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Fan S, van den Heuvel OA, Cath DC, van der Werf YD, de Wit SJ, de Vries FE, Veltman DJ, Pouwels PJW. Mild White Matter Changes in Un-medicated Obsessive-Compulsive Disorder Patients and Their Unaffected Siblings. Front Neurosci 2016; 9:495. [PMID: 26793045 PMCID: PMC4707235 DOI: 10.3389/fnins.2015.00495] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/14/2015] [Indexed: 11/21/2022] Open
Abstract
Objective: Obsessive-compulsive disorder (OCD) is a common neuropsychiatric disorder with moderate genetic influences and white matter abnormalities in frontal-striatal and limbic regions. Inconsistencies in reported white matter results from diffusion tensor imaging (DTI) studies can be explained, at least partly, by medication use and between-group differences in disease profile and stage. We used a family design aiming to establish whether white matter abnormalities, if present in un-medicated OCD patients, also exist in their unaffected siblings. Method: Forty-four OCD patients, un-medicated for at least the past 4 weeks, 15 of their unaffected siblings, and 37 healthy controls (HC) underwent DTI using a 3-Tesla MRI-scanner. Data analysis was done using tract-based spatial statistics (TBSS). Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) values were compared within seven skeletonised regions of interest (ROIs), i.e., corpus callosum, bilateral cingulum bundle, bilateral inferior longitudinal fasciculus/frontal-occipital fasciculus (ILF/FOF) and bilateral superior longitudinal fasciculus (SLF). Results: Un-medicated OCD patients, compared with HC, had significantly lower FA in the left cingulum bundle. FA was trend-significantly lower in all other ROIs, except for the corpus callosum. Significant three-group differences in FA (and in RD at trend-significant level) were observed in the left cingulum bundle, with the unaffected siblings representing an intermediate group between OCD patients and HC. Conclusions: OCD patients showed lower FA in the left cingulum bundle, partly driven by trend-significantly higher values in RD. Since the unaffected siblings were found to be an intermediate group between OCD patients and HC, this white matter alteration may be considered an endophenotype for OCD.
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Affiliation(s)
- Siyan Fan
- Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands; Department of Psychiatry, VU University Medical CenterAmsterdam, Netherlands; Department of Social and Behavioural Science, Utrecht UniversityUtrecht, Netherlands
| | - Odile A van den Heuvel
- Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands; Department of Psychiatry, VU University Medical CenterAmsterdam, Netherlands; Neuroscience Campus Amsterdam, VU/VU University Medical CenterAmsterdam, Netherlands; The OCD Team, Haukeland University HospitalBergen, Norway
| | - Danielle C Cath
- Department of Social and Behavioural Science, Utrecht UniversityUtrecht, Netherlands; Academic Anxiety Center AltrechtUtrecht, Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands; Neuroscience Campus Amsterdam, VU/VU University Medical CenterAmsterdam, Netherlands; Netherlands Institute for NeuroscienceAmsterdam, Netherlands
| | - Stella J de Wit
- Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands; Department of Psychiatry, VU University Medical CenterAmsterdam, Netherlands; Neuroscience Campus Amsterdam, VU/VU University Medical CenterAmsterdam, Netherlands; The OCD Team, Haukeland University HospitalBergen, Norway
| | - Froukje E de Vries
- Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands; Department of Psychiatry, VU University Medical CenterAmsterdam, Netherlands; Neuroscience Campus Amsterdam, VU/VU University Medical CenterAmsterdam, Netherlands
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical CenterAmsterdam, Netherlands; Neuroscience Campus Amsterdam, VU/VU University Medical CenterAmsterdam, Netherlands
| | - Petra J W Pouwels
- Neuroscience Campus Amsterdam, VU/VU University Medical CenterAmsterdam, Netherlands; Department of Physics and Medical Technology, VU University Medical CenterAmsterdam, Netherlands
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Olvet DM, Delaparte L, Yeh F, DeLorenzo C, McGrath PJ, Weissman MM, Adams P, Fava M, Deckersbach T, McInnis MG, Carmody TJ, Cooper CM, Kurian BT, Lu H, Toups MS, Trivedi MH, Parsey RV. A COMPREHENSIVE EXAMINATION OF WHITE MATTER TRACTS AND CONNECTOMETRY IN MAJOR DEPRESSIVE DISORDER. Depress Anxiety 2016; 33:56-65. [PMID: 26477532 PMCID: PMC4701622 DOI: 10.1002/da.22445] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 09/04/2015] [Accepted: 09/21/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a debilitating disorder characterized by widespread brain abnormalities. The literature is mixed as to whether or not white matter abnormalities are associated with MDD. This study sought to examine fractional anisotropy (FA) in white matter tracts in individuals with MDD using diffusion tensor imaging (DTI). METHODS 139 participants with MDD and 39 healthy controls (HC) in a multisite study were included. DTI scans were acquired in 64 directions and FA was determined in the brain using four methods: region of interest (ROI), tract-based spatial statistics (TBSS), and diffusion tractography. Diffusion connectometry was used to identify white matter pathways associated with MDD. RESULTS There were no significant differences when comparing FA in MDD and HC groups using any method. In the MDD group, there was a significant relationship between depression severity and FA in the right medial orbitofrontal cortex, and between age of onset of MDD and FA in the right caudal anterior cingulate cortex using the ROI method. There was a significant relationship between age of onset and connectivity in the thalamocortical radiation, inferior longitudinal fasciculus, and cerebellar tracts using diffusion connectometry. CONCLUSIONS The lack of group differences in FA and connectometry analysis may result from the clinically heterogenous nature of MDD. However, the relationship between FA and depression severity may suggest a state biomarker of depression that should be investigated as a potential indicator of response. Age of onset may also be a significant clinical feature to pursue when studying white matter tracts.
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Affiliation(s)
- Doreen M. Olvet
- Department of PsychiatryStony Brook UniversityStony BrookNew York
| | - Lauren Delaparte
- Department of PsychologyStony Brook UniversityStony BrookNew York
| | - Fang‐Cheng Yeh
- Department of PsychologyCarnegie Mellon University, PittsburghPittsburgh
| | | | - Patrick J. McGrath
- Department of Psychiatry, New York State Psychiatric InstituteColumbia University College of Physicians and Surgeons, New YorkNew York
| | - Myrna M. Weissman
- Department of Psychiatry, New York State Psychiatric InstituteColumbia University College of Physicians and Surgeons, New YorkNew York
| | - Phillip Adams
- Department of Psychiatry, New York State Psychiatric InstituteColumbia University College of Physicians and Surgeons, New YorkNew York
| | - Maurizio Fava
- Department of PsychiatryMassachusetts General Hospital, BostonMassachusetts
| | - Thilo Deckersbach
- Department of PsychiatryMassachusetts General Hospital, BostonMassachusetts
| | - Melvin G. McInnis
- Department of PsychiatryUniversity of Michigan School of Medicine, Ann ArborMichigan
| | - Thomas J. Carmody
- Department of PsychiatryUniversity of Texas Southwestern Medical CenterDallasTexas
| | - Crystal M. Cooper
- Department of PsychiatryUniversity of Texas Southwestern Medical CenterDallasTexas
| | - Benji T. Kurian
- Department of PsychiatryUniversity of Texas Southwestern Medical CenterDallasTexas
| | - Hanzhang Lu
- Department of PsychiatryUniversity of Texas Southwestern Medical CenterDallasTexas
| | - Marisa S. Toups
- Department of PsychiatryUniversity of Texas Southwestern Medical CenterDallasTexas
| | - Madhukar H. Trivedi
- Department of PsychiatryUniversity of Texas Southwestern Medical CenterDallasTexas
| | - Ramin V. Parsey
- Department of PsychiatryStony Brook UniversityStony BrookNew York,Department of RadiologyStony Brook UniversityStony BrookNew York
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Onnink AMH, Zwiers MP, Hoogman M, Mostert JC, Dammers J, Kan CC, Vasquez AA, Schene AH, Buitelaar J, Franke B. Deviant white matter structure in adults with attention-deficit/hyperactivity disorder points to aberrant myelination and affects neuropsychological performance. Prog Neuropsychopharmacol Biol Psychiatry 2015; 63:14-22. [PMID: 25956761 PMCID: PMC4515357 DOI: 10.1016/j.pnpbp.2015.04.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 04/27/2015] [Accepted: 04/27/2015] [Indexed: 10/23/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) in childhood is characterized by gray and white matter abnormalities in several brain areas. Considerably less is known about white matter microstructure in adults with ADHD and its relation with clinical symptoms and cognitive performance. In 107 adult ADHD patients and 109 gender-, age- and IQ-matched controls, we used diffusion tensor imaging (DTI) with tract-based spatial statistics (TBSS) to investigate whole-skeleton changes of fractional anisotropy (FA) and mean, axial, and radial diffusivity (MD, AD, RD). Additionally, we studied the relation of FA and MD values with symptom severity and cognitive performance on tasks measuring working memory, attention, inhibition, and delay discounting. In comparison to controls, participants with ADHD showed reduced FA in corpus callosum, bilateral corona radiata, and thalamic radiation. Higher MD and RD were found in overlapping and even more widespread areas in both hemispheres, also encompassing internal and external capsule, sagittal stratum, fornix, and superior lateral fasciculus. Values of FA and MD were not associated with symptom severity. However, within some white matter clusters that distinguished patients from controls, worse inhibition performance was associated with reduced FA and more impulsive decision making was associated with increased MD. This study shows widespread differences in white matter integrity between adults with persistent ADHD and healthy individuals. Changes in RD suggest aberrant myelination as a pathophysiological factor in persistent ADHD. The microstructural differences in adult ADHD may contribute to poor inhibition and greater impulsivity but appear to be independent of disease severity.
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Affiliation(s)
- A. Marten H. Onnink
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands,Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Marcel P. Zwiers
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Martine Hoogman
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Jeanette C. Mostert
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands,Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Janneke Dammers
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands,Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Cornelis C. Kan
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Alejandro Arias Vasquez
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands,Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands,Department of Cognitive Neurosciences, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Aart H. Schene
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Jan Buitelaar
- Department of Cognitive Neurosciences, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands,Karakter Child and Adolescent Psychiatric University Centre, Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
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Bracht T, Linden D, Keedwell P. A review of white matter microstructure alterations of pathways of the reward circuit in depression. J Affect Disord 2015; 187:45-53. [PMID: 26318270 DOI: 10.1016/j.jad.2015.06.041] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 05/30/2015] [Accepted: 06/24/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Depressed mood, anhedonia, psychomotor retardation and alterations of circadian rhythm are core features of the depressive syndrome. Its neural correlates can be located within a frontal-striatal-tegmental neural network, commonly referred to as the reward circuit. It is the aim of this article to review literature on white matter microstructure alterations of the reward system in depression. METHOD We searched for diffusion tensor imaging (DTI)-studies that have explored neural deficits within the cingulum bundle, the uncinate fasciculus and the supero-lateral medial forebrain bundle/anterior thalamic radiation - in adolescent and adult depression (acute and remitted), melancholic depression, treatment-resistant depression and those at familial risk of depression. The relevant diffusion MRI literature was identified using PUBMED. RESULTS Thirty-five studies were included. In people at familial risk for depression the main finding was reduced fractional anisotropy (FA) in the cingulum bundle. Both increases and decreases of FA have been reported in the uncinate fasciculus in adolescents. Reductions of FA in the uncinate fasciculus and the anterior thalamic radiation/supero-lateral medial forebrain bundle during acute depressive episodes in adults were most consistently reported. LIMITATIONS Non-quantitative approach. CONCLUSIONS Altered cingulum bundle microstructure in unaffected relatives may either indicate resilience or vulnerability to depression. Uncinate fasciculus and supero-lateral medial forebrain bundle microstructure may be altered during depressive episodes in adult MDD. Future studies call for a careful clinical stratification of clinically meaningful subgroups.
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Affiliation(s)
- Tobias Bracht
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom; Translational Research Center, University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
| | - David Linden
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom; MRC Centre for Neuropsychiatry Genetics & Genomics, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Paul Keedwell
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom
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105
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Grieve SM, Menon P, Korgaonkar MS, Gomes L, Foster S, Kiernan MC, Vucic S. Potential structural and functional biomarkers of upper motor neuron dysfunction in ALS. Amyotroph Lateral Scler Frontotemporal Degener 2015; 17:85-92. [DOI: 10.3109/21678421.2015.1074707] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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106
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Increased cerebrospinal fluid fibrinogen in major depressive disorder. Sci Rep 2015; 5:11412. [PMID: 26081315 PMCID: PMC4469953 DOI: 10.1038/srep11412] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/26/2015] [Indexed: 01/14/2023] Open
Abstract
Major depressive disorder (MDD) presumably includes heterogeneous subgroups with differing pathologies. To obtain a marker reflecting such a subgroup, we analyzed the cerebrospinal fluid (CSF) levels of fibrinogen, which has been reported to be elevated in the plasma of patients with MDD. Three fibrinogen-related proteins were measured using aptamer-based analyses and CSF samples of 30 patients with MDD and 30 controls. The numbers of patients with an excessively high level (>99 percentile of the controls) was significantly increased (17 to 23%). Measurement reproducibility of these results was confirmed by an ELISA for fibrinogen (Pearson’s r = 0.77). In an independent sample set from 36 patients and 30 controls, using the ELISA, results were similar (22%). When these two sample sets were combined, the number of patients with a high fibrinogen level was significantly increased (15/66; odds ratio 8.53; 95% confidence interval 1.9–39.1, p = 0.0011). By using diffusion tensor imaging, we found white matter tracts abnormalities in patients with a high fibrinogen level but not those patients with a normal fibrinogen level, compared with controls. Plasma fibrinogen levels were similar among the diagnostic groups. Our results point to a subgroup of MDD represented by increased CSF fibrinogen and white matter tract abnormalities.
