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White matter abnormalities in depression: A categorical and phenotypic diffusion MRI study. NEUROIMAGE-CLINICAL 2019; 22:101710. [PMID: 30849644 PMCID: PMC6406626 DOI: 10.1016/j.nicl.2019.101710] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/25/2019] [Accepted: 02/03/2019] [Indexed: 01/10/2023]
Abstract
Mood depressive disorder is one of the most disabling chronic diseases with a high rate of everyday life disability that affects 350 million people around the world. Recent advances in neuroimaging have reported widespread structural abnormalities, suggesting a dysfunctional frontal-limbic circuit involved in the pathophysiological mechanisms of depression. However, a variety of different white matter regions has been implicated and is sought to suffer from lack of reproducibility of such categorical-based biomarkers. These inconsistent results might be attributed to various factors: actual categorical definition of depression as well as clinical phenotype variability. In this study, we 1/ examined WM changes in a large cohort (114 patients) compared to a healthy control group and 2/ sought to identify specific WM alterations in relation to specific depressive phenotypes such as anhedonia (i.e. lack of pleasure), anxiety and psychomotor retardation –three core symptoms involved in depression. Consistent with previous studies, reduced white matter was observed in the genu of the corpus callosum extending to the inferior fasciculus and posterior thalamic radiation, confirming a frontal-limbic circuit abnormality. Our analysis also reported other patterns of increased fractional anisotropy and axial diffusivity as well as decreased apparent diffusion coefficient and radial diffusivity in the splenium of the corpus callosum and posterior limb of the internal capsule. Moreover, a positive correlation between FA and anhedonia was found in the superior longitudinal fasciculus as well as a negative correlation in the cingulum. Then, the analysis of the anxiety and diffusion metric revealed that increased anxiety was associated with greater FA values in genu and splenium of corpus callosum, anterior corona radiata and posterior thalamic radiation. Finally, the motor retardation analysis showed a correlation between increased Widlöcher depressive retardation scale scores and reduced FA in the body and genu of the corpus callosum, fornix, and superior striatum. Through this twofold approach (categorical and phenotypic), this study has underlined the need to move forward to a symptom-based research area of biomarkers, which help to understand the pathophysiology of mood depressive disorders and to stratify precise phenotypes of depression with targeted therapeutic strategies. Mood depressive disorder is one of the most disabling chronic disease. Past studies of diffusion analysis had found inconsistent results. We analyzed white matter integrity in a large cohort of depressed patients. We conducted both categorical and dimensional approaches. In the future, these biomarkers could help to develop new therapeutic strategies.
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Millard SJ, Lum JS, Fernandez F, Weston-Green K, Newell KA. Perinatal exposure to fluoxetine increases anxiety- and depressive-like behaviours and alters glutamatergic markers in the prefrontal cortex and hippocampus of male adolescent rats: A comparison between Sprague-Dawley rats and the Wistar-Kyoto rat model of depression. J Psychopharmacol 2019; 33:230-243. [PMID: 30698051 DOI: 10.1177/0269881118822141] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND With approximately 10% of pregnant women prescribed antidepressant drugs for the treatment of depressive disorders, there is growing concern regarding the potential long-term effects of this exposure on offspring. Research is needed in clinically relevant models to determine the effects on offspring behaviour and associated neurobiological systems. AIM The aim of this study was to determine the effects of maternal fluoxetine treatment on anxiety-like and depressive-like behaviours in adolescent offspring as well as associated glutamatergic markers, using a clinically relevant rodent model of depression. METHODS Wistar-Kyoto (model of innate depression) and Sprague-Dawley rats were treated with fluoxetine (10 mg/kg) from gestational day 0 to postnatal day 14. Male offspring underwent behavioural testing (open field, elevated plus maze, forced swim test) at adolescence followed by quantitative immuno-detection of glutamatergic markers in the prefrontal cortex and ventral hippocampus. RESULTS Perinatal fluoxetine exposure exacerbated the anxiety-like and depressive-like phenotype in Wistar-Kyoto offspring and induced an anxiety-like and depressive-like phenotype in Sprague-Dawley offspring. Wistar-Kyoto offspring showed reductions in NMDA receptor NR1, NR2A and NR2B subunits, as well as post-synaptic density 95 (PSD-95) and metabotropic glutamate receptor subtype 1 (mGluR1) in the prefrontal cortex; perinatal fluoxetine exposure further reduced NR1, NR2A, PSD-95 and mGluR1 expression in Wistar-Kyoto as well as Sprague-Dawley offspring. In the ventral hippocampus perinatal fluoxetine exposure reduced PSD-95 and increased metabotropic glutamate receptor subtype 5 (mGluR5) and Homer1b/c in both Sprague-Dawley and Wistar-Kyoto strains. CONCLUSION These findings suggest that maternal fluoxetine treatment exacerbates effects of underlying maternal depression on offspring behaviour, which may be mediated through alterations in the glutamatergic system. Further research investigating how to minimise these effects, whilst ensuring optimal treatment for mothers, is essential to move the field forward.
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Affiliation(s)
- Samuel J Millard
- 1 Molecular Horizons and School of Medicine, University of Wollongong, Wollongong, NSW, Australia
- 2 Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Jeremy S Lum
- 1 Molecular Horizons and School of Medicine, University of Wollongong, Wollongong, NSW, Australia
- 2 Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Francesca Fernandez
- 3 School of Science, Australian Catholic University, Brisbane, QLD, Australia
| | - Katrina Weston-Green
- 1 Molecular Horizons and School of Medicine, University of Wollongong, Wollongong, NSW, Australia
- 2 Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Kelly A Newell
- 1 Molecular Horizons and School of Medicine, University of Wollongong, Wollongong, NSW, Australia
- 2 Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
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Perlman K, Benrimoh D, Israel S, Rollins C, Brown E, Tunteng JF, You R, You E, Tanguay-Sela M, Snook E, Miresco M, Berlim MT. A systematic meta-review of predictors of antidepressant treatment outcome in major depressive disorder. J Affect Disord 2019; 243:503-515. [PMID: 30286415 DOI: 10.1016/j.jad.2018.09.067] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/29/2018] [Accepted: 09/16/2018] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The heterogeneity of symptoms and complex etiology of depression pose a significant challenge to the personalization of treatment. Meanwhile, the current application of generic treatment approaches to patients with vastly differing biological and clinical profiles is far from optimal. Here, we conduct a meta-review to identify predictors of response to antidepressant therapy in order to select robust input features for machine learning models of treatment response. These machine learning models will allow us to learn associations between patient features and treatment response which have predictive value at the individual patient level; this learning can be optimized by selecting high-quality input features for the model. While current research is difficult to directly apply to the clinic, machine learning models built using knowledge gleaned from current research may become useful clinical tools. METHODS The EMBASE and MEDLINE/PubMed online databases were searched from January 1996 to August 2017, using a combination of MeSH terms and keywords to identify relevant literature reviews. We identified a total of 1909 articles, wherein 199 articles met our inclusion criteria. RESULTS An array of genetic, immune, endocrine, neuroimaging, sociodemographic, and symptom-based predictors of treatment response were extracted, varying widely in clinical utility. LIMITATIONS Due to heterogeneous sample sizes, effect sizes, publication biases, and methodological disparities across reviews, we could not accurately assess the strength and directionality of every predictor. CONCLUSION Notwithstanding our cautious interpretation of the results, we have identified a multitude of predictors that can be used to formulate a priori hypotheses regarding the input features for a computational model. We highlight the importance of large-scale research initiatives and clinically accessible biomarkers, as well as the need for replication studies of current findings. In addition, we provide recommendations for future improvement and standardization of research efforts in this field.
