate, sleep for a shorter length of time. This suggests that a decrease in DA reuptake due to reduced DAT availability causes a shorter sleep duration in poor sleepers.
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Affiliation(s)
- Nan-Tsing Chiu
- Department of Nuclear Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Lu YA, Lee SY, Chen SL, Chen SH, Chu CH, Tzeng NS, Huang SY, Kuo PH, Wang CL, Lee IH, Yeh TL, Yang YK, Lu RB. Gene-temperament interactions might distinguish between bipolar I and bipolar II disorders: a cross-sectional survey of Han Chinese in Taiwan. J Clin Psychiatry 2012; 73:339-45. [PMID: 22152117 DOI: 10.4088/jcp.10m06330] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 12/16/2010] [Indexed: 10/15/2022]
Abstract
BACKGROUND Whether bipolar II disorder is a distinct disorder or simply a milder form of bipolar I disorder has been debated. Family, twin, and adoption studies provide robust evidence of genetic contributions to bipolar disorder, and heritable temperaments are also believed to contribute to the susceptibility to bipolar disorders. In this study, we sought to clarify the relationship between bipolar I and bipolar II disorder. METHOD In this cross-sectional survey, 314 participants (82 bipolar I disorder patients, 121 bipolar II disorder patients, and 111 healthy controls) completed the Hamilton Depression Rating Scale, the Young Mania Rating Scale, and the Tridimensional Personality Questionnaire, which assessed the personality dimensions of novelty seeking and harm avoidance. We also determined which participants carried the serine-to-glycine substitution at amino acid position 9 polymorphism of the dopamine D3 receptor gene (DRD3) and the serotonin transporter gene-linked polymorphic region (5-HTTLPR) genotypes. All patients met the DSM-IV-TR diagnosis criteria for bipolar disorder. This study was conducted from September 2005 to July 2009 at National Cheng Kung University Hospital, Tainan, Taiwan, and Tri-Service General Hospital, Taipei, Taiwan. RESULTS Binary logistic regression analysis showed significant main effects for the 5-HTTLPR polymorphism (P = .045), novelty seeking (P = .022), and harm avoidance (P = .017) scores and a significant interaction effect between harm avoidance and 5-HTTLPR genotypes (P = .042) in distinguishing between bipolar I and bipolar II disorder patients. Bipolar I disorder patients with the long allele at 5-HTTLPR had lower harm avoidance scores than did bipolar II disorder patients (bipolar I disorder = 16.23, bipolar II disorder = 19.80; P = .023); however, the difference was not significant after multiple test correction. All these data suggest a distinction between bipolar I and bipolar II disorder. CONCLUSIONS We provide initial evidence that 5-HTTLPR genotypes might moderate the association between harm avoidance and bipolar I and bipolar II disorder. There appear to be unique differences in the gene-temperament interactions of bipolar I and bipolar II disorder patients.
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Affiliation(s)
- Yi-Ann Lu
- Institute of Behavioral Medicine, National Cheng Kung University, Tainan, Taiwan
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Yeh TL, Chen KC, Lin SH, Lee IH, Chen PS, Yao WJ, Lee SY, Yang YK, Lu RB, Liao MH, Chiu NT. Availability of dopamine and serotonin transporters in opioid-dependent users--a two-isotope SPECT study. Psychopharmacology (Berl) 2012; 220:55-64. [PMID: 21881874 DOI: 10.1007/s00213-011-2454-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 08/10/2011] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVE The aims of this study were to examine the differences between 32 opioid-dependent users treated with a very low dose of methadone or undergoing methadone-free abstinence and 32 controls. METHODS SPECT analysis using [(99m)Tc] TRODAT-1 to assess striatal dopamine transporter (DAT) availability and [(123)I] ADAM to assess midbrain serotonin transporter (SERT) availability were performed. RESULTS Lower striatal DAT and midbrain SERT availabilities were noted in low-dose methadone users. History of metamphatamine use was associated with the lower striatal DAT. The striatal DAT of methadone-free abstainers was also lower than controls. The midbrain SERT availability tended to be higher in the methadone-free abstainers than the low-dose methadone users. The severity of depressive symptoms was negatively correlated with midbrain SERT availability in the opioid users. CONCLUSION The availability of striatal DAT tended to be, and the availability of midbrain SERT was, lower in the opioid users. History of metamphatamine use may confound the difference in straital DAT between controls and opioid users, as midbrain SERT and depressive symptoms are also associated with opioid use and abstinence.