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107
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Ota M, Noda T, Sato N, Hattori K, Hori H, Sasayama D, Teraishi T, Nagashima A, Obu S, Higuchi T, Kunugi H. White matter abnormalities in major depressive disorder with melancholic and atypical features: A diffusion tensor imaging study. Psychiatry Clin Neurosci 2015; 69:360-8. [PMID: 25384997 DOI: 10.1111/pcn.12255] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 11/03/2014] [Accepted: 11/06/2014] [Indexed: 11/28/2022]
Abstract
AIM The DSM-IV recognizes some subtypes of major depressive disorder (MDD). It is known that the effectiveness of antidepressants differs among the MDD subtypes, and thus the differentiation of the subtypes is important. However, little is known as to structural brain changes in MDD with atypical features (aMDD) in comparison with MDD with melancholic features (mMDD), which prompted us to examine possible differences in white matter integrity assessed with diffusion tensor imaging (DTI) between these two subtypes. METHODS Subjects were 21 patients with mMDD, 24 with aMDD, and 37 age- and sex-matched healthy volunteers whose DTI data were obtained by 1.5 tesla magnetic resonance imaging. We compared fractional anisotropy and mean diffusivity value derived from DTI data on a voxel-by-voxel basis among the two diagnostic groups and healthy subjects. RESULTS There were significant decreases of fractional anisotropy and increases of mean diffusivity in patients with MDD compared with healthy subjects in the corpus callosum, inferior fronto-occipital fasciculus, and left superior longitudinal fasciculus. However, we detected no significant difference in any brain region between mMDD and aMDD. CONCLUSION Our results suggest that patients with MDD had reduced white matter integrity in some regions; however, there was no major difference between aMDD and mMDD.
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Affiliation(s)
- Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takamasa Noda
- Department of Psychiatry, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
| | - Noriko Sato
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
| | - Kotaro Hattori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Daimei Sasayama
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Toshiya Teraishi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Anna Nagashima
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Satoko Obu
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
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108
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Jiang W, Gong G, Wu F, Kong L, Chen K, Cui W, Ren L, Fan G, Sun W, Ma H, Xu K, Tang Y, Wang F. The papez circuit in first-episode, treatment-naive adults with major depressive disorder: combined atlas-based tract-specific quantification analysis and voxel-based analysis. PLoS One 2015; 10:e0126673. [PMID: 25996480 PMCID: PMC4440648 DOI: 10.1371/journal.pone.0126673] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 04/06/2015] [Indexed: 11/18/2022] Open
Abstract
Previous findings suggest that the Papez Circuit may have a role in major depressive disorders. We used atlas-based tract-specific quantification analysis and voxel-based analysis to examine the integrity of white matter tracts involved in mood regulation (including tracts in the Papez Circuit). Diffusion tensor imaging acquired from 35 first-episode, treatment-naive adults with major depressive disorders and 34 healthy adult controls were compared. Our statistical approach compared structural integrity of 11 major white matter tracts between the major depressive disorder and adult controls, as well as illness duration influence in patients. Fractional anisotropy was decreased in the hippocampal cingulum and in the anterior thalamic radiation according to both analytical approaches, all of which were important tracts included in the Papez Circuit. Our results support the role of the Papez Circuit in major depressive disorders with the minimal probability of false positive due to similar findings in both analyses that have complementary advantages. Dysfunction of the Papez Circuit may be a potential marker for studying the pathogenesis of major depressive disorders.
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Affiliation(s)
- Wenyan Jiang
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
- Department of Radiology, The Liaoning Cancer Hospital & Institute, Shenyang 110042, Liaoning, PR China
| | - Gaolang Gong
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, PR China
| | - Feng Wu
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Lingtao Kong
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Kaiyuan Chen
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Wenhui Cui
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Ling Ren
- Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Guoguang Fan
- Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Wenge Sun
- Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Huan Ma
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Ke Xu
- Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
- * E-mail: (KX); (YT)
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
- * E-mail: (KX); (YT)
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
- Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
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109
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Altered white matter integrity in individuals with cognitive vulnerability to depression: a tract-based spatial statistics study. Sci Rep 2015; 5:9738. [PMID: 25984712 PMCID: PMC4434894 DOI: 10.1038/srep09738] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 03/11/2015] [Indexed: 01/08/2023] Open
Abstract
The microstructure of white matter in patients with major depressive disorder (MDD) has been demonstrated to be abnormal. However, it remains unclear whether these changes exist prior to the onset of disease. In this study, diffusion tensor imaging was used to evaluate white matter integrity in individuals who exhibited cognitive vulnerability to depression (CVD), MDD, and healthy controls (HC). Compared with the HC, MDD exhibited a lower fractional anisotropy (FA) in ten brain regions: the cerebral peduncle, the anterior and posterior limbs of the internal capsule (ALIC and PLIC), the external capsule, the retrolenticular part of the internal capsule (RLIC), the body and splenium of the corpus callosum, the superior and posterior corona radiata, and the cingulum. Moreover, CVD had significantly lower FA in the ALIC, the PLIC, the external capsule, the RLIC, the cerebral peduncle, and the superior corona radiata than did the HC. However, the white matter integrity was not significantly different between the CVD and MDD. These preliminary results indicate that alterations in the white matter observed in CVD may be a marker of vulnerability to MDD and that these alterations may exist prior to the onset of depression.
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110
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Day CV, Gatt JM, Etkin A, DeBattista C, Schatzberg AF, Williams LM. Cognitive and emotional biomarkers of melancholic depression: An iSPOT-D report. J Affect Disord 2015; 176:141-50. [PMID: 25710095 DOI: 10.1016/j.jad.2015.01.061] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depressed patients with melancholic features have distinct impairments in cognition and anhedonia, but it remains unknown whether these impairments can be quantified on neurocognitive biomarker tests of behavioral performance. We compared melancholic major depressive disorder (MDD) patients to non-melancholic MDD patients and controls on a neurocognitive test battery that assesses eight general and emotional cognitive domains including the hypothesized decision-making and reward-threat perception. METHODS MDD outpatients (n=1008) were assessed using a computerized battery of tests. MDD participants met DSM-IV criteria for MDD and had a score ≥16 on the 17-item Hamilton Rating Scale for Depression. Melancholic MDD was defined using the Mini-International Neuropsychiatric Interview and a psychomotor disturbance observer-rated CORE measure score >7. Controls were age- and gender-matched with no previous DSM-IV or significant medical history. RESULTS Melancholic participants (33.7% of the MDD sample) exhibited significantly poorer performance than controls across each domain of cognitive function and for speed of emotion identification and implicit emotion priming. Compared to the non-melancholic group, specific disturbances were seen on tests of information speed, decision speed, and reward-relevant emotional processing of happy expressions, even after co-varying for symptom severity. LIMITATIONS Assessments were taken at only one medication-free time point. Reward was investigated using an emotional faces task. CONCLUSIONS Melancholic MDD is distinguished by a specific neurocognitive marker profile consistent with reduced decision-making capacity under time demands and loss of reward sensitivity. This profile suggests an underlying deficit in mesolimbic-cortical circuitry for motivationally-directed behavior.
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Affiliation(s)
- Claire V Day
- The Brain Dynamics Centre, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney 2006, NSW, Australia; Westmead Millennium Institute, Westmead 2145, NSW, Australia; Brain Resource Ltd., 235 Jones Street, Sydney, NSW, Australia; Brain Resource Inc., 1000 Sansome Street, San Francisco, CA 94111, USA
| | - Justine M Gatt
- The Brain Dynamics Centre, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney 2006, NSW, Australia; Westmead Millennium Institute, Westmead 2145, NSW, Australia; Neuroscience Research Australia, Randwick 2031, NSW, Australia; School of Psychology, University of New South Wales, Sydney 2052, NSW, Australia
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Sierra-Pacific Mental Illness Research, Education and Clinical Center (MIRECC) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Charles DeBattista
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Alan F Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Sierra-Pacific Mental Illness Research, Education and Clinical Center (MIRECC) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA.
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Lener MS, Iosifescu DV. In pursuit of neuroimaging biomarkers to guide treatment selection in major depressive disorder: a review of the literature. Ann N Y Acad Sci 2015; 1344:50-65. [DOI: 10.1111/nyas.12759] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Marc S. Lener
- Department of Psychiatry; Icahn School of Medicine at Mount Sinai; New York New York
| | - Dan V. Iosifescu
- Department of Psychiatry; Icahn School of Medicine at Mount Sinai; New York New York
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The medial forebrain bundle as a deep brain stimulation target for treatment resistant depression: A review of published data. Prog Neuropsychopharmacol Biol Psychiatry 2015; 58:59-70. [PMID: 25530019 DOI: 10.1016/j.pnpbp.2014.12.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 12/08/2014] [Accepted: 12/09/2014] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Despite a wide variety of therapeutic interventions for major depressive disorder (MDD), treatment resistant depression (TRD) remains to be prevalent and troublesome in clinical practice. In recent years, deep brain stimulation (DBS) has emerged as an alternative for individuals suffering from TRD not responding to combining antidepressants, multiple adjunctive strategies and electroconvulsive therapy (ECT). Although the best site for TRD-DBS is still unclear, pilot data suggests that the medial forebrain bundle (MFB) might be a key target to accomplish therapeutic efficacy in TRD patients. OBJECTIVE To explore the anatomic, electrophysiologic, neurocognitive and treatment data supporting the MFB as a target for TRD-DBS. RESULTS The MFB connects multiple targets involved in motivated behavior, mood regulation and antidepressant response. Specific phenomenology associated with TRD can be linked specifically to the superolateral branch (sl) of the MFB (slMFB). TRD patients who received DBS-slMFB reported high response/remission rates with an improvement in functioning and no significant adverse outcomes in their physical health or neurocognitive performance. DISCUSSION The slMFB is an essential component of a network of structural and functional pathways connecting different areas possibly involved in the pathogenesis of mood disorders. Therefore, the slMFB should be considered as an exciting therapeutic target for DBS therapy to achieve a sustained relief in TRD patients. CONCLUSION There is an urgent need for clinical trials exploring DBS-slMFB in TRD. Further efforts should pursue measuring baseline pro-inflammatory cytokines, oxidative stress, and cognition as possible biomarkers of DBS-slMFB response in order to aid clinicians in better patient selection.
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Bracht T, Doidge AN, Keedwell PA, Jones DK. Hedonic tone is associated with left supero-lateral medial forebrain bundle microstructure. Psychol Med 2015; 45:865-874. [PMID: 25124530 PMCID: PMC4413785 DOI: 10.1017/s0033291714001949] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Revised: 07/17/2014] [Accepted: 07/17/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND The medial forebrain bundle (MFB) is an important pathway of the reward system. Two branches have been described using diffusion magnetic resonance imaging (MRI)-based tractography: the infero-medial MFB (imMFB) and the supero-lateral MFB (slMFB). Previous studies point to white-matter microstructural alterations of the slMFB in major depressive disorder (MDD) during acute episodes. To extend this finding, this study investigates whether white-matter microstructure is also altered in MDD patients that are in remission. Further, we explore associations between diffusion MRI-based metrics of white-matter microstructure of imMFB, slMFB and hedonic tone, the ability to derive pleasure. METHOD Eighteen remitted depressed (RD) and 22 never depressed (ND) participants underwent high angular resolution diffusion-weighted imaging (HARDI) scans. To reconstruct the two pathways of the MFB (imMFB and slMFB) we used the damped Richardson-Lucy (dRL) algorithm. Mean fractional anisotropy (FA) was sampled along the tracts. RESULTS Mean FA of imMFB, slMFB and a comparison tract (the middle cerebellar peduncle) did not differ between ND and RD participants. Hedonic capacity correlated negatively with mean FA of the left slMFB, explaining 21% of the variance. CONCLUSIONS Diffusion MRI-based metrics of white-matter microstructure of the MFB in RD do not differ from ND. Hedonic capacity is associated with altered white-matter microstructure of the slMFB.
