Reduced cerebrovascular reactivity among adolescents with bipolar disorder

Urback, Adam; Metcalfe, Arron W.S.; Korczak, Daphne J.; MacIntosh, Bradley J.; Goldstein, Benjamin I.

doi:10.1111/bdi.12719

Cited by 17 publications

(10 citation statements)

References 51 publications

(89 reference statements)

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“…Both WMHs 38 and BD 39 have been associated with an increased risk for cardiovascular disease, and cardiovascular disorders have been found to be more prevalent in BD patients with DWMHs than in BD patients without them. 14 Relatedly, our group has previously reported reduced cardiovascular reactivity 40 and an unchanged rate of global oxygen metabolism in adolescents with BD, despite an increase in global cerebral blood flow. 41 Taking the results of prior studies and these related anomalies in cerebrovascular physiology together, we expected to find higher rates of WMHs among adolescents.…”

Section: Discussionmentioning

confidence: 88%

Prevalence of white matter hyperintensities is not elevated in a large sample of adolescents and young adults with bipolar disorder

Mehrhof

Popel

Mio

et al. 2021

Braz. J. Psychiatry

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Objective: The increased prevalence rate of white matter hyperintensities is one of the most consistently reported brain abnormalities in adults with bipolar disorder. However, findings in children and adolescents with bipolar disorder are less consistent. Prior studies have been constrained by small sample sizes and/or poor age-and sex-matching of healthy controls. We examined this topic in the largest sample of adolescents with bipolar disorder to date. Methods: T 2-weighted 3-Tesla magnetic resonance imaging data were acquired for 83 adolescents with bipolar disorder diagnosed via the Kiddie Schedule for Affective Disorders and the Schizophrenia, Present and Lifetime version semi-structured interview and 64 age-and sex-matched healthy controls. All acquired scans were examined by neuroradiologists and the presence or absence of white matter hyperintensities was determined for each participant. Results: The prevalence of white matter hyperintensities did not differ between adolescents with bipolar disorder (13.3%) and controls (21.9%; w 2 = 1.90; p = 0.168). Conclusion: In contrast to the study hypothesis, the prevalence of white matter hyperintensities was not higher in adolescents with bipolar disorder than controls. The large sample size and good matching for age and sex bolster the reliability of this negative finding. Future studies are warranted to evaluate the prevalence, incidence, and predictors of white matter hyperintensities in early-onset bipolar disorder prospectively.

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Section: Discussionmentioning

confidence: 88%

Prevalence of white matter hyperintensities is not elevated in a large sample of adolescents and young adults with bipolar disorder

Mehrhof

Popel

Mio

et al. 2021

Braz. J. Psychiatry

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“…A shared link in pathophysiology between bipolar disorder and diabetes has been proposed (Calkin et al 2013), with common genetic links, epigenetic factors as well as lifestyle and treatment of bipolar disorder being factors associated with a poorer glycemic control and a worse general outcome of diabetes and cardiovascular disease as a whole (Calkin et al 2013). Furthermore, a reduced cerebrovascular reactivity among adolescents with bipolar disorder compared to psychiatrically healthy controls has been observed, suggesting a poorer cerebrovascular health (Urback et al 2018).…”

Section: Cardiovascular Diseasementioning

confidence: 99%

Why are somatic diseases in bipolar disorder insufficiently treated?

Nielsen

Kugathasan

Straszek

et al. 2019

Int J Bipolar Disord

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Background Somatic diseases, including cardiovascular, respiratory, and cancer diseases, are the main contributors to a shortened life expectancy of 10–20 years in patients with bipolar disorder as compared to the general population. In the general population an increase in survival has been observed over the last decades, primarily due to the advances in primary prophylaxis, medical treatment and progress in early detection and monitoring of somatic diseases. In this narrative review, we discuss the existing literature on treatment and outcomes of cardiovascular, respiratory, and cancer diseases in patients with bipolar disorder, and put this in the context of findings in studies on patients diagnosed with other severe mental disorders. Main body The existing literature suggests that patients with bipolar disorder receive fewer or delayed medical interventions, when admitted with severe somatic diseases, compared to those not diagnosed with bipolar disorder. Cardiovascular disease is the most investigated disease regarding outcomes in patients with severe mental illness, and novel findings indicate that the increased mortality following cardiac events in these patients can be reduced if they are intensively treated with secondary prophylactic cardiac intervention. Elderly patients diagnosed with mental disorders and cancer experience a delay in receiving specific cancer treatment. No studies have investigated treatment outcomes in patients with severe mental disease and respiratory diseases. Conclusion It is surprising and of major concern that patients with bipolar disorder have not benefitted from the significant improvement that has taken place over time over time of somatic treatments in general, especially in countries with equal and free access to healthcare services. Therefore, no matter whether this situation is a result of a negative attitude from health care providers to patients with mental illness, the result of the patient’s lack of awareness of their physical illness or the results of other factors, further attention including research on developing strategies for improving the management of somatic diseases in patients with bipolar disorder is needed.

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“…Adolescence is a time of increased onset of bipolar disorder, a psychiatric condition with putative vascular underpinnings. 14 – 16 Bipolar disorder is characterized by recurrent manic/hypomanic and depressive mood episodes. 17 Studies of adults with bipolar disorder report widespread anomalies in both CBF and grey matter 18 , 19 ; studies of adolescents with bipolar disorder report anomalous CBF and grey matter mostly in the frontal lobe and amygdala.…”

Section: Introductionmentioning

confidence: 99%

Correspondence between patterns of cerebral blood flow and structure in adolescents with and without bipolar disorder

Luciw

Toma

Goldstein

et al. 2021

J Cereb Blood Flow Metab

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Adolescence is a period of rapid development of the brain’s inherent functional and structural networks; however, little is known about the region-to-region organization of adolescent cerebral blood flow (CBF) or its relationship to neuroanatomy. Here, we investigate both the regional covariation of CBF MRI and the covariation of structural MRI, in adolescents with and without bipolar disorder. Bipolar disorder is a disease with increased onset during adolescence, putative vascular underpinnings, and evidence of anomalous CBF and brain structure. In both groups, through hierarchical clustering, we found CBF covariance was principally described by clusters of regions circumscribed to the left hemisphere, right hemisphere, and the inferior brain; these clusters were spatially reminiscent of cerebral vascular territories. CBF covariance was associated with structural covariance in both the healthy group (n = 56; r = 0.20, p < 0.0001) and in the bipolar disorder group (n = 68; r = 0.36, p < 0.0001), and this CBF-structure correspondence was higher in bipolar disorder ( p = 0.0028). There was lower CBF covariance in bipolar disorder compared to controls between the left angular gyrus and pre- and post-central gyri. Altogether, CBF covariance revealed distinct brain organization, had modest correspondence to structural covariance, and revealed evidence of differences in bipolar disorder.

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Reduced cerebrovascular reactivity among adolescents with bipolar disorder

Cited by 17 publications

References 51 publications

Prevalence of white matter hyperintensities is not elevated in a large sample of adolescents and young adults with bipolar disorder

Prevalence of white matter hyperintensities is not elevated in a large sample of adolescents and young adults with bipolar disorder

Why are somatic diseases in bipolar disorder insufficiently treated?

Correspondence between patterns of cerebral blood flow and structure in adolescents with and without bipolar disorder

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