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Wang M, An X, Han D, Hou X, Yang C. The effect of systematic antidepressant treatments in the early stages on sleep and impulsivity in bipolar euthymic patients: A cross-sectional study. PLoS One 2025; 20:e0322274. [PMID: 40300003 PMCID: PMC12040253 DOI: 10.1371/journal.pone.0322274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Accepted: 03/19/2025] [Indexed: 05/01/2025] Open
Abstract
BACKGROUND AND OBJECTIVES Due to early misdiagnosis, bipolar patients who had a depressive episode as their initial onset often received systematic antidepressant treatments and continued to suffer from sleep disturbances and elevated impulsivity, even during euthymic state. The study aims to assess the effect of systematic antidepressant treatments in the early stages on sleep and impulsivity in bipolar euthymic patients, and further explore the potential mediating role of sleep in the relationship between early antidepressant uses and impulsivity. METHODS A total of 124 bipolar euthymic patients were enrolled. Based on the early use of antidepressants, patients were divided into AT group (systematic antidepressant treatment group) and NT group (no systematic antidepressant treatment group). Sleep quality and impulsivity were assessed using Pittsburgh Sleep Quality Index and Barratt Impulsivity Scale Questionnaire version 11, respectively. Statistical analyses were conducted using the t-test, Chi-square test, and Mann-Whitney U test, and mediation analysis was performed using bootstrapping. RESULTS Patients in the AT group showed poorer sleep quality and higher impulsivity than those in the NT group. Patients' sleep quality was positively correlated with impulsivity. Sleep quality mediated the relationship between antidepressant uses and impulsivity, including both overall impulsivity and non-planning impulsivity. CONCLUSIONS This study suggests a correlation between early-stage antidepressant use, sleep quality, and impulsivity of bipolar euthymic patients, highlighting the importance of early diagnosis of bipolar disorder and appropriate antidepressant prescriptions. Furthermore, improving sleep quality would be effective in reducing the risk of impulsive behaviors.
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Affiliation(s)
- Mingjin Wang
- Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
- Tianjin Medical University, Tianjin, China
| | - Xuguang An
- Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Dongyu Han
- Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Xiaofei Hou
- Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Chenghao Yang
- Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
- Tianjin Medical University, Tianjin, China
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Chen F, Chen C, Wu M, Luo B, Cai H, Yu F, Wang L. Impaired emotional response inhibition among adolescents with bipolar depression: evidence from event-related potentials and behavioral performance. BMC Psychiatry 2025; 25:303. [PMID: 40165142 PMCID: PMC11956177 DOI: 10.1186/s12888-025-06748-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Accepted: 03/19/2025] [Indexed: 04/02/2025] Open
Abstract
BACKGROUND Impaired inhibition of inappropriate responses in the emotional context is a core feature in patients with bipolar disorder. However, there has been little research exploring the underlying mechanism of impaired response inhibition for emotional stimuli in adolescents with bipolar depression. To explore this issue, we employed event-related potentials (ERPs) to investigate the underlying neuroelectrophysiological mechanisms of inhibition of inappropriate emotional stimuli in adolescents with bipolar depression. METHODS Twenty-five adolescents with bipolar depression and nineteen healthy controls completed an emotional Go/No-Go task during electroencephalography recording. Reaction time (RT), reaction time variability (RTV), discriminability, and response bias were measured as behavioral performance indicators. ERP components, theta-band oscillation and inter-trial coherence (ITC) were compared between the two groups. RESULTS Behavioral performance analysis found that adolescents with bipolar depression showed smaller d' values, and larger RT and RTV, than healthy controls. Nogo-P3 amplitude was decreased in adolescents with bipolar depression in comparison with healthy controls. Theta-band oscillation and ITC for emotional stimuli were also reduced in adolescents with bipolar depression. Pearson correlation analysis showed there was a negative correlation between the Nogo-P3 amplitude induced by negative trials and RTV in adolescents with bipolar depression. CONCLUSION Our findings suggest that adolescents with bipolar depression exhibit abnormal response inhibition in the emotional context. Impaired attentional function and discrimination of emotional information are related to the failure of behavioral inhibition in negative emotional contexts, and attenuated P3 amplitude and theta-band oscillation could be an electrophysiological indicator for this impairment.
