Category: Mental Health Diagnosis

Investigating Spontaneous Brain Activity in Bipolar Disorder

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Research Paper Title

Investigating spontaneous brain activity in bipolar disorder: A resting-state functional magnetic resonance imaging study.

Background

Despite several neuroimaging studies in the past few years, the exact pathophysiology responsible for the development of bipolar disorder (BD) is still not completely known.

Importantly, to the best of our knowledge, no study from India has examined resting state (RS) connectivity abnormalities in BD using regional homogeneity (ReHo).

Hence, the researchers examined spontaneous brain activity in patients with BD using RS functional magnetic resonance imaging (RS-fMRI).

Therefore, the aim of the study was to examine the spontaneous brain activity in patients with BD-I using ReHo approach and RS-fMRI compared to age- and gender-matched healthy control (HC).

Methods

A total of 20 patients with BD and 20 age-, gender-, and education-matched HCs participated in the study. The fMRI data were obtained using 1.5T scanner. RS-fMRI abnormalities were analysed using ReHo method.

Results

Compared to healthy adults, significantly increased ReHo in the BD group was found in the right precuneus, right insula, right supramarginal gyrus, left superior frontal gyrus, right inferior frontal gyrus, right precentral gyrus, and right paracentral lobule.

No region had significantly lower ReHo values in BD patients compared to controls.

Conclusions

These results suggested that abnormal local synchronisation of spontaneous brain activity is present in the frontoparietoinsular region which may be related to the pathophysiology of BD.

Reference

Achalia, R.M., Jacob, A., Achalia, G., Sable, A., Venkatasubramanian, G. & Rao, N.P. (2019) Investigating spontaneous brain activity in bipolar disorder: A resting-state functional magnetic resonance imaging study. Indian Journal of Psychiatry. 61(6):630-634. doi: 10.4103/psychiatry.IndianJPsychiatry_391_19.

Is Skin Fairness a Better Predictor for Impaired Physical & Mental Health than Hair Redness?

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Research Paper Title

Skin fairness is a better predictor for impaired physical and mental health than hair redness.

Background

About 1-2% of people of European origin have red hair.

Especially female redheads are known to suffer higher pain sensitivity and higher incidence of some disorders, including skin cancer, Parkinson’s disease and endometriosis.

Methods

Recently, an explorative study performed on 7,000 subjects showed that both male and female redheads score worse on many health-related variables and express a higher incidence of cancer.

Here, the researchers ran the preregistered study on a population of 4,117 subjects who took part in an anonymous electronic survey.

Results

They confirmed that the intensity of hair redness negatively correlated with physical health, mental health, fecundity and sexual desire, and positively with the number of kinds of drugs prescribed by a doctor currently taken, and with reported symptoms of impaired mental health.

It also positively correlated with certain neuropsychiatric disorders, most strongly with learning disabilities disorder and phobic disorder in men and general anxiety disorder in women.

However, most of these associations disappeared when the darkness of skin was included in the models, suggesting that skin fairness, not hair redness, is responsible for the associations.

Conclusions

The researchers discussed two possible explanations for the observed pattern, the first based on vitamin D deficiency due to the avoidance of sunbathing by subjects with sensitive skin, including some redheads, and second based on folic acid depletion in fair skinned subjects, again including some (a different subpopulation of) redheads.

It must be emphasised, however, that both of these explanations are only hypothetical as no data on the concentration of vitamin D or folic acid are available for the subjects.

The results, as well as the conclusions of current reviews, suggest that the new empirical studies on the concentration of vitamin D and folic acids in relation to skin and hair pigmentation are urgently needed.

Reference

Flegr, J. & Sýkorová, K. (2019) Skin fairness is a better predictor for impaired physical and mental health than hair redness. Scientific Reports. 9(1):18138. doi: 10.1038/s41598-019-54662-5.

Cognitive Subgroups of Schizophrenia: Are There Brain Morphological & Functional Features?

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Research Paper Title

Brain morphological and functional features in cognitive subgroups of schizophrenia.

Background

Previous studies have reported different brain morphologies in different cognitive subgroups of patients with schizophrenia. The researchers aimed to examine the brain structures and functional connectivity in these cognitive subgroups of schizophrenia.

