A C Altamura1, G Delvecchio2, G Marotta3, L Oldani1, A Pigoni1, V Ciappolino1, E Caletti1, C Rovera1, C Dobrea1, C Arici1, B Benatti1, G Camuri1, C Prunas1, R A Paoli1, B Dell'osso4, C Cinnante3, F M Triulzi3, P Brambilla5. 1. Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy. 2. Scientific Institute IRCCS "E. Medea", San Vito al Tagliamento (PN), Italy. 3. Department of Services, Neuroradiology Unit, Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 4. Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry, Bipolar Disorders Clinic, Stanford University, CA, USA. 5. Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA. Electronic address: paolo.brambilla1@unimi.it.
Abstract
BACKGROUND: Bipolar disorder (BD) may be characterized by the presence of psychotic symptoms and comorbid substance abuse. In this context, structural and metabolic dysfunctions have been reported in both BD with psychosis and addiction, separately. In this study, we aimed at identifying neural substrates differentiating psychotic BD, with or without substance abuse, versus substance-induced psychosis (SIP) by coupling, for the first time, magnetic resonance imaging (MRI) and positron emission tomography (PET). METHODS: Twenty-seven BD type I psychotic patients with (n=10) or without (n=17) substance abuse, 16 SIP patients and 54 healthy controls were enrolled in this study. 3T MRI and 18-FDG-PET scanning were acquired. RESULTS: Gray matter (GM) volume and cerebral metabolism reductions in temporal cortices were observed in all patients compared to healthy controls. Moreover, a distinct pattern of fronto-limbic alterations were found in patients with substance abuse. Specifically, BD patients with substance abuse showed volume reductions in ventrolateral prefrontal cortex, anterior cingulate, insula and thalamus, whereas SIP patients in dorsolateral prefrontal cortex and posterior cingulate. Common alterations in cerebellum, parahippocampus and posterior cingulate were found in both BD with substance abuse and SIP. Finally, a unique pattern of GM volumes reduction, with concomitant increased of striatal metabolism, were observed in SIP patients. CONCLUSIONS: These findings contribute to shed light on the identification of common and distinct neural markers associated with bipolar psychosis and substance abuse. Future longitudinal studies should explore the effect of single substances of abuse in patients at the first-episode of BD and substance-induced psychosis.
BACKGROUND:Bipolar disorder (BD) may be characterized by the presence of psychotic symptoms and comorbid substance abuse. In this context, structural and metabolic dysfunctions have been reported in both BD with psychosis and addiction, separately. In this study, we aimed at identifying neural substrates differentiating psychotic BD, with or without substance abuse, versus substance-induced psychosis (SIP) by coupling, for the first time, magnetic resonance imaging (MRI) and positron emission tomography (PET). METHODS: Twenty-seven BD type I psychoticpatients with (n=10) or without (n=17) substance abuse, 16 SIP patients and 54 healthy controls were enrolled in this study. 3T MRI and 18-FDG-PET scanning were acquired. RESULTS: Gray matter (GM) volume and cerebral metabolism reductions in temporal cortices were observed in all patients compared to healthy controls. Moreover, a distinct pattern of fronto-limbic alterations were found in patients with substance abuse. Specifically, BD patients with substance abuse showed volume reductions in ventrolateral prefrontal cortex, anterior cingulate, insula and thalamus, whereas SIP patients in dorsolateral prefrontal cortex and posterior cingulate. Common alterations in cerebellum, parahippocampus and posterior cingulate were found in both BD with substance abuse and SIP. Finally, a unique pattern of GM volumes reduction, with concomitant increased of striatal metabolism, were observed in SIP patients. CONCLUSIONS: These findings contribute to shed light on the identification of common and distinct neural markers associated with bipolar psychosis and substance abuse. Future longitudinal studies should explore the effect of single substances of abuse in patients at the first-episode of BD and substance-induced psychosis.
Authors: Andreia V Faria; Yi Zhao; Chenfei Ye; Johnny Hsu; Kun Yang; Elizabeth Cifuentes; Lei Wang; Susumu Mori; Michael Miller; Brian Caffo; Akira Sawa Journal: Hum Brain Mapp Date: 2020-12-30 Impact factor: 5.399
Authors: Mari N Maia da Silva; Fábio Henrique de Gobbi Porto; Pedro Maranhão Gomes Lopes; Catarina Sodré de Castro Prado; Norberto Anízio Ferreira Frota; Candida Helena Lopes Alves; Gilberto Sousa Alves Journal: Front Psychiatry Date: 2021-12-02 Impact factor: 4.157