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Lorincz-Comi N, Yang Y, Li G, Zhu X. MRBEE: A novel bias-corrected multivariable Mendelian Randomization method. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.10.523480. [PMID: 37066391 PMCID: PMC10103949 DOI: 10.1101/2023.01.10.523480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Mendelian randomization (MR) is an instrumental variable approach used to infer causal relationships between exposures and outcomes and can apply to summary data from genome-wide association studies (GWAS). Since GWAS summary statistics are subject to estimation errors, most existing MR approaches suffer from measurement error bias, whose scale and direction are influenced by weak instrumental variables and GWAS sample overlap, respectively. We introduce MRBEE (MR using Bias-corrected Estimating Equation), a novel multivariable MR method capable of simultaneously removing measurement error bias and identifying horizontal pleiotropy. In simulations, we showed that MRBEE is capable of effectively removing measurement error bias in the presence of weak instrumental variables and sample overlap. In two independent real data analyses, we discovered that the causal effect of BMI on coronary artery disease risk is entirely mediated by blood pressure, and that existing MR methods may underestimate the causal effect of cannabis use disorder on schizophrenia risk compared to MRBEE. MRBEE possesses significant potential for advancing genetic research by providing a valuable tool to study causality between multiple risk factors and disease outcomes, particularly as a large number of GWAS summary statistics become publicly available.
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Affiliation(s)
- Noah Lorincz-Comi
- Department of Population and Quantitative Health Sciences, School of Medicine
- Case Western Reserve University, Cleveland, OH 44106, USA June 12, 2023
| | - Yihe Yang
- Department of Population and Quantitative Health Sciences, School of Medicine
- Case Western Reserve University, Cleveland, OH 44106, USA June 12, 2023
| | - Gen Li
- Department of Population and Quantitative Health Sciences, School of Medicine
- Case Western Reserve University, Cleveland, OH 44106, USA June 12, 2023
| | - Xiaofeng Zhu
- This work was supported by grant HG011052 (to X.Z.) from the National Human Genome Research Institute (NHGRI), USA.
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Altamura AC, Maggioni E, Dhanoa T, Ciappolino V, Paoli RA, Cremaschi L, Prunas C, Orsenigo G, Caletti E, Cinnante CM, Triulzi FM, Dell'Osso B, Yatham L, Brambilla P. The impact of psychosis on brain anatomy in bipolar disorder: A structural MRI study. J Affect Disord 2018; 233:100-109. [PMID: 29223329 DOI: 10.1016/j.jad.2017.11.092] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/24/2017] [Accepted: 11/27/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is a major psychiatric illness characterized by heterogeneous symptoms including psychotic features. Up until now, neuroimaging studies investigating cerebral morphology in patients with BD have underestimated the potential impact of psychosis on brain anatomy in BD patients. In this regard, psychotic and non-psychotic BD may represent biologically different subtypes of the disorder, being possibly associated with specific cerebral features. METHODS In the present study, magnetic resonance imaging (MRI) at 3T was used to identify the neuroanatomical correlates of psychosis in an International sample of BD patients. A large sample of structural MRI data from healthy subjects (HC) and BD patients was collected across two research centers. Voxel based morphometry was used to compare gray matter (GM) volume among psychotic and non-psychotic BD patients and HC. RESULTS We found specific structural alterations in the two patient groups, more extended in the psychotic sample. Psychotic patients showed GM volume deficits in left frontal cortex compared to HC, and in right temporo-parietal cortex compared to both HC and non-psychotic patients (p < 0.001, > 100 voxels). Psychotic patients also exhibited enhanced age-related GM volume deficits in a set of subcortical and cortical regions. LIMITATIONS The integration of multiple datasets may have affected the results. CONCLUSIONS Overall, our results confirm the importance of classifying BD based on psychosis. The knowledge of the neuronal bases of psychotic symptomatology in BD can provide a more comprehensive picture of the determinants of BD, in the light of the continuum characteristic of major psychoses.