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Affiliation(s)
- Fangfang Chen
- Wuhu Forth People's Hospital, Wuhu, 241000, China
- Wuhu Hospital of Anding Hospital, Wuhu, 241000, China
| | - Cheng Chen
- Health Education Center, Anhui Normal University, Wuhu, 241000, China
| | - Mingfei Wu
- Wuhu Forth People's Hospital, Wuhu, 241000, China
- Wuhu Hospital of Anding Hospital, Wuhu, 241000, China
| | - Bingqing Luo
- Wuhu Forth People's Hospital, Wuhu, 241000, China
- Wuhu Hospital of Anding Hospital, Wuhu, 241000, China
| | - Han Cai
- Wuhu Forth People's Hospital, Wuhu, 241000, China
- Wuhu Hospital of Anding Hospital, Wuhu, 241000, China
| | - Fengqiong Yu
- Research Center for Translational Medicine, The Second Hospital of Anhui Medical University, Hefei, 230000, China.
| | - Lianzi Wang
- Wuhu Forth People's Hospital, Wuhu, 241000, China.
- Wuhu Hospital of Anding Hospital, Wuhu, 241000, China.
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Rahimi Chahooei M, Zahedi Tajrishi K, Zargarinejad G, Shabani A. Executive function performance in high and low medication adherent patients with euthymic bipolar i disorder: a comparative study. BMC Psychiatry 2025; 25:239. [PMID: 40082820 PMCID: PMC11905722 DOI: 10.1186/s12888-025-06665-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2024] [Accepted: 02/27/2025] [Indexed: 03/16/2025] Open
Abstract
INTRODUCTION Medication nonadherence is a prevalent issue among patients with bipolar disorder, leading to substantial negative consequences. Despite documented cognitive deficits in this population, the relationship between executive dysfunction and medication nonadherence remains unclear. This study aims to investigate the association between executive functions and medication adherence in euthymic patients with bipolar I disorder. METHOD In this cross-sectional, comparative study, we recruited 200 euthymic bipolar I disorder patients aged 18 to 55 years from the outpatient clinic of Iran Psychiatric Hospital in Tehran in 2024, using a convenience sampling method. The euthymic phase was confirmed using the Persian versions of the Young Mania Rating Scale and the Hamilton Rating Scale for Depression. Patients completed the Medication Adherence Rating Scale, along with a series of executive function tests including Go/No-Go, Wisconsin Card Sorting Test, and Iowa Gambling Task. Multivariate analysis of covariance was employed to analyze the results, controlling for demographic and clinical variables as covariates. RESULTS Of the participants, 54.5% had low medication adherence. Low adherent patients exhibited significantly poorer performance in Go/No-Go as indicated by higher commission errors (F [1] = 7.63, p = 0.006) as well as the Wisconsin Card Sorting Test, evidenced by a higher number of perseveration errors (F [1] = 8.61, p = 0.004) and fewer completed categories (F [1] = 6.67, p = 0.011), compared to high adherent patients. Notably, although differences in decision-making were observed between the two groups, these did not reach statistical significance (p = 0.139). CONCLUSIONS This study establishes a correlation between low medication adherence and deficits in executive functions-specifically response inhibition and cognitive flexibility-in patients with bipolar I disorder. Furthermore, even after controlling for covariates, the differences in executive functions between medication adherence groups remained significant.
