1
|
Sun H, Yan R, Hua L, Xia Y, Chen Z, Huang Y, Wang X, Xia Q, Yao Z, Lu Q. Abnormal stability of spontaneous neuronal activity as a predictor of diagnosis conversion from major depressive disorder to bipolar disorder. J Psychiatr Res 2024; 171:60-68. [PMID: 38244334 DOI: 10.1016/j.jpsychires.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVE Bipolar disorder (BD) is often misdiagnosed as major depressive disorder (MDD) in the early stage, which may lead to inappropriate treatment. This study aimed to characterize the alterations of spontaneous neuronal activity in patients with depressive episodes whose diagnosis transferred from MDD to BD. METHODS 532 patients with MDD and 132 healthy controls (HCs) were recruited over 10 years. During the follow-up period, 75 participants with MDD transferred to BD (tBD), and 157 participants remained with the diagnosis of unipolar depression (UD). After excluding participants with poor image quality and excessive head movement, 68 participants with the diagnosis of tBD, 150 participants with the diagnosis of UD, and 130 HCs were finally included in the analysis. The dynamic amplitude of low-frequency fluctuations (dALFF) of spontaneous neuronal activity was evaluated in tBD, UD and HC using functional magnetic resonance imaging at study inclusion. Receiver operating characteristic (ROC) analysis was performed to evaluate sensitivity and specificity of the conversion prediction from MDD to BD based on dALFF. RESULTS Compared to HC, tBD exhibited elevated dALFF at left premotor cortex (PMC_L), right lateral temporal cortex (LTC_R) and right early auditory cortex (EAC_R), and UD showed reduced dALFF at PMC_L, left paracentral lobule (PCL_L), bilateral medial prefrontal cortex (mPFC), right orbital frontal cortex (OFC_R), right dorsolateral prefrontal cortex (DLPFC_R), right posterior cingulate cortex (PCC_R) and elevated dALFF at LTC_R. Furthermore, tBD exhibited elevated dALFF at PMC_L, PCL_L, bilateral mPFC, bilateral OFC, DLPFC_R, PCC_R and LTC_R than UD. In addition, ROC analysis based on dALFF in differential areas obtained an area under the curve (AUC) of 72.7%. CONCLUSIONS The study demonstrated the temporal dynamic abnormalities of tBD and UD in the critical regions of the somatomotor network (SMN), default mode network (DMN), and central executive network (CEN). The differential abnormal patterns of temporal dynamics between the two diseases have the potential to predict the diagnosis transition from MDD to BD.
Collapse
Affiliation(s)
- Hao Sun
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Rui Yan
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Lingling Hua
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Yi Xia
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Zhilu Chen
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Yinghong Huang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Xiaoqin Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Qiudong Xia
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Zhijian Yao
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China; School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, 210096, China.
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, 210096, China.
| |
Collapse
|
2
|
Feusner JD, Kurth F, Luders E, Ly R, Wong WW. Cytoarchitectonically Defined Volumes of Early Extrastriate Visual Cortex in Unmedicated Adults With Body Dysmorphic Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:909-917. [PMID: 34688924 PMCID: PMC9037993 DOI: 10.1016/j.bpsc.2021.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 04/23/2023]
Abstract
BACKGROUND Individuals with body dysmorphic disorder (BDD) misperceive that they have prominent defects in their appearance, resulting in preoccupations, time-consuming rituals, and distress. Previous neuroimaging studies have found abnormal activation patterns in the extrastriate visual cortex, which may underlie experiences of distorted perception of appearance. Correspondingly, we investigated gray matter volumes in individuals with BDD in the early extrastriate visual cortex using cytoarchitectonically defined maps that were previously derived from postmortem brains. METHODS We analyzed T1-weighted magnetic resonance imaging data from 133 unmedicated male and female participants (BDD: n = 65; healthy control subjects: n = 68). We used cytoarchitectonically defined probability maps for the early extrastriate cortex, consisting of areas corresponding to V2, V3d, V3v/VP, V3a, and V4v. Gray matter volumes were compared between groups, supplemented by testing associations with clinical symptoms. RESULTS The BDD group exhibited significantly larger gray matter volumes in the left and right early extrastriate cortex. Region-specific follow-up analyses revealed multiple subregions showing larger volumes in BDD, significant in the left V4v. There were no significant associations after corrections for multiple comparisons between gray matter volumes in early extrastriate cortex and BDD symptoms, comorbid symptoms, or duration of illness. CONCLUSIONS Greater volumes of the early extrastriate visual cortex were evident in those with BDD, which aligns with outcomes of prior studies revealing BDD-specific functional abnormalities in these regions. Enlarged volumes of the extrastriate cortex in BDD might manifest during neurodevelopment, which could predispose individuals to aberrant visual perception and contribute to the core phenotype of distortion of perception for appearance.
