White matter abnormalities and cognitive function in euthymic patients with bipolar disorder and major depressive disorder

Masuda, Yoshikazu; Okada, Go; Takamura, Masahiro; Shibasaki, Chiyo; Yoshino, Atsuo; Yokoyama, Satoshi; Ichikawa, Naho; Okuhata, Shiho; Kobayashi, Tetsuo; Yamawaki, Shigeto; Okamoto, Yasumasa

doi:10.1002/brb3.1868

Cited by 16 publications

(8 citation statements)

References 81 publications

(98 reference statements)

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“…It should be noted that the brain regions implicated in the current study are also relevant to mood/emotional dysfunction [42,43]. After the introduction of ART in 2005, the relevance of mood dysfunction on HIV-related clinical outcomes focused on the potential negative effects on suboptimal adherence to ART.…”

Section: Discussionmentioning

confidence: 91%

Ensemble machine learning classification of daily living abilities among older people with HIV

et al. 2021

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Background: clinically relevant methods to identify individuals at risk for impaired daily living abilities secondary to neurocognitive impairment (ADLs) remain elusive. This is especially true for complex clinical conditions such as HIV-Associated Neurocognitive Disorders (HAND). The aim of this study was to identify novel and modifiable factors that have potential to improve diagnostic accuracy of ADL risk, with the long-term goal of guiding future interventions to minimize ADL disruption. Methods: study participants included 79 people with HIV (PWH; mean age = 63; range = 55À80) enrolled in neuroHIV studies at University California San Francisco (UCSF) between 2016 and 2019. All participants were virally suppressed and exhibited objective evidence of neurocognitive impairment. ADL status was defined as either normative (n = 39) or at risk (n = 40) based on a task-based protocol. Gradient boosted multivariate regression (GBM) was employed to identify the combination of variables that differentiated ADL subgroup classification. Predictor variables included demographic factors, HIV disease severity indices, brain white matter integrity quantified using diffusion tensor imaging, cognitive test performance, and health co-morbidities. Model performance was examined using average Area Under the Curve (AUC) with repeated fivefold cross validation. Findings: the univariate GBM yielded an average AUC of 83% using Wide Range Achievement test 4 (WRAT-4) reading score, self-reported thought confusion and difficulty reading, radial diffusivity (RD) in the left external capsule, fractional anisotropy (FA) in the left cingulate gyrus, and Stroop performance. The model allowing for two-way interactions modestly improved classification performance (AUC of 88%) and revealed synergies between race, reading ability, cognitive performance, and neuroimaging metrics in the genu and uncinate fasciculus. Conversion of Neuropsychological Assessment Battery Daily Living Module (NAB-DLM) performance from raw scores into T scores amplified differences between White and non-White study participants. Interpretation: demographic and sociocultural factors are critical determinants of ADL risk status among older PWH who meet diagnostic criteria for neurocognitive impairment. Task-based ADL assessment that relies heavily on reading proficiency may artificially inflate the frequency/severity of ADL impairment among diverse clinical populations. Culturally relevant measures of ADL status are needed for individuals with acquired neurocognitive disorders, including HAND.

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Section: Discussionmentioning

confidence: 91%

Ensemble machine learning classification of daily living abilities among older people with HIV

et al. 2021

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“…Calcium overload caused by cellular Ca influx under stress has been shown to induce mitochondrial damage, increase ROS generation, and promote K + efflux ( 30 - 32 ), which suggests that mitochondrial damage may be the key to NLRP3 inflammasome activation. Studies have shown that irisin inhibits Ca 2+ influx ( 33 ) and reduces mitochondrial damage ( 34 ), which suggests that aerobic exercise may inhibit the progression of PSD by inhibiting inflammasome activation. We found that aerobic exercise significantly reduced the expression of NLRP3, Caspase1, and IL-1β, which suggests that aerobic exercise plays a key role in inhibiting the activation of the NLRP3 inflammasome, which may be the mechanism underlying the anti-PSD effect.…”

Section: Discussionmentioning

confidence: 99%

Aerobic exercise reverses the NF-κB/NLRP3 inflammasome/5-HT pathway by upregulating irisin to alleviate post-stroke depression

