Magnetic resonance spectroscopic measurement of cerebral gamma-aminobutyric acid concentrations in patients with bipolar disorders

2006 ◽  
Vol 18 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Po W. Wang ◽  
Napapon Sailasuta ◽  
Rebecca A. Chandler ◽  
Terence A. Ketter
Keyword(s):  
Bipolar Disorder ◽  
Magnetic Resonance ◽  
Mood Disorders ◽  
Bipolar Disorders ◽  
Occipital Lobe ◽  
Gabaergic Neurotransmission ◽  
Control Subjects ◽  
Bipolar Ii ◽  
Healthy Control ◽  
Cr Concentration

Background:Animal models of depression and psychopharmacological mechanisms of action suggest the importance of the gamma-amino butyric acid (GABA) system in the pathophysiology of mood disorders. Mood stabilizers have overlapping effects on GABAergic neurotransmission, and antidepressant use has been associated with alterations in GABAB receptor function. Magnetic resonance spectroscopy (MRS) provides an opportunity to noninvasively assess cerebral GABA concentrations in anterior paralimbic circuits that have been implicated in mood disorders.Methods:In bipolar disorder patients and healthy control subjects, we used MRS with a modified GABA-edited point resolved spectroscopy sequence (TE 68 ms, TR 1500 ms, 512 averages, total scan time 26 min) to assess GABA in an 18-cm3 occipital voxel. In addition, in another cohort of bipolar disorder patients and healthy control subjects, we similarly assessed GABA in a 12.5-cm3 medial prefrontal/anterior cingulate (MPF/AC) voxel. The concentration of GABA was referenced to creatine (Cr) from unedited spectra.Results:In bipolar patients and controls, we consistently detected 3.0 p.p.m. GABA peaks in occipital lobe and MPF/AC. In 16 bipolar (nine bipolar I and seven bipolar II) disorder patients, compared with six healthy control subjects, mean occipital GABA/Cr concentration was 61% higher. In addition, in 15 bipolar (five bipolar I, nine bipolar II, and one bipolar not otherwise specified) disorder patients, compared with six healthy control subjects, mean MPF/AC GABA/Cr concentration tended to be 41% higher.Conclusions:Patients with bipolar disorders may have increased cerebral GABA concentrations. Although this was more evident in the occipital lobe, MPC/AC GABA disturbance may be of greater potential interest in view the more established role of MPF/AC in affective processing. Additional studies are warranted to assess changes in GABAergic neurotransmission and the influences of diagnosis, mood state, and medication status in bipolar disorder patients.

Pain perception in patients with bipolar disorder and schizophrenia

2007 ◽  
Vol 19 (5) ◽  
pp. 284-290 ◽  
Author(s):  
Levent Atik ◽  
Numan Konuk ◽  
Omer Akay ◽  
Devrim Ozturk ◽  
Ayten Erdogan
Keyword(s):  
Bipolar Disorder ◽  
Pain Perception ◽  
Cold Pressor Test ◽  
Bipolar Disorders ◽  
Cold Pressor ◽  
Study Groups ◽  
Pain Tolerance ◽  
Control Subjects ◽  
Lower Pain ◽  
Healthy Control

Objective:Pain perception is reported to be altered in patients with depression and schizophrenia. However, few studies have investigated the pain perception in patients with bipolar disorders. We therefore aimed to compare pain sensitivity between patients with bipolar disorder, schizophrenia and controls.Methods:Study groups consisted of 30 patients with bipolar disorder, and control groups consisted of 27 patients with schizophrenia and 59 healthy subjects. Pain perception was assessed with cold pressor test (CPT) by exposure to ice-water.Results:Patients with schizophrenia had significantly higher pain thresholds (PTh) than patients with bipolar disorder. There were no differences between the PTh of patients with schizophrenia and healthy control subjects. However, patients with bipolar disorder had significantly lower pain tolerance (PT) in the CPT than patients with schizophrenia and corresponding healthy control subjects.Conclusions:The higher PTh in the schizophrenia group compared with the bipolar group found in this study supports further investigation of a potential difference in the pain perception between patients with schizophrenia and bipolar disorder. Theoretical implications of these findings and possible relevant behavioural and neurochemical mechanisms are discussed.

