Poster No:
364
Submission Type:
Abstract Submission
Authors:
Pao-Huan Chen1,2,3, Tzu-Yu Hsu4,5, Cheng-Yi Hsiao6,7
Institutions:
1Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan, 2Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan, 3Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, 4Graduate Institute of Mind, Brain, and Consciousness, Taipei Medical University, Taipei, Taiwan, 5Research Center of Neuroscience, Taipei Medical University, Taipei, Taiwan, 6Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, 7Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan
First Author:
Pao-Huan Chen
Department of Psychiatry, Taipei Medical University Hospital|Psychiatric Research Center, Taipei Medical University Hospital|Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University
Taipei, Taiwan|Taipei, Taiwan|Taipei, Taiwan
Co-Author(s):
Tzu-Yu Hsu
Graduate Institute of Mind, Brain, and Consciousness, Taipei Medical University|Research Center of Neuroscience, Taipei Medical University
Taipei, Taiwan|Taipei, Taiwan
Cheng-Yi Hsiao
Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital|Cardiovascular Research Center, Taipei Medical University Hospital
Taipei, Taiwan|Taipei, Taiwan
Introduction:
Bipolar disorder is a severe mental disorder that usually first manifests in adolescence and young adulthood (McIntyre et al., 2020). Beyond the affective symptoms across the lifespan, cardiovascular diseases are prevalent in individuals with bipolar disorder (Goldstein et al., 2020) and are associated with mood instability (Kemp et al., 2014), impulsivity (Naiberg et al., 2016), suicide mortality (Chen et al., 2023) and reduced regional brain structure (Kennedy et al., 2021; McWhinney et al., 2021). Despite evidence that individuals with bipolar disorder tend to have electroencephalogram (EEG) microstate abnormalities (Xue et al., 2024), few studies have assessed the connections between cardiovascular burden and aberrant EEG microstates in individuals with bipolar disorder. Herein we investigated whether cardiovascular burden was associated with aberrant EEG microstates among patients diagnosed with bipolar disorder.
Methods:
This study examined the resting EEG data, cardiac imaging and cardiovascular risk factors of 53 participants (27 euthymic patients with bipolar disorder and 26 age- and sex-matched healthy controls) aged between 20 and 45 years old. EEG topographic maps were categorized into seven microstate classes: A, B, C, D, E, F, and G. Three microstate parameters, namely duration, occurrence, and proportion, were calculated for each class. Speckle-tracking echocardiographic images were obtained to evaluate heart function following the guidelines and practical techniques recommended by the American Society of Echocardiography and European Association of Cardiovascular Imaging. Cardiovascular risk factor profiles comprised body mass index, blood pressure, fasting glucose and lipids. The study protocol was approved by the Joint Institutional Review Board of Taipei Medical University (Approval Numbers: N202106045 and N202204047). All participants provided written informed consent before engaging in study procedures.
Results:
Compared to the age- and sex-matched healthy controls, euthymic patients with bipolar disorder exhibited a greater body mass index (Cohen's d = 1.24, p < 0.05), higher serum fasting glucose (Cohen's d = 2.13, p < 0.05) and reduced global longitudinal strain (Cohen's d = 1.27, p < 0.05). Additionally, euthymic patients with bipolar disorder had a decreased occurrence of microstate D (Cohen's d = 0.22, p < 0.05) and increased occurrence of microstate F (Cohen's d = 0.40, p < 0.05). Correlation analyses showed that the occurrence of microstate D was negatively correlated with systolic blood pressure (r = –0.35, p < 0.05), diastolic blood pressure (r = –0.39, p < 0.05) and serum level of fasting glucose (r = –0.37, p < 0.05), whereas the occurrence of microstate F was negatively correlated to the global longitudinal strain (r = –0.36, p < 0.05).
Conclusions:
This study in line with the literature suggests an increased risk of cardiovascular burden in individuals with bipolar disorder. Moreover, this study illustrated that cardiovascular burden was associated with aberrant EEG microstates. Future studies are required to validate our present findings and delineate mechanisms beneath the associations between cardiovascular burden and aberrant EEG microstates using a larger study sample.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 1
Novel Imaging Acquisition Methods:
EEG 2
Keywords:
Other - bipolar disorder; electroencephalogram; microstate; cardiovascular risk factor; speckle-tracking echocardiographic imaging
1|2Indicates the priority used for review
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Please indicate below if your study was a "resting state" or "task-activation” study.
Resting state
Healthy subjects only or patients (note that patient studies may also involve healthy subjects):
Patients
Was this research conducted in the United States?
No
Were any human subjects research approved by the relevant Institutional Review Board or ethics panel?
NOTE: Any human subjects studies without IRB approval will be automatically rejected.
Yes
Were any animal research approved by the relevant IACUC or other animal research panel?
NOTE: Any animal studies without IACUC approval will be automatically rejected.
Not applicable
Please indicate which methods were used in your research:
EEG/ERP
Other, Please specify
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speckle-tracking echocardiography
Provide references using APA citation style.
Chen, P.H. (2023). Sex-specific risk profiles for suicide mortality in bipolar disorder: incidence, healthcare utilization and comorbidity. Psychological Medicine, 53(4), 1500-1509.
Goldstein, B.I. (2020). Call to action regarding the vascular-bipolar link: A report from the Vascular Task Force of the International Society for Bipolar Disorders. Bipolar Disorders, 22(5), 440-460.
Kemp, D.E. (2014). General medical burden in bipolar disorder: findings from the LiTMUS comparative effectiveness trial. Acta Psychiatrica Scandinavica, 129(1), 24-34.
Kennedy, K.G. (2021). Elevated lipids are associated with reduced regional brain structure in youth with bipolar disorder. Acta Psychiatrica Scandinavica, 143(6), 513-525.
McIntyre, R.S. (2020). Bipolar disorders. Lancet, 396(10265), 1841-1856.
McWhinney, S.R. (2021). Association between body mass index and subcortical brain volumes in bipolar disorders-ENIGMA study in 2735 individuals. Molecular Psychiatry, 26(11), 6806-6819.
Naiberg, M.R. (2016). Impulsivity is associated with blood pressure and waist circumference among adolescents with bipolar disorder. Journal of Psychiatric Research, 83, 230-239.
Xue, R. (2024). Shared and distinct electroencephalogram microstate abnormalities across schizophrenia, bipolar disorder, and depression. Psychological Medicine, Online ahead of print.
No