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Knorr U, Simonsen AH, Nilsson J, Brinkmalm A, Zetterberg H, Blennow K, Knudsen MB, Forman J, Hasselbalch SG, Kessing LV. Cerebrospinal fluid synaptic biomarker changes in bipolar disorder - A longitudinal case-control study. J Affect Disord 2024; 358:250-259. [PMID: 38723679 DOI: 10.1016/j.jad.2024.05.034] [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: 01/18/2024] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND This exploratory study investigated cerebrospinal fluid (CSF) synaptic protein biomarkers in bipolar disorder (BD), aiming to highlight the neurobiological basis of the disorder. With shared cognitive impairment features between BD and Alzheimer's disease, and considering increased dementia risk in BD patients, the study explores potential connections. METHODS Fifty-nine well-characterized patients with BD and thirty-seven healthy control individuals were examined and followed for one year. Synaptic proteins encompassing neuronal pentraxins (NPTX)1, NPTX2, and NPTX-receptor, 14-3-3 protein family epsilon, and zeta/delta, activating protein-2 complex subunit beta, synucleins beta-synuclein and gamma-synuclein, complexin-2, phosphatidylethanolamine-binding protein 1, rab GDP dissociation inhibitor alpha, and syntaxins 1B and 7 were measured in CSF using a microflow liquid chromatography-mass spectrometric multiple reaction monitoring set-up. Biomarker levels were compared between BD and HC and in BD before, during, and after mood episodes. RESULTS The synaptic proteins revealed no statistically significant differences between BD and HC, neither at baseline, one-year follow-up, or in terms of changes from baseline to follow-up. Moreover, the CSF synaptic protein levels in patients with BD were unaltered compared to baseline when they stabilized in euthymia following an affective episode and at one-year follow-up. LIMITATION It is uncertain what the CSF biomarker concentrations reflect since we yet do not know the mechanisms of release of these proteins, and we are uncertain of what increased or decreased levels reflect. CONCLUSION This first-ever investigation of a panel of CSF protein biomarkers of synaptic dysfunction in patients with BD and HC individuals found no statistically significant differences cross-sectionally or longitudinally.
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Affiliation(s)
- Ulla Knorr
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Department Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark.
| | - Anja Hviid Simonsen
- Danish Dementia Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Johanna Nilsson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Ann Brinkmalm
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease, University College London, Queen Square, London, United Kingdom; UK Dementia Research Institute University College London, London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Paris Brain Institute, ICM, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France; Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, and Department of Neurology, Institute on Aging and Brain Disorders, University of Science and Technology of China and First Affiliated Hospital of USTC, Hefei, PR China
| | - Mark Bech Knudsen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Denmark
| | - Julie Forman
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Denmark
| | - Steen Gregers Hasselbalch
- Danish Dementia Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Department Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
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Hjorthøj C, Madsen T, Starzer M, Erlangsen A, Nordentoft M. Mortality in substance-induced psychosis: a register-based national cohort study. Addiction 2021; 116:3515-3524. [PMID: 34105214 DOI: 10.1111/add.15598] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/25/2021] [Accepted: 05/26/2021] [Indexed: 12/20/2022]
Abstract
AIMS We aimed to analyze whether people with substance-induced psychosis (SIP), both those who convert and do not convert to schizophrenia, have higher all-cause and cause-specific mortality when compared to the general population. DESIGN Prospective cohort study. SETTING Nationwide Danish registers. PARTICIPANTS/CASES We included all people born in Denmark, living in Denmark on their 15th birthday, and age 15 or more during the study period from January 1, 1994, and August 10, 2017. MEASUREMENTS Exposure was categorized as: (i) neither SIP nor schizophrenia; (ii) SIP without preceding schizophrenia; (iii) SIP converted to schizophrenia; and (iv) schizophrenia without preceding SIP. Any SIP and substance-specific SIPS were examined regarding all-cause and cause-specific mortality. FINDINGS The study included a total of 5 619 691 individuals. Compared to people with neither schizophrenia nor SIP, people with SIP without preceding schizophrenia had an increased risk of dying (hazard ratio [HR] = 6.23, 95% CI = 5.96-6.50), as had those with SIP converting to schizophrenia (HR = 9.77, 95% CI = 8.84-10.79) and those with only schizophrenia (HR = 3.07, 95% CI = 3.03-3.13). A similar pattern, albeit with higher HRs, was observed for suicides and accidental deaths. Other cause-specific-mortality groups also generally showed the same pattern, as did types of individual substances. CONCLUSIONS Substance-induced psychosis was strongly associated with an increased risk of both all-cause and cause-specific mortality, even among cases who did not convert to schizophrenia. This provides a strong rationale for monitoring people with previous diagnosis of substance-induced psychosis and developing and implementing interventions to reduce this excess mortality.
