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1.
Mol Psychiatry ; 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33173193

RESUMO

Abnormalities within frontal lobe gray and white matter of bipolar disorder (BD) patients have been consistently reported in adult and pediatric studies, yet little is known about the neurochemistry of the anterior white matter (AWM) in pediatric BD and how medication status may affect it. The present cross-sectional 3T 1H MRS study is the first to use a multivoxel approach to study the AWM of BD youth. Absolute metabolite levels from four bilateral AWM voxels were collected from 49 subjects between the ages of 8 and 18 (25 healthy controls (HC); 24 BD) and quantified. Our study found BD subjects to have lower levels of N-acetylaspartate (NAA) and glycerophosphocholine plus phosphocholine (GPC + PC), metabolites that are markers of neuronal viability and phospholipid metabolism and have also been implicated in adult BD. Further analysis indicated that the observed patterns were mostly driven by BD subjects who were medicated at the time of scanning and had an ADHD diagnosis. Although limited by possible confounding effects of mood state, medication, and other mood comorbidities, these findings serve as evidence of altered neurochemistry in BD youth that is sensitive to medication status and ADHD comorbidity.

2.
Hum Brain Mapp ; 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32596977

RESUMO

The ENIGMA group on Generalized Anxiety Disorder (ENIGMA-Anxiety/GAD) is part of a broader effort to investigate anxiety disorders using imaging and genetic data across multiple sites worldwide. The group is actively conducting a mega-analysis of a large number of brain structural scans. In this process, the group was confronted with many methodological challenges related to study planning and implementation, between-country transfer of subject-level data, quality control of a considerable amount of imaging data, and choices related to statistical methods and efficient use of resources. This report summarizes the background information and rationale for the various methodological decisions, as well as the approach taken to implement them. The goal is to document the approach and help guide other research groups working with large brain imaging data sets as they develop their own analytic pipelines for mega-analyses.

3.
Mol Psychiatry ; 2020 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-32467648

RESUMO

Emerging evidence suggests that obesity impacts brain physiology at multiple levels. Here we aimed to clarify the relationship between obesity and brain structure using structural MRI (n = 6420) and genetic data (n = 3907) from the ENIGMA Major Depressive Disorder (MDD) working group. Obesity (BMI > 30) was significantly associated with cortical and subcortical abnormalities in both mass-univariate and multivariate pattern recognition analyses independent of MDD diagnosis. The most pronounced effects were found for associations between obesity and lower temporo-frontal cortical thickness (maximum Cohen´s d (left fusiform gyrus) = -0.33). The observed regional distribution and effect size of cortical thickness reductions in obesity revealed considerable similarities with corresponding patterns of lower cortical thickness in previously published studies of neuropsychiatric disorders. A higher polygenic risk score for obesity significantly correlated with lower occipital surface area. In addition, a significant age-by-obesity interaction on cortical thickness emerged driven by lower thickness in older participants. Our findings suggest a neurobiological interaction between obesity and brain structure under physiological and pathological brain conditions.

4.
Magn Reson Imaging ; 61: 16-19, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31078614

RESUMO

PURPOSE: To reduce patient anxiety caused by the MRI scanner acoustic noise. MATERIAL AND METHODS: We developed a simple and low-cost system for patient distraction using visual computer animations that were synchronized to the MRI scanner's acoustic noise during the MRI exam. The system was implemented on a 3T MRI system and tested in 28 pediatric patients with bipolar disorder. The patients were randomized to receive noise-synchronized animations in the form of abstract animations in addition to music (n = 13, F/M = 6/7, age = 10.9 ±â€¯2.5 years) or, as a control, receive only music (n = 15, F/M = 7/8, age = 11.6 ±â€¯2.3 years). After completion of the scans, all subjects answered a questionnaire about their scan experience and the perceived scan duration. RESULTS: The scan duration with multisensory input (animations and music) was perceived to be ~15% shorter than in the control group (43 min vs. 50 min, P < 0.05). However, the overall scan experience was scored less favorably (3.9 vs. 4.6 in the control group, P < 0.04). CONCLUSIONS: This simple system provided patient distraction and entertainment leading to perceived shorter scan times, but the provided visualization with abstract animations was not favored by this patient cohort.


