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Wang W, Zhou E, Nie Z, Deng Z, Gong Q, Ma S, Kang L, Yao L, Cheng J, Liu Z. Exploring mechanisms of anhedonia in depression through neuroimaging and data-driven approaches. J Affect Disord 2024; 363:409-419. [PMID: 39038623 DOI: 10.1016/j.jad.2024.07.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 07/05/2024] [Accepted: 07/16/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Anhedonia is a core symptom of depression that is closely related to prognosis and treatment outcomes. However, accurate and efficient treatments for anhedonia are lacking, mandating a deeper understanding of the underlying mechanisms. METHODS A total of 303 patients diagnosed with depression and anhedonia were assessed by the Snaith-Hamilton Pleasure Scale (SHAPS) and magnetic resonance imaging (MRI). The patients were categorized into a low-anhedonia group and a high-anhedonia group using the K-means algorithm. A data-driven approach was used to explore the differences in brain structure and function with different degrees of anhedonia based on MATLAB. A random forest model was used exploratorily to test the predictive ability of differences in brain structure and function on anhedonia in depression. RESULTS Structural and functional differences were apparent in several brain regions of patients with depression and high-level anhedonia, including in the temporal lobe, paracingulate gyrus, superior frontal gyrus, inferior occipital gyrus, right insular gyrus, and superior parietal lobule. And changes in these brain regions were significantly correlated with scores of SHAPS. CONCLUSIONS These brain regions may be useful as biomarkers that provide a more objective assessment of anhedonia in depression, laying the foundation for precision medicine in this treatment-resistant, relatively poor prognosis group.
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Affiliation(s)
- Wei Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Enqi Zhou
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhaowen Nie
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zipeng Deng
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qian Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Simeng Ma
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lijun Kang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lihua Yao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jing Cheng
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China; Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China.
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2
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Jung M, Han KM. Behavioral Activation and Brain Network Changes in Depression. J Clin Neurol 2024; 20:362-377. [PMID: 38951971 PMCID: PMC11220350 DOI: 10.3988/jcn.2024.0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 07/03/2024] Open
Abstract
Behavioral activation (BA) is a well-established method of evidence-based treatment for depression. There are clear links between the neural mechanisms underlying reward processing and BA treatment for depressive symptoms, including anhedonia; however, integrated interpretations of these two domains are lacking. Here we examine brain imaging studies involving BA treatments to investigate how changes in brain networks, including the reward networks, mediate the therapeutic effects of BA, and whether brain circuits are predictors of BA treatment responses. Increased activation of the prefrontal and subcortical regions associated with reward processing has been reported after BA treatment. Activation of these regions improves anhedonia. Conversely, some studies have found decreased activation of prefrontal regions after BA treatment in response to cognitive control stimuli in sad contexts, which indicates that the therapeutic mechanism of BA may involve disengagement from negative or sad contexts. Furthermore, the decrease in resting-state functional connectivity of the default-mode network after BA treatment appears to facilitate the ability to counteract depressive rumination, thereby promoting enjoyable and valuable activities. Conflicting results suggest that an intact neural response to rewards or defective reward functioning is predictive of the efficacy of BA treatments. Increasing the benefits of BA treatments requires identification of the unique individual characteristics determining which of these conflicting findings are relevant for the personalized treatment of each individual with depression.
