Global functional connectivity density alterations in patients with bipolar disorder with auditory verbal hallucinations and modest short‐term effects of transcranial direct current stimulation augmentation treatment—Baseline and follow‐up study. Issue 6 (18th April 2020)

• Record Type: Journal Article
• Authors: Zhuo, Chuanjun; Ji, Feng; Lin, Xiaodong; Tian, Hongjun; Wang, Lina; Xu, Yong; Wang, Wenqiang; Jiang, Deguo
• Is Part Of: Brain and behavior. Volume 10:Issue 6(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-04-18
• Subjects: auditory verbal hallucination -- bipolar disorder -- gFCD -- hippocampus -- tDCS; Neurology -- Periodicals; Neurosciences -- Periodicals; Psychology -- Periodicals; Psychiatry -- Periodicals; 616.8005
• DOI: 10.1002/brb3.1637
• Languages: English
• ISSNs: 2162-3279

Abstract

Abstract: Objectives: To investigate the neuroimaging characteristics of auditory verbal hallucinations (AVHs) in patients with bipolar disorder (BP) experiencing depressive episodes with and without AVHs, and alterations in those characteristics after transcranial direct current stimulation (tDCS). Methods: For a baseline pilot study, we recruited 80 patients with BP and depressive status (40 with and 40 without AVHs), and 40 healthy controls (HCs). Their global functional connectivity density (gFCD) was screened by functional magnetic resonance imaging (fMRI). Voxel‐wise one‐way analysis of covariance (ANCOVA) was conducted to detect intergroup differences in gFCD. In a follow‐up study, the effects of 5 weeks of tDCS augmentation treatment on clinical symptoms and gFCD were assessed in the 40 BP patients with AVHs. Results: Compared to HCs, BP patients with and without AVHs exhibited increased gFCD in the central parietal lobe, insular lobe, and middle cingulate cortex, with decreased gFCD in the posterior parietal cortex, lateral prefrontal cortex, and occipital lobe (all bilateral). Only patients with AVHs showed increased gFCD in the Broca and Wernicke regions, and decreased gFCD in the hippocampus (all bilateral). After 5 weeks of tDCS, AVHs were slightly alleviated and gFCD abnormalities in the hippocampus were mildly attenuated. Conclusions: Patients with BP and AVHs showed disturbances in the brain's communication capacity mainly in the left frontoparietal network, control network, and memory circuitry. Five weeks of tDCS alleviated AVHs slightly, without improving depressive symptoms, and attenuated hippocampal gFCD alterations in these patients. Abstract : To the best of our knowledge, this report is the first to date to describe gFCD alterations in patients with BD with and without AVHs and to investigate the effects of tDCS augmentation treatment on AVHs in patients diagnosed with BD. Our findings suggest that there are information communication disturbances affecting the left frontoparietal network, control network, and memory circuitry in patients with BD and AVHs. Short‐term (5‐week) tDCS augmentation treatment alleviated AVHs modestly in this patient population while reversing BD‐associated gFCD alterations in the hippocampus. Going forward, it will be important to optimize tDCS treatment regimens for patients with BD.