Meta-analysis, Database, and Meta-regression of 98 Structural Imaging Studies in Bipolar Disorder

Kempton, Matthew J.; Geddes, John; Ettinger, Ulrich; Williams, Steven; Grasby, Paul M.

doi:10.1001/archpsyc.65.9.1017

Cited by 496 publications

(405 citation statements)

References 164 publications

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“…Thus, while schizophrenia is characterized by a reduction in whole volume of around 2%, coupled with larger reductions in regions such as the frontal lobe and the hippocampus 15, bipolar disorder appears to be associated with only at most minor whole brain and regional volume changes 16, 17. Few studies have examined schizoaffective disorder using conventional CT or MRI measures 18, 19, 20, 21, and these have mostly been underpowered and have not demonstrated clear differences from either schizophrenia or bipolar disorder.…”

Section: Introductionmentioning

confidence: 99%

Brain structural changes in schizoaffective disorder compared to schizophrenia and bipolar disorder

Amann

Canales‐Rodríguez

Madre

et al. 2015

Acta Psychiatr Scand

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ObjectiveBrain structural changes in schizoaffective disorder, and how far they resemble those seen in schizophrenia and bipolar disorder, have only been studied to a limited extent.MethodForty‐five patients meeting DSM‐IV and RDC criteria for schizoaffective disorder, groups of patients with 45 matched schizophrenia and bipolar disorder, and 45 matched healthy controls were examined using voxel‐based morphometry (VBM).ResultsAnalyses comparing each patient group with the healthy control subjects found that the patients with schizoaffective disorder and the patients with schizophrenia showed widespread and overlapping areas of significant volume reduction, but the patients with bipolar disorder did not. A subsequent analysis compared the combined group of patients with the controls followed by extraction of clusters. In regions where the patients differed significantly from the controls, no significant differences in mean volume between patients with schizoaffective disorder and patients with schizophrenia in any of five regions of volume reduction were found, but mean volumes in the patients with bipolar disorder were significantly smaller in three of five.ConclusionThe findings provide evidence that, in terms of structural gray matter brain abnormality, schizoaffective disorder resembles schizophrenia more than bipolar disorder.

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Section: Introductionmentioning

confidence: 99%

Brain structural changes in schizoaffective disorder compared to schizophrenia and bipolar disorder

Amann

Canales‐Rodríguez

Madre

et al. 2015

Acta Psychiatr Scand

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“…BD has also been coupled to cognitive impairment including reduced abilities in executive function and verbal memory (Martinez-Aran et al, 2000;Zarate et al, 2000;Martinez-Aran et al, 2005;Robinson et al, 2006;Sanchez-Moreno et al, 2009;Palsson et al, 2013). Structural imaging studies have suggested that the decline in cognitive function is associated with morphological abnormalities of the brain (Altshuler et al, 1995;McDonald et al, 2004;Kempton et al, 2008;Konarski et al, 2008), and that the number of manic episodes is associated with decreased gray matter in dorsolateral prefrontal cortex (Ekman et al, 2010). The most frequent abnormal morphological findings are lateral ventricular enlargements and increased rates of deep white matter hyperintensities (Kempton et al, 2008;Beyer et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Structural imaging studies have suggested that the decline in cognitive function is associated with morphological abnormalities of the brain (Altshuler et al, 1995;McDonald et al, 2004;Kempton et al, 2008;Konarski et al, 2008), and that the number of manic episodes is associated with decreased gray matter in dorsolateral prefrontal cortex (Ekman et al, 2010). The most frequent abnormal morphological findings are lateral ventricular enlargements and increased rates of deep white matter hyperintensities (Kempton et al, 2008;Beyer et al, 2009). The association between white matter pathology and BD has been further supported by morphometric studies showing reductions in total white matter volumes (Strakowski et al, 1993;Kieseppa et al, 2003;Davis et al, 2004;Rosso et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Elevated Concentrations of Neurofilament Light Chain in the Cerebrospinal Fluid of Bipolar Disorder Patients

