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Porta-Casteràs D, Vicent-Gil M, Serra-Blasco M, Navarra-Ventura G, Solé B, Montejo L, Torrent C, Martinez-Aran A, De la Peña-Arteaga V, Palao D, Vieta E, Cardoner N, Cano M. Increased grey matter volumes in the temporal lobe and its relationship with cognitive functioning in euthymic patients with bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2024; 132:110962. [PMID: 38365103 DOI: 10.1016/j.pnpbp.2024.110962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Bipolar disorder (BD) is characterized by episodic mood dysregulation, although a significant portion of patients suffer persistent cognitive impairment during euthymia. Previous magnetic resonance imaging (MRI) research suggests BD patients may have accelerated brain aging, observed as lower grey matter volumes. How these neurostructural alterations are related to the cognitive profile of BD is unclear. METHODS We aim to explore this relationship in euthymic BD patients with multimodal structural neuroimaging. A sample of 27 euthymic BD patients and 24 healthy controls (HC) underwent structural grey matter MRI and diffusion-weighted imaging (DWI). BD patient's cognition was also assessed. FreeSurfer algorithms were used to obtain estimations of regional grey matter volumes. White matter pathways were reconstructed using TRACULA, and four diffusion metrics were extracted. ANCOVA models were performed to compare BD patients and HC values of regional grey matter volume and diffusion metrics. Global brain measures were also compared. Bivariate Pearson correlations were explored between significant brain results and five cognitive domains. RESULTS Euthymic BD patients showed higher ventricular volume (F(1, 46) = 6.04; p = 0.018) and regional grey matter volumes in the left fusiform (F(1, 46) = 15.03; pFDR = 0.015) and bilateral parahippocampal gyri compared to HC (L: F(1, 46) = 12.79, pFDR = 0.025/ R: F(1, 46) = 15.25, pFDR = 0.015). Higher grey matter volumes were correlated with greater executive function (r = 0.53, p = 0.008). LIMITATIONS We evaluated a modest sample size with concurrent pharmacological treatment. CONCLUSIONS Higher medial temporal volumes in euthymic BD patients may be a potential signature of brain resilience and cognitive adaptation to a putative illness neuroprogression. This knowledge should be integrated into further efforts to implement imaging into BD clinical management.
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Affiliation(s)
- D Porta-Casteràs
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Vicent-Gil
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - M Serra-Blasco
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Programa eHealth ICOnnecta't, Institut Català d'Oncologia, Barcelona, Spain
| | - G Navarra-Ventura
- Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Son Espases University Hospital (HUSE), Palma (Mallorca), Spain; CIBERES, Carlos III Health Institute, Madrid, Spain
| | - B Solé
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - L Montejo
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - C Torrent
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - A Martinez-Aran
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - V De la Peña-Arteaga
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - D Palao
- Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - E Vieta
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - N Cardoner
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain.
| | - M Cano
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
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2
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Sun H, Yan R, Hua L, Xia Y, Huang Y, Wang X, Yao Z, Lu Q. Based on white matter microstructure to early identify bipolar disorder from patients with depressive episode. J Affect Disord 2024; 350:428-434. [PMID: 38244786 DOI: 10.1016/j.jad.2024.01.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVE Because of similar clinical manifestations, bipolar disorder (BD) patients are often misdiagnosed as major depressive disorder (MDD). This study aimed to compare the difference between depressed patients later converting to BD and unipolar depression (UD) according to diffusion tensor imaging (DTI). METHOD Patients with MDD (562 participants) in depressive episode states and healthy controls (HCs) (145 participants) were recruited over 10 years. Demographic and magnetic resonance imaging (MRI) data were collected at the time of recruitment. All patients with MDD were followed up for 5 years and classified into the transfer to BD (tBD) group (83 participants) and UD group (160 participants) according to the follow-up results. DTI and functional magnetic resonance imaging at baseline were compared. RESULTS Common abnormalities were found in both tBD and UD groups, including left superior cerebellar peduncle (SCP.L), right anterior limb of the internal capsule (ALIC.R), right superior fronto-occipital fasciculus (SFOF.R), and right inferior fronto-occipital fasciculus (IFOF.R). The tBD showed more extensive abnormalities than the UD in the body of corpus callosum, fornix, left superior corona radiata, left posterior corona radiata, left superior longitudinal fasciculus, and left superior fronto-occipital fasciculus. CONCLUSION The study demonstrated the common and distinct abnormalities of tBD and UD when compared to HC. The tBD group showed more extensive disruptions of white matter integrity, which could be a potential biomarker for the early identification of BD.
