Predominant polarity as a neurobiological specifier in bipolar disorder: Evidence from a multimodal neuroimaging study.

Humans Bipolar Disorder / diagnostic imaging Brain / diagnostic imaging Cerebral Cortex Prefrontal Cortex Neuroimaging Magnetic Resonance Imaging / methods
Bipolar disorder Cortical thickness Onset polarity Predominant polarity Tractography Volume

Journal

Progress in neuro-psychopharmacology & biological psychiatry
ISSN: 1878-4216
Titre abrégé: Prog Neuropsychopharmacol Biol Psychiatry
Pays: England
ID NLM: 8211617

Informations de publication

Date de publication:
20 04 2023
Historique:
received: 04 07 2022
revised: 28 11 2022
accepted: 06 01 2023
pubmed: 13 1 2023
medline: 8 2 2023
entrez: 12 1 2023
Statut: ppublish

Résumé

While predominant (PP) and onset polarity (OP) have considerable clinical and treatment implications in bipolar disorder (BD), the neurobiological underpinnings of PP and OP from a radiological perspective remain largely unknown. The main objective of this study is to investigate the neuroanatomical profile of polarity subphenotypes (PP and OP) in euthymic BD patients, using a standardized multimodal neuroimaging protocol to evaluate regional gray matter (GM) volumes, cortical thickness, as well as white matter (WM) integrity of major projection, commissural and association tracts. Forty-two euthymic BD patients stratified for PP and OP and 42 healthy controls (HC) were included in this computational neuroimaging study to comprehensively characterize gray and white matter alterations. Univariate analyses of covariance (ANCOVAs) were conducted with Bonferroni corrections for each MRI modality and Cohen's d effect sizes were calculated for group comparisons. Phenotype-associated cortical thickness abnormalities and volumetric alterations were identified, but no WM changes ascertained. Specifically, we found a main effect of OP on GM volume of left middle frontal gyrus and of OP and PP (either or both) on cortical thickness of various regions previously implicated in BD, i.e. inferior frontal gyrus-pars opercularis (left) and pars orbitalis (bilateral), left lateral orbitofrontal gyrus, bilateral medial segment of the superior frontal gyrus, left planum polare, right anterior cingulate gyrus, left anterior and posterior insula, bilateral frontal operculum (both OP and PP); left anterior and posterior orbitofrontal gyrus, left transverse temporal gyrus, right posterior insula (only OP); and right medial frontal cortex (only PP). Based on the magnitude of differences on pairwise comparisons, we found a large effect of OP on cortical thickness in a single region (left anterior orbitofrontal gyrus) (OP-M > OP-D), while PP subgroups showed large or medium effect size differences in cortical thickness (PP-M > PP-D) in a wider array of regions (right medial frontal cortex, left frontal operculum, left inferior frontal gyrus-pars opercularis, bilateral medial segment of the superior frontal gyrus). For most regions, PP-D patients showed the greatest decreases in cortical thickness compared to HC while PP-M showed the smallest, with PP-U showing an "unspecified" pattern mostly lying in-between PP-D and PP-M. Our multimodal imaging findings suggest specific polarity BD subgroups with compromised cortical thickness; we recorded a greater impact of PP on brain structure compared to OP, which provides additional evidence that PP can be considered as a neurobiological specifier in BD.