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Affiliation(s)
- Kelly Perlman
- Montreal Neurological Institute, McGill University, 3801 Rue Université, Montréal, QC H3A 2B4, Canada.
| | - David Benrimoh
- Department of Psychiatry, McGill University, Montreal, Canada; Faculty of Medicine, McGill University, Montreal, Canada
| | - Sonia Israel
- Department of Psychiatry, McGill University, Montreal, Canada; Douglas Mental Health University Institute, Montreal, Canada
| | - Colleen Rollins
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK
| | - Eleanor Brown
- Montreal Neurological Institute, McGill University, 3801 Rue Université, Montréal, QC H3A 2B4, Canada
| | - Jingla-Fri Tunteng
- Montreal Children's Hospital, McGill University Health Center, Montreal, Canada
| | - Raymond You
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Eunice You
- Faculty of Medicine, McGill University, Montreal, Canada
| | - Myriam Tanguay-Sela
- Montreal Neurological Institute, McGill University, 3801 Rue Université, Montréal, QC H3A 2B4, Canada
| | - Emily Snook
- Douglas Mental Health University Institute, Montreal, Canada
| | - Marc Miresco
- Department of Psychiatry, Jewish General Hospital, Montreal, Canada
| | - Marcelo T Berlim
- Department of Psychiatry, McGill University, Montreal, Canada; Douglas Mental Health University Institute, Montreal, Canada
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Suh JS, Schneider MA, Minuzzi L, MacQueen GM, Strother SC, Kennedy SH, Frey BN. Cortical thickness in major depressive disorder: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2019; 88:287-302. [PMID: 30118825 DOI: 10.1016/j.pnpbp.2018.08.008] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/30/2018] [Accepted: 08/13/2018] [Indexed: 01/10/2023]
Abstract
Neuroimaging studies assessing neurobiological differences between patients with major depressive disorder (MDD) and healthy controls (HC) are often hindered by small sample sizes and heterogeneity of the patient sample. We performed a comprehensive literature search for studies assessing cortical thickness between patient and control groups, including studies investigating treatment effects on cortical thickness. We identified 34 studies meeting criteria for the systematic review and used Seed-based d Mapping to meta-analyze 24 of those that met additional criteria. Analysis of the full sample of subjects (MDD = 1073; HC = 936) revealed significant thinning in the MDD group in the bilateral orbitofrontal gyrus (BA 11), left pars opercularis (BA 45) and left calcarine fissure/lingual gyrus (BA 17), as well as an area of significant thickening in the left supramarginal gyrus (BA 40). These results support other imaging modalities that report disruptions in various frontal and temporal areas in MDD and identify additional areas in all major cerebral lobes likely to be significant when parsing for biomarkers of treatment or relapse.
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Affiliation(s)
- Jee Su Suh
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Maiko Abel Schneider
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luciano Minuzzi
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Glenda M MacQueen
- Department of Psychiatry, Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, AB, Canada
| | - Stephen C Strother
- Rotman Research Institute, Baycrest and Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Sidney H Kennedy
- Canadian Biomarker Integration Network for Depression, St. Michael's Hospital, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Arthur Sommer Rotenberg Chair in Suicide & Depression Studies, St. Michael's Hospital, Toronto, ON, Canada
| | - Benicio N Frey
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada; Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
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Schulz P. Opportunities and challenges in psychopharmacology
. DIALOGUES IN CLINICAL NEUROSCIENCE 2019; 21:119-130. [PMID: 31636486 PMCID: PMC6787536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
This review addresses novel approaches for influencing the transcriptome, the epigenome, the microbiome, the proteome, and the energy metabolome. These innovations help develop psychotropic medications which will directly reach the molecular targets, leading to beneficial effects, and which will be individually adapted to provide more efficacy and less toxicity. The series of advances described here show that these once utopian goals for psychiatric treatment are now real themes of research, indicating that the future path for psychopharmacology might not be as narrow and grim as considered during the last few decades.
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Affiliation(s)
- Pierre Schulz
- Private practice as psychiatrist; Head of the Unit of Clinical Psychopharmacology (retired), Geneva University Hospitals, Geneva, Switzerland
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Peng D, Yao Z. Neuroimaging Advance in Depressive Disorder. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1180:59-83. [DOI: 10.1007/978-981-32-9271-0_3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Koenig J, Westlund Schreiner M, Klimes-Dougan B, Ubani B, Mueller BA, Lim KO, Kaess M, Cullen KR. Increases in orbitofrontal cortex thickness following antidepressant treatment are associated with changes in resting state autonomic function in adolescents with major depression - Preliminary findings from a pilot study. Psychiatry Res Neuroimaging 2018; 281:35-42. [PMID: 30216863 PMCID: PMC6204080 DOI: 10.1016/j.pscychresns.2018.08.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 07/23/2018] [Accepted: 08/22/2018] [Indexed: 12/18/2022]
Abstract
In adults with major depressive disorder (MDD), effective treatment has been associated with increases in both heart rate variability (HRV) and cortical thickness. However, the impact of treatment on these indices has not yet been examined in adolescents. Cortical thickness and HRV were measured in twelve adolescents with MDD before and after 8 weeks of treatment with a selective serotonin reuptake inhibitor (SSRI). We examined treatment-related changes in depression symptoms, HRV, heart rate (HR), and cortical thickness, and analyzed correlations among these change indices. At follow-up, patients showed significantly decreased depression severity, increased HRV and increased thickness of the left medial orbitofrontal cortex (OFC). Clinical improvement was associated with increased HRV and decreased HR. Increased HRV was associated with increased cortical thickness of left lateral OFC and superior frontal cortex. Due to the small sample size, results represent preliminary findings that need replication. Further, in the absence of a placebo arm, we cannot confirm that the observed effects are due solely to medication. These preliminary findings suggest that SSRI treatment in adolescents impacts both cortical thickness and autonomic functioning. Confirmation of these findings would support OFC thickness and HRV as neurobiological mediators of treatment outcome.