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Affiliation(s)
- T. Bracht
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
- Neuroscience, Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - A. N. Doidge
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
- Neuroscience, Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - P. A. Keedwell
- Neuroscience, Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - D. K. Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
- Neuroscience, Mental Health Research Institute, Cardiff University, Cardiff, UK
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Mayer AR, Hanlon FM, Ling JM. Gray matter abnormalities in pediatric mild traumatic brain injury. J Neurotrauma 2015; 32:723-30. [PMID: 25313896 DOI: 10.1089/neu.2014.3534] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Pediatric mild traumatic brain injury (pmTBI) is the most prevalent neurological insult in children and is associated with both acute and chronic neuropsychiatric sequelae. However, little is known about underlying pathophysiology changes in gray matter diffusion and atrophy from a prospective stand-point. Fifteen semi-acute pmTBI patients and 15 well-matched healthy controls were evaluated with a clinical and neuroimaging battery, with a subset of participants returning for a second visit. Clinical measures included tests of attention, processing speed, executive function, working memory, memory, and self-reported post-concussive symptoms. Measures of diffusion (fractional anisotropy [FA]) and atrophy were also obtained for cortical and subcortical gray matter structures to characterize effects of injury as a function of time. Patients exhibited decreased scores in the domains of attention and processing speed relative to controls during the semi-acute injury stage, in conjunction with increased anisotropic diffusion in the left superior temporal gyrus and right thalamus. Evidence of increased diffusion in these regions was also present at four months post-injury, with performance on cognitive tests partially normalizing. In contrast, signs of cortical atrophy in bilateral frontal areas and other left-hemisphere cortical areas only emerged at four months post-injury for patients. Current results suggest potentially differential time-courses of recovery for neurobehavioral markers, anisotropic diffusion and atrophy following pmTBI. Importantly, these data suggest that relying on patient self-report or standard clinical assessments may underestimate the time for true injury recovery.
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Affiliation(s)
- Andrew R Mayer
- 1 The Mind Research Network/Lovelace Biomedical and Environmental Research Institute , Albuquerque, New Mexico
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Phillips ML, Chase HW, Sheline YI, Etkin A, Almeida JR, Deckersbach T, Trivedi MH. Identifying predictors, moderators, and mediators of antidepressant response in major depressive disorder: neuroimaging approaches. Am J Psychiatry 2015; 172:124-38. [PMID: 25640931 PMCID: PMC4464814 DOI: 10.1176/appi.ajp.2014.14010076] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Despite significant advances in neuroscience and treatment development, no widely accepted biomarkers are available to inform diagnostics or identify preferred treatments for individuals with major depressive disorder. METHOD In this critical review, the authors examine the extent to which multimodal neuroimaging techniques can identify biomarkers reflecting key pathophysiologic processes in depression and whether such biomarkers may act as predictors, moderators, and mediators of treatment response that might facilitate development of personalized treatments based on a better understanding of these processes. RESULTS The authors first highlight the most consistent findings from neuroimaging studies using different techniques in depression, including structural and functional abnormalities in two parallel neural circuits: serotonergically modulated implicit emotion regulation circuitry, centered on the amygdala and different regions in the medial prefrontal cortex; and dopaminergically modulated reward neural circuitry, centered on the ventral striatum and medial prefrontal cortex. They then describe key findings from the relatively small number of studies indicating that specific measures of regional function and, to a lesser extent, structure in these neural circuits predict treatment response in depression. CONCLUSIONS Limitations of existing studies include small sample sizes, use of only one neuroimaging modality, and a focus on identifying predictors rather than moderators and mediators of differential treatment response. By addressing these limitations and, most importantly, capitalizing on the benefits of multimodal neuroimaging, future studies can yield moderators and mediators of treatment response in depression to facilitate significant improvements in shorter- and longer-term clinical and functional outcomes.
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Bracht T, Jones DK, Müller TJ, Wiest R, Walther S. Limbic white matter microstructure plasticity reflects recovery from depression. J Affect Disord 2015; 170:143-9. [PMID: 25240841 DOI: 10.1016/j.jad.2014.08.031] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/22/2014] [Accepted: 08/22/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND White matter microstructure alterations of limbic and reward pathways have been reported repeatedly for depressive episodes in major depressive disorder (MDD) and bipolar disorder (BD). However, findings during remission are equivocal. It was the aim of this study to investigate if white matter microstructure changes during the time course of clinical remission. METHODS Fifteen depressed patients (11 MDD, 4 BD) underwent diffusion-weighted MRI both during depression, and during remission following successful antidepressive treatment (average time interval between scans = 6 months). Fractional anisotropy (FA) was sampled along reconstructions of the supero-lateral medial forebrain bundle (slMFB), the cingulum bundle (CB), the uncinate fasciculus (UF), the parahippocampal cingulum (PHC) and the fornix. Repeated measures ANCOVAs controlling for the effect of age were calculated for each tract. RESULTS There was a significant main effect of time (inter-scan interval) for mean-FA for the right CB and for the left PHC. For both pathways there was a significant time × age interaction. In the right CB, FA increased in younger patients, while FA decreased in older patients. In the left PHC, a reverse pattern was seen. FA changes in the right CB correlated positively with symptom reductions. Mean-FA of UF, slMFB and fornix did not change between the two time points. LIMITATIONS All patients were medicated, sample size, and lack of control group. CONCLUSIONS Right CB and left PHC undergo age-dependent plastic changes during the course of remission and may serve as a state marker in depression. UF, slMFB and FO microstructure remains stable.
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Affiliation(s)
- Tobias Bracht
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom; University Hospital of Psychiatry, University of Bern, Bern, Switzerland.
| | - Derek K Jones
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Thomas J Müller
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
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Abstract
The fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 defines mental disorders as syndromes and also introduced disorder "specifiers" with the aim of providing increased diagnostic specificity by defining more homogeneous subgroups of those with the disorder and who share certain features. While the majority of specifiers in DSM-5 define a specific aspect of the disorder such as age at onset or severity, some define syndromes that appear to meet the DSM-5 definition of a mental disorder. Specifically, melancholia is positioned in DSM-5 as a major depressive disorder (non-coded) specifier, while catatonia is listed as both a disorder secondary to a medical condition and as a specifier associated with other mental disorders such as schizophrenia, major depressive disorder, and bipolar disorder. Despite decades of research supporting melancholia's status as a categorical "disorder" (a higher-order construct than a specifier), failure to provide convincing support for its disorder status has contributed to its current positioning in DSM-5. As DSM-5 has similar symptom criteria for major depression and for its melancholia specifier, research seeking to differentiate melancholic and non-melancholic depression according to DSM-5 criteria will have limited capacity to demonstrate "melancholia" as a separate disorder and risks melancholia continuing to be reified as a low-order specifier and thus clinical marginalization. There have been few advances in catatonia research in recent years with its positioning largely relying on opinion and clinical observation rather than on empirical studies.
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Affiliation(s)
- Gordon Parker
- University of New South Wales, Randwick, Sydney, Australia,
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Functional and Anatomical Brain Abnormalities and Effects of Antidepressant in Major Depressive Disorder. J Comput Assist Tomogr 2015; 39:766-73. [DOI: 10.1097/rct.0000000000000264] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Korgaonkar MS, Rekshan W, Gordon E, Rush AJ, Williams LM, Blasey C, Grieve SM. Magnetic Resonance Imaging Measures of Brain Structure to Predict Antidepressant Treatment Outcome in Major Depressive Disorder. EBioMedicine 2014; 2:37-45. [PMID: 26137532 PMCID: PMC4484820 DOI: 10.1016/j.ebiom.2014.12.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 11/30/2014] [Accepted: 12/01/2014] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Less than 50% of patients with Major Depressive Disorder (MDD) reach symptomatic remission with their initial antidepressant medication (ADM). There are currently no objective measures with which to reliably predict which individuals will achieve remission to ADMs. METHODS 157 participants with MDD from the International Study to Predict Optimized Treatment in Depression (iSPOT-D) underwent baseline MRIs and completed eight weeks of treatment with escitalopram, sertraline or venlafaxine-ER. A score at week 8 of 7 or less on the 17 item Hamilton Rating Scale for Depression defined remission. Receiver Operator Characteristics (ROC) analysis using the first 50% participants was performed to define decision trees of baseline MRI volumetric and connectivity (fractional anisotropy) measures that differentiated non-remitters from remitters with maximal sensitivity and specificity. These decision trees were tested for replication in the remaining participants. FINDINGS Overall, 35% of all participants achieved remission. ROC analyses identified two decision trees that predicted a high probability of non-remission and that were replicated: 1. Left middle frontal volume < 14 · 8 mL & right angular gyrus volume > 6 · 3 mL identified 55% of non-remitters with 85% accuracy; and 2. Fractional anisotropy values in the left cingulum bundle < 0 · 63, right superior fronto-occipital fasciculus < 0 · 54 and right superior longitudinal fasciculus < 0 · 50 identified 15% of the non-remitters with 84% accuracy. All participants who met criteria for both decision trees were correctly identified as non-remitters. INTERPRETATION Pretreatment MRI measures seem to reliably identify a subset of patients who do not remit with a first step medication that includes one of these commonly used medications. Findings are consistent with a neuroanatomical basis for non-remission in depressed patients. FUNDING Brain Resource Ltd is the sponsor for the iSPOT-D study (NCT00693849).
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Affiliation(s)
- Mayuresh S Korgaonkar
- The Brain Dynamics Centre, Westmead Millennium Institute, Sydney Medical School, Sydney, NSW, Australia ; Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, NSW, Australia
| | - William Rekshan
- Brain Resource Ltd, Sydney, NSW, Australia ; Brain Resource Ltd, San Francisco, CA, USA
| | - Evian Gordon
- The Brain Dynamics Centre, Westmead Millennium Institute, Sydney Medical School, Sydney, NSW, Australia ; Brain Resource Ltd, Sydney, NSW, Australia ; Brain Resource Ltd, San Francisco, CA, USA
| | - A John Rush
- Duke-National University of Singapore, Singapore
| | - Leanne M Williams
- The Brain Dynamics Centre, Westmead Millennium Institute, Sydney Medical School, Sydney, NSW, Australia ; Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305, USA ; Sierra-Pacific Mental Illness Research, Education, Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | | | - Stuart M Grieve
- The Brain Dynamics Centre, Westmead Millennium Institute, Sydney Medical School, Sydney, NSW, Australia ; Sydney Translational Imaging Laboratory, Charles Perkins Centre and Sydney Medical School, University of Sydney, NSW 2006, Australia ; Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2006, Australia
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Korgaonkar MS, Williams LM, Song YJ, Usherwood T, Grieve SM. Diffusion tensor imaging predictors of treatment outcomes in major depressive disorder. Br J Psychiatry 2014; 205:321-8. [PMID: 24970773 DOI: 10.1192/bjp.bp.113.140376] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Functional neuroimaging studies implicate anterior cingulate and limbic dysfunction in major depressive disorder (MDD) and responsiveness to antidepressants. Diffusion tensor imaging (DTI) enables characterisation of white matter tracts that relate to these regions. AIMS To examine whether DTI measures of anterior cingulate and limbic white matter are useful prognostic biomarkers for MDD. METHOD Of the 102 MDD out-patients from the International Study to Predict Optimized Treatment for Depression (iSPOT-D) who provided baseline magnetic resonance imaging (MRI) data, 74 completed an 8-week course of antidepressant medication (randomised to escitalopram, sertraline or extended-release venlafaxine) and were included in the present analyses. Thirty-four matched controls also provided DTI data. Fractional anisotropy was measured for five anterior cingulate-limbic white matter tracts: cingulum cingulate and hippocampus bundle, fornix, stria terminalis and uncinate fasciculus. (Trial registered at ClinicalTrials.gov: NCT00693849.) RESULTS A cross-validated logistic regression model demonstrated that altered connectivity for the cingulum part of the cingulate and stria terminalis tracts significantly predicted remission independent of demographic and clinical measures with 62% accuracy. Prediction improved to 74% when age was added to this model. CONCLUSIONS Anterior cingulate-limbic white matter is a useful predictor of antidepressant treatment outcome in MDD.
