Frontosubcortical Neuroanatomy and the Continuous Performance Test in Mania

Sax, Kenji W.; Strakowski, Stephen M.; Zimmerman, Molly E.; DelBello, Melissa P.; Keck, Paul E.; Hawkins, John

doi:10.1176/ajp.156.1.139

Cited by 225 publications

(186 citation statements)

References 9 publications

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“…Right caudate volume was larger only in affected monozygotic twins. 206 Imaging studies of caudate in adults with BD have been ambiguous, with some studies also showing an increased volume, 207 but other suggesting either a difference in the opposite direction-decreased caudate in older bipolar patients, particularly those with illness onset after 45 years of age 208 -or no differences in patients with minimal exposure to antipsychotics, 209 hospitalized manic patients, 210 bipolar patients, 211 or first-episode manic patients. 212 The heritability of caudate volume is unknown, but enlarged caudate volumes are associated with both genetic 213,214 and environmental factors, 215 including antipsychotic use.…”

Section: Basal Gangliamentioning

confidence: 99%

The phenotypes of bipolar disorder: relevance for genetic investigations

2005

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The search for susceptibility genes for bipolar disorder (BD) depends on appropriate definitions of the phenotype. In this paper, we review data on diagnosis and clinical features of BD that could be used in genetic studies to better characterize patients or to define homogeneous subgroups. Clinical symptoms, long-term course, comorbid conditions, and response to prophylactic treatment may define groups associated with more or less specific loci. One such group is characterized by symptoms of psychosis and linkage to 13q and 22q. A second group includes mainly bipolar II patients with comorbid panic disorder, rapid mood switching, and evidence of chromosome 18 linkage. A third group comprises typical BD with an episodic course and favourable response to lithium prophylaxis. Reproducibility of cognitive deficits across studies raises the possibility of using cognitive profiles as endophenotypes of BD, with deficits in verbal explicit memory and executive function commonly reported. Brain imaging provides a more ambiguous data set consistent with heterogeneity of the illness. Keywords: bipolar disorder; genetics; endophenotype; neurocognitive function; brain imaging Bipolar disorder (BD) has a genetic basis with heritability of at least 80%. 1 A number of studies have attempted to map the susceptibility loci giving evidence of linkage in multiple genomic regions. In particular, findings in 4p, 4q, 8q, 10p, 12q24, 13q, 18p, 18q, 21q, and 22q have been supported by more than one study. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] However, these studies have not identified any specific genes, and a recent metaanalysis of available genome scans showed no regions with a conclusive evidence of linkage. 20 The relatively slow progress of gene-mapping efforts is often explained by the 'complex' nature of the illness and of the genotype-phenotype relation. The complexity most likely includes heterogeneity, interactions of multiple loci, incomplete penetrance, as well as phenotypes resulting from environmental effects-either alone or in interaction with the genetic predisposition. The goal of psychiatric genetic research is identification of (heritable) variations in DNA sequence or function that influence behaviour or give rise to mental illness. By definition, in complex (multifactorial) traits, this link is not unique and specific. That is, a particular change in gene sequence does not necessarily lead to a specific behaviour, and similar behaviours (symptoms) may be due to distinct (sets of) genes. Moreover, we must consider the possibility that the path between the genotype and behaviour is not unidirectional. Emerging examples point not only to general effects of environment, for instance stress, on behaviour, but also to specific behaviours influencing gene function that can be transmitted onto the next generation. 21 No single method is considered clearly superior in identifying susceptibility genes for complex traits such as BD. Most researchers agree that a combination of strategies is most lik...

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Section: Basal Gangliamentioning

confidence: 99%

The phenotypes of bipolar disorder: relevance for genetic investigations

2005

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“…16 Reduced volumes have also been noted in the subgenual cingulate, 35,93 in the hippocampus, 88,125 and in the striatum of patients with major depressive disorder, but again, other studies have failed to support these findings. 69,108 Interestingly, postmortem analyses of patients who have died with depression have documented decreased volume in the hippocampus, 119 striatum, 9 and OFC. 103 Methodological issues related to postmortem tissue processing and significant confounds associated with premortem medication history and symptoms make such studies difficult to interpret.…”

Section: Structural Mr Imagingmentioning

confidence: 99%

Biological basis for the surgical treatment of depression

Abosch¹,

Cosgrove

2008

FOC

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An estimated 20% of patients with major depression are refractory to existing therapies. The purpose of this review is to provide a theoretical and neuroscientific framework in which to interpret new work in the field of surgical treatment for depression. This review focuses on existing clinical and imaging data, current disease models, and results of recent case reports and patient series that together may inform the construction of appropriate clinical trials for the surgical treatment of refractory depression.

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“…Diminuição da substância cinzenta no córtex pré-frontal subgenual foi reportado em pacientes com TAB e unipolares com história familiar para transtornos de humor 22 . Os mesmos autores, em estudos com neuropatologia, confirmaram esses achados, associando com diminuição da glia, sem diminuição da densidade ou tamanho neuronal correspondente 23,24 . Dois estudos reportaram diminuição do volume ou área do lobo temporal 25 , enquanto outros três não demonstraram alterações nesta área 26,27,20 .…”

Section: Estudos Anatômicos (Estruturais)unclassified

Neurobiologia do transtorno de humor bipolar e tomada de decisão na abordagem psicofarmacológica

Machado‐Vieira

Schwartzhaupt²,

Frey

et al. 2003

Rev. psiquiatr. Rio Gd. Sul

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INTRODUÇÃOO Transtorno do Humor Bipolar (THB) caracteriza-se por oscilações do humor que causam prejuízos significativos no âmbito biopsicossocial, com critérios específicos para seus subdiagnósticos (DSM-IV). O surgimento de novos fármacos com propriedade de estabilizar o humor, o refinamento diagnóstico, as estimativas de uma maior prevalência, o risco de suicídio, assim como os prejuízos sociais causados para o indivíduo portador do transtorno, sua família e a sociedade enfatizam a importân-cia de cada vez mais este transtorno ser estudado de forma sistemática, continuada e críti-ca. Este artigo avalia criticamente as opções já estudadas para tratamento farmacológico dos diferentes subtipos de THB, avaliando sua eficácia para as indicações específicas, bem como as perspectivas de novos estudos com fárma-cos que ainda apresentam resultados limitados, especialmente devido à não sistematização dos estudos clínicos feitos até o presente momento. FÁRMACOS UTILIZADOS E MECANISMOS DE AÇÃO LítioO lítio interfere no metabolismo do inositol trifosfato, responsável pela liberação do cálcio de seus depósitos intracelulares, possivelmente através da inibição de enzimas na rota de formação do inositol2,3. Há também outras hipóteses que justificam seu uso como estabilizador do humor:-por sua similaridade com outros elementos (sódio, potássio, cálcio e magnésio), eleva Neurobiologia do transtorno de humor bipolar e tomada de decisão na abordagem psicofarmacológica

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Frontosubcortical Neuroanatomy and the Continuous Performance Test in Mania

Abstract: These results suggest that certain neuroanatomic structures may be associated with attentional dysfunction in mania.

Cited by 225 publications

References 9 publications

The phenotypes of bipolar disorder: relevance for genetic investigations

The phenotypes of bipolar disorder: relevance for genetic investigations

Biological basis for the surgical treatment of depression

Neurobiologia do transtorno de humor bipolar e tomada de decisão na abordagem psicofarmacológica

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