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Affiliation(s)
- A Carlo Altamura
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Taj Dhanoa
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Riccardo A Paoli
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Laura Cremaschi
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Cecilia Prunas
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Giulia Orsenigo
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Elisabetta Caletti
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Claudia M Cinnante
- Department of Neuroradiology, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Fabio M Triulzi
- Department of Neuroradiology, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Bernardo Dell'Osso
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, CA, USA
| | - Lakshmi Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA.
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Maggioni E, Crespo-Facorro B, Nenadic I, Benedetti F, Gaser C, Sauer H, Roiz-Santiañez R, Poletti S, Marinelli V, Bellani M, Perlini C, Ruggeri M, Altamura AC, Diwadkar VA, Brambilla P. Common and distinct structural features of schizophrenia and bipolar disorder: The European Network on Psychosis, Affective disorders and Cognitive Trajectory (ENPACT) study. PLoS One 2017; 12:e0188000. [PMID: 29136642 PMCID: PMC5685634 DOI: 10.1371/journal.pone.0188000] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 10/30/2017] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Although schizophrenia (SCZ) and bipolar disorder (BD) share elements of pathology, their neural underpinnings are still under investigation. Here, structural Magnetic Resonance Imaging (MRI) data collected from a large sample of BD and SCZ patients and healthy controls (HC) were analyzed in terms of gray matter volume (GMV) using both voxel based morphometry (VBM) and a region of interest (ROI) approach. METHODS The analysis was conducted on two datasets, Dataset1 (802 subjects: 243 SCZ, 176 BD, 383 HC) and Dataset2, a homogeneous subset of Dataset1 (301 subjects: 107 HC, 85 BD and 109 SCZ). General Linear Model analyses were performed 1) at the voxel-level in the whole brain (VBM study), 2) at the regional level in the anatomical regions emerged from the VBM study (ROI study). The GMV comparison across groups was integrated with the analysis of GMV correlates of different clinical dimensions. RESULTS The VBM results of Dataset1 showed 1) in BD compared to HC, GMV deficits in right cingulate, superior temporal and calcarine cortices, 2) in SCZ compared to HC, GMV deficits in widespread cortical and subcortical areas, 3) in SCZ compared to BD, GMV deficits in insula and thalamus (p<0.05, cluster family wise error corrected). The regions showing GMV deficits in the BD group were mostly included in the SCZ ones. The ROI analyses confirmed the VBM results at the regional level in most of the clusters from the SCZ vs. HC comparison (p<0.05, Bonferroni corrected). The VBM and ROI analyses of Dataset2 provided further evidence for the enhanced GMV deficits characterizing SCZ. Based on the clinical-neuroanatomical analyses, we cannot exclude possible confounding effects due to 1) age of onset and medication in BD patients, 2) symptoms severity in SCZ patients. CONCLUSION Our study reported both shared and specific neuroanatomical characteristics between the two disorders, suggesting more severe and generalized GMV deficits in SCZ, with a specific role for insula and thalamus.
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Affiliation(s)
- Eleonora Maggioni
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain
| | - Igor Nenadic
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Psychiatry and Psychotherapy, Philipps University Marburg / Marburg University Hospital UKGM, Marburg, Germany
| | - Francesco Benedetti
- Department of Clinical Neurosciences and Centro di Eccellenza Risonanza Magnetica ad Alto Campo, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Christian Gaser
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Heinrich Sauer
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Roberto Roiz-Santiañez
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Santander, Spain
| | - Sara Poletti
- Department of Clinical Neurosciences and Centro di Eccellenza Risonanza Magnetica ad Alto Campo, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy
| | - Veronica Marinelli
- Department of Experimental and Clinical Medical Sciences (DISM), University of Udine, Udine, Italy
| | - Marcella Bellani
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Mirella Ruggeri
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - A. Carlo Altamura
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Vaibhav A. Diwadkar
- Department of Psychiatry & Behavioral Neuroscience, Wayne State University, Detroit, MI, United States of America
| | - Paolo Brambilla
