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Stanca S, Rossetti M, Bongioanni P. The Cerebellum's Role in Affective Disorders: The Onset of Its Social Dimension. Metabolites 2023; 13:1113. [PMID: 37999209 PMCID: PMC10672979 DOI: 10.3390/metabo13111113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/22/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
Major Depressive Disorder (MDD) and Bipolar Disorder (BD) are the most frequent mental disorders whose indeterminate etiopathogenesis spurs to explore new aetiologic scenarios. In light of the neuropsychiatric symptoms characterizing Cerebellar Cognitive Affective Syndrome (CCAS), the objective of this narrative review is to analyze the involvement of the cerebellum (Cbm) in the onset of these conditions. It aims at detecting the repercussions of the Cbm activities on mood disorders based on its functional subdivision in vestibulocerebellum (vCbm), pontocerebellum (pCbm) and spinocerebellum (sCbm). Despite the Cbm having been, for decades, associated with somato-motor functions, the described intercellular pathways, without forgiving the molecular impairment and the alteration in the volumetric relationships, make the Cbm a new important therapeutic target for MDD and BD. Given that numerous studies have showed its activation during mnestic activities and socio-emotional events, this review highlights in the Cbm, in which the altered external space perception (vCbm) is strictly linked to the cognitive-limbic Cbm (pCbm and sCbm), a crucial role in the MDD and BD pathogenesis. Finally, by the analysis of the cerebellar activity, this study aims at underlying not only the Cbm involvement in affective disorders, but also its role in social relationship building.
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Affiliation(s)
- Stefano Stanca
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Via Savi 10, 56126 Pisa, Italy
- NeuroCare Onlus, 56100 Pisa, Italy
| | - Martina Rossetti
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Via Savi 10, 56126 Pisa, Italy
- NeuroCare Onlus, 56100 Pisa, Italy
| | - Paolo Bongioanni
- NeuroCare Onlus, 56100 Pisa, Italy
- Medical Specialties Department, Azienda Ospedaliero-Universitaria Pisana, 56100 Pisa, Italy
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Is SARS-CoV-2 a Risk Factor of Bipolar Disorder?-A Narrative Review. J Clin Med 2022; 11:jcm11206060. [PMID: 36294388 PMCID: PMC9604904 DOI: 10.3390/jcm11206060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
For 2.5 years we have been facing the coronavirus disease (COVID-19) and its health, social and economic effects. One of its known consequences is the development of neuropsychiatric diseases such as anxiety and depression. However, reports of manic episodes related to COVID-19 have emerged. Mania is an integral part of the debilitating illness-bipolar disorder (BD). Due to its devastating effects, it is therefore important to establish whether SARS-CoV-2 infection is a causative agent of this severe mental disorder. In this narrative review, we discuss the similarities between the disorders caused by SARS-CoV-2 and those found in patients with BD, and we also try to answer the question of whether SARS-CoV-2 infection may be a risk factor for the development of this affective disorder. Our observation shows that disorders in COVID-19 showing the greatest similarity to those in BD are cytokine disorders, tryptophan metabolism, sleep disorders and structural changes in the central nervous system (CNS). These changes, especially intensified in severe infections, may be a trigger for the development of BD in particularly vulnerable people, e.g., with family history, or cause an acute episode in patients with a pre-existing BD.
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Cui L, Li H, Li JB, Zeng H, Zhang Y, Deng W, Zhou W, Cao L. Altered cerebellar gray matter and cerebellar-cortex resting-state functional connectivity in patients with bipolar disorder Ⅰ. J Affect Disord 2022; 302:50-57. [PMID: 35074460 DOI: 10.1016/j.jad.2022.01.073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Bipolar disorder (BP) is a common psychiatric disorder characterized by extreme fluctuations in mood. Recent studies have indicated the involvement of cerebellum in the pathogenesis of BP. However, no study has focused on the precise role of cerebellum exclusively in patients with bipolar I disorder (BP-I). METHODS Forty-five patients with BP-I and 40 healthy controls were recruited. All subjects underwent clinical evaluation and Magnetic Resonance diffusion Tension Imaging scans. For structural images, we used a spatially unbiased infratentorial template toolbox to isolate the cerebellum and then preformed voxel-based morphometry (VBM) analyses to assess the difference in cerebellar gray matter volume (GMV) between the two groups. For the functional images, we chose the clusters that survived from VBM analysis as seeds and performed functional connectivity (FC) analysis. Between-group differences were assessed using the independent Students t test or the nonparametric Mann-Whitney U Test. For multiple comparisons, the results were further corrected with Gaussian random field (GRF) approach (voxel-level P < 0.001, cluster-level P < 0.05). RESULTS Compared with healthy controls, BP-I patients showed significantly decreased GMV in left lobule V and left lobule VI (P < 0.05, GRF corrected). The FC of cerebellum with bilateral superior temporal gyrus, bilateral insula, bilateral rolandic operculum, right putamen, and left precentral gyrus was disrupted in BP-I patients (P < 0.05, GRF corrected). CONCLUSIONS BP-I patients showed decreased cerebellar GMV and disrupted cerebellar-cortex resting-state FC. This suggests that cerebellar abnormalities may play an important role in the pathogenesis of BP-I.
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Affiliation(s)
- Liqian Cui
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China.
| | - Hao Li
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Jin Biao Li
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Huixing Zeng
- Department of Neurology, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Yizhi Zhang
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
| | - Wenhao Deng
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
| | - Wenjin Zhou
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China
| | - Liping Cao
- Guangzhou Huiai, Hospital, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510370, China.
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4
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Williams ES, Mazei-Robison M, Robison AJ. Sex Differences in Major Depressive Disorder (MDD) and Preclinical Animal Models for the Study of Depression. Cold Spring Harb Perspect Biol 2022; 14:a039198. [PMID: 34404738 PMCID: PMC8886985 DOI: 10.1101/cshperspect.a039198] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Depression and related mood disorders constitute an enormous burden on health, quality of life, and the global economy, and women have roughly twice the lifetime risk of men for experiencing depression. Here, we review sex differences in human brain physiology that may be connected to the increased susceptibility of women to major depressive disorder (MDD). Moreover, we summarize decades of preclinical research using animal models for the study of mood dysfunction that uncover some of the potential molecular, cellular, and circuit-level mechanisms that may underlie sex differences and disease etiology. We place particular emphasis on a series of recent studies demonstrating the central contribution of the circuit projecting from ventral hippocampus to nucleus accumbens and how inherent sex differences in the excitability of this circuit may predict and drive depression-related behaviors. The findings covered in this review underscore the continued need for studies using preclinical models and circuit-specific strategies for uncovering molecular and physiological mechanisms that could lead to potential sex-specific diagnosis, prognosis, prevention, and/or treatments for MDD and other mood disorders.
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Affiliation(s)
- Elizabeth S Williams
- Department of Physiology, Michigan State University, East Lansing, Michigan 48824, USA
| | | | - A J Robison
- Department of Physiology, Michigan State University, East Lansing, Michigan 48824, USA
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5
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Sun K, Liu Z, Chen G, Zhou Z, Zhong S, Tang Z, Wang S, Zhou G, Zhou X, Shao L, Ye X, Zhang Y, Jia Y, Pan J, Huang L, Liu X, Liu J, Tian J, Wang Y. A two-center radiomic analysis for differentiating major depressive disorder using multi-modality MRI data under different parcellation methods. J Affect Disord 2022; 300:1-9. [PMID: 34942222 DOI: 10.1016/j.jad.2021.12.065] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 09/13/2021] [Accepted: 12/19/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND The present study aimed to explore the difference in the brain function and structure between patients with major depressive disorder (MDD) and healthy controls (HCs) using two-center and multi-modal MRI data, which would be helpful to investigate the pathogenesis of MDD. METHODS The subjects were collected from two hospitals. One including 140 patients with MDD and 138 HCs was used as primary cohort. Another one including 29 patients with MDD and 52 HCs was used as validation cohort. Functional and structural magnetic resonance images (MRI) were acquired to extract four types of features: functional connectivity (FC), amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo), and gray matter volume (GMV). Then classifiers using different combinations among the four types of selected features were respectively built to discriminate patients from HCs. Different templates were applied and the results under different templates were compared. RESULTS The classifier built with the combination of FC, ALFF, and GMV under the AAL template discriminated patients from HCs with the best performance (AUC=0.916, ACC=84.8%). The regions selected in all the different templates were mainly located in the default mode network, affective network, prefrontal cortex. LIMITATIONS First, the sample size of the validation cohort was limited. Second, diffusion tensor imaging data were not collected. CONCLUSION The performance of classifier was improved by using multi-modal MRI imaging. Different templates would be suitable for different types of analysis. The regions selected in all the different templates are possibly the core regions to investigate the pathophysiology of MDD.
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Affiliation(s)
- Kai Sun
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China; CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, China
| | - Zhenyu Liu
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Science, Beijing, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhifeng Zhou
- Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhenchao Tang
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Beihang University, Beijing, China
| | - Shuo Wang
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Beihang University, Beijing, China
| | - Guifei Zhou
- School of Computer and Information Technology, Beijing Jiaotong University, Beijing, China
| | - Xuezhi Zhou
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China; CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, China
| | - Lizhi Shao
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, China; School of Computer Science and Engineering, Southeast University, Nanjing, China
| | - Xiaoying Ye
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yingli Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jiyang Pan
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xia Liu
- Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen, China.
| | - Jiangang Liu
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Beihang University, Beijing, China; Key Laboratory of Big Data-Based Precision Medicine (Beihang University), Ministry of Industry and Information Technology.
| | - Jie Tian
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China; CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Beihang University, Beijing, China; Key Laboratory of Big Data-Based Precision Medicine (Beihang University), Ministry of Industry and Information Technology; School of Artificial Intelligence, University of Chinese Academy of Science, Beijing, China.
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.
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6
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Volumetric alterations in subregions of the amygdala in adults with major depressive disorder. J Affect Disord 2021; 295:108-115. [PMID: 34419778 DOI: 10.1016/j.jad.2021.08.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Although major depressive disorder (MDD) has been associated with volumetric abnormalities in the amygdala, studies investigating the association between structural alterations of the amygdala and depression have yielded varying results. Since the amygdala comprises several subregions, it is difficult to detect subtle regional changes by measuring the total amygdala volume. This study aimed to examine the volume in each amygdala subregion in adults with and without a diagnosis of MDD. METHODS A total of 147 participants with a current history of major depression and 144 healthy participants ranging in age from 19 to 64 years underwent 3T magnetic resonance imaging scanning. Automatic segmentation of the nine nuclei of the amygdala was performed using FreeSurfer. One-way analysis of covariance, with individual volumes as dependent variables, and age, sex, and total intracranial volume as covariates, was performed to analyze volume differences. RESULTS Patients with MDD had significantly lower volumes of the entire amygdala and subregions, including the lateral nucleus and anterior amygdaloid area, than healthy volunteers (HCs). There were no significant associations between subregion volumes and antidepressant use, illness duration, or depression severity. LIMITATIONS Our cross-sectional design cannot provide a causal relationship between the volume change in the amygdala subregion and the risk of MDD. CONCLUSION Our findings suggest that specific amygdala subregions are more susceptible to volumetric alterations in patients with MDD than in HCs. These findings may advance our understanding of the neuroanatomic basis on MDD.
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7
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Romano E, Ma R, Perera G, Stewart R, Tsamakis K, Solmi M, Vancampfort D, Firth J, Stubbs B, Mueller C. Risk of hospitalised falls and hip fractures in working age adults receiving mental health care. Gen Hosp Psychiatry 2021; 72:81-87. [PMID: 34332346 DOI: 10.1016/j.genhosppsych.2021.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This retrospective cohort study investigates risks of hospitalised fall or hip fractures in working age adults receiving mental health care in South London. METHODS Patients aged 18 to 64, who received a first mental illness diagnosis between 2008 and 2016 were included. Primary outcome was hospitalised falls, secondary outcome was hip fractures. Age- and gender-standardised incidence rates and incidence rate ratios (IRRs) compared to local general population were calculated. Multivariate Cox proportionate hazard models were used to investigate which mental health diagnoses were most at risk. RESULTS In 50,885 patients incidence rates were 8.3 and 0.8 per 1,000 person-years for falls and hip fractures respectively. Comparing mental health patients to the general population, age-and-gender-adjusted IRR for falls was 3.6 (95% CI: 3.3-4.0) and for hip fractures 7.5 (95% CI: 5.2-10.4). The falls IRR was highest for borderline personality and bipolar disorder and lowest for schizophreniform and anxiety disorder. After adjusting for multiple confounders in the sample of mental health service users, borderline personality disorder yielded a higher and anxiety disorder a lower falls risk. CONCLUSION Working age adults using mental health services have almost four times the incidence of hospitalised falls compared to general population. Targeted interventions are warranted.
