fMRI brain activation changes following treatment of a first bipolar manic episode
Objectives We tested the hypothesis that, with treatment, functional magnetic resonance imaging (fMRI) regional brain activation in first‐episode mania would normalize – i.e., that differences from healthy subjects would diminish over time, and would be associated with clinical remission status, pot...
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| Published in | Bipolar disorders Vol. 18; no. 6; pp. 490 - 501 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Denmark
Blackwell Publishing Ltd
01.09.2016
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 1398-5647 1399-5618 1399-5618 |
| DOI | 10.1111/bdi.12426 |
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| Abstract | Objectives
We tested the hypothesis that, with treatment, functional magnetic resonance imaging (fMRI) regional brain activation in first‐episode mania would normalize – i.e., that differences from healthy subjects would diminish over time, and would be associated with clinical remission status, potentially identifying neuroanatomic treatment response markers.
Methods
Forty‐two participants with bipolar I disorder were recruited during their first manic episode, pseudo‐randomized to open‐label lithium or quetiapine, and followed for 8 weeks. fMRI scans were obtained at baseline and then after 1 and 8 weeks of treatment, while participants performed a continuous performance task with emotional distracters. Healthy participants received fMRI scans at these same intervals. Specific region‐of‐interest (ROI) activations within prefrontal emotional networks were assessed as potential measures of treatment response.
Results
ROI data were reduced using exploratory factor analysis, which identified five factors that were organizationally consistent with functional anatomic models of human emotion modulation. Half of the participants with bipolar disorder achieved remission by Week 8 and were contrasted with the other half that did not. Analyses demonstrated that, in the bipolar disorder group in general, treatment led to decreases in activation across brain regions toward healthy subject values. However, differences in activation changes were observed between subjects with bipolar disorder who did or did not achieve remission in subcortical and amygdala factors.
Conclusions
These findings provide evidence for potential neuroanatomic treatment response markers in first‐episode bipolar disorder. |
|---|---|
| AbstractList | Objectives
We tested the hypothesis that, with treatment, functional magnetic resonance imaging (fMRI) regional brain activation in first‐episode mania would normalize – i.e., that differences from healthy subjects would diminish over time, and would be associated with clinical remission status, potentially identifying neuroanatomic treatment response markers.
Methods
Forty‐two participants with bipolar I disorder were recruited during their first manic episode, pseudo‐randomized to open‐label lithium or quetiapine, and followed for 8 weeks. fMRI scans were obtained at baseline and then after 1 and 8 weeks of treatment, while participants performed a continuous performance task with emotional distracters. Healthy participants received fMRI scans at these same intervals. Specific region‐of‐interest (ROI) activations within prefrontal emotional networks were assessed as potential measures of treatment response.
Results
ROI data were reduced using exploratory factor analysis, which identified five factors that were organizationally consistent with functional anatomic models of human emotion modulation. Half of the participants with bipolar disorder achieved remission by Week 8 and were contrasted with the other half that did not. Analyses demonstrated that, in the bipolar disorder group in general, treatment led to decreases in activation across brain regions toward healthy subject values. However, differences in activation changes were observed between subjects with bipolar disorder who did or did not achieve remission in subcortical and amygdala factors.
