Anterior cingulate cortex abnormalities associated with a first psychotic episode in bipolar disorder

BackgroundThe anterior cingulate cortex is frequently implicated in the pathophysiology of bipolar disorder, but magnetic resonance imaging (MRI) studies have reported variable findings owing to a reliance on patient samples with chronic illness and to limited appreciation of the region's heterogeneity.AimsTo characterise anterior cingulate cortex abnormalities in patients with bipolar disorder experiencing their first episode of psychosis while accounting for regional anatomical variability.MethodGrey matter volume, surface area and cortical thickness were measured in six anterior cingulate cortex subregions per hemisphere using MRI scans acquired from 26 patients with bipolar I disorder experiencing first-episode psychosis and 26 healthy controls matched for age, gender and regional morphological variability.ResultsRelative to controls, male patients displayed increased thickness in the right subcallosal limbic anterior cingulate cortex. No significant differences were identified in females for grey matter volume or surface area measures. The findings were not attributable to medication effects.ConclusionsThese data suggest that first-episode psychosis in bipolar disorder is associated with a gender-specific, right-lateralised thickness increase in anterior cingulate cortex subregions known to play a role in regulating physiological stress responses.

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VARIATION IN GREY MATTER VOLUME WITH DEGREE OF INSIGHT IN FIRST EPISODE PSYCHOSIS AND CHRONIC SCHIZOPHRENIA

Schizophrenia Research ◽

10.1016/j.schres.2010.02.589 ◽

2010 ◽

Vol 117 (2-3) ◽

pp. 340

Author(s):

J. McFarland ◽

D. Cannon ◽

H. Schmidt ◽

M. Ahmed ◽

S. Hehir ◽

...

Keyword(s):

Grey Matter ◽

Chronic Schizophrenia ◽

First Episode Psychosis ◽

First Episode ◽

Grey Matter Volume ◽

Matter Volume ◽

Episode Psychosis

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Resting-state functional connectivity of the striatum predicts improvement in negative symptoms and general functioning in patients with first-episode psychosis: A 1-year naturalistic follow-up study

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867419885452 ◽

2019 ◽

Vol 54 (5) ◽

pp. 509-518 ◽

Cited By ~ 1

Author(s):

Sanghoon Oh ◽

Minah Kim ◽

Taekwan Kim ◽

Tae Young Lee ◽

Jun Soo Kwon

Keyword(s):

Functional Connectivity ◽

Anterior Cingulate Cortex ◽

Negative Symptoms ◽

Primary Motor Cortex ◽

Cingulate Cortex ◽

First Episode Psychosis ◽

Anterior Cingulate ◽

First Episode ◽

Healthy Controls ◽

Episode Psychosis

Objective: The persistent disease burden of psychotic disorders often comes from negative symptoms; however, prognostic biomarkers for negative symptoms have not been fully understood. This study investigated whether the altered functional connectivity of the striatum predicts improvement in negative symptoms and functioning after 1 year of usual treatment in patients with first-episode psychosis. Methods: Resting-state functional magnetic imaging was obtained from 40 first-episode psychosis patients and 40 age- and sex-matched healthy control subjects. Whole-brain functional connectivity maps were generated with subdivisions of the striatum as seed regions and compared between first-episode psychosis patients and healthy controls. In 22 patients with first-episode psychosis, follow-up assessments of negative symptom severity and general functional status were conducted after 1 year of usual treatment. Multiple regression analyses were performed to examine factors predictive of symptomatic or functional improvements over the 1-year period. Results: First-episode psychosis patients showed greater functional connectivity between the left dorsal caudate and left primary motor cortex, as well as between the left ventral rostral putamen and right temporal occipital fusiform cortex, than healthy controls. Lower functional connectivity between the right dorsal rostral putamen and anterior cingulate cortex was observed in the first-episode psychosis patients than in healthy controls. In multiple regression analyses, lower functional connectivity of the left dorsal caudate–left primary motor cortex/right dorsal rostral putamen–anterior cingulate cortex predicted improvement in negative symptoms. In addition, lower right dorsal rostral putamen–anterior cingulate cortex functional connectivity predicted improvement in general functioning. Conclusion: These results suggest that altered striatal functional connectivity can be a potent neurobiological marker in the prognosis prediction of first-episode psychosis. Furthermore, altered striatal functional connectivity may provide a potential target in developing treatments for negative symptoms.