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Affiliation(s)
- Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Stöckli, Bolligenstrasse 111, 3000, Bern 60, Switzerland; Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Blumenstr. 8, 69115, Heidelberg, Germany.
| | - Melinda Westlund Schreiner
- Department of Psychology, University of Minnesota, College of Liberal Arts, N218 Elliott Hall, 75 East River Road, Minneapolis, MN, USA
| | - Bonnie Klimes-Dougan
- Department of Psychology, University of Minnesota, College of Liberal Arts, N218 Elliott Hall, 75 East River Road, Minneapolis, MN, USA
| | - Benjamin Ubani
- Department of Psychiatry, University of Minnesota, Medical School, F256/2B West Building, 2450 Riverside Avenue, Minneapolis, MN, USA
| | - Bryon A Mueller
- Department of Psychiatry, University of Minnesota, Medical School, F256/2B West Building, 2450 Riverside Avenue, Minneapolis, MN, USA
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Medical School, F256/2B West Building, 2450 Riverside Avenue, Minneapolis, MN, USA
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Stöckli, Bolligenstrasse 111, 3000, Bern 60, Switzerland; Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Blumenstr. 8, 69115, Heidelberg, Germany
| | - Kathryn R Cullen
- Department of Psychiatry, University of Minnesota, Medical School, F256/2B West Building, 2450 Riverside Avenue, Minneapolis, MN, USA.
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Visco DB, Manhães-de-Castro R, Chaves WF, Lacerda DC, Pereira SDC, Ferraz-Pereira KN, Toscano AE. Selective serotonin reuptake inhibitors affect structure, function and metabolism of skeletal muscle: A systematic review. Pharmacol Res 2018; 136:194-204. [DOI: 10.1016/j.phrs.2018.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/01/2018] [Accepted: 09/04/2018] [Indexed: 12/14/2022]
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Rafa-Zabłocka K, Kreiner G, Bagińska M, Nalepa I. Selective Depletion of CREB in Serotonergic Neurons Affects the Upregulation of Brain-Derived Neurotrophic Factor Evoked by Chronic Fluoxetine Treatment. Front Neurosci 2018; 12:637. [PMID: 30294251 PMCID: PMC6158386 DOI: 10.3389/fnins.2018.00637] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/24/2018] [Indexed: 11/24/2022] Open
Abstract
Neurotrophic factors are regarded as crucial regulatory components in neuronal plasticity and are postulated to play an important role in depression pathology. The abundant expression of brain-derived neurotrophic factor (BDNF) in various brain structures seems to be of particular interest in this context, as downregulation of BDNF is postulated to be correlated with depression and its upregulation is often observed after chronic treatment with common antidepressants. It is well-known that BDNF expression is regulated by cyclic AMP response element-binding protein (CREB). In our previous study using mice lacking CREB in serotonergic neurons (Creb1TPH2CreERT2 mice), we showed that selective CREB ablation in these particular neuronal populations is crucial for drug-resistant phenotypes in the tail suspension test observed after fluoxetine administration in Creb1TPH2CreERT2 mice. The aim of this study was to investigate the molecular changes in the expression of neurotrophins in Creb1TPH2CreERT2 mice after chronic fluoxetine treatment, restricted to the brain structures implicated in depression pathology with profound serotonergic innervation including the prefrontal cortex (PFC) and hippocampus. Here, we show for the first time that BDNF upregulation observed after fluoxetine in the hippocampus or PFC might be dependent on the transcription factor CREB residing, not within these particular structures targeted by serotonergic projections, but exclusively in serotonergic neurons. This observation may shed new light on the neurotrophic hypothesis of depression, where the effects of BDNF observed after antidepressants in the hippocampus and other brain structures were rather thought to be regulated by CREB residing within the same brain structures. Overall, these results provide further evidence for the pivotal role of CREB in serotonergic neurons in maintaining mechanisms of antidepressant drug action by regulation of BDNF levels.
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Affiliation(s)
- Katarzyna Rafa-Zabłocka
- Department of Brain Biochemistry, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
| | - Grzegorz Kreiner
- Department of Brain Biochemistry, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
| | - Monika Bagińska
- Department of Brain Biochemistry, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
| | - Irena Nalepa
- Department of Brain Biochemistry, Institute of Pharmacology, Polish Academy of Sciences, Kraków, Poland
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Yüksel D, Engelen J, Schuster V, Dietsche B, Konrad C, Jansen A, Dannlowski U, Kircher T, Krug A. Longitudinal brain volume changes in major depressive disorder. J Neural Transm (Vienna) 2018; 125:1433-1447. [PMID: 30167933 DOI: 10.1007/s00702-018-1919-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/20/2018] [Indexed: 12/31/2022]
Abstract
Patients with major depressive disorder (MDD) exhibit gray matter volume (GMV) reductions in limbic regions. Clinical variables-such as the number of depressive episodes-seem to affect volume alterations. It is unclear whether the observed cross-sectional GMV abnormalities in MDD change over time, and whether there is a longitudinal relationship between GMV changes and the course of disorder. We investigated T1 structural MRI images of 54 healthy control (HC) and 37 MDD patients in a 3-Tesla-MRI with a follow-up interval of 3 years. The Cat12 toolbox was used to analyze longitudinal data (p < 0.05, FWE-corrected, whole-brain analysis; flexible factorial design). Interaction effects indicated increasing GMV in MDD in the bilateral amygdala, and decreasing GMV in the right thalamus between T1 and T2. Further analyses comparing patients with a mild course of disorder (MCD; 0-1 depressive episode during the follow-up) to patients with a severe course of disorder (SCD; > 1 depressive episode during the follow-up) revealed increasing amygdalar volume in MCD. Our study confirms structural alterations in limbic regions in MDD patients and an association between these impairments and the course of disorder. Thus, we assume that the reported volumetric alterations in the left amygdala (i.e. volumetric normalization) are reversible and apparently driven by the clinical phenotype. Hence, these results support the assumption that the severity and progression of disease influences amygdalar GMV changes in MDD or vice versa.