Conclusions
These findings provide evidence for potential neuroanatomic treatment response markers in first‐episode bipolar disorder. We tested the hypothesis that, with treatment, functional magnetic resonance imaging (fMRI) regional brain activation in first-episode mania would normalize - i.e., that differences from healthy subjects would diminish over time, and would be associated with clinical remission status, potentially identifying neuroanatomic treatment response markers. Forty-two participants with bipolar I disorder were recruited during their first manic episode, pseudo-randomized to open-label lithium or quetiapine, and followed for 8 weeks. fMRI scans were obtained at baseline and then after 1 and 8 weeks of treatment, while participants performed a continuous performance task with emotional distracters. Healthy participants received fMRI scans at these same intervals. Specific region-of-interest (ROI) activations within prefrontal emotional networks were assessed as potential measures of treatment response. ROI data were reduced using exploratory factor analysis, which identified five factors that were organizationally consistent with functional anatomic models of human emotion modulation. Half of the participants with bipolar disorder achieved remission by Week 8 and were contrasted with the other half that did not. Analyses demonstrated that, in the bipolar disorder group in general, treatment led to decreases in activation across brain regions toward healthy subject values. However, differences in activation changes were observed between subjects with bipolar disorder who did or did not achieve remission in subcortical and amygdala factors. These findings provide evidence for potential neuroanatomic treatment response markers in first-episode bipolar disorder. We tested the hypothesis that, with treatment, functional magnetic resonance imaging (fMRI) regional brain activation in first-episode mania would normalize - i.e., that differences from healthy subjects would diminish over time, and would be associated with clinical remission status, potentially identifying neuroanatomic treatment response markers.OBJECTIVESWe tested the hypothesis that, with treatment, functional magnetic resonance imaging (fMRI) regional brain activation in first-episode mania would normalize - i.e., that differences from healthy subjects would diminish over time, and would be associated with clinical remission status, potentially identifying neuroanatomic treatment response markers.Forty-two participants with bipolar I disorder were recruited during their first manic episode, pseudo-randomized to open-label lithium or quetiapine, and followed for 8 weeks. fMRI scans were obtained at baseline and then after 1 and 8 weeks of treatment, while participants performed a continuous performance task with emotional distracters. Healthy participants received fMRI scans at these same intervals. Specific region-of-interest (ROI) activations within prefrontal emotional networks were assessed as potential measures of treatment response.METHODSForty-two participants with bipolar I disorder were recruited during their first manic episode, pseudo-randomized to open-label lithium or quetiapine, and followed for 8 weeks. fMRI scans were obtained at baseline and then after 1 and 8 weeks of treatment, while participants performed a continuous performance task with emotional distracters. Healthy participants received fMRI scans at these same intervals. Specific region-of-interest (ROI) activations within prefrontal emotional networks were assessed as potential measures of treatment response.ROI data were reduced using exploratory factor analysis, which identified five factors that were organizationally consistent with functional anatomic models of human emotion modulation. Half of the participants with bipolar disorder achieved remission by Week 8 and were contrasted with the other half that did not. Analyses demonstrated that, in the bipolar disorder group in general, treatment led to decreases in activation across brain regions toward healthy subject values. However, differences in activation changes were observed between subjects with bipolar disorder who did or did not achieve remission in subcortical and amygdala factors.RESULTSROI data were reduced using exploratory factor analysis, which identified five factors that were organizationally consistent with functional anatomic models of human emotion modulation. Half of the participants with bipolar disorder achieved remission by Week 8 and were contrasted with the other half that did not. Analyses demonstrated that, in the bipolar disorder group in general, treatment led to decreases in activation across brain regions toward healthy subject values. However, differences in activation changes were observed between subjects with bipolar disorder who did or did not achieve remission in subcortical and amygdala factors.These findings provide evidence for potential neuroanatomic treatment response markers in first-episode bipolar disorder.CONCLUSIONSThese findings provide evidence for potential neuroanatomic treatment response markers in first-episode bipolar disorder. Objectives We tested the hypothesis that, with treatment, functional magnetic resonance imaging (fMRI) regional brain activation in first-episode mania would normalize - i.e., that differences from healthy subjects would diminish over time, and would be associated with clinical remission status, potentially identifying neuroanatomic treatment response markers. Methods Forty-two participants