Polarised views about bipolar disorder(s): A critique of the 2020 College guidelines for mood disorders

2021 ◽  
pp. 000486742110200
Author(s):  
Gordon Parker
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
International Classification Of Diseases ◽  
Bipolar Ii Disorder ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Bipolar Ii ◽  
Classification Of Diseases ◽  
Formal Status

The 2020 College guidelines for mood disorders banish bipolar II disorder – despite its formal status in Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases manuals for more than two decades – and argue that there is no need to partition bipolar disorder into separate sub-types. Their single-entity model is seemingly based on opinion rather than any support from referenced scientific studies. The author challenges the Committee’s model of there being only one bipolar disorder and argues that it presents several clinical management risks, particularly of ‘over-treatment’.

Cytokine Polymorphisms in the Pathophysiology of Mood Disorders

CNS Spectrums ◽  
2009 ◽  
Vol 14 (8) ◽  
pp. 419-425 ◽  
Author(s):  
Mario Clerici ◽  
Beatrice Arosio ◽  
Emanuela Mundo ◽  
Elisabetta Cattaneo ◽  
Sara Pozzoli ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Lower Percentage ◽  
Genetic Profile ◽  
Type I ◽  
Genotype Distribution ◽  
Bipolar Ii ◽  
Tnf Α ◽  
Ifn Γ ◽  
Disorder Type

ABSTRACTIntroduction: An increasing amount of data suggests that dysregulation of the immune system, including the cytokine network, is associated with the etiology and pathophysiology of mood disorders. Genes encoding cytokines are highly polymorphic and single nucleotide polymorphisms, associated with increased or reduced cytokine production, have been described. The aim of this study was to define the genetic immunologic scenario associated with major depressive disorder (MDD) and bipolar disorder.Methods: Eighty-four Italian outpatients affected by bipolar disorder type I, bipolar disorder type II, or MDD, and 363 healthy controls were enrolled into the study. We analyzed allele and genotype distribution of −308 (G/A) tumor necrosis factor-α (TNF-α), +874 (T/A) interferon-γ (IFN-γ), -174 (G/C) interleukin (IL)-6, and −1082 (G/A) IL-10 promoter polymorphisms by Polymerase Chain Reaction Sequence Specific Primers technique.Results: We observed different genotype and allele distributions of TNF-α, IFN-γ, and IL-10 polymorphisms in the three groups of patients analyzed. In particular, bipolar II patients were characterized by an absence of adenine (A) high producer allele of TNF-α (P<.001) and a lower percentage of TT high producer genotype of IFN-γ (P <.001); bipolar I individuals showed reduced percentage of AA low producer genotype of IL-10 (P<.001). Both bipolar I and bipolar II patients not carrying guanine (G) high producer IL-6 allele showed a lower mean age at onset (P=.048).Conclusion: These data support the existence of a genetic profile related to pro-inflammatory cytokines in patients affected by mood disorders. The differences observed across the three clinical phenotypes suggest the presence of different pathogenetic mechanisms involved in the susceptibility of phenotypically different mood disorders.

scholarly journals Nrf2 Dysregulation in Major Depressive and Bipolar Disorders

2021 ◽  
Vol 10 ◽  
pp. e2074
Author(s):  
Maryam Ghanbarirad ◽  
Mehrdad Hashemi ◽  
Seyed Mehdi Saberi ◽  
Ahmad Majd
Keyword(s):  
Mental Disorders ◽  
Defense Mechanisms ◽  
Bipolar Disorders ◽  
Expression Level ◽  
Control Group ◽  
Roc Curve Analysis ◽  
Major Depressive ◽  
Control Subjects ◽  
Healthy Control ◽  
Nrf2 Expression

Background: Major depressive disorder (MDD) and bipolar disorder (BPD) are two of the most important mental disorders that greatly impact different aspects of life. These conditions imply heavy health and economic burden and are heterogeneous in nature. Inflammation is reported as the etiology of mental disorders. Nrf2 transcription factor plays a key role in the defense mechanisms against inflammation and oxidative stress. So, this study aimed to evaluate the expression level of Nrf2 in MDD and BPD patients and compared it with healthy control subjects. Materials and Methods: In this study, real-time PCR was conducted to evaluate the expression level of Nrf2 in 100 MDD and 100 BPD patients compared to 100 healthy control subjects. Statistical analysis conducted on GraphPad Prism 8 and SPSS21 included ANOVA, Tukey’s test, receiver operating characteristic (ROC), and odds ratio. Results: Results suggest a significant downregulation of Nrf2 in these conditions compared to the control group. ROC curve analysis demonstrates Nrf2 as a biomarker of these psychiatric disorders. Conclusion: The elevated levels of reactive oxygen species and downregulation of detoxifying enzymes were observed in MDD and BPD, which can be associated with the downregulation of Nrf2. Concerning its role in inflammatory response pathways, alternation of Nrf2 expression can be associated with the pathology of these conditions.