Tang¹,

Liao²,

Liu³

et al. 2022

Ann Transl Med

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Background: Post-stroke depression (PSD) is one of the most common and serious sequelae of stroke.The pathogenesis of PSD involves both psychosocial and biological mechanisms, and aerobic exercise is a potential therapeutic target. We conducted an in-depth exploration of the protective mechanisms of aerobic exercise in a PSD mouse model. Methods:In this study, C57BL/6 mice were used as the research objects, and a PSD mouse model was established by combining middle cerebral artery occlusion and chronic unpredictable mild stimulation.Real-time quantitative polymerase chain reaction, enzyme-linked immunosorbent assays, adeno-associated virus microinjection technology, co-immunoprecipitation, fluorescence in-situ hybridization, and western blotting were performed. A moderate-load treadmill exercise was used for aerobic exercise intervention. The moderate-intensity aerobic exercise training method adopted 0 slopes and treadmill adaptation training for 5 days. We verified the effects of aerobic exercise on the nuclear factor kappa B (NF-κB)/nucleotide-binding oligomerization domain--like receptor protein 3 (NLRP3) inflammasome/5-hydroxytryptamine (5-HT) pathway.Results: Aerobic exercise effectively alleviated the neurological damage caused by PSD (P<0.01). The results from the PSD mouse model in vivo were consistent with those of the cell experiments. Moreover, overexpression of irisin improves depression-like behavior in PSD mice. We confirmed that aerobic exercise is involved in PSD through 5-HT, which inhibits NF-κB/NLRP3 inflammasome initiation through irisin and alleviates mitochondrial damage under stress by reducing calcium overload, thereby inhibiting NLRP3 inflammasome activation.Conclusions: Aerobic exercise reversed the NF-κB/NLRP3 inflammasome/5-HT pathway by upregulating irisin expression to alleviate PSD.

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“…Furthermore, studying OABD using DTI methods is a burgeoning area, with several studies showing FA decreases in similar areas as in younger samples with BD, including ventral corpus callosum, and uncinate fasciculus [ 74 , 75 ]. In addition to contributions to emotion dysregulation in BD, contributions to cognitive deficits are implicated by negative correlations between cognitive performance across multiple domains, including working memory, information processing, executive function, and attention, with FA in the corpus callosum and uncinate fasciculus [ 76 – 78 ]. As cognitive decline is a feature for some individuals with BD during later life, that causes suffering, impaired functioning, and is associated with poor prognosis [ 79 ], elucidating disturbances in these key WM tracts may be integral to preventing some of the severe clinical outcomes associated with BD during later life.…”

Section: White Matter In Bipolar Disordermentioning

confidence: 99%

Neuroimaging Studies of Brain Structure in Older Adults with Bipolar Disorder: A Review

Rajashekar

Blumberg

Villa

2022

J Psychiatry Brain Sci

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Bipolar disorder (BD) is a common mood disorder that can have severe consequences during later life, including suffering and impairment due to mood and cognitive symptoms, elevated risk for dementia and an especially high risk for suicide. Greater understanding of the brain circuitry differences involved in older adults with BD (OABD) in later life and their relationship to aging processes is required to improve outcomes of OABD. The current literature on gray and white matter findings, from high resolution structural and diffusion-weighted magnetic resonance imaging (MRI) studies, has shown that BD in younger age groups is associated with gray matter reductions within cortical and subcortical brain regions that subserve emotion processing and regulation, as well as reduced structural integrity of white matter tracts connecting these brain regions. While fewer neuroimaging studies have focused on OABD, it does appear that many of the structural brain differences found in younger samples are present in OABD. There is also initial suggestion that there are additional brain differences, for at least a subset of OABD, that may result from more pronounced gray and white matter declines with age that may contribute to adverse outcomes. Preclinical and clinical data supporting neuro-plastic and -protective effects of mood-stabilizing medications, suggest that treatments may reverse and/or prevent the progression of brain changes thereby reducing symptoms. Future neuroimaging research implementing longitudinal designs, and large-scale, multi-site initiatives with detailed clinical and treatment data, holds promise for reducing suffering, cognitive dysfunction and suicide in OABD.

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White matter abnormalities and cognitive function in euthymic patients with bipolar disorder and major depressive disorder

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 16 publications

References 81 publications

Ensemble machine learning classification of daily living abilities among older people with HIV

Ensemble machine learning classification of daily living abilities among older people with HIV

Aerobic exercise reverses the NF-κB/NLRP3 inflammasome/5-HT pathway by upregulating irisin to alleviate post-stroke depression

Neuroimaging Studies of Brain Structure in Older Adults with Bipolar Disorder: A Review

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