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Affiliation(s)
- Tzung Lieh Yeh
- Department of Psychiatry, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan, 704, Taiwan
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Chou MH, Chen KC, Yeh TL, Lee IH, Yao WJ, Chen PS, Chang KW, Liao MH, Yang YK. Association between somatization subscale score and serotonin transporter availability in healthy volunteers--a single photon emission computed tomography study with [¹²³I] ADAM. Psychopharmacology (Berl) 2012; 219:1011-6. [PMID: 21845388 DOI: 10.1007/s00213-011-2431-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 07/27/2011] [Indexed: 12/21/2022]
Abstract
RATIONALE AND OBJECTIVE Serotonin is one of the key neuromodulators involved in fundamental cerebral functions and behaviors. Previous study has demonstrated that somatization symptoms are probably associated with central serotonergic circuits, which are implicated in anxiety and nociception regulation. This study aims to examine the correlation between somatization subscale score and serotonin transporter (SERT) availability in healthy volunteers. METHODS Sixty-four healthy participants, 26 males and 38 females, were enrolled from the community and were administered the single somatization subscale of the Chinese symptom checklist 90 revised (SCL90-R). Single photon emission computed tomography with [(123)I] 2-((2-((dimethylamino)methyl)phenyl)thio)-5-iodophenylamine was also performed to examine SERT availability. RESULTS The somatization scores were negatively correlated with SERT availability (Spearman's ρ = -0.35, p = 0.005), particularly in males (Spearman's ρ = -0.54, p = 0.004). CONCLUSION This result reconfirmed the correlation between central serotonergic activity and the intensity of somatization symptoms, even in healthy participants. However, a gender difference exists in this correlation.
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Affiliation(s)
- Ming Hui Chou
- Department of Psychiatry, National Cheng Kung University Hospital, Tainan, Taiwan
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Chang YH, Chen SL, Chen SH, Chu CH, Lee SY, Yang HF, Tzeng NS, Lee IH, Chen PS, Yeh TL, Huang SY, Chou KR, Yang YK, Ko HC, Lu RB, Angst J. Low anxiety disorder comorbidity rate in bipolar disorders in Han Chinese in Taiwan. Prog Neuropsychopharmacol Biol Psychiatry 2012; 36:194-7. [PMID: 21996277 DOI: 10.1016/j.pnpbp.2011.09.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [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] [Received: 07/29/2011] [Revised: 09/27/2011] [Accepted: 09/28/2011] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Studies report high comorbidity of lifetime anxiety disorders with bipolar disorders in Western patients, but it is unclear in Taiwan. The authors explored the comorbidity of anxiety disorders in different bipolar disorder subtypes in Han Chinese in Taiwan. METHODS Three hundred twenty-five patients with bipolar disorder (bipolar I: 120; bipolar II: 205) disorder were recruited from two general medical outpatient services. They were evaluated and their diagnoses confirmed by a psychiatrist using the Chinese version of the Modified Schedule of Affective Disorder and Schizophrenia-Lifetime. The exclusion criteria were: any DSM-IV-TR Axis I diagnosis, other than bipolar disorder, being outside the 18-65-year-old age range, any other major and minor mental illnesses except anxiety disorder, any neurological disorders or organic mental disorders. RESULTS Thirty-two (26.7%) of patients were comorbid with lifetime anxiety disorder and bipolar I, 80 (39.0%) with lifetime anxiety disorder and bipolar II, 7 (5.8%) were comorbid with two or more anxiety disorders and bipolar I, and 27 (13.2%) with two or more anxiety disorders and bipolar II. CONCLUSION That more than twice as many bipolar II than bipolar I patients reported two or more anxiety disorders implies that the complication is more prevalent in bipolar II patients.