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Affiliation(s)
- Hao Sun
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China
| | - Rui Yan
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China
| | - Lingling Hua
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China
| | - Yi Xia
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China
| | - Yinghong Huang
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China
| | - Xiaoqin Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China
| | - Zhijian Yao
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing 210029, China; School of Biological Sciences and Medical Engineering, Southeast University, Nanjing 210096, China.
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing 210096, China.
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3
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Caruana GF, Carruthers SP, Berk M, Rossell SL, Van Rheenen TE. To what extent does white matter map to cognition in bipolar disorder? A systematic review of the evidence. Prog Neuropsychopharmacol Biol Psychiatry 2024; 128:110868. [PMID: 37797735 DOI: 10.1016/j.pnpbp.2023.110868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/19/2023] [Accepted: 10/01/2023] [Indexed: 10/07/2023]
Abstract
Cognitive impairment is a prominent feature of bipolar disorder (BD), however the neural substrates underpinning it remain unclear. Several studies have explored white matter as a correlate of cognitive functioning in BD cohorts, but mixed results and varied methodologies from one to another make inferences about this relationship difficult to draw. Here we sought to systematically synthesise the findings of these studies to more clearly explicate the nature and extent of relationships between white matter and cognition in BD and determine best practice methodologies and areas for future research in this area. Using PRISMA guidelines, we identified and systematically reviewed 37 relevant studies, all of which were cross-sectional by design. There was substantial methodological heterogeneity and variability in the clinical presentations of BD cohorts encapsulated within the studies we reviewed, which complicated our synthesis of the findings. Nonetheless, there was some evidence that cognition is related to both white matter macrostructure and microstructure in people with BD. In particular, multiple microstructural studies consistently reported that higher fractional anisotropy, both globally and in the corpus callosum, associated with better complex attention skills and executive functioning. However, several reports did not identify any associations at all, and in general, associations between WM and cognition tended to only be evident in studies utilising larger samples and post-hoc selection of WM regions of interest. Further research with increased statistical power and standardised methods are required moving forward.
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Affiliation(s)
- Georgia F Caruana
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria 3053, Australia
| | - Sean P Carruthers
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Victoria 3122, Australia
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong 3220, Australia; Centre for Youth Mental Health and Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Victoria 3052, Australia; Barwon Health, University Hospital Geelong, Victoria 3220, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Victoria 3052, Australia
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Victoria 3122, Australia; St Vincent's Mental Health, St Vincent's Hospital, VIC, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria 3053, Australia; Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Victoria 3122, Australia; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong 3220, Australia.
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Fan S, Asch RH, Davis MT, DellaGioia N, Cool R, Blumberg HP, Esterlis I. Preliminary Study of White Matter Abnormalities and Associations With the Metabotropic Glutamate Receptor 5 to Distinguish Bipolar and Major Depressive Disorders. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2024; 8:24705470231225320. [PMID: 38250007 PMCID: PMC10798116 DOI: 10.1177/24705470231225320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
Background Understanding distinct neurobiological mechanisms underlying bipolar disorder (BD) and major depressive disorder (MDD) is crucial for accurate diagnosis and the discovery of novel and more effective targeted treatments. Previous diffusion-weighted MRI studies have suggested some common frontotemporal corticolimbic system white matter (WM) abnormalities across the disorders. However, critical to the development of more precise diagnosis and treatment is identifying distinguishing abnormalities. Promising candidates include more prominent frontotemporal WM abnormalities observed in BD in the uncinate fasciculus (UF) that have been associated with frontal-amygdala functional dysconnectivity, and with suicide that is especially high in BD. Prior work also showed differentiation in metabotropic glutamate receptor 5 (mGlu5) abnormalities in BD versus MDD, which could be a mechanism affected in the frontotemporal system. However, associations between WM and mGlu5 have not been examined previously as a differentiator of BD. Using a multimodal neuroimaging approach, we examined WM integrity alterations in the disorders and their associations with mGluR5 levels. Methods Individuals with BD (N = 21), MDD (N = 10), and HC (N = 25) participated in structural and diffusion-weighted MRI scanning, and imaging with [18F]FPEB PET for quantification of mGlu5 availability. Whole-brain analyses were used to assess corticolimbic WM matter fractional anisotropy (FA) across BD and MDD relative to HC; abnormalities were tested for associations with mGlu5 availability. Results FA corticolimbic reductions were observed in both disorders and altered UF WM integrity was observed only in BD. In BD, lower UF FA was associated with lower amygdala mGlu5 availability (p < .05). Conclusions These novel preliminary findings suggest important associations between lower UF FA and lower amygdala mGlu5 levels that could represent a disorder-specific neural mechanism in which mGluR5 is associated with the frontotemporal dysconnectivity of the disorder.
