Cerebral blood flow in bipolar disorder: A systematic review

Toma, Simina; MacIntosh, Bradley J.; Swardfager, Walter; Goldstein, Benjamin I.

doi:10.1016/j.jad.2018.08.040

Cited by 64 publications

(51 citation statements)

References 104 publications

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“…While our study demonstrated significantly increased perfusion fluctuations chiefly in the inferior temporal and temporal pole regions, it detected no significant time averaged perfusion change in bipolar patients when compared to healthy controls. This is consistent with a meta‐analysis of blood flow studies in bipolar disorder, which found no consistent results in euthymic patients. Decreased perfusion in temporal lobes has been reported in both unipolar and bipolar depression .…”

Section: Discussionsupporting

confidence: 90%

“…Many studies using measures linked to cerebral perfusion (blood flow) have been reported in BD. Some such studies using positron emission tomography (PET) and single photon emission computed tomography (SPECT) have reported reduced perfusion in BD patients in frontal, parietal and temporal cortical and subcortical regions, but a recent meta‐analysis finds little consistency . Fluctuations in brain function and their regional temporal correlations have been predominantly studied using blood‐oxygen‐level dependent (BOLD) functional magnetic resonance imaging (fMRI) .…”

Section: Introductionmentioning

confidence: 99%

“…Anterior cingulate cortex (ACC) and orbitofrontal cortex (OFC) in the PFC, known to be involved in the cognitive and emotional control, are among the investigated regions of BD deficits. In fact, BD patients have shown deficits in the ACC and OFC regions from brain structural, functional, neuropathological and as inferred indirectly from neuropsychological studies . Altered connectivity with the ACC and OFC regions has been reported sporadically in BD at rest or during challenge tasks .…”

Section: Introductionmentioning

confidence: 99%

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Abnormal perfusion fluctuation and perfusion connectivity in bipolar disorder measured by dynamic arterial spin labeling

et al. 2019

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Objectives:We sought to evaluate whether dynamic Arterial Spin Labeling (dASL), a novel quantitative technique robust to artifacts and noise that especially arise in inferior brain regions, could characterize neural substrates of BD pathology and symptoms.Methods: Forty-five subjects (19 BD patients, 26 controls) were imaged using a dASL sequence. Maps of average perfusion, perfusion fluctuation, and perfusion connectivity with anterior cingulate cortex (ACC) were derived. Patient symptoms were quantified along four symptom dimensions determined using factor analysis of the subjects from the Bipolar and Schizophrenia Network on Intermediate Phenotypes (BSNIP) study. Maps of the perfusion measures were compared between BD patients and controls and correlated with the symptom dimensions in the BD patients only by voxel-level and region-level analyses. Results: BD patients exhibited (i) significantly increased perfusion fluctuations in the left fusiform and inferior temporal regions (P = .020, voxel-level corrected) and marginally increased perfusion fluctuations in the right temporal pole and inferior temporal regions (P = .063, cluster-level corrected), (ii) significantly increased perfusion connectivity between ACC and the occipitoparietal cortex (P = .050, clusterlevel corrected). In BD patients, positive symptoms were negatively associated with ACC perfusion connectivity to the right orbitofrontal and superior frontal regions (P = .002, cluster-level corrected) and right orbitofrontal and inferior frontal regions (P = .023, cluster-level corrected). Conclusion: The abnormal perfusion fluctuations and connectivity alterations may underlie the mood fluctuations and cognitive and emotional dysregulation that characterize BD. K E Y W O R D S arterial spin labeling, bipolar disorder, functional connectivity, perfusion fluctuation, symptom dimension S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. How to cite this article: Dai W, Chen M, Duan W, et al Abnormal perfusion fluctuation and perfusion connectivity in bipolar disorder measured by dynamic arterial spin labeling.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Abnormal perfusion fluctuation and perfusion connectivity in bipolar disorder measured by dynamic arterial spin labeling

et al. 2019

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“…However, a randomized cross‐over design was utilized in this investigation to allow each individual to be their own control across each condition. This is a strength of the methodology as this substantially reduces the likelihood any confounding effects may influence the results due to a small number of subjects, such as history of concussion/subconcussive impacts (Wright et al, ), cardiorespiratory fitness levels (Labrecque et al, ), history of migraines (Knol et al, ), and mood disorders (Toma, MacIntosh, Swardfager, & Goldstein, ), etc. Therefore, despite the smaller sample size, the results are highly valid, as there is a reduced likelihood that any extraneous variables may influence the results given the methodology employed.…”

Section: Discussionmentioning

confidence: 99%

Dynamic cerebral autoregulation across the cardiac cycle during 8 hr of recovery from acute exercise

et al. 2020

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Current protocols examining cerebral autoregulation (CA) parameters require participants to refrain from exercise for 12–24 hr, however there is sparse objective evidence examining the recovery trajectory of these measures following exercise across the cardiac cycle (diastole, mean, and systole). Therefore, this study sought to determine the duration acute exercise impacts CA and the within‐day reproducibility of these measures. Nine participants performed squat–stand maneuvers at 0.05 and 0.10 Hz at baseline before three interventions: 45‐min moderate‐continuous exercise (at 50% heart‐rate reserve), 30‐min high‐intensity intervals (ten, 1‐min at 85% heart‐rate reserve), and a control day (30‐min quiet rest). Squat–stands were repeated at hours zero, one, two, four, six, and eight after each condition. Transcranial doppler ultrasound of the middle cerebral artery (MCA) and the posterior cerebral artery (PCA) was used to characterize CA parameters across the cardiac cycle. At baseline, the systolic CA parameters were different than mean and diastolic components (ps < 0.015), however following both exercise protocols in both frequencies this disappeared until hour four within the MCA (ps > 0.079). In the PCA, phase values were affected only following high‐intensity intervals until hour four (ps > 0.055). Normalized gain in all cardiac cycle domains remained different following both exercise protocols (ps < 0.005) and across the control day (p < .050). All systolic differences returned by hour six across all measures (ps < 0.034). Future CA studies may use squat–stand maneuvers to assess the cerebral pressure–flow relationship 6 hr after exercise. Finally, CA measures under this paradigm appear to have negligible within‐day variation, allowing for reproducible interpretations to be drawn.

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“…Various brain‐imaging techniques, such as arterial spin labeling, perfusion‐weighted imaging, positron emission tomography, and single photon emission computed tomography, have determined perfusion abnormalities that are particularly more severe during bipolar disorder (BD) episodes . Retinal fundus imaging is a noninvasive reliable method that can provide information about the cerebral microvascular system .…”

Section: Comparison Of the Retinal Measures And Growth Factor Levels mentioning

confidence: 99%

Retinal fundus imaging in bipolar disorder: A pilot study

Yusifova

Atagün

Uğurlu

et al. 2019

Psychiatry Clin Neurosci

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Cerebral blood flow in bipolar disorder: A systematic review

Cited by 64 publications

References 104 publications

Abnormal perfusion fluctuation and perfusion connectivity in bipolar disorder measured by dynamic arterial spin labeling

Abnormal perfusion fluctuation and perfusion connectivity in bipolar disorder measured by dynamic arterial spin labeling

Dynamic cerebral autoregulation across the cardiac cycle during 8 hr of recovery from acute exercise

Retinal fundus imaging in bipolar disorder: A pilot study

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