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Affiliation(s)
- Eugenia Romano
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom.
| | - Ruimin Ma
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Gayan Perera
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom
| | - Konstantinos Tsamakis
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; National and Kapodistrian University of Athens, School of Medicine, Second Department of Psychiatry, University General Hospital 'ATTIKON', Athens, Greece
| | - Marco Solmi
- Padua Neuroscience Center, University of Padova, Padova, Italy
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; University Psychiatric Centre, KU Leuven, Leuven Kortenberg, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Brendon Stubbs
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom
| | - Christoph Mueller
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom
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8
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A key requirement for synaptic Reelin signaling in ketamine-mediated behavioral and synaptic action. Proc Natl Acad Sci U S A 2021; 118:2103079118. [PMID: 33975959 PMCID: PMC8157952 DOI: 10.1073/pnas.2103079118] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Ketamine is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist that produces rapid antidepressant action in some patients with treatment-resistant depression. However, recent data suggest that ∼50% of patients with treatment-resistant depression do not respond to ketamine. The factors that contribute to the nonresponsiveness to ketamine's antidepressant action remain unclear. Recent studies have reported a role for secreted glycoprotein Reelin in regulating pre- and postsynaptic function, which suggests that Reelin may be involved in ketamine's antidepressant action, although the premise has not been tested. Here, we investigated whether the disruption of Reelin-mediated synaptic signaling alters ketamine-triggered synaptic plasticity and behavioral effects. To this end, we used mouse models with genetic deletion of Reelin or apolipoprotein E receptor 2 (Apoer2), as well as pharmacological inhibition of their downstream effectors, Src family kinases (SFKs) or phosphoinositide 3-kinase. We found that disruption of Reelin, Apoer2, or SFKs blocks ketamine-driven behavioral changes and synaptic plasticity in the hippocampal CA1 region. Although ketamine administration did not affect tyrosine phosphorylation of DAB1, an adaptor protein linked to downstream signaling of Reelin, disruption of Apoer2 or SFKs impaired baseline NMDA receptor-mediated neurotransmission. These results suggest that maintenance of baseline NMDA receptor function by Reelin signaling may be a key permissive factor required for ketamine's antidepressant effects. Taken together, our results suggest that impairments in Reelin-Apoer2-SFK pathway components may in part underlie nonresponsiveness to ketamine's antidepressant action.
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9
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Damme KSF, Alloy LB, Young CB, Kelley NJ, Chein J, Ng TH, Titone MK, Black CL, Nusslock R. Amygdala subnuclei volume in bipolar spectrum disorders: Insights from diffusion-based subsegmentation and a high-risk design. Hum Brain Mapp 2020; 41:3358-3369. [PMID: 32386113 PMCID: PMC7375099 DOI: 10.1002/hbm.25021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 04/06/2020] [Accepted: 04/13/2020] [Indexed: 12/31/2022] Open
Abstract
Amygdala abnormalities are widely documented in bipolar spectrum disorders (BSD). Amygdala volume typically is measured after BSD onset; thus, it is not known whether amygdala abnormalities predict BSD risk or relate to the disorder. Additionally, past literature often treated the amygdala as a homogeneous structure, and did not consider its distinct subnuclei and their differential connectivity to other brain regions. To address these issues, we used a behavioral high‐risk design and diffusion‐based subsegmentation to examine amygdala subnuclei among medication‐free individuals with, and at risk for, BSD. The behavioral high‐risk design (N = 114) included low‐risk (N = 37), high‐risk (N = 47), and BSD groups (N = 30). Diffusion‐based subsegmentation of the amygdala was conducted to determine whether amygdala volume differences related to particular subnuclei. Individuals with a BSD diagnosis showed greater whole, bilateral amygdala volume compared to Low‐Risk individuals. Examination of subnuclei revealed that the BSD group had larger volumes compared to the High‐Risk group in both the left medial and central subnuclei, and showed larger volume in the right lateral subnucleus compared to the Low‐Risk group. Within the BSD group, specific amygdala subnuclei volumes related to time since first episode onset and number of lifetime episodes. Taken together, whole amygdala volume analyses replicated past findings of enlargement in BSD, but did not detect abnormalities in the high‐risk group. Examination of subnuclei volumes detected differences in volume between the high‐risk and BSD groups that were missed in the whole amygdala volume. Results have implications for understanding amygdala abnormalities among individuals with, and at risk for, a BSD.
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Affiliation(s)
| | - Lauren B Alloy
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Christina B Young
- Department of Psychology, Northwestern University, Evanston, Illinois, USA.,Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Nicholas J Kelley
- Department of Psychology, Northwestern University, Evanston, Illinois, USA.,School of Psychology, University of Southampton, Southampton, UK
| | - Jason Chein
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Tommy H Ng
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Madison K Titone
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Chelsea L Black
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA.,Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Robin Nusslock
- Department of Psychology, Northwestern University, Evanston, Illinois, USA
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10
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Cordner ZA, MacKinnon DF, DePaulo JR. The Care of Patients With Complex Mood Disorders. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2020; 18:129-138. [PMID: 33162850 PMCID: PMC7587882 DOI: 10.1176/appi.focus.20200007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This article focuses on some common dilemmas facing clinicians, patients, and families in managing the treatment of complicated mood disorders. Specifically, this article reviews the interaction of depressive states, including unipolar, bipolar, and mixed, with other adversities, including comorbid physical and psychological disorders, personality vulnerabilities, misuse of drugs and alcohol, and social and family problems. These issues are not always clearly differentiated from the depressive illness. Each of these adversities can worsen an existing mood disorder and influence the patient's resolve to persist with a treatment plan. Although this article is not focused strictly on treatment-resistant depression, these coexisting issues make depressive states harder to manage therapeutically. For brevity, the aim of this article has been limited to discussion of some complex situations that psychiatrists in general practice may encounter.
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Affiliation(s)
- Zachary A Cordner
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Cordner, MacKinnon, DePaulo)
| | - Dean F MacKinnon
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Cordner, MacKinnon, DePaulo)
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Cordner, MacKinnon, DePaulo)
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11
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Bai YM, Chen MH, Hsu JW, Huang KL, Tu PC, Chang WC, Su TP, Li CT, Lin WC, Tsai SJ. A comparison study of metabolic profiles, immunity, and brain gray matter volumes between patients with bipolar disorder and depressive disorder. J Neuroinflammation 2020; 17:42. [PMID: 32000805 PMCID: PMC6990475 DOI: 10.1186/s12974-020-1724-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/23/2020] [Indexed: 12/22/2022] Open
Abstract
Background Previous individual studies have shown the differences in inflammatory cytokines and gray matter volumes between bipolar disorder (BD) and unipolar depression (UD). However, few studies have investigated the association between pro-inflammatory cytokines and differences in brain gray matter volumes between BD and UD. Methods In this study, 72 BD patients and 64 UD patients were enrolled, with comparable gender and age distributions (33.8% males and an average age of 39.3 ± 13.7 years). Each participant underwent metabolic profiling (including body mass index (BMI), glucose, triglyceride, high-density lipoprotein (HDL), leptin, insulin, adiponectin), pro-inflammatory cytokine (including soluble interleukin-6 receptor (sIL-6R), soluble interleukin-2 receptor (sIL-2R), C-reactive protein (CRP), soluble tumor necrosis factor receptor type 1 (sTNF-R1) examinations, and structural magnetic resonance imaging exams. Voxel-based morphometry was performed to investigate the gray matter volume differences between BD and UD patients. Correlations between pro-inflammatory cytokines and the gray matter volume difference were analyzed. Results Compared to UD patients, the BD group had significantly higher BMI, and higher levels of sIL-6R and sTNF-R1 than the UD patients. The BMI significantly correlated with the level of pro-inflammatory cytokines. Adjusted for age, sex, BMI, duration of illness and total intracranial volume, the BD individuals had significantly more reduced gray matter volumes over 12 areas: R. cerebellar lobule VIII, R. putamen, L. putamen, R. superior frontal gyrus, L. lingual gyrus, L. precentral gyrus, R. fusiform gyrus, L. calcarine, R. precuneus, L. inferior temporal gyrus, L. hippocampus, and L. superior frontal gyrus. These 12 gray matter volume differences between BP and UD patients negatively correlated with sIL-6R and sTNF-R1 levels. Conclusions Our results suggested that BD patients had higher BMI and pro-inflammatory cytokine levels in comparison to UD patients, especially IL-6 and sTNF-R1, which may contribute to greater gray matter reductions in BD patients in comparison to UD patients. The results support the neuro-inflammation pathophysiology mechanism in mood disorder. It is clinically important to monitor BMI, which, in this investigation, positively correlated with levels of inflammatory cytokines.
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Affiliation(s)
- Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan
| | - Wan-Chen Chang
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Cheng Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan. .,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
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12
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Kuang L, Cui D, Jiao Q, Guo Y, Cao W, Gao W, Qiu J, Su L, Lu G. Alterations of Cognition and Cerebral Ventricle Volume in Manic and Euthymic Pediatric Bipolar Disorder. Front Psychiatry 2020; 11:593629. [PMID: 33381058 PMCID: PMC7767823 DOI: 10.3389/fpsyt.2020.593629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction: It remains unknown whether volumetric alterations of ventricles are similar or not in pediatric bipolar disorder (PBD) among different mood states. The present study aims to estimate ventricular volumetric alteration of PBD patients in manic and euthymic status, as well as the relationship between this alteration and cognitive changes. Methods: T1 magnetic resonance images were obtained from 20 manic PBD patients, 21 euthymic PBD patients, and 19 healthy controls (HCs). Ventricular volumes were automatically obtained via FreeSurfer 6.0 software. Ventricular volumes and cognitive indices were compared among the three groups, and the relationship between ventricular volumes and cognitive/clinical indices was analyzed. Results: In contrast to HCs, manic and euthymic PBD patients exhibited decreased cognitive scores of the Stroop color-word test and the digit span subtest. Manic PBD subjects presented enlarged volumes in the bilateral ventricles, third ventricle, and whole ventricles, and euthymic PBD participants displayed increased volumes in the third ventricle, fourth ventricle, and whole ventricles. No significant differences in cognitive performance and ventricular volumes were found between PBD groups. No significant correlation was discovered between ventricular volumes and cognitive/clinical indices in both manic and euthymic PBD patients. Conclusions: No significant differences in cognitive performance and ventricle volume were observed between euthymic and manic PBD groups, which may imply that the alterations are not specific to mood state. It may indicate structural and functional damage of corresponding brain circuits in euthymic PBD patients similar with that of manic PBD, which may provide clues to the diagnosis and treatment of euthymic PBD.
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Affiliation(s)
- Liangfeng Kuang
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Dong Cui
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Qing Jiao
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Yongxin Guo
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Weifang Cao
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Weijia Gao
- Department of Child Psychology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianfeng Qiu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Linyan Su
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, China
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13
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Wong NML, Shao R, Wu J, Tao J, Chen L, Lee TMC. Cerebellar neural markers of susceptibility to social isolation and positive affective processing. Brain Struct Funct 2019; 224:3339-3351. [PMID: 31701265 PMCID: PMC6875157 DOI: 10.1007/s00429-019-01965-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/23/2019] [Indexed: 02/07/2023]
Abstract
Chronic loneliness predicts mood disturbances and onset of major depressive disorder. However, little research has examined the neural correlates of individual difference in susceptibility to perceiving loneliness. In addition, the role of cerebellum, which is heavily implicated in social, cognitive and affective processes, in loneliness is unclear. We studied 99 healthy individuals divided into susceptible, concordant and robust groups depending on whether the participant’s loneliness level was greater, comparable or less than her/his objective social isolation level. The cerebellar gray matter structure, functional activity and connectivity patterns during performing an emotion stroop task were examined. We found greater posterior and medial cerebellar volume in the susceptible group than the other groups. In addition, the posterior and medial cerebellar activities when processing positive versus neutral words exhibited significant interactive effects of both loneliness and social network, and susceptibility to isolation. Loneliness and social network also had positive effects on the right posterior cerebellar functional connectivity with the visual and premotor cortices. Our findings provide novel evidence on the intricate role of the cerebellum in loneliness and susceptibility to isolation, suggesting that socio-cognitive processes of the cerebellum in the hedonic domain may be a key mechanism underlying loneliness proneness.
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Affiliation(s)
- Nichol M L Wong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China.,Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong, China.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robin Shao
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China.,Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong, China.,Institute of Clinical Neuropsychology, The University of Hong Kong, Hong Kong, China
| | - Jingsong Wu
- Rehabilitation Medicine College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jing Tao
- Rehabilitation Medicine College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lidian Chen
- Fujian University of Traditional Chinese Medicine, Fuzhou, China.
| | - Tatia M C Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China. .,Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong, China. .,Institute of Clinical Neuropsychology, The University of Hong Kong, Hong Kong, China.