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Affiliation(s)
- Siyan Fan
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Ruth H. Asch
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Margaret T. Davis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale School of Medicine, New Haven, CT, USA
| | - Nicole DellaGioia
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Ryan Cool
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale School of Medicine, New Haven, CT, USA
- Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
- Clinical Neurosciences Division, U.S. Department of Veteran Affairs Nation Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
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5
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Macoveanu J, Damgaard V, Ysbæk-Nielsen AT, Frangou S, Yatham LN, Chakrabarty T, Stougaard ME, Knudsen GM, Vinberg M, Kessing LV, Kjærstad HL, Miskowiak KW. Early longitudinal changes in brain structure and cognitive functioning in remitted patients with recently diagnosed bipolar disorder. J Affect Disord 2023; 339:153-161. [PMID: 37442440 DOI: 10.1016/j.jad.2023.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/08/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Patients with bipolar disorder (BD) who are presenting with cognitive impairment and associated structural brain abnormalities have generally a poorer clinical outcome. This study aims to map the early longitudinal trajectories in brain structure and cognition in patients with recently diagnosed BD. METHODS Fully or partially remitted patients with a recent diagnosis of BD and matched healthy controls (HC) underwent structural MRI and neuropsychological testing at baseline (BD n = 97; HC n = 66) and again following an average of 16 (range 6-27) months (BD n = 50; HC n = 38). We investigated the differential trajectories in BD vs. HC in cortical gray matter volume and thickness, total cerebral white matter, hippocampal and amygdala volumes, estimated brain age, and cognitive functioning using linear mixed models. Within patients, we further investigated whether brain structural abnormalities detected at baseline were associated with subsequent mood episodes. RESULTS Compared to HC, patients showed a decline in total white matter volume over time and they had a larger amygdala volume, both at baseline and at follow-up time. Patients further showed lower cognitive performance at both times of investigation with no significant change over time. There were no differences between patients and HC in cortical gray matter volume or thickness, hippocampal volume, or brain-aging patterns. CONCLUSIONS Cognitive impairment and amygdala enlargement may represent stable markers of BD early in the course of illness, whereas subtle white matter decline may result from illness progression.
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Affiliation(s)
- Julian Macoveanu
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark.
| | - Viktoria Damgaard
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Denmark
| | - Alexander Tobias Ysbæk-Nielsen
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Denmark
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lakshmi N Yatham
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Canada
| | - Trisha Chakrabarty
- Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Canada
| | - Marie Eschau Stougaard
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Maj Vinberg
- Department of Clinical Medicine, University of Copenhagen, Denmark; Psychiatric Research Unit, Psychiatric Centre North Zealand, Hillerød, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Hanne Lie Kjærstad
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Psychology, University of Copenhagen, Denmark
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Videtta G, Squarcina L, Rossetti MG, Brambilla P, Delvecchio G, Bellani M. White matter modifications of corpus callosum in bipolar disorder: A DTI tractography review. J Affect Disord 2023; 338:220-227. [PMID: 37301293 DOI: 10.1016/j.jad.2023.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 05/08/2023] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND The recent widespread use of diffusion tensor imaging (DTI) tractography allowed researchers to investigate the diffusivity modifications and neuroanatomical changes of white matter (WM) fascicles in major psychiatric disorders, including bipolar disorder (BD). In BD, corpus callosum (CC) seems to have a crucial role in explaining the pathophysiology and cognitive impairment of this psychiatric disorder. This review aims to provide an overview on the latest results emerging from studies that investigated neuroanatomical changes of CC in BD using DTI tractography. METHODS Bibliographic research was conducted on PubMed, Scopus and Web of Science datasets until March 2022. Ten studies fulfilled our inclusion criteria. RESULTS From the reviewed DTI tractography studies a significant decrease of fractional anisotropy emerged in the genu, body and splenium of CC of BD patients compared to controls. This finding is coupled with reduction of fiber density and modification in fiber tract length. Finally, an increase of radial and mean diffusivity in forceps minor and in the entire CC was also reported. LIMITATIONS Small sample size, heterogeneity in terms of methodological (diffusion gradient) and clinical (lifetime comorbidity, BD status, pharmacological treatments) characteristics. CONCLUSIONS Overall, these findings suggest the presence of structural modifications in CC in BD patients, which may in turn explain the cognitive impairments often observed in this psychiatric disorder, especially in executive processing, motor control and visual memory. Finally, structural modifications may suggest an impairment in the amount of functional information and a morphological impact within those brain regions connected by CC.
