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Structural correlates of trait impulsivity in patients with bipolar disorder and healthy controls: a surface-based morphometry study

Published online by Cambridge University Press:  12 January 2017

P. C. Tu ,
Y. H. Kuan ,
C. T. Li  and
T. P. Su
P. C. Tu
Affiliation:
Department of Medical Research, Taipei Veterans General Hospital, Taipei 112, Taiwan Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
Y. H. Kuan
Affiliation:
Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
C. T. Li
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
T. P. Su*
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
*
*Address for correspondence: T.-P. Su, Office of the Vice Superintendent, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan. (Email: tomsu0402@gmail.com)
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Abstract

Background

Patients with bipolar disorder (BD) frequently exhibit impulsive behaviors independent of their mood state, and trait impulsivity is increasingly recognized as a crucial BD biomarker. This study aimed to investigate structural correlates of trait impulsivity measured using the Barratt Impulsiveness Scale (BIS) in healthy controls (HCs) and patients with BD.

Method

We recruited 59 patients diagnosed with BD I or BD II (35.3 ± 8.5 years) and 56 age- and sex-matched HCs (33.9 ± 7.4 years). Participants underwent structural magnetic resonance imaging and clinical evaluations, and their BIS scores were evaluated. An automated surface-based method (FreeSurfer) was used to measure cortical thickness and generate thickness maps for each participant. Brain-wise regression analysis of the association between cortical thickness and BIS scores was performed separately for BD and HC groups by using a general linear model.

Results

Patients with BD obtained significantly higher BIS scores than HCs. In HCs, higher BIS scores were associated with a thinner cortex in the left inferior, middle and medial frontal cortices. By contrast, in BD patients, higher BIS scores were associated with a thicker cortex in the right insula. Patients with BD showed a thinner cortex than HCs in all these four structures.

Conclusions

The findings indicate that the left prefrontal cortex plays a cardinal role in trait impulsivity of healthy individuals. Patients with BD have a different structural correlate of trait impulsivity in the right insula. However, the use of various psychotropics in patients with BD may limit our interpretation of BD findings.

Keywords

Cortical thicknesssurface-based methodstrait impulsivity

Information

Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 7 , May 2017 , pp. 1292 - 1299
Copyright
Copyright © Cambridge University Press 2017 

