A longitudinal study of fronto-limbic brain structures in patients with bipolar I disorder during lithium treatment

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art_NERY_A_longitudinal_study_of_fronto_limbic_brain_structures_2013.PDF (623.1 KB)
Citações na Scopus
34
Tipo de produção
article
Data de publicação
2013
Editora
ELSEVIER SCIENCE BV
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
SELEK, Salih
NICOLETTI, Mark
ZUNTA-SOARES, Giovana B.
HATCH, John P.
MATSUO, Koji
SANCHES, Marsal
SOARES, Jair C.
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
JOURNAL OF AFFECTIVE DISORDERS, v.150, n.2, p.629-633, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
In order to assess the association between therapeutic response to lithium treatment and fronto-limbic brain structures' volumes in bipolar 1 patients (BPI) 24 BPI and 11 healthy comparisons underwent MRI scans at baseline and 4 weeks later. The BPIs received lithium during the 4 week period with a goal of achieving therapeutic blood levels of > 0.5 mEq/L (mean level 0.67 mEq/L). Mood symptoms were rated with the Hamilton Depression and the Young Mania Rating Scales at baseline and after 4 weeks, and response was defined as > 50% decrease on either scale. Hippocampus, amygdala, prefrontal (PFC), dorsolateral prefrontal (DLPFC), and anterior cingulate cortex (ACC) volumes were obtained by Freesurfer image analysis suite. According to baseline symptoms and treatment response, patients were assigned to three groups: euthymics (n=6), responders (n=12) and non-responders (n=6). Taken over both time periods, non-responders had smaller right amygdala than healthy comparisons and euthymic BPI (p=0.035 and p=0.003, respectively). When baseline and after treatment volumes were compared, there was a significant enlargement in left PFC and left DLPFC in BPI who responded to treatment (p=0.002 and p=0.006, respectively). Left hippocampus and right ACC volumes decreased in non-responders (p=0.02 and p=0.0001, respectively). According to the findings decreased left hippocampus and right ACC volumes may be markers of non-response to lithium amongst BPI. Smaller right amygdala may reflect symptomatic remission and be a marker of treatment non-response. Increases in left PFC and left DLPFC as a result of lithium treatment may relate to lithium's neurotrophic effects. (C) 2013 Elsevier B.V. All rights reservecl
Palavras-chave
Lithium, Bipolar disorder, Prefrontal cortex
URI
https://observatorio.fm.usp.br/handle/OPI/4572
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Coleções
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/21