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Affiliation(s)
- Mayuresh S Korgaonkar
- Mayuresh S. Korgaonkar, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia; Leanne M. Williams, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney, Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia and Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA; Yun Ju Song, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia; Tim Usherwood, MD, BS, FRACGP, Department of General Practice, Sydney Medical School, Westmead, Sydney, Australia; Stuart M. Grieve, MBBS, BSc, DPhil, RANZCR, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Sydney Translational Imaging Laboratory, Sydney Medical School, Sydney, Australia
| | - Leanne M Williams
- Mayuresh S. Korgaonkar, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia; Leanne M. Williams, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney, Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia and Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA; Yun Ju Song, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia; Tim Usherwood, MD, BS, FRACGP, Department of General Practice, Sydney Medical School, Westmead, Sydney, Australia; Stuart M. Grieve, MBBS, BSc, DPhil, RANZCR, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Sydney Translational Imaging Laboratory, Sydney Medical School, Sydney, Australia
| | - Yun Ju Song
- Mayuresh S. Korgaonkar, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia; Leanne M. Williams, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney, Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia and Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA; Yun Ju Song, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia; Tim Usherwood, MD, BS, FRACGP, Department of General Practice, Sydney Medical School, Westmead, Sydney, Australia; Stuart M. Grieve, MBBS, BSc, DPhil, RANZCR, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Sydney Translational Imaging Laboratory, Sydney Medical School, Sydney, Australia
| | - Tim Usherwood
- Mayuresh S. Korgaonkar, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia; Leanne M. Williams, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney, Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia and Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA; Yun Ju Song, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia; Tim Usherwood, MD, BS, FRACGP, Department of General Practice, Sydney Medical School, Westmead, Sydney, Australia; Stuart M. Grieve, MBBS, BSc, DPhil, RANZCR, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Sydney Translational Imaging Laboratory, Sydney Medical School, Sydney, Australia
| | - Stuart M Grieve
- Mayuresh S. Korgaonkar, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia; Leanne M. Williams, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney, Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia and Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA; Yun Ju Song, PhD, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, Australia; Tim Usherwood, MD, BS, FRACGP, Department of General Practice, Sydney Medical School, Westmead, Sydney, Australia; Stuart M. Grieve, MBBS, BSc, DPhil, RANZCR, The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney and Sydney Translational Imaging Laboratory, Sydney Medical School, Sydney, Australia
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Neuropathic pain-induced depressive-like behavior and hippocampal neurogenesis and plasticity are dependent on TNFR1 signaling. Brain Behav Immun 2014; 41:65-81. [PMID: 24938671 PMCID: PMC4167189 DOI: 10.1016/j.bbi.2014.04.003] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 04/07/2014] [Accepted: 04/08/2014] [Indexed: 02/07/2023] Open
Abstract
Patients suffering from neuropathic pain have a higher incidence of mood disorders such as depression. Increased expression of tumor necrosis factor (TNF) has been reported in neuropathic pain and depressive-like conditions and most of the pro-inflammatory effects of TNF are mediated by the TNF receptor 1 (TNFR1). Here we sought to investigate: (1) the occurrence of depressive-like behavior in chronic neuropathic pain and the associated forms of hippocampal plasticity, and (2) the involvement of TNFR1-mediated TNF signaling as a possible regulator of such events. Neuropathic pain was induced by chronic constriction injury of the sciatic nerve in wild-type and TNFR1(-/-) mice. Anhedonia, weight loss and physical state were measured as symptoms of depression. Hippocampal neurogenesis, neuroplasticity, myelin remodeling and TNF/TNFRs expression were analyzed by immunohistochemical analysis and western blot assay. We found that neuropathic pain resulted in the development of depressive symptoms in a time dependent manner and was associated with profound hippocampal alterations such as impaired neurogenesis, reduced expression of neuroplasticity markers and myelin proteins. The onset of depressive-like behavior also coincided with increased hippocampal levels of TNF, and decreased expression of TNF receptor 2 (TNFR2), which were all fully restored after mice spontaneously recovered from pain. Notably, TNFR1(-/-) mice did not develop depressive-like symptoms after injury, nor were there changes in hippocampal neurogenesis and plasticity. Our data show that neuropathic pain induces a cluster of depressive-like symptoms and profound hippocampal plasticity that are dependent on TNF signaling through TNFR1.
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Lai CH, Wu YT. Alterations in white matter micro-integrity of the superior longitudinal fasciculus and anterior thalamic radiation of young adult patients with depression. Psychol Med 2014; 44:2825-2832. [PMID: 25065445 DOI: 10.1017/s0033291714000440] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND This study surveyed the characteristics of white matter (WM) micro-integrity in patients who were diagnosed with major depressive disorder (MDD) without co-morbidities. METHOD A total of 44 patients with MDD and 27 normal controls were enrolled in our study. Diffusion tensor imaging images of patients and controls were pre-processed and analysed to estimate differences in WM micro-integrity between patients and controls by performing comparisons of the values obtained from fractional anisotropy (FA). FA outputs of patients and controls were compared by a non-parametric permutation-based method with global brain volume, age and gender as covariates. In addition, the between-group differences of radial diffusivity (RD) and axial diffusivity (AD) were assessed to explain the alterations in FA values. Correlations between clinical variables (such as depression severity, anxiety severity, illness duration) and FA values were also estimated in each group and across both groups. RESULTS The patients with MDD had significantly lower FA values than the controls, for the left superior longitudinal fasciculus (SLF) and the right anterior thalamic radiation (ATR). The reductions in FA values occurred in combination with elevated RD values in the bilateral SLF and decreased AD values in the bilateral ATR. FA values were negatively correlated with depression severity in the SLF and with illness duration in the right SLF and ATR. CONCLUSIONS MDD patients had significant alterations in the WM micro-integrity of the left SLF and the right ATR.
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Affiliation(s)
- C H Lai
- Department of Psychiatry,Cheng Hsin General Hospital,Taipei City,Taiwan, ROC
| | - Y T Wu
- Department of Biomedical Imaging and Radiological Sciences,National Yang-Ming University,Taipei,Taiwan, ROC
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Korgaonkar MS, Fornito A, Williams LM, Grieve SM. Abnormal structural networks characterize major depressive disorder: a connectome analysis. Biol Psychiatry 2014; 76:567-74. [PMID: 24690111 DOI: 10.1016/j.biopsych.2014.02.018] [Citation(s) in RCA: 249] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 02/12/2014] [Accepted: 02/13/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) has been shown to be associated with a disrupted topological organization of functional brain networks. However, little is known regarding whether these changes have a structural basis. Diffusion tensor imaging (DTI) enables comprehensive whole-brain mapping of the white matter tracts that link regions distributed throughout the entire brain, the so-called human connectome. METHODS We examined whole-brain structural networks in a cohort of 95 MDD outpatients and 102 matched control subjects. Structural networks were represented by an 84 × 84 connectivity matrix representing probabilistic white matter connections between 84 parcellated cortical and subcortical regions using DTI tractography. Network-based statistics were used to assess differences in the interregional connectivity matrix between the two groups, and graph theory was used to examine overall topological organization. RESULTS Our network-based statistics analysis demonstrates lowered structural connectivity within two distinct brain networks that are present in depression: the first primarily involves the regions of the default mode network and the second comprises the frontal cortex, thalamus, and caudate regions that are central in emotional and cognitive processing. These two altered networks were observed in the context of an overall preservation of topology as reflected as no significant group differences for the graph-theory measures. CONCLUSIONS This is the first report to use DTI to show the structural connectomic alterations present in MDD. Our findings highlight that altered structural connectivity between nodes of the default mode network and the frontal-thalamo-caudate regions are core neurobiological features associated with MDD.
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Affiliation(s)
- Mayuresh S Korgaonkar
- The Brain Dynamics Centre, Sydney Medical School-Westmead and Westmead Millennium Institute for Medical Research, Sydney; Discipline of Psychiatry, University of Sydney Medical School: Western, Westmead Hospital, Sydney
| | - Alex Fornito
- Monash Clinical and Imaging Neuroscience, School of Psychology and Psychiatry & Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Leanne M Williams
- The Brain Dynamics Centre, Sydney Medical School-Westmead and Westmead Millennium Institute for Medical Research, Sydney; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Stuart M Grieve
- The Brain Dynamics Centre, Sydney Medical School-Westmead and Westmead Millennium Institute for Medical Research, Sydney; Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Australia; Department of Radiology, Royal Prince Alfred Hospital, Australia; Charles Perkins Centre, University of Sydney, Camperdown, Australia.
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124
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Zakszewski E, Adluru N, Tromp DPM, Kalin N, Alexander AL. A diffusion-tensor-based white matter atlas for rhesus macaques. PLoS One 2014; 9:e107398. [PMID: 25203614 PMCID: PMC4159318 DOI: 10.1371/journal.pone.0107398] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 08/11/2014] [Indexed: 01/20/2023] Open
Abstract
Atlases of key white matter (WM) structures in humans are widely available, and are very useful for region of interest (ROI)-based analyses of WM properties. There are histology-based atlases of cortical areas in the rhesus macaque, but none currently of specific WM structures. Since ROI-based analysis of WM pathways is also useful in studies using rhesus diffusion tensor imaging (DTI) data, we have here created an atlas based on a publicly available DTI-based template of young rhesus macaques. The atlas was constructed to mimic the structure of an existing human atlas that is widely used, making results translatable between species. Parcellations were carefully hand-drawn on a principle-direction color-coded fractional anisotropy image of the population template. The resulting atlas can be used as a reference to which registration of individual rhesus data can be performed for the purpose of white-matter parcellation. Alternatively, specific ROIs from the atlas may be warped into individual space to be used in ROI-based group analyses. This atlas will be made publicly available so that it may be used as a resource for DTI studies of rhesus macaques.
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Affiliation(s)
- Elizabeth Zakszewski
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin - Madison, Madison, Wisconsin, United States of America
- Department of Medical Physics, University of Wisconsin - Madison, Wisconsin Institutes for Medical Research, Madison, Wisconsin, United States of America
| | - Nagesh Adluru
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin - Madison, Madison, Wisconsin, United States of America
| | - Do P. M. Tromp
- Health Emotions Research Institute, University of Wisconsin - Madison, Health Emotions Research Institute Madison, Wisconsin, United States of America
| | - Ned Kalin
- Health Emotions Research Institute, University of Wisconsin - Madison, Health Emotions Research Institute Madison, Wisconsin, United States of America
- Department of Psychiatry, University of Wisconsin - Madison, Wisconsin Psychiatric Institute & Clinics, Madison, Wisconsin, United States of America
| | - Andrew L. Alexander
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin - Madison, Madison, Wisconsin, United States of America
- Department of Psychiatry, University of Wisconsin - Madison, Wisconsin Psychiatric Institute & Clinics, Madison, Wisconsin, United States of America
- Department of Medical Physics, University of Wisconsin - Madison, Wisconsin Institutes for Medical Research, Madison, Wisconsin, United States of America
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125
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Aghajani M, Veer IM, van Lang NDJ, Meens PHF, van den Bulk BG, Rombouts SARB, Vermeiren RRJM, van der Wee NJ. Altered white-matter architecture in treatment-naive adolescents with clinical depression. Psychol Med 2014; 44:2287-2298. [PMID: 24330845 DOI: 10.1017/s0033291713003000] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Depressive disorders are highly prevalent in adolescence and confer a heightened risk of recurrence in adulthood. Insight into the developmental neurocircuitry of depression could advance our understanding of depression and aid the development of effective treatment strategies. Whereas white-matter (WM) abnormalities are strongly implicated in adult depression, we still lack a firm understanding of WM architecture in adolescent depression. Using diffusion tensor imaging (DTI), we set out to investigate WM microstructure in a sample of clinically depressed adolescents relative to matched controls. METHOD We employed tract-based spatial statistics (TBSS) to examine WM microstructure in 25 treatment-naive adolescents with clinical depression relative to 21 matched controls. Using TBSS, we examined fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD). Threshold-free cluster enhancement (TFCE) with family-wise error (FWE) correction was used to control for multiple comparisons. RESULTS Our analysis revealed abnormal WM microstructure in clinically depressed adolescents. More specifically, whole-brain analysis revealed that patients had lower FA values in the body of the corpus callosum (CC), coupled with elevated RD and MD, and preserved AD. Conversely, region-of-interest analysis revealed that patients had higher FA values in the uncinate fasciculus (UF), coupled with elevated AD, reduced RD and preserved MD. CONCLUSIONS In line with neurocircuitry models of depression, our findings suggest that WM abnormalities within pathways facilitating cognitive and emotional functioning are involved in the pathophysiology of depression. Importantly, our findings show that these WM abnormalities are already present early in the course of the disorder.
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Affiliation(s)
- M Aghajani
- Department of Child and Adolescent Psychiatry, Curium,Leiden University Medical Center,The Netherlands
| | - I M Veer
- Leiden Institute for Brain and Cognition (LIBC),The Netherlands
| | - N D J van Lang
- Department of Child and Adolescent Psychiatry, Curium,Leiden University Medical Center,The Netherlands
| | - P H F Meens
- Department of Child and Adolescent Psychiatry, Curium,Leiden University Medical Center,The Netherlands
| | - B G van den Bulk
- Department of Child and Adolescent Psychiatry, Curium,Leiden University Medical Center,The Netherlands
| | | | - R R J M Vermeiren
- Department of Child and Adolescent Psychiatry, Curium,Leiden University Medical Center,The Netherlands
| | - N J van der Wee
- Leiden Institute for Brain and Cognition (LIBC),The Netherlands
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Tsujii N, Mikawa W, Akashi H, Tsujimoto E, Adachi T, Kirime E, Takaya M, Yanagi M, Shirakawa O. Right temporal activation differs between melancholia and nonmelancholic depression: a multichannel near-infrared spectroscopy study. J Psychiatr Res 2014; 55:1-7. [PMID: 24780385 DOI: 10.1016/j.jpsychires.2014.04.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 03/17/2014] [Accepted: 04/01/2014] [Indexed: 11/24/2022]
Abstract
The aim of this study was to determine whether melancholia differs from nonmelancholic depression in frontotemporal functioning by means of multichannel near-infrared spectroscopy. We recruited 32 major depressive disorder (MDD) patients with melancholic features (MDD-MF), 28 MDD patients with nonmelancholic features (MDD-NMF), and 24 healthy controls. Regional hemodynamic changes induced by a verbal fluency task (VFT) were monitored, and their correlations with depressive symptoms were examined. In comparison with the controls, significant differences were observed in mean oxygenated hemoglobin (oxy-Hb) changes induced by VFT in patients with MDD-MF in 25 channels (p = 0.000-0.047) and in those with MDD-NMF in 12 channels (p = 0.000-0.023). Moreover, patients with MDD-MF had significantly smaller mean oxy-Hb changes than those with MDD-NMF in 8 channels of the right temporal region (p = 0.001-0.048). No significant correlations were observed between mean oxy-Hb changes and the Hamilton rating scale for depression (HAMD) 17 total score in both groups of patients with MDD. On examining each item of HAMD17, psychomotor retardation in patients with MDD-MF showed a significant positive correlation with mean oxy-Hb changes in the right temporal region (ch43; ρ = 0.55; p = 0.001), whereas that in patients with MDD-NMF showed a significant negative correlation with mean oxy-Hb changes in the frontal and left temporal regions in 3 channels (ρ = -0.60 to -0.53; p = 0.000-0.004). In conclusion, our results indicate that melancholia is qualitatively distinct from nonmelancholic depression both clinically and biologically.