Collapse
Affiliation(s)
- Jamie D Feusner
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California Los Angeles, Los Angeles, California.
| | - Florian Kurth
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Eileen Luders
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Laboratory of Neuro Imaging, School of Medicine, University of Southern California, Los Angeles, California; School of Psychology, University of Auckland, Auckland, New Zealand
| | - Ronald Ly
- Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Wan-Wa Wong
- Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California Los Angeles, Los Angeles, California
| |
Collapse
|
3
|
Lloyd EC, Foerde KE, Muratore AF, Aw N, Semanek D, Steinglass JE, Posner J. Large-Scale Exploration of Whole-Brain Structural Connectivity in Anorexia Nervosa: Alterations in the Connectivity of Frontal and Subcortical Networks. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:864-873. [PMID: 35714857 PMCID: PMC11060509 DOI: 10.1016/j.bpsc.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/27/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Anorexia nervosa (AN) is characterized by disturbances in cognition and behavior surrounding eating and weight. The severity of AN combined with the absence of localized brain abnormalities suggests distributed, systemic underpinnings that may be identified using diffusion-weighted magnetic resonance imaging and tractography to reconstruct white matter pathways. METHODS Diffusion-weighted magnetic resonance imaging data acquired from female patients with AN (n= 147) and female healthy control (HC) participants (n = 119), ages 12 to 40 years, were combined across 5 studies. Probabilistic tractography was completed, and full-cortex connectomes describing streamline counts between 84 brain regions were generated and harmonized. Graph theory methods were used to describe alterations in network organization in AN. The network-based statistic tested between-group differences in brain subnetwork connectivity. The metrics strength and efficiency indexed the connectivity of brain regions (network nodes) and were compared between groups using multiple linear regression. RESULTS Individuals with AN, relative to HC peers, had reduced connectivity in a network comprising subcortical regions and greater connectivity between frontal cortical regions (p < .05, familywise error corrected). Node-based analyses indicated reduced connectivity of the left hippocampus in patients relative to HC peers (p < .05, permutation corrected). Severity of illness, assessed by body mass index, was associated with subcortical connectivity (p < .05, uncorrected). CONCLUSIONS Analyses identified reduced structural connectivity of subcortical networks and regions, and stronger cortical network connectivity, among individuals with AN relative to HC peers. These findings are consistent with alterations in feeding, emotion, and executive control circuits in AN, and may direct hypothesis-driven research into mechanisms of persistent restrictive eating behavior.
Collapse
Affiliation(s)
- E Caitlin Lloyd
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York.
| | - Karin E Foerde
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York; Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Alexandra F Muratore
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York
| | - Natalie Aw
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York
| | - David Semanek
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York
| | - Joanna E Steinglass
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York
| | - Jonathan Posner
- Department of Psychiatry, Duke University, Durham, North Carolina
| |
Collapse
|
4
|
Cerasa A, Gaggioli A, Marino F, Riva G, Pioggia G. The promise of the metaverse in mental health: the new era of MEDverse. Heliyon 2022; 8:e11762. [PMID: 36458297 PMCID: PMC9706139 DOI: 10.1016/j.heliyon.2022.e11762] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/11/2022] [Accepted: 11/14/2022] [Indexed: 11/24/2022] Open
Abstract
Since Mark Zuckerberg's announcement about the development of new three-dimensional virtual worlds for social communication, a great debate has been raised about the promise of such a technology. The metaverse, a term formed by combining meta and universe, could open a new era in mental health, mainly in psychological disorders, where the creation of a full-body illusion via digital avatar could promote healthcare and personal well-being. Patients affected by body dysmorphism symptoms (i.e., eating disorders), social deficits (i.e. autism) could greatly benefit from this kind of technology. However, it is not clear which advantage the metaverse would have in treating psychological disorders with respect to the well-known and effective virtual reality (VR) exposure therapy. Indeed, in the last twenty years, a plethora of studies have demonstrated the effectiveness of VR technology in reducing symptoms of pain, anxiety, stress, as well as, in improving cognitive and social skills. We hypothesize that the metaverse will offer more opportunities, such as a more complex, virtual realm where sensory inputs, and recurrent feedback, mediated by a "federation" of multiple technologies - e.g., artificial intelligence, tangible interfaces, Internet of Things and blockchain, can be reinterpreted for facilitating a new kind of communication overcoming self-body representation. However, nowadays a clear starting point does not exist. For this reason, it is worth defining a theoretical framework for applying this new kind of technology in a social neuroscience context for developing accurate solutions to mental health in the future.