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References

Ansell, BR, Dwyer, DB, Wood, SJ, Bora, E, Brewer, WJ, Proffitt, TM, Velakoulis, D, McGorry, PD, Pantelis, C (2015). Divergent effects of first-generation and second-generation antipsychotics on cortical thickness in first-episode psychosis. Psychological Medicine 45, 515–527.Google Scholar
Aron, AR (2011). From reactive to proactive and selective control: developing a richer model for stopping inappropriate responses. Biological Psychiatry 69, e55–e68.Google Scholar
Aron, AR, Monsell, S, Sahakian, BJ, Robbins, TW (2004 a). A componential analysis of task-switching deficits associated with lesions of left and right frontal cortex. Brain 127, 1561–1573.Google Scholar
Aron, AR, Robbins, TW, Poldrack, RA (2004 b). Inhibition and the right inferior frontal cortex. Trends in Cognitive Sciences 8, 170–177.Google Scholar
Brass, M, Haggard, P (2007). To do or not to do: the neural signature of self-control. Journal of Neuroscience 27, 9141–9145.Google Scholar
Chan, H, Chen, E, Chan, R, Hung, S, Cheung, E, Law, C, Chan, P, Lam, M (2003). A comparison of psychological profiles between suicide ideators and non-ideators among psychiatric patients: a preliminary report. Schizophrenia Research 60 (Suppl. 1), 337.Google Scholar
Dale, AM, Fischl, B, Sereno, MI (1999). Cortical surface-based analysis: I. Segmentation and surface reconstruction. NeuroImage 9, 179–194.Google Scholar
Dambacher, F, Sack, AT, Lobbestael, J, Arntz, A, Brugman, S, Schuhmann, T (2015). Out of control: evidence for anterior insula involvement in motor impulsivity and reactive aggression. Social Cognitive and Affective Neuroscience 10, 508–516.Google Scholar
Dosenbach, NU, Fair, DA, Miezin, FM, Cohen, AL, Wenger, KK, Dosenbach, RA, Fox, MD, Snyder, AZ, Vincent, JL, Raichle, ME, Schlaggar, BL, Petersen, SE (2007). Distinct brain networks for adaptive and stable task control in humans. Proceedings of the National Academy of Sciences of the USA 104, 11073–11078.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1997). User's Guide for the Structured Clinical Interview for DSM-IV Axis I Disorders SCID-I: Clinician Version. American Psychiatric Press: Washington, DC.Google Scholar
Fischl, B, Dale, AM (2000). Measuring the thickness of the human cerebral cortex from magnetic resonance images. Proceedings of the National Academy of Sciences of the USA 97, 11050–11055.Google Scholar
Fischl, B, Sereno, MI, Dale, AM (1999 a). Cortical surface-based analysis: II: inflation, flattening, and a surface-based coordinate system. NeuroImage 9, 195–207.Google Scholar
Fischl, B, Sereno, MI, Tootell, RBH, Dale, AM (1999 b). High-resolution intersubject averaging and a coordinate system for the cortical surface. Human Brain Mapping 8, 272–284.Google Scholar
Giakoumatos, CI, Nanda, P, Mathew, IT, Tandon, N, Shah, J, Bishop, JR, Clementz, BA, Pearlson, GD, Sweeney, JA, Tamminga, CA, Keshavan, MS (2015). Effects of lithium on cortical thickness and hippocampal subfield volumes in psychotic bipolar disorder. Journal of Psychiatric Research 61, 180–187.Google Scholar
Goghari, VM, Smith, GN, Honer, WG, Kopala, LC, Thornton, AE, Su, W, Macewan, GW, Lang, DJ (2013). Effects of eight weeks of atypical antipsychotic treatment on middle frontal thickness in drug-naive first-episode psychosis patients. Schizophrenia Research 149, 149–155.Google Scholar
Hagler, DJ Jr., Saygin, AP, Sereno, MI (2006). Smoothing and cluster thresholding for cortical surface-based group analysis of fMRI data. NeuroImage 33, 1093–1103.Google Scholar
Hajek, T, Alda, M, Hajek, E, Ivanoff, J (2013). Functional neuroanatomy of response inhibition in bipolar disorders – combined voxel based and cognitive performance meta-analysis. Journal of Psychiatric Research 47, 1955–1966.Google Scholar
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 56–62.Google Scholar
Henna, E, Hatch, JP, Nicoletti, M, Swann, AC, Zunta-Soares, G, Soares, JC (2013). Is impulsivity a common trait in bipolar and unipolar disorders? Bipolar Disorders 15, 223–227.Google Scholar
Kaag, AM, Crunelle, CL, van Wingen, G, Homberg, J, van den Brink, W, Reneman, L (2014). Relationship between trait impulsivity and cortical volume, thickness and surface area in male cocaine users and non-drug using controls. Drug and Alcohol Dependence 144, 210–217.Google Scholar
Kuperberg, GR, Broome, MR, McGuire, PK, David, AS, Eddy, M, Ozawa, F, Goff, D, West, WC, Williams, SC, van der Kouwe, AJ, Salat, DH, Dale, AM, Fischl, B (2003). Regionally localized thinning of the cerebral cortex in schizophrenia. Archives of General Psychiatry 60, 878–888.Google Scholar
Lesh, TA, Tanase, C, Geib, BR, Niendam, TA, Yoon, JH, Minzenberg, MJ, Ragland, JD, Solomon, M, Carter, CS (2015). A multimodal analysis of antipsychotic effects on brain structure and function in first-episode schizophrenia. JAMA Psychiatry 72, 226–234.Google Scholar
Matsuo, K, Nicoletti, M, Nemoto, K, Hatch, JP, Peluso, MA, Nery, FG, Soares, JC (2009 a). A voxel-based morphometry study of frontal gray matter correlates of impulsivity. Human Brain Mapping 30, 1188–1195.Google Scholar
Matsuo, K, Nicoletti, MA, Peluso, MA, Hatch, JP, Nemoto, K, Watanabe, Y, Nery, FG, Monkul, ES, Zunta-Soares, GB, Bowden, CL, Soares, JC (2009 b). Anterior cingulate volumes associated with trait impulsivity in individuals with bipolar disorder. Bipolar Disorders 11, 628–636.Google Scholar