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Affiliation(s)
- Mona Rahimi Chahooei
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatric), Iran University of Medical Sciences, Tehran Hemat Highway next to Milad Tower, Tehran, Iran
| | - Komeil Zahedi Tajrishi
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatric), Iran University of Medical Sciences, Tehran Hemat Highway next to Milad Tower, Tehran, Iran.
| | - Ghazaleh Zargarinejad
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatric), Iran University of Medical Sciences, Tehran Hemat Highway next to Milad Tower, Tehran, Iran
| | - Amir Shabani
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
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McAllister-Williams RH, Goudie N, Azim L, Bartle V, Berger M, Butcher C, Chadwick T, Clare E, Courtney P, Dixon L, Duffelen N, Fouweather T, Gann W, Geddes J, Gupta S, Hall B, Helter T, Hindmarch P, Holstein EM, Lawrence W, Mawson P, McKinnon I, Milne A, Molloy A, Moore A, Morriss R, Nakulan A, Simon J, Smith D, Stokes-Crossley B, Stokes PRA, Swain A, Taiwo A, Walmsley Z, Weetman C, Young AH, Watson S. A randomised double-blind, placebo-controlled trial of pramipexole in addition to mood stabilisers for patients with treatment-resistant bipolar depression (the PAX-BD study). J Psychopharmacol 2025; 39:106-120. [PMID: 39829389 PMCID: PMC11831867 DOI: 10.1177/02698811241309622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2025]
Abstract
BACKGROUND Options for 'treatment-resistant bipolar depression' (TRBD) are limited. Two small, short-term, trials of pramipexole suggest it might be an option. AIMS To evaluate the clinical effectiveness and safety of pramipexole in the management of TRBD. METHODS A multi-centre randomised, double-blind controlled trial including participants ⩾18 years old with TRBD (failure to respond, tolerate or clinical contraindication/patient refusal of ⩾2 of quetiapine, olanzapine, lamotrigine or lurasidone) randomised 1:1 to pramipexole (max 2.5 mg/day salt weight) or placebo added to ongoing mood stabiliser (n = 39). Primary outcome: Quick Inventory of Depressive Symptoms, Self-rated (QIDS-SR) at 12 weeks. Up to 48 weeks follow-up. RESULTS Pramipexole (n = 18) was associated with a greater reduction in QIDS-SR score at 12 weeks versus placebo (n = 21, 4.4 (4.8) vs 2.1 (5.1)): a medium sized (d = -0.72) but not statistically significant difference (95% CI: -0.4 to 6.3, p = 0.087). Similarly, there was a non-significant approximate 2-point (d = -0.76) improvement in pleasure at 6 weeks (95% CI: -0.11 to 4.20). Significant advantages of pramipexole on QIDS-SR score (6.28 points: 95% CI: 1.85-10.71) and psychosocial function (5.36 points: 95% CI: 0.38-10.35) were seen at 36 weeks post-randomisation, and on the response (46% vs 6%; p = 0.026) and remission (31% vs 0%; p = 0.030) rates at trial exit (48 weeks or last available data after 16 weeks for those affected by the early study closure). Hypomania ratings were significantly higher at 12 weeks. Otherwise, pramipexole was well tolerated. CONCLUSIONS Clinically large, but statistically non-significant, effects of pramipexole on depression at 12 weeks, with significant longer-term benefits on mood and function were observed. Pramipexole use was complicated by dose titration and increased hypomanic symptoms. The small sample size limits interpretation. Furthermore, larger randomised placebo-controlled trials are warranted.