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14
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Pletzer B, Harris T, Hidalgo-Lopez E. Previous contraceptive treatment relates to grey matter volumes in the hippocampus and basal ganglia. Sci Rep 2019; 9:11003. [PMID: 31358839 PMCID: PMC6662764 DOI: 10.1038/s41598-019-47446-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 07/17/2019] [Indexed: 12/30/2022] Open
Abstract
Oral contraceptive (OC) effects on the brain have gained increasing interest, but are highly controversial. Previous studies suggest that OC users have larger hippocampi, parahippocampi, fusiform gyri and Cerebelli. Preliminary evidence from one of those studies even suggests an effect of previous contraceptive use on the hippocampi of women who are not current users of OCs. Furthermore, more recent studies postulate an involvement of previous OC treatment in later development of mood disorders. To address the question whether previous OC treatment affects women’s brain structure later in life, high resolution structural images were obtained from 131 naturally cycling women. Among them, 52 women had never used OC before, 52 had previously used one OC for a continuous time period and 27 had previously used multiple contraceptives. The groups did not differ in gray matter volumes. Since endogenous sex hormones modulate gray matter volumes of the hippocampus and basal ganglia along the menstrual cycle, we hypothesize effects of OC use on these areas. Specifically, we hypothesize that a longer duration of previous OC treatment is related to larger hippocampi and larger basal ganglia. Indeed we found the duration of previous OC use to be positively correlated to hippocampal and basal ganglia volumes bilaterally. For the hippocampus, but not for the basal ganglia, this association disappeared after controlling for the time since discontinuation. These results suggest that for the hippocampus, but not for the basal ganglia, effects of previous contraceptive treatment are reversed after a time period comparable to treatment duration. These data question the immediate reversibility of OC effects on brain structure. Accordingly, some changes in the brain due to long-term contraceptive use, while subtle, may be long-lasting.
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Affiliation(s)
- Belinda Pletzer
- Department of Psychology & Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.
| | - TiAnni Harris
- Department of Psychology & Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Esmeralda Hidalgo-Lopez
- Department of Psychology & Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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15
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Pletzer B, Harris T, Hidalgo-Lopez E. Subcortical structural changes along the menstrual cycle: beyond the hippocampus. Sci Rep 2018; 8:16042. [PMID: 30375425 PMCID: PMC6207699 DOI: 10.1038/s41598-018-34247-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 10/12/2018] [Indexed: 01/08/2023] Open
Abstract
Animal studies have robustly shown hormone related changes in spine density in various brain areas, specifically the hippocampus. Literature on hormone dependent gray matter volume changes in humans is however less consistent. While various areas have been reported to change along the menstrual cycle in women, many do not survive multiple-comparisons correction and only hippocampal changes have been replicated. We attribute these problems to small sample sizes and inconsistent definitions of menstrual cycle phases. In the present study a large sample of 55 women was scanned three times along their menstrual cycle in concisely defined time windows of hormonal changes. Accordingly this is the first study using a large enough sample size to assess menstrual cycle dependent changes in human brain structure with sufficient power. Results confirm a significant estradiol-dependent pre-ovulatory increase in gray matter volumes of the bilateral hippocampus, but also show a significant, progesterone-dependent increase in gray matter volumes of the right basal ganglia after ovulation. No other areas were affect by hormonal changes along the menstrual cycle. These hormone driven menstrual cycle changes in human brain structure are small, but may be the underlying cause of menstrual cycle dependent changes in cognition and emotion.
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Affiliation(s)
- Belinda Pletzer
- Department of Psychology & Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.
| | - TiAnni Harris
- Department of Psychology & Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Esmeralda Hidalgo-Lopez
- Department of Psychology & Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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16
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Wang Y, Chen G, Zhong S, Jia Y, Xia L, Lai S, Zhao L, Huang L, Liu T. Association between resting-state brain functional connectivity and cortisol levels in unmedicated major depressive disorder. J Psychiatr Res 2018; 105:55-62. [PMID: 30189325 DOI: 10.1016/j.jpsychires.2018.08.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 08/30/2018] [Accepted: 08/31/2018] [Indexed: 01/10/2023]
Abstract
Disturbed hypothalamus-pituitary-adrenal axis function, which leads to excessive and prolonged hypercortisolemia, is a core feature of major depressive disorder (MDD). However, the relationships between depression, brain structure and function, and cortisol levels are unclear. The current study examined the whole-brain functional connectivity pattern of patients with MDD and evaluated the association between functional connectivity and serum cortisol levels in MDD. A total of 93 unmedicated patients with MDD and 139 healthy control subjects underwent resting-state functional magnetic resonance imaging. Voxel-wise whole-brain connectivity was analyzed by using a graph theory approach: functional connectivity strength (FCS). A seed-based resting-state functional connectivity analysis was further performed to investigate abnormal functional connectivity patterns of those regions with changed FCS. Morning blood samples were drawn for cortisol measurements in some subjects (including 53 MDD patients and 30 controls). The MDD patients had a significantly lower FCS in the left posterior lobes of the cerebellum (mainly lobule Crus II) (p < 0.05, TFCE corrected). The seed-based functional connectivity analysis revealed decreased functional connectivity between the left posterior cerebellum and the left medial orbitofrontal cortex (OFC) (p < 0.05, TFCE corrected). Moreover, the functional connectivity between the left posterior cerebellum and the left medial OFC were significantly positively correlated with the serum cortisol levels in MDD patients. Our results suggest that cerebellar dysconnectivity, in particular distributed cerebellar-OFC functional connectivity, may be associated with serum cortisol levels in MDD patients.
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Affiliation(s)
- Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China.
| | - Guanmao Chen
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Liu Xia
- Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen, 518003, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
| | - Lianping Zhao
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Tiebang Liu
- Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen, 518003, China.
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17
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Yasmin N, Pandey R. Prospective memory, working memory, planning, and attention in schizophrenia and bipolar disorder: A comparative study. APPLIED COGNITIVE PSYCHOLOGY 2018. [DOI: 10.1002/acp.3423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Natasha Yasmin
- School of Psychology; University of Birmingham; Birmingham UK
| | - Rashmi Pandey
- Department of Clinical Psychology, Amity Institute of Behavioural Health & Allied Sciences; AMITY University; Noida India
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18
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Pan CC, Hu LY, Lu T, Tu MS, Shen CC, Chen ZJ. Risk of hip fractures in patients with depressive disorders: A nationwide, population-based, retrospective, cohort study. PLoS One 2018; 13:e0194961. [PMID: 29641581 PMCID: PMC5894998 DOI: 10.1371/journal.pone.0194961] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 03/14/2018] [Indexed: 11/19/2022] Open
Abstract
Background Some studies have suggested that depressive disorders may play a vital role in the incidence of hip fractures. However, nationwide data are lacking regarding the association between depressive disorders and hip fractures. Objective We aimed to explore the association between depressive disorders and new-onset hip fractures. Methods We conducted a retrospective study of 11,207 patients with depressive disorders and 11,207 control patients using Taiwan’s National Health Insurance Research Database. A Cox regression model was used to evaluate the risk of hip fractures in patients with depressive disorders. Results The incidence rate ratio of hip fractures between patients with depressive disorders and controls was 1.6 (95% confidence interval [CI] = 1.29–1.99, P < .001). After adjustment for potential confounders in multivariate analysis using the Cox regression model, patients with depressive disorders were found to have 1.34 times higher risk of hip fractures than controls (95% CI = 1.08–1.66, P = .008). Furthermore, age (hazard ratio [HR] = 7.43, 95% CI = 4.94–11.19, P < .001), hypertension (HR = 1.63, 95% CI = 1.17–2.28, P = .004), diabetes mellitus (HR = 1.47, 95% CI = 1.08–1.99, P = .014), cerebrovascular disease (HR = 1.76, 95% CI = 1.31–2.35, P < .001), living in rural areas (HR = 1.88, 95% CI = 1.30–2.70, P = .001), and low monthly income (NT$0–NT$19,000: HR = 4.08, 95% CI = 1.79–9.29, P = .001 and NT$19,100–NT$42,000: HR = 4.09, 95% CI = 1.76–9.49, P = .001) were independent risk factors for new-onset hip fractures in patients with depressive disorders. Conclusion Depressive disorders might increase the risk of new-onset hip fractures, particularly in older patients and patients with hypertension, diabetes mellitus, cerebrovascular disease, or low socioeconomic status.
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Affiliation(s)
- Chih-Chuan Pan
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Li-Yu Hu
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ti Lu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ming-Shium Tu
- Department of Family Medicine, Pingtung Branch, Kaohsiung Veterans General Hospital, Pingtung, Taiwan
| | - Cheng-Che Shen
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
- Department of Information Management, National Chung-Cheng University, Chiayi, Taiwan
| | - Zi-Jun Chen
- Department of Family Medicine, Pingtung Branch, Kaohsiung Veterans General Hospital, Pingtung, Taiwan
- * E-mail:
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19
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Rensel MA, Ding JA, Pradhan DS, Schlinger BA. 11β-HSD Types 1 and 2 in the Songbird Brain. Front Endocrinol (Lausanne) 2018; 9:86. [PMID: 29593652 PMCID: PMC5857549 DOI: 10.3389/fendo.2018.00086] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/23/2018] [Indexed: 12/29/2022] Open
Abstract
Glucocorticoid (GC) hormones act on the brain to regulate diverse functions, from behavior and homeostasis to the activity of the hypothalamic-pituitary-adrenal axis. Local regeneration and metabolism of GCs can occur in target tissues through the actions of the 11β-hydroxysteroid dehydrogenases [11 beta-hydroxysteroid dehydrogenase type 1 (11β-HSD1) and 11 beta-hydroxysteroid dehydrogenase type 2 (11β-HSD2), respectively] to regulate access to GC receptors. Songbirds have become especially important model organisms for studies of stress hormone action; however, there has been little focus on neural GC metabolism. Therefore, we tested the hypothesis that 11β-HSD1 and 11β-HSD2 are expressed in GC-sensitive regions of the songbird brain. Localization of 11β-HSD expression in these regions could provide precise temporal and spatial control over GC actions. We quantified GC sensitivity in zebra finch (Taeniopygia guttata) brain by measuring glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) expression across six regions, followed by quantification of 11β-HSD1 and 11β-HSD2 expression. We detected GR, MR, and 11β-HSD2 mRNA expression throughout the adult brain. Whereas 11β-HSD1 expression was undetectable in the adult brain, we detected low levels of expression in the brain of developing finches. Across several adult brain regions, expression of 11β-HSD2 covaried with GR and MR, with the exception of the cerebellum and hippocampus. It is possible that receptors in these latter two regions require direct access to systemic GC levels. Overall, these results suggest that 11β-HSD2 expression protects the adult songbird brain by rapid metabolism of GCs in a context and region-specific manner.
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Affiliation(s)
- Michelle A. Rensel
- The Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA, United States
- Laboratory of Neuroendocrinology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jessica A. Ding
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Devaleena S. Pradhan
- Laboratory of Neuroendocrinology, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Barney A. Schlinger
- Laboratory of Neuroendocrinology, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Integrative Biology and Physiology, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, CA, United States
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20
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Surguladze S, Keedwell P, Phillips M. Neural systems underlying affective disorders. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.9.6.446] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Three main approaches are used to explore the neural correlates of mood disorder: neuropsychological studies, neuroimaging studies and post-mortem investigations. Lesion studies implicate disturbances in the frontal lobe, basal ganglia, striatum and anterior temporal cortex. Early neurocognitive and neuropathological investigations led to a ‘hypofrontality’ hypothesis of unipolar and bipolar depression, but functional neuroimaging has revealed a more complex picture. Thus, increased metabolism may occur in the subgenual anterior cingulate gyrus in resting-state studies of depression and sad-mood induction. Antidepressants may reduce this activity. Amygdala hyperactivation also is associated with affective disorders. Task-related studies reveal abnormal biases in memory, the experience of pleasure and the perception of emotional facial expressions. There is still little clarity whether the abnormalities in brain activation represent state or trait characteristics of affective disorders.