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Affiliation(s)
- Dilara Yüksel
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany.
| | - Jennifer Engelen
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
| | - Verena Schuster
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
| | - Bruno Dietsche
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
- Agaplesion Diakonieklinikum Rotenburg, Centre for Psychosocial Medicine, Elise-Averdieck-Straße 17, 27356, Rotenburg (Wümme), Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany
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Zhuo C, Zhu J, Wang C, Qu H, Ma X, Qin W. Different spatial patterns of brain atrophy and global functional connectivity impairments in major depressive disorder. Brain Imaging Behav 2018; 11:1678-1689. [PMID: 27766588 PMCID: PMC5707231 DOI: 10.1007/s11682-016-9645-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Alterations in grey matter structure and functional connectivity (FC) are pathological features of major depressive disorder (MDD). However, the relationship between brain structural and functional impairments in MDD remains uncertain. Thus, the aim of this study was to investigate the relationship between alterations in grey matter volume (GMV) and resting-state global functional connectivity density (rs-gFCD) in MDD. Forty-five patients with MDD and 48 healthy controls underwent structural and resting-state functional magnetic resonance imaging (fMRI). GMV and rs-gFCD maps of each subject were created, and the intergroup differences in these neuroimaging metrics were evaluated. Compared to healthy controls, patients with MDD displayed reduced GMV in the left insula, putamen, amygdala and hippocampus (mainly in the limbic system). In contrast, decreased rs-gFCD was observed in the left postcentral and precentral gyri, right fusiform gyrus and lingual gyrus (mainly in the sensory system). Furthermore, we found no significant correlations between GMV and rs-gFCD in these brain regions. Finally, overlap ratio analysis demonstrated that the spatial distribution patterns of intergroup differences on the GMV and rs-gFCD maps were distinct. Our findings suggest that the presence of distinct spatial distribution patterns of brain atrophy and global FC impairments might be pathological features of MDD.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.,Department of Psychiatry Functional Neuroimaging Laboratory, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China.,Department of Psychiatry, Wenzhou seventh people's hospital, Wenzhou, Zhejiang, China.,Institute of Mental Health, Jining Medical University, Jining, Shandong, China
| | - Jiajia Zhu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Chunli Wang
- Department of Psychiatry Functional Neuroimaging Laboratory, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Hongru Qu
- Department of Psychiatry Functional Neuroimaging Laboratory, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Xiaolei Ma
- Department of Psychiatry Functional Neuroimaging Laboratory, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
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Jeganathan J, Perry A, Bassett DS, Roberts G, Mitchell PB, Breakspear M. Fronto-limbic dysconnectivity leads to impaired brain network controllability in young people with bipolar disorder and those at high genetic risk. NEUROIMAGE-CLINICAL 2018; 19:71-81. [PMID: 30035004 PMCID: PMC6051310 DOI: 10.1016/j.nicl.2018.03.032] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/20/2018] [Accepted: 03/25/2018] [Indexed: 01/19/2023]
Abstract
Recent investigations have used diffusion-weighted imaging to reveal disturbances in the neurocircuitry that underlie cognitive-emotional control in bipolar disorder (BD) and in unaffected siblings or children at high genetic risk (HR). It has been difficult to quantify the mechanism by which structural changes disrupt the superimposed brain dynamics, leading to the emotional lability that is characteristic of BD. Average controllability is a concept from network control theory that extends structural connectivity data to estimate the manner in which local neuronal fluctuations spread from a node or subnetwork to alter the state of the rest of the brain. We used this theory to ask whether structural connectivity deficits previously observed in HR individuals (n = 84, mean age 22.4), patients with BD (n = 38, mean age 23.9), and age- and gender-matched controls (n = 96, mean age 22.6) translate to differences in the ability of brain systems to be manipulated between states. Localized impairments in network controllability were seen in the left parahippocampal, left middle occipital, left superior frontal, right inferior frontal, and right precentral gyri in BD and HR groups. Subjects with BD had distributed deficits in a subnetwork containing the left superior and inferior frontal gyri, postcentral gyrus, and insula (p = 0.004). HR participants had controllability deficits in a right-lateralized subnetwork involving connections between the dorsomedial and ventrolateral prefrontal cortex, the superior temporal pole, putamen, and caudate nucleus (p = 0.008). Between-group controllability differences were attenuated after removal of topological factors by network randomization. Some previously reported differences in network connectivity were not associated with controllability-differences, likely reflecting the contribution of more complex brain network properties. These analyses highlight the potential functional consequences of altered brain networks in BD, and may guide future clinical interventions. Control theory estimates how neuronal fluctuations spread from local networks. We compare brain controllability in bipolar disorder and their high-risk relatives. These groups have impaired controllability in networks supporting cognitive and emotional control. Weaker connectivity as well as topological alterations contribute to these changes.
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Affiliation(s)
- Jayson Jeganathan
- Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
| | - Alistair Perry
- Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Max Planck Institute for Human Development, Berlin, Germany
| | - Danielle S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Electrical & Systems Engineering, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Michael Breakspear
- Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; Metro North Mental Health Service, Brisbane, QLD, Australia
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63
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Brown GM, McIntyre RS, Rosenblat J, Hardeland R. Depressive disorders: Processes leading to neurogeneration and potential novel treatments. Prog Neuropsychopharmacol Biol Psychiatry 2018; 80:189-204. [PMID: 28433459 DOI: 10.1016/j.pnpbp.2017.04.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/01/2017] [Indexed: 12/18/2022]
Abstract
Mood disorders are wide spread with estimates that one in seven of the population are affected at some time in their life (Kessler et al., 2012). Many of those affected with severe depressive disorders have cognitive deficits which may progress to frank neurodegeneration. There are several peripheral markers shown by patients who have cognitive deficits that could represent causative factors and could potentially serve as guides to the prevention or even treatment of neurodegeneration. Circadian rhythm misalignment, immune dysfunction and oxidative stress are key pathologic processes implicated in neurodegeneration and cognitive dysfunction in depressive disorders. Novel treatments targeting these pathways may therefore potentially improve patient outcomes whereby the primary mechanism of action is outside of the monoaminergic system. Moreover, targeting immune dysfunction, oxidative stress and circadian rhythm misalignment (rather than primarily the monoaminergic system) may hold promise for truly disease modifying treatments that may prevent neurodegeneration rather than simply alleviating symptoms with no curative intent. Further research is required to more comprehensively understand the contributions of these pathways to the pathophysiology of depressive disorders to allow for disease modifying treatments to be discovered.