Assuntos
Ansiedade/prevenção & controle , Transtorno Bipolar/psicologia , Imagem por Ressonância Magnética/psicologia , Música/psicologia , Estimulação Luminosa/métodos , Acústica , Adolescente , Ansiedade/etiologia , Ansiedade/psicologia , Criança , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Ruído , Satisfação do Paciente/estatística & dados numéricos , Inquéritos e Questionários
5.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(3): 254-256, May-June 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1039095

RESUMO

Objective: Bipolar disorder (BD) is highly heritable. The present study aimed at identifying brain morphometric features that could represent markers of BD vulnerability in non-bipolar relatives of bipolar patients. Methods: In the present study, structural magnetic resonance imaging brain scans were acquired from a total of 93 subjects, including 31 patients with BD, 31 non-bipolar relatives of BD patients, and 31 healthy controls. Volumetric measurements of the anterior cingulate cortex (ACC), lateral ventricles, amygdala, and hippocampus were completed using the automated software FreeSurfer. Results: Analysis of covariance (with age, gender, and intracranial volume as covariates) indicated smaller left ACC volumes in unaffected relatives as compared to healthy controls and BD patients (p = 0.004 and p = 0.037, respectively). No additional statistically significant differences were detected for other brain structures. Conclusion: Our findings suggest smaller left ACC volume as a viable biomarker candidate for BD.


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Transtorno Bipolar/patologia , Giro do Cíngulo/patologia , Hipocampo/patologia , Transtorno Bipolar/genética , Imagem por Ressonância Magnética , Família , Estudos de Casos e Controles , Endofenótipos , Pessoa de Meia-Idade
6.
Cogn Neuropsychiatry ; 24(2): 93-107, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30774035

RESUMO

BACKGROUND AND AIMS: Cognitive impairments are primary hallmarks symptoms of bipolar disorder (BD). Whether these deficits are markers of vulnerability or symptoms of the disease is still unclear. This study used a component-wise gradient (CGB) machine learning algorithm to identify cognitive measures that could accurately differentiate pediatric BD, unaffected offspring of BD parents, and healthy controls. METHODS: 59 healthy controls (HC; 11.19 ± 3.15 yo; 30 girls), 119 children and adolescents with BD (13.31 ± 3.02 yo, 52 girls) and 49 unaffected offspring of BD parents (UO; 9.36 ± 3.18 yo; 22 girls) completed the CANTAB cognitive battery. RESULTS: CGB achieved accuracy of 73.2% and an AUROC of 0.785 in classifying individuals as either BD or non-BD on a dataset held out for validation for testing. The strongest cognitive predictors of BD were measures of processing speed and affective processing. Measures of cognition did not differentiate between UO and HC. CONCLUSIONS: Alterations in processing speed and affective processing are markers of BD in pediatric populations. Longitudinal studies should determine whether UO with a cognitive profile similar to that of HC are at less or equal risk for mood disorders. Future studies should include relevant measures for BD such as verbal memory and genetic risk scores.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/psicologia , Testes Neuropsicológicos , Adolescente , Criança , Cognição/fisiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Memória/fisiologia , Pais/psicologia
7.
Braz J Psychiatry ; 41(3): 254-256, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30540025

RESUMO

OBJECTIVE: Bipolar disorder (BD) is highly heritable. The present study aimed at identifying brain morphometric features that could represent markers of BD vulnerability in non-bipolar relatives of bipolar patients. METHODS: In the present study, structural magnetic resonance imaging brain scans were acquired from a total of 93 subjects, including 31 patients with BD, 31 non-bipolar relatives of BD patients, and 31 healthy controls. Volumetric measurements of the anterior cingulate cortex (ACC), lateral ventricles, amygdala, and hippocampus were completed using the automated software FreeSurfer. RESULTS: Analysis of covariance (with age, gender, and intracranial volume as covariates) indicated smaller left ACC volumes in unaffected relatives as compared to healthy controls and BD patients (p = 0.004 and p = 0.037, respectively). No additional statistically significant differences were detected for other brain structures. CONCLUSION: Our findings suggest smaller left ACC volume as a viable biomarker candidate for BD.