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Affiliation(s)
- Giovanni Videtta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Maria Gloria Rossetti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Marcella Bellani
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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7
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Thiel K, Meinert S, Winter A, Lemke H, Waltemate L, Breuer F, Gruber M, Leenings R, Wüste L, Rüb K, Pfarr JK, Stein F, Brosch K, Meller T, Ringwald KG, Nenadić I, Krug A, Repple J, Opel N, Koch K, Leehr EJ, Bauer J, Grotegerd D, Hahn T, Kircher T, Dannlowski U. Reduced fractional anisotropy in bipolar disorder v. major depressive disorder independent of current symptoms. Psychol Med 2023; 53:4592-4602. [PMID: 35833369 PMCID: PMC10388324 DOI: 10.1017/s0033291722001490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Patients with bipolar disorder (BD) show reduced fractional anisotropy (FA) compared to patients with major depressive disorder (MDD). Little is known about whether these differences are mood state-independent or influenced by acute symptom severity. Therefore, the aim of this study was (1) to replicate abnormalities in white matter microstructure in BD v. MDD and (2) to investigate whether these vary across depressed, euthymic, and manic mood. METHODS In this cross-sectional diffusion tensor imaging study, n = 136 patients with BD were compared to age- and sex-matched MDD patients and healthy controls (HC) (n = 136 each). Differences in FA were investigated using tract-based spatial statistics. Using interaction models, the influence of acute symptom severity and mood state on the differences between patient groups were tested. RESULTS Analyses revealed a main effect of diagnosis on FA across all three groups (ptfce-FWE = 0.003). BD patients showed reduced FA compared to both MDD (ptfce-FWE = 0.005) and HC (ptfce-FWE < 0.001) in large bilateral clusters. These consisted of several white matter tracts previously described in the literature, including commissural, association, and projection tracts. There were no significant interaction effects between diagnosis and symptom severity or mood state (all ptfce-FWE > 0.704). CONCLUSIONS Results indicated that the difference between BD and MDD was independent of depressive and manic symptom severity and mood state. Disruptions in white matter microstructure in BD might be a trait effect of the disorder. The potential of FA values to be used as a biomarker to differentiate BD from MDD should be further addressed in future studies using longitudinal designs.