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Affiliation(s)
- Gregory M Brown
- Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health, 250 College St. Toronto, ON M5T 1R8, Canada.
| | - Roger S McIntyre
- Psychiatry and Pharmacology, University of Toronto, Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325, Toronto, ON M5T 2S8, Canada.
| | - Joshua Rosenblat
- Resident of Psychiatry, Clinician Scientist Stream, University of Toronto, Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325, Toronto, ON M5T 2S8, Canada
| | - Rüdiger Hardeland
- Johann Friedrich Blumenbach Institut für Zoologie und Anthropologie, Universität Göttingen, Buergerstrasse 50, D-37073 Göttingen, Germany.
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64
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Kim YK, Na KS. Application of machine learning classification for structural brain MRI in mood disorders: Critical review from a clinical perspective. Prog Neuropsychopharmacol Biol Psychiatry 2018. [PMID: 28648568 DOI: 10.1016/j.pnpbp.2017.06.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Mood disorders are a highly prevalent group of mental disorders causing substantial socioeconomic burden. There are various methodological approaches for identifying the underlying mechanisms of the etiology, symptomatology, and therapeutics of mood disorders; however, neuroimaging studies have provided the most direct evidence for mood disorder neural substrates by visualizing the brains of living individuals. The prefrontal cortex, hippocampus, amygdala, thalamus, ventral striatum, and corpus callosum are associated with depression and bipolar disorder. Identifying the distinct and common contributions of these anatomical regions to depression and bipolar disorder have broadened and deepened our understanding of mood disorders. However, the extent to which neuroimaging research findings contribute to clinical practice in the real-world setting is unclear. As traditional or non-machine learning MRI studies have analyzed group-level differences, it is not possible to directly translate findings from research to clinical practice; the knowledge gained pertains to the disorder, but not to individuals. On the other hand, a machine learning approach makes it possible to provide individual-level classifications. For the past two decades, many studies have reported on the classification accuracy of machine learning-based neuroimaging studies from the perspective of diagnosis and treatment response. However, for the application of a machine learning-based brain MRI approach in real world clinical settings, several major issues should be considered. Secondary changes due to illness duration and medication, clinical subtypes and heterogeneity, comorbidities, and cost-effectiveness restrict the generalization of the current machine learning findings. Sophisticated classification of clinical and diagnostic subtypes is needed. Additionally, as the approach is inevitably limited by sample size, multi-site participation and data-sharing are needed in the future.
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Affiliation(s)
- Yong-Ku Kim
- Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kyoung-Sae Na
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea.
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65
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Ciappolino V, Delvecchio G, Agostoni C, Mazzocchi A, Altamura AC, Brambilla P. The role of n-3 polyunsaturated fatty acids (n-3PUFAs) in affective disorders. J Affect Disord 2017; 224:32-47. [PMID: 28089169 DOI: 10.1016/j.jad.2016.12.034] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 12/22/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND Among emerging treatments for depressive disorders several studies suggested that n-3 polyunsaturated fatty acids (n-3PUFAs) supplementation can be used. However, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) differ in terms of biochemistry, metabolism and therapeutic effects. Therefore, a clear picture of their specific and different role on affective disorders has not yet emerged. OBJECTIVES To investigate the effects of n-3PUFAs on affective disorders including major depression, bipolar disorder and perinatal depression. METHODS a comprehensive search on PUBMED, Medline and PsychINFO of all RCTs using n-3PUFAs patients with depressive symptoms published up to April 2016 was performed. We included trials that examined unipolar or bipolar disorder and trials that investigated depressive symptoms in relation to pregnancy. Trials were excluded if the depressive symptomatology was related to other primary organic diseases. RESULTS 264 RCT studies were identified but only 36 met the inclusion criteria. First, it has been reported that n-3PUFAs supplementation might have clinical benefits on depressive symptoms. Second, EPA supplement, rather than DHA, seems to be more effective in treating major depression. Third, n-3PUFAs can have beneficial effects in bipolar depression but not in perinatal depression. CONCLUSIONS there are only some evidence on the efficacy of n-3PUFAs in affective disorders especially to unipolar and bipolar depression not powered enough to confirm a therapeutic effect for affective disorder. Therefore, further studies with larger and more homogeneous samples, are required to confirm these effects.
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Affiliation(s)
- Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | - Carlo Agostoni
- Pediatric Clinic, Fondazione IRCCS Ospedale Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, 20121 Milan, Italy
| | - Alessandra Mazzocchi
- Pediatric Clinic, Fondazione IRCCS Ospedale Cà Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, 20121 Milan, Italy
| | - Alfredo Carlo Altamura
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, TX, USA.
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66
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Perez DL, Matin N, Williams B, Tanev K, Makris N, LaFrance WC, Dickerson BC. Cortical thickness alterations linked to somatoform and psychological dissociation in functional neurological disorders. Hum Brain Mapp 2017; 39:428-439. [PMID: 29080235 DOI: 10.1002/hbm.23853] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/21/2017] [Accepted: 10/10/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Links between dissociation and functional neurological disorder (FND)/conversion disorder are well-established, yet the pathophysiology of dissociation remains poorly understood. This MRI study investigated structural alterations associated with somatoform and psychological dissociation in FND. We hypothesized that multimodal, paralimbic cingulo-insular regions would relate to the severity of somatoform dissociation in patients with FND. METHODS FreeSurfer cortical thickness and subcortical volumetric analyses were performed in 26 patients with motor FND and 27 matched healthy controls. Patients with high dissociation as measured by the Somatoform Dissociation Questionnaire-20 (SDQ) or Dissociative Experiences Scale (DES) were compared to controls in stratified analyses. Within-group analyses were also performed with SDQ and DES scores in patients with FND. All cortical thickness analyses were whole-brain corrected at the cluster-wise level. RESULTS Patients with FND and high somatoform dissociation (SDQ > 35) showed reduced left caudal anterior cingulate cortex (ACC) cortical thickness compared to controls. In within-group analyses, SDQ scores inversely correlated with left caudal ACC cortical thickness in patients with FND. Depersonalization/derealization scores positively correlated with right lateral occipital cortical thickness. Both within-group findings remained statistically significant controlling for trait anxiety/depression, borderline personality disorder and post-traumatic stress disorder, adverse life events, and motor FND subtypes in post-hoc analyses. CONCLUSION Using complementary between-group and within-group analyses, an inverse association between somatoform dissociation and left caudal ACC cortical thickness was observed in patients with FND. A positive relationship was also appreciated between depersonalization/derealization severity and cortical thickness in visual association areas. These findings advance our neuropathobiological understanding of dissociation in FND. Hum Brain Mapp 39:428-439, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- David L Perez
- Department of Neurology, Functional Neurology Research Group, Cognitive Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Psychiatry, Neuropsychiatry Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Nassim Matin
- Department of Neurology, Functional Neurology Research Group, Cognitive Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Benjamin Williams