- IRCCS Scientific Institute “E. Medea”, Bosisio Parini, Lecco, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Delvecchio G, Pigoni A, Perlini C, Barillari M, Ruggeri M, Altamura AC, Bellani M, Brambilla P. Sexual dimorphism of the planum temporale in schizophrenia: A MRI study. Aust N Z J Psychiatry 2017; 51:1010-1019. [PMID: 28410561 DOI: 10.1177/0004867417702748] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Anatomical alterations in the superior temporal gyrus have been consistently reported in patients with schizophrenia, and they have mostly been linked to positive symptoms, including hallucinations and thought disorders. The superior temporal gyrus is considered one of the most asymmetric and lateralized structure of the human brain, and the process of lateralization seems to vary according to gender in the normal population. However, although it has been consistently suggested that patients with schizophrenia did not show normal brain lateralization in several regions, only few studies investigated it in the superior temporal gyrus and its sub-regions considering the effects of gender. In this context, the aim of this study was to evaluate sexual dimorphism in superior temporal gyrus volumes in a sample of patients with schizophrenia compared to age- and gender-matched healthy controls. METHODS A total of 72 right/left-handed males (40 schizophrenia patients and 32 healthy controls) and 45 right/left-handed females (18 schizophrenia patients and 27 healthy controls) underwent clinical evaluation and a 1.5T magnetic resonance imaging scan. Gray and white matter volumes of regions of interest within the superior temporal gyrus were manually detected, including the Heschl's gyrus and the planum temporale. RESULTS Female patients with schizophrenia presented a reduction in left planum temporale gray matter volumes ( F = 4.58, p = 0.03) and a lack of the normal planum temporale asymmetry index ( t = 0.27; p = 0.79) compared to female controls ( t = 5.47; p = 0.001). No differences were found between males for any volumes or laterality indices. Finally, in female patients with schizophrenia, Heschl's gyrus gray and white matter volumes negatively correlated with positive symptoms ( r = -0.56, p = 0.01). CONCLUSION Our results showed that sexual dimorphism plays a key role on planum temporale in schizophrenia, underlining the importance of gender as a modulator of brain morphology and lateralization of schizophrenia.
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Affiliation(s)
- Giuseppe Delvecchio
- 1 Scientific Institute, IRCCS 'Eugenio Medea', San Vito al Tagliamento, Italy
| | - Alessandro Pigoni
- 2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Cinzia Perlini
- 3 Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,4 InterUniversity Centre for Behavioural Neurosciences, University of Verona, Verona, Italy
| | - Marco Barillari
- 5 Section of Radiology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Mirella Ruggeri
- 6 Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alfredo Carlo Altamura
- 2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Marcella Bellani
- 4 InterUniversity Centre for Behavioural Neurosciences, University of Verona, Verona, Italy.,7 Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Paolo Brambilla
- 2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.,8 Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Squarcina L, Bellani M, Rossetti MG, Perlini C, Delvecchio G, Dusi N, Barillari M, Ruggeri M, Altamura CA, Bertoldo A, Brambilla P. Similar white matter changes in schizophrenia and bipolar disorder: A tract-based spatial statistics study. PLoS One 2017; 12:e0178089. [PMID: 28658249 PMCID: PMC5489157 DOI: 10.1371/journal.pone.0178089] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 05/07/2017] [Indexed: 12/17/2022] Open
Abstract
Several strands of evidence reported a significant overlapping, in terms of clinical symptoms, epidemiology and treatment response, between the two major psychotic disorders—Schizophrenia (SCZ) and Bipolar Disorder (BD). Nevertheless, the shared neurobiological correlates of these two disorders are far from conclusive. This study aims toward a better understanding of possible common microstructural brain alterations in SCZ and BD. Magnetic Resonance Diffusion data of 33 patients with BD, 19 with SCZ and 35 healthy controls were acquired. Diffusion indexes were calculated, then analyzed using Tract-Based Spatial Statistics (TBSS). We tested correlations with clinical and psychological variables. In both patient groups mean diffusion (MD), volume ratio (VR) and radial diffusivity (RD) showed a significant increase, while fractional anisotropy (FA) and mode (MO) decreased compared to the healthy group. Changes in diffusion were located, for both diseases, in the fronto-temporal and callosal networks. Finally, no significant differences were identified between patient groups, and a significant correlations between length of disease and FA and VR within the corpus callosum, corona radiata and thalamic radiation were observed in bipolar disorder. To our knowledge, this is the first study applying TBSS on all the DTI indexes at the same time in both patient groups showing that they share similar impairments in microstructural connectivity, with particular regards to fronto-temporal and callosal communication, which are likely to worsen over time. Such features may represent neural common underpinnings characterizing major psychoses and confirm the central role of white matter pathology in schizophrenia and bipolar disorder.