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Affiliation(s)
- Noa Tsujii
- Department of Neuropsychiatry, Kinki University Faculty of Medicine, Osaka, Japan.
| | - Wakako Mikawa
- Department of Neuropsychiatry, Kinki University Faculty of Medicine, Osaka, Japan
| | - Hiroyuki Akashi
- Department of Neuropsychiatry, Kinki University Faculty of Medicine, Osaka, Japan
| | - Emi Tsujimoto
- Department of Neuropsychiatry, Kinki University Faculty of Medicine, Osaka, Japan; Department of Psychological Science, Graduate School of Humanities, Kwansei Gakuin University, Hyogo, Japan
| | - Toru Adachi
- Department of Neuropsychiatry, Kinki University Faculty of Medicine, Osaka, Japan
| | - Eiji Kirime
- Department of Neuropsychiatry, Kinki University Faculty of Medicine, Osaka, Japan
| | - Masahiko Takaya
- Department of Neuropsychiatry, Kinki University Faculty of Medicine, Osaka, Japan
| | - Masaya Yanagi
- Department of Neuropsychiatry, Kinki University Faculty of Medicine, Osaka, Japan
| | - Osamu Shirakawa
- Department of Neuropsychiatry, Kinki University Faculty of Medicine, Osaka, Japan
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127
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Choi KS, Holtzheimer PE, Franco AR, Kelley ME, Dunlop BW, Hu XP, Mayberg HS. Reconciling variable findings of white matter integrity in major depressive disorder. Neuropsychopharmacology 2014; 39:1332-9. [PMID: 24352368 PMCID: PMC3988550 DOI: 10.1038/npp.2013.345] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 11/14/2013] [Accepted: 11/26/2013] [Indexed: 01/19/2023]
Abstract
Diffusion tensor imaging (DTI) has been used to evaluate white matter (WM) integrity in major depressive disorder (MDD), with several studies reporting differences between depressed patients and controls. However, these findings are variable and taken from relatively small studies often using suboptimal analytic approaches. The presented DTI study examined WM integrity in large samples of medication-free MDD patients (n=134) and healthy controls (n=54) using voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) approaches, and rigorous statistical thresholds. Compared with health control subjects, MDD patients show no significant differences in fractional anisotropy, radial diffusivity, mean diffusivity, and axonal diffusivity with either the VBM or the TBSS approach. Our findings suggest that disrupted WM integrity does not have a major role in the neurobiology of MDD in this relatively large study using optimal imaging acquisition and analysis; however, this does not eliminate the possibility that certain patient subgroups show WM disruption associated with depression.
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Affiliation(s)
- Ki Sueng Choi
- Department of Psychiatry, Emory University, Atlanta, GA, USA,The Wallace H Coulter, Department of Biomedical Engineering, Biomedical, Imaging Technology Center, Georgia Institute of Technology, Emory University, Atlanta, GA, USA,Department of Psychiatry, Emory University or The Wallace H Coulter, Department of Biomedical Engineering, Biomedical, Imaging Technology Center, Georgia Institute of Technology, Emory University, 101 Woodruff Circle WMB 4306, Atlanta, GA 30345, USA, Tel: +404 727 5528, E-mail:
| | - Paul E Holtzheimer
- Department of Psychiatry, Emory University, Atlanta, GA, USA,Departments of Psychiatry and Surgery, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Alexandre R Franco
- Department of Electrical Engineering, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Mary E Kelley
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Boadie W Dunlop
- Department of Psychiatry, Emory University, Atlanta, GA, USA
| | - Xiaoping P Hu
- The Wallace H Coulter, Department of Biomedical Engineering, Biomedical, Imaging Technology Center, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | - Helen S Mayberg
- Department of Psychiatry, Emory University, Atlanta, GA, USA,Department of Neurology, Emory University, Atlanta, GA, USA
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Lyden H, Espinoza RT, Pirnia T, Clark K, Joshi SH, Leaver AM, Woods RP, Narr KL. Electroconvulsive therapy mediates neuroplasticity of white matter microstructure in major depression. Transl Psychiatry 2014; 4:e380. [PMID: 24713861 PMCID: PMC4012285 DOI: 10.1038/tp.2014.21] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 02/25/2014] [Indexed: 12/12/2022] Open
Abstract
Whether plasticity of white matter (WM) microstructure relates to therapeutic response in major depressive disorder (MDD) remains uncertain. We examined diffusion tensor imaging (DTI) correlates of WM structural connectivity in patients receiving electroconvulsive therapy (ECT), a rapidly acting treatment for severe MDD. Tract-Based Spatial Statistics (TBSS) applied to DTI data (61 directions, 2.5 mm(3) voxel size) targeted voxel-level changes in fractional anisotropy (FA), and radial (RD), axial (AD) and mean diffusivity (MD) in major WM pathways in MDD patients (n=20, mean age: 41.15 years, 10.32 s.d.) scanned before ECT, after their second ECT and at transition to maintenance therapy. Comparisons made at baseline with demographically similar controls (n=28, mean age: 39.42 years, 12.20 s.d.) established effects of diagnosis. Controls were imaged twice to estimate scanning-related variance. Patients showed significant increases of FA in dorsal fronto-limbic circuits encompassing the anterior cingulum, forceps minor and left superior longitudinal fasciculus between baseline and transition to maintenance therapy (P<0.05, corrected). Decreases in RD and MD were observed in overlapping regions and the anterior thalamic radiation (P<0.05, corrected). Changes in DTI metrics associated with therapeutic response in tracts showing significant ECT effects differed between patients and controls. All measures remained stable across time in controls. Altered WM microstructure in pathways connecting frontal and limbic areas occur in MDD, are modulated by ECT and relate to therapeutic response. Increased FA together with decreased MD and RD, which trend towards normative values with treatment, suggest increased fiber integrity in dorsal fronto-limbic pathways involved in mood regulation.
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Affiliation(s)
- H Lyden
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - R T Espinoza
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - T Pirnia
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - K Clark
- Connectivity and Network Development Laboratory, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA, USA
| | - S H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - A M Leaver
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - R P Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA,Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - K L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA,Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA,Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, 225 Neuroscience Research Building, 635 Charles Young Drive South, Los Angeles, CA 90095, USA. E-mail:
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129
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A diffusion tensor imaging study of suicide attempters. J Psychiatr Res 2014; 51:60-67. [PMID: 24462041 PMCID: PMC4060601 DOI: 10.1016/j.jpsychires.2014.01.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 12/02/2013] [Accepted: 01/06/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Few studies have examined white matter abnormalities in suicide attempters using diffusion tensor imaging (DTI). This study sought to identify white matter regions altered in individuals with a prior suicide attempt. METHODS DTI scans were acquired in 13 suicide attempters with major depressive disorder (MDD), 39 non-attempters with MDD, and 46 healthy participants (HP). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were determined in the brain using two methods: region of interest (ROI) and tract-based spatial statistics (TBSS). ROIs were limited a priori to white matter adjacent to the caudal anterior cingulate cortex, rostral anterior cingulate cortex, dorsomedial prefrontal cortex, and medial orbitofrontal cortex. RESULTS Using the ROI approach, suicide attempters had lower FA than MDD non-attempters and HP in the dorsomedial prefrontal cortex. Uncorrected TBSS results confirmed a significant cluster within the right dorsomedial prefrontal cortex indicating lower FA in suicide attempters compared to non-attempters. There were no differences in ADC when comparing suicide attempters, non-attempters and HP groups using ROI or TBSS methods. CONCLUSIONS Low FA in the dorsomedial prefrontal cortex was associated with a suicide attempt history. Converging findings from other imaging modalities support this finding, making this region of potential interest in determining the diathesis for suicidal behavior.
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130
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Chou KH, Yang FC, Fuh JL, Huang CC, Lirng JF, Lin YY, Lee PL, Kao HW, Lin CP, Wang SJ. Altered white matter microstructural connectivity in cluster headaches: a longitudinal diffusion tensor imaging study. Cephalalgia 2014; 34:1040-52. [PMID: 24668118 DOI: 10.1177/0333102414527649] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Functional and structural disruptions to the pain matrix, which may involve changes in white matter (WM) pathways connecting the pain-processing system and hypothalamus, have been implicated in the pathophysiology of cluster headache (CH). However, previous studies have obtained inconclusive results regarding WM changes in CH, and WM variations between "in-bout" and "out-of-bout" periods of CH remain to be determined. METHODS Multiple diffusivity indices obtained by diffusion tensor imaging (DTI) and post-hoc probabilistic tractography were used to elucidate CH pathophysiology. RESULTS Compared to healthy participants, in-bout CH patients showed regionally higher absolute (radial and mean) diffusivities in the left medial frontal gyrus and frontal sub-gyrus and lower absolute (axial, radial and mean) diffusivities in the right parahippocampal gyrus of the limbic lobe. These changes during the in-bout period generally persisted in the out-of-bout period, except for the left cerebellar tonsil. Post-hoc probabilistic tractography showed highly consistent anatomical connections between these altered areas and the hypothalamus across participants. CONCLUSIONS Distinct WM changes were observed in episodic CH. Connections between the pain-modulation areas and hypothalamus may be involved in CH pathophysiology.
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Affiliation(s)
- Kun-Hsien Chou
- Institute of Neuroscience, National Yang-Ming University, Taiwan Brain Research Center, National Yang-Ming University, Taiwan
| | - Fu-Chi Yang
- Institute of Brain Science, National Yang-Ming University, Taiwan Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, National Yang-Ming University, Taiwan Department of Neurology, Taipei Veterans General Hospital, Taiwan
| | - Chu-Chung Huang
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taiwan
| | - Jiing-Feng Lirng
- Department of Radiology, National Yang-Ming University, Taiwan Department of Radiology, Taipei, Veterans General Hospital, Taiwan
| | - Yung-Yang Lin
- Brain Research Center, National Yang-Ming University, Taiwan Institute of Brain Science, National Yang-Ming University, Taiwan Department of Neurology, National Yang-Ming University, Taiwan Department of Neurology, Taipei Veterans General Hospital, Taiwan
| | - Pei-Lin Lee
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taiwan
| | - Hung-Wen Kao
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taiwan
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang-Ming University, Taiwan Brain Research Center, National Yang-Ming University, Taiwan Institute of Brain Science, National Yang-Ming University, Taiwan Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang-Ming University, Taiwan Institute of Brain Science, National Yang-Ming University, Taiwan Department of Neurology, National Yang-Ming University, Taiwan Department of Neurology, Taipei Veterans General Hospital, Taiwan
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131
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Hypothalamus-anchored resting brain network changes before and after sertraline treatment in major depression. BIOMED RESEARCH INTERNATIONAL 2014; 2014:915026. [PMID: 24772438 PMCID: PMC3977500 DOI: 10.1155/2014/915026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 02/12/2014] [Accepted: 02/13/2014] [Indexed: 12/20/2022]
Abstract
Sertraline, one of the oldest antidepressants, remains to be the most efficacious treatment for depression. However, major depression disorder (MDD) is characterized by altered emotion processing and deficits in cognitive control. In cognitive interference tasks, patients with MDD have shown excessive hypothalamus activity. The purpose of this study was to examine the effects of antidepressant treatment (sertraline) on hypothalamus-anchored resting brain circuitry. Functional magnetic resonance imaging was conducted on depressed patients (n=12) both before and after antidepressant treatment. After eight weeks of antidepressant treatment, patients with depression showed significantly increased connectivity between the hypothalamus and dorsolateral prefrontal cortex, orbitofrontal cortex, anterior cingulate cortex, insula, putamen, caudate, and claustrum. By contrast, decreased connectivity of the hypothalamus-related areas was primarily located in the inferior frontal gyrus, medial frontal gyrus, cingulated gyrus, precuneus, thalamus, and cerebellum. After eight weeks of antidepressant therapy, 8 out of the 12 depressed subjects achieved 70% reduction or better in depressive symptoms, as measured on the Hamilton depression rating scale. Our findings may infer that antidepressant treatment can alter the functional connectivity of the hypothalamus resting brain to achieve its therapeutic effect.
