Common and specific patterns of functional and structural brain alterations in schizophrenia and bipolar disorder: a multimodal voxel-based meta-analysis

Journal of Psychiatry and Neuroscience, Journal Year: 2022, Volume and Issue: 47(1), P. E32 - E47

Published: Feb. 1, 2022

Background:

Schizophrenia and bipolar disorder have been linked to alterations in the functional activity grey matter volume of some brain areas, reflected impaired regional homogeneity aberrant voxel-based morphometry. However, because variable findings methods used across studies, identifying patterns alteration schizophrenia has difficult.

Methods:

We conducted a meta-analysis differences morphometry between patients healthy controls for separately, using seed-based d mapping.

Results:

included 45 publications on (26 19 disorder) 190 (120 70 disorder). Patients with showed increased frontal cortex striatum supplementary motor area; they decreased insula, primary sensory (visual auditory cortices) sensorimotor cortex. striatum; insula. superior temporal gyrus, inferior cingulate cerebellum. cortex, thalamus. Overlap analysis that displayed left insula gyrus;

Limitations:

The small sample size our subgroup (unmedicated versus medicated substantial heterogeneity results regions could limit interpretability generalizability results.

Conclusion:

shared common pattern structural more widespread impairment, most prominently areas.

Language: Английский

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Efficacy of pentoxifylline for the treatment of bipolar I/II patients with treatment-resistant depression: A proof-of-concept, randomized, double-blind, placebo-controlled trial

Brain Research Bulletin, Journal Year: 2024, Volume and Issue: 216, P. 111047 - 111047

Published: Aug. 10, 2024

Immune dysregulation can play a role in depression pathophysiology, and immunological antagonists improve depressive symptoms treatment-resistant bipolar (TRD) patients according to studies. To evaluate the anti-depressant effects of anti-inflammatory drug, pentoxifylline (PTX) TRD I/II adult subjects. This 12-week, randomized, double-blind, placebo-controlled, parallel-group trial 60 participants was conducted at Hawler Psychiatric Hospital Private Clinic Erbil, Iraq. Participants were confirmed as being qualified for based on DSM-5 criteria. Data analyzed using modified intent-to-treat analysis. There no significant differences between two groups Hamilton Rating Scale Depression-17 (HAM-D-17) scores (χ2=1.9, P =.48) or time × treatment interaction (χ2=7.1, P=.54). Nevertheless, effect observed with both groups' reduction HAM-D-17 from start endpoint (χ2= 2.11, P=.002). Besides, CRP found (χ2=3.1, P=0.016), where there more score PTX-treated subjects CRP> 7.1 mg/L. The response rate difference PTX placebo group did not reach significance level (χ2=0.84, p=0.43). Furthermore, serum concentrations TNF-α, CRP, IL-6 significantly reduced week 12 (P=.007,.04, <.001, respectively). current proof concept study that terms overall effectiveness TRD, is superior placebo. However, it may mood subpopulation higher pretreatment inflammatory profile.

Language: Английский

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Proof‐of‐concept randomized controlled trial of single‐session nitrous oxide treatment for refractory bipolar depression: Focus on cerebrovascular target engagement

Bipolar Disorders, Journal Year: 2022, Volume and Issue: 25(3), P. 221 - 232

Published: Dec. 29, 2022

There remain few efficacious treatments for bipolar depression, which dominates the course of disorder (BD). Despite multiple studies reporting associations between depression and cerebral blood flow (CBF), little is known regarding CBF as a treatment target, or predictor and/or indicator response, in BD. Nitrous oxide, an anesthetic gas with vasoactive putative antidepressant properties, has long history neuroimaging probe. We undertook experimental medicine paradigm, coupling in-scanner single-session nitrous oxide repeated measures CBF.In this double-blind randomized controlled trial, 25 adults BD I/II current treatment-refractory received either: (1) (20 min at 25% concentration) plus intravenous saline (n = 12), (2) medical air midazolam (2 mg total; n 13). Study outcomes included changes severity (Montgomery-Asberg Depression Rating Scale scores, primary) (via arterial spin labeling magnetic resonance imaging).There were no significant between-group differences 24-h post-treatment MADRS change response. However, group had significantly greater same-day reductions severity. Lower baseline regional predicted but not midazolam. In region-of-interest voxel-wise analyses, there was pattern following versus oxide.Present findings, while tentative based on secondary endpoints, suggest differential hemodynamics. Larger integrating targets sessions are warranted.