Sleep spindles in bipolar disorder - a comparison to healthy control subjects

2018 ◽  
Vol 138 (2) ◽  
pp. 163-172 ◽  
Author(s):  
P. S. Ritter ◽  
J. Schwabedal ◽  
M. Brandt ◽  
W. Schrempf ◽  
F. Brezan ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Sleep Spindles ◽  
Control Subjects ◽  
Healthy Control

Introduction to mood disorders

2012 ◽  
pp. 629-632
Author(s):  
John R. Geddes
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Subsequent Development ◽  
Bipolar Disorders ◽  
Early History ◽  
Diagnostic Systems ◽  
Psychiatric Nosology ◽  
Future Developments ◽  
Mood Depression

The concept of mood is difficult to define. In psychiatry, it has come to mean a pervasive emotional tone varying along an axis from happiness to sadness—and perhaps anxiety. The boundaries between normal and abnormal mood are equally difficult to define. Nonetheless, there is usually no doubt about the most extreme manifestations of low mood, depression, or elevated mood, mania. This chapter begins by discussing the early history and subsequent development of modern psychiatric nosology. It then covers the distinction between unipolar and bipolar disorders, modern diagnostic systems and the birth of diagnostic criteria, subgroups of unipolar and bipolar disorder, and likely future developments in the classification of mood disorders.

The Use of Antiepileptic Drugs in Bipolar Disorders: A Review Based on Evidence From Controlled Trials

CNS Spectrums ◽  
2006 ◽  
Vol 11 (10) ◽  
pp. 788-799 ◽  
Author(s):  
Richard H. Weisler ◽  
Andrew J. Cutler ◽  
James C. Ballenger ◽  
Robert M. Post ◽  
Terence A. Ketter
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Antiepileptic Drugs ◽  
Bipolar Disorders ◽  
Acute Mania ◽  
Controlled Trials ◽  
Rapid Cycling ◽  
Comorbid Conditions ◽  
United States Food ◽  
States Food

ABSTRACTAntiepileptic drugs (AEDs) have diverse psychotropic profiles. Some AEDs have proven to be efficacious in the treatment of mood disorders, especially bipolar disorder. Others are ineffective as primary treatments but may be useful adjuncts for mood disorders or comorbid conditions. Valproate (acute mania and mixed episodes), carbamazepine (acute mania and mixed episodes), and lamotrigine (maintenance to delay recurrence) have United States Food and Drug Administration indications for the treatment of bipolar disorder. This article provides an overview of data on the use of AEDs in bipolar disorder, including acute mania and depression, prophylaxis, and rapid cycling.

scholarly journals Cerebral Metabolism of Patients with Stenosis of the Internal Carotid Artery before and after Endarterectomy

1996 ◽  
Vol 16 (2) ◽  
pp. 320-326 ◽  
Author(s):  
J. van der Grond ◽  
R. Balm ◽  
C. J. M. Klijn ◽  
L. J. Kappelle ◽  
B. C. Eikelboom ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Carotid Endarterectomy ◽  
Internal Carotid ◽  
Cerebral Metabolism ◽  
Control Subjects ◽  
Increased Risk ◽  
Before And After ◽  
Healthy Control ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

Occlusion or severe stenosis, with a reduction in the diameter of more than 70% of the extracranial arteries may lead to hypoperfusion of the brain with an increased risk of cerebral infarction. The aim of this study was to investigate whether endarterectomy of stenosed internal carotid arteries leads to alterations in cerebral metabolism in regions in which no infarcts were visible with magnetic resonance imaging (MRI). We studied 10 healthy control subjects and 20 patients with transient or nondisabling cerebral ischemia with MRI and 1H magnetic resonance spectroscopic imaging. All patients underwent carotid endarterectomy. Patients were examined 1 week before and 3–6 months after carotid endarterectomy. The N-acetyl aspartate (NAA)/choline ratio in the symptomatic hemisphere before endarterectomy (2.29 ± 0.42) was significantly ( p < 0.001) lower than for control subjects (3.18 ± 0.32). In five of the patients lactate was detected preoperatively in regions that were not infarcted. The NAA/choline ratio in the symptomatic hemisphere of these five patients did not increase significantly after endarterectomy (1.99 ± 0.22 vs. 2.23 ± 0.48). The NAA/choline ratio in patients without lactate preoperatively increased significantly ( p < 0.01) after endarterectomy to a normal level (from 2.39 ± 0.42 to 2.92 ± 0.52). These results indicate that the presence of cerebral lactate may predict whether the NAA/choline ratio increases after carotid endarterectomy.

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