Collapse
Affiliation(s)
- Antonio Cerasa
- Institute for Biomedical Research and Innovation, National Research Council, IRIB-CNR, 98164 Messina, Italy
- S. Anna Institute, 88900 Crotone, Italy
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, 87036 Arcavacata, Italy
| | - Andrea Gaggioli
- Research Center in Communication Psychology, Catholic University of Milan, Milan, Italy
- Applied Technology for Neuro-Psychology Lab., Istituto Auxologico Italiano, Milan, Italy
| | - Flavia Marino
- Institute for Biomedical Research and Innovation, National Research Council, IRIB-CNR, 98164 Messina, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab., Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Lab, Catholic University of Milan, Milan, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation, National Research Council, IRIB-CNR, 98164 Messina, Italy
| |
Collapse
|
5
|
Siegel-Ramsay JE, Bertocci MA, Wu B, Phillips ML, Strakowski SM, Almeida JRC. Distinguishing between depression in bipolar disorder and unipolar depression using magnetic resonance imaging: a systematic review. Bipolar Disord 2022; 24:474-498. [PMID: 35060259 DOI: 10.1111/bdi.13176] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Magnetic resonance imaging (MRI) studies comparing bipolar and unipolar depression characterize pathophysiological differences between these conditions. However, it is difficult to interpret the current literature due to differences in MRI modalities, analysis methods, and study designs. METHODS We conducted a systematic review of publications using MRI to compare individuals with bipolar and unipolar depression. We grouped studies according to MRI modality and task design. Within the discussion, we critically evaluated and summarized the functional MRI research and then further complemented these findings by reviewing the structural MRI literature. RESULTS We identified 88 MRI publications comparing participants with bipolar depression and unipolar depressive disorder. Compared to individuals with unipolar depression, participants with bipolar disorder exhibited heightened function, increased within network connectivity, and reduced grey matter volume in salience and central executive network brain regions. Group differences in default mode network function were less consistent but more closely associated with depressive symptoms in participants with unipolar depression but distractibility in bipolar depression. CONCLUSIONS When comparing mood disorder groups, the neuroimaging evidence suggests that individuals with bipolar disorder are more influenced by emotional and sensory processing when responding to their environment. In contrast, depressive symptoms and neurofunctional response to emotional stimuli were more closely associated with reduced central executive function and less adaptive cognitive control of emotionally oriented brain regions in unipolar depression. Researchers now need to replicate and refine network-level trends in these heterogeneous mood disorders and further characterize MRI markers associated with early disease onset, progression, and recovery.
Collapse
Affiliation(s)
- Jennifer E Siegel-Ramsay
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Michele A Bertocci
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Bryan Wu
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Stephen M Strakowski
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Jorge R C Almeida
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| |
Collapse
|
6
|
Collantoni E, Alberti F, Meregalli V, Meneguzzo P, Tenconi E, Favaro A. Brain networks in eating disorders: a systematic review of graph theory studies. Eat Weight Disord 2022; 27:69-83. [PMID: 33754274 PMCID: PMC8860943 DOI: 10.1007/s40519-021-01172-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/12/2021] [Indexed: 11/05/2022] Open
Abstract
PURPOSE Recent evidence from neuroimaging research has shown that eating disorders (EDs) are characterized by alterations in interconnected neural systems, whose characteristics can be usefully described by connectomics tools. The present paper aimed to review the neuroimaging literature in EDs employing connectomic tools, and, specifically, graph theory analysis. METHODS A systematic review of the literature was conducted to identify studies employing graph theory analysis on patients with eating disorders published before the 22nd of June 2020. RESULTS Twelve studies were included in the systematic review. Ten of them address anorexia nervosa (AN) (AN = 199; acute AN = 85, weight recovered AN with acute diagnosis = 24; fully recovered AN = 90). The remaining two articles address patients with bulimia nervosa (BN) (BN = 48). Global and regional unbalance in segregation and integration properties were described in both disorders. DISCUSSION The literature concerning the use of connectomics tools in EDs evidenced the presence of alterations in the topological characteristics of brain networks at a global and at a regional level. Changes in local characteristics involve areas that have been demonstrated to be crucial in the neurobiology and pathophysiology of EDs. Regional imbalances in network properties seem to reflect on global patterns. LEVEL OF EVIDENCE Level I, systematic review.