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Affiliation(s)
- Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Public Health, Section of Epidemiology, University of Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPsych, Copenhagen and Aarhus, Denmark
| | - Trine Madsen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,Danish Research Institute of Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Capital Region of Denmark, Denmark
| | - Marie Starzer
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Annette Erlangsen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,Danish Research Institute of Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Capital Region of Denmark, Denmark.,Center of Mental Health Research, Australian National University, Canberra, Australia.,Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPsych, Copenhagen and Aarhus, Denmark.,Danish Research Institute of Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Capital Region of Denmark, Denmark
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Gao W, Cui D, Jiao Q, Su L, Yang R, Lu G. Brain structural alterations in pediatric bipolar disorder patients with and without psychotic symptoms. J Affect Disord 2021; 286:87-93. [PMID: 33714175 DOI: 10.1016/j.jad.2021.02.077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/02/2021] [Accepted: 02/28/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Bipolar disorder (BD) with psychotic symptoms is a specific phenotype that presents greater risk of relapse and worse outcomes than nonpsychotic BD, however, the underlying mechanisms remain unknown and are less revealed in youth. Thus, the aims of the present study were to investigate brain structural alterations in pediatric bipolar disorder (PBD) patients with and without psychotic symptoms, and specifically to evaluate the impact of psychotic features on gray matter volume (GMV) in PBD patients. METHOD A total of 73 individuals were recruited into three groups, n = 28, psychotic PBD, P-PBD; n = 26, nonpsychotic PBD, NP-PBD; and n = 19, healthy controls, HC. All participants underwent high-resolution structural magnetic resonance scans. Voxel-based morphometry was used to investigate GMV alterations. Analyses of variance (ANOVA) were performed to obtain brain regions with significant differences among three groups and then post hoc tests were calculated for inter-group comparisons. RESULTS The ANOVA revealed significant GMV differences among three groups in the bilateral amygdala-hippocampus-parahippocampal complex (AMY-HIS-ParaHIS complex), left superior temporal gyrus (STG), left inferior frontal gyrus (IFG), bilateral putamen (PUT), left precentral gyrus (PG), left supramarginal gyrus (SMG), and right inferior parietal lobule (IPL). Compared with HCs, P-PBD patients showed decreased GMV in the bilateral AMY-HIS-ParaHIS complex, left STG, left IFG, bilateral PUT, and left PG; while NP-PBD patients exhibited decreased GMV in the left IFG, left PG, left SMG, and right IPL. Furthermore, P-PBD patients showed increased GMV in the right IPL when comparing to NP-PBD patients. LIMITATION The present findings require replication in larger samples and verification in medication free subjects. CONCLUSION The present findings suggested that psychotic features in PBD were associated with extensive brain structural lesions mainly located in the prefrontal-limbic-striatum circuit, which might represent the pathological basis of more sever symptoms in patients with psychotic PBD.
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Affiliation(s)
- Weijia Gao
- Department of Child Psychology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, Zhejiang, China
| | - Dong Cui
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong, China
| | - Qing Jiao
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong, China.
| | - Linyan Su
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Key Laboratory of Psychiatry and Mental Health of Hunan Province, National Technology Institute of Psychiatry, Changsha, Hunan, China.
| | - Rongwang Yang
- Department of Child Psychology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, Zhejiang, China.