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21
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Halappa NG, Thirthalli J, Varambally S, Rao M, Christopher R, Nanjundaiah GB. Improvement in neurocognitive functions and serum brain-derived neurotrophic factor levels in patients with depression treated with antidepressants and yoga. Indian J Psychiatry 2018; 60:32-37. [PMID: 29736060 PMCID: PMC5914260 DOI: 10.4103/psychiatry.indianjpsychiatry_154_17] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
CONTEXT AND AIMS Impairment in cognition is well-known in patients with major depressive disorder. This study examined the effect of yoga therapy with or without antidepressants and antidepressants alone on certain neuropsychological functions in patients with depression. Correlation between changes in neuropsychological test performance and serum brain-derived neurotrophic factor (BDNF) levels was also explored. MATERIALS AND METHODS Antidepressant-naïve/antidepressant-free outpatients with depression received antidepressant medication alone (n = 23) or yoga therapy with (n = 26) or without (n = 16) antidepressants. Depression was assessed using the Hamilton Depression Rating Scale. Neuropsychological tests included digit-span forward and backward, Rey Auditory Verbal Learning Test, and Trail Making Tests (TMT-A and B). These tests were administered before and 3 months after the treatment in patients, and once in healthy comparison subjects (n = 19). STATISTICAL ANALYSIS Baseline differences were analyzed using independent sample t-test, Chi-square, and one-way ANOVA. Paired t-test was used to analyze the change from baseline to follow-up. Pearson's correlation was used to explore the association of change between 2 variables. RESULTS Patients had impaired performance on most neuropsychological tests. After 3 months, there was significant improvement - patients' performance was comparable to that of healthy controls on majority of the tests. Significant inverse correlation was observed between increase in BDNF levels and improvement in TMT "A" duration in Yoga-alone group (r = -0.647; P = 0.009). CONCLUSIONS To conclude that, Yoga therapy, alone or in combination with medications, is associated with improved neuropsychological functions and neuroplastic effects in patients with depression.
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Affiliation(s)
- Naveen Gowrapura Halappa
- Department of Health and Yoga, Faculty of Allied Health Sciences, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, NIMHANS Integrated Centre for Yoga, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Shivarama Varambally
- Department of Psychiatry, NIMHANS Integrated Centre for Yoga, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Mukund Rao
- Department of Psychiatry, NIMHANS Integrated Centre for Yoga, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Rita Christopher
- Department of Neurochemistry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Gangadhar B Nanjundaiah
- Department of Psychiatry, NIMHANS Integrated Centre for Yoga, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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22
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An Oldie but Goodie: Lithium in the Treatment of Bipolar Disorder through Neuroprotective and Neurotrophic Mechanisms. Int J Mol Sci 2017; 18:ijms18122679. [PMID: 29232923 PMCID: PMC5751281 DOI: 10.3390/ijms18122679] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 12/04/2017] [Accepted: 12/07/2017] [Indexed: 12/21/2022] Open
Abstract
Lithium has been used for the treatment of bipolar disorder (BD) for the last sixty or more years, and recent studies with more reliable designs and updated guidelines have recommended lithium to be the treatment of choice for acute manic, mixed and depressive episodes of BD, along with long-term prophylaxis. Lithium’s specific mechanism of action in mood regulation is progressively being clarified, such as the direct inhibition on glycogen synthase kinase 3β, and its various effects on neurotrophic factors, neurotransmitters, oxidative metabolism, apoptosis, second messenger systems, and biological systems are also being revealed. Furthermore, lithium has been proposed to exert its treatment effects through mechanisms associated with neuronal plasticity. In this review, we have overviewed the clinical aspects of lithium use for BD, and have focused on the neuroprotective and neurotrophic effects of lithium.
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23
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Au RWC, Xiang YT, Ungvari GS, Lee E, Shum DHK, Man D, Tang WK. Prospective Memory Performance in Persons With Schizophrenia and Bipolar Disorder and Healthy Persons. Perspect Psychiatr Care 2017; 53:266-274. [PMID: 27373547 DOI: 10.1111/ppc.12172] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/25/2016] [Accepted: 05/30/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE There is a paucity of studies comparing prospective memory (PM) impairment between persons with schizophrenia and bipolar disorder. The aim of this study was to directly compare PM performances of these two groups and healthy controls. DESIGN AND METHODS A total of 44 persons with schizophrenia and 76 with bipolar disorder, and 44 healthy controls formed the study sample. FINDINGS Patients were found to be impaired in PM relative to controls and the two patient groups showed similar level of PM performance after controlling confounding sociodemographic and clinical variables. PRACTICE IMPLICATIONS The findings add to the evidence concerning the neurocognitive similarity between cohorts of schizophrenia and bipolar disorder with respect to PM. Rehabilitative effort in PM remedies for both patient groups is warranted.
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Affiliation(s)
- Raymond W C Au
- Senior Occupational Therapist, Occupational Therapy Department, United Christian Hospital, Hong Kong SAR, China
| | - Yu-Tao Xiang
- Associate Professor, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Gabor S Ungvari
- Professor, Marian Centre, University of Notre Dame Australia, Perth, Australia
| | - Edwin Lee
- Assistant Professor, Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - David H K Shum
- Professor, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - David Man
- Professor, Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Wai-Kwong Tang
- Professor, Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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The Role of the Cerebellum in Unconscious and Conscious Processing of Emotions: A Review. APPLIED SCIENCES-BASEL 2017. [DOI: 10.3390/app7050521] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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The COMT Val158Met Polymorphism Is Associated With Response to Add-on Dextromethorphan Treatment in Bipolar Disorder. J Clin Psychopharmacol 2017; 37:94-98. [PMID: 27930497 DOI: 10.1097/jcp.0000000000000633] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE/BACKGROUND We previously conducted a randomized, double-blind, controlled, 12-week study evaluating the effect of add-on dextromethorphan (DM), a noncompetitive N-methyl-D-aspartate receptor antagonist, on patients with bipolar disorder (BD) treated using valproate (VPA), which showed negative clinical differences. The genetic variation between each individual may be responsible for interindividual differences. The catechol-O-methyltransferase (COMT) gene has been a candidate gene for BD. In the current study, we investigated whether the COMT Val158Met polymorphism predicts treatment response to VPA + add-on DM and to VPA + placebo. METHODS/PROCEDURES Patients with BD (n = 309) undergoing regular VPA treatments were randomly assigned to groups given either add-on DM (30 mg/d) (n = 102), DM (60 mg/d) (n = 101), or placebo (n = 106) for 12 weeks. The Hamilton Depression Rating Scale and Young Mania Rating Scale were used to evaluate clinical response during weeks 0, 1, 2, 4, 8, and 12. The genotypes of the COMT Val158Met polymorphism were determined using polymerase chain reaction plus restriction fragment length polymorphism analysis. To adjust for within-subject dependence over repeated assessments, multiple linear regression with generalized estimating equation methods was used. FINDINGS/RESULTS When stratified by the COMT Val158Met genotypes, significantly greater decreases in Hamilton Depression Rating Scale scores were found in the VPA + DM (30 mg/d) group in patients with the Val/Met genotype (P = 0.008). CONCLUSIONS We conclude that the COMT Val158Met polymorphism may influence responses to DM (30 mg/d) by decreasing depressive symptoms in BD patients.
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Abstract
BACKGROUND Personalized medicine is a model in which a patient's unique clinical, genetic, and environmental characteristics are the basis for treatment and prevention. Aim, method, and results: This review aims to describe the current tools, phenomenological features, clinical risk factors, and biomarkers used to provide personalized medicine. Furthermore, this study describes the target areas in which they can be applied including diagnostics, treatment selection and response, assessment of risk of side-effects, and prevention. DISCUSSION AND CONCLUSION Personalized medicine in psychiatry is challenged by the current taxonomy, where the diagnostic categories are broad and great biological heterogeneity exists within each category. There is, thus, a gap between the current advanced research prospects and clinical practice, and the current taxonomy is, thus, a poor basis for biological research. The discussion proposes possible solutions to narrow this gap and to move psychiatric research forward towards personalized medicine.
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Affiliation(s)
| | - Maj Vinberg
- b Psychiatric Center Copenhagen , Copenhagen University , Copenhagen , Denmark
| | - Lars Vedel Kessing
- b Psychiatric Center Copenhagen , Copenhagen University , Copenhagen , Denmark
| | - Roger S McIntyre
- c Mood Disorders Psychopharmacology Unit , University Health Network , Toronto , ON , Canada
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Re TJ, Levman J, Lim AR, Righini A, Grant PE, Takahashi E. High-angular resolution diffusion imaging tractography of cerebellar pathways from newborns to young adults. Brain Behav 2017; 7:e00589. [PMID: 28127511 PMCID: PMC5256176 DOI: 10.1002/brb3.589] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 08/22/2016] [Accepted: 08/23/2016] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Many neurologic and psychiatric disorders are thought to be due to, or result in, developmental errors in neuronal cerebellar connectivity. In this connectivity analysis, we studied the developmental time-course of cerebellar peduncle pathways in pediatric and young adult subjects. METHODS A cohort of 80 subjects, newborns to young adults, was studied on a 3T MR system with 30 diffusion-weighted measurements with high-angular resolution diffusion imaging (HARDI) tractography. RESULTS Qualitative and quantitative results were analyzed for age-based variation. In subjects of all ages, the superior cerebellar peduncle pathway (SCP) and two distinct subpathways of the middle cerebellar peduncle (MCP), as described in previous ex vivo studies, were identified in vivo with this technique: pathways between the rostral pons and inferior-lateral cerebellum (MCP cog), associated predominantly with higher cognitive function, and pathways between the caudal pons and superior-medial cerebellum (MCP mot), associated predominantly with motor function. DISCUSSION Our findings showed that the inferior cerebellar peduncle pathway (ICP), involved primarily in proprioception and balance appears to have a later onset followed by more rapid development than that exhibited in other tracts. We hope that this study may provide an initial point of reference for future studies of normal and pathologic development of cerebellar connectivity.
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Affiliation(s)
- Thomas J. Re
- Department of RadiologyBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Fetal‐Neonatal Brain Imaging and Developmental Science CenterBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Department of RadiologyUniversity of MilanMilanItaly
| | - Jacob Levman
- Fetal‐Neonatal Brain Imaging and Developmental Science CenterBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Division of Newborn MedicineDepartment of MedicineBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
| | - Ashley R. Lim
- Division of Newborn MedicineDepartment of MedicineBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Department of Behavioral NeuroscienceNortheastern UniversityBostonMAUSA
| | - Andrea Righini
- Department of Pediatric Radiology and NeuroradiologyChildren's Hospital V. BuzziMilanItaly
| | - Patricia Ellen Grant
- Department of RadiologyBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Fetal‐Neonatal Brain Imaging and Developmental Science CenterBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Division of Newborn MedicineDepartment of MedicineBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
| | - Emi Takahashi
- Fetal‐Neonatal Brain Imaging and Developmental Science CenterBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
- Division of Newborn MedicineDepartment of MedicineBoston Children's HospitalHarvard Medical SchoolBostonMAUSA
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Bezchlibnyk YB, Stone SSD, Hamani C, Lozano AM. High frequency stimulation of the infralimbic cortex induces morphological changes in rat hippocampal neurons. Brain Stimul 2016; 10:315-323. [PMID: 27964870 DOI: 10.1016/j.brs.2016.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/03/2016] [Accepted: 11/21/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Although a significant subset of patients with major depressive disorder (MDD) fail to respond to medical or behavioural therapy, deep brain stimulation (DBS) applied to the subgenual cingulate cortex (SCC; sg25) has been shown to reduce depressive symptoms in a subset of patients. This area receives projections from neurons in the CA1 region and subiculum of the hippocampus (HC), a brain region implicated in the pathobiology and treatment of MDD. OBJECTIVE To assess whether high frequency stimulation (HFS) of the infralimbic cortex is associated with changes in cellular morphology in the HC. METHODS Rats were subjected to either infralimbic HFS or sham-stimulation. Measures of cellular morphology, including dendritic length and complexity, were assessed in pyramidal neurons in the CA1 region of the HC by means of the Golgi-Cox histological stain. RESULTS Dendritic length (p = 0.013) and number of branch points (p = 0.004) were significantly increased across the entire dendritic tree in animals subjected to HFS. Subsequent Scholl analysis revealed that for dendritic length these effects were localized to the region between 80 and 160 μm from the soma (p < 0.001 for either 40 μm interval) in the basal dendritic tree, while branch point number was predominantly increased between 120 and 160 μm from the soma (p < 0.001) in the apical dendritic tree. CONCLUSIONS High-frequency stimulation of the infralimbic cortex increases the complexity of apical dendrites and the length of basal dendritic trees of pyramidal neurons located in the CA1 hippocampal subfield relative to sham-stimulated animals.
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Affiliation(s)
- Yarema B Bezchlibnyk
- Department of Neurosurgery, Emory University Hospital, Atlanta, GA, United States
| | - Scellig S D Stone
- Harvard Medical School, Boston, MA, United States; Department of Neurosurgery, Boston Children's Hospital, Boston, MA, United States
| | - Clement Hamani
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Toronto Western Research Institute, Krembil Discovery Tower, University Health Network, Toronto, Ontario, Canada.