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Serotonin - 1A binding in the subgenual anterior cingulate cortex is associated with regional grey matter volume in striatum and temporal areas

European Psychiatry ◽

10.1016/s0924-9338(11)72639-6 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 934-934

Author(s):

C. Kraus ◽

M. Savli ◽

A. Hahn ◽

P. Baldinger ◽

A. Höflich ◽

...

Keyword(s):

Anterior Cingulate Cortex ◽

Receptor Binding ◽

Emotional Processing ◽

Grey Matter ◽

Ventral Striatum ◽

Cingulate Cortex ◽

Magnetic Resonance Images ◽

Anterior Cingulate ◽

Grey Matter Volume ◽

Matter Volume

IntroductionThe subgenual part of the anterior cingulate cortex (sgACC) has been frequently reported to be structurally and cytoarchitectually changed in major depressive disorder (MDD) and is also a promising target in deep brain stimulation in treatment-resistant MDD. Furthermore, substantial evidence demonstrates a high density of serotonin-1A (5-HT1A) receptors in the sgACC, a key area involved in emotional processing.ObjectivesHere, we investigated the relationship between the 5-HT1A receptor in the sgACC and changes in regional grey matter volume with voxel-based morphometry.MethodsPET ([carbonyl-11C]WAY-100635) was used to quantify 5-HT1A receptor binding (BPND) together with structural magnetic resonance images from 32 healthy subjects (mean 26.68 ± 5.1 years; 17 women). Regression analysis was performed in SPM8 (p < .001 uncorr.) using sgACC 5-HT1A BPND as regressor, controlling for sex, age and total grey matter volume (GMV).Results5-HT1A BPND in the sgACC was positively associated with regional GMV in the medial temporal gyri (T=4.37) and nucleus accumbens bilaterally (T = 4.19). Furthermore, sgACC 5-HT1A binding was negatively correlated with GMV within the inferior temporal gyri (T = 5.22) and putamen bilaterally (T = 5.12).ConclusionsOur findings demonstrate structural relationships between sgACC 5-HT1A receptor binding and grey matter volume in the ventral striatum as well as in temporal regions, which both exhibit close neuronal connections with the sgACC. Moreover, the GMV of the ventral striatum has been reported to be decreased in patients with MDD. Conclusively, our results underpin the role of serotonergic neuronal transmission in cytoarchitectural processes within regions involved in the modulation of mood.

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Duration of untreated psychosis is associated with orbital–frontal grey matter volume reductions in first episode psychosis

Schizophrenia Research ◽

10.1016/j.schres.2010.09.021 ◽

2011 ◽

Vol 125 (1) ◽

pp. 13-20 ◽

Cited By ~ 68

Author(s):

Ashok K. Malla ◽

Michael Bodnar ◽

Ridha Joober ◽

Martin Lepage

Keyword(s):

Grey Matter ◽

First Episode Psychosis ◽

First Episode ◽

Grey Matter Volume ◽

Duration Of Untreated Psychosis ◽

Matter Volume ◽

Episode Psychosis

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Connectivity of the precuneus-posterior cingulate cortex with the anterior cingulate cortex-medial prefrontal cortex differs consistently between control subjects and first-episode psychosis patients during a movie stimulus

Schizophrenia Research ◽

10.1016/j.schres.2018.03.018 ◽

2018 ◽

Vol 199 ◽

pp. 235-242 ◽

Cited By ~ 5

Author(s):

Eva Rikandi ◽

Teemu Mäntylä ◽

Maija Lindgren ◽

Tuula Kieseppä ◽

Jaana Suvisaari ◽

...

Keyword(s):

Prefrontal Cortex ◽

Anterior Cingulate Cortex ◽

Medial Prefrontal Cortex ◽

Cingulate Cortex ◽

First Episode Psychosis ◽

Posterior Cingulate Cortex ◽

Anterior Cingulate ◽

First Episode ◽

Control Subjects ◽

Episode Psychosis

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Network Constraints on Longitudinal Grey Matter Changes in First Episode Psychosis

10.1101/2022.01.11.22268989 ◽

2022 ◽

Author(s):

Sidhant Chopra ◽

Stuart Oldham ◽

Ashlea Segal ◽

Alexander Holmes ◽

Kristina Sabaroedin ◽

...