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Affiliation(s)
- Minjee Jung
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Korea
| | - Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
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3
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Zhao H, Rong B, Gao G, Zhou M, Huang J, Tu N, Bu L, Xiao L, Wang G. Alterations in the white matter structure of major depressive disorder patients and their link to childhood trauma. Front Psychiatry 2024; 15:1364786. [PMID: 38510805 PMCID: PMC10951898 DOI: 10.3389/fpsyt.2024.1364786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
Objectives Major Depressive Disorder (MDD) is significantly influenced by childhood trauma (CT), affecting brain anatomy and functionality. Despite the unique disease trajectory in MDD patients with CT, the underlying neurobiological mechanisms remain unclear. Our objective is to investigate CT's impact on the white matter structure of the brain in patients with MDD. Methods This research employed tract-based spatial statistics (TBSS) to detect variations between groups in Fractional Anisotropy (FA) throughout the whole brain in 71 medication-free MDD patients and 97 HCs. Participants filled out the Childhood Trauma Questionnaire (CTQ) and assessments for depression and anxiety symptoms. The relationship between FA and CTQ scores was explored with partial correlation analysis, adjusting for factors such as age, gender, educational background, and length of illness. Results Compared to HCs, the MDD group showed decreased FA values in the right posterior limb of the internal capsule (PLIC), the inferior fronto-occipital fasciculus (IFOF), and bilateral superior longitudinal fasciculus (SLF). Simple effects analysis revealed that compared to HC-CT, the MDD-CT group demonstrated decreased FA values in right PLIC, IFOF, and bilateral SLF. The MDD-nCT group showed decreased FA values in right PLIC and IFOF compared to HC-nCT. The total scores and subscale scores of CTQ were negatively correlated with the FA in the right SLF. Conclusion The right SLF may potentially be influenced by CT during the brain development of individuals with MDD. These results enhance our knowledge of the role of the SLF in the pathophysiology of MDD and the neurobiological mechanisms by which CT influences MDD.
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Affiliation(s)
- Haomian Zhao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Bei Rong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Guoqing Gao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Mingzhe Zhou
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Junhua Huang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ning Tu
- PET-CT/MR Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Lihong Bu
- PET-CT/MR Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ling Xiao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, Hubei, China
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4
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Israel-Elgali I, Pan H, Oved K, Pillar N, Levy G, Barak B, Carneiro A, Gurwitz D, Shomron N. Impaired myelin ultrastructure is reversed by citalopram treatment in a mouse model for major depressive disorder. J Psychiatr Res 2023; 166:100-114. [PMID: 37757703 DOI: 10.1016/j.jpsychires.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/24/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
Major depressive disorder (MDD) is the most common and widespread mental disorder. Selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment for MDD. The relation between the inhibition of serotonin reuptake in the central nervous system and remission from MDD remains controversial, as reuptake inhibition occurs rapidly, but remission from MDD takes weeks to months. Myelination-related deficits and white matter abnormalities were shown to be involved in psychiatric disorders such as MDD. This may explain the delay in remission following SSRI administration. The raphe nuclei (RN), located in the brain stem, consist of clusters of serotonergic (5-HT) neurons that project to almost all regions of the brain. Thus, the RN are an intriguing area for research of the potential effect of SSRI on myelination, and their involvement in MDD. MicroRNAs (miRNAs) regulate many biological features that might be altered by antidepressants. Two cohorts of chronic unpredictable stress (CUS) mouse model for depression underwent behavioral tests for evaluating stress, anxiety, and depression levels. Following application of the CUS protocol and treatment with the SSRI, citalopram, 48 mice of the second cohort were tested via magnetic resonance imaging and diffusion tensor imaging for differences in brain white matter tracts. RN and superior colliculus were excised from both cohorts and measured for changes in miRNAs, mRNA, and protein levels of candidate genes. Using MRI-DTI scans we found lower fractional anisotropy and axial diffusivity in brains of stressed mice. Moreover, both miR-30b-5p and miR-101a-3p were found to be downregulated in the RN following CUS, and upregulated following CUS and citalopram treatment. The direct binding of these miRNAs to Qki, and the subsequent effects on mRNA and protein levels of myelin basic protein (Mbp), indicated involvement of these miRNAs in myelination ultrastructure processes in the RN, in response to CUS followed by SSRI treatment. We suggest that SSRIs are implicated in repairing myelin deficits resulting from chronic stress that leads to depression.
