Structural and metabolic differentiation between bipolar disorder with psychosis and substance-induced psychosis: An integrated MRI/PET study
| Autor: | Chiara Arici, Alessandro Pigoni, Alfredo Carlo Altamura, Cristina Dobrea, Bernardo Dell'Osso, Valentina Ciappolino, G. Camuri, Chiara Rovera, Riccardo A. Paoli, Beatrice Benatti, Claudia Cinnante, Paolo Brambilla, Giuseppe Delvecchio, Giorgio Marotta, Elisabetta Caletti, Cecilia Prunas, Fabio Triulzi, Lucio Oldani |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Oncology Psychosis medicine.medical_specialty Bipolar Disorder Ventrolateral prefrontal cortex Young Adult 03 medical and health sciences 0302 clinical medicine Thalamus Internal medicine medicine Humans Bipolar disorder Gray Matter Psychiatry Cerebral Cortex Middle Aged medicine.disease Magnetic Resonance Imaging Substance-induced psychosis Temporal Lobe 030227 psychiatry Substance abuse Dorsolateral prefrontal cortex Psychiatry and Mental health medicine.anatomical_structure Psychotic Disorders Case-Control Studies Positron-Emission Tomography Posterior cingulate Female Psychology Insula 030217 neurology & neurosurgery |
| Zdroj: | European Psychiatry. 41:85-94 |
| ISSN: | 1778-3585 0924-9338 |
| DOI: | 10.1016/j.eurpsy.2016.09.009 |
| Popis: | BackgroundBipolar disorder (BD) may be characterized by the presence of psychotic symptoms and comorbid substance abuse. In this context, structural and metabolic dysfunctions have been reported in both BD with psychosis and addiction, separately. In this study, we aimed at identifying neural substrates differentiating psychotic BD, with or without substance abuse, versus substance-induced psychosis (SIP) by coupling, for the first time, magnetic resonance imaging (MRI) and positron emission tomography (PET).MethodsTwenty-seven BD type I psychotic patients with (n= 10) or without (n= 17) substance abuse, 16 SIP patients and 54 healthy controls were enrolled in this study. 3T MRI and 18-FDG-PET scanning were acquired.ResultsGray matter (GM) volume and cerebral metabolism reductions in temporal cortices were observed in all patients compared to healthy controls. Moreover, a distinct pattern of fronto-limbic alterations were found in patients with substance abuse. Specifically, BD patients with substance abuse showed volume reductions in ventrolateral prefrontal cortex, anterior cingulate, insula and thalamus, whereas SIP patients in dorsolateral prefrontal cortex and posterior cingulate. Common alterations in cerebellum, parahippocampus and posterior cingulate were found in both BD with substance abuse and SIP. Finally, a unique pattern of GM volumes reduction, with concomitant increased of striatal metabolism, were observed in SIP patients.ConclusionsThese findings contribute to shed light on the identification of common and distinct neural markers associated with bipolar psychosis and substance abuse. Future longitudinal studies should explore the effect of single substances of abuse in patients at the first-episode of BD and substance-induced psychosis. |
| Databáze: | OpenAIRE |
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