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J Affect Disord. 2018 Oct 1;238:16-23. doi: 10.1016/j.jad.2018.05.017. Epub 2018 May 21.

Illness, at-risk and resilience neural markers of early-stage bipolar disorder.

Author information

1
Department of Affective Disorders, Guangzhou Brain Hospital, The Affiliated Hospital of Guangzhou Medical University, 36 Mingxin Road, Guangzhou, Guangdong 510370, China; Laboratory of Emotion and Cognition, The Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; GMH Institute of CNS Regeneration, Jinan University, Guangzhou, China; GMU-HKU Mood and Brain Science Center, Guangzhou, China. Electronic address: linkangguang@163.com.
2
Department of Affective Disorders, Guangzhou Brain Hospital, The Affiliated Hospital of Guangzhou Medical University, 36 Mingxin Road, Guangzhou, Guangdong 510370, China; Laboratory of Emotion and Cognition, The Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; GMU-HKU Mood and Brain Science Center, Guangzhou, China; The State Key Laboratory of Brain and Cognitive Sciences and Department of Ophthalmology, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology and Laboratory of Social Cognitive Affective Neuroscience, Department of Psychology, University of Hong Kong, Hong Kong.
3
The State Key Laboratory of Brain and Cognitive Sciences and Department of Ophthalmology, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology and Laboratory of Social Cognitive Affective Neuroscience, Department of Psychology, University of Hong Kong, Hong Kong.
4
Department of Affective Disorders, Guangzhou Brain Hospital, The Affiliated Hospital of Guangzhou Medical University, 36 Mingxin Road, Guangzhou, Guangdong 510370, China; Laboratory of Emotion and Cognition, The Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
5
Department of Affective Disorders, Guangzhou Brain Hospital, The Affiliated Hospital of Guangzhou Medical University, 36 Mingxin Road, Guangzhou, Guangdong 510370, China.
6
Department of Affective Disorders, Guangzhou Brain Hospital, The Affiliated Hospital of Guangzhou Medical University, 36 Mingxin Road, Guangzhou, Guangdong 510370, China; Laboratory of Emotion and Cognition, The Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; GMU-HKU Mood and Brain Science Center, Guangzhou, China.
7
GMH Institute of CNS Regeneration, Jinan University, Guangzhou, China; GMU-HKU Mood and Brain Science Center, Guangzhou, China; The State Key Laboratory of Brain and Cognitive Sciences and Department of Ophthalmology, The University of Hong Kong, Hong Kong.

Abstract

BACKGROUND:

Current knowledge on objective and specific neural markers for bipolar risk and resilience-related processes is lacking, partly due to not subdividing high-risk individuals manifesting different levels of subclinical symptoms who possibly possess different levels of resilience.

METHODS:

We delineated grey matter markers for bipolar illness, genetic high risk (endophenotype) and resilience, through comparing across 42 young non-comorbid bipolar patients, 42 healthy controls, and 72 diagnosis-free, medication-naive high-genetic-risk individuals subdivided into a combined-high-risk group who additionally manifested bipolar risk-relevant subsyndromes (N = 38), and an asymptomatic high-risk group (N = 34). Complementary analyses assessed the additional predictive and classification values of grey matter markers beyond those of clinical scores, through using logistic regression and support vector machine analyses.

RESULTS:

Illness-related effects manifested as reduced grey matter volumes of bilateral temporal limbic-striatal and cerebellar regions, which significantly differentiated bipolar patients from healthy controls and improved clinical classification specificity by 20%. Reduced bilateral cerebellar grey matter volume emerged as a potential endophenotype and (along with parieto-occipital grey matter changes) separated combined-high-risk individuals from healthy and high-risk individuals, and increased clinical classification specificity by approximately 10% and 27%, respectively, while the relatively normalized cerebellar grey matter volumes in the high-risk sample may confer resilience.

LIMITATIONS:

The cross-validation procedure was not performed on an independent sample using independently-derived features. The BD group had different age and sex distributions than some other groups which may not be fully addressable statistically.

CONCLUSIONS:

Our framework can be applied in other measurement domains to derive complete profiles for bipolar patients and at-risk individuals, towards forming strategies for promoting resilience and preclinical intervention.

KEYWORDS:

Bipolar disorder; Cerebellum; Endophenotype; Grey matter volume; Resilience; Support vector machine

PMID:
29852342
DOI:
10.1016/j.jad.2018.05.017
[Indexed for MEDLINE]

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