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Affiliation(s)
| | | | - Maria Gloria Rossetti
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Cinzia Perlini
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, Verona, Italy
| | | | - Nicola Dusi
- Section of Psychiatry, AOUI Verona, Verona, Italy
| | - Marco Barillari
- Department of Radiology, University of Verona, Verona, Italy
| | | | - Carlo A. Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Alessandra Bertoldo
- Department of Information Engineering (DEI), University of Padova, Padova, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
- Department of Psychiatry and Behavioral Sciences, UTHouston Medical School, Houston, Texas, United States of America
- * E-mail:
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Atagun MI, Balaban OD, Yesilbas D, Keskinkilic C, Evren C. Effect of Lateralization on Motor and Mental Speed in Bipolar Disorder. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20120827114812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Murat Ilhan Atagun
- Namık Kemal University Medical School, Department of Psychiatry, Tekirdağ - Turkey
| | - Ozlem Devrim Balaban
- Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul - Turkey
| | - Dilek Yesilbas
- Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul - Turkey
| | - Cahit Keskinkilic
- Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul - Turkey
| | - Cuneyt Evren
- Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul - Turkey
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Fornaro M, De Berardis D, De Pasquale C, Indelicato L, Pollice R, Valchera A, Perna G, Iasevoli F, Tomasetti C, Martinotti G, Koshy AS, Fasmer OB, Oedegaard KJ. Prevalence and clinical features associated to bipolar disorder-migraine comorbidity: a systematic review. Compr Psychiatry 2015; 56:1-16. [PMID: 25306379 DOI: 10.1016/j.comppsych.2014.09.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 09/18/2014] [Accepted: 09/23/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The prevalence and clinical features associated with bipolar disorders (BDs)-migraine comorbidity have been reported inconsistently across different studies, therefore warranting a systematic review on the matter. METHODS A systematic review was conducted in accordance with the PRISMA statement searching major electronic databases for documents indexed between January, 2000 and July, 2014. Eligible studies were those including quantitative data on prevalence rates and clinical features associated to BD-migraine comorbidity; case reports excluded. Three authors independently conducted searches, quality assessment of the studies and data extraction. RESULTS Several cross-sectional studies, and a handful of retrospective follow-up studies or non-systematic reviews assessed the prevalence and/or the clinical correlates of migraine-BD comorbidity. High prevalence rates and a significant burden of BD-migraine comorbidity were common findings, particularly in case of BD-II women (point-prevalence rates up to 77%), migraine with aura (up to 53%) and/or cyclothymic temperament (up to 45% of the cases). LIMITATIONS Some of the biases encountered in a few studies accounted by the present review may nonetheless have hampered the generalizability of the overall conclusions drawn herein. CONCLUSIONS BD-migraine comorbidity may comprise of a sub-phenotype of BDs requiring patient-tailored therapeutic interventions to achieve an optimal outcome. Specifically, additional studies including longitudinal follow-up studies are aimed in order to shed further light on the actual prevalence rates and clinical features associated to BD-migraine comorbidity, with a special emphasis towards the clinically suggestive potential connection between mixed features, bipolar depression, migraine, and increased risk for suicidality. PROSPERO registration number: CRD42014009335.