with bipolar I disorder were recruited during their first manic episode, pseudo-randomized to open-label lithium or quetiapine, and followed for 8 weeks. fMRI scans were obtained at baseline and then after 1 and 8 weeks of treatment, while participants performed a continuous performance task with emotional distracters. Healthy participants received fMRI scans at these same intervals. Specific region-of-interest (ROI) activations within prefrontal emotional networks were assessed as potential measures of treatment response. Results ROI data were reduced using exploratory factor analysis, which identified five factors that were organizationally consistent with functional anatomic models of human emotion modulation. Half of the participants with bipolar disorder achieved remission by Week 8 and were contrasted with the other half that did not. Analyses demonstrated that, in the bipolar disorder group in general, treatment led to decreases in activation across brain regions toward healthy subject values. However, differences in activation changes were observed between subjects with bipolar disorder who did or did not achieve remission in subcortical and amygdala factors. Conclusions These findings provide evidence for potential neuroanatomic treatment response markers in first-episode bipolar disorder. |
| Author | Stover, Amanda Blom, Thomas J Strawn, Jeffrey R Dudley, Jonathan A DelBello, Melissa P Weber, Wade Welge, Jeffrey Norris, Matthew Lee, Jing-Huei Komoroski, Richard A Fleck, David E Eliassen, James C Strakowski, Stephen M Chu, Wen-Jang Durling, Michelle Klein, Christina Adler, Caleb M |
| AuthorAffiliation | b Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, TX, USA a Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH |
| AuthorAffiliation_xml | – name: b Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, TX, USA – name: a Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH |
| Author_xml | – sequence: 1 givenname: Stephen M surname: Strakowski fullname: Strakowski, Stephen M email: steve.strakowski@austin.utexas.edu, steve.strakowski@austin.utexas.edu organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA – sequence: 2 givenname: David E surname: Fleck fullname: Fleck, David E organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 3 givenname: Jeffrey surname: Welge fullname: Welge, Jeffrey organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 4 givenname: James C surname: Eliassen fullname: Eliassen, James C organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 5 givenname: Matthew surname: Norris fullname: Norris, Matthew organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 6 givenname: Michelle surname: Durling fullname: Durling, Michelle organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 7 givenname: Richard A surname: Komoroski fullname: Komoroski, Richard A organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 8 givenname: Wen-Jang surname: Chu fullname: Chu, Wen-Jang organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 9 givenname: Wade surname: Weber fullname: Weber, Wade organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 10 givenname: Jonathan A surname: Dudley fullname: Dudley, Jonathan A organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 11 givenname: Thomas J surname: Blom fullname: Blom, Thomas J organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 12 givenname: Amanda surname: Stover fullname: Stover, Amanda organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 13 givenname: Christina surname: Klein fullname: Klein, Christina organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 14 givenname: Jeffrey R surname: Strawn fullname: Strawn, Jeffrey R organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 15 givenname: Melissa P surname: DelBello fullname: DelBello, Melissa P organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 16 givenname: Jing-Huei surname: Lee fullname: Lee, Jing-Huei organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA – sequence: 17 givenname: Caleb M surname: Adler fullname: Adler, Caleb M organization: Department of Psychiatry and Behavioral Neuroscience and Center for Imaging Research, University of Cincinnati College of Medicine, OH, Cincinnati, USA |
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We tested the hypothesis that, with treatment, functional magnetic resonance imaging (fMRI) regional brain activation in first‐episode mania would... We tested the hypothesis that, with treatment, functional magnetic resonance imaging (fMRI) regional brain activation in first-episode mania would normalize -... Objectives We tested the hypothesis that, with treatment, functional magnetic resonance imaging (fMRI) regional brain activation in first-episode mania would... |
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| SubjectTerms | Adult amygdala Amygdala - diagnostic imaging Amygdala - physiopathology Antimanic Agents - therapeutic use bipolar disorder Bipolar Disorder - diagnosis Bipolar Disorder - psychology Bipolar Disorder - therapy Emotions - physiology Episode of Care Female first-episode fMRI Humans Lithium - therapeutic use Magnetic Resonance Imaging - methods Male mania prefrontal Psychiatric Status Rating Scales Quetiapine Fumarate - therapeutic use Task Performance and Analysis treatment Treatment Outcome |
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| Title | fMRI brain activation changes following treatment of a first bipolar manic episode |
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