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China
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Wu C, Ren C, Teng Z, Li S, Silva F, Wu H, Chen J. Cerebral glucose metabolism in bipolar disorder: A voxel-based meta-analysis of positron emission tomography studies. Brain Behav 2021; 11:e02117. [PMID: 33769704 PMCID: PMC8119802 DOI: 10.1002/brb3.2117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 03/01/2021] [Accepted: 03/09/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Previous positron emission tomography studies have reported the changes of cerebral glucose metabolism in bipolar disorder. However, the findings across studies remain controversial, containing differing results. METHODS A systematic literature search of the PubMed, Embase, Cochrane Library, and Web of Science databases was conducted. We conducted a voxel-wide meta-analysis of cerebral glucose metabolism studies, using the seed-based mapping approach, in patients with bipolar disorder (BD). RESULTS We identified 7 studies suitable for inclusion, which included a total of 126 individuals with BD and 160 healthy controls. The most consistent and robust findings were an increase in cerebral glucose metabolism in the right precentral gyrus and a decrease in the left superior temporal gyrus, left middle temporal gyrus, and cerebellum. Additionally, the sex distribution and illness duration had significant moderating effects on cerebral glucose metabolism alterations. CONCLUSIONS Cerebral glucose metabolism alterations in these brain regions are likely to reflect the disease-related functional abnormalities such as emotion and cognition. These findings contribute to a better understanding of the neurobiological underpinnings of bipolar disorder. LIMITATIONS This study was done at a study level and cannot be addressed at the patient level. Subgroup analysis of BD I and BD II is not possible due to limited literature data.
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Affiliation(s)
- Chujun Wu
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chutong Ren
- The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ziwei Teng
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Sujuan Li
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Floyd Silva
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Haishan Wu
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jindong Chen
- National Clinical Research Center for Mental Disorders, Department of Psychaitry, China National Technology Institute on Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
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5
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Mendez MF. Degenerative dementias: Alterations of emotions and mood disorders. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:261-281. [PMID: 34389121 DOI: 10.1016/b978-0-12-822290-4.00012-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Degenerative dementias such as Alzheimer's disease and frontotemporal dementia result in distinct alterations in emotional processing, emotional experiences, and mood. The neuropathology of these dementias extends to structures involved in emotional processing, including the basolateral limbic network (orbitofrontal cortex, anterior temporal lobe, amygdala, and thalamus), the insula, and ventromedial frontal lobe. Depression is the most common emotion and mood disorder affecting patients with Alzheimer's disease. The onset of depression can be a prodromal sign of this dementia. Anxiety can also be present early in the course of Alzheimer's disease and especially among patients with early-onset forms of the disease. In contrast, patients with behavioral variant frontotemporal dementia demonstrate hypoemotionality, deficits in the recognition of emotion, and decreased psychophysiological reactivity to emotional stimuli. They typically have a disproportionate impairment in emotional and cognitive empathy. One other unique feature of behavioral variant frontotemporal dementia is the frequent occurrence of bipolar disorder. The management strategies for these alterations of emotion and mood in degenerative dementias primarily involve the judicious use of the psychiatric armamentarium of medications.
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Affiliation(s)
- Mario F Mendez
- Behavioral Neurology Program, Department of Neurology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States; Neurology Service, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States.
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6
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Maia da Silva MN, Porto FHDG, Lopes PMG, Sodré de Castro Prado C, Frota NAF, Alves CHL, Alves GS. Frontotemporal Dementia and Late-Onset Bipolar Disorder: The Many Directions of a Busy Road. Front Psychiatry 2021; 12:768722. [PMID: 34925096 PMCID: PMC8674641 DOI: 10.3389/fpsyt.2021.768722] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/13/2021] [Indexed: 12/18/2022] Open
Abstract
It is a common pathway for patients with the behavioral variant of frontotemporal dementia (bvFTD) to be first misdiagnosed with a primary psychiatric disorder, a considerable proportion of them being diagnosed with bipolar disorder (BD). Conversely, not rarely patients presenting in late life with a first episode of mania or atypically severe depression are initially considered to have dementia before the diagnosis of late-onset BD is reached. Beyond some shared features that make these conditions particularly prone to confusion, especially in the elderly, the relationship between bvFTD and BD is far from simple. Patients with BD often have cognitive complaints as part of their psychiatric disorder but are at an increased risk of developing dementia, including FTD. Likewise, apathy and disinhibition, common features of depression and mania, respectively, are among the core features of the bvFTD syndrome, not to mention that depression may coexist with dementia. In this article, we take advantage of the current knowledge on the neurobiology of these two nosologic entities to review their historical and conceptual interplay, highlighting the clinical, genetic and neuroimaging features that may be shared by both disorders or unique to each of them.