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Affiliation(s)
- Michele Fornaro
- Department of Education Science, University of Catania, Catania, Italy.
| | - Domenico De Berardis
- National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy.
| | | | - Luisa Indelicato
- Department of Education Science, University of Catania, Catania, Italy.
| | - Rocco Pollice
- Service for Monitoring and early Intervention against psychoLogical and mEntal suffering in young people" (SMILE), L'Aquila University, Italy.
| | - Alessandro Valchera
- Hermanas Hospitalarias, Villa San Giuseppe Hospital, 63100 Ascoli Piceno, Italy.
| | - Giampaolo Perna
- Department of Clinical Neuroscience, Villa San Benedetto Menni, Hermanas Hospitalarias, Albese con Cassano, Como, Italy.
| | - Felice Iasevoli
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University "Federico II" of Naples, Via Pansini 5, 80131 Naples, Italy.
| | - Carmine Tomasetti
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University "Federico II" of Naples, Via Pansini 5, 80131 Naples, Italy.
| | - Giovanni Martinotti
- Department of Neurosciences and Imaging, University "G. d'Annunzio" of Chieti, 66013 Chieti, Italy.
| | - Ann Sarah Koshy
- St. John's National Academy of Health Sciences, Bangalore, India.
| | - Ole Bernt Fasmer
- Department of Clinical Medicine, Section for Psychiatry, University of Bergen, Bergen, Norway.
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Peruzzo D, Castellani U, Perlini C, Bellani M, Marinelli V, Rambaldelli G, Lasalvia A, Tosato S, De Santi K, Murino V, Ruggeri M, Brambilla P. Classification of first-episode psychosis: a multi-modal multi-feature approach integrating structural and diffusion imaging. J Neural Transm (Vienna) 2014; 122:897-905. [PMID: 25344845 DOI: 10.1007/s00702-014-1324-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 10/05/2014] [Indexed: 12/23/2022]
Abstract
Currently, most of the classification studies of psychosis focused on chronic patients and employed single machine learning approaches. To overcome these limitations, we here compare, to our best knowledge for the first time, different classification methods of first-episode psychosis (FEP) using multi-modal imaging data exploited on several cortical and subcortical structures and white matter fiber bundles. 23 FEP patients and 23 age-, gender-, and race-matched healthy participants were included in the study. An innovative multivariate approach based on multiple kernel learning (MKL) methods was implemented on structural MRI and diffusion tensor imaging. MKL provides the best classification performances in comparison with the more widely used support vector machine, enabling the definition of a reliable automatic decisional system based on the integration of multi-modal imaging information. Our results show a discrimination accuracy greater than 90 % between healthy subjects and patients with FEP. Regions with an accuracy greater than 70 % on different imaging sources and measures were middle and superior frontal gyrus, parahippocampal gyrus, uncinate fascicles, and cingulum. This study shows that multivariate machine learning approaches integrating multi-modal and multisource imaging data can classify FEP patients with high accuracy. Interestingly, specific grey matter structures and white matter bundles reach high classification reliability when using different imaging modalities and indices, potentially outlining a prefronto-limbic network impaired in FEP with particular regard to the right hemisphere.
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Affiliation(s)
- Denis Peruzzo
- Department of Computer Science, University of Verona, Strada le Grazie 15, 37134, Verona, Italy
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Logue DD, Logue RT, Kaufmann WE, Belcher HME. Psychiatric disorders and left-handedness in children living in an urban environment. Laterality 2014; 20:249-56. [DOI: 10.1080/1357650x.2014.961927] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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10
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Florio V, Savazzi S, Conca A, Marzi CA. Differential impairment of interhemispheric transmission in bipolar disease. Exp Brain Res 2013; 230:175-85. [DOI: 10.1007/s00221-013-3642-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 06/30/2013] [Indexed: 01/02/2023]
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Psychosis Incident Cohort Outcome Study (PICOS). A multisite study of clinical, social and biological characteristics, patterns of care and predictors of outcome in first-episode psychosis. Background, methodology and overview of the patient sample. Epidemiol Psychiatr Sci 2012; 21:281-303. [PMID: 22794251 DOI: 10.1017/s2045796012000315] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIMS This paper aims at providing an overview of the background, design and initial findings of Psychosis Incident Cohort Outcome Study (PICOS). METHODS PICOS is a large multi-site population-based study on first-episode psychosis (FEP) patients attending public mental health services in the Veneto region (Italy) over a 3-year period. PICOS has a naturalistic longitudinal design and it includes three different modules addressing, respectively, clinical and social variables, genetics and brain imaging. Its primary aims are to characterize FEP patients in terms of clinical, psychological and social presentation, and to investigate the relative weight of clinical, environmental and biological factors (i.e. genetics and brain structure/functioning) in predicting the outcome of FEP. RESULTS An in-depth description of the research methodology is given first. Details on recruitment phase and baseline and follow-up evaluations are then provided. Initial findings relating to patients' baseline assessments are also presented. Future planned analyses are outlined. CONCLUSIONS Both strengths and limitations of PICOS are discussed in the light of issues not addressed in the current literature on FEP. This study aims at making a substantial contribution to research on FEP patients. It is hoped that the research strategies adopted in PICOS will enhance the convergence of methodologies in ongoing and future studies on FEP.