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Joshi SH, Vizueta N, Foland-Ross L, Townsend JD, Bookheimer SY, Thompson PM, Narr KL, Altshuler LL. Relationships Between Altered Functional Magnetic Resonance Imaging Activation and Cortical Thickness in Patients With Euthymic Bipolar I Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:507-517. [PMID: 27990494 DOI: 10.1016/j.bpsc.2016.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Performance during cognitive control functional magnetic resonance imaging (fMRI) tasks are associated with frontal lobe hypoactivation in patients with bipolar disorder, even while euthymic. Here, we study the structural underpinnings for this functional abnormality simultaneously with brain activation data. METHODS In a sample of ninety adults (45 with inter-episode Bipolar I disorder and 45 healthy controls), we explored whether abnormal functional activation patterns in bipolar euthymic subjects during a Go-NoGo fMRI task are associated with regional deficits in cortical gray matter thickness in the same regions. Cross-sectional differences in fMRI activation were used to form a-priori hypotheses for region-of-interest cortical gray matter thickness analyses. fMRI BOLD to structural magnetic resonance imaging (sMRI) thickness correlations were conducted across the sample and within patients and controls separately. RESULTS During response inhibition (NoGo minus Go), bipolar subjects showed significant hypoactivation and reduced thickness in the inferior frontal cortex (IFC), superior frontal gyrus and cingulate compared to controls. Cingulate hypoactivation corresponded with reduced regional thickness. A significant activation by disease state interaction was observed with thickness in left prefrontal areas. CONCLUSIONS Reduced cingulate fMRI activation is associated with reduced cortical thickness. In the left frontal lobe, a thinner cortex was associated with increased fMRI activation in patients, but showed a reverse trend in controls. These findings suggest that reduced activation in the IFC and cingulate during a response inhibition task may have an underlying structural etiology, which may explain task-related functional hypoactivation that persists even when patients are euthymic.
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Affiliation(s)
- Shantanu H Joshi
- Ahmanson Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA
| | - Nathalie Vizueta
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
| | | | - Jennifer D Townsend
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
| | - Susan Y Bookheimer
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
| | - Paul M Thompson
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA; Imaging Genetics Center, University of Southern California, Marina del Rey, CA
| | - Katherine L Narr
- Ahmanson Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
| | - Lori L Altshuler
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
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Porcu M, Balestrieri A, Siotto P, Lucatelli P, Anzidei M, Suri JS, Zaccagna F, Argiolas GM, Saba L. Clinical neuroimaging markers of response to treatment in mood disorders. Neurosci Lett 2016; 669:43-54. [PMID: 27737806 DOI: 10.1016/j.neulet.2016.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 09/01/2016] [Accepted: 10/06/2016] [Indexed: 12/22/2022]
Abstract
Mood disorders (MD) are important and frequent psychiatric illness. The management of patients affected by these conditions represents an important factor of disability as well as a significant social and economic burden. The "in-vivo" studies can help researchers to understand the first developmental events of the pathology and to identify the molecular and non-molecular targets of therapies. However, they have strong limitations due to the fact that human brain circuitry can not be reproduced in animal models. In addition, these neural pathways are difficult to be selectively studied with the modern imaging (such as Magnetic Resonance and Positron Emitted Tomography/Computed Tomography) and non-imaging (such as electroencephalography, magnetoencephalography, transcranial magnetic stimulation and evoked potentials) methods. In comparison with other methods, the "in-vivo" imaging investigations have higher temporal and spatial resolution compared to the "in-vivo" non-imaging techniques. All these factors make difficult to fully understand the aetiology and pathophysiology of these disorders, and consequently hinder the analysis of the effects of pharmacological and non-pharmacological therapies, which have been demonstrated effective in clinical settings. In this review, we will focus our attention on the current state of the art of imaging in the assessment of treatment efficacy in MD. We will analyse briefly the actual classification of MD; then we will focus on the "in vivo" imaging methods used in research and clinical activity, the current knowledge about the neural models at the base of MD. Finally the last part of the review will focus on the analysis of the main markers of response to treatment.
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Affiliation(s)
- Michele Porcu
- Department of Radiology, AOU of Cagliari, SS 554 Monserrato, CA, Italy
| | | | - Paolo Siotto
- Department of Radiology, AOB Azienda Ospedaliera Brotzu, CA, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Michele Anzidei
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Jasjit S Suri
- Diagnostic and Monitoring Division, AtheroPoint™, Roseville, CA, USA; Electrical Engineering Department, Idaho State University (Aff.), Pocatello, ID, USA
| | - Fulvio Zaccagna
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | | | - Luca Saba
- Department of Radiology, AOU of Cagliari, SS 554 Monserrato, CA, Italy.
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Shao WH, Chen JJ, Fan SH, Lei Y, Xu HB, Zhou J, Cheng PF, Yang YT, Rao CL, Wu B, Liu HP, Xie P. Combined Metabolomics and Proteomics Analysis of Major Depression in an Animal Model: Perturbed Energy Metabolism in the Chronic Mild Stressed Rat Cerebellum. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2016; 19:383-92. [PMID: 26134254 DOI: 10.1089/omi.2014.0164] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Major depressive disorder (MDD) is a highly prevalent, debilitating mental illness of importance for global health. However, its molecular pathophysiology remains poorly understood. Combined proteomics and metabolomics approaches should provide a comprehensive understanding of MDD's etiology. The present study reports novel "-omics" insights from a rodent model of MDD. Cerebellar samples from chronic mild stressed (CMS)-treated depressed rats and controls were compared with a focus on the differentially expressed proteins and metabolites using isobaric tags for relative and absolute quantitation (iTRAQ)-based proteomics and gas chromotography/mass spectrometry (GC-MS) metabolomics techniques, respectively. The combined analyses found significant alterations associated with cerebellar energy metabolism, as indicated by (1) abnormal amino acid metabolism accompanied by corresponding metabolic enzymatic alterations and disturbed protein turnover, (2) increased glycolytic and tricarboxylic acid (TCA) cycle enzyme levels paralleled by changes in the concentrations of associated metabolites, and (3) perturbation of ATP biosynthesis through adenosine accompanied by perturbation of the mitochondrial respiratory chain. To the best of our knowledge, this study is the first to integrate proteomics and metabolomics analyses to examine the pathophysiological mechanism(s) underlying MDD in a CMS rodent model of depression. These results can offer important insights into the pathogenesis of MDD.
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Affiliation(s)
- Wei-hua Shao
- 1 Department of Respiratory Medicine, First Affiliated Hospital of Chongqing Medical University , Chongqing, China .,3 Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University , Chongqing, China .,4 Chongqing Key Laboratory of Neurobiology , Chongqing, China
| | - Jian-jun Chen
- 3 Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University , Chongqing, China .,4 Chongqing Key Laboratory of Neurobiology , Chongqing, China
| | - Song-hua Fan
- 2 Department of Neurology, First Affiliated Hospital of Chongqing Medical University , Chongqing, China .,3 Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University , Chongqing, China .,4 Chongqing Key Laboratory of Neurobiology , Chongqing, China
| | - Yang Lei
- 2 Department of Neurology, First Affiliated Hospital of Chongqing Medical University , Chongqing, China .,3 Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University , Chongqing, China .,4 Chongqing Key Laboratory of Neurobiology , Chongqing, China
| | - Hong-bo Xu
- 2 Department of Neurology, First Affiliated Hospital of Chongqing Medical University , Chongqing, China .,3 Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University , Chongqing, China .,4 Chongqing Key Laboratory of Neurobiology , Chongqing, China
| | - Jian Zhou
- 3 Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University , Chongqing, China .,4 Chongqing Key Laboratory of Neurobiology , Chongqing, China
| | - Peng-fei Cheng
- 2 Department of Neurology, First Affiliated Hospital of Chongqing Medical University , Chongqing, China .,3 Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University , Chongqing, China .,4 Chongqing Key Laboratory of Neurobiology , Chongqing, China
| | - Yong-tao Yang
- 2 Department of Neurology, First Affiliated Hospital of Chongqing Medical University , Chongqing, China .,3 Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University , Chongqing, China .,4 Chongqing Key Laboratory of Neurobiology , Chongqing, China
| | - Cheng-long Rao
- 3 Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University , Chongqing, China .,4 Chongqing Key Laboratory of Neurobiology , Chongqing, China
| | - Bo Wu
- 3 Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University , Chongqing, China .,4 Chongqing Key Laboratory of Neurobiology , Chongqing, China
| | - Hai-peng Liu
- 2 Department of Neurology, First Affiliated Hospital of Chongqing Medical University , Chongqing, China .,3 Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University , Chongqing, China .,4 Chongqing Key Laboratory of Neurobiology , Chongqing, China
| | - Peng Xie
- 2 Department of Neurology, First Affiliated Hospital of Chongqing Medical University , Chongqing, China .,3 Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University , Chongqing, China .,4 Chongqing Key Laboratory of Neurobiology , Chongqing, China
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Papmeyer M, Sussmann JE, Stewart T, Giles S, Centola JG, Zannias V, Lawrie SM, Whalley HC, McIntosh AM. Prospective longitudinal study of subcortical brain volumes in individuals at high familial risk of mood disorders with or without subsequent onset of depression. Psychiatry Res 2016; 248:119-125. [PMID: 26778365 PMCID: PMC4834463 DOI: 10.1016/j.pscychresns.2015.12.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/08/2015] [Accepted: 12/28/2015] [Indexed: 12/19/2022]
Abstract
Subcortical volumetric brain abnormalities have been observed in mood disorders. However, it is unknown whether these reflect adverse effects predisposing to mood disorders or emerge at illness onset. Magnetic resonance imaging was conducted at baseline and after two years in 111 initially unaffected young adults at increased risk of mood disorders because of a close family history of bipolar disorder and 93 healthy controls (HC). During the follow-up, 20 high-risk subjects developed major depressive disorder (HR-MDD), with the others remaining well (HR-well). Volumes of the lateral ventricles, caudate, putamen, pallidum, thalamus, hippocampus and amygdala were extracted for each hemisphere. Using linear mixed-effects models, differences and longitudinal changes in subcortical volumes were investigated between groups (HC, HR-MDD, HR-well). There were no significant differences for any subcortical volume between groups controlling for multiple testing. Additionally, no significant differences emerged between groups over time. Our results indicate that volumetric subcortical brain abnormalities of these regions using the current method appear not to form familial trait markers for vulnerability to mood disorders in close relatives of bipolar disorder patients over the two-year time period studied. Moreover, they do not appear to reduce in response to illness onset at least for the time period studied.
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Affiliation(s)
- Martina Papmeyer
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom; Division of Systems Neuroscience of Psychopathology, Translational Research Center, University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
| | - Jessika E Sussmann
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - Tiffany Stewart
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - Stephen Giles
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - John G Centola
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - Vasileios Zannias
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - Heather C Whalley
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, United Kingdom
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Chao LL, Reeb R, Esparza IL, Abadjian LR. Associations between the self-reported frequency of hearing chemical alarms in theater and regional brain volume in Gulf War Veterans. Neurotoxicology 2016; 53:246-256. [PMID: 26920621 DOI: 10.1016/j.neuro.2016.02.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/01/2016] [Accepted: 02/21/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND We previously reported evidence of reduced cortical gray matter (GM), white matter (WM), and hippocampal volume in Gulf War (GW) veterans with predicted exposure to low-levels of nerve agent according to the 2000 Khamisiyah plume model analysis. Because there is suggestive evidence that other nerve agent exposures may have occurred during the Gulf War, we examined the association between the self-reported frequency of hearing chemical alarms sound during deployment in the Gulf War and regional brain volume in GW veterans. METHODS Ninety consecutive GW veterans (15 female, mean age: 52±8years) participating in a VA-funded study underwent structural magnetic resonance imaging (MRI) on a 3T scanner. Freesurfer (version 5.1) was used to obtain regional measures of cortical GM, WM, hippocampal, and insula volume. Multiple linear regression was used to determine the association between the self-reported frequencies of hearing chemical alarms during the Gulf War and regional brain volume. RESULTS There was an inverse association between the self-reported frequency of hearing chemical alarms sound and total cortical GM (adjusted p=0.007), even after accounting for potentially confounding demographic and clinical variables, the veterans' current health status, and other concurrent deployment-related exposures that were correlated with hearing chemical alarms. Post-hoc analyses extended the inverse relationship between the frequency of hearing chemical alarms to GM volume in the frontal (adjusted p=0.02), parietal (adjusted p=0.01), and occipital (adjusted p=0.001) lobes. In contrast, regional brain volumes were not significantly associated with predicted exposure to the Khamisiyah plume or with Gulf War Illness status defined by the Kansas or Centers for Disease Control and Prevention criteria. CONCLUSIONS Many veterans reported hearing chemical alarms sound during the Gulf War. The current findings suggest that exposure to substances that triggered those chemical alarms during the Gulf War likely had adverse neuroanatomical effects.
