Limbic changes identified by imaging in bipolar patients.
ABSTRACT The hippocampus and amygdala are key limbic regions for memory formation and emotion modulation that are potentially involved in the cognitive and affective symptoms of bipolar disorder. Here we discuss the most consistent MRI literature in bipolar disorder, focusing on the role of the hippocampus and amygdala. In child and adolescent patients, a unique pattern of abnormalities has begun to emerge, with volume deficits in the hippocampus and amygdala already detectable early in the illness course. In adults, it is unclear whether hippocampal volumes are abnormal, whereas the amygdala is reported to be larger and hyperactive to external emotional stimuli. However, available findings are often conflicting, and most studies suffer from limitations. Future longitudinal magnetic resonance studies should focus on juvenile patients; first-episode, drug-free patients; and unaffected family members. Jointly with genetic, postmortem, and neuropsychological studies, these studies will be extremely valuable in separating state from trait brain abnormalities and further characterizing the pathophysiology of bipolar disorder.
Full-textDOI: · Available from: Paolo Brambilla, Dec 08, 2014
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ABSTRACT: Bipolar disorder (BD) is a psychiatric disorder accompanied by deficits in declarative memory. Given the importance of the hippocampus in declarative memory, it is not surprising that BD patients have been reported to show hippocampal abnormalities. Review evidence about structural and functional hippocampal abnormalities in BD. Systematic review of studies comparing BD patients and healthy controls with respect to hippocampal structure or function. Twenty-five studies were included, together involving 1043 patients, 21 of which compared patients to controls. Decrease in hippocampal volume was found in four of 18 studies using adult samples, and two of three samples using adolescents. Four studies revealed localized hippocampal deficits. Meta-analysis revealed a significant but small effect with lower hippocampal volumes when comparing all BD patients with controls. Lithium treatment was associated with larger hippocampal volumes across studies. The three functional studies yielded contradictory evidence. Studies were only cross-sectional in nature and all used MRI or fMRI to investigate hippocampal volume or function. Heterogeneous patients groups and different methodologies for hippocampal segmentation, may have contributed to difficulties when comparing the different studies. There seems to be a small reduction in hippocampal volume in BD, which perhaps is more pronounced in early-onset BD and is counteracted by a neuroprotective effect of lithium treatment. However, how these structural abnormalities relate to functional deficits is largely unclear. Given the few functional neuroimaging studies and given the lack of congruence in these results, further investigation of especially hippocampal function in BD is recommended. Copyright © 2014 Elsevier B.V. All rights reserved.Journal of Affective Disorders 11/2014; 174C:113-125. DOI:10.1016/j.jad.2014.11.001 · 3.71 Impact Factor
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ABSTRACT: Automatic segmentation of deep brain structures, such as the hippocampus (HC), in MR images has attracted considerable scientific attention due to the widespread use of MRI and to the principal role of some structures in various mental disorders. In this literature, there exists a substantial amount of work relying on deformable models incorporating prior knowledge about structures’ anatomy and shape information. However, shape priors capture global shape characteristics and thus fail to model boundaries of varying properties; HC boundaries present rich, poor, and missing gradient regions. On top of that, shape prior knowledge is blended with image information in the evolution process, through global weighting of the two terms, again neglecting the spatially varying boundary properties, causing segmentation faults. An innovative method is hereby presented that aims to achieve highly accurate HC segmentation in MR images, based on the modeling of boundary properties at each anatomical location and the inclusion of appropriate image information for each of those, within an active contour model framework. Hence, blending of image information and prior knowledge is based on a local weighting map, which mixes gradient information, regional and whole brain statistical information with a multi-atlas-based spatial distribution map of the structure’s labels. Experimental results on three different datasets demonstrate the efficacy and accuracy of the proposed method.IEEE Transactions on Biomedical Engineering 04/2014; 61(4):1015-1026. DOI:10.1109/TBME.2013.2293023 · 2.23 Impact Factor
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ABSTRACT: Perinatal immune challenge leads to neurodevelopmental dysfunction, permanent immune dysregulation and abnormal behaviour, which have been shown to have translational validity to findings in human neuropsychiatric disorders (e.g. schizophrenia, mood and anxiety disorders, autism, Parkinson's disease and Alzheimer's disease). The aim of this animal study was to elucidate the influence of early immune stimulation triggered by systemic postnatal lipopolysaccharide administration on biochemical, histopathological and morphological measures, which may be relevant to the neurobiology of human psychopathology. In the present study of adult male Wistar rats we examined the brain and plasma levels of monoamines (dopamine, serotonin), their metabolites, the levels of the main excitatory and inhibitory neurotransmitters glutamate and γ-aminobutyric acid and the levels of tryptophan and its metabolites from the kynurenine catabolic pathway. Further, we focused on histopathological and morphological markers related to pathogenesis of brain diseases - glial cell activation, neurodegeneration, hippocampal volume reduction and dopaminergic synthesis in the substantia nigra. Our results show that early immune stimulation in adult animals alters the levels of neurotransmitters and their metabolites, activates the kynurenine pathway of tryptophan metabolism and leads to astrogliosis, hippocampal volume reduction and a decrease of tyrosine hydroxylase immunoreactivity in the substantia nigra. These findings support the crucial pathophysiological role of early immune stimulation in the above mentioned neuropsychiatric disorders.PLoS ONE 01/2015; 10(1):e0115439. DOI:10.1371/journal.pone.0115439 · 3.53 Impact Factor