Davis KA, Kwon A, Cardenas VA, Deicken RF. Decreased cortical gray and cerebral white matter in male patients with familial bipolar I disorder. J Affect Disord 82: 475-485

ArticleinJournal of Affective Disorders 82(3):475-85 · December 2004with5 Reads
DOI: 10.1016/j.jad.2004.03.010 · Source: PubMed
Previous MRI studies of bipolar disorder have failed to consistently demonstrate cortical gray or cerebral white matter tissue loss, as well as sulcal or ventricular enlargement. The inconsistencies are most likely due to the clinical and gender heterogeneity of the study populations as well as the different MRI acquisition and processing techniques. The objective of this study was to determine if there was a cortical gray matter and cerebral white matter deficit as well as sulcal and ventricular enlargement in a homogeneous sample of euthymic male patients with familial bipolar I disorder. MRI tissue segmentation was utilized to obtain cortical gray matter, cerebral white matter, ventricular cerebrospinal fluid (CSF), and sulcal CSF volumes in 22 euthymic males with familial bipolar I disorder and 32 healthy male control subjects. Relative to the controls, the familial bipolar I patients demonstrated: (1) significant reductions of both cortical gray matter and cerebral white matter volumes; and (2) significant increases in both sulcal and ventricular CSF volumes. In the bipolar group, there was a significant negative correlation between cortical gray matter volume and sulcal CSF volume. Small sample size, retrospective interviews, possible medication effects. These results provide evidence for significant cortical gray matter and cerebral white matter deficits and associated sulcal and ventricular enlargement in euthymic males with familial bipolar I disorder.
    • "Bipolar disorder (BD) is a severe psychiatric condition characterized by episodes of mania / hypomania and depression alternating with euthymic periods, affecting more than 1% of the world population and often result in functional and cognitive impairment and a reduction in quality of life (Grande et al., 2016). Several histopathological studies have consistently shown reductions in glial cell density or glial cell numbers in the prefrontal brain regions in bipolar disorder, mainly in the medial prefrontal cortex (mPFC) and subgenual anterior cingulate; these findings have indicated changes in brain volume, supported by morphometric studies showing reductions in total white matter volume (Davis et al., 2004; Kieseppa et al., 2003; Rosso et al., 2007; Strakowski et al., 1993). These volume alterations could be attributed mainly to changes in the function and morphology of astrocytes and oligodendrocytes (Johnston-Wilson et al., 2000; Rajkowska and Miguel-Hidalgo, 2007; Schroeter et al., 2010; Uranova et al., 2004; Vostrikov et al., 2004). "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Bipolar disorder (BD) is a neuropsychiatric disorder characterized by recurrent episodes of mania/hypomania, affecting more than 1% of the world population. S100B is a calcium-binding protein, mostly produced and secreted by astrocytes in the CNS that participate in several cellular responses. Previous studies have shown that patients with bipolar disorder had higher peripheral S100B levels than healthy individuals, suggesting a potential role for S100B BD. Methods: In this study, a systematic and quantitative meta-analysis of studies S100B serum was performed according to the guidelines PRISMA-statement to confirm the increase of serum S100B in patients with manic bipolar disorder. Results: We included in the meta-analysis two studies that reported the mean and standard deviation of serum S100B 52 patients manic BP and 52 control studies. Our results showed higher levels of S100B peripheral TB patients compared with healthy controls. In this meta-analysis, we found evidence that serum S100B are increased in patients with bipolar disorder. Conclusion: In conclusion, several studies have observed morphological abnormalities in the brains of bipolar disorder patients, changes in the peripheral S100B levels in mood disorders were described, and this protein could be a putative marker for damage to the brain. Thus, in this meta-analysis we have found evidence, based on two studies of 52 patients and 52 healthy controls, that the serum concentrations of S100B are increased in bipolar disorder patients.
    Full-text · Article · Jul 2016
    • "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). Patients with cerebral small vessel disease share common features with bipolar patients such as poor performance on tests of executive function and processing speed, generalized brain atrophy as well as ventricular enlargement, blood brain barrier (BBB) dysfunction , and white matter changes in periventricular as well as in the deep white matter (Chui, 2007). "
    [Show abstract] [Hide abstract] ABSTRACT: 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 bipolar disorder. To investigate this hypothesis, we sampled CSF from 133 patients with bipolar disorder and 86 healthy controls. The concentrations of neurofilament light chain (NF-L), myelin basic protein (MBP), S100B, and heart-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, though 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.Neuropsychopharmacology accepted article peview online, 03 April 2014; doi:10.1038/npp.2014.81.
    Article · Apr 2014
    • "Also, enlargement of the amygdala has been identified in association with illness pro- gression [50, 53, 54], contrasting with the smaller size of the structure at early stages. Volume deficits such as decreased white matter density, can also be found in bipolar patients [55]. Finally, loss of white matter in the prefrontal cortex can be observed as early as in the first manic episode, becoming more evident after multiple episodes [56][57][58]. "
    [Show abstract] [Hide abstract] ABSTRACT: In bipolar disorder illness progression has been associated with a higher number of mood episodes and hospitalizations, poorer response to treatment, and more severe cognitive and functional impairment. This supports the notion of the use of staging models in this illness. The value of staging models has long been recognized in many medical and malignant conditions. Staging models rely on the fact that different interventions may suit different stages of the disorder, and that better outcomes can be obtained if interventions are implemented earlier in the course of illness. Thus, treatment planning would benefit from the assessment of cognition, functioning and comorbidities. Staging may offer a means to refine treatment options, and most importantly, to establish a more precise diagnosis. Moreover, staging could have utility as course specifier and may guide treatment planning and better information to patients and their family members of what could be expected in terms of prognosis. The present study reviews the clinical and biological basis of the concept of illness progression in bipolar disorder.
    Full-text · Article · Mar 2014
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