Assuntos
Transtorno Bipolar/patologia , Giro do Cíngulo/patologia , Hipocampo/patologia , Adulto , Transtorno Bipolar/genética , Estudos de Casos e Controles , Endofenótipos , Família , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
J Clin Psychiatry ; 80(1)2018 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-30549489

RESUMO

OBJECTIVE: Neuroinflammation has been implicated in the pathophysiology of bipolar disorder. Some evidence shows that nonsteroidal anti-inflammatory drugs (NSAIDs) have promising antidepressant effects. The antioxidant N-acetylcysteine (NAC) may enhance the effects of NSAIDs. No study has, however, tested the adjunctive therapeutic benefits of an NSAID and NAC in bipolar disorder. METHODS: The sample included 24 medicated patients diagnosed with DSM-IV-TR bipolar disorder who were aged 18-65 years and had a Montgomery-Asberg Depression Rating Scale (MADRS) score ≥ 20. Participants were randomly assigned to receive either aspirin (1,000 mg), NAC (1,000 mg), combined aspirin and NAC (1,000 mg each), or placebo. Data were collected between 2013 and 2017. The primary outcome was a ≥ 50% reduction in MADRS scores. Participants completed mood and global functioning questionnaires. They also underwent blood tests prior to and following 8 and 16 weeks of treatment. A Bayesian analytic method was adopted, and posterior probability distributions were calculated to determine the probability of treatment response. RESULTS: Following the first 8-week treatment phase, individuals on treatment with placebo and NAC + aspirin had a similar probability for successful treatment response (about 70%). Following a 16-week treatment period, NAC + aspirin was associated with higher probability of treatment response (67%) compared to placebo (55%), NAC (57%), and aspirin (33%). There was no treatment effect on interleukin-6 and C-reactive protein levels at either 8 or 16 weeks. CONCLUSIONS: The coadministration of NAC and aspirin during a period of 16 weeks was associated with a reduction in depressive symptoms. The adverse effects were minimal. These preliminary findings may serve as a starting point for future studies assessing the efficacy, tolerability, and safety of anti-inflammatory and antioxidant agents in the treatment of bipolar depression. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01797575.


Assuntos
Acetilcisteína/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Aspirina/administração & dosagem , Transtorno Bipolar/tratamento farmacológico , Transtorno Depressivo/tratamento farmacológico , Acetilcisteína/farmacocinética , Adulto , Idoso , Análise de Variância , Anti-Inflamatórios não Esteroides/farmacologia , Aspirina/farmacologia , Teorema de Bayes , Transtorno Bipolar/complicações , Quimioterapia Adjuvante , Transtorno Depressivo/complicações , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo/efeitos dos fármacos , Resultado do Tratamento
9.
Psychiatry Res Neuroimaging ; 278: 13-20, 2018 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-29944976

RESUMO

The neural mechanisms underlying the therapeutic effects of lamotrigine in bipolar depression are still unexplored. This preliminary study compares the effects of a 12-week treatment with lamotrigine on brain volumes in adults with bipolar disorder (BD).12 BD type II patients (age: 49.33 ± 9.95 years, 3 males, 9 females) and 12 age and gender-matched healthy controls (HC) (HC; age: 41 ± 8.60 years, 3 males, 9 females). BD patients were initially administered 25 mg/day of lamotrigine, which was progressively escalated to 200 mg/d. BD participants underwent brain imaging prior to and following lamotrigine treatment. A 50% reduction in depressive scores indicated "remission". Bayesian general linear models controlled for age, gender and intracranial volume were used to examine changes in relevant brain region following treatment. A posterior probability > 0.90 indicated evidence that there was an effect of diagnosis or remission on brain volumes. Probability distributions of interaction effects between remission and time indicated that BD responders displayed decreased amygdala, cerebellum and nucleus accumbens volumes following lamotrigine treatment. No serious adverse side effects were reported. The antidepressant effects of lamotrigine may be linked to volumetric changes in brain regions involved in mood and emotional regulation. These findings are preliminary and replication in a larger sample is warranted.


Assuntos
Antidepressivos/farmacologia , Transtorno Bipolar/patologia , Encéfalo/patologia , Lamotrigina/farmacologia , Adulto , Tonsila do Cerebelo/efeitos dos fármacos , Tonsila do Cerebelo/patologia , Teorema de Bayes , Transtorno Bipolar/tratamento farmacológico , Encéfalo/efeitos dos fármacos , Cerebelo/efeitos dos fármacos , Cerebelo/patologia , Emoções/fisiologia , Feminino , Humanos , Modelos Lineares , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Núcleo Accumbens/efeitos dos fármacos , Núcleo Accumbens/patologia , Tamanho do Órgão/efeitos dos fármacos , Resultado do Tratamento
10.
J Psychiatr Res ; 101: 57-62, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29550609

