OBJECTIVES: Bipolar disorder is marked by progressive symptomatic changes, which have been linked with episode-related structural findings-particularly in the prefrontal cortex. However, few studies have examined neurofunctional and neurochemical effects of disease burden. In this study, we compared first- and multi-episode bipolar individuals. We hypothesized that the latter would demonstrate evidence of neurophysiological differences consistent with a model of progressive functional degradation of these networks. METHODS: First- and multi-episode manic bipolar subjects participated in functional magnetic resonance imaging (fMRI) including a continuous performance task with emotional distractors, and in single-voxel (1 H) magnetic resonance spectroscopy (MRS). A priori fMRI regions-of-interest (ROI) included structures comprising prefrontal-striatal-amygdala networks; (1 H)MRS voxels were placed within bilateral ventrolateral prefrontal (VLPFC) and anterior cingulate cortex (ACC). Both ROI and voxel-based brain activation in response to emotional stimuli, and neurochemical concentrations derived from (1 H)MRS were compared across bipolar groups. RESULTS: Multi-episode bipolar subjects showed relatively lower regional activation across prefrontal-striatal-amygdala networks, including bilateral VLPFC, orbitofrontal cortex, ACC, putamen, caudate, and amygdala. Exploratory whole-brain, voxel-based analysis suggested additional areas of lower activation extending into Brodmann area 22, posterior parietal regions, and right thalamus. Glutamate and N-acetylaspartate (NAA) concentrations were also relatively lower in the ACC of multi-episode subjects. CONCLUSIONS: Disease burden, exemplified by multiple affective episodes is associated with evidence of widespread decrements in affective network activity. Lower ACC NAA concentration is similarly consistent with a model of progressive functional deficits. These findings support the functional significance of previously observed progressive structural changes throughout these regions.
OBJECTIVES:Bipolar disorder is marked by progressive symptomatic changes, which have been linked with episode-related structural findings-particularly in the prefrontal cortex. However, few studies have examined neurofunctional and neurochemical effects of disease burden. In this study, we compared first- and multi-episode bipolar individuals. We hypothesized that the latter would demonstrate evidence of neurophysiological differences consistent with a model of progressive functional degradation of these networks. METHODS: First- and multi-episode manic bipolar subjects participated in functional magnetic resonance imaging (fMRI) including a continuous performance task with emotional distractors, and in single-voxel (1 H) magnetic resonance spectroscopy (MRS). A priori fMRI regions-of-interest (ROI) included structures comprising prefrontal-striatal-amygdala networks; (1 H)MRS voxels were placed within bilateral ventrolateral prefrontal (VLPFC) and anterior cingulate cortex (ACC). Both ROI and voxel-based brain activation in response to emotional stimuli, and neurochemical concentrations derived from (1 H)MRS were compared across bipolar groups. RESULTS:Multi-episode bipolar subjects showed relatively lower regional activation across prefrontal-striatal-amygdala networks, including bilateral VLPFC, orbitofrontal cortex, ACC, putamen, caudate, and amygdala. Exploratory whole-brain, voxel-based analysis suggested additional areas of lower activation extending into Brodmann area 22, posterior parietal regions, and right thalamus. Glutamate and N-acetylaspartate (NAA) concentrations were also relatively lower in the ACC of multi-episode subjects. CONCLUSIONS: Disease burden, exemplified by multiple affective episodes is associated with evidence of widespread decrements in affective network activity. Lower ACC NAA concentration is similarly consistent with a model of progressive functional deficits. These findings support the functional significance of previously observed progressive structural changes throughout these regions.
Authors: Du Lei; Wenbin Li; Kun Qin; Yuan Ai; Maxwell J Tallman; L Rodrigo Patino; Jeffrey A Welge; Thomas J Blom; Christina C Klein; David E Fleck; Qiyong Gong; Caleb M Adler; Jeffrey R Strawn; John A Sweeney; Melissa P DelBello Journal: Neuropsychopharmacology Date: 2022-10-13 Impact factor: 8.294
Authors: Du Lei; Wenbin Li; Maxwell J Tallman; Stephen M Strakowski; Melissa P DelBello; L Rodrigo Patino; David E Fleck; Su Lui; Qiyong Gong; John A Sweeney; Jeffrey R Strawn; Fabiano G Nery; Jeffrey A Welge; Emily Rummelhoff; Caleb M Adler Journal: Neuropsychopharmacology Date: 2022-05-18 Impact factor: 8.294
Authors: Diego Librenza-Garcia; Jee Su Suh; Devon Patrick Watts; Pedro Lemos Ballester; Luciano Minuzzi; Flavio Kapczinski; Benicio N Frey Journal: Curr Top Behav Neurosci Date: 2021
Authors: Jay C Fournier; Michele Bertocci; Cecile D Ladouceur; Lisa Bonar; Kelly Monk; Halimah Abdul-Waalee; Amelia Versace; João Paulo Lima Santos; Satish Iyengar; Boris Birmaher; Mary L Phillips Journal: Neuropsychopharmacology Date: 2021-03-29 Impact factor: 8.294
Authors: Manpreet K Singh; Akua F Nimarko; Amy S Garrett; Aaron J Gorelik; Donna J Roybal; Patricia D Walshaw; Kiki D Chang; David J Miklowitz Journal: J Am Acad Child Adolesc Psychiatry Date: 2020-08-01 Impact factor: 8.829