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Selvaraj S, Arnone D, Job D, Stanfield A, Farrow TF, Nugent AC, Scherk H, Gruber O, Chen X, Sachdev PS, Dickstein DP, Malhi GS, Ha TH, Ha K, Phillips ML, McIntosh AM. Grey matter differences in bipolar disorder: a meta-analysis of voxel-based morphometry studies. Bipolar Disord 2012; 14:135-45. [PMID: 22420589 DOI: 10.1111/j.1399-5618.2012.01000.x] [Citation(s) in RCA: 219] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Several neuroimaging studies have reported structural brain differences in bipolar disorder using automated methods. While these studies have several advantages over those using region of interest techniques, no study has yet estimated a summary effect size or tested for between-study heterogeneity. We sought to address this issue using meta-analytic techniques applied for the first time in bipolar disorder at the level of the individual voxel. METHODS A systematic review identified 16 voxel-based morphometry (VBM) studies comparing individuals with bipolar disorder with unaffected controls, of which eight were included in the meta-analysis. In order to take account of heterogeneity, summary effect sizes were computed using a random-effects model with appropriate correction for multiple testing. RESULTS Compared with controls, subjects with bipolar disorder had reduced grey matter in a single cluster encompassing the right ventral prefrontal cortex, insula, temporal cortex, and claustrum. Study heterogeneity was widespread throughout the brain; though the significant cluster of grey matter reduction remained once these extraneous voxels had been removed. We found no evidence of publication bias (Eggers p = 0.63). CONCLUSIONS Bipolar disorder is consistently associated with reductions in right prefrontal and temporal lobe grey matter. Reductions elsewhere may be obscured by clinical and methodological heterogeneity.
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Affiliation(s)
- Sudhakar Selvaraj
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK.
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13
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Brambilla P, Como G, Isola M, Taboga F, Zuliani R, Goljevscek S, Ragogna M, Brondani G, Baiano M, Perini L, Ferro A, Bazzocchi M, Zuiani C, Balestrieri M. White-matter abnormalities in the right posterior hemisphere in generalized anxiety disorder: a diffusion imaging study. Psychol Med 2012; 42:427-434. [PMID: 21781374 DOI: 10.1017/s0033291711001255] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Prior imaging studies have shown structural, functional and biochemical impairments in patients with generalized anxiety disorder (GAD), particularly in the right hemisphere. In this study we investigated, for the first time to the best of our knowledge, the white-matter microstructure organization in GAD. METHOD A total of 12 patients with DSM-IV GAD and 15 matched healthy controls underwent a magnetic resonance imaging session of diffusion weighted imaging, exploring white-matter water molecules by the means of apparent diffusion coefficients (ADCs). Regions of interests were placed in the frontal, parietal, temporal and occipital lobes and in the splenium and genu of the corpus callosum, bilaterally. RESULTS ADC measures were significantly greater in patients with GAD in the right splenium and right parietal cortex compared with healthy controls (p⩽0.002). No significant correlations between ADCs and age or clinical variables were found. CONCLUSIONS We provide evidence that GAD is associated with disrupted white-matter coherence of posterior right hemisphere regions, which may partly sustain the impaired cognitive regulation of anxiety. Future diffusion imaging investigations are expected to better elucidate the communication between the parietal cortex and other right hemisphere regions in sustaining the cognitive processing of social and emotional stimuli in patients with GAD.