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Affiliation(s)
- Mari N Maia da Silva
- Geriatric Neuropsychiatry Outpatient Service, Nina Rodrigues Hospital, São Luís, Brazil
| | - Fábio Henrique de Gobbi Porto
- Laboratory of Psychiatric Neuroimaging (LIM-21) and Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | - Norberto Anízio Ferreira Frota
- University of Fortaleza (UNIFOR) School of Medicine, Cognitive and Behavioral Neurology Service, Hospital Geral de Fortaleza, Fortaleza, Brazil
| | | | - Gilberto Sousa Alves
- Geriatric Neuropsychiatry Outpatient Service, Nina Rodrigues Hospital, São Luís, Brazil.,Post Graduation in Psychiatry and Mental Health, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Faria AV, Zhao Y, Ye C, Hsu J, Yang K, Cifuentes E, Wang L, Mori S, Miller M, Caffo B, Sawa A. Multimodal MRI assessment for first episode psychosis: A major change in the thalamus and an efficient stratification of a subgroup. Hum Brain Mapp 2020; 42:1034-1053. [PMID: 33377594 PMCID: PMC7856640 DOI: 10.1002/hbm.25276] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/29/2020] [Accepted: 10/18/2020] [Indexed: 02/06/2023] Open
Abstract
Multi‐institutional brain imaging studies have emerged to resolve conflicting results among individual studies. However, adjusting multiple variables at the technical and cohort levels is challenging. Therefore, it is important to explore approaches that provide meaningful results from relatively small samples at institutional levels. We studied 87 first episode psychosis (FEP) patients and 62 healthy subjects by combining supervised integrated factor analysis (SIFA) with a novel pipeline for automated structure‐based analysis, an efficient and comprehensive method for dimensional data reduction that our group recently established. We integrated multiple MRI features (volume, DTI indices, resting state fMRI—rsfMRI) in the whole brain of each participant in an unbiased manner. The automated structure‐based analysis showed widespread DTI abnormalities in FEP and rs‐fMRI differences between FEP and healthy subjects mostly centered in thalamus. The combination of multiple modalities with SIFA was more efficient than the use of single modalities to stratify a subgroup of FEP (individuals with schizophrenia or schizoaffective disorder) that had more robust deficits from the overall FEP group. The information from multiple MRI modalities and analytical methods highlighted the thalamus as significantly abnormal in FEP. This study serves as a proof‐of‐concept for the potential of this methodology to reveal disease underpins and to stratify populations into more homogeneous sub‐groups.
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Affiliation(s)
- Andreia V Faria
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yi Zhao
- Department of Biostatistics, Indiana University, School of Medicine, Indianapolis, Indiana, USA
| | - Chenfei Ye
- Department of Electronics and Information, Harbin Institute of Technology Shenzhen Graduate School, Guangdong, China
| | - Johnny Hsu
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kun Yang
- Department Psychiatry, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Elizabeth Cifuentes
- Department Psychiatry, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lei Wang
- Department of Psychiatry and Behavioral Sciences and Radiology, Northwestern University, Evanston, Illinois, USA
| | - Susumu Mori
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael Miller
- Department of Biomedical Engineering, The Whiting School of Engineering, Baltimore, Maryland, USA
| | - Brian Caffo
- Department of Biostatistics, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Akira Sawa
- Department Psychiatry, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Biomedical Engineering, The Whiting School of Engineering, Baltimore, Maryland, USA.,Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Mental Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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8
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Neuroanatomic and Functional Neuroimaging Findings. Curr Top Behav Neurosci 2020; 48:173-196. [PMID: 33040316 DOI: 10.1007/7854_2020_174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The search for brain morphology findings that could explain behavioral disorders has gone through a long path in the history of psychiatry. With the advance of brain imaging technology, studies have been able to identify brain morphology and neural circuits associated with the pathophysiology of mental illnesses, such as bipolar disorders (BD). Promising results have also shown the potential of neuroimaging findings in the identification of outcome predictors and response to treatment among patients with BD. In this chapter, we present brain imaging structural and functional findings associated with BD, as well as their hypothesized relationship with the pathophysiological aspects of that condition and their potential clinical applications.