- Department of Neurology, Functional Neurology Research Group, Cognitive Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kaloyan Tanev
- Department of Psychiatry, Neuropsychiatry Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Nikos Makris
- Center for Morphometric Analysis, Departments of Neurology and Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - W Curt LaFrance
- Neuropsychiatry and Behavioral Neurology Division, Rhode Island Hospital, Departments of Psychiatry and Neurology, Brown University, Alpert Medical School, Providence, Rhode Island
| | - Bradford C Dickerson
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts.,Department of Neurology, Frontotemporal Disorders Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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67
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Aberrant brain grey matter volume patterns differ among Chinese Han drug-naïve depression patients with acute and chronic stress. Oncotarget 2017; 8:91958-91964. [PMID: 29190889 PMCID: PMC5696155 DOI: 10.18632/oncotarget.20954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 08/26/2017] [Indexed: 01/18/2023] Open
Abstract
Chronic or acute stress can induce structural changes and brain alterations associated with the neural mechanisms of depression. Aimed to investigate the GMV alterations in the drug-naïve depression patients with chronic and acute stress experience,we enrolled fifty depression patients with acute stress experience, fifty five depression patients with chronic stress experience and forty seven healthy controls(HC) to participant in the present study. We used voxel-based morphometry to analyze the brain grey matter volume (GMV) alterations. Compared with the HC, the patients with acute stress and those with chronic stress exhibited a distinct GMV impairment pattern. Widespread, decreased GMV was detected in most of the cerebral cortex in all the depression patients. Importantly, the greatest finding in our study is that the decreased GMV in the depression patients with chronic stress was more widespread than that in the patients with acute stress. All brain regions with decreased GMV participated in the regulation of emotions, memory, and executive function processing, which is consistent with previous findings. There was no significant difference between the major depression disorder patients with acute stressful life events and those with chronic stressful life events, and this finding largely weakens the support of our current conclusion. Thus, we cannot confirm this postulation. However, our findings probably indicate that GMV may be more sensitive to major depression disorder patients when compared to healthy controls, it did not sensitive when in the comparison of patient's group. Overall, our findings provide important information for the use of appropriate treatment methods to address acute stress and alleviate chronic stress in patients with depression, and such treatments can delay the deterioration of the affected brain regions and improve remission rates. More importantly, all the inexplicable findings in the present study encourage us to conduct a follow-up study to describe the developmental trajectory of the pathological brain features of depression patients and explore therapeutic targets for future personalized treatment.
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68
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Amare AT, Schubert KO, Baune BT. Pharmacogenomics in the treatment of mood disorders: Strategies and Opportunities for personalized psychiatry. EPMA J 2017; 8:211-227. [PMID: 29021832 DOI: 10.1007/s13167-017-0112-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 08/11/2017] [Indexed: 01/08/2023]
Abstract
Personalized medicine (personalized psychiatry in a specific setting) is a new model towards individualized care, in which knowledge from genomics and other omic pillars (microbiome, epigenomes, proteome, and metabolome) will be combined with clinical data to guide efforts to new drug development and targeted prescription of the existing treatment options. In this review, we summarize pharmacogenomic studies in mood disorders that may lay the foundation towards personalized psychiatry. In addition, we have discussed the possible strategies to integrate data from omic pillars as a future path to personalized psychiatry. So far, the progress of uncovering single nucleotide polymorphisms (SNPs) underpinning treatment efficacy in mood disorders (e.g., SNPs associated with selective serotonin re-uptake inhibitors or lithium treatment response in patients with bipolar disorder and major depressive disorder) are encouraging, but not adequate. Genetic studies have pointed to a number of SNPs located at candidate genes that possibly influence response to; (a) antidepressants COMT, HTR2A, HTR1A, CNR1, SLC6A4, NPY, MAOA, IL1B, GRIK4, BDNF, GNB3, FKBP5, CYP2D6, CYP2C19, and ABCB1 and (b) mood stabilizers (lithium) 5-HTT, TPH, DRD1, FYN, INPP1, CREB1, BDNF, GSK3β, ARNTL, TIM, DPB, NR3C1, BCR, XBP1, and CACNG2. We suggest three alternative and complementary strategies to implement knowledge gained from pharmacogenomic studies. The first strategy can be to implement diagnostic, therapeutic, or prognostic genetic testing based on candidate genes or gene products. The second alternative is an integrative analysis (systems genomics approach) to combine omics data obtained from the different pillars of omics investigation, including genomics, epigenomes, proteomics, metabolomics and microbiomes. The main goal of system genomics is an identification and understanding of biological pathways, networks, and modules underlying drug-response. The third strategy aims to the development of multivariable diagnostic or prognostic algorithms (tools) combining individual's genomic information (polygenic score) with other predictors (e.g., omics pillars, neuroimaging, and clinical characteristics) to finally predict therapeutic outcomes. An integration of molecular science with that of traditional clinical practice is the way forward to drug discoveries and novel therapeutic approaches and to characterize psychiatric disorders leading to a better predictive, preventive, and personalized medicine (PPPM) in psychiatry. With future advances in the omics technology and methodological developments for data integration, the goal of PPPM in psychiatry is promising.
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Affiliation(s)
- Azmeraw T Amare
- Discipline of Psychiatry, School of Medicine, University of Adelaide, North Terrace, Adelaide, SA 5005 Australia
| | - Klaus Oliver Schubert
- Discipline of Psychiatry, School of Medicine, University of Adelaide, North Terrace, Adelaide, SA 5005 Australia.,Northern Adelaide Local Health Network, Mental Health Services, Adelaide, SA Australia
| | - Bernhard T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, North Terrace, Adelaide, SA 5005 Australia
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69
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Liu J, Xu X, Luo Q, Luo Y, Chen Y, Lui S, Wu M, Zhu H, Kemp GJ, Gong Q. Brain grey matter volume alterations associated with antidepressant response in major depressive disorder. Sci Rep 2017; 7:10464. [PMID: 28874763 PMCID: PMC5585337 DOI: 10.1038/s41598-017-10676-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 08/14/2017] [Indexed: 02/05/2023] Open
Abstract
Not all patients with major depressive disorder respond to adequate pharmacological therapy. Psychoradiological studies have reported that antidepressant responders and nonresponders show different alterations in brain grey matter, but the findings are inconsistent. The present study reports a meta-analysis of voxel-based morphometric studies of patients with major depressive disorder, both antidepressant responders and nonresponders, using the anisotropic effect size version of Seed-based D Mapping to identify brain regions correlated to clinical response. A systematic search was conducted up to June 2016 to identify studies focussing on antidepressant response. In responders across 9 datasets grey matter volume (GMV) was significantly higher in the left inferior frontal gyrus and insula, while GMV was significantly lower in the bilateral anterior cingulate cortex (ACC) and the right superior frontal gyrus (SFG). In nonresponders across 5 datasets GMV was significantly lower in the bilateral ACC, median cingulate cortex (MCC) and right SFG. Conjunction analysis confirmed significant differences in the bilateral ACC and right SFG, where GMV was significantly lower in nonresponders but higher in responders. The current study adds to psychoradiology, an evolving subspecialty of radiology mainly for psychiatry and clinical psychology.