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Affiliation(s)
- Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute of Translational Neuroscience, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lena Waltemate
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Fabian Breuer
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ramona Leenings
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lucia Wüste
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Kathrin Rüb
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | | | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Kai Gustav Ringwald
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Koch
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Elisabeth J. Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jochen Bauer
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
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8
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Tang XQ, Liao RY, Zheng LJ, Yang LL, Ma ZL, Yi C, Liu J, Liu JC, Kuang YJ, Cai HA, Huang L. Aerobic exercise reverses the NF-κB/NLRP3 inflammasome/5-HT pathway by upregulating irisin to alleviate post-stroke depression. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1350. [PMID: 36660693 PMCID: PMC9843332 DOI: 10.21037/atm-22-5443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/12/2022] [Indexed: 01/01/2023]
Abstract
Background Post-stroke depression (PSD) is one of the most common and serious sequelae of stroke. The pathogenesis of PSD involves both psychosocial and biological mechanisms, and aerobic exercise is a potential therapeutic target. We conducted an in-depth exploration of the protective mechanisms of aerobic exercise in a PSD mouse model. Methods In this study, C57BL/6 mice were used as the research objects, and a PSD mouse model was established by combining middle cerebral artery occlusion and chronic unpredictable mild stimulation. Real-time quantitative polymerase chain reaction, enzyme-linked immunosorbent assays, adeno-associated virus microinjection technology, co-immunoprecipitation, fluorescence in-situ hybridization, and western blotting were performed. A moderate-load treadmill exercise was used for aerobic exercise intervention. The moderate-intensity aerobic exercise training method adopted 0 slopes and treadmill adaptation training for 5 days. We verified the effects of aerobic exercise on the nuclear factor kappa B (NF-κB)/nucleotide-binding oligomerization domain--like receptor protein 3 (NLRP3) inflammasome/5-hydroxytryptamine (5-HT) pathway. Results Aerobic exercise effectively alleviated the neurological damage caused by PSD (P<0.01). The results from the PSD mouse model in vivo were consistent with those of the cell experiments. Moreover, overexpression of irisin improves depression-like behavior in PSD mice. We confirmed that aerobic exercise is involved in PSD through 5-HT, which inhibits NF-κB/NLRP3 inflammasome initiation through irisin and alleviates mitochondrial damage under stress by reducing calcium overload, thereby inhibiting NLRP3 inflammasome activation. Conclusions Aerobic exercise reversed the NF-κB/NLRP3 inflammasome/5-HT pathway by upregulating irisin expression to alleviate PSD.
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Affiliation(s)
- Xue-Qin Tang
- Department of Rehabilitation Medicine, Department of Sports Medicine, Institute of Translational Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Ruo-Yi Liao
- The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, China
| | - Li-Jun Zheng
- Department of Rehabilitation Medicine, Department of Sports Medicine, Institute of Translational Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Ling-Ling Yang
- Department of Rehabilitation Medicine, Department of Sports Medicine, Institute of Translational Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Zhi-Lin Ma
- Department of Rehabilitation Medicine, Department of Sports Medicine, Institute of Translational Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Chan Yi
- Department of Rehabilitation Medicine, Department of Sports Medicine, Institute of Translational Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Jin Liu
- Department of Rehabilitation Medicine, Department of Sports Medicine, Institute of Translational Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Jin-Can Liu
- College of Acupuncture-moxibustion, Tuina and Rehabilitation, Hunan University of Traditional Chinese Medicine, Changsha, China
| | - Yi-Jin Kuang
- College of Acupuncture-moxibustion, Tuina and Rehabilitation, Hunan University of Traditional Chinese Medicine, Changsha, China
| | - Hua-An Cai
- Department of Rehabilitation Medicine, Department of Sports Medicine, Institute of Translational Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Liang Huang
- Department of Rehabilitation Medicine, Department of Sports Medicine, Institute of Translational Medicine, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
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Rajashekar N, Blumberg HP, Villa LM. Neuroimaging Studies of Brain Structure in Older Adults with Bipolar Disorder: A Review. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2022; 7:e220006. [PMID: 36092855 PMCID: PMC9453888 DOI: 10.20900/jpbs.20220006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Bipolar disorder (BD) is a common mood disorder that can have severe consequences during later life, including suffering and impairment due to mood and cognitive symptoms, elevated risk for dementia and an especially high risk for suicide. Greater understanding of the brain circuitry differences involved in older adults with BD (OABD) in later life and their relationship to aging processes is required to improve outcomes of OABD. The current literature on gray and white matter findings, from high resolution structural and diffusion-weighted magnetic resonance imaging (MRI) studies, has shown that BD in younger age groups is associated with gray matter reductions within cortical and subcortical brain regions that subserve emotion processing and regulation, as well as reduced structural integrity of white matter tracts connecting these brain regions. While fewer neuroimaging studies have focused on OABD, it does appear that many of the structural brain differences found in younger samples are present in OABD. There is also initial suggestion that there are additional brain differences, for at least a subset of OABD, that may result from more pronounced gray and white matter declines with age that may contribute to adverse outcomes. Preclinical and clinical data supporting neuro-plastic and -protective effects of mood-stabilizing medications, suggest that treatments may reverse and/or prevent the progression of brain changes thereby reducing symptoms. Future neuroimaging research implementing longitudinal designs, and large-scale, multi-site initiatives with detailed clinical and treatment data, holds promise for reducing suffering, cognitive dysfunction and suicide in OABD.