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132
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Bracht T, Horn H, Strik W, Federspiel A, Schnell S, Höfle O, Stegmayer K, Wiest R, Dierks T, Müller TJ, Walther S. White matter microstructure alterations of the medial forebrain bundle in melancholic depression. J Affect Disord 2014; 155:186-93. [PMID: 24252169 DOI: 10.1016/j.jad.2013.10.048] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 10/01/2013] [Accepted: 10/29/2013] [Indexed: 12/26/2022]
Abstract
BACKGROUND The medial forebrain bundle (MFB) is a key structure of the reward system and connects the ventral tegmental area (VTA) with the nucleus accumbens (NAcc), the medial and lateral orbitofrontal cortex (mOFC, lOFC) and the dorsolateral prefrontal cortex (dlPFC). Previous diffusion tensor imaging (DTI) studies in major depressive disorder point to white matter alterations of regions which may be incorporated in the MFB. Therefore, it was the aim of our study to probe white matter integrity of the MFB using a DTI-based probabilistic fibre tracking approach. METHODS 22 patients with major depressive disorder (MDD) (12 melancholic-MDD patients, 10 non-melancholic-MDD patients) and 21 healthy controls underwent DTI scans. We used a bilateral probabilistic fibre tracking approach to extract pathways between the VTA and NACC, mOFC, lOFC, dlPFC respectively. Mean fractional anisotropy (FA) values were used to compare structural connectivity between groups. RESULTS Mean-FA did not differ between healthy controls and all MDD patients. Compared to healthy controls melancholic MDD-patients had reduced mean-FA in right VTA-lOFC and VTA-dlPFC connections. Furthermore, melancholic-MDD patients had lower mean-FA than non-melancholic MDD-patients in the right VTA-lOFC connection. Mean-FA of these pathways correlated negatively with depression scale rating scores. LIMITATIONS Due to the small sample size and heterogeneous age group comparisons between melancholic and non-melancholic MDD-patients should be regarded as preliminary. CONCLUSIONS Our results suggest that the melancholic subtype of MDD is characterized by white matter microstructure alterations of the MFB. White matter microstructure is associated with both depression severity and anhedonia.
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Affiliation(s)
- Tobias Bracht
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
| | - Helge Horn
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Werner Strik
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Andrea Federspiel
- University Hospital of Psychiatry, Department of Psychiatric Neurophysiology, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Susanne Schnell
- Departments of Radiology and Biomedical Engineering, Northwestern University, Feinberg School of Medicine, 737 N. Michigan Ave Suite 1600, Chicago, IL 60611, USA
| | - Oliver Höfle
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Katharina Stegmayer
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Roland Wiest
- Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Freiburgstrasse 3010, Bern, Switzerland
| | - Thomas Dierks
- University Hospital of Psychiatry, Department of Psychiatric Neurophysiology, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Thomas J Müller
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
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Song YJC, Korgaonkar MS, Armstrong LV, Eagles S, Williams LM, Grieve SM. Tractography of the brainstem in major depressive disorder using diffusion tensor imaging. PLoS One 2014; 9:e84825. [PMID: 24465436 PMCID: PMC3897382 DOI: 10.1371/journal.pone.0084825] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 11/21/2013] [Indexed: 12/29/2022] Open
Abstract
Background The brainstem is the main region that innervates neurotransmitter release to the Hypothalamic-Pituitary Adrenal (HPA) axis and fronto-limbic circuits, two key brain circuits found to be dysfunctional in Major Depressive Disorder (MDD). However, the brainstem’s role in MDD has only been evaluated in limited reports. Using Diffusion Tensor Imaging (DTI), we investigated whether major brainstem white matter tracts that relate to these two circuits differ in MDD patients compared to healthy controls. Methods MDD patients (n = 95) and age- and gender-matched controls (n = 34) were assessed using probabilistic tractography of DTI to delineate three distinct brainstem tracts: the nigrostriatal tract (connecting brainstem to striatum), solitary tract (connecting brainstem to amygdala) and corticospinal tract (connecting brainstem to precentral cortex). Fractional anisotropy (FA) was used to measure the white matter integrity of these tracts, and measures were compared between MDD and control participants. Results MDD participants were characterized by a significant and specific decrease in white matter integrity of the right solitary tract (p<0.009 using independent t-test), which is a “bottom up” afferent pathway that connects the brainstem to the amygdala. This decrease was not related to symptom severity. Conclusions The results provide new evidence to suggest that structural connectivity between the brainstem and the amygdala is altered in MDD. These results are interesting in light of predominant theories regarding amygdala-mediated emotional reactivity observed in functional imaging studies of MDD. The characterization of altered white matter integrity in the solitary tract in MDD supports the possibility of dysfunctional brainstem-amygdala connectivity impacting vulnerable circuits in MDD.
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Affiliation(s)
- Yun Ju C. Song
- The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney, NSW, Australia
- Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, NSW, Australia
| | - Mayuresh S. Korgaonkar
- The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney, NSW, Australia
- Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, NSW, Australia
| | - Lucy V. Armstrong
- The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney, NSW, Australia
| | - Sarah Eagles
- The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney, NSW, Australia
| | - Leanne M. Williams
- The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney, NSW, Australia
- Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, NSW, Australia
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States of America
| | - Stuart M. Grieve
- The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney, NSW, Australia
- * E-mail:
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134
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Day CVA, Williams LM. Finding a biosignature for melancholic depression. Expert Rev Neurother 2014; 12:835-47. [DOI: 10.1586/ern.12.72] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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135
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Philp DJ, Korgaonkar MS, Grieve SM. Thalamic volume and thalamo-cortical white matter tracts correlate with motor and verbal memory performance. Neuroimage 2014; 91:77-83. [PMID: 24401559 DOI: 10.1016/j.neuroimage.2013.12.057] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 12/12/2013] [Accepted: 12/23/2013] [Indexed: 10/25/2022] Open
Abstract
Cognitive testing and diffusion tensor imaging data from 121 normal subjects were combined to investigate the relationship between thalamic connectivity and cognitive performance. Thalamic regions were segmented based on their cortical connectivity, and regions for both ipsilateral and contralateral thalamocortical connections were identified. White matter tracts corresponding to these regions were identified and the mean fractional anisotropy, and axial and radial diffusivities within each tract were measured. Motor task performance correlated with radial diffusivity in the dominant thalamo-precentral tract. Verbal memory corresponded with the thalamic volume connected to the left temporal lobe. These data support the use of diffusion tractography to identify functionally important regions within the thalamus. Our findings provide the first robust correlation between thalamic volumes and tract characteristics with cognitive performance data in normal subjects.
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Affiliation(s)
- David J Philp
- The Brain Dynamics Centre, Sydney Medical School - Westmead, Sydney, NSW 2145, Australia; Westmead Millennium Institute, Westmead, Sydney, NSW 2145, Australia; Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Camperdown, NSW 2050, Australia
| | - Mayuresh S Korgaonkar
- The Brain Dynamics Centre, Sydney Medical School - Westmead, Sydney, NSW 2145, Australia; Westmead Millennium Institute, Westmead, Sydney, NSW 2145, Australia; Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Camperdown, NSW 2050, Australia; Discipline of Psychiatry, University of Sydney Medical School: Western, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Stuart M Grieve
- The Brain Dynamics Centre, Sydney Medical School - Westmead, Sydney, NSW 2145, Australia; Westmead Millennium Institute, Westmead, Sydney, NSW 2145, Australia; Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Camperdown, NSW 2050, Australia; Department of Radiology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
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136
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Wise T, Cleare AJ, Herane A, Young AH, Arnone D. Diagnostic and therapeutic utility of neuroimaging in depression: an overview. Neuropsychiatr Dis Treat 2014; 10:1509-22. [PMID: 25187715 PMCID: PMC4149389 DOI: 10.2147/ndt.s50156] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
A growing number of studies have used neuroimaging to further our understanding of how brain structure and function are altered in major depression. More recently, these techniques have begun to show promise for the diagnosis and treatment of depression, both as aids to conventional methods and as methods in their own right. In this review, we describe recent neuroimaging findings in the field that might aid diagnosis and improve treatment accuracy. Overall, major depression is associated with numerous structural and functional differences in neural systems involved in emotion processing and mood regulation. Furthermore, several studies have shown that the structure and function of these systems is changed by pharmacological and psychological treatments of the condition and that these changes in candidate brain regions might predict clinical response. More recently, "machine learning" methods have used neuroimaging data to categorize individual patients according to their diagnostic status and predict treatment response. Despite being mostly limited to group-level comparisons at present, with the introduction of new methods and more naturalistic studies, neuroimaging has the potential to become part of the clinical armamentarium and may improve diagnostic accuracy and inform treatment choice at the patient level.
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Affiliation(s)
- Toby Wise
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Centre for Affective Disorders, London, United Kingdom
| | - Anthony J Cleare
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Centre for Affective Disorders, London, United Kingdom
| | - Andrés Herane
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Centre for Affective Disorders, London, United Kingdom ; Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago, Chile
| | - Allan H Young
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Centre for Affective Disorders, London, United Kingdom
| | - Danilo Arnone
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Centre for Affective Disorders, London, United Kingdom
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137
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Hayashi K, Yoshimura R, Kakeda S, Kishi T, Abe O, Umene-Nakano W, Katsuki A, Hori H, Ikenouchi-Sugita A, Watanabe K, Ide S, Ueda I, Moriya J, Iwata N, Korogi Y, Kubicki M, Nakamura J. COMT Val158Met, but not BDNF Val66Met, is associated with white matter abnormalities of the temporal lobe in patients with first-episode, treatment-naïve major depressive disorder: a diffusion tensor imaging study. Neuropsychiatr Dis Treat 2014; 10:1183-90. [PMID: 25061303 PMCID: PMC4079817 DOI: 10.2147/ndt.s61275] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
We investigated the association between the Val158Met polymorphism of the catechol-O-methyltransferase (COMT) gene, the Val66Met polymorphism of the brain-derived neurotrophic factor (BDNF) gene, and white matter changes in patients with major depressive disorder (MDD) and healthy subjects using diffusion tensor imaging (DTI). We studied 30 patients with MDD (17 males and 13 females, with mean age ± standard deviation [SD] =44±12 years) and 30 sex- and age-matched healthy controls (17 males and 13 females, aged 44±13 years). Using DTI analysis with a tract-based spatial statistics (TBSS) approach, we investigated the differences in fractional anisotropy, radial diffusivity, and axial diffusivity distribution among the three groups (patients with the COMT gene Val158Met, those with the BDNF gene Val66Met, and the healthy subjects). In a voxel-wise-based group comparison, we found significant decreases in fractional anisotropy and axial diffusivity within the temporal lobe white matter in the Met-carriers with MDD compared with the controls (P<0.05). No correlations in fractional anisotropy, axial diffusivity, or radial diffusivity were observed between the MDD patients and the controls, either among those with the BDNF Val/Val genotype or among the BDNF Met-carriers. These results suggest an association between the COMT gene Val158Met and the white matter abnormalities found in the temporal lobe of patients with MDD.
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Affiliation(s)
| | | | - Shingo Kakeda
- Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Taro Kishi
- Department of Psychiatry, Fujita Health University, Toyoake, Japan
| | - Osamu Abe
- Department of Radiology, Nihon University School of Medicine, Tokyo, Japan
| | | | | | | | | | - Keita Watanabe
- Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Satoru Ide
- Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Issei Ueda
- Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Junji Moriya
- Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University, Toyoake, Japan
| | - Yukunori Korogi
- Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Singh MK, Kesler SR, Hosseini SH, Kelley RG, Amatya D, Hamilton JP, Chen MC, Gotlib IH. Anomalous gray matter structural networks in major depressive disorder. Biol Psychiatry 2013; 74:777-85. [PMID: 23601854 PMCID: PMC3805751 DOI: 10.1016/j.biopsych.2013.03.005] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 03/13/2013] [Accepted: 03/13/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is characterized by abnormalities in structure, function, and connectivity in several brain regions. Few studies have examined how these regions are organized in the brain or investigated network-level structural aberrations that might be associated with depression. METHODS We used graph analysis to examine the gray matter structural networks of individuals diagnosed with MDD (n = 93) and a demographically similar healthy comparison group (n = 151) with no history of psychopathology. The efficiency of structural networks for processing information was determined by quantifying local interconnectivity (clustering) and global integration (path length). We also compared the groups on the contributions of high-degree nodes (i.e., hubs) and regional network measures, including degree (number of connections in a node) and betweenness (fraction of short path connections in a node). RESULTS Depressed participants had significantly decreased clustering in their brain networks across a range of network densities. Compared with control subjects, depressed participants had fewer hubs primarily in medial frontal and medial temporal areas, had higher degree in the left supramarginal gyrus and right gyrus rectus, and had higher betweenness in the right amygdala and left medial orbitofrontal gyrus. CONCLUSIONS Networks of depressed individuals are characterized by a less efficient organization involving decreased regional connectivity compared with control subjects. Regional connections in the amygdala and medial prefrontal cortex may play a role in maintaining or adapting to depressive pathology. This is the first report of anomalous large-scale gray matter structural networks in MDD and provides new insights concerning the neurobiological mechanisms associated with this disorder.