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Affiliation(s)
- Jia Liu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xin Xu
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Qiang Luo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Ya Luo
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Ying Chen
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Min Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Hongyan Zhu
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.
| | - Graham J Kemp
- Institute of Ageing and Chronic Disease, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom.,Liverpool Magnetic Resonance Imaging Centre (LiMRIC), University of Liverpool, Liverpool, United Kingdom
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
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Kajta M, Wnuk A, Rzemieniec J, Litwa E, Lason W, Zelek-Molik A, Nalepa I, Rogóż Z, Grochowalski A, Wojtowicz AK. Depressive-like effect of prenatal exposure to DDT involves global DNA hypomethylation and impairment of GPER1/ESR1 protein levels but not ESR2 and AHR/ARNT signaling. J Steroid Biochem Mol Biol 2017; 171:94-109. [PMID: 28263910 DOI: 10.1016/j.jsbmb.2017.03.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 02/22/2017] [Accepted: 03/01/2017] [Indexed: 01/01/2023]
Abstract
Several lines of evidence suggest that exposures to Endocrine Disrupting Chemicals (EDCs) such as pesticides increase the risks of neuropsychiatric disorders. Despite extended residual persistence of dichlorodiphenyltrichloroethane (DDT) in the environment, the mechanisms of perinatal actions of DDT that could account for adult-onset of depression are largely unknown. This study demonstrated the isomer-specific induction of depressive-like behavior and impairment of Htr1a/serotonin signaling in one-month-old mice that were prenatally exposed to DDT. The effects were reversed by the antidepressant citalopram as evidenced in the forced swimming (FST) and tail suspension (TST) tests in the male and female mice. Prenatally administered DDT accumulated in mouse brain as determined with gas chromatography and tandem mass spectrometry, led to global DNA hypomethylation, and altered the levels of methylated DNA in specific genes. The induction of depressive-like behavior and impairment of Htr1a/serotonin signaling were accompanied by p,p'-DDT-specific decrease in the levels of estrogen receptors i.e. ESR1 and/or GPER1 depending on sex. In contrast, o,p'-DDT did not induce depressive-like effects and exhibited quite distinct pattern of biochemical alterations that was related to aryl hydrocarbon receptor (AHR), its nuclear translocator ARNT, and ESR2. Exposure to o,p'-DDT increased AHR expression in male and female brains, and reduced expression levels of ARNT and ESR2 in the female brains. The evolution of p,p'-DDT-induced depressive-like behavior was preceded by attenuation of Htr1a and Gper1/GPER1 expression as observed in the 7-day-old mouse pups. Because p,p'-DDT caused sex- and age-independent attenuation of GPER1, we suggest that impairment of GPER1 signaling plays a key role in the propagation of DDT-induced depressive-like symptoms.
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Affiliation(s)
- Malgorzata Kajta
- Department of Experimental Neuroendocrinology, Institute of Pharmacology, Polish Academy of Sciences, Smetna Street 12, 31-343 Krakow, Poland.
| | - Agnieszka Wnuk
- Department of Experimental Neuroendocrinology, Institute of Pharmacology, Polish Academy of Sciences, Smetna Street 12, 31-343 Krakow, Poland
| | - Joanna Rzemieniec
- Department of Experimental Neuroendocrinology, Institute of Pharmacology, Polish Academy of Sciences, Smetna Street 12, 31-343 Krakow, Poland
| | - Ewa Litwa
- Department of Experimental Neuroendocrinology, Institute of Pharmacology, Polish Academy of Sciences, Smetna Street 12, 31-343 Krakow, Poland
| | - Wladyslaw Lason
- Department of Experimental Neuroendocrinology, Institute of Pharmacology, Polish Academy of Sciences, Smetna Street 12, 31-343 Krakow, Poland
| | - Agnieszka Zelek-Molik
- Department of Brain Biochemistry, Institute of Pharmacology, Polish Academy of Sciences, Smetna Street 12, 31-343 Krakow, Poland
| | - Irena Nalepa
- Department of Brain Biochemistry, Institute of Pharmacology, Polish Academy of Sciences, Smetna Street 12, 31-343 Krakow, Poland
| | - Zofia Rogóż
- Department of Pharmacology, Institute of Pharmacology, Polish Academy of Sciences, Smetna Street 12, 31-343 Krakow, Poland
| | - Adam Grochowalski
- Department of Analytical Chemistry, Krakow University of Technology, Warszawska Street 24, 31-155 Krakow, Poland
| | - Anna K Wojtowicz
- Department of Animal Biotechnology, Faculty of Animal Sciences, University of Agriculture, Redzina Street 1B, 30-248 Krakow, Poland
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71
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Cano M, Martínez-Zalacaín I, Bernabéu-Sanz Á, Contreras-Rodríguez O, Hernández-Ribas R, Via E, de Arriba-Arnau A, Gálvez V, Urretavizcaya M, Pujol J, Menchón JM, Cardoner N, Soriano-Mas C. Brain volumetric and metabolic correlates of electroconvulsive therapy for treatment-resistant depression: a longitudinal neuroimaging study. Transl Psychiatry 2017; 7:e1023. [PMID: 28170003 PMCID: PMC5438019 DOI: 10.1038/tp.2016.267] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/12/2016] [Accepted: 11/13/2016] [Indexed: 02/08/2023] Open
Abstract
Recent research suggests that neuroplastic and neuroinflammatory changes may account for the mode of action of electroconvulsive therapy (ECT), although extant data do not allow for a clear disambiguation between these two hypotheses. Multimodal neuroimaging approaches (for example, combining structural and metabolic information) may help in clarifying this issue. Here we aimed to assess longitudinal changes in (i) regional gray matter (GM) volumes and (ii) hippocampal metabolite concentrations throughout an acute course of bitemporal ECT, as well as (iii) to determine the association between imaging changes and clinical improvement. We assessed 12 patients with treatment-resistant depression (TRD) at four time points (pre-treatment, after the first ECT session, after the ninth ECT session and 15 days after ECT course completion) and 10 healthy participants at two time points, 5 weeks apart. Patients with TRD showed bilateral medial temporal lobe (MTL) and perigenual anterior cingulate cortex volume increases. Left MTL volume increase was associated with (i) a hippocampal N-acetylaspartate concentration decrease, (ii) a hippocampal Glutamate+Glutamine concentration increase and (iii) significant clinical improvement. The observed findings are, in part, compatible with both neuroplastic and neuroinflammatory changes induced by ECT. We postulate that such phenomena may be interrelated, therefore reconciling the neuroplasticity and neuroinflammatory hypotheses of ECT action.