Methods

The researchers compared brain structures among healthy controls and cognitively deteriorated and preserved subgroups of patients with schizophrenia according to the decline in intelligence quotient.

Connectivity analyses between subcortical regions and other brain areas were performed using resting-state functional magnetic resonance imaging among the groups.

Results

Whole brain and total cortical gray matter, right fusiform gyrus, left pars orbitalis gyrus, right pars triangularis, left superior temporal gyrus and left insula volumes and bilateral cortical thickness were decreased in the deteriorated group compared to the control and preserved groups.

Both schizophrenia subgroups had increased left lateral ventricle, right putamen and left pallidum and decreased bilateral hippocampus, left precentral gyrus, right rostral middle frontal gyrus and bilateral superior frontal gyrus volumes compared with controls.

Hyperconnectivity between the thalamus and a broad range of brain regions was observed in the deteriorated group compared to connectivity in the control group, and this hyperconnectivity was less evident in the preserved group.

The researchers also found hyperconnectivity between the accumbens and the superior and middle frontal gyri in the preserved group compared with connectivity in the deteriorated group.

Conclusions

These findings provide evidence of prominent structural and functional brain abnormalities in deteriorated patients with schizophrenia, suggesting that cognitive subgroups in schizophrenia might be useful biotypes to elucidate brain pathophysiology for new diagnostic and treatment strategies.

Reference

Yasuda, Y., Okada, N., Nemoto, K., Fukunaga, M., Yamamori, H., Ohi, K., Koshiyama, D., Kudo, N., Shiino, T., Morita, S., Morita, K., Azechi, H., Fujimoto, M., Miura, K., Watanabe, Y., Kasai, K. & Hashimoto, R. (2019) Brain morphological and functional features in cognitive subgroups of schizophrenia. Psychiatry and Clinical Neurosciences. doi: 10.1111/pcn.12963. [Epub ahead of print].

Would a Clinical Staging Tool be useful in Clinical Practice to Predict Disease Course in Anxiety Disorders?

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Research Paper Title

A clinical staging approach to improving diagnostics in anxiety disorders: Is it the way to go?

Background

Clinical staging is a paradigm in which stages of disease progression are identified; these, in turn, have prognostic value.

A staging model that enables the prediction of long-term course in anxiety disorders is currently unavailable but much needed as course trajectories are highly heterogenic.

This study therefore tailored a heuristic staging model to anxiety disorders and assessed its validity.

Methods

A clinical staging model was tailored to anxiety disorders, distinguishing nine stages of disease progression varying from subclinical stages (0, 1A, 1B) to clinical stages (2A-4B).

At-risk subjects and subjects with anxiety disorders (n = 2352) from the longitudinal Netherlands Study of Depression and Anxiety were assigned to these nine stages.

The model’s validity was assessed by comparing baseline (construct validity) and 2-year, 4-year and 6-year follow-up (predictive validity) differences in anxiety severity measures across stages.

Differences in depression severity and disability were assessed as secondary outcome measures.

Results

Results showed that the anxiety disorder staging model has construct and predictive validity.

At baseline, differences in anxiety severity, social avoidance behaviours, agoraphobic avoidance behaviours, worrying, depressive symptoms and levels of disability existed across all stages (all p-values < 0.001).

Over time, these differences between stages remained present until the 6-year follow-up.

Differences across stages followed a linear trend in all analyses: higher stages were characterised by the worst outcomes.

Regarding the stages, subjects with psychiatric comorbidity (stages 2B, 3B, 4B) showed a deteriorated course compared with those without comorbidity (stages 2A, 3A, 4A).

Conclusions

A clinical staging tool would be useful in clinical practice to predict disease course in anxiety disorders.

Reference

Bokma, W.A., Batelaan, N.M., Hoogendoorn, A.W., Penninx, B.W. & van Balkom, A.J. (2019) A clinical staging approach to improving diagnostics in anxiety disorders: Is it the way to go? The Australian & New Zealand Journal of Psychiatry. doi: 10.1177/0004867419887804. [Epub ahead of print].