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Affiliation(s)
- Linda L Chao
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, 4150 Clement Street, 114M, San Francisco, CA 94121, United States; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States; Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States.
| | - Rosemary Reeb
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, 4150 Clement Street, 114M, San Francisco, CA 94121, United States; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Iva L Esparza
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, 4150 Clement Street, 114M, San Francisco, CA 94121, United States
| | - Linda R Abadjian
- Center for Imaging of Neurodegenerative Diseases, San Francisco Veterans Affairs Medical Center, 4150 Clement Street, 114M, San Francisco, CA 94121, United States
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Sani G, Chiapponi C, Piras F, Ambrosi E, Simonetti A, Danese E, Janiri D, Brugnoli R, De Filippis S, Caltagirone C, Girardi P, Spalletta G. Gray and white matter trajectories in patients with bipolar disorder. Bipolar Disord 2016; 18:52-62. [PMID: 26782273 DOI: 10.1111/bdi.12359] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 10/26/2015] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Findings on brain structural abnormalities in patients with bipolar disorder (BP) are inconsistent and little is known about age-related evolution of these changes. We employed a cross-sectional, case-control study to compare structural age-related brain trajectories in patients with BP and healthy control subjects (HC) over a period of approximately 50 years. The primary aim was to understand whether white (WM) and gray matter (GM) abnormalities are present from the beginning of the illness and how they change over time. METHODS Seventy-eight patients with BP and 78 HC matched for age, gender, and educational level underwent a high-resolution structural magnetic resonance imaging protocol. A voxel-based morphometry (VBM) analysis was used to capture GM and WM differences between subjects with BP and HC. Factorial analysis of covariance was used to compare brain volume alterations at different ages between the groups. RESULTS We found an age-related atrophy in GM and WM volumes both in patients with BP and HC. A main effect of diagnosis emerged in the posterior cingulate cortex bilaterally, in the right thalamus, in the cerebellum bilaterally, and in the left posterior limb of the internal capsule. No interaction between diagnosis and age emerged, indicating that the volumes of these areas were permanently reduced in subjects with BP throughout the entire age range under investigation. CONCLUSIONS Brain alterations in patients with BP are present from the beginning of the illness and remain stable over time. All the affected areas are involved in mood and psychomotor control process. This suggests a possible neurodevelopmental involvement in the mechanism of BP.
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Affiliation(s)
- Gabriele Sani
- Neurosciences, Mental Health, and Sensory Organs Department (NESMOS), Sapienza University, Rome, School of Medicine and Psychology, Sant' Andrea Hospital, Italy.,Centro Lucio Bini, Rome, Italy
| | - Chiara Chiapponi
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Medicine of Systems, Tor Vergata University, Rome, Italy
| | - Fabrizio Piras
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Enrico Fermi Center for Study and Research, Rome, Italy
| | - Elisa Ambrosi
- Neurosciences, Mental Health, and Sensory Organs Department (NESMOS), Sapienza University, Rome, School of Medicine and Psychology, Sant' Andrea Hospital, Italy
| | - Alessio Simonetti
- Neurosciences, Mental Health, and Sensory Organs Department (NESMOS), Sapienza University, Rome, School of Medicine and Psychology, Sant' Andrea Hospital, Italy.,Centro Lucio Bini, Rome, Italy
| | - Emanuela Danese
- Neurosciences, Mental Health, and Sensory Organs Department (NESMOS), Sapienza University, Rome, School of Medicine and Psychology, Sant' Andrea Hospital, Italy
| | - Delfina Janiri
- Neurosciences, Mental Health, and Sensory Organs Department (NESMOS), Sapienza University, Rome, School of Medicine and Psychology, Sant' Andrea Hospital, Italy.,Centro Lucio Bini, Rome, Italy
| | - Roberto Brugnoli
- Neurosciences, Mental Health, and Sensory Organs Department (NESMOS), Sapienza University, Rome, School of Medicine and Psychology, Sant' Andrea Hospital, Italy
| | | | - Carlo Caltagirone
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Medicine of Systems, Tor Vergata University, Rome, Italy
| | - Paolo Girardi
- Neurosciences, Mental Health, and Sensory Organs Department (NESMOS), Sapienza University, Rome, School of Medicine and Psychology, Sant' Andrea Hospital, Italy.,Centro Lucio Bini, Rome, Italy
| | - Gianfranco Spalletta
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Division of Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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Abstract
INTRODUCTION White matter hyperintensities (WMHs) are one the most common neuroimaging findings in patients with bipolar disorder (BD). It has been suggested that WMHs are associated with impaired insight in schizophrenia and schizoaffective patients; however, the relationship between insight and WMHs in BD type I has not been directly investigated. METHODS Patients with BD-I (148) were recruited and underwent brain magnetic resonance imaging (MRI). Affective symptoms were assessed using Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS17); the presence of impaired insight was based on the corresponding items of YMRS and HDRS17. RESULTS Multiple punctate periventricular WMHs (PWMHs) and deep WMHs (DWMHs) were observed in 49.3% and 39.9% of the cases, respectively. Subjects with lower insight for mania had significantly more PWMHs (54.6% vs 22.2%; p < 0.05) when compared to BD-I patients with higher insight for mania. The presence of PWMHs was independently associated with lower insight for mania: patients who denied illness according to the YMRS were 4 times more likely to have PWMHs (95% CI: 1.21/13.42) than other patients. CONCLUSIONS Impaired insight in BD-I is associated with periventricular WMHs. The early identification of BD-I subjects with PWMHs and impaired insight may be crucial for clinicians.
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Quigley SJ, Scanlon C, Kilmartin L, Emsell L, Langan C, Hallahan B, Murray M, Waters C, Waldron M, Hehir S, Casey H, McDermott E, Ridge J, Kenney J, O'Donoghue S, Nannery R, Ambati S, McCarthy P, Barker GJ, Cannon DM, McDonald C. Volume and shape analysis of subcortical brain structures and ventricles in euthymic bipolar I disorder. Psychiatry Res 2015; 233:324-30. [PMID: 26254541 DOI: 10.1016/j.pscychresns.2015.05.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 04/11/2015] [Accepted: 05/19/2015] [Indexed: 12/17/2022]
Abstract
Previous structural magnetic resonance imaging (S-MRI) studies of bipolar disorder have reported variable morphological changes in subcortical brain structures and ventricles. This study aimed to establish trait-related subcortical volumetric and shape abnormalities in a large, homogeneous sample of prospectively confirmed euthymic bipolar I disorder (BD-I) patients (n=60), compared with healthy volunteers (n=60). Participants were individually matched for age and gender. Volume and shape metrics were derived from manually segmented S-MR images for the hippocampus, amygdala, caudate nucleus, and lateral ventricles. Group differences were analysed, controlling for age, gender and intracranial volume. BD-I patients displayed significantly smaller left hippocampal volumes and significantly larger left lateral ventricle volumes compared with controls. Shape analysis revealed an area of contraction in the anterior head and medial border of the left hippocampus, as well as expansion in the right hippocampal tail medially, in patients compared with controls. There were no significant associations between volume or shape variation and lithium status or duration of use. A reduction in the head of the left hippocampus in BD-I patients is interesting, given this region's link to verbal memory. Shape analysis of lateral ventricular changes in patients indicated that these are not regionally specific.
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Affiliation(s)
- Stephen J Quigley
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Cathy Scanlon
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Liam Kilmartin
- Electrical and Electronic Engineering, College of Engineering and Informatics, National University of Ireland, Galway, Ireland
| | - Louise Emsell
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland; Translational MRI, Department of Imaging & Pathology, KU Leuven & Radiology, University Hospitals, Leuven, Belgium
| | - Camilla Langan
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Brian Hallahan
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Michael Murray
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Conor Waters
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Mairead Waldron
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Sarah Hehir
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Helen Casey
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Emma McDermott
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Jason Ridge
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Joanne Kenney
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Stefani O'Donoghue
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Rory Nannery
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Srinath Ambati
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Peter McCarthy
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London SE5 8AF, United Kingdom
| | - Dara M Cannon
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Colm McDonald
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland.
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Ho KA, Bai S, Martin D, Alonzo A, Dokos S, Puras P, Loo CK. A pilot study of alternative transcranial direct current stimulation electrode montages for the treatment of major depression. J Affect Disord 2015; 167:251-8. [PMID: 24998841 DOI: 10.1016/j.jad.2014.06.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/12/2014] [Accepted: 06/12/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Typically, transcranial direct current stimulation (tDCS) treatments for depression have used bifrontal montages with anodal (excitatory) stimulation targeting the left dorsolateral prefrontal cortex (DLPFC). There is limited research examining the effects of alternative electrode montages. OBJECTIVE/HYPOTHESIS This pilot study aimed to examine the feasibility, tolerability and safety of two alternative electrode montages and provide preliminary data on efficacy. The montages, Fronto-Occipital (F-O) and Fronto-Cerebellar (F-C), were designed respectively to target midline brain structures and the cerebellum. METHODS The anode was placed over the left supraorbital region and the cathode over the occipital and cerebellar region for the F-O and F-C montages respectively. Computational modelling was used to determine the electric fields produced in the brain regions of interest compared to a standard bifrontal montage. The two montages were evaluated in an open label study of depressed participants (N=14). Mood and neuropsychological functioning were assessed at baseline and after four weeks of tDCS. RESULTS Computational modelling revealed that the novel montages resulted in greater activation in the anterior cingulate cortices and cerebellum than the bifrontal montage, while activation of the DLPFCs was higher for the bifrontal montage. After four weeks of tDCS, overall mood improvement rates of 43.8% and 15.9% were observed under the F-O and F-C conditions, respectively. No significant neuropsychological changes were found. LIMITATIONS The clinical pilot was open-label, without a control condition and computational modelling was based on one healthy participant. CONCLUSIONS Results found both montages safe and feasible. The F-O montage showed promising antidepressant potential.
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Affiliation(s)
- Kerrie-Anne Ho
- School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia
| | - Siwei Bai
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
| | - Donel Martin
- School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia
| | - Angelo Alonzo
- School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia
| | - Socrates Dokos
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
| | - Pablo Puras
- Department of Psychiatry, Hospital Universitario de Getafe, Getafe, Madrid, Spain; School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia
| | - Colleen K Loo
- School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, NSW 2031, Australia; Department of Psychiatry, St George Hospital, Sydney, Australia.
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Roda Â, Chendo I, Kunz M. Biomarkers and staging of bipolar disorder: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2014; 37:3-11. [PMID: 25860561 DOI: 10.1590/2237-6089-2014-0002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 07/22/2014] [Indexed: 01/09/2023]
Abstract
INTRODUCTION A growing body of evidence suggests that bipolar disorder (BD) is a progressive disease according to clinical, biochemical and neuroimaging findings. This study reviewed the literature on the relationship between specific biomarkers and BD stages. METHODS A comprehensive literature search of MEDLINE and PubMed was conducted to identify studies in English and Portuguese using the keywords biomarker, neurotrophic factors, inflammation, oxidative stress, neuroprogression and staging models cross-referenced with bipolar disorder. RESULTS Morphometric studies of patients with BD found neuroanatomic abnormalities, such as ventricular enlargement, grey matter loss in the hippocampus and cerebellum, volume decreases in the prefrontal cortex and variations in the size of the amygdala. Other studies demonstrated that serum concentrations of neurotrophic factors, inflammatory mediators and oxidative stress may be used as BD biomarkers. CONCLUSIONS The analysis of neurobiological changes associated with BD progression and activity may confirm the existence of BD biomarkers, which may be then included in staging models that will lead to improvements in treatment algorithms and more effective, individually tailored treatment regimens. Biomarkers may also be used to define early interventions to control disease progression.
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Affiliation(s)
- Ângela Roda
- Faculdade de Medicina de Lisboa, Lisbon, Portugal
| | - Inês Chendo
- Faculdade de Medicina de Lisboa, University Clinic, Lisboa, Portugal
| | - Mauricio Kunz
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Chen SL, Lee SY, Chang YH, Chen PS, Lee IH, Wang TY, Chen KC, Yang YK, Hong JS, Lu RB. Therapeutic effects of add-on low-dose dextromethorphan plus valproic acid in bipolar disorder. Eur Neuropsychopharmacol 2014; 24:1753-9. [PMID: 25262178 DOI: 10.1016/j.euroneuro.2014.09.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 08/08/2014] [Accepted: 09/03/2014] [Indexed: 12/24/2022]
Abstract
UNLABELLED Changes in inflammatory cytokines and dysfunction of the neurotrophic system are thought to be involved in the pathology of bipolar disorder (BP). We investigated whether inflammatory and neurotrophic factors were changed in BP. We also investigated whether treating BP with valproic acid (VPA) plus low-dose (30 or 60 mg/day) dextromethorphan (DM) is more effective than treating it with VPA only, and whether DM affects plasma cytokines and brain derived neurotrophic factor (BDNF) levels. In a 12-week, randomized, double-blind study, patients were randomly assigned to the VPA+DM30, VPA+DM60, or VPA+Placebo groups. The Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS) were used to evaluate symptom severity, and ELISA to analyze plasma cytokine and BDNF levels. We recruited 309 patients with BP and 123 healthy controls. Before treatment, patients with BP had significantly higher plasma cytokine and lower plasma BDNF levels than did healthy controls. After treatment, HDRS and YMRS scores in each group showed significant improvement. Plasma cytokine levels tended to decline in all groups. Changes in plasma BDNF levels were significantly greater in the VPA+DM60 group than in the VPA+Placebo group. CONCLUSION patients with BP have a certain degree of systemic inflammation and BDNF dysfunction. Treatment with VPA plus DM (60 mg/day) provided patients with BP significantly more neurotrophic benefit than did VPA treatment alone.