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Affiliation(s)
- Yun-Hsuan Chang
- Division of Clinical Psychology, Institute of Allied Health Sciences, Department of Psychiatry, College of Medicine, National Cheng Kung University, and National Cheng Kung University Hospital, Tainan, Taiwan
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Wang TY, Lee SY, Chen SL, Chen SH, Chu CH, Huang SY, Tzeng NS, Chang YH, Wang CL, Lee IH, Yeh TL, Yang YK, Lu RB. The aldehyde dehydrogenase 2 gene is associated with heroin dependence. Drug Alcohol Depend 2012; 120:220-4. [PMID: 21723677 DOI: 10.1016/j.drugalcdep.2011.06.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 06/03/2011] [Accepted: 06/07/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Determining the influences of genes involved in metabolizing dopamine and encoding dopamine receptors, such as the aldehyde dehydrogenase 2 (ALDH2) and dopamine D2 receptor/ankyrin repeat and kinase domain containing 1 (DRD2/ANKK1) genes, is critical for understanding addictive behavior. Therefore, we investigated the association between the ALDH2 and DRD2/ANKK1 Taq IA polymorphisms and heroin dependence. METHODS Heroin-dependent Han Chinese patients (250) and healthy controls (312) were recruited. ALDH2 and DRD2/ANKK1 Taq IA polymorphisms were genotyped. RESULTS The frequency of ALDH2*1/*2 and *2/*2 genotypes was significantly higher in heroin-dependent patients than in controls, but the frequency of DRD2 Taq IA genotypes was not significantly different. Logistic regression analysis showed no significant interaction between ALDH2 and DRD2 Taq IA genotypes in patients. CONCLUSIONS The ALDH2 polymorphism, but not the DRD2, was associated with heroin dependence.
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Affiliation(s)
- Tzu-Yun Wang
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Wu HI, Chang YH, Lai CC, Wu JYW, Chen SL, Chu CH, Lee IH, Yeh TL, Tzeng NS, Huang SY, Yang YK, Lu RB. The effect of comorbid anxiety disorder on neuropsychological function in bipolar II disorder. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1841-5. [PMID: 21839796 DOI: 10.1016/j.pnpbp.2011.07.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [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] [Received: 01/25/2011] [Revised: 06/22/2011] [Accepted: 07/27/2011] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Bipolar disorder (BP) is often comorbid with anxiety disorder (ANX), especially in bipolar II disorder (BP-II). BP patients with comorbid ANX often manifest intensified symptoms and harmful dysfunctions. However, most studies have focused on bipolar I disorder (BP-I); few have investigated the effect of comorbid ANX on the neuropsychological function of BP-II patients. We examined neuropsychological functions in BP-II patients with and without comorbid ANX. METHODS Fifty-nine participants were recruited: 20 patients with interepisode (symptom-free) BP-II without comorbid ANX, 20 with interepisode BP-II with comorbid ANX, and 19 healthy controls. All participants were screened using the Chinese version of the Modified Schedule of Affective Disorder and Schizophrenia-Lifetime (SADS-L). Individuals comorbid with major or minor mental illness other than BP-II were excluded. Comparisons were made between the three groups using neuropsychological tests to assess memory, attention, psychomotor speed, and frontal executive function. RESULTS BP-II patients with comorbid ANX showed poorer neuropsychological functions than those in the BP-II-only and control groups. Additionally, BP-II-only patients and controls showed equal cognitive performance. CONCLUSIONS Because BP-II patients with comorbid ANX had the lowest scores in the majority of neuropsychological functional tests, we conclude that they have greater cognitive impairments than do BP-II patients without comorbid ANX. Neuropsychological dysfunctions seemed more strongly associated with ANX than with BP-II in interepisode periods. Identifying and managing ANX comorbidity is critical when treating BP-II patients.
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Affiliation(s)
- Hsin-I Wu
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Lee SY, Chen SL, Chen SH, Huang SY, Tzeng NS, Chang YH, Wang CL, Lee IH, Yeh TL, Yang YK, Lu RB. The COMT and DRD3 genes interacted in bipolar I but not bipolar II disorder. World J Biol Psychiatry 2011; 12:385-91. [PMID: 20698735 DOI: 10.3109/15622975.2010.505298] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES. Clarifying the association between bipolar I and bipolar II disorders at the genetic level is essential for improving our understanding of them. In this study, we evaluated the hypothesis that the dopaminergic polymorphisms are risk factors for bipolar disorders. We examined the association between the catechol-O-methyltransferase (COMT) Val158Met and dopamine D3 receptor (DRD3) Ser9Gly polymorphisms and bipolar I and II disorders, as well as possible interactions between these genes. METHODS. Seven hundred and eleven participants were recruited: 205 with bipolar I, 270 with bipolar II, and 236 healthy controls. The genotypes of the COMT Val158Met and DRD3 Ser9Gly polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. RESULTS. Logistic regression analyses showed a statistically significant main effect for the Met/Met genotype of the COMT Val158Met polymorphism (P=0.032) and a significant interaction effect for the Met/Met genotype of the COMT Val158Met and Ser/Ser genotypes of the DRD3 Ser9Gly polymorphism (P=0.001) predicted bipolar I patients. However, there was no association between the COMT Val158Met or DRD3 Ser9Gly and bipolar II. CONCLUSIONS. We provide initial evidence that the COMT Val158Met and DRD3 Ser9Gly genotypes interact in bipolar I and bipolar II disorders and that bipolar I and bipolar II are genetically distinct.