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Oxidative-Antioxidant Imbalance and Impaired Glucose Metabolism in Schizophrenia. Biomolecules 2020; 10:biom10030384. [PMID: 32121669 PMCID: PMC7175146 DOI: 10.3390/biom10030384] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 02/07/2023] Open
Abstract
Schizophrenia is a neurodevelopmental disorder featuring chronic, complex neuropsychiatric features. The etiology and pathogenesis of schizophrenia are not fully understood. Oxidative-antioxidant imbalance is a potential determinant of schizophrenia. Oxidative, nitrosative, or sulfuric damage to enzymes of glycolysis and tricarboxylic acid cycle, as well as calcium transport and ATP biosynthesis might cause impaired bioenergetics function in the brain. This could explain the initial symptoms, such as the first psychotic episode and mild cognitive impairment. Another concept of the etiopathogenesis of schizophrenia is associated with impaired glucose metabolism and insulin resistance with the activation of the mTOR mitochondrial pathway, which may contribute to impaired neuronal development. Consequently, cognitive processes requiring ATP are compromised and dysfunctions in synaptic transmission lead to neuronal death, preceding changes in key brain areas. This review summarizes the role and mutual interactions of oxidative damage and impaired glucose metabolism as key factors affecting metabolic complications in schizophrenia. These observations may be a premise for novel potential therapeutic targets that will delay not only the onset of first symptoms but also the progression of schizophrenia and its complications.
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Delvecchio G, Pigoni A, Bauer IE, Soares JC, Brambilla P. Disease-discordant twin structural MRI studies on affective disorders. Neurosci Biobehav Rev 2019; 108:459-471. [PMID: 31790709 DOI: 10.1016/j.neubiorev.2019.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/24/2019] [Accepted: 11/26/2019] [Indexed: 01/01/2023]
Abstract
Magnetic resonance imaging (MRI) studies have identified neural structures implicated in the pathophysiology of mood disorders, especially bipolar disorder (BD) and major depressive disorder (MDD). However, the role of genetic and environmental influences on such brain deficits is still unclear. In this context, the present review summarizes the current evidence from structural MRI and Diffusion Tensor Imaging (DTI) studies on twin samples concordant or discordant for BD or MDD, with the aim of clarifying the role of genetic and environmental risk factors on brain alterations. Although the results showed a complex interplay between gene and environment in affective disorders, the evidence seem to underline that both genetic and environmental risk factors have an impact on brain areas and vulnerability to MDD and BD. However, the precise mechanism of action and the interaction between these factors still needs to be unveiled. Therefore, future larger studies on concordant or discordant twins should be encouraged, because this population provides a unique opportunity to probe separately genetic and environmental markers of disease vulnerability.