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Affiliation(s)
- Niroop Rajashekar
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA
- Child Study Center, Yale School of Medicine, New Haven, CT 06519, USA
| | - Luca M. Villa
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
- Department of Psychiatry, University of Oxford, Oxford, OX37JX, UK
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10
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Kim JS, Baek JH. Cognitive Dysfunction in Mood Disorder: Similarities and Differences Between Depression Subtypes. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20220221-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Differentiating white matter measures that protect against vs. predispose to bipolar disorder and other psychopathology in at-risk youth. Neuropsychopharmacology 2021; 46:2207-2216. [PMID: 34285367 PMCID: PMC8505429 DOI: 10.1038/s41386-021-01088-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/17/2021] [Accepted: 06/24/2021] [Indexed: 12/02/2022]
Abstract
Bipolar disorder (BD) is highly heritable. Identifying objective biomarkers reflecting pathophysiological processes predisposing to, versus protecting against BD, can help identify BD risk in offspring of BD parents. We recruited 21 BD participants with a first-degree relative with BD, 25 offspring of BD parents, 27 offspring of comparison parents with non-BD psychiatric disorders, and 32 healthy offspring of healthy parents. In at-risk groups, 23 had non-BD diagnoses and 29, no Axis-I diagnoses(healthy). Five at-risk offspring who developed BD post scan(Converters) were included. Diffusion imaging(dMRI) analysis with tract segmentation identified between-group differences in the microstructure of prefrontal tracts supporting emotional regulation relevant to BD: forceps minor, anterior thalamic radiation(ATR), cingulum bundle(CB), and uncinate fasciculus(UF). BD participants showed lower fractional anisotropy (FA) in the right CB (anterior portion) than other groups (q < 0.05); and in bilateral ATR (posterior portion) versus at-risk groups (q < 0.001). Healthy, but not non-BD, at-risk participants showed significantly higher FA in bilateral ATR clusters than healthy controls (qs < 0.05). At-risk groups showed higher FA in these clusters than BD participants (qs < 0.05). Non-BD versus healthy at-risk participants, and Converters versus offspring of BD parents, showed lower FA in the right ATR cluster (qs < 0.05). Low anterior right CB FA in BD participants versus other groups might result from having BD. High bilateral ATR FA in at-risk groups, and in healthy at-risk participants, versus healthy controls might protect against BD/other psychiatric disorders. Absence of elevated right ATR FA in non-BD versus healthy at-risk participants, and in Converters versus non-converter offspring of BD parents, might lower protection against BD in at-risk groups.
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12
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Huang H, Li H, Zhang X, Shi G, Xu M, Ru X, Chen Y, Patel MB, Ely EW, Lin S, Zhang G, Zhou J. Association of postoperative delirium with cognitive outcomes: A meta-analysis. J Clin Anesth 2021; 75:110496. [PMID: 34482263 DOI: 10.1016/j.jclinane.2021.110496] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 08/26/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
STUDY OBJECTIVE To determine the association between postoperative delirium (POD) and cognitive outcomes at least 1 month after surgery in elderly patients, and synthesize the dynamic risk trajectory of cognition impairment after POD. DESIGN Meta-analysis searching PubMed, Cochrane and EMBASE from inception to November 1, 2020. The terms postoperative delirium, delirium after surgery, postsurgical delirium, postoperative cogniti*, postoperative cognitive dysfunction, postoperative cognition decline, cognitive decline, cognitive impair* and dement* were searched alone or in combination. MEASUREMENTS Inclusion criteria were prospective cohort studies investigating the association between POD and cognitive outcomes in patients aged ≥60 years underwent surgery. The primary outcome was the association between POD and cognitive outcomes at 1 or more months after surgery. We considered cognitive outcomes measured up to 12 months after surgery as short-term and beyond 12 months as long-term. Two authors performed the study screening, data extraction and quality assessments. Effect sizes were calculated as Hedges g or Odds ratio (OR) based on random- and fixed-effects models. Meta-regression was conducted to analyze the role of potential contributors to heterogeneity. MAIN RESULTS Eighteen studies were included. Our result showed a significant and medium association between POD and cognitive outcomes after at least 1 month postoperatively (g = 0.61 95% CI 0.43-0.79; I2 = 65.1%), indicating that patients with POD were associated with worse cognitive outcomes. The association of POD with short- and long-term cognitive impairment were also both significant (short-term: g = 0.46 95% CI 0.24-0.68; I2 = 53.1%; and long-term: g = 0.82 95% CI 0.57-1.06; I2 = 57.1%). A multivariate meta-regression suggested that age and measure of delirium were significant sources of heterogeneity. POD was also associated with the significant risk for dementia (OR = 6.08 95% CI 3.80-9.72; I2 = 0) as well as attention (OR = 1.74 95% CI 1.13-2.68; I2 = 0), executive (OR = 1.33 95% CI 1.00-1.80; I2 = 0) and memory impairment (OR = 1.59 95% CI 1.20-2.10; I2 = 43.0%). Additionally, our results showed that the risk trajectory for cognitive decline associated with POD within five years after surgery revealed exponential growth. CONCLUSIONS This is the first meta-analysis quantifying the association between POD and cognitive outcomes. Our results showed that POD was significantly associated with worse cognitive outcomes, including short- and long-term cognitive outcomes following surgery.
