Frontotemporal Alterations in Pediatric Bipolar Disorder

Dickstein, Daniel P.; Milham, Michael P.; Nugent, Allison C.; Drevets, Wayne C.; Charney, Dennis S.; Pine, Daniel S.; Leibenluft, Ellen

doi:10.1001/archpsyc.62.7.734

Cited by 245 publications

(193 citation statements)

References 84 publications

(109 reference statements)

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“…While it is notable that in several studies reporting small ACC volumes, patients with MDD were free of medication for periods ranging between 2 and 4 weeks (Drevets et al, 1997;Lavretsky et al, 2007;Caetano et al, 2006;Ballmaier et al, 2004); it is unknown whether the withdrawal of antidepressants influenced the pattern of findings reported. Medication history is an important factor in studies of patients with MDD (Dickstein et al, 2005;Strasser et al, 2005;Frazier et al, 2005;Rajkowska, 2002) and our data further support the notion that even relatively short-term treatment may exert a measurable effect on the volumes of key brain regions.…”

Section: Discussionsupporting

confidence: 82%

Anterior Cingulate Volumes in Never-Treated Patients with Major Depressive Disorder

Yücel

McKinnon

Chahal

et al. 2008

Neuropsychopharmacol

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The anterior cingulate cortex (ACC) is implicated in the cognitive and affective abnormalities observed in mood disorders. Bilateral ACC volume reductions have been reported in patients with major depressive disorder (MDD) when compared to healthy controls. We compared regional brain volumes in the subgenual prefrontal cortex (SGPFC; Brodmann area (BA) 24 sg ), subcallosal gyrus (BA25), and paracingulate gyrus (BA32) in 65 patients receiving a first course of treatment for MDD and 93 healthy control subjects. Patients with more than three episodes of untreated MDD had smaller subcallosal gyrus volumes than healthy controls, while those with three or fewer past untreated episodes did not differ from controls. We also found preliminary evidence that medication-exposed patients had smaller SGPFC volumes than patients with no exposure to medication and healthy controls. There was no evidence that these effects related to mood state, duration of untreated illness, or to patient age. No differences were apparent in paracingulate gyrus volumes between patients and controls. These findings confirm the presence of ACC volume reductions in untreated patients with MDD and suggest that illness burden and short-term medication exposure mediate this change.

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Section: Discussionsupporting

confidence: 82%

Anterior Cingulate Volumes in Never-Treated Patients with Major Depressive Disorder

Yücel

McKinnon

Chahal

et al. 2008

Neuropsychopharmacol

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“…As mentioned above, the most prominent reduction is reported in the left (but not right) subgenual prefrontal cortex. An increase in the size of the third ventricle also has been consistently reported in patients with bipolar disorder, suggesting volumetric re-duction of the thalamus and hypothalamus (reviewed in Beyer et al, 2004; 76 Manji et al, 2003 77 ).…”

Section: Volumetric Studies In Mood Disordersmentioning

confidence: 86%

“…Dickstein et al (2005) 76 noted reductions in the left DLPFC and, to a lesser extent, in the left accumbens and left amygdala among a group of 20 BD subjects. Amygdalar volume reduction has been reported in a group of 20 children and adolescents with MDD (Rosso et al, 2005).…”

Section: Volumetric Studies In Mood Disordersmentioning

confidence: 94%

Neural circuitry and neuroplasticity in mood disorders: Insights for novel therapeutic targets

Carlson¹,

Singh²,

Zarate³

et al. 2006

NeuroRX

Self Cite

132

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Summary:Major depressive disorder and bipolar disorder are severe mood disorders that affect the lives and functioning of millions each year. The majority of previous neurobiological research and standard pharmacotherapy regimens have approached these illnesses as purely neurochemical disorders, with particular focus on the monoaminergic neurotransmitter systems. Not altogether surprisingly, these treatments are inadequate for many individuals afflicted with these devastating illnesses. Recent advances in functional brain imaging have identified critical neural circuits involving the amygdala and other limbic structures, prefrontal cortical regions, thalamus, and basal ganglia that modulate emotional behavior and are disturbed in primary and secondary mood disorders. Growing evidence suggests that mechanisms of neural plasticity and cellular resilience, including impairments of neurotrophic signaling cascades as well as altered glutamatergic and glucocorticoid signaling, underlie the dysregulation in these circuits. The increasing ability to monitor and modulate activity in these circuits is beginning to yield greater insight into the neurobiological basis of mood disorders. Modulation of dysregulated activity in these affective circuits via pharmacological agents that enhance neuronal resilience and plasticity, and possibly via emerging nonpharmacologic, circuitry-based modalities (for example, deep brain stimulation, magnetic stimulation, or vagus nerve stimulation) offers promising targets for novel experimental therapeutics in the treatment of mood disorders.

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“…Research employing a statistical parametric mapping approach also revealed reduced gray matter density in the fronto-limbic cortex, particularly in the cingulate [12,13], and in Bearden and colleagues' study [5] greatest differences in gray matter density were found in the bilateral cingulate and paralimbic cortices in lithium-treated bipolar patients (n=20) compared to those not taking lithium (n=8) and healthy controls (n=28). The DLPFC is an understudied region in bipolar disorder, with one study [14] showing significantly smaller gray matter volumes in the left middle and superior, and the right middle and inferior prefrontal regions in 17 bipolar patients hospitalized for a manic episode and receiving various psychotropic medications, and another study demonstrating decreased gray matter volume in the left DLPFC in pediatric bipolar patients [15]. Bearden and colleagues [5] also noted greater gray matter density in the left DLPFC in lithium-treated bipolar patients compared to healthy controls.…”

Section: Discussionmentioning

confidence: 99%

Prefrontal gray matter increases in healthy individuals after lithium treatment: A voxel-based morphometry study

Monkul

Matsuo

Nicoletti

et al. 2007

Neuroscience Letters

114

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The objective of this study was to test the hypothesis that 4 weeks of lithium administration would be associated with changes in brain gray and white matter volumes in healthy individuals. Thirteen right-handed healthy volunteers (6 females, mean age = 25.9 ± 10.0 y) were studied. 3D SPGR MRIs (TR = 25ms, TE = 5ms, slice-thickness = 1.5mm) were acquired using a 1.5 T GE Signa Imaging System, at baseline and after 4 weeks of lithium administration at therapeutically relevant doses. Optimized voxel based morphometry (VBM) analyses were conducted. Left and right dorsolateral prefrontal cortex and left anterior cingulate gray matter volumes increased significantly following lithium administration. Total white matter volume was increased, whereas total brain volume and total gray matter volume were not significantly changed following 4 weeks of lithium. Lithium treatment resulted in prefrontal regional gray matter volume increases in healthy volunteers, as well as increases in total white matter volume. Whether these changes are mediated by neurotrophic/ neuroprotective or osmotic effects remains unknown.

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Frontotemporal Alterations in Pediatric Bipolar Disorder

Cited by 245 publications

References 84 publications

Anterior Cingulate Volumes in Never-Treated Patients with Major Depressive Disorder

Anterior Cingulate Volumes in Never-Treated Patients with Major Depressive Disorder

Neural circuitry and neuroplasticity in mood disorders: Insights for novel therapeutic targets

Prefrontal gray matter increases in healthy individuals after lithium treatment: A voxel-based morphometry study

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