RESUMO

The hippocampus has been implicated in various mood disorders, with global volume deficits consistently found in patient populations. The hippocampus, however, consists of anatomically distinct subfields, and examination of specific subfield differences may elucidate the possible molecular mechanisms behind psychiatric pathologies. Indeed, adult studies have reported smaller hippocampal subfield volumes in regions within the cornu ammonis (CA1 and CA4), dentate gyrus (DG), and hippocampal tails in both patients with Major Depressive Disorder (MDD) and Bipolar Disorder (BD) compared to healthy controls. Subfield differences in pediatric patients with mood disorders, on the other hand, have not been extensively investigated. In the current study, magnetic resonance imaging scans were acquired for 141 children and adolescents between the ages of eight and eighteen (57 with BD, 30 with MDD, and 54 healthy controls). An automated segmentation method was then used to assess differences in hippocampal subfield volumes. Children and adolescents with BD were found to have significantly smaller volumes in the right CA1, CA4, and right subiculum, as well as the bilateral granule cell layer (GCL), molecular layer (ML), and hippocampal tails. The volume of the right subiculum in BD patients was also found to be negatively correlated with illness duration. Overall, the findings from this cross-sectional study provide evidence for specific hippocampal subfield volume differences in children and adolescents with BD compared to healthy controls and suggest progressive reductions with increased illness duration.


Assuntos
Transtorno Bipolar/patologia , Transtorno Depressivo Maior/patologia , Hipocampo/patologia , Neuroimagem/métodos , Adolescente , Transtorno Bipolar/diagnóstico por imagem , Criança , Transtorno Depressivo Maior/diagnóstico por imagem , Feminino , Hipocampo/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino
11.
Int J Bipolar Disord ; 5(1): 33, 2017 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-28921165

RESUMO

In the original version of this article (Wu et al. 2017), published on 1 September 2017, the name of author 'Bo Cao' was wrongly displayed. In this Erratum the incorrect name and correct name are shown. The original publication of this article has been corrected.

12.
Int J Bipolar Disord ; 5(1): 32, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28861763

RESUMO

Bipolar disorder (BD) is a common disorder with high reoccurrence rate in general population. It is critical to have objective biomarkers to identify BD patients at an individual level. Neurocognitive signatures including affective Go/No-go task and Cambridge Gambling task showed the potential to distinguish BD patients from health controls as well as identify individual siblings of BD patients. Moreover, these neurocognitive signatures showed the ability to be replicated at two independent cohorts which indicates the possibility for generalization. Future studies will examine the possibility of combining neurocognitive data with other biological data to develop more accurate signatures.

13.
Sci Rep ; 7(1): 511, 2017 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-28360420

RESUMO

Cortical gyrification of the brain represents the folding characteristic of the cerebral cortex. How the brain cortical gyrification changes from childhood to old age in healthy human subjects is still unclear. Additionally, studies have shown regional gyrification alterations in patients with major psychiatric disorders, such as major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SCZ). However, whether the lifespan trajectory of gyrification over the brain is altered in patients diagnosed with major psychiatric disorders is still unknown. In this study, we investigated the trajectories of gyrification in three independent cohorts based on structural brain images of 881 subjects from age 4 to 83. We discovered that the trajectory of gyrification during normal development and aging was not linear and could be modeled with a logarithmic function. We also found that the gyrification trajectories of patients with MDD, BD and SCZ were deviated from the healthy one during adulthood, indicating altered aging in the brain of these patients.


Assuntos
Transtorno Bipolar/patologia , Encéfalo/patologia , Transtorno Depressivo Maior/patologia , Longevidade , Esquizofrenia/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
Neuropsychopharmacology ; 42(11): 2252-2258, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28220797

RESUMO

Previous studies have found increased levels of choline-containing compounds (ie, glycerophosphocholine plus phosphocholine (GPC+PC)) in bipolar disorder using in vivo proton magnetic resonance spectroscopy (1H MRS), especially in bipolar I disorder (BD-I). Increased levels of GPC+PC suggest alterations in the membrane phospholipids metabolism in bipolar disorder. Rapid cycling (RC) bipolar disorder is considered as a severe course of bipolar disorder, but it is unclear whether rapid cycling bipolar disorder is linked to highly altered membrane phospholipid metabolism. The purpose of this study was to investigate whether the regional extent of elevated GPC+PC were greater in BD-I patients with rapid cycling compared to BD-I patients without rapid cycling and healthy controls. Using a multi-voxel 1H MRS approach at 3 Tesla with high spatial resolution and absolute quantification, GPC+PC levels from the anterior cingulate cortex (ACC), caudate and putamen of 16 RC BD-I, 34 non-RC BD-I and 44 healthy controls were assessed. We found significantly elevated GPC+PC levels in ACC, putamen and caudate of RC BD-I patients compared to healthy controls (P<0.005) and in ACC compared to non-RC BD-I patients (P<0.05). These results suggest greater alteration of membrane phospholipid metabolisms in rapid cycling BD-I compared to non-rapid-cycling BD-I.