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Affiliation(s)
- Sheng-Yu Lee
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Chen PS, Yeh TL, Lee IH, Lin CB, Tsai HC, Chen KC, Chiu NT, Yao WJ, Yang YK, Chou YH. Effects of C825T polymorphism of the GNB3 gene on availability of dopamine transporter in healthy volunteers — A SPECT study. Neuroimage 2011; 56:1526-30. [DOI: 10.1016/j.neuroimage.2010.10.082] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 09/30/2010] [Accepted: 10/30/2010] [Indexed: 10/18/2022] Open
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Lee IH, Yang YK, Chen PS, Huang HC, Yeh TL, Lu RB, Chiu NT, Yao WJ, Lin SH. Loudness dependence of auditory evoked potentials (LDAEP) correlates with the availability of dopamine transporters and serotonin transporters in healthy volunteers-a two isotopes SPECT study. Psychopharmacology (Berl) 2011; 214:617-24. [PMID: 21072504 DOI: 10.1007/s00213-010-2064-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [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] [Received: 06/07/2010] [Accepted: 10/18/2010] [Indexed: 11/27/2022]
Abstract
RATIONALE AND OBJECTIVE Although loudness dependence of auditory evoked potentials (LDAEPs) had been suggested as a noninvasive measure of central serotonin functions, recent studies suggest that LDAEP may be modulated by multiple neuromodulatory systems, such as dopamine. Here, we explore the relationship between LDAEP and dopamine and serotonin in the level of monoamine transporter availability. METHODS Forty-nine healthy volunteers received LDAEP and single-photon emission computed tomography (SPECT) using [(99m)Tc] TRODAT and [(123)I] ADAM to approximate the availability of dopamine transporters (DATs) and serotonin transporters (SERTs). RESULTS LDAEP was found to be positively associated with DAT, after adjusting for age and gender, and the log-transformed slope of loudness dependence at Cz was negatively associated with SERT. CONCLUSION Our findings provide further evidence for the possible involvement of dopamine and serotonins in the genesis of LDAEP.
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Affiliation(s)
- I Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan, 70428, Taiwan, Republic of China.
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Wang HC, Yeh TL, Chang HH, Gean PW, Chi MH, Yang YK, Lu RB, Chen PS. TPH1 is associated with major depressive disorder but not with SSRI/SNRI response in Taiwanese patients. Psychopharmacology (Berl) 2011; 213:773-9. [PMID: 20945066 DOI: 10.1007/s00213-010-2034-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [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: 03/21/2010] [Accepted: 09/24/2010] [Indexed: 01/18/2023]
Abstract
RATIONALE Tryptophan hydroxylase 1 (TPH1), which encodes the rate-limiting enzyme tryptophan hydroxylase in the biosynthesis of serotonin, is a candidate gene in the development and treatment response of major depressive disorder (MDD); however, its actual role is uncertain. OBJECTIVES We aimed to compare the allele frequencies of TPH1 in MDD patients and healthy controls in Taiwan, and also to investigate the association between TPH1 A218C and treatment response to either fluoxetine or venlafaxine in a Taiwanese population with MDD. METHODS One hundred five healthy controls and 115 outpatients diagnosed with MDD were recruited and genotyped for the TPH1 218A/C (rs1800532) polymorphism. Patients were randomized into either the fluoxetine or venlafaxine treatment group. The 21-item Hamilton rating scale for depression (HAM-D) was administered to evaluate depressive symptoms at baseline and bi-weekly over 6 weeks of treatment. RESULTS The TPH1 218A/C allele frequencies differed significantly between healthy controls and MDD patients in Taiwan, with a higher prevalence of the A allele in the patient group (p = 0.025). The odds ratio of the A allele to the C allele was 0.507 for the subjects with MDD. There was no significant correlation between the percentage change in HAM-D score and either TPH1 218A/C genotype or TPH1 allele frequencies. CONCLUSIONS This study indicated that the TPH1 218A/C genotype and allele frequencies differed between the Taiwanese healthy controls and MDD patients but could not be used to predict treatment outcome in Taiwanese MDD patients. Further research with larger sample sizes is needed to confirm the role of TPH1 218A/C.