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Affiliation(s)
- R Hamish McAllister-Williams
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Northern Centre for Mood Disorders, Newcastle University, Newcastle upon Tyne, UK
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nicola Goudie
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lumbini Azim
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Victoria Bartle
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Michael Berger
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Chrissie Butcher
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Thomas Chadwick
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Emily Clare
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Paul Courtney
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Lyndsey Dixon
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nichola Duffelen
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Tony Fouweather
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - William Gann
- Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK
| | - John Geddes
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sumeet Gupta
- Tees, Esk and Wear Valleys NHS Foundation Trust, Darlington, UK
| | - Beth Hall
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Timea Helter
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Paul Hindmarch
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Eva-Maria Holstein
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ward Lawrence
- Surrey and Borders Partnership NHS Trust, Leatherhead, UK
| | - Phil Mawson
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Iain McKinnon
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Adam Milne
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Aisling Molloy
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Abigail Moore
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Richard Morriss
- Academic Unit of Mental Health and Neuroscience, University of Nottingham, Nottingham, UK
| | - Anisha Nakulan
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Daniel Smith
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Paul RA Stokes
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Andrew Swain
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Adeola Taiwo
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Zoë Walmsley
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Christopher Weetman
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Allan H Young
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Stuart Watson
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Northern Centre for Mood Disorders, Newcastle University, Newcastle upon Tyne, UK
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
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Abdullaeva BS, Abdullaev D, Djuraeva L, Sagdullaeva DK, Kholikov A. Applications of Behavioral Economics and Neuroeconomics in Mental Health. IRANIAN JOURNAL OF PSYCHIATRY 2025; 20:93-101. [PMID: 40093521 PMCID: PMC11904746 DOI: 10.18502/ijps.v20i1.17404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 09/24/2024] [Accepted: 09/26/2024] [Indexed: 03/19/2025]
Abstract
Objective: The integration of behavioral economics and neuroeconomics into mental health offers innovative perspectives on understanding and addressing psychological disorders. This overview aims to synthesize current knowledge and explore the implications of these interdisciplinary approaches in the context of mental health. Method : In this narrative review, we summarized the current evidence regarding the applications of behavioral economics and neuroeconomics approaches in the field of mental health. Results: Behavioral economics and neuroeconomics provide valuable insights into the cognitive and emotional processes underlying mental health disorders, such as irrational decision-making, impulsivity, and self-control issues. Concepts such as loss aversion, temporal discounting, and framing effects inform the development of innovative interventions and policy initiatives. Behavioral economic interventions, including nudges, incentives, and commitment devices, show promise in promoting treatment adherence, reducing risky behaviors, and enhancing mental well-being. Neuroeconomics contributes by identifying neural markers predictive of treatment response and relapse risk, paving the way for personalized treatment approaches. Conclusion: The integration of behavioral economics and neuroeconomics into mental health research and practice holds significant potential for improving the understanding of psychological disorders and developing more effective, personalized interventions. Further research is needed to elucidate the mechanisms of action, optimize intervention strategies, and address ethical considerations associated with these approaches in mental health settings.
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Affiliation(s)
| | - Diyorjon Abdullaev
- Department of Scientific Affairs, Vice-Rector for Scientific Affairs, Urganch State Pedagogical Institute, Urgench, Uzbekistan
| | - Laylo Djuraeva
- Department of Innovation and Sciences, New Uzbekistan University, Tashkent, Uzbekistan
- The State Conservatory of Uzbekistan, Tashkent, Uzbekistan
| | - Dilfuza Karimullaevna Sagdullaeva
- Department of Uzbek Language and Classical Eastern Literature, Faculty of Classical Eastern Philology, International Islamic Academy of Uzbekistan, Tashkent, Uzbekistan
| | - Azam Kholikov
- Department of Mother Language and Teaching Methodology in Primary Education, Tashkent State Pedagogical University, Tashkent, Uzbekistan
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Wan L, Pei P, Zhang Q, Gao W. Specificity in the commonalities of inhibition control: using meta-analysis and regression analysis to identify the key brain regions in psychiatric disorders. Eur Psychiatry 2024; 67:e69. [PMID: 39397695 PMCID: PMC11730059 DOI: 10.1192/j.eurpsy.2024.1785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 07/01/2024] [Accepted: 08/19/2024] [Indexed: 10/15/2024] Open
Abstract
BACKGROUND The differential diagnosis of psychiatric disorders is relatively challenging for several reasons. In this context, we believe that task-based magnetic resonance imaging (MRI) can serve as a tool for differential diagnosis. The aim of this study was to explore the commonalities in brain activities among individuals with psychiatric disorders and to identify the key brain regions that can distinguish between these disorders. METHODS The PubMed, MEDLINE, EMBASE, Web of Science, Scopus, PsycINFO, and Google Scholar databases were searched for whole-brain functional MRI studies that compared psychiatric patients and normal controls. The psychiatric disorders included schizophrenia (SCZ), bipolar disorder (BD), major depressive disorder (MDD), obsessive-compulsive disorder, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). Studies using go-nogo paradigms were selected, we then conducted activation likelihood estimation (ALE) meta-analysis, factor analysis, and regression analysis on these studies subsequently. RESULTS A total of 152 studies (108 with patients) were selected and a consistent pattern was found, that is, decreased activities in the same brain regions across six disorders. Factor analysis clustered six disorders into three pairs: SCZ and ASD, MDD and BD, and ADHD and BD. Furthermore, the heterogeneity of SCZ and ASD was located in the left and right thalamus; and the heterogeneity of MDD and BD was located in the thalamus, insula, and superior frontal gyrus. CONCLUSION The results can lead to a new classification method for psychiatric disorders, benefit the differential diagnosis at an early stage, and help to understand the biobasis of psychiatric disorders.