McHugh, MJ, Demers, CH, Braud, J, Briggs, R, Adinoff, B, Stein, EA (2013). Striatal–insula circuits in cocaine addiction: implications for impulsivity and relapse risk. American Journal of Drug and Alcohol Abuse 39, 424–432.Google Scholar
Moeller, FG, Barratt, ES, Dougherty, DM, Schmitz, JM, Swann, AC (2001). Psychiatric aspects of impulsivity. American Journal of Psychiatry 158, 1783–1793.Google Scholar
Najt, P, Perez, J, Sanches, M, Peluso, MA, Glahn, D, Soares, JC (2007). Impulsivity and bipolar disorder. European Neuropsychopharmacology 17, 313–320.Google Scholar
Nandagopal, JJ, Fleck, DE, Adler, CM, Mills, NP, Strakowski, SM, DelBello, MP (2011). Impulsivity in adolescents with bipolar disorder and/or attention-deficit/hyperactivity disorder and healthy controls as measured by the Barratt Impulsiveness Scale. Journal of Child and Adolescent Psychopharmacology 21, 465–468.Google Scholar
Ozten, M, Erol, A, Karayilan, S, Kapudan, H, Orsel, ES, Kumsar, NA (2015). Impulsivity in bipolar and substance use disorders. Comprehensive Psychiatry 59, 28–32.Google Scholar
Pardoe, HR, Berg, AT, Jackson, GD (2013). Sodium valproate use is associated with reduced parietal lobe thickness and brain volume. Neurology 80, 1895–1900.Google Scholar
Patton, JH, Stanford, MS, Barratt, ES (1995). Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology 51, 768–774.Google Scholar
Powers, RL, Russo, M, Mahon, K, Brand, J, Braga, RJ, Malhotra, AK, Burdick, KE (2013). Impulsivity in bipolar disorder: relationships with neurocognitive dysfunction and substance use history. Bipolar Disorders 15, 876–884.Google Scholar
Roberts, G, Green, MJ, Breakspear, M, McCormack, C, Frankland, A, Wright, A, Levy, F, Lenroot, R, Chan, HN, Mitchell, PB (2013). Reduced inferior frontal gyrus activation during response inhibition to emotional stimuli in youth at high risk of bipolar disorder. Biological Psychiatry 74, 55–61.Google Scholar
Rosas, HD, Liu, AK, Hersch, S, Glessner, M, Ferrante, RJ, Salat, DH, van der Kouwe, A, Jenkins, BG, Dale, AM, Fischl, B (2002). Regional and progressive thinning of the cortical ribbon in Huntington's disease. Neurology 58, 695–701.Google Scholar
Schilling, C, Kuhn, S, Paus, T, Romanowski, A, Banaschewski, T, Barbot, A, Barker, GJ, Bruhl, R, Buchel, C, Conrod, PJ, Dalley, JW, Flor, H, Ittermann, B, Ivanov, N, Mann, K, Martinot, JL, Nees, F, Rietschel, M, Robbins, TW, Smolka, MN, Strohle, A, Kathmann, N, Garavan, H, Heinz, A, Schumann, G, Gallinat, J (2013 a). Cortical thickness of superior frontal cortex predicts impulsiveness and perceptual reasoning in adolescence. Molecular Psychiatry 18, 624–630.Google Scholar
Schilling, C, Kuhn, S, Romanowski, A, Banaschewski, T, Barbot, A, Barker, GJ, Bruhl, R, Buchel, C, Charlet, K, Conrod, PJ, Czech, K, Dalley, JW, Flor, H, Hake, I, Ittermann, B, Ivanov, N, Mann, K, Ludemann, K, Martinot, JL, Palafox, C, Paus, T, Poline, JB, Reuter, J, Rietschel, M, Robbins, TW, Smolka, MN, Strohle, A, Walaszek, B, Kathmann, N, Schumann, G, Heinz, A, Garavan, H, Gallinat, J (2013 b). Common structural correlates of trait impulsiveness and perceptual reasoning in adolescence. Human Brain Mapping 34, 374–383.Google Scholar
Schilling, C, Kuhn, S, Romanowski, A, Schubert, F, Kathmann, N, Gallinat, J (2012). Cortical thickness correlates with impulsiveness in healthy adults. NeuroImage 59, 824–830.Google Scholar
Seeley, WW, Menon, V, Schatzberg, AF, Keller, J, Glover, GH, Kenna, H, Reiss, AL, Greicius, MD (2007). Dissociable intrinsic connectivity networks for salience processing and executive control. Journal of Neuroscience 27, 2349–2356.Google Scholar
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59 (Suppl. 20), 22–33; quiz 34–57.Google Scholar
Steinbeis, N, Bernhardt, BC, Singer, T (2012). Impulse control and underlying functions of the left DLPFC mediate age-related and age-independent individual differences in strategic social behavior. Neuron 73, 1040–1051.Google Scholar
Swann, AC, Anderson, JC, Dougherty, DM, Moeller, FG (2001). Measurement of inter-episode impulsivity in bipolar disorder. Psychiatry Research 101, 195–197.Google Scholar
Swann, AC, Pazzaglia, P, Nicholls, A, Dougherty, DM, Moeller, FG (2003). Impulsivity and phase of illness in bipolar disorder. Journal of Affective Disorders 73, 105–111.Google Scholar
Townsend, JD, Bookheimer, SY, Foland-Ross, LC, Moody, TD, Eisenberger, NI, Fischer, JS, Cohen, MS, Sugar, CA, Altshuler, LL (2012). Deficits in inferior frontal cortex activation in euthymic bipolar disorder patients during a response inhibition task. Bipolar Disorders 14, 442–450.Google Scholar
Wessa, M, Kollmann, B, Linke, J, Schonfelder, S, Kanske, P (2015). Increased impulsivity as a vulnerability marker for bipolar disorder: evidence from self-report and experimental measures in two high-risk populations. Journal of Affective Disorders 178, 18–24.Google Scholar
Wisner, KM, Patzelt, EH, Lim, KO, MacDonald, AW III (2013). An intrinsic connectivity network approach to insula-derived dysfunctions among cocaine users. American Journal of Drug and Alcohol Abuse 39, 403–413.Google Scholar
Young, RC, Biggs, JT, Ziegler, VE, Meyer, DA (1978). A rating scale for mania: reliability, validity and sensitivity. British Journal of Psychiatry 133, 429–435.Google Scholar
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