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Affiliation(s)
- Hsuan-Chi Wang
- Department of Psychiatry, Hospital and College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Hueng TT, Lee IH, Guog YJ, Chen KC, Chen SS, Chuang SP, Yeh TL, Yang YK. Is a patient-administered depression rating scale valid for detecting cognitive deficits in patients with major depressive disorder? Psychiatry Clin Neurosci 2011; 65:70-6. [PMID: 21265938 DOI: 10.1111/j.1440-1819.2010.02166.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [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: 11/30/2022]
Abstract
AIMS Although cognitive deficits are a common and potentially debilitating feature of major depressive disorder (MDD), such subjective declines in cognitive function are seldom validated by objective methods as a clinical routine. The aim of this study was to validate the Taiwanese Depression Questionnaire (TDQ) for detecting cognitive deficits in a sample of drug-free patients with MDD. METHODS The subjects consisted of 40 well-characterized medication-free patients with MDD and 40 healthy controls. Clinical and neuropsychological assessments, including the Wisconsin Card Sorting Test, the Wechsler Memory Scale-Revised, the Continuous Performance Test, and the Finger-Tapping Test, were administered at the time of recruitment. RESULTS Factor analyses of the TDQ yielded three factors. Memory, attention and psychomotor performance were significantly poorer in patients with MDD. The performances of verbal and delayed memory of the Wechsler Memory Scale-Revised were correlated with the cognitive domains of the TDQ. Generalization of our results must be undertaken with caution considering the relatively small sample size, which could lead to increased β-error. CONCLUSION Cognitive subdomains might be considered important for including in patient-administered questionnaires used to measure symptoms of MDD when developing a new scale.
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Affiliation(s)
- Tieng-Ts Hueng
- Department of Psychiatry, Zuoying Armed Forces General Hospital, Kaohsiung, Taiwan
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Shan C, Lee SY, Chang YH, Wu JYW, Chen SL, Chen SH, Hsiao YL, Yang HF, Lee IH, Chen PS, Yeh TL, Yang YK, Lu RB. Neuropsychological functions in Han Chinese patients in Taiwan with bipolar II disorder comorbid and not comorbid with alcohol abuse/alcohol dependence disorder. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:131-6. [PMID: 20951757 DOI: 10.1016/j.pnpbp.2010.10.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [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: 06/04/2010] [Revised: 08/30/2010] [Accepted: 10/08/2010] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Studies exploring neuropsychological functions of bipolar disorder (BP) specifically include patients comorbid with alcohol abuse (AB), alcohol dependence (AD), or both (AB/AD). Contradictory assessments of neuropsychological impairment may be caused by not excluding the confounding effects of comorbid AB/AD. Most of the literature discusses BP without subtyping, which overlooks that BP-II may be a valid diagnosis different from BP-I. Because neuropsychological functions are involved in overall BP-II outcomes, we hypothesized that the neuropsychological functions of patients with BP-II comorbid with AD (BP(+AD)) are significantly different from and more impaired than those of patients with BP-II not comorbid with AD (BP(-AD)). METHODS Using DSM-IV criteria, the study included 69 patients with BP-II (19 with BP(+AD); 28 with BP(-AD)) and 22 healthy controls compared using a battery of neuropsychological tests that assessed memory, psychomotor speed, and certain aspects of frontal executive function. All BP-II patients were in an inter-episode period (a period of remission between states of mania, hypomania, and depression). RESULTS BP(+AD) patients had lower scores than did BP(-AD) patients and controls in verbal memory, visual memory, attention, psychomotor speed, and executive function. Working memory was poorer for BP(+AD) than BP(-AD) patients and for both BP groups than for controls. CONCLUSIONS BP(+AD) patients manifested wide neuropsychological dysfunctions, and BP(-AD) patients showed a reduction in working memory, which suggested that working memory might be related to a history of BP-II. Neuropsychological dysfunctions seemed more strongly associated with AB/AD than with BP-II in inter-episode periods.
