Decreased functional connectivity in the language regions in bipolar patients during depressive episodes but not remission

Lv, Dongsheng; Lin, Wuhong; Zhang, Xue; Pu, Weidan; Yang, Qing; Huang, Xiaojun; Zhou, Li; Yang, Lihua; Liu, Zhening

doi:10.1016/j.jad.2016.03.026

Cited by 46 publications

(13 citation statements)

References 56 publications

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“…Controlling for BMI (which was significantly higher in BD vs HC) retained the primary BD < HC findings, and yielded additional CVR findings of BD < HC in areas with peaks in lingual gyrus, SMG, and temporal poles. Prior studies have implicated these regions in decreased functional connectivity and anomalous brain structure in BD. Similarly, these regions have been associated with high metabolic activity, and are sensitive to CVR differences in relation to high altitude, burden of vascular risk factors, and stroke …”

Section: Discussionmentioning

confidence: 99%

Reduced cerebrovascular reactivity among adolescents with bipolar disorder

et al. 2018

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Objectives Cardiovascular disease (CVD) is excessive and premature among individuals with bipolar disorder (BD). Cerebrovascular reactivity (CVR), reflecting vasodilatory capacity of cerebral blood vessels in response to vasoactive substances, is a marker of cerebrovascular health. Despite informative findings in other diseases, CVR has not previously been examined in BD. Methods Twenty‐five adolescents with BD and 25 age and sex‐matched psychiatrically healthy controls (HCs) completed six 15‐second breath‐holds (BHs) during functional magnetic resonance imaging (fMRI) at 3‐Tesla. CVR was determined by comparing blood‐oxygenation‐level dependent (BOLD) signal changes. Voxel‐wise contrasts were analyzed. Body mass index (BMI) was examined as a potential confound. Results CVR in the posterior cingulate gyrus and periventricular white matter was lower in BD vs HC. After controlling for differences in BMI, additional between‐group CVR differences were observed in the temporal poles, supramarginal gyrus, and lingual gyrus. There were no regions in which CVR was significantly greater in BD vs HC. CVR was not associated with mood symptoms. Conclusions This preliminary study provides evidence of cerebrovascular dysfunction in BD, including regions known to be susceptible to cerebrovascular dysfunction and/or disease. These findings warrant additional research on the causes and consequences of cerebrovascular dysfunction in early‐onset BD.

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Section: Discussionmentioning

confidence: 99%

Reduced cerebrovascular reactivity among adolescents with bipolar disorder

et al. 2018

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“…They observed that dorsal medial frontal nodes (e.g. medial superior frontal gyrus ROI) demonstrate significantly decreased connectivity to other portions of the DMN (angular gyrus and anterior cingulate ROIs) in euthymic bipolar disorder compared to HC subjects (supplementary materials in (Lv et al, 2016)). These results are consistent with our own findings described above.…”

Section: Discussionmentioning

confidence: 99%

Differential brain network activity across mood states in bipolar disorder

Brady

Tandon

Masters

et al. 2017

Journal of Affective Disorders

105

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Background This study aimed to identify how the activity of large-scale brain networks differs between mood states in bipolar disorder. The authors measured spontaneous brain activity in subjects with bipolar disorder in mania and euthymia and compared these states to a healthy comparison population. Methods 23 subjects with bipolar disorder type I in a manic episode, 24 euthymic bipolar I subjects, and 23 matched healthy comparison (HC) subjects underwent resting state fMRI scans. Using an existing parcellation of the whole brain, we measured functional connectivity between brain regions and identified significant differences between groups. Results In unbiased whole-brain analyses, functional connectivity between parietal, occipital, and frontal nodes within the dorsal attention network (DAN) were significantly greater in mania than euthymia or HC subjects. In the default mode network (DMN), connectivity between dorsal frontal nodes and the rest of the DMN differentiated both mood state and diagnosis. Limitations The bipolar groups were separate cohorts rather than subjects imaged longitudinally across mood states. Conclusions Bipolar mood states are associated with highly significant alterations in connectivity in two large-scale brain networks. These same networks also differentiate bipolar mania and euthymia from a HC population. State related changes in DAN and DMN connectivity suggest a circuit based pathology underlying cognitive dysfunction as well as activity / reactivity in bipolar mania. Altered activities in neural networks may be biomarkers of bipolar disorder diagnosis and mood state that are accessible to neuromodulation are promising novel targets for scientific investigation and possible clinical intervention.

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“…Moreover, a complex developing brain, with an inbuilt self-overvaluing, reverberating circuit, which is active normally at the resting state, may modulate the function of this circuit through interactions with other inbuilt systems, like the circuit underpinning the egalitarian drive [75], which originates mirror-neurone/representation-related phenomena like empathy and perspective taking, cooperativeness, social value orientation, altruism, compassion, and emotional contagion, that are subject to refinement through both evolution and personal development [76-81]. Interestingly, an empathy substrate is activity in insula and inferior frontal gyrus (IFG) [82, 83]; reduced IFG activity was found in patients with mania [54] and euthymic BD in an uncertain study as to the PoM hypothesis [65] and reduced insular activity in patients with mania [17], while insular activity and connectivity was found to be increased in patients with BD and depression [19, 62] and in euthymic BD [24]. It is possible that the empathy network negatively modulates the self-overvaluing circuit, so that some “uncertain” results we found relative to the PoM hypothesis could be due to interference carried by other networks.…”

Section: Discussionmentioning

confidence: 99%

Neurobiological Evidence for the Primacy of Mania Hypothesis

Kotzalidis¹,

Rapinesi

Savoja

et al. 2017

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Background: Athanasios Koukopoulos proposed the primacy of mania hypothesis (PoM) in a 2006 book chapter and later, in two peer-reviewed papers with Nassir Ghaemi and other collaborators. This hypothesis supports that in bipolar disorder, mania leads to depression, while depression does not lead to mania.Objective: To identify evidence in literature that supports or falsifies this hypothesis.Method: We searched the medical literature (PubMed, Embase, PsycINFO, and the Cochrane Library) for peer-reviewed papers on the primacy of mania, the default mode function of the brain in normal people and in bipolar disorder patients, and on illusion superiority until 6 June, 2016. Papers resulting from searches were considered for appropriateness to our objective. We adopted the PRISMA method for our review. The search for consistency with PoM was filtered through the neurobiological results of superiority illusion studies.Results: Out of a grand total of 139 records, 59 were included in our analysis. Of these, 36 were of uncertain value as to the primacy of mania hypothesis, 22 favoured it, and 1 was contrary, but the latter pooled patients in their manic and depressive phases, so to invalidate possible conclusions about its consistency with regard to PoM. All considered studies were not focused on PoM or superiority illusion, hence most of their results were, as expected, unrelated to the circuitry involved in superiority illusion. A considerable amount of evidence is consistent with the hypothesis, although indirectly so. Limitations. Only few studies compared manic with depressive phases, with the majority including patients in euthymia.Conclusion: It is possible that humans have a natural tendency for elation/optimism and positive self-consideration, that are more akin to mania; the depressive state could be a consequence of frustrated or unsustainable mania. This would be consistent with PoM.

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Decreased functional connectivity in the language regions in bipolar patients during depressive episodes but not remission

Cited by 46 publications

References 56 publications

Reduced cerebrovascular reactivity among adolescents with bipolar disorder

Reduced cerebrovascular reactivity among adolescents with bipolar disorder

Differential brain network activity across mood states in bipolar disorder

Neurobiological Evidence for the Primacy of Mania Hypothesis

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