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Affiliation(s)
- P Brambilla
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
| | - G Como
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - M Isola
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - F Taboga
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
| | - R Zuliani
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
| | - S Goljevscek
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
| | - M Ragogna
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
| | - G Brondani
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - M Baiano
- Centre for Weight and Eating Disorders, Portogruaro, Venice, Italy
| | - L Perini
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
| | - A Ferro
- Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, Inter-University Centre for Behavioural Neurosciences, University of Verona, Verona, Italy
| | - M Bazzocchi
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - C Zuiani
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - M Balestrieri
- Department of Experimental Clinical Medical Sciences, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy
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Castellani U, Rossato E, Murino V, Bellani M, Rambaldelli G, Perlini C, Tomelleri L, Tansella M, Brambilla P. Classification of schizophrenia using feature-based morphometry. J Neural Transm (Vienna) 2011; 119:395-404. [PMID: 21904897 DOI: 10.1007/s00702-011-0693-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 07/16/2011] [Indexed: 11/28/2022]
Abstract
The objective of this study was to use a combined local descriptor, namely scale invariance feature transform (SIFT), and a non linear support vector machine (SVM) technique to automatically classify patients with schizophrenia. The dorsolateral prefrontal cortex (DLPFC), considered a reliable neuroanatomical marker of the disease, was chosen as region of interest (ROI). Fifty-four schizophrenia patients and 54 age- and gender-matched normal controls were studied with a 1.5T MRI (slice thickness 1.25 mm). Three steps were conducted: (1) landmark detection and description of the DLPFC, (2) feature vocabulary construction and Bag-of-Words (BoW) computation for brain representation, (3) SVM classification which adopted the local kernel to implicitly implement the feature matching. Moreover, a new weighting approach was proposed to take into account the discriminant relevance of the detected groups of features. Substantial results were obtained for the classification of the whole dataset (left side 75%, right side 66.38%). The performances were higher when females (left side 84.09%, right side 77.27%) and seniors (left side 81.25%, right side 70.83%) were considered separately. In general, the supervised weighed functions increased the efficacy in all the analyses. No effects of age, gender, antipsychotic treatment and chronicity were shown on DLPFC volumes. This integrated innovative ROI-SVM approach allows to reliably detect subjects with schizophrenia, based on a structural brain marker for the disease such as the DLPFC. Such classification should be performed in first-episode patients in future studies, by considering males and females separately.
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Affiliation(s)
- U Castellani
- Department of Computer Science, University of Verona, Verona, Italy
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15
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Dutt A, Ganguly T, Shaikh M, Walshe M, Schulze K, Marshall N, Constante M, McDonald C, Murray RM, Allin MPG, Bramon E. Association between hippocampal volume and P300 event related potential in psychosis: support for the Kraepelinian divide. Neuroimage 2011; 59:997-1003. [PMID: 21924362 DOI: 10.1016/j.neuroimage.2011.08.067] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 08/08/2011] [Accepted: 08/21/2011] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Abnormalities of the P300 event related potential (ERP) and of hippocampal structure are observed in individuals with psychotic disorders and their unaffected relatives. The understanding and clinical management of psychotic disorders are largely based on the descriptive Kraepelinian distinction between 'dementia praecox' and 'manic depressive psychosis', and not dependant on any well demarcated biological underpinnings. The hippocampus is postulated to be one of the main P300 generators, yet it remains unknown whether hippocampal volume decrements are associated with P300 deficits in psychosis, and whether any association is shared across non-affective and affective psychotic disorders. METHODS 228 subjects from the Maudsley Family Psychosis Study comprising 55 patients with non-affective psychosis, 23 patients with psychotic bipolar disorder, 98 unaffected relatives, and 52 unrelated controls contributed structural MRI and ERP data. To study the relationship between hippocampal volume and P300 ERP, a seemingly unrelated regression methodology was used, accounting for whole brain volumes, clinical groups, age and gender in the analysis. RESULTS An association between left hippocampal volume and P300 latency in the combined sample comprising non-affective and affective psychotic patients, their relatives and controls was observed. There was an inverse relationship between brain structure and function in that prolongation of P300 latencies was associated with smaller left hippocampal volumes. On subdividing the sample based on Kraepelinian dichotomy, this association remained significant only for the non-affective psychosis group, comprising patients and their unaffected relatives. CONCLUSIONS Based on our findings, P300 latency, a measure of the speed of neural transmission, appears to be related to the size of the left hippocampus in schizophrenia, but not in psychotic bipolar disorder. It seems that underlying neuro-biological characteristics could help in unravelling the traditional Kraepelinian differentiation between the two major psychoses. The specificity of this brain structure-function association for schizophrenia opens the scope for further research using integration of multimodal biological data for objective categorisation of psychosis.