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Affiliation(s)
- G Delvecchio
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy
| | - A Pigoni
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy
| | - I E Bauer
- Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - J C Soares
- Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - P Brambilla
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
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11
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Squarcina L, Dagnew TM, Rivolta MW, Bellani M, Sassi R, Brambilla P. Automated cortical thickness and skewness feature selection in bipolar disorder using a semi-supervised learning method. J Affect Disord 2019; 256:416-423. [PMID: 31229930 DOI: 10.1016/j.jad.2019.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/26/2019] [Accepted: 06/07/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Bipolar disorder (BD) broadly affects brain structure, in particular areas involved in emotion processing and cognition. In the last years, the psychiatric field's interest in machine learning approaches has been steadily growing, thanks to the potentiality of automatically discriminating patients from healthy controls. METHODS In this work, we employed cortical thickness of 58 regions of interest obtained from magnetic resonance imaging scans of 41 BD patients and 34 healthy controls, to automatically identify the regions which are mostly involved with the disease. We used a semi-supervised method, addressing the criticisms on supervised methods, related to the fact that the diagnosis is not unaffected by uncertainty. RESULTS Our results confirm findings in previous studies, with a classification accuracy of about 75% when mean thickness and skewness of up to five regions are considered. We obtained that the parietal lobe and some areas in the temporal sulcus were the regions which were the most involved with BD. LIMITATIONS The major limitation of our work is the limited size or our dataset, but in line with other recent machine learning works in the field. Moreover, we considered chronic patients, whose brain characteristics may thus be affected. CONCLUSIONS The automatic selection of the brain regions most involved in BD may be of great importance when dealing with the pathogenesis of the disorder. Our method selected regions which are known to be involved with BD, indicating that damage to the identified areas can be considered as a marker of disease.
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Affiliation(s)
- L Squarcina
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
| | - T M Dagnew
- Department of Computer Science, University of Milan, Milan, Italy.
| | - M W Rivolta
- Department of Computer Science, University of Milan, Milan, Italy
| | - M Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
| | - R Sassi
- Department of Computer Science, University of Milan, Milan, Italy
| | - P Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Delvecchio G, Mandolini GM, Arighi A, Prunas C, Mauri CM, Pietroboni AM, Marotta G, Cinnante CM, Triulzi FM, Galimberti D, Scarpini E, Altamura AC, Brambilla P. Structural and metabolic cerebral alterations between elderly bipolar disorder and behavioural variant frontotemporal dementia: A combined MRI-PET study. Aust N Z J Psychiatry 2019; 53:413-423. [PMID: 30545239 DOI: 10.1177/0004867418815976] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Elderly bipolar disorder (BD) and behavioural variant of frontotemporal dementia (bvFTD) may exhibit similar symptoms and both disorders are characterized by selective abnormalities in cortical and subcortical regions that are associated with cognitive and emotional impairments. We aimed to investigate common and distinct neural substrates of BD and bvFTD by coupling, for the first time, magnetic resonance imaging (MRI) and positron emission tomography (PET) techniques. METHODS 3-Tesla MRI and 18 fluorodeoxyglucose-PET scans were acquired for 16 elderly BD patients, 23 bvFTD patients with mild cognitive impairments and 68 healthy controls (48 for PET and 20 for MRI analyses). RESULTS BD and bvFTD patients exhibit a different localization of grey matter reductions in the lateral prefrontal cortex, with the first group showing grey matter decrease in the ventrolateral prefrontal cortex and the latter group showing grey matter reductions in the dorsolateral prefrontal cortex as well as unique grey matter and metabolic alterations within the orbitofrontal cortex. The bvFTD group also displayed unique volumetric shrinkage in regions within the temporo-parietal network together with greater metabolic impairments within the temporal cortex and more extensive volumetric and metabolic abnormalities within the limbic lobe. Finally, while the BD group showed greater grey matter volumes in caudate nucleus, bvFTD subjects displayed lower metabolism. CONCLUSION This MRI-PET study explored, for the first time to the best of our knowledge, structural and functional abnormalities in bvFTD and elderly BD patients, with the final aim of identifying the specific biological signature of these disorders, which might have important implications not only in prevention but also in differential diagnosis and treatment.