Collapse
Affiliation(s)
- Enrico Collantoni
- Department of Neurosciences, University of Padua, Via Giustiniani, 2, 35128, Padua, Italy.
| | - Francesco Alberti
- Department of Neurosciences, University of Padua, Via Giustiniani, 2, 35128, Padua, Italy
| | - Valentina Meregalli
- Department of Neurosciences, University of Padua, Via Giustiniani, 2, 35128, Padua, Italy
| | - Paolo Meneguzzo
- Department of Neurosciences, University of Padua, Via Giustiniani, 2, 35128, Padua, Italy
| | - Elena Tenconi
- Department of Neurosciences, University of Padua, Via Giustiniani, 2, 35128, Padua, Italy.,Padua Neuroscience Center, University of Padua, Padua, Italy
| | - Angela Favaro
- Department of Neurosciences, University of Padua, Via Giustiniani, 2, 35128, Padua, Italy.,Padua Neuroscience Center, University of Padua, Padua, Italy
| |
Collapse
|
7
|
Merki-Feld GS, Bitzer J. Contraception in adolescents with anorexia nervosa. Is there evidence for a negative impact of combined hormonal contraceptives on bone mineral density and the course of the disease? EUR J CONTRACEP REPR 2020; 25:213-220. [PMID: 32336145 DOI: 10.1080/13625187.2020.1743826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objective: Adolescents with anorexia nervosa (AN) are at increased risk of unplanned pregnancies and bone loss, due to low oestrogen levels and low use of efficient contraception. The negative impact of combined hormonal contraceptives (CHC) on peak bone mass during adolescence might limit wider use in anorexic women. Another issue limiting CHC use is the concern, that CHC-induced cyclic bleeding reduces the motivation for further weight gain and thus exerts a negative impact on recovery. We wanted to find evidence based answers about the impact of CHC use on bone health and course of the disease in adolescents with AN.Methods: We performed a narrative review of the current literature investigating the effect of CHC or progestin-only contraceptives on bone density, body shape and course of disease in young women with anorexia.Results: There is no evidence that CHC use aggravates the bone loss associated with AN. In long-term users CHC exert a protective effect. Anorexic women using CHC showed at least the same or a greater weight gain in comparison with controls. Eating disorder attitudes did not worsen.Conclusion: We conclude, that at present there is no evidence, that use of CHC by AN patients has a negative impact on bone density or the course of disease.
Collapse
Affiliation(s)
| | - Johannes Bitzer
- Department of Obstetrics and Gynaecology, Basel University Hospital, Basel, Switzerland
| |
Collapse
|
8
|
Abstract
PURPOSE OF REVIEW Eating disorders are severe psychiatric disorders with a suspected complex biopsychosocial cause. The purpose of this review is to synthesize the recent literature on brain imaging in eating disorders. RECENT FINDINGS Food restriction as well as binge eating and purging behaviors are associated with lower regional brain volumes or cortical thickness, but those changes largely return to normal with normalization of weight and eating behavior. Computational modeling has started to identify patterns of structural and functional imaging data that classify eating disorder subtypes, which could be used in the future, diagnostically and to better understand disorder-specific psychopathology. The prediction error model, a computational approach to assess dopamine-related brain reward function, helped support a brain-based model for anorexia nervosa. In that model, the conscious motivation to restrict conflicts with body signals that stimulate eating. This conflict causes anxiety and drives a vicious cycle of food restriction. SUMMARY Novel brain research supports the notion that eating disorders have distinct neurobiological underpinnings. This new knowledge can be used to describe disease models to patients and develop novel treatments.
Collapse
|
9
|
Abstract
PURPOSE OF REVIEW This article reviews new research in the context of existing literature to identify approaches that will advance understanding of the persistence of anorexia nervosa. RECENT FINDINGS Neuroscience research in anorexia nervosa has yielded disparate findings: no definitive neural mechanism underlying illness vulnerability or persistence has been identified and no clear neural target for intervention has emerged. Recent advances using structural and functional neuroimaging research, as well as new techniques for applying and combining these approaches, have led to a refined understanding of changes in neural architecture among individuals who are acutely ill, have undergone renourishment, or are in recovery/remission. In particular, advances have come from the incorporation of computational and translational approaches, as well as efforts to link experimental paradigms with illness-relevant behavior. Recent findings converge to suggest abnormalities in systems involved in reward learning and processing among individuals with anorexia nervosa. SUMMARY Anorexia nervosa is associated with neurobiological abnormalities. Aberrant learning and reward processing may contribute to the persistence of illness. To better utilize new techniques to understand the neural mechanisms of persistent anorexia nervosa, it may help to distinguish stages of illness and to link neurobiology with maladaptive behavior.
Collapse
|