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Affiliation(s)
- Huawei Huang
- Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Haoyi Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaokang Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guangzhi Shi
- Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ming Xu
- Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaojuan Ru
- Department of Neuro-epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - You Chen
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Electrical Engineering & Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Mayur B Patel
- Section of Surgical Sciences, Departments of Surgery & Neurosurgery, Division of Trauma, Surgical Critical Care, and Emergency General Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Geriatric Research and Education Clinical Center, Surgical Services, Veteran Affairs Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Eugene Wesley Ely
- Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Song Lin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guobin Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Jianxin Zhou
- Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Paul R, Tsuei T, Cho K, Belden A, Milanini B, Bolzenius J, Javandel S, McBride J, Cysique L, Lesinski S, Valcour V. Ensemble machine learning classification of daily living abilities among older people with HIV. EClinicalMedicine 2021; 35:100845. [PMID: 34027327 PMCID: PMC8129893 DOI: 10.1016/j.eclinm.2021.100845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/11/2021] [Accepted: 03/17/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND clinically relevant methods to identify individuals at risk for impaired daily living abilities secondary to neurocognitive impairment (ADLs) remain elusive. This is especially true for complex clinical conditions such as HIV-Associated Neurocognitive Disorders (HAND). The aim of this study was to identify novel and modifiable factors that have potential to improve diagnostic accuracy of ADL risk, with the long-term goal of guiding future interventions to minimize ADL disruption. METHODS study participants included 79 people with HIV (PWH; mean age = 63; range = 55-80) enrolled in neuroHIV studies at University California San Francisco (UCSF) between 2016 and 2019. All participants were virally suppressed and exhibited objective evidence of neurocognitive impairment. ADL status was defined as either normative (n = 39) or at risk (n = 40) based on a task-based protocol. Gradient boosted multivariate regression (GBM) was employed to identify the combination of variables that differentiated ADL subgroup classification. Predictor variables included demographic factors, HIV disease severity indices, brain white matter integrity quantified using diffusion tensor imaging, cognitive test performance, and health co-morbidities. Model performance was examined using average Area Under the Curve (AUC) with repeated five-fold cross validation. FINDINGS the univariate GBM yielded an average AUC of 83% using Wide Range Achievement test 4 (WRAT-4) reading score, self-reported thought confusion and difficulty reading, radial diffusivity (RD) in the left external capsule, fractional anisotropy (FA) in the left cingulate gyrus, and Stroop performance. The model allowing for two-way interactions modestly improved classification performance (AUC of 88%) and revealed synergies between race, reading ability, cognitive performance, and neuroimaging metrics in the genu and uncinate fasciculus. Conversion of Neuropsychological Assessment Battery Daily Living Module (NAB-DLM) performance from raw scores into T scores amplified differences between White and non-White study participants. INTERPRETATION demographic and sociocultural factors are critical determinants of ADL risk status among older PWH who meet diagnostic criteria for neurocognitive impairment. Task-based ADL assessment that relies heavily on reading proficiency may artificially inflate the frequency/severity of ADL impairment among diverse clinical populations. Culturally relevant measures of ADL status are needed for individuals with acquired neurocognitive disorders, including HAND.