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Affiliation(s)
- M Cano
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Á Bernabéu-Sanz
- Magnetic Resonance Department, Inscanner SL, Alicante, Spain
| | - O Contreras-Rodríguez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Carlos III Health Institute, CIBERSAM, Madrid, Spain
| | - R Hernández-Ribas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Carlos III Health Institute, CIBERSAM, Madrid, Spain
| | - E Via
- Mental Health Department, Parc Taulí Sabadell, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A de Arriba-Arnau
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - V Gálvez
- School of Psychiatry, University of New South Wales (UNSW) and Black Dog Institute, Randwick, Sydney, NSW, Australia
| | - M Urretavizcaya
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Carlos III Health Institute, CIBERSAM, Madrid, Spain
| | - J Pujol
- Carlos III Health Institute, CIBERSAM, Madrid, Spain,MRI Research Unit, Radiology Department, Hospital del Mar, Barcelona, Spain
| | - J M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Carlos III Health Institute, CIBERSAM, Madrid, Spain,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain E-mail:
| | - N Cardoner
- Mental Health Department, Parc Taulí Sabadell, Universitat Autònoma de Barcelona, Barcelona, Spain,Mental Health Department, Parc Taulí Sabadell, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell, 08208 Barcelona, Spain. E-mail:
| | - C Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Carlos III Health Institute, CIBERSAM, Madrid, Spain,Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
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Progressive disability and prefrontal shrinkage in schizophrenia patients with poor outcome: A 3-year longitudinal study. Schizophr Res 2017; 179:104-111. [PMID: 27624681 DOI: 10.1016/j.schres.2016.09.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 09/05/2016] [Accepted: 09/05/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Schizophrenia is a severe disabling disorder with heterogeneous illness courses. In this longitudinal study we characterized schizophrenia patients with poor and good outcome (POS, GOS), using functional and imaging metrics. Patients were defined in accordance to Keefe's criteria (i.e. Kraepelinian and non-Kraepelinian patients). METHODS 35 POS patients, 35 GOS patients and 76 healthy controls (H) underwent clinical, functioning and magnetic resonance imaging (MRI) assessments twice over three years of follow-up. Information on psychopathology, treatment, disability (using the World Health Organization Disability Assessment Scale II, WHO-DAS-2) and prefrontal morphology was collected. Dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC) were manually traced. RESULTS At baseline, subjects with POS showed significantly decreased right dorsolateral prefrontal cortex (DLPFC) white matter volumes (WM) compared to healthy controls and GOS patients (POS VS HC, p<0.001; POS vs GOS, p=0.03), with shrinkage of left DLPFC WM volumes at follow up (t=2.66, p=0.01). Also, POS patients had higher disability in respect to GOS subjects both at baseline and after 3years at the WHO-DAS-2 (p<0.05). DISCUSSION Our study supports the hypothesis that POS is characterized by progressive deficits in brain structure and in "real-life" functioning. These are particularly notable in the DLPFC.
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73
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He Z, Cui Q, Zheng J, Duan X, Pang Y, Gao Q, Han S, Long Z, Wang Y, Li J, Wang X, Zhao J, Chen H. Frequency-specific alterations in functional connectivity in treatment-resistant and -sensitive major depressive disorder. J Psychiatr Res 2016; 82:30-9. [PMID: 27459030 DOI: 10.1016/j.jpsychires.2016.07.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 07/08/2016] [Accepted: 07/08/2016] [Indexed: 01/06/2023]
Abstract
Major depressive disorder (MDD) may involve alterations in brain functional connectivity in multiple neural circuits and present large-scale network dysfunction. Patients with treatment-resistant depression (TRD) and treatment-sensitive depression (TSD) show different responses to antidepressants and aberrant brain functions. This study aims to investigate functional connectivity patterns of TRD and TSD at the whole brain resting state. Seventeen patients with TRD, 17 patients with TSD, and 17 healthy controls matched with age, gender, and years of education were recruited in this study. The brain was divided using an automated anatomical labeling atlas into 90 regions of interest, which were used to construct the entire brain functional networks. An analysis method called network-based statistic was used to explore the dysconnected subnetworks of TRD and TSD at different frequency bands. At resting state, TSD and TRD present characteristic patterns of network dysfunction at special frequency bands. The dysconnected subnetwork of TSD mainly lies in the fronto-parietal top-down control network. Moreover, the abnormal neural circuits of TRD are extensive and complex. These circuits not only depend on the abnormal affective network but also involve other networks, including salience network, auditory network, visual network, and language processing cortex. Our findings reflect that the pathological mechanism of TSD may refer to impairment in cognitive control, whereas TRD mainly triggers the dysfunction of emotion processing and affective cognition. This study reveals that differences in brain functional connectivity at resting state reflect distinct pathophysiological mechanisms in TSD and TRD. These findings may be helpful in differentiating two types of MDD and predicting treatment responses.
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Affiliation(s)
- Zongling He
- Center for Information in BioMedicine, Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China; Mental Health Center, The Fourth People's Hospital of Chengdu, Sichuan 610000, China
| | - Qian Cui
- School of Political Science and Public Administration, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Junjie Zheng
- Center for Information in BioMedicine, Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Xujun Duan
- Center for Information in BioMedicine, Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Yajing Pang
- Center for Information in BioMedicine, Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Qing Gao
- Center for Information in BioMedicine, Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Shaoqiang Han
- Center for Information in BioMedicine, Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Zhiliang Long
- Center for Information in BioMedicine, Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Yifeng Wang
- Center for Information in BioMedicine, Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Jiao Li
- Center for Information in BioMedicine, Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Xiao Wang
- Center for Information in BioMedicine, Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Jingping Zhao
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Huafu Chen
- Center for Information in BioMedicine, Key Laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China.
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