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Affiliation(s)
- Giuseppe Delvecchio
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Gian Mario Mandolini
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Arighi
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,3 'Dino Ferrari' Center, Milan, Italy
| | - Cecilia Prunas
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Massimo Mauri
- 2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna M Pietroboni
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,3 'Dino Ferrari' Center, Milan, Italy
| | - Giorgio Marotta
- 2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Maria Cinnante
- 2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Maria Triulzi
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Galimberti
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,3 'Dino Ferrari' Center, Milan, Italy
| | - Elio Scarpini
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,3 'Dino Ferrari' Center, Milan, Italy
| | - Alfredo Carlo Altamura
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,2 Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- 1 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,4 Department of Psychiatry and Behavioural Sciences, UT Houston Medical School, Houston, TX, USA
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Marotta G, Delvecchio G, Pigoni A, Mandolini G, Ciappolino V, Oldani L, Madonna D, Grottaroli M, Altamura AC, Brambilla P. The metabolic basis of psychosis in bipolar disorder: A positron emission tomography study. Bipolar Disord 2019; 21:151-158. [PMID: 30506616 DOI: 10.1111/bdi.12710] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Psychotic symptoms are a common feature in bipolar disorder (BD), especially during manic phases, and are associated with a more severe course of illness. However, not all bipolar subjects experience psychosis during the course of their illness, and this difference often guides assessment and pharmacological treatment. The aim of the present study is to elucidate, for the first time, the FDG uptake dysfunctions associated with psychosis in BD patients with and without a history of past psychotic symptoms, through a positron emission tomography (PET) approach. METHODS Fifty BD patients with lifetime psychotic symptoms, 40 BD patients without lifetime psychotic symptoms and 27 healthy controls (HC) were recruited and underwent an 18F-FDG-PET session. RESULTS Compared to HC, BD subjects shared common FDG uptake deficits in several brain areas, including insula, inferior temporal gyrus and middle occipital gyrus. Moreover, we found that BD patients with a history of past psychotic symptoms had a unique FDG uptake alteration in the right fusiform gyrus compared to both BD patients without lifetime psychotic symptoms and HC (all P < 0.01, cFWE corrected). CONCLUSIONS Overall, our results suggest that FDG uptake alterations in brain regions involved in emotion regulation are a key feature of BD, regardless the presence of past psychosis. Finally, we demonstrated that the FDG uptake reduction in fusiform gyrus is associated with the presence of past psychotic symptoms in BD, ultimately leading towards the idea that the fusiform gyrus might be considered a putative biomarker of psychosis.
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Affiliation(s)
- Giorgio Marotta
- Department of Nuclear Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Scientific Institute, IRCCS E. Medea, Pordenone, Italy
| | - Alessandro Pigoni
- 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
| | - Gianmario Mandolini
- 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
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Lucio Oldani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Domenico Madonna
- 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
| | - Marika Grottaroli
- 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
| | - Alfredo Carlo Altamura
- 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
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Psychiatry and Behavioural Sciences, UT Houston Medical School, Houston, TX, USA
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Wang X, Tian F, Wang S, Cheng B, Qiu L, He M, Wang H, Duan M, Dai J, Jia Z. Gray matter bases of psychotic features in adult bipolar disorder: A systematic review and voxel-based meta-analysis of neuroimaging studies. Hum Brain Mapp 2018; 39:4707-4723. [PMID: 30096212 DOI: 10.1002/hbm.24316] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 07/05/2018] [Indexed: 02/05/2023] Open
Abstract
Psychotic bipolar disorder (P-BD) is a specific subset that presents greater risk of relapse and worse outcomes than nonpsychotic bipolar disorder (NP-BD). To explore the neuroanatomical bases of psychotic dimension in bipolar disorder (BD), a systematic review was carried out based on the gray matter volume (GMV) among P-BD and NP-BD patients and healthy controls (HC). Further, we conducted a meta-analysis of GMV differences between P-BD patients and HC using a whole-brain imaging approach. Our review revealed that P-BD patients exhibited smaller GMVs mainly in the prefronto-temporal and cingulate cortices, the precentral gyrus, and insula relative to HC both qualitatively and quantitatively. Qualitatively the comparison between P-BD and NP-BD patients suggested inconsistent GMV alterations mainly involving the prefrontal cortex, while NP-BD patients showed GMV deficits in local regions compared with HC. The higher proportions of female patients and patients taking psychotropic medication in P-BD and P-BD type I were associated with smaller GMV in the right precentral gyrus, and the right insula, respectively. In conclusions, psychosis in BD might be associated with specific cortical GMV deficits. Gender and psychotropic medication might have effects on the regional GMVs in P-BD patients. It is necessary to distinguish psychotic dimension in neuroimaging studies of BD.