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Affiliation(s)
- Cindy Shan
- Institute of Behavioral Medicine, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan
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Hsieh PC, Lee IH, Yeh TL, Chen KC, Huang HC, Chen PS, Yang YK, Yao WJ, Lu RB, Chiu NT. Distribution volume ratio of serotonin and dopamine transporters in euthymic patients with a history of major depression - a dual-isotope SPECT study. Psychiatry Res 2010; 184:157-61. [PMID: 21030217 DOI: 10.1016/j.pscychresns.2010.09.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 08/06/2010] [Accepted: 09/07/2010] [Indexed: 10/18/2022]
Abstract
Serotonin transporter (SERT) and dopamine transporter (DAT) levels differ in patients with major depression who are in a depressed state in comparison with healthy controls. The aim of this study was to examine the distribution volume ratios (DVRs) of SERT and DAT in drug-free and euthymic patients with a history of major depression. Subjects comprised 13 patients with a history of major depression and 26 sex- and age-matched healthy controls. The euthymic state of depression was defined as a score of 7 or less on the Hamilton Depression Rating Scale. The DVRs of SERT and DAT were approximated using SPECT, with [(123)I] 2-((2-((dimethylamino)methyl)phenyl)thio)-5-iodophenylamine (ADAM) and [(99m)Tc] TRODAT-1 as the ligands, respectively. There were no significant differences in the DVRs of SERT or DAT between healthy subjects and euthymic patients with a history of major depression; hence, the SERT and DAT DVRs may not therefore be trait markers for patients with major depression, which helps us to understand more about the pathophysiology of depression.
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Affiliation(s)
- Pei Chun Hsieh
- Department of Psychiatry, National Cheng Kung University Hospital, Tainan, Taiwan
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Huang HY, Lee IH, Chen KC, Yeh TL, Chen PS, Yang YK, Chiu NT, Yao WJ, Chen CC. Association of novelty seeking scores and striatal dopamine D₂/D₃ receptor availability of healthy volunteers: single photon emission computed tomography with ¹²³i-iodobenzamide. J Formos Med Assoc 2010; 109:736-9. [PMID: 20970071 DOI: 10.1016/s0929-6646(10)60119-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 06/22/2009] [Accepted: 09/06/2009] [Indexed: 11/17/2022] Open
Abstract
It has been speculated that novelty seeking (NS) behavior is related to the dopaminergic system. Fifty-two subjects completed the Tridimensional Personality Questionnaire and underwent single photon emission computed tomography with (123)I-iodobenzamide. A marginally positive correlation was noted between NS and striatal dopamine D(2)/D(3) receptor availability (r = 0.25, p =0.07). A positive association was noted between the NS scores and left striatal D(2)/D(3) receptor availability (r= 0.29, p =0.04). The results suggest that a relationship might exist between NS score and dopaminergic activity.
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Affiliation(s)
- Hsiang Yu Huang
- Department of Psychiatry, National Cheng Kung University Hospital, Tainan, Taiwan; Department of Psychiatry, Tainan Municipal Hospital, 138 Shen Li Road, Tainan, Taiwan
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Lin CI, Lee SY, Chang YH, Wu JYW, Wu YS, Wu PL, Chen HC, Chen SL, Lee IH, Yeh TL, Yang YK, Ko HC, Lu RB. Temperamentsxgenes in bipolar I and bipolar II disorder patients. Psychiatry Res 2010; 177:364-6. [PMID: 20399505 DOI: 10.1016/j.psychres.2010.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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: 04/03/2009] [Revised: 01/03/2010] [Accepted: 03/09/2010] [Indexed: 11/28/2022]
Abstract
We found the main effects of harm avoidance temperament in predicting bipolar I and II, but the interaction between novelty seeking and Ser9Gly polymorphisms of dopamine D3 receptor gene was demonstrated in bipolar-I patients only. This study provided evidence that differences existed between BP-I and BPII in gene and temperament interactions.
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Affiliation(s)
- Ching-I Lin
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, R.O.C
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