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139
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Korgaonkar MS, Antees C, Williams LM, Gatt JM, Bryant RA, Cohen R, Paul R, O'Hara R, Grieve SM. Early exposure to traumatic stressors impairs emotional brain circuitry. PLoS One 2013; 8:e75524. [PMID: 24073270 PMCID: PMC3779182 DOI: 10.1371/journal.pone.0075524] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 08/13/2013] [Indexed: 01/12/2023] Open
Abstract
Exposure to early life trauma (ELT) is known to have a profound impact on mental development, leading to a higher risk for depression and anxiety. Our aim was to use multiple structural imaging methods to systematically investigate how traumatic stressors early in life impact the emotional brain circuits, typically found impaired with clinical diagnosis of depression and anxiety, across the lifespan in an otherwise healthy cohort. MRI data and self-reported histories of ELT from 352 healthy individuals screened for no psychiatric disorders were analyzed in this study. The volume and cortical thickness of the limbic and cingulate regions were assessed for all participants. A large subset of the cohort also had diffusion tensor imaging data, which was used to quantify white matter structural integrity of these regions. We found a significantly smaller amygdala volume and cortical thickness in the rostral anterior cingulate cortex associated with higher ELT exposure only for the adolescence group. White matter integrity of these regions was not affected. These findings demonstrate that exposure to early life trauma is associated with alterations in the gray matter of cingulate-limbic regions during adolescence in an otherwise healthy sample. These findings are interesting in the context that the affected regions are central neuroanatomical components in the psychopathology of depression, and adolescence is a peak period for risk and onset of the disorder.
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Affiliation(s)
- Mayuresh S Korgaonkar
- The Brain Dynamics Centre, University of Sydney Medical School - Westmead and Westmead Millennium Institute, Sydney, New South Wales, Australia ; Discipline of Psychiatry, University of Sydney Medical School: Western, Westmead Hospital, Sydney, New South Wales, Australia
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140
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Grieve SM, Korgaonkar MS, Koslow SH, Gordon E, Williams LM. Widespread reductions in gray matter volume in depression. NEUROIMAGE-CLINICAL 2013; 3:332-9. [PMID: 24273717 PMCID: PMC3814952 DOI: 10.1016/j.nicl.2013.08.016] [Citation(s) in RCA: 261] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 08/12/2013] [Accepted: 08/29/2013] [Indexed: 01/01/2023]
Abstract
Abnormalities in functional limbic–anterior cingulate–prefrontal circuits associated with emotional reactivity, evaluation and regulation have been implicated in the pathophysiology of major depressive disorder (MDD). However, existing knowledge about structural alterations in depression is equivocal and based on cohorts of limited sample size. This study used voxel-based morphometry (VBM) and surface-based cortical thickness to investigate the structure of these circuits in a large and well-characterized patient cohort with MDD. Non-geriatric MDD outpatients (n = 102) and age- and gender-matched healthy control participants (n = 34) provided T1-weighted magnetic resonance imaging data during their baseline visit as part of the International Study to Predict Optimized Treatment for Depression. Whole-brain VBM volumetric and surface-based cortical thickness assessments were performed voxel-wise and compared (at p < 0.05 corrected for multiple comparisons) between the MDD and control groups. MDD participants had reduced gray matter volume in the anterior cingulate cortex, regions of the prefrontal circuits, including dorsolateral and dorsomedial prefrontal cortices, and lateral and medial orbitofrontal cortices, but not in limbic regions. Additional reductions were observed cortically in the posterior temporal and parieto-occipital cortices and, subcortically in the basal ganglia and cerebellum. Focal cortical thinning in the medial orbitofrontal cortex was also observed for the MDD group. These alterations in volume and cortical thickness were not associated with severity of depressive symptoms. The findings demonstrate that widespread gray matter structural abnormalities are present in a well-powered study of patients with depression. The patterns of gray matter loss correspond to the same brain functional network regions that were previously established to be abnormal in MDD, which may support an underlying structural abnormality for these circuits. Focal gray matter volume decrease in depression exceeded loss via aging 11–50 years. Gray matter differences were found in regions with established roles in depression. Structural change findings support the idea of depression as a network abnormality. Hippocampal gray matter volume loss likely has no role in non-geriatric depression. Amygdala gray matter volume loss likely plays no role in depression pathophysiology.
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Key Words
- AAL, Automated Anatomical Labeling
- ACC, Anterior Cingulate Cortex
- BAs, Brodmann Areas
- CVNA, Change in Volume expected in that region through Normal Aging
- Cortical thickness
- DLPFC, Dorsolateral Prefrontal Cortex
- DTI, Diffusion Tensor Imaging
- FDR, False Discovery Rate
- GM, Gray Matter
- Gray matter
- HRSD17, 17-Item Hamilton Rating Scale for Depression
- MDD, Major Depressive Disorder
- MPFC, Medial Prefrontal Cortex
- MRI, Magnetic Resonance Imaging
- Major depressive disorder
- OFC, Orbitofrontal Cortex
- PFC, Prefrontal Cortex
- VBM
- VBM, Voxel-Based Morphometry
- Volume
- fMRI, functional Magnetic Resonance Imaging
- iSPOT-D
- iSPOT-D, International Study to Predict Optimized Treatment in Depression
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Affiliation(s)
- Stuart M Grieve
- The Brain Dynamics Center, Sydney Medical School, The University of Sydney and Westmead Millennium Institute, Sydney, NSW, Australia
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Yu D, Yuan K, Zhao L, Dong M, Liu P, Yang X, Liu J, Sun J, Zhou G, Xue T, Zhao L, Cheng P, Dong T, von Deneen KM, Qin W, Tian J. White matter integrity affected by depressive symptoms in migraine without aura: a tract-based spatial statistics study. NMR IN BIOMEDICINE 2013; 26:1103-1112. [PMID: 23447382 DOI: 10.1002/nbm.2924] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Revised: 12/15/2012] [Accepted: 12/20/2012] [Indexed: 06/01/2023]
Abstract
Previous studies have proven that migraine and depression are bidirectionally linked. However, few studies have investigated white matter (WM) integrity affected by depressive symptoms in patients suffering from migraine without aura (MWoA). Forty patients with MWoA were divided into two groups according to their self-rating depression scale (SDS) score in the present study, including 20 in the SDS (+) (SDS > 49) group and 20 in the SDS (-) (SDS ≤ 49) group. Forty healthy participants were also recruited as the control group. Tract-based spatial statistics analyses with multiple diffusion tensor imaging-derived indices [fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD)] were employed collectively to investigate WM integrity between all patients with MWoA and all healthy controls, between each subgroup (SDS (-) group and SDS (+) group) and healthy controls, and between the SDS (-) and SDS (+) groups. Compared with healthy controls, decreased AD was shown in several WM tracts of the whole MWoA group, SDS (-) group and SDS (+) group. In addition, compared with the SDS (-) group, the SDS (+) group showed decreased FA and increased MD and RD, with conserved AD, including the genu, body and splenium of the corpus callosum, bilateral superior longitudinal fasciculi, the right anterior corona radiata and some other WM tracts, similar to previous findings in depression disorder. Furthermore, mean FA and RD in some of the above-mentioned WM tracts in the SDS (+) group were correlated significantly with SDS scores, including the genu and splenium of the corpus callosum, the right anterior corona radiata and the superior longitudinal fasciculi. Our results suggest that WM integrity may be affected by both depression symptoms (more sensitive as RD) and migraine (more sensitive as AD). The findings may serve as a sensitive biomarker of depression severity in MWoA.
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Affiliation(s)
- Dahua Yu
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi, China
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Yip SW, Chandler RA, Rogers RD, Mackay CE, Goodwin GM. White matter alterations in antipsychotic- and mood stabilizer-naïve individuals with bipolar II/NOS disorder. NEUROIMAGE-CLINICAL 2013; 3:271-8. [PMID: 24273712 PMCID: PMC3814955 DOI: 10.1016/j.nicl.2013.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 07/30/2013] [Accepted: 08/04/2013] [Indexed: 01/16/2023]
Abstract
Structural magnetic resonance imaging (MRI) studies using voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) have been inconsistent in demonstrating impairments in gray matter (GM) and white matter (WM) structures in bipolar disorder (BD). This may be a consequence of significant confounding effects of medication, illness history and selection of controls in existing studies. Study of bipolar II or not-otherwise-specified (BD II/NOS) disorder provides a solution to these confounds and a bridge to unipolar cases across the affective spectrum. Thirty-eight euthymic, antipsychotic- and mood stabilizer-naïve young adults (mean age = 20.9 years) with BD II/NOS and 37 age-, cognitive ability- and gender-matched healthy controls (HCs) underwent MRI. Voxel-wise and regional gray matter volume comparisons were conducted using voxel-based morphometry (VBM). Tract-based spatial statistics (TBSS) were used to assess whole-brain WM, as indexed using fractional anisotropy (FA), mean diffusivity (MD), parallel and perpendicular diffusion values. No between-group differences were observed for whole-brain VBM comparisons. By contrast, in comparison to HCs, participants with BD II/NOS had significant widespread reductions in FA and increased MD and perpendicular diffusion values in virtually all the major cortical white matter tracts. These data suggest pathophysiological involvement of WM microstructures - but not GM macrostructures - in high functioning BD II/NOS patients at an early age and before significant clinical adversity has been recorded. We propose that white matter development is a valid candidate target for understanding genetic and environmental antecedents to bipolar disorder and mood disorder more generally.
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Affiliation(s)
- Sarah W Yip
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
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Xu K, Wang F. Influence of 5-HTTLPR genotypes on structural and functional connectivity within amygdala-prefrontal cortex circuitry. Neurosci Bull 2013; 29:1-2. [PMID: 23322004 DOI: 10.1007/s12264-013-1302-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Ke Xu
- Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang, 110001, China.
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Grieve SM, Korgaonkar MS, Etkin A, Harris A, Koslow SH, Wisniewski S, Schatzberg AF, Nemeroff CB, Gordon E, Williams LM. Brain imaging predictors and the international study to predict optimized treatment for depression: study protocol for a randomized controlled trial. Trials 2013; 14:224. [PMID: 23866851 PMCID: PMC3729660 DOI: 10.1186/1745-6215-14-224] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 07/04/2013] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Approximately 50% of patients with major depressive disorder (MDD) do not respond optimally to antidepressant treatments. Given this is a large proportion of the patient population, pretreatment tests that predict which patients will respond to which types of treatment could save time, money and patient burden. Brain imaging offers a means to identify treatment predictors that are grounded in the neurobiology of the treatment and the pathophysiology of MDD. METHODS/DESIGN The international Study to Predict Optimized Treatment in Depression is a multi-center, parallel model, randomized clinical trial with an embedded imaging sub-study to identify such predictors. We focus on brain circuits implicated in major depressive disorder and its treatment. In the full trial, depressed participants are randomized to receive escitalopram, sertraline or venlafaxine-XR (open-label). They are assessed using standardized multiple clinical, cognitive-emotional behavioral, electroencephalographic and genetic measures at baseline and at eight weeks post-treatment. Overall, 2,016 depressed participants (18 to 65 years old) will enter the study, of whom a target of 10% will be recruited into the brain imaging sub-study (approximately 67 participants in each treatment arm) and 67 controls. The imaging sub-study is conducted at the University of Sydney and at Stanford University. Structural studies include high-resolution three-dimensional T1-weighted, diffusion tensor and T2/Proton Density scans. Functional studies include standardized functional magnetic resonance imaging (MRI) with three cognitive tasks (auditory oddball, a continuous performance task, and Go-NoGo) and two emotion tasks (unmasked conscious and masked non-conscious emotion processing tasks). After eight weeks of treatment, the functional MRI is repeated with the above tasks. We will establish the methods in the first 30 patients. Then we will identify predictors in the first half (n=102), test the findings in the second half, and then extend the analyses to the total sample. TRIAL REGISTRATION International Study to Predict Optimized Treatment--in Depression (iSPOT-D). ClinicalTrials.gov, NCT00693849.