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Affiliation(s)
- Ifat Israel-Elgali
- Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hope Pan
- Department of Pharmacology, Center for Molecular Neuroscience, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Keren Oved
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nir Pillar
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gilad Levy
- Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel
| | - Boaz Barak
- Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel; Faculty of Social Sciences, School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ana Carneiro
- Department of Pharmacology, Center for Molecular Neuroscience, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - David Gurwitz
- Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Noam Shomron
- Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Edmond J Safra Center for Bioinformatics, Tel Aviv University, Tel Aviv, Israel; Tel Aviv University Innovation Laboratories (TILabs), Tel Aviv, Israel.
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5
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Benson KL, Winkelman JW, Gönenç A. Disrupted white matter integrity in primary insomnia and major depressive disorder: relationships to sleep quality and depression severity. J Sleep Res 2023; 32:e13913. [PMID: 37138521 DOI: 10.1111/jsr.13913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/25/2023] [Accepted: 04/05/2023] [Indexed: 05/05/2023]
Abstract
This study examined the integrity of white matter tracts in 25 participants with primary insomnia (PI), 50 participants with major depressive disorder (MDD), and 25 healthy controls. Seven white matter tracts, selected based on prior research, were quantified by fractional anisotropy (FA) as well as by related measures of diffusivity using diffusion tensor imaging (DTI) on a 3-T scanner. All 100 participants were free of significant medical, psychiatric (excluding the MDD group) and sleep disorders (excluding the PI group), were free of central nervous system medications, and completed an extensive clinical assessment. Subjective and objective sleep measures revealed significant sleep disruption in both the PI and MDD groups. Relative to the controls, both the PI and MDD groups demonstrated impaired integrity in three of the seven white matter tracts: the genu of the corpus callosum (GenuCC), the superior longitudinal fasciculus (SLF), and the inferior longitudinal fasciculus (ILF). We demonstrated reduced FA in the GenuCC, reduced FA and reduced axial diffusivity (AD) in the SLF, as well as reduced AD and radial diffusivity in the ILF. Finally, in an exploratory analysis of the combined cohorts, FA in the GenuCC and FA in the SLF were negatively correlated with depression severity and positively correlated with total sleep time. Abnormalities documented in the GenuCC, SLF and ILF, and present in both the PI and MDD groups may suggest some shared neurobiology.
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Affiliation(s)
- Kathleen L Benson
- McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - John W Winkelman
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Departments of Psychiatry and Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Atilla Gönenç
- McLean Imaging Center, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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6
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Xu EP, Nguyen L, Leibenluft E, Stange JP, Linke JO. A meta-analysis on the uncinate fasciculus in depression. Psychol Med 2023; 53:2721-2731. [PMID: 37051913 PMCID: PMC10235669 DOI: 10.1017/s0033291723000107] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 04/14/2023]
Abstract
Aberrant microstructure of the uncinate fasciculus (UNC), a white matter (WM) tract implicated in emotion regulation, has been hypothesized as a neurobiological mechanism of depression. However, studies testing this hypothesis have yielded inconsistent results. The present meta-analysis consolidates evidence from 44 studies comparing fractional anisotropy (FA) and radial diffusivity (RD), two metrics characterizing WM microstructure, of the UNC in individuals with depression (n = 5016) to healthy individuals (n = 18 425). We conduct meta-regressions to identify demographic and clinical characteristics that contribute to cross-study heterogeneity in UNC findings. UNC FA was reduced in individuals with depression compared to healthy individuals. UNC RD was comparable between individuals with depression and healthy individuals. Comorbid anxiety explained inter-study heterogeneity in UNC findings. Depression is associated with perturbations in UNC microstructure, specifically with respect to UNC FA and not UNC RD. The association between depression and UNC microstructure appears to be moderated by anxiety. Future work should unravel the cellular mechanisms contributing to aberrant UNC microstructure in depression; clarify the relationship between UNC microstructure, depression, and anxiety; and link UNC microstructure to psychological processes, such as emotion regulation.
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Affiliation(s)
- Ellie P. Xu
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Lynn Nguyen
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Ellen Leibenluft
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Jonathan P. Stange
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Julia O. Linke
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
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7
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Lv JM