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Affiliation(s)
- Shiou-Lan Chen
- Department of Neurology, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veteran׳s General Hospital, Kaohsiung, Taiwan
| | - Yun-Hsuan Chang
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Po-See Chen
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - I-Hui Lee
- Department of Neurology, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Institute of Behavioral Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzu-Yun Wang
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Kao-Ching Chen
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yen-Kuang Yang
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Jau-Shyong Hong
- Laboratory of Toxicology and Pharmacology, NIH/NIEHS, Research Triangle Park, NC, USA
| | - Ru-Band Lu
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Addiction Research Center, National Cheng Kung University, Tainan, Taiwan; Center for Neuropsychiatric Research, National Health Research Institute, Miaoli, Taiwan.
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40
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Lee SY, Chen SL, Chang YH, Chen PS, Huang SY, Tzeng NS, Wang YS, Wang LJ, Lee IH, Wang TY, Yeh TL, Yang YK, Hong JS, Lu RB. The effects of add-on low-dose memantine on cytokine levels in bipolar II depression: a 12-week double-blind, randomized controlled trial. J Clin Psychopharmacol 2014; 34:337-43. [PMID: 24717258 DOI: 10.1097/jcp.0000000000000109] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Memantine, a noncompetitive N-methyl-d-aspartate receptor antagonist with a mood-stabilizing effect, and an association between bipolar disorder and proinflammatory cytokine levels have been reported. Whether adding-on memantine would reduce cytokine levels and is more effective than valproic acid (VPA) alone in bipolar II disorder was investigated. A randomized, double-blind, controlled, 12-week study was conducted. Patients undergoing regular VPA treatments were randomly assigned to a group: VPA + memantine (5 mg/d) (n = 106) or VPA + placebo (n = 108). The Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) were used to evaluate clinical response. Symptom severity, plasma tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), IL-8, and IL-1 levels were examined during weeks 0, 1, 2, 4, 8, and 12. To adjust within-subject dependence over repeated assessments, multiple linear regressions with generalized estimating equation methods were used to examine the therapeutic effect. Tumor necrosis factor α levels were significantly lower in the VPA + memantine group than in the VPA + placebo group (P = 0.013). Posttreatment HDRS and YMRS scores decreased significantly in both groups, but not significant, nor was the other between-group cytokine level difference pretreatment and posttreatment. The HDRS score changes were significantly associated with IL-6 (P = 0.012) and IL-1 (P = 0.005) level changes and changes in YMRS score changes with TNF-α (P = 0.005) level changes. Treating bipolar II depression with VPA + memantine may improve the plasma TNF-α level. However, adding-on memantine may not improve clinical symptoms or cytokine levels other than TNF-α. Clinical symptoms may be correlated with certain cytokines.
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Affiliation(s)
- Sheng-Yu Lee
- From the *Department of Psychiatry, †Institute of Behavioral Medicine, and ‡Institute of Allied Health Sciences, College of Medicine and Hospital, National Cheng Kung University, Tainan; §Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei; ∥Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung; ¶Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan; #Addiction Research Center, National Cheng Kung University, Tainan, Taiwan; and **Laboratory of Toxicology and Pharmacology, NIH/NIEHS, Research Triangle Park, NC
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Biedermann SV, Weber-Fahr W, Demirakca T, Tunc-Skarka N, Hoerst M, Henn F, Sartorius A, Ende G. 31P RINEPT MRSI and VBM reveal alterations in brain aging associated with major depression. Magn Reson Med 2014; 73:1390-400. [PMID: 24798730 DOI: 10.1002/mrm.25278] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 03/24/2014] [Accepted: 04/14/2014] [Indexed: 01/18/2023]
Abstract
PURPOSE Phosphomono- and diesters, the major components of the choline peak in (1) H magnetic resonance spectroscopy, are associated with membrane anabolic and catabolic mechanisms. With the refocused insensitive nuclei-enhanced polarization transfer technique, these phospholipids are edited and enhanced in the (31) P MR spectrum. In depressed patients, alterations of the choline peak and cerebral volume have been found, indicating a possible relation. Thus, combining MR phosphorous spectroscopy and volumetry in depressed patients seems to be a promising approach to detect underlying pathomechanisms. METHODS Depressed in-patients were either treated with antidepressive medication or with electroconvulsive therapy and compared to matched healthy controls. (31) P magnetic resonance spectroscopy imaging was conducted before and after the treatment phases. A 3D MRI dataset for volumetry was acquired in a dedicated (1) H head coil. RESULTS Phosphocholine and phosphoethanolamine were increased in depressed patients. Though patients responded to the treatments, phospholipids were not significantly altered. An increased age-related gray matter loss in fronto-limbic regions along with an altered relation of phosphomonoesters/phosphodiesters with age were found in depressed patients. DISCUSSION The findings of increased phosphomonoesthers and an age*group interaction for gray matter volumes need further research to define the role of phospholipids in major depression and possible associations to gray matter loss.
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Affiliation(s)
- Sarah V Biedermann
- Department Neuroimaging, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Abstract
From a neurobiological perspective there is no such thing as bipolar disorder. Rather, it is almost certainly the case that many somewhat similar, but subtly different, pathological conditions produce a disease state that we currently diagnose as bipolarity. This heterogeneity - reflected in the lack of synergy between our current diagnostic schema and our rapidly advancing scientific understanding of the condition - limits attempts to articulate an integrated perspective on bipolar disorder. However, despite these challenges, scientific findings in recent years are beginning to offer a provisional "unified field theory" of the disease. This theory sees bipolar disorder as a suite of related neurodevelopmental conditions with interconnected functional abnormalities that often appear early in life and worsen over time. In addition to accelerated loss of volume in brain areas known to be essential for mood regulation and cognitive function, consistent findings have emerged at a cellular level, providing evidence that bipolar disorder is reliably associated with dysregulation of glial-neuronal interactions. Among these glial elements are microglia - the brain's primary immune elements, which appear to be overactive in the context of bipolarity. Multiple studies now indicate that inflammation is also increased in the periphery of the body in both the depressive and manic phases of the illness, with at least some return to normality in the euthymic state. These findings are consistent with changes in the hypothalamic-pituitary-adrenal axis, which are known to drive inflammatory activation. In summary, the very fact that no single gene, pathway, or brain abnormality is likely to ever account for the condition is itself an extremely important first step in better articulating an integrated perspective on both its ontological status and pathogenesis. Whether this perspective will translate into the discovery of innumerable more homogeneous forms of bipolarity is one of the great questions facing the field and one that is likely to have profound treatment implications, given that fact that such a discovery would greatly increase our ability to individualize - and by extension, enhance - treatment.
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Affiliation(s)
- Vladimir Maletic
- Department of Neuropsychiatry and Behavioral Sciences, University of South Carolina School of Medicine , Columbia, SC , USA
| | - Charles Raison
- Department of Psychiatry, University of Arizona , Tucson, AZ , USA ; Norton School of Family and Consumer Sciences, College of Agriculture and Life Sciences, University of Arizona , Tucson, AZ , USA
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Ren X, Rizavi HS, Khan MA, Bhaumik R, Dwivedi Y, Pandey GN. Alteration of cyclic-AMP response element binding protein in the postmortem brain of subjects with bipolar disorder and schizophrenia. J Affect Disord 2014; 152-154:326-33. [PMID: 24148789 PMCID: PMC3878615 DOI: 10.1016/j.jad.2013.09.033] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 09/20/2013] [Indexed: 02/02/2023]
Abstract
BACKGROUND Abnormalities of cyclic-AMP (cAMP) response element binding protein (CREB) function has been suggested in bipolar (BP) illness and schizophrenia (SZ), based on both indirect and direct evidence. To further elucidate the role of CREB in these disorders, we studied CREB expression and function in two brain areas implicated in these disorders, i.e., dorsolateral prefrontal cortex (DLPFC) and cingulate gyrus (CG). METHODS We determined CREB protein expression using Western blot technique, CRE-DNA binding using gel shift assay, and mRNA expression using real-time RT-polymerase chain reaction (qPCR) in DLPFC and CG of the postmortem brain of BP (n=19), SZ (n=20), and normal control (NC, n=20) subjects. RESULTS We observed that CREB protein and mRNA expression and CRE-DNA binding activity were significantly decreased in the nuclear fraction of DLPFC and CG obtained from BP subjects compared with NC subjects. However, the protein and mRNA expression and CRE-DNA binding in SZ subjects was significantly decreased in CG, but not in DLPFC, compared with NC. CONCLUSION These studies thus indicate region-specific abnormalities of CREB expression and function in both BP and SZ. They suggest that abnormalities of CREB in CG may be associated with both BP and SZ, but its abnormality in DLPFC is specific to BP illness.
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Affiliation(s)
- Xinguo Ren
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL 60612, USA
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Au RWC, Ungvari GS, Lee E, Man D, Shum DHK, Xiang YT, Tang WK. Prospective memory impairment and its implications for community living skills in bipolar disorder. Bipolar Disord 2013; 15:885-92. [PMID: 24034473 DOI: 10.1111/bdi.12122] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Accepted: 05/17/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Prospective memory (PM) refers to the ability to undertake intended actions in the future. The functional significance of PM in bipolar disorder (BD) has not yet been investigated. This study examined PM impairment and its role in community living skills in clinically stable individuals with BD. METHODS Seventy-six individuals with BD and 44 healthy individuals were assessed with the Chinese version of the Cambridge Prospective Memory Test. Socio-demographic characteristics, retrospective memory (RM; the ability to recall or recognize past information), and intelligence were also measured in all participants. The clinical condition and community living skills of patients with BD were rated independently with standardized instruments. RESULTS Patients with BD showed PM impairment and their PM total scores independently predicted the level of community living skills in regression analyses. In follow-up analyses, the contribution was found to be accounted for by the time-based PM scores. CONCLUSIONS Given the expanding body of research on the utility of PM in predicting functioning, these findings further support the role of PM in community living skills in individuals with BD. The results suggest that PM training might be an integral part of clinical rehabilitation devised for individuals with BD.
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Affiliation(s)
- Raymond W C Au
- Occupational Therapy Department, United Christian Hospital, Hong Kong SAR, China; Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
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Zhang WN, Chang SH, Guo LY, Zhang KL, Wang J. The neural correlates of reward-related processing in major depressive disorder: a meta-analysis of functional magnetic resonance imaging studies. J Affect Disord 2013; 151:531-539. [PMID: 23856280 DOI: 10.1016/j.jad.2013.06.039] [Citation(s) in RCA: 244] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 05/27/2013] [Accepted: 06/18/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND A growing number of functional magnetic resonance imaging (fMRI) studies have been conducted in major depressive disorder (MDD) to elucidate reward-related brain functions. The aim of this meta-analysis was to examine the common reward network in the MDD brain and to further distinguish the brain activation patterns between positive stimuli and monetary rewards as well as reward anticipation and outcome. METHODS A series of activation likelihood estimation (ALE) meta-analyses were performed across 22 fMRI studies that examined reward-related processing, with a total of 341 MDD patients and 367 healthy controls. RESULTS We observed several frontostriatal regions that participated in reward processing in MDD. The common reward network in MDD was characterized by decreased subcortical and limbic areas activity and an increased cortical response. In addition, the cerebellum, lingual gyrus, parahippocampal gyrus and fusiform gyrus preferentially responded to positive stimuli in MDD, while the insula, precuneus, cuneus, PFC and inferior parietal lobule selectively responded to monetary rewards. Our results indicated a reduced caudate response during both monetary anticipation and outcome stages as well as increased activation in the middle frontal gyrus and dorsal anterior cingulate during reward anticipation in MDD. LIMITATIONS The reward-related tasks and mood states of patients included in our analysis were heterogeneous. CONCLUSIONS Our current findings suggest that there exist emotional or motivational pathway dysfunctions in MDD during reward-related processing. Future studies may be strengthened by paying careful attention to the types of reward used as well as the different components of reward processing examined.