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Affiliation(s)
- Anirban Dutt
- NIHR Biomedical Research Centre, Institute of Psychiatry (King's College London)/South London and Maudsley NHS Foundation Trust, London, UK.
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16
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Brambilla P, Cerruti S, Bellani M, Perlini C, Ferro A, Marinelli V, Giusto D, Tomelleri L, Rambaldelli G, Tansella M, Diwadkar VA. Shared impairment in associative learning in schizophrenia and bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1093-9. [PMID: 21420463 DOI: 10.1016/j.pnpbp.2011.03.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 03/09/2011] [Accepted: 03/09/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND Schizophrenia (SCZ) and bipolar disorder (BD) share some cognitive commonalities. However, the role of associative learning, which is a cornerstone of human cognition mainly relying on hippocampus, has been under-investigated. We assessed behavioral performance during associative learning in a group of SCZ, BD and healthy controls (HC). METHODS Nineteen patients with SCZ (36 ± 8.1 years; 13 males, 6 females; all Caucasians), 14 patients with BD (41 ± 9.6 years; 5 males, 9 females; all Caucasians) and 45 HC (27.7 ± 6.9 years; 18 males, 27 females; all Caucasians) were studied. Learning was assessed using an established object-location paired-associative learning paradigm. Subjects learned associations between nine equi-familiar common objects and locations in a nine-location grid. Performance data were analyzed in a repeated measures analysis of variance with time (repeated) and group as factors. RESULTS Learning curves (performance = (1-e(-k x time)) fitted to average performance data in the three groups revealed lower learning rates in SCZ and BD (k = 0.17 and k = 0.34) than HC (k = 0.78). Significant effects of group (F = 11.05, p < 0.001) and time (F = 122.06, p < 0.001) on learning performance were observed. CONCLUSIONS Our study showed that associative learning is impaired in both SCZ and BD, being potentially not affected by medication. Future studies should investigate the neural substrates of learning deficits in SCZ and BD, particularly focusing on hippocampus function and glutamatergic transmission.
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Affiliation(s)
- Paolo Brambilla
- DISM, Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy.
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Corpus callosum deficits in antipsychotic-naïve schizophrenia: evidence for neurodevelopmental pathogenesis. Psychiatry Res 2010; 182:141-5. [PMID: 20413279 DOI: 10.1016/j.pscychresns.2010.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Revised: 12/06/2009] [Accepted: 01/08/2010] [Indexed: 11/21/2022]
Abstract
The corpus callosum (CC), the largest inter-hemispheric tract connecting the association cortices, has been shown to be affected in disorders with aberrant neurodevelopment. Previous studies that investigated CC abnormalities in schizophrenia have reported mixed findings potentially due to various confounding factors. In this study, we used magnetic resonance imaging to examine a large sample of antipsychotic-naïve schizophrenia patients (n=66) in comparison with age-, sex-, and handedness-matched (as a group) healthy comparison subjects (n=46). Mid-sagittal areas of CC sub-regions--namely, the genu, body, isthmus and splenium--were measured based on Witelson's method with good inter- and intra-rater reliability. The genu and body of the CC were significantly smaller in schizophrenia patients in comparison to healthy subjects after controlling for the potential confounding effects of age, sex and intracranial area. In male schizophrenia patients, there was a significant positive correlation between the age at onset of psychosis and the area of the genu. Together, these findings suggest neurodevelopmentally mediated hypoconnectivity in schizophrenia.
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