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Affiliation(s)
- Li Wan
- Affiliated Psychological Hospital of Anhui Medical University; Anhui Mental Health Center; Hefei Fourth People’s Hospital, Hefei, China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Key Laboratory of Philosophy and Social Science of Anhui Province on Adolescent Mental Health and Crisis Intelligence Intervention, Hefei Normal University, Hefei, China
- National Clinical Research Center for Mental Disorders-Anhui Branch, Hefei, China
| | - Pingting Pei
- Department of Psychology, Anhui University, Hefei, China
| | - Qinghui Zhang
- Affiliated Psychological Hospital of Anhui Medical University; Anhui Mental Health Center; Hefei Fourth People’s Hospital, Hefei, China
| | - Wenxiang Gao
- Affiliated Psychological Hospital of Anhui Medical University; Anhui Mental Health Center; Hefei Fourth People’s Hospital, Hefei, China
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Shen H, Ma Z, Hans E, Duan Y, Bi GH, Chae YC, Bonifazi A, Battiti FO, Newman AH, Xi ZX, Yang Y. Involvement of dopamine D3 receptor in impulsive choice decision-making in male rats. Neuropharmacology 2024; 257:110051. [PMID: 38917939 PMCID: PMC11401648 DOI: 10.1016/j.neuropharm.2024.110051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 06/27/2024]
Abstract
Impulsive decision-making has been linked to impulse control disorders and substance use disorders. However, the neural mechanisms underlying impulsive choice are not fully understood. While previous PET imaging and autoradiography studies have shown involvement of dopamine and D2/3 receptors in impulsive behavior, the roles of distinct D1, D2, and D3 receptors in impulsive decision-making remain unclear. In this study, we used a food reward delay-discounting task (DDT) to identify low- and high-impulsive rats, in which low-impulsive rats exhibited preference for large delayed reward over small immediate rewards, while high-impulsive rats showed the opposite preference. We then examined D1, D2, and D3 receptor gene expression using RNAscope in situ hybridization assays. We found that high-impulsive male rats exhibited lower levels of D2 and D3, and particularly D3, receptor expression in the nucleus accumbens (NAc), with no significant changes in the insular, prelimbic, and infralimbic cortices. Based on these findings, we further explored the role of the D3 receptor in impulsive decision-making. Systemic administration of a selective D3 receptor agonist (FOB02-04) significantly reduced impulsive choices in high-impulsive rats but had no effects in low-impulsive rats. Conversely, a selective D3 receptor antagonist (VK4-116) produced increased both impulsive and omission choices in both groups of rats. These findings suggest that impulsive decision-making is associated with a reduction in D3 receptor expression in the NAc. Selective D3 receptor agonists, but not antagonists, may hold therapeutic potentials for mitigating impulsivity in high-impulsive subjects.
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Affiliation(s)
- Hui Shen
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, 21224, USA
| | - Zilu Ma
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, 21224, USA
| | - Emma Hans
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, 21224, USA
| | - Ying Duan
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, 21224, USA
| | - Guo-Hua Bi
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, 21224, USA
| | - Yurim C Chae
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, 21224, USA
| | - Alessandro Bonifazi
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, 21224, USA
| | - Francisco O Battiti
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, 21224, USA
| | - Amy Hauck Newman
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, 21224, USA
| | - Zheng-Xiong Xi
- Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, 21224, USA.
| | - Yihong Yang
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, 21224, USA.