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Affiliation(s)
- Xiuli Wang
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Fangfang Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Song Wang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Lihua Qiu
- Department of Radiology, The Second People's Hospital of Yibin, Yibin, China
| | - Manxi He
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Hongming Wang
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Mingjun Duan
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Jing Dai
- Department of Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
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Sun JJ, Liu XM, Shen CY, Feng K, Liu PZ. Abnormal prefrontal brain activation during a verbal fluency task in bipolar disorder patients with psychotic symptoms using multichannel NIRS. Neuropsychiatr Dis Treat 2018; 14:3081-3090. [PMID: 30519029 PMCID: PMC6239130 DOI: 10.2147/ndt.s176153] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Bipolar disorder (BD) patients with psychotic symptoms (BDp) worsens prognosis and decreases rates of recovery. The study investigated cognitive performance and brain function between BD patients in depressive episode with and without psychotic symptoms to find potential neurobiological markers associated with psychotic features of BD patients in depressive episode. PATIENTS AND METHODS Thirty-one patients without psychotic symptoms and 29 patients with psychotic symptoms diagnosed with bipolar I disorder with a current depressive episode were included in the present study. The neural function of prefrontal cortex (PFC) and cognitive performance among BDp, BD patients without psychotic symptoms, and 23 healthy controls (HC) were examined using near-infrared spectroscopy during verbal fluency task (VFT). RESULTS 1) Both the BD groups exhibited significantly worse performance of VFT and lower activation of oxygenated hemoglobin (oxy-Hb) changes in the bilateral ventrolateral PFC compared with the HC group. 2) Within the BD group, VFT performance was not significantly different. 3) The prefrontal activation of oxy-Hb changes in the BDp patients was significantly lower than that in the BD patients without psychotic symptoms in the right dorsolateral PFC. 4) Activation of oxy-Hb changes in right dorsolateral PFC was negatively correlated with the severity of psychotic symptoms in BDp patients. CONCLUSION The prefrontal function differs between BD patients in depressive episode with or without psychotic symptoms measured with near-infrared spectroscopy.
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Affiliation(s)
- Jing-Jing Sun
- School of Clinical Medicine, Medicine Institute, Tsinghua University, Beijing, China.,Yu Quan Hospital, Clinical Neuroscience Institute, Tsinghua University, Beijing, China,
| | - Xiao-Min Liu
- Yu Quan Hospital, Clinical Neuroscience Institute, Tsinghua University, Beijing, China,
| | - Chen-Yu Shen
- Yu Quan Hospital, Clinical Neuroscience Institute, Tsinghua University, Beijing, China,
| | - Kun Feng
- School of Clinical Medicine, Medicine Institute, Tsinghua University, Beijing, China.,Yu Quan Hospital, Clinical Neuroscience Institute, Tsinghua University, Beijing, China,
| | - Po-Zi Liu
- Yu Quan Hospital, Clinical Neuroscience Institute, Tsinghua University, Beijing, China,
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Abstract
Single-photon emission computed tomography (SPECT) and positron emission tomography (PET) with different radiotracers enable regional evaluation of blood flow and glucose metabolism, of receptors and transporters of several molecules, and of abnormal deposition of peptides and proteins in the brain. The cerebellum has been used as a reference region for different radiotracers in several disease conditions. Whole-brain voxel-wise analysis is not affected by a priori knowledge bias and should be preferred. SPECT and PET have contributed to establishing the cerebellum role in motion, cognition, and emotion control in physiologic and pathophysiologic conditions. The basic abnormal imaging findings include decreased or increased uptake of flow or metabolism tracers in the cerebellum alone or as part of a network. Decreased uptake is generally observed in primary structural damage of the cerebellum, but can also represent a distant effect of cerebral damage (crossed diaschisis). Increased uptake can be observed in Freidreich ataxia, inflammatory or immune-mediated diseases of the cerebellum, and in status epilepticus. The possibility is also recognized that primary structural damage of the cerebellum might determine distance effects on other brain structures (reversed diaschisis). So far, SPECT and PET have been predominantly used in clinical studies to investigate cerebellar changes in neurologic and psychiatric diseases and in connection with pharmacologic, transcranial magnetic stimulation, deep-brain stimulation, or surgical treatments.
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17
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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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