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Affiliation(s)
- Wei-Na Zhang
- The Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, China
| | - Su-Hua Chang
- The Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Li-Yuan Guo
- The Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Kun-Lin Zhang
- The Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jing Wang
- The Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
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Add-on memantine to valproate treatment increased HDL-C in bipolar II disorder. J Psychiatr Res 2013; 47:1343-8. [PMID: 23870798 PMCID: PMC4786167 DOI: 10.1016/j.jpsychires.2013.06.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 04/13/2013] [Accepted: 06/26/2013] [Indexed: 12/20/2022]
Abstract
UNLABELLED Memantine is a noncompetitive NMDA receptor antagonist. As an augmenting agent, it has an antidepressant-like and mood-stabilizing effect. Memantine also reduces binge eating episodes and weight. We investigated whether memantine added on to valproate (VPA) is more effective than VPA alone for treating BP-II depression and improving the patient's metabolic profile. This was a randomized, double-blind, controlled study. BP-II patients undergoing regular VPA treatments were randomly assigned to one of two groups: VPA plus either add-on [1] memantine (5 mg/day) (n = 62) or [2] placebo (n = 73) for 12 weeks. The Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS) were used to evaluate clinical response. Height, weight, fasting serum glucose, fasting total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides were followed regularly. Multiple linear regressions with generalized estimating equation methods were used to analyze the effects of memantine on clinical performance. There were no significant differences in pre- and post-treatment YMRS and HDRS scores between the VPA + memantine and VPA + placebo groups. Although there were no significant differences in the pre- and post-treatment values of most metabolic indices between the two groups, there was a significant increase of HDL-C (p = 0.009) in the VPA + memantine group compared with the VPA + placebo group. This increase remained significant even after controlling for body mass index (BMI) (p = 0.020). We conclude that add-on memantine plus VPA treatment of BP-II depression increases the blood level of HDL-C even in the absence of change in affective symptoms. TRIAL REGISTRATION NCT01188148 (https://register.clinicaltrials.gov/), Trial date was from 1st August, 2008 to 31st July, 2012 in National Cheng Kung University and Tri-Service General Hospital.
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Selek S, Nicoletti M, Zunta-Soares GB, Hatch JP, Nery FG, Matsuo K, Sanches M, Soares JC. A longitudinal study of fronto-limbic brain structures in patients with bipolar I disorder during lithium treatment. J Affect Disord 2013; 150:629-33. [PMID: 23764385 DOI: 10.1016/j.jad.2013.04.020] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Accepted: 04/19/2013] [Indexed: 12/13/2022]
Abstract
In order to assess the association between therapeutic response to lithium treatment and fronto-limbic brain structures' volumes in bipolar I patients (BPI) 24 BPI and 11 healthy comparisons underwent MRI scans at baseline and 4 weeks later. The BPIs received lithium during the 4 week period with a goal of achieving therapeutic blood levels of >0.5 mEq/L (mean level 0.67 mEq/L). Mood symptoms were rated with the Hamilton Depression and the Young Mania Rating Scales at baseline and after 4 weeks, and response was defined as >50% decrease on either scale. Hippocampus, amygdala, prefrontal (PFC), dorsolateral prefrontal (DLPFC), and anterior cingulate cortex (ACC) volumes were obtained by Freesurfer image analysis suite. According to baseline symptoms and treatment response, patients were assigned to three groups: euthymics (n=6), responders (n=12) and non-responders (n=6). Taken over both time periods, non-responders had smaller right amygdala than healthy comparisons and euthymic BPI (p=0.035 and p=0.003, respectively). When baseline and after treatment volumes were compared, there was a significant enlargement in left PFC and left DLPFC in BPI who responded to treatment (p=0.002 and p=0.006, respectively). Left hippocampus and right ACC volumes decreased in non-responders (p=0.02 and p=0.0001, respectively). According to the findings decreased left hippocampus and right ACC volumes may be markers of non-response to lithium amongst BPI. Smaller right amygdala may reflect symptomatic remission and be a marker of treatment non-response. Increases in left PFC and left DLPFC as a result of lithium treatment may relate to lithium's neurotrophic effects.
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Affiliation(s)
- Salih Selek
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States.
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Naveen GH, Thirthalli J, Rao MG, Varambally S, Christopher R, Gangadhar BN. Positive therapeutic and neurotropic effects of yoga in depression: A comparative study. Indian J Psychiatry 2013; 55:S400-4. [PMID: 24049208 PMCID: PMC3768221 DOI: 10.4103/0019-5545.116313] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
CONTEXT Therapeutic effect of yoga in depression is recognized. Neuroplastic effects of antidepressant therapies are inferred by elevations in brain-derived neurotrophic factor (BDNF). Role of yoga in both these effects has not been studied. MATERIALS AND METHODS Non-suicidal, consecutive out-patients of depression were offered yoga either alone or with antidepressants. The depression severity was rated on Hamilton Depression Rating Scale (HDRS) before and at 3 months. Serum BDNF levels were measured at the same time points. Repeated-measures analysis of variance was performed to look at change across groups with respect to HDRS scores and BDNF levels over 3 months of follow-up. Relationship between change in serum BDNF levels and change in HDRS scores was assessed using the Pearson's correlation coefficient. RESULTS Both yoga groups were better than drugs-only group with respect to reduction in HDRS scores. Serum BDNF rose in the total sample in the 3-month period. This was not, however, different across treatment groups. There was a significant positive correlation between fall in HDRS and rise in serum BDNF levels in yoga-only group (r=0.702; P=0.001), but not in those receiving yoga and antidepressants or antidepressants-alone. CONCLUSIONS Neuroplastic mechanisms may be related to the therapeutic mechanisms of yoga in depression.
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Affiliation(s)
- G H Naveen
- Department of Psychiatry, Advanced Centre for Yoga, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Radua J, El-Hage W, Monté GC, Gohier B, Tropeano M, Phillips ML, Surguladze SA. COMT Val158Met × SLC6A4 5-HTTLPR interaction impacts on gray matter volume of regions supporting emotion processing. Soc Cogn Affect Neurosci 2013; 9:1232-8. [PMID: 23748501 DOI: 10.1093/scan/nst089] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
There have been several reports on the association between the Val(158)Met genetic polymorphism of the catechol-O-methyltransferase (COMT) gene, as well as the serotonin transporter-linked polymorphic region (5-HTTLPR) of the serotonin transporter gene (SLC6A4), and frontolimbic region volumes, which have been suggested to underlie individual differences in emotion processing or susceptibility to emotional disorders. However, findings have been somewhat inconsistent. This study used diffeomorphic anatomic registration through exponentiated Lie algebra (DARTEL) whole-brain voxel-based morphometry to study the genetic effects of COMT Val(158)Met and SLC6A4 5-HTTLPR, as well as their interaction, on the regional gray matter volumes of a sample of 91 healthy volunteers. An interaction of COMT Val(158)Met × SLC6A4 5-HTTLPR genotypes with gray matter volume was found in bilateral parahippocampal gyrus, amygdala, hippocampus, vermis of cerebellum and right putamen/insula. In particular, the gray matter volume in these regions was smaller in individuals who were both COMT-Met and 5-HTTLPR-S carriers, or both COMT-Val and 5-HTTLPR-L homozygotes, as compared with individuals with intermediate combinations of alleles. The interaction of COMT Val(158)Met and SLC6A4 5-HTTLPR adds to the understanding of individual differences in emotion processing.
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Affiliation(s)
- Joaquim Radua
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK, Department of Neuroimaging Research, FIDMAG Germanes Hospitalàries, CIBERSAM, Barcelona, Spain, INSERM U930 ERL, Université François Rabelais, Tours, France, Département de Psychiatrie, CHU Angers, LPPL EA4638, Université Angers, Angers, France, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, Department of Psychological Medicine, Cardiff University School of Medicine, Cardiff, UK, and Social and Affective Neuroscience Lab, Ilia State University, Tbilisi, GeorgiaDepartment of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK, Department of Neuroimaging Research, FIDMAG Germanes Hospitalàries, CIBERSAM, Barcelona, Spain, INSERM U930 ERL, Université François Rabelais, Tours, France, Département de Psychiatrie, CHU Angers, LPPL EA4638, Université Angers, Angers, France, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, Department of Psychological Medicine, Cardiff University School of Medicine, Cardiff, UK, and Social and Affective Neuroscience Lab, Ilia State University, Tbilisi, Georgia
| | - Wissam El-Hage
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK, Department of Neuroimaging Research, FIDMAG Germanes Hospitalàries, CIBERSAM, Barcelona, Spain, INSERM U930 ERL, Université François Rabelais, Tours, France, Département de Psychiatrie, CHU Angers, LPPL EA4638, Université Angers, Angers, France, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, Department of Psychological Medicine, Cardiff University School of Medicine, Cardiff, UK, and Social and Affective Neuroscience Lab, Ilia State University, Tbilisi, Georgia
| | - Gemma C Monté
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK, Department of Neuroimaging Research, FIDMAG Germanes Hospitalàries, CIBERSAM, Barcelona, Spain, INSERM U930 ERL, Université François Rabelais, Tours, France, Département de Psychiatrie, CHU Angers, LPPL EA4638, Université Angers, Angers, France, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, Department of Psychological Medicine, Cardiff University School of Medicine, Cardiff, UK, and Social and Affective Neuroscience Lab, Ilia State University, Tbilisi, Georgia
| | - Benedicte Gohier
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK, Department of Neuroimaging Research, FIDMAG Germanes Hospitalàries, CIBERSAM, Barcelona, Spain, INSERM U930 ERL, Université François Rabelais, Tours, France, Département de Psychiatrie, CHU Angers, LPPL EA4638, Université Angers, Angers, France, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, Department of Psychological Medicine, Cardiff University School of Medicine, Cardiff, UK, and Social and Affective Neuroscience Lab, Ilia State University, Tbilisi, Georgia
| | - Maria Tropeano
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK, Department of Neuroimaging Research, FIDMAG Germanes Hospitalàries, CIBERSAM, Barcelona, Spain, INSERM U930 ERL, Université François Rabelais, Tours, France, Département de Psychiatrie, CHU Angers, LPPL EA4638, Université Angers, Angers, France, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, Department of Psychological Medicine, Cardiff University School of Medicine, Cardiff, UK, and Social and Affective Neuroscience Lab, Ilia State University, Tbilisi, Georgia
| | - Mary L Phillips
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK, Department of Neuroimaging Research, FIDMAG Germanes Hospitalàries, CIBERSAM, Barcelona, Spain, INSERM U930 ERL, Université François Rabelais, Tours, France, Département de Psychiatrie, CHU Angers, LPPL EA4638, Université Angers, Angers, France, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, Department of Psychological Medicine, Cardiff University School of Medicine, Cardiff, UK, and Social and Affective Neuroscience Lab, Ilia State University, Tbilisi, GeorgiaDepartment of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK, Department of Neuroimaging Research, FIDMAG Germanes Hospitalàries, CIBERSAM, Barcelona, Spain, INSERM U930 ERL, Université François Rabelais, Tours, France, Département de Psychiatrie, CHU Angers, LPPL EA4638, Université Angers, Angers, France, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, Department of Psychological Medicine, Cardiff University School of Medicine, Cardiff, UK, and Social and Affective Neuroscience Lab, Ilia State University, Tbilisi, Georgia
| | - Simon A Surguladze
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK, Department of Neuroimaging Research, FIDMAG Germanes Hospitalàries, CIBERSAM, Barcelona, Spain, INSERM U930 ERL, Université François Rabelais, Tours, France, Département de Psychiatrie, CHU Angers, LPPL EA4638, Université Angers, Angers, France, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, Department of Psychological Medicine, Cardiff University School of Medicine, Cardiff, UK, and Social and Affective Neuroscience Lab, Ilia State University, Tbilisi, GeorgiaDepartment of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK, Department of Neuroimaging Research, FIDMAG Germanes Hospitalàries, CIBERSAM, Barcelona, Spain, INSERM U930 ERL, Université François Rabelais, Tours, France, Département de Psychiatrie, CHU Angers, LPPL EA4638, Université Angers, Angers, France, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, Department of Psychological Medicine, Cardiff University School of Medicine, Cardiff, UK, and Social and Affective Neuroscience Lab, Ilia State University, Tbilisi, Georgia
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Jones AKP, Huneke NTM, Lloyd DM, Brown CA, Watson A. Role of functional brain imaging in understanding rheumatic pain. Curr Rheumatol Rep 2013; 14:557-67. [PMID: 22936576 DOI: 10.1007/s11926-012-0287-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Rheumatic pain and, in particular, rheumatoid arthritis, osteoarthritis and fibromyalgia, are common and debilitating chronic pain syndromes. Recently, human functional neuroimaging, for example EEG, fMRI, and PET has begun to reveal some of the crucial central nervous system mechanisms underlying these diseases. The purpose of this review is to summarise current knowledge on the brain mechanisms of rheumatic pain revealed by functional neuroimaging techniques. The evidence suggests that two mechanisms may be largely responsible for the clinical pain associated with these rheumatic diseases: abnormalities in the medial pain system and/or central nervous system sensitisation and inhibition. If we can understand how functioning of the central nociceptive system becomes altered, even in the absence of peripheral nociceptive input, by using functional neuroimaging techniques, in the future we may be able to develop improved, more effective treatments for patients with chronic rheumatic pain.
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Affiliation(s)
- Anthony K P Jones
- Human Pain Research Group, School of Translational Medicine, University of Manchester, Clinical Sciences Building, Salford Royal NHS Foundation Trust, Salford, M6 8HD, UK.
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