Language: Английский

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Neuroimaging and Network Mechanisms in Bipolar Disorder

Oxford University Press eBooks, Journal Year: 2025, Volume and Issue: unknown, P. 273 - 284

Published: Jan. 1, 2025

Abstract Bipolar disorder is characterized by episodic depression and periods of elevated mood. This mood lability thought to arise from altered brain structure function. Neuroimaging has identified alterations in several large-scale networks the disorder. Dysfunction these may lead task-based engagement their hubs. Another key focus functional neuroimaging literature bipolar reward anticipation. These studies also show function reward-associated regions. Consistent with findings, reduced gray matter volume cortical thickness are observed regions associated anticipation emotion regulation. Similarly, diffusion imaging methods have white integrity tracts that form structural basis networks. Taken together, findings contribute an emerging neuroanatomic model potential aid development novel approaches prevention treatment.

Language: Английский

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List of Abbreviations and Acronyms

Published: Jan. 30, 2025

Language: Английский

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Dimensions and Implications of Cultural Identity

Oxford University Press eBooks, Journal Year: 2025, Volume and Issue: unknown, P. 60 - 87

Published: Jan. 30, 2025

Abstract Cultural identity is intersectional: It includes not only race and nationality but also socioeconomic class, occupation, religion, gender, age/generation, life stage. Culture usefully characterized dimensionally. Hofstede identified dimensions of individualism/collectivism, power distance, uncertainty avoidance, gender role differentiation, short-term/long-term orientation, indulgence/restraint. Trust in individuals institutions, as well social capital—structural, relational, instrumental, cognitive—moderate the emotional effects stress adversity. clinicians enables effective treatment. The expression depression mediated by cultural communication styles, with their high-context/low-context, direct/indirect, self-enhancing/self-effacing, elaborate/understated. Word choices metaphors—which vary culture—help identify depression, indicate its severity, reveal suicide risk. Details critical for accurate diagnosis treatment can be “lost translation.”

Language: Английский

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Seeing Depression Through A Cultural Lens

Oxford University Press eBooks, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Abstract Seeing Depression through a Cultural Lens, the collaborative work of clinical neuroscientist and scholar comparative culture, examines effects cultural identity on epidemiology, phenomenology, narratives depression, bipolar spectrum, suicide. Culture is associated with emotional communication style, “idioms distress,” conception depression disorders, how people mood disorders might be stigmatized. It linked to structural factors—environmental, social, economic circumstances—that create or mitigate risk sometimes precipitate episodes illness, facilitate impede treatment. shapes depressed people’s willingness disclose acknowledge their condition seek care, relationships clinicians, acceptance rejection specific treatments. context essential understanding underlies motives for suicide, facilitating inhibiting factors, social acceptability death by availability lethal means self-harm. always intersectional—comprising elements related race ethnicity; gender; age, generation, life stage; education; class; occupation; migrant minority status; region residence; religious belief practice. Lens explores implications each these dimensions using salient concepts form sciences; memorable from literature, film, clinic; quantitative findings epidemiology psychometrics. offers readers framework culturally aware assessment management bipolarity, suicidal in individuals populations.

Language: Английский

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Preface

Oxford University Press eBooks, Journal Year: 2025, Volume and Issue: unknown, P. xv - xxii

Published: Jan. 30, 2025

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Faces of Clinical Depression

Oxford University Press eBooks, Journal Year: 2025, Volume and Issue: unknown, P. 23 - 47

Published: Jan. 30, 2025

Abstract Current diagnostic criteria for major depressive disorder (MDD) do not capture the diversity of phenotypes clinically significant depression. Culture can entail suppression, normalization, or concealment symptoms. Clinically depressed people who are “subsyndromal” by MDD often fall in a “middle zone” between normal negative emotion and frank mental illness. Alternative clinical depression proposed that better accommodate cultural differences as well variations personality pathophysiology. Such validate illness whose subsyndromal entails functional impairment, persistent distress, suicide risk. Appreciation middle zone clinicians public could reduce stigma facilitate its timely treatment. Questionnaire-based screening tests like nine-item Patient Health Questionnaire, Center Epidemiologic Studies Depression Scale, Beck Inventory function if cut points modified according to culture their translations from English other languages consider connotations explicit meanings items.

Language: Английский

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Unnatural Deaths

Oxford University Press eBooks, Journal Year: 2025, Volume and Issue: unknown, P. 99 - 112

Published: Jan. 30, 2025

Abstract Suicide and other “unnatural deaths” are the most dramatic expression of mortality depression, more deaths from depression bipolar spectrum disorders can be attributed to self-neglect careless risk-taking. A framework for relating culture suicide combines Joiner’s interpersonal theory with neuropsychiatric existential considerations availability highly lethal means: an interpersonal-neuropsychiatric model. Collectivist accentuates thwarted belongingness in those ostracized or bullied. shame and/or “face” contribute perceived burdensomeness. Cultural normalization, rationalization, romanticization increases acquired capacity suicide. Activation inhibition, pain pleasure relate its structural correlates. Mediators include formal education informal acculturation, normalized trauma, lifestyle-related occupation-related illness injury, culturally sanctioned substance use. Religious spiritual perspectives national, regional, ethnic cultures associated hope reasons live.

Language: Английский

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