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Affiliation(s)
- Stuart M Grieve
- The Brain Dynamics Centre, University of Sydney Medical School - Westmead and Westmead Millennium Institute, Sydney, NSW 2145, Australia
- Brain Resource, Level 12, 235 Jones Street, Ultimo, Sydney, NSW 2007, Australia and Suite 200, 1000 Sansome Street, San Francisco, CA 94111, USA
- Sydney Medical School, University of Sydney, Camperdown, NSW 2050, Australia
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Mayuresh S Korgaonkar
- The Brain Dynamics Centre, University of Sydney Medical School - Westmead and Westmead Millennium Institute, Sydney, NSW 2145, Australia
- Discipline of Psychiatry, University of Sydney Medical School: Western, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305, USA
- Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
| | - Anthony Harris
- The Brain Dynamics Centre, University of Sydney Medical School - Westmead and Westmead Millennium Institute, Sydney, NSW 2145, Australia
- Discipline of Psychiatry, University of Sydney Medical School: Western, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Stephen H Koslow
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- BRAINnet Foundation, 71 Stephenson Street, Suite 400, San Francisco, CA 94105, USA
| | - Stephen Wisniewski
- Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
| | - Alan F Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305, USA
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Evian Gordon
- The Brain Dynamics Centre, University of Sydney Medical School - Westmead and Westmead Millennium Institute, Sydney, NSW 2145, Australia
- Brain Resource, Level 12, 235 Jones Street, Ultimo, Sydney, NSW 2007, Australia and Suite 200, 1000 Sansome Street, San Francisco, CA 94111, USA
| | - Leanne M Williams
- The Brain Dynamics Centre, University of Sydney Medical School - Westmead and Westmead Millennium Institute, Sydney, NSW 2145, Australia
- Discipline of Psychiatry, University of Sydney Medical School: Western, Westmead Hospital, Sydney, NSW 2145, Australia
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305, USA
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Kochunov P, Chiappelli J, Hong LE. Permeability-diffusivity modeling vs. fractional anisotropy on white matter integrity assessment and application in schizophrenia. NEUROIMAGE-CLINICAL 2013; 3:18-26. [PMID: 24179845 PMCID: PMC3791292 DOI: 10.1016/j.nicl.2013.06.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 06/23/2013] [Accepted: 06/28/2013] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Diffusion tensor imaging (DTI) assumes a single pool of anisotropically diffusing water to calculate fractional anisotropy (FA) and is commonly used to ascertain white matter (WM) deficits in schizophrenia. At higher b-values, diffusion-signal decay becomes bi-exponential, suggesting the presence of two, unrestricted and restricted, water pools. Theoretical work suggests that semi-permeable cellular membrane rather than the presence of two physical compartments is the cause. The permeability-diffusivity (PD) parameters measured from bi-exponential modeling may offer advantages, over traditional DTI-FA, in identifying WM deficits in schizophrenia. METHODS Imaging was performed in N = 26/26 patients/controls (age = 20-61 years, average age = 40.5 ± 12.6). Imaging consisted of fifteen b-shells: b = 250-3800 s/mm(2) with 30 directions/shell, covering seven slices of mid-sagittal corpus callosum (CC) at 1.7 × 1.7 × 4.6 mm. 64-direction DTI was also collected. Permeability-diffusivity-index (PDI), the ratio of restricted to unrestricted apparent diffusion coefficients, and the fraction of unrestricted compartment (Mu) were calculated for CC and cingulate gray matter (GM). FA values for CC were calculated using tract-based-spatial-statistics. RESULTS Patients had significantly reduced PDI in CC (p ≅ 10(- 4)) and cingulate GM (p = 0.002), while differences in CC FA were modest (p ≅ .03). There was no group-related difference in Mu. Additional theoretical-modeling analysis suggested that reduced PDI in patients may be caused by reduced cross-membrane water molecule exchanges. CONCLUSION PDI measurements for cerebral WM and GM yielded more robust patient-control differences than DTI-FA. Theoretical work offers an explanation that patient-control PDI differences should implicate abnormal active membrane permeability. This would implicate abnormal activities in ion-channels that use water as substrate for ion exchange, in cerebral tissues of schizophrenia patients.
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Affiliation(s)
- P Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, USA ; Department of Physics, University of Maryland Baltimore County, USA
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146
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de Kwaasteniet B, Ruhe E, Caan M, Rive M, Olabarriaga S, Groefsema M, Heesink L, van Wingen G, Denys D. Relation between structural and functional connectivity in major depressive disorder. Biol Psychiatry 2013; 74:40-7. [PMID: 23399372 DOI: 10.1016/j.biopsych.2012.12.024] [Citation(s) in RCA: 138] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 12/04/2012] [Accepted: 12/20/2012] [Indexed: 01/12/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is characterized by abnormalities in both brain structure and function within a frontolimbic network. However, little is known about the relation between structural and functional abnormalities in MDD. Here, we used a multimodal neuroimaging approach to investigate the relation between structural connectivity and functional connectivity within the frontolimbic network. METHODS Eighteen MDD and 24 healthy control subjects were included, of which the integrity of the uncinate fasciculus was assessed that connects the subgenual anterior cingulate cortex (ACC) to the medial temporal lobe (MTL) with diffusion tensor imaging. Furthermore, we assessed the functional connectivity between these brain regions with functional magnetic resonance imaging. RESULTS The results showed that white matter integrity of the uncinate fasciculus was reduced and that functional connectivity between the subgenual ACC and MTL was enhanced in MDD. Importantly, we identified a negative correlation between uncinate fasciculus integrity and subgenual ACC functional connectivity with the bilateral hippocampus in MDD but not in healthy control subjects. Moreover, this negative structure-function relation in MDD was positively associated with depression severity. CONCLUSIONS These findings suggest that structural abnormalities in MDD are associated with increased functional connectivity between subgenual ACC and MTL and that these changes are concomitant with severity of depressive symptoms. This association indicates that structural abnormalities in MDD contribute to increased functional connectivity within the frontolimbic network.
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147
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Tha KK, Terae S, Nakagawa S, Inoue T, Kitagawa N, Kako Y, Nakato Y, Akter Popy K, Fujima N, Zaitsu Y, Yoshida D, Ito YM, Miyamoto T, Koyama T, Shirato H. Impaired integrity of the brain parenchyma in non-geriatric patients with major depressive disorder revealed by diffusion tensor imaging. Psychiatry Res 2013; 212:208-15. [PMID: 23149032 DOI: 10.1016/j.pscychresns.2012.07.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 06/16/2012] [Accepted: 07/11/2012] [Indexed: 10/27/2022]
Abstract
Diffusion tensor imaging (DTI) is considered to be able to non-invasively quantify white matter integrity. This study aimed to use DTI to evaluate white matter integrity in non-geriatric patients with major depressive disorder (MDD) who were free of antidepressant medication. DTI was performed on 19 non-geriatric patients with MDD, free of antidepressant medication, and 19 age-matched healthy subjects. Voxel-based and histogram analyses were used to compare fractional anisotropy (FA) and mean diffusivity (MD) values between the two groups, using two-sample t tests. The abnormal DTI indices, if any, were tested for correlation with disease duration and severity, using Pearson product-moment correlation analysis. Voxel-based analysis showed clusters with FA decrease at the bilateral frontal white matter, anterior limbs of internal capsule, cerebellum, left putamen and right thalamus of the patients. Histogram analysis revealed lower peak position of FA histograms in the patients. FA values of the abnormal clusters and peak positions of FA histograms of the patients exhibited moderate correlation with disease duration and severity. These results suggest the implication of frontal-subcortical circuits and cerebellum in MDD, and the potential utility of FA in evaluation of brain parenchymal integrity.
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Affiliation(s)
- Khin K Tha
- Hokkaido University Graduate School of Medicine, Department of Radiobiology and Medical Engineering, N-15, W-7, Kita-ku, Sapporo 060-8638, Japan.
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148
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Anderson G, Maes M, Berk M. Schizophrenia is primed for an increased expression of depression through activation of immuno-inflammatory, oxidative and nitrosative stress, and tryptophan catabolite pathways. Prog Neuropsychopharmacol Biol Psychiatry 2013; 42:101-14. [PMID: 22930036 DOI: 10.1016/j.pnpbp.2012.07.016] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 07/25/2012] [Accepted: 07/26/2012] [Indexed: 02/08/2023]
Abstract
Schizophrenia and depression are two common and debilitating psychiatric conditions. Up to 61% of schizophrenic patients have comorbid clinical depression, often undiagnosed. Both share significant overlaps in underlying biological processes, which are relevant to the course and treatment of both conditions. Shared processes include changes in cell-mediated immune and inflammatory pathways, e.g. increased levels of pro-inflammatory cytokines and a Th1 response; activation of oxidative and nitrosative stress (O&NS) pathways, e.g. increased lipid peroxidation, damage to proteins and DNA; decreased antioxidant levels, e.g. lowered coenzyme Q10, vitamin E, glutathione and melatonin levels; autoimmune responses; and activation of the tryptophan catabolite (TRYCAT) pathway through induction of indoleamine-2,3-dioxygenase. Both show cognitive and neurostructural evidence of a neuroprogressive process. Here we review the interlinked nature of these biological processes, suggesting that schizophrenia is immunologically primed for an increased expression of depression. Such a conceptualization explains, and incorporates, many of the current perspectives on the nature of schizophrenia and depression, and has implications for the nature of classification and treatment of both disorders. An early developmental etiology to schizophrenia, driven by maternal infection, with subsequent impact on offspring immuno-inflammatory responses, creates alterations in the immune pathways, which although priming for depression, also differentiates the two disorders.
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149
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Kochunov P, Glahn DC, Rowland LM, Olvera RL, Winkler A, Yang YH, Sampath H, Carpenter WT, Duggirala R, Curran J, Blangero J, Hong LE. Testing the hypothesis of accelerated cerebral white matter aging in schizophrenia and major depression. Biol Psychiatry 2013; 73:482-91. [PMID: 23200529 PMCID: PMC3645491 DOI: 10.1016/j.biopsych.2012.10.002] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 08/19/2012] [Accepted: 10/03/2012] [Indexed: 12/21/2022]
Abstract
BACKGROUND Elevated rate of aging-related biological and functional decline, termed "accelerated aging," is reported in patients with schizophrenia (SCZ) and major depressive disorder (MDD). We used diffusion tensor imaging derived fractional anisotropy (FA) as a biomarker of aging-related decline in white matter (WM) integrity to test the hypotheses of accelerated aging in SCZ and MDD. METHODS The SCZ cohort comprised 58 SCZ patients and 60 controls (aged 20-60 years). The MDD cohort comprised 136 MDD patients and 351 controls (aged 20-79 years). The main outcome measures were the diagnosis-by-age interaction on whole-brain-averaged WM FA values and FA values from 12 major WM tracts. RESULTS Diagnosis-by-age interaction for the whole-brain average FA was significant for the SCZ (p = .04) but not the MDD (p = .80) cohort. Diagnosis-by-age interaction was nominally significant (p<.05) for five WM tracts for SCZ and for none of the tracts in the MDD cohort. Tract-specific heterochronicity of the onset of age-related decline in SCZ demonstrated strong negative correlations with the age-of-peak myelination and the rates of age-related decline obtained from normative sample (r =-.61 and-.80, p<.05, respectively). No such trends existed for MDD cohort. CONCLUSIONS Cerebral WM showed accelerated aging in SCZ but not in MDD, suggesting some difference in the pathophysiology underlying their WM aging changes. Tract-specific heterochronicity of WM development modulated presentation of accelerated aging in SCZ: WM tracts that matured later in life appeared more sensitive to the pathophysiology of SCZ and demonstrated more susceptibility to disorder-related accelerated decline in FA values with age. This trend was not observed in MDD cohort.
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Affiliation(s)
- Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA.
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Henderson SE, Johnson AR, Vallejo AI, Katz L, Wong E, Gabbay V. A preliminary study of white matter in adolescent depression: relationships with illness severity, anhedonia, and irritability. Front Psychiatry 2013; 4:152. [PMID: 24324445 PMCID: PMC3839092 DOI: 10.3389/fpsyt.2013.00152] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 11/08/2013] [Indexed: 11/13/2022] Open
Abstract
Major depressive disorder (MDD) during adolescence is a common and disabling psychiatric condition; yet, little is known about its neurobiological underpinning. Evidence indicates that MDD in adults involves alterations in white and gray matter; however, sparse research has focused on adolescent MDD. Similarly, little research has accounted for the wide variability of symptom severity among depressed teens. Here, we aimed to investigate white matter (WM) microstructure between 17 adolescents with MDD and 16 matched healthy controls (HC) using diffusion tensor imaging. We further assessed within the MDD group relationships between WM integrity and depression severity, as well as anhedonia and irritability - two core symptoms of adolescent MDD. As expected, adolescents with MDD manifested decreased WM integrity compared to HC in the anterior cingulum and anterior corona radiata. Within the MDD group, greater depression severity was correlated with reduced WM integrity in the genu of corpus callosum, anterior thalamic radiation, anterior cingulum, and sagittal stratum. However, anhedonia and irritability were associated with alterations in distinct WM tracts. Specifically, anhedonia was associated with disturbances in tracts related to reward processing, including the anterior limb of the internal capsule and projection fibers to the orbitofrontal cortex. Irritability was associated with decreased integrity in the sagittal stratum, anterior corona radiata, and tracts leading to prefrontal and temporal cortices. Overall, these preliminary findings provide further support for the hypotheses that there is a disconnect between prefrontal and limbic emotional regions in depression, and that specific clinical symptoms involve distinct alterations in WM tracts.
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Affiliation(s)
- Sarah E Henderson
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, NY , USA
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