Sections du résumé

BACKGROUND
While predominant (PP) and onset polarity (OP) have considerable clinical and treatment implications in bipolar disorder (BD), the neurobiological underpinnings of PP and OP from a radiological perspective remain largely unknown. The main objective of this study is to investigate the neuroanatomical profile of polarity subphenotypes (PP and OP) in euthymic BD patients, using a standardized multimodal neuroimaging protocol to evaluate regional gray matter (GM) volumes, cortical thickness, as well as white matter (WM) integrity of major projection, commissural and association tracts.
METHODS
Forty-two euthymic BD patients stratified for PP and OP and 42 healthy controls (HC) were included in this computational neuroimaging study to comprehensively characterize gray and white matter alterations. Univariate analyses of covariance (ANCOVAs) were conducted with Bonferroni corrections for each MRI modality and Cohen's d effect sizes were calculated for group comparisons.
RESULTS
Phenotype-associated cortical thickness abnormalities and volumetric alterations were identified, but no WM changes ascertained. Specifically, we found a main effect of OP on GM volume of left middle frontal gyrus and of OP and PP (either or both) on cortical thickness of various regions previously implicated in BD, i.e. inferior frontal gyrus-pars opercularis (left) and pars orbitalis (bilateral), left lateral orbitofrontal gyrus, bilateral medial segment of the superior frontal gyrus, left planum polare, right anterior cingulate gyrus, left anterior and posterior insula, bilateral frontal operculum (both OP and PP); left anterior and posterior orbitofrontal gyrus, left transverse temporal gyrus, right posterior insula (only OP); and right medial frontal cortex (only PP). Based on the magnitude of differences on pairwise comparisons, we found a large effect of OP on cortical thickness in a single region (left anterior orbitofrontal gyrus) (OP-M > OP-D), while PP subgroups showed large or medium effect size differences in cortical thickness (PP-M > PP-D) in a wider array of regions (right medial frontal cortex, left frontal operculum, left inferior frontal gyrus-pars opercularis, bilateral medial segment of the superior frontal gyrus). For most regions, PP-D patients showed the greatest decreases in cortical thickness compared to HC while PP-M showed the smallest, with PP-U showing an "unspecified" pattern mostly lying in-between PP-D and PP-M.
CONCLUSIONS
Our multimodal imaging findings suggest specific polarity BD subgroups with compromised cortical thickness; we recorded a greater impact of PP on brain structure compared to OP, which provides additional evidence that PP can be considered as a neurobiological specifier in BD.

Identifiants

DOI: 10.1016/j.pnpbp.2023.110718 PMID: 36634808
pubmed: 36634808
pii: S0278-5846(23)00004-0
doi: 10.1016/j.pnpbp.2023.110718
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

110718

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest GDA has no conflict of interest. FC has no conflict of interest. EK has no conflict of interest. PB has no conflict of interest. AA has no conflict of interest. GV has no conflict of interest. IS has no conflict of interest. NK has no conflict of interest. NS has no conflict of interest. OP has no conflict of interest. EE has no conflict of interest. PF has no conflict of interest.

Auteurs

Georgios D Argyropoulos (GD)

Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Foteini Christidi (F)

2nd Department of Psychiatry, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Medical Physics Laboratory, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: christidi.f.a@gmail.com.

Efstratios Karavasilis (E)

Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.

Peter Bede (P)

Department of Neurology, St James's Hospital, Dublin, Ireland; Computational Neuroimaging Group, Trinity College Dublin, Ireland.

Anastasia Antoniou (A)

2nd Department of Psychiatry, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Georgios Velonakis (G)

Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Ioannis Seimenis (I)

Medical Physics Laboratory, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Nikolaos Kelekis (N)

Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Nikolaos Smyrnis (N)

2nd Department of Psychiatry, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Olympia Papakonstantinou (O)

Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Efstathios Efstathopoulos (E)

Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Panagiotis Ferentinos (P)

2nd Department of Psychiatry, Attikon General University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Predominant polarity as a neurobiological...
questionsmedicales.fr › Troubles mentaux › Troubles de l'humeur › Troubles bipolaires et apparentés › Trouble bipolaire › Predominant polarity as a neurobiological...
questionsmedicales.fr › Système nerveux › Système nerveux central › Encéphale › Predominant polarity as a neurobiological...
questionsmedicales.fr › Système nerveux › Système nerveux central › Encéphale › Prosencéphale › Télencéphale › Cerveau › Cortex cérébral › Predominant polarity as a neurobiological...
questionsmedicales.fr › Système nerveux › Système nerveux central › Encéphale › Prosencéphale › Télencéphale › Cerveau › Cortex cérébral › Lobe frontal › Cortex préfrontal › Predominant polarity as a neurobiological...
questionsmedicales.fr › Techniques d'investigation › Neuroimagerie › Predominant polarity as a neurobiological...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Tomographie › Imagerie par résonance magnétique › Predominant polarity as a neurobiological...