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Affiliation(s)
- Robert Paul
- Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO 63121-4400, United States
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, United States
- Corresponding author at: Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO 63121-4400, United States.
| | - Torie Tsuei
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, United States
| | - Kyu Cho
- Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO 63121-4400, United States
| | - Andrew Belden
- Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO 63121-4400, United States
| | - Benedetta Milanini
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, United States
| | - Jacob Bolzenius
- Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO 63121-4400, United States
| | - Shireen Javandel
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, United States
| | - Joseph McBride
- Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO 63121-4400, United States
| | - Lucette Cysique
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Samantha Lesinski
- Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO 63121-4400, United States
| | - Victor Valcour
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, United States
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, United States
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Common variants in CREB1 gene confer risk for bipolar disorder in Han Chinese. Asian J Psychiatr 2021; 59:102648. [PMID: 33848807 DOI: 10.1016/j.ajp.2021.102648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/23/2021] [Accepted: 04/05/2021] [Indexed: 12/25/2022]
Abstract
Recently, we have identified involvement of the gene encoding cAMP responsive element-binding 1 (CREB1) in risk of BD in European ancestry. CREB1 has significant genetic diversity between Europeans and Chinese, thereby resulting in diverged CREB1 genetic backgrounds. In this study, we aimed to determine whether CREB1 confers susceptibility to BD and cognitive dysfunction in Han Chinese. We recruited 572 patients with BD and 611 healthy controls for genetic study. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used for cognitive evaluation. SNP rs10932201 and rs3770704 within CREB1 were genotyped. The frequency of the G allele of rs10932201 was significantly greater in BD patients (41.8 %) than that in control subjects (37.2 %), with P = 0.02, corrected P = 0.04. There were significant differences in the scores of RBANS attention and total scores between the patients with different genotypes of rs10932201 polymorphism (P = 0.002 and 0.003, corrected P = 0.012 and 0.018, respectively). Post-hoc comparisons showed that rs10932201 G/G or G/A carriers had lower RBANS attention and total scores than those with A/A carriers (P = 0.002 and 0.004, P = 0.002 and 0.006, respectively). We observed a significant association between the rs10932201 and CREB1 expression in intralobular white matter (P = 0.037). Carriers with G allele have significantly lower levels of CREB1 expression in intralobular white matter than those without G allele. In conclusion, this study identified a novel BD risk SNP rs10932201 in Han Chinese and this SNP may be a risk factor for cognitive dysfunction in patients with BD.
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Masuda Y, Okada G, Takamura M, Shibasaki C, Yoshino A, Yokoyama S, Ichikawa N, Okuhata S, Kobayashi T, Yamawaki S, Okamoto Y. White matter abnormalities and cognitive function in euthymic patients with bipolar disorder and major depressive disorder. Brain Behav 2020; 10:e01868. [PMID: 33009714 PMCID: PMC7749556 DOI: 10.1002/brb3.1868] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 08/12/2020] [Accepted: 09/14/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES In recent years, a growing number of diffusion tensor imaging (DTI) studies have compared white matter integrity between patients with major depressive disorder (MDD) and bipolar disorder (BD). However, few studies have examined the pathophysiological significance of different degrees of white matter abnormalities between the two disorders. The present study comprehensively assessed white matter integrity among healthy controls (HC) and euthymic patients with MDD and BD using whole-brain tractography and examined associations between white matter integrity and cognitive functioning. METHODS We performed neurocognitive examinations and DTI with 30 HCs, 30 patients with MDD, and 30 patients with BD. We statistically evaluated white matter integrity and cognitive function differences across the three groups, assessing associations between white matter integrities and cognitive function. RESULTS The BD group showed lower fractional anisotropy (FA) for the corpus callosum body, as well as lower, sustained attention and set-shifting scores compared to the other groups. FA for the left body of the corpus callosum was correlated with sustained attention in patients with BD. CONCLUSIONS The significant reduction of white matter integrity in the corpus callosum in BD, compared to MDD, was associated with an impairment of sustained attention. This result promotes the understanding of the significance of white matter integrity in mood disorders.
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Affiliation(s)
- Yoshikazu Masuda
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Go Okada
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Masahiro Takamura
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Chiyo Shibasaki
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Atsuo Yoshino
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Satoshi Yokoyama
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Naho Ichikawa
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Shiho Okuhata
- Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | | | - Shigeto Yamawaki
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
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