Assuntos
Transtorno Bipolar/metabolismo , Transtorno Bipolar/patologia , Encéfalo/metabolismo , Glicerilfosforilcolina/metabolismo , Fosforilcolina/metabolismo , Adolescente , Adulto , Idoso , Transtorno Bipolar/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Espectroscopia de Prótons por Ressonância Magnética , Escalas de Graduação Psiquiátrica , Adulto Jovem
15.
Neuroimage ; 145(Pt B): 254-264, 2017 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-26883067

RESUMO

Diagnosis, clinical management and research of psychiatric disorders remain subjective - largely guided by historically developed categories which may not effectively capture underlying pathophysiological mechanisms of dysfunction. Here, we report a novel approach of identifying and validating distinct and biologically meaningful clinical phenotypes of bipolar disorders using both unsupervised and supervised machine learning techniques. First, neurocognitive data were analyzed using an unsupervised machine learning approach and two distinct clinical phenotypes identified namely; phenotype I and phenotype II. Second, diffusion weighted imaging scans were pre-processed using the tract-based spatial statistics (TBSS) method and 'skeletonized' white matter fractional anisotropy (FA) and mean diffusivity (MD) maps extracted. The 'skeletonized' white matter FA and MD maps were entered into the Elastic Net machine learning algorithm to distinguish individual subjects' phenotypic labels (e.g. phenotype I vs. phenotype II). This calculation was performed to ascertain whether the identified clinical phenotypes were biologically distinct. Original neurocognitive measurements distinguished individual subjects' phenotypic labels with 94% accuracy (sensitivity=92%, specificity=97%). TBSS derived FA and MD measurements predicted individual subjects' phenotypic labels with 76% and 65% accuracy respectively. In addition, individual subjects belonging to phenotypes I and II were distinguished from healthy controls with 57% and 92% accuracy respectively. Neurocognitive task variables identified as most relevant in distinguishing phenotypic labels included; Affective Go/No-Go (AGN), Cambridge Gambling Task (CGT) coupled with inferior fronto-occipital fasciculus and callosal white matter pathways. These results suggest that there may exist two biologically distinct clinical phenotypes in bipolar disorders which can be identified from healthy controls with high accuracy and at an individual subject level. We suggest a strong clinical utility of the proposed approach in defining and validating biologically meaningful and less heterogeneous clinical sub-phenotypes of major psychiatric disorders.


Assuntos
Transtorno Bipolar/diagnóstico , Imagem de Difusão por Ressonância Magnética/métodos , Aprendizado de Máquina , Neuroimagem/métodos , Substância Branca/diagnóstico por imagem , Adulto , Transtorno Bipolar/diagnóstico por imagem , Transtorno Bipolar/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Sensibilidade e Especificidade
16.
J Psychiatr Res ; 81: 48-55, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27376506

RESUMO

BACKGROUND: Previous proton magnetic resonance spectroscopy ((1)H MRS) studies have reported elevated glycerophosphocholine plus phosphocholine (GPC+PC) in the basal ganglia of patients with bipolar disorders (BD), which implicates an imbalance between synthesis and degradation activity of neuronal and glia membrane phospholipids (MPLs). However, the full extent of altered metabolites of MPLs in subareas within the basal ganglia, such as caudate and putamen, as well as anterior cingulate cortex (ACC) of BD patients is poorly understood. METHODS: Multi-voxel (1)H MRS measurements were acquired in 50 type-one BD (BD-I) and 44 healthy controls (HC) on a 3-T MRI scanner. Four different anatomically defined voxels covering ACC, caudate and putamen were systematically extracted and quantified using LCModel. Group differences in absolute GPC+PC and other metabolites were tested with age and gender as covariates. RESULTS: BD-I patients had higher GPC+PC levels in the anterior-dorsal ACC (p = 0.037), caudate (p = 0.005) and putamen (p = 0.004) compared to HC. GPC+PC levels in the caudate were elevated most significantly in currently unmediated BD-I patients (p = 0.022) and were positively correlated with HAM-D scores (r = 0.51, p = 0.005). PCr+Cr and myo-inositol levels were also significantly higher in the caudate head (F(1,45) = 6.010, p = 0.018) of patients compared to HC. NAA and glutamate levels were not significantly different between BD-I and HC in these regions (p > 0.05). CONCLUSION: The increased GPC+PC in BD-I patients may reflect an imbalance in the MPL metabolism. Caudate GPC+PC levels may be a potential biomarker for depressive symptoms in BD.