Keyword(s):

Volume Change ◽

Grey Matter ◽

Structural Connectivity ◽

First Episode Psychosis ◽

First Episode ◽

Control Group ◽

Grey Matter Volume ◽

Volume Changes ◽

Matter Volume ◽

Episode Psychosis

Background: Different regions of the brain's grey matter are connected by a complex structural network of white matter fibres which are responsible for the propagation of action potentials and the transport of trophic and other molecules. In neurodegenerative disease, these connections constrain the way in which grey matter volume loss progresses. Here, we investigated whether connectome architecture also shapes the spatial pattern of longitudinal grey matter volume changes attributable to illness and antipsychotic medication in first episode psychosis (FEP). Methods: We conducted a triple-blind randomised placebo-control MRI study where 62 young adults with first episode psychosis received either an atypical antipsychotic or placebo over 6-months. A healthy control group was also recruited. Anatomical MRI scans were acquired at baseline, 3-months and 12-months. Deformation-based morphometry was used to estimate illness-related and antipsychotic-related grey matter volume changes over time. Representative functional and structural brain connectivity patterns were derived from an independent healthy control group using resting-state functional MRI and diffusion-weighted imaging. We used neighbourhood deformation models to predict the extent of brain change in a given area by the changes observed in areas to which it is either structurally connected or functionally coupled. Results: At baseline, we found that empirical illness-related regional volume differences were strongly correlated with predicted differences using a model constrained by structural connectivity weights (ρ = .541; p < .001). At 3-months and 12-months, we also found a strong correlation between longitudinal regional illness-related (ρ > .516; p < .001) and antipsychotic-related volume change (ρ > .591; p < .001) with volumetric changes in structurally connected areas. These correlations were significantly greater than those observed across various null models accounting for lower-order spatial and network properties of the data. Associations between empirical and predicted volume change estimates were much lower for models that only considered binary structural connectivity (all ρ < .376), or which were constrained by inter-regional functional coupling (all ρ < .436). Finally, we found that potential epicentres of volume change emerged posteriorly early in the illness and shifted to the prefrontal cortex by later illness stages. Conclusion: Psychosis- and antipsychotic-related grey matter volume changes are strongly shaped by anatomical brain connectivity. This result is consistent with findings in other neurological disorders and implies that such connections may constrain pathological processes causing brain dysfunction in FEP.

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Depressive symptom in the first-episode schizophrenic patients is related to the reduction of grey matter volume in the subgenual anterior cingulate cortex - a pilot study

Oncotarget ◽

10.18632/oncotarget.24180 ◽

2018 ◽

Vol 0 (0) ◽

Author(s):

Jiaojiao Xu ◽

Xibo He ◽

Ce Chen ◽

Hongjun Tian ◽

Lina Wang ◽

...

Keyword(s):

Depressive Symptom ◽

Pilot Study ◽

Anterior Cingulate Cortex ◽

Grey Matter ◽

Anterior Cingulate ◽

First Episode ◽

Grey Matter Volume ◽

Subgenual Anterior Cingulate Cortex ◽

Matter Volume ◽

Schizophrenic Patients

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A review of altered biochemistry in the anterior cingulate cortex of first-episode psychosis

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796016000895 ◽

2017 ◽

Vol 26 (2) ◽

pp. 122-128 ◽

Cited By ~ 3

Author(s):

L. Squarcina ◽

J. A. Stanley ◽

M. Bellani ◽

C. A. Altamura ◽

P. Brambilla

Keyword(s):

Anterior Cingulate Cortex ◽

Psychotic Disorders ◽

Cingulate Cortex ◽

First Episode Psychosis ◽

Anterior Cingulate ◽

First Episode ◽

Resonance Spectroscopy ◽

Chronic Patients ◽

Episode Psychosis

Relevant biochemicals of the brain can be quantified in vivo, non-invasively, using proton Magnetic Resonance Spectroscopy (¹H MRS). This includes metabolites associated with neural general functioning, energetics, membrane phospholipid metabolism and neurotransmission. Moreover, there is substantial evidence of implication of the frontal and prefrontal areas in the pathogenesis of psychotic disorders such as schizophrenia. In particular, the anterior cingulate cortex (ACC) plays an important role in cognitive control of emotional and non-emotional processes. Thus the study of its extent of biochemistry dysfunction in the early stages of psychosis is of particular interest in gaining a greater understanding of its aetiology. In this review, we selected ¹H MRS studies focused on the ACC of first-episode psychosis (FEP). Four studies reported increased glutamatergic levels in FEP, while other four showed preserved concentrations. Moreover, findings on FEP do not fully mirror those in chronic patients. Due to conflicting findings, larger longitudinal ¹H MRS studies are expected to further explore glutamatergic neurotransmission in ACC of FEP in order to have a better understanding of the glutamatergic mechanisms underlying psychosis, possibly using ultra high field MR scanners.

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