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8
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Guo Z, Cui Y, Qiu R, Bu L, Yang T, Li Y, Zhu X. The association of impulsivity with depression and anxiety symptoms: A transdiagnostic network analysis and replication. J Affect Disord 2024; 359:100-108. [PMID: 38772504 DOI: 10.1016/j.jad.2024.05.076] [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: 01/08/2024] [Revised: 05/11/2024] [Accepted: 05/17/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Impulsivity increases the risk for depression and anxiety. However, the granular pathways among them remain unknown. A network approach that moves from disorder-level analysis to symptom-level analysis can provide further understanding of psychopathological mechanisms. In this study, we examined the network structure of impulsivity and separate and comorbid symptoms of depression and anxiety. METHODS Regularized partial-correlation networks were estimated using cross-sectional data from 1047 Chinese participants aged 18-26 years (main dataset, mean age = 21.45 ± 2.01 years) and 325 Chinese participants aged 18-36 years (an independent replication dataset, mean age = 21.49 ± 3.73 years), including impulsivity-depression, impulsivity-anxiety, and impulsivity-depression-anxiety networks. The datasets were collected from 1 June 2023 to 4 August 2023 and from 27 April 2022 to 16 May 2022, respectively. Impulsivity, depression, and anxiety were assessed using Barratt Impulsiveness Scale Version 11, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7, respectively. Bridge centrality was analyzed, and a network comparison test (NCT) was conducted to investigate the differences between the main dataset and replication dataset. RESULTS The motor impulsivity dimension was revealed to be closely connected with individual symptoms of depression and anxiety regardless of whether they were in separate disorder forms or comorbid forms. In all the networks, motor impulsivity was the most important bridge node. The NCT showed comparable network connectivity and network structure between the main and replication datasets. LIMITATIONS The use of cross-sectional data limited the inferences about the direction of causality between variables. CONCLUSIONS These findings elucidate the psychopathological mechanisms underlying how impulsivity functions within depression, anxiety, and comorbidity and support that motor impulsivity is an important risk factor across different mental disorders and is responsible for comorbidity. The implications of these findings are discussed.
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Affiliation(s)
- Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Yi Cui
- Department of Nursing, Air Force Medical University, Xi'an, China
| | - Rui Qiu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Lingbo Bu
- Teaching Evaluation Center, Air Force Medical University, Xi'an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Yijun Li
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China.
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Lee Y, Gilbert JR, Waldman LR, Zarate CA, Ballard ED. Potential association between suicide risk, aggression, impulsivity, and the somatosensory system. Soc Cogn Affect Neurosci 2024; 19:nsae041. [PMID: 38874947 PMCID: PMC11219302 DOI: 10.1093/scan/nsae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 04/05/2024] [Accepted: 06/13/2024] [Indexed: 06/15/2024] Open
Abstract
Aggression and impulsivity are linked to suicidal behaviors, but their relationship to the suicidal crisis remains unclear. This magnetoencephalography (MEG) study investigated the link between aggression, impulsivity, and resting-state MEG power and connectivity. Four risk groups were enrolled: high-risk (HR; n = 14), who had a recent suicidal crisis; lower-risk (LR; n = 41), who had a history of suicide attempts but no suicide attempt or ideation in the past year; clinical control (CC; n = 38), who had anxiety/mood disorders but no suicidal history; and minimal risk (MR; n = 28), who had no psychiatric/suicidal history. No difference in resting-state MEG power was observed between the groups. Individuals in the HR group with high self-reported aggression and impulsivity scores had reduced MEG power in regions responsible for sensory/emotion regulation vs. those in the HR group with low scores. The HR group also showed downregulated bidirectional glutamatergic feedback between the precuneus (PRE) and insula (INS) compared to the LR, CC, and MR groups. High self-reported impulsivity was linked to reduced PRE to INS feedback, whereas high risk-taking impulsivity was linked to upregulated INS to postcentral gyrus (PCG) and PCG to INS feedback. These preliminary findings suggest that glutamatergic-mediated sensory and emotion-regulation processes may function as potential suicide risk markers.
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Affiliation(s)
- Yoojin Lee
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, United States
| | - Jessica R Gilbert
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, United States
| | - Laura R Waldman
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, United States
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, United States
| | - Elizabeth D Ballard
- Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, United States
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10
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Hughes NC, Qian H, Zargari M, Zhao Z, Singh B, Wang Z, Fulton JN, Johnson GW, Li R, Dawant BM, Englot DJ, Constantinidis C, Roberson SW, Bick SK. Reward Circuit Local Field Potential Modulations Precede Risk Taking. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.10.588629. [PMID: 38645237 PMCID: PMC11030333 DOI: 10.1101/2024.04.10.588629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Risk taking behavior is a symptom of multiple neuropsychiatric disorders and often lacks effective treatments. Reward circuitry regions including the amygdala, orbitofrontal cortex, insula, and anterior cingulate have been implicated in risk-taking by neuroimaging studies. Electrophysiological activity associated with risk taking in these regions is not well understood in humans. Further characterizing the neural signalling that underlies risk-taking may provide therapeutic insight into disorders associated with risk-taking. Eleven patients with pharmacoresistant epilepsy who underwent stereotactic electroencephalography with electrodes in the amygdala, orbitofrontal cortex, insula, and/or anterior cingulate participated. Patients participated in a gambling task where they wagered on a visible playing card being higher than a hidden card, betting $5 or $20 on this outcome, while local field potentials were recorded from implanted electrodes. We used cluster-based permutation testing to identify reward prediction error signals by comparing oscillatory power following unexpected and expected rewards. We also used cluster-based permutation testing to compare power preceding high and low bets in high-risk (<50% chance of winning) trials and two-way ANOVA with bet and risk level to identify signals associated with risky, risk averse, and optimized decisions. We used linear mixed effects models to evaluate the relationship between reward prediction error and risky decision signals across trials, and a linear regression model for associations between risky decision signal power and Barratt Impulsiveness Scale scores for each patient. Reward prediction error signals were identified in the amygdala (p=0.0066), anterior cingulate (p=0.0092), and orbitofrontal cortex (p=6.0E-4, p=4.0E-4). Risky decisions were predicted by increased oscillatory power in high-gamma frequency range during card presentation in the orbitofrontal cortex (p=0.0022), and by increased power following bet cue presentation across the theta-to-beta range in the orbitofrontal cortex ( p =0.0022), high-gamma in the anterior cingulate ( p =0.0004), and high-gamma in the insula ( p =0.0014). Risk averse decisions were predicted by decreased orbitofrontal cortex gamma power ( p =2.0E-4). Optimized decisions that maximized earnings were preceded by decreases within the theta to beta range in orbitofrontal cortex ( p =2.0E-4), broad frequencies in amygdala ( p =2.0E-4), and theta to low-gamma in insula ( p =4.0E-4). Insula risky decision power was associated with orbitofrontal cortex high-gamma reward prediction error signal ( p =0.0048) and with patient impulsivity ( p =0.00478). Our findings identify and help characterize reward circuitry activity predictive of risk-taking in humans. These findings may serve as potential biomarkers to inform the development of novel treatment strategies such as closed loop neuromodulation for disorders of risk taking.
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11
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Guo YB, Jiao Q, Zhang XT, Xiao Q, Wu Z, Cao WF, Cui D, Yu GH, Dou RH, Su LY, Lu GM. Increased regional Hurst exponent reflects response inhibition related neural complexity alterations in pediatric bipolar disorder patients during an emotional Go-Nogo task. Cereb Cortex 2024; 34:bhad442. [PMID: 38031362 PMCID: PMC10793568 DOI: 10.1093/cercor/bhad442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Fractal patterns have been shown to change in resting- and task-state blood oxygen level-dependent signals in bipolar disorder patients. However, fractal characteristics of brain blood oxygen level-dependent signals when responding to external emotional stimuli in pediatric bipolar disorder remain unclear. Blood oxygen level-dependent signals of 20 PBD-I patients and 17 age- and sex-matched healthy controls were extracted while performing an emotional Go-Nogo task. Neural responses relevant to the task and Hurst exponent of the blood oxygen level-dependent signals were assessed. Correlations between clinical indices and Hurst exponent were estimated. Significantly increased activations were found in regions covering the frontal lobe, parietal lobe, temporal lobe, insula, and subcortical nuclei in PBD-I patients compared to healthy controls in contrast of emotional versus neutral distractors. PBD-I patients exhibited higher Hurst exponent in regions that involved in action control, such as superior frontal gyrus, inferior frontal gyrus, inferior temporal gyrus, and insula, with Hurst exponent of frontal orbital gyrus correlated with onset age. The present study exhibited overactivation, increased self-similarity and decreased complexity in cortical regions during emotional Go-Nogo task in patients relative to healthy controls, which provides evidence of an altered emotional modulation of cognitive control in pediatric bipolar disorder patients. Hurst exponent may be a fractal biomarker of neural activity in pediatric bipolar disorder.
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Affiliation(s)
- Yi-Bing Guo
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
- Brain and Mind Center, The University of Sydney, Sydney, NSW 2008, Australia
| | - Qing Jiao
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
| | - Xiao-Tong Zhang
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
| | - Qian Xiao
- Mental Health Centre of Xiangya Hospital, Central South University, Changsha 410083, China
| | - Zhou Wu
- School of Psychology, Nanjing Normal University, Nanjing 210097, China
| | - Wei-Fang Cao
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
| | - Dong Cui
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
| | - Guang-Hui Yu
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
| | - Ru-Hai Dou
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
| | - Lin-Yan Su
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha 410083, China
| | - Guang-Ming Lu
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing 210023, China
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12
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Cui S, Jiang P, Cheng Y, Cai H, Zhu J, Yu Y. Molecular mechanisms underlying resting-state brain functional correlates of behavioral inhibition. Neuroimage 2023; 283:120415. [PMID: 37863277 DOI: 10.1016/j.neuroimage.2023.120415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/22/2023] [Accepted: 10/18/2023] [Indexed: 10/22/2023] Open
Abstract
Previous literature has established the presence of sex differences in behavioral inhibition as well as its neural substrates and related disease risk. However, there is limited evidence that speaks directly to the question of whether or not there are sex-dependent associations between behavioral inhibition and resting-state brain function and, if so, how they are modulated by the underlying molecular mechanisms. We computed functional connectivity density (FCD) using resting-state functional MRI data to examine their associations with behavioral inhibition ability measured using a Go/No-Go task across a large cohort of 510 healthy young adults. Then, we examined the spatial relationships of the FCD correlates of behavioral inhibition with gene expression and neurotransmitter atlases to explore their potential genetic architecture and neurochemical basis. A significant negative correlation between behavioral inhibition and FCD in the left superior parietal lobule was found in females but not males. Further spatial correlation analyses demonstrated that the identified neural correlates of behavioral inhibition were associated with expression of gene categories predominantly implicating essential components of the cerebral cortex (glial cell, neuron, axon, dendrite, and synapse) and ion channel activity, as well as were linked to the serotonergic system. Our findings may not only yield important insights into the molecular mechanisms underlying the female-specific neural substrates of behavioral inhibition, but also provide a critical context for understanding how biological sex might contribute to variation in behavioral inhibition and its related disease risk.
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Affiliation(s)
- Shunshun Cui
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Ping Jiang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Yan Cheng
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Huanhuan Cai
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China.
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Research Center of Clinical Medical Imaging, Anhui Province, Hefei 230032, China; Anhui Provincial Institute of Translational Medicine, Hefei 230032, China.
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