Assuntos
Transtorno Bipolar/patologia , Corpo Estriado/metabolismo , Giro do Cíngulo/metabolismo , Fosfolipídeos/metabolismo , Adulto , Idoso , Transtorno Bipolar/diagnóstico por imagem , Corpo Estriado/diagnóstico por imagem , Creatina , Feminino , Ácido Glutâmico , Giro do Cíngulo/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Espectroscopia de Prótons por Ressonância Magnética , Escalas de Graduação Psiquiátrica , Adulto Jovem
17.
J Psychiatr Res ; 80: 64-72, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27302871

RESUMO

BACKGROUND: Bipolar disorder (BD) is characterized by affective processing bias and variations in personality traits. It is still unknown whether these features are linked to the same structural brain alterations. The aim of this study was to investigate relationships between specific personality traits, white matter (WM) properties, and affective processing in BD and HC. METHODS: 24 healthy controls (HC) and 38 adults with BDI (HC: 29.47 ± 2.23 years, 15 females; BDI: 32.44 ± 1.84 years, 20 females) completed clinical scales and the Big Five Inventory. They were also administered the Affective Go/No-Go (AGN) and the Rapid Visual Processing (RVP) tasks of the Cambridge Neuropsychological Test Automated Battery. Diffusion Tensor Imaging (DTI) assessed the microstructure of WM tracts. RESULTS: In BDI measures of WM properties were reduced across all major brain white matter tracts. As expected, individuals with BDI reported greater neuroticism, lower agreeableness and conscientiousness, and made a greater number of errors in response to affective stimuli in the AGN task compared to HC. High neuroticism scores were associated with faster AGN latency, and overall reduced AGN accuracy in both HC and BDI. Elevated FA values were associated with reduced neuroticism and increased cognitive processing in HC but not in BDI. CONCLUSIONS: Our findings showed important potential links between personality, affective processing and WM integrity in BD. In the future therapeutic interventions for BD using brain stimulation protocols might benefit from the use of DTI to target pathways underlying abnormal affective processing.


Assuntos
Afeto/fisiologia , Transtorno Bipolar/complicações , Transtorno Bipolar/psicologia , Transtornos Cognitivos/etiologia , Leucoencefalopatias/etiologia , Personalidade , Adulto , Análise de Variância , Anisotropia , Imagem de Tensor de Difusão , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Testes Neuropsicológicos , Testes de Personalidade , Escalas de Graduação Psiquiátrica , Estatística como Assunto
18.
J Affect Disord ; 201: 51-6, 2016 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-27179338

RESUMO

BACKGROUND: Cognitive deficits have been consistently reported in individuals with bipolar disorder (BD). The cognitive profile of siblings of individuals with BD is, however, less clearly established possibly due to the heterogeneity of neuropsychological measures used in previous studies. The aim of this exploratory study was to assess the cognitive function of siblings of individuals with BD and compare it with that of their first-degree relatives suffering with BD, and healthy controls (HC) using the Cambridge Neuropsychological Test Automated Battery (CANTAB) - a comprehensive and validated computerized cognitive battery. METHODS: We recruited 23 HC (33.52±10.29 years, 8 males), 27 individuals with BD (34.26±10.19 years, 9 males, 25 BDI, 1BDII and 1 BD-NOS), and 15 of their biologically related siblings (37.47±13.15 years, 4 males). Siblings had no current or lifetime history of mental disorders. Participants performed the CANTAB and completed questionnaires assessing mood and global functioning. Multivariate analyses compared CANTAB measures across the three participant groups. RESULTS: Individuals with BD and their siblings were less accurate in a task of sustained attention (Rapid Visual Processing) when compared to HC. Further, individuals with BD displayed pronounced deficits in affective processing (Affective Go/No-Go) compared to HC. There were no cognitive differences between siblings and individuals with BD. After correcting for current depressive symptoms, these results did not reach statistical significance. CONCLUSIONS: Subthreshold depressive symptoms may be associated with reduced sustained attention in healthy siblings of BD patients. This preliminary result needs to be corroborated by large-scale, longitudinal studies assessing the relationship between cognition and mood in vulnerable individuals.


Assuntos
Transtorno Bipolar/complicações , Transtorno Bipolar/psicologia , Transtornos Cognitivos/complicações , Transtornos Cognitivos/psicologia , Irmãos/psicologia , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Análise Multivariada , Testes Neuropsicológicos , Inquéritos e Questionários , Análise e Desempenho de Tarefas
19.
Biol Psychiatry Cogn Neurosci Neuroimaging ; 1(2): 186-194, 2016 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-27047994

RESUMO

BACKGROUND: Neuroanatomical abnormalities in Bipolar disorder (BD) have previously been reported. However, the utility of these abnormalities in distinguishing individual BD patients from Healthy controls and stratify patients based on overall illness burden has not been investigated in a large cohort. METHODS: In this study, we examined whether structural neuroimaging scans coupled with a machine learning algorithm are able to distinguish individual BD patients from Healthy controls in a large cohort of 256 subjects. Additionally, we investigated the relationship between machine learning predicted probability scores and subjects' clinical characteristics such as illness duration and clinical stages. Neuroimaging scans were acquired from 128 BD patients and 128 Healthy controls. Gray and white matter density maps were obtained and used to 'train' a relevance vector machine (RVM) learning algorithm which was used to distinguish individual patients from Healthy controls. RESULTS: The RVM algorithm distinguished patients from Healthy controls with 70.3 % accuracy (74.2 % specificity, 66.4 % sensitivity, chi-square p<0.005) using white matter density data and 64.9 % accuracy (71.1 % specificity, 58.6 % sensitivity, chi-square p<0.005) with gray matter density. Multiple brain regions - largely covering the fronto - limbic system were identified as 'most relevant' in distinguishing both groups. Patients identified by the algorithm with high certainty (a high probability score) - belonged to a subgroup with more than ten total lifetime manic episodes including hospitalizations (late stage). CONCLUSIONS: These results indicate the presence of widespread structural brain abnormalities in BD which are associated with higher illness burden - which points to neuroprogression.

20.
J Affect Disord ; 198: 198-205, 2016 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-27018938

RESUMO

BACKGROUND: Previous studies investigated the impact of brain-derived neurotrophic factor (BDNF) val66met (rs6265) on hippocampus volumes and neurocognition in bipolar disorders (BD), but the results were not consistent. This study aimed to investigate the effect of BDNF polymorphism on hippocampus volumes and memory performance in well-characterized adult populations diagnosed with type I BD (BD-I) and major depressive disorder (MDD) compared with healthy controls (HC). METHODS: 48 BD-I patients, 33 MDD patients and 60 HC were genotyped for BDNF rs6265 using DNA isolated from white blood cells. Individuals with val/met and met/met genotypes were grouped as met carriers and compared to those with the val/val. Brain segmentations were obtained from structural magnetic resonance imaging (MRI) using the Freesurfer. Memory performance was assessed with the California Verbal Learning Task (CVLT). RESULTS: We found a significant diagnosis effect and marginal interaction between diagnosis and BDNF genotype group for both hippocampus volumes and memory performance. BDNF met allele carrier BD patients had smaller hippocampus volumes and reduced performance on multiple CVLT scores compared to MDD patients and HC. CONCLUSIONS: We provide strong evidence for the BDNF val66met polymorphism as a putative biological signature for the neuroanatomical and cognitive abnormalities commonly observed in BD patients.


Assuntos
Transtorno Bipolar/complicações , Fator Neurotrófico Derivado do Encéfalo/genética , Transtorno Depressivo Maior/complicações , Hipocampo/patologia , Transtornos da Memória/complicações , Adulto , Alelos , Transtorno Bipolar/genética , Transtorno Bipolar/psicologia , Transtorno Depressivo Maior/genética , Transtorno Depressivo Maior/psicologia , Feminino , Genótipo , Hipocampo/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Transtornos da Memória/genética , Transtornos da Memória/psicologia , Tamanho do Órgão , Polimorfismo de Nucleotídeo Único/genética
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