Jakobsson

Bjerke

Ekman

et al. 2014

Neuropsychopharmacol

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Bipolar disorder (BD) is characterized by mood swings between manic and depressive states. The etiology and pathogenesis of BD is unclear, but many of the affected cognitive domains, as well as neuroanatomical abnormalities, resemble symptoms and signs of small vessel disease. In small vessel disease, cerebrospinal fluid (CSF) markers reflecting damages in different cell types and subcellular structures of the brain have been established. Hence, we hypothesized that CSF markers related to small vessel disease may also be applicable as biomarkers for BD. To investigate this hypothesis, we sampled CSF from 133 patients with BD and 86 healthy controls. The concentrations of neurofilament light chain (NF-L), myelin basic protein (MBP), S100B, and heart-type fatty acid binding protein (H-FABP) were measured in CSF and analyzed in relation to diagnosis, clinical characteristics, and ongoing medications. Hereby we found an elevation of the marker of subcortical axonal damage, NF-L, in bipolar subjects. We also identified positive associations between NF-L and treatment with atypical antipsychotics, MBP and lamotrigine, and H-FABP and lithium. These findings indicate axonal damage as an underlying neuropathological component of bipolar disorder, although the clinical value of elevated NF-L remains to be validated in follow-up studies. The associations between current medications and CSF brain injury markers might aid in the understanding of both therapeutic and adverse effects of these drugs.

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“…Lateral ventricular enlargement has been a regular finding in studies of bipolar disorder and is supported by meta-analyses (Arnone et al, 2009, Kempton et al, 2008.…”

Section: Neuroimaging Structural Imaging Studies In Schizoaffective Dmentioning

confidence: 83%

“…However, these meta-analyses found only small effect sizes for whole brain volume reduction, which were significant in one (Arnone et al, 2009) but not in the other (Kempton et al, 2008). In contrast, studies using VBM have found more consistent evidence of abnormality, which affect principally the anterior cingulate cortex, insula and inferior frontal cortex (Bora et al, 2010, Selvaraj et al, 2012.…”

Section: Neuroimaging Structural Imaging Studies In Schizoaffective Dmentioning

confidence: 85%

Neuropsychological and Brain Functional Changes Across the Different Phases of Schizoaffective Disorder

Merce

Raduà

Amann

2015

European Psychiatry

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Schizoaffective disorder was first described by J. Kasanin in 1933, since then its nosology remains a matter of controversy. We aim to add further neurobiological findings to this debate.Memory and executive function were tested in 22 acutely ill schizoaffective patients; they also underwent fMRI scanning during performance of the n-back working memory test. The same measures were obtained after they had been in remission for ≥2 months. 22 matched healthy individuals were also examined.Compared to controls, acute schizoaffective patients showed reduced activation in the DLPFC and also a failure of deactivation in the medial frontal cortex (1).In clinical remission, schizomanic patients showed an improvement of memory but not of executive function, while schizodepressive patients did not change in either domain. All schizoaffective patients in clinical remission showed memory and executive impairment compared to the controls. On fMRI, acutely ill schizomanic patients had reversible frontal hypo-activation when compared to clinical remission, while activation patterns in ill and remitted schizodepressive patients were similar. The whole group of schizoaffective patients in clinical remission showed a failure of de-activation in the medial frontal gyrus compared to the healthy controls. There was evidence for memory improvement and state dependent changes in activation in schizomanic patients across relapse and remission (2).The results demonstrate that schizoaffective disorder is characterized by medial frontal failure of deactivation and hence default mode network dysfunction (3), which is present during both active illness and remission suggesting that it is a trait factor for the disorder.

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Meta-analysis, Database, and Meta-regression of 98 Structural Imaging Studies in Bipolar Disorder

Cited by 496 publications

References 164 publications

Brain structural changes in schizoaffective disorder compared to schizophrenia and bipolar disorder

Brain structural changes in schizoaffective disorder compared to schizophrenia and bipolar disorder

Elevated Concentrations of Neurofilament Light Chain in the Cerebrospinal Fluid of Bipolar Disorder Patients

Neuropsychological and Brain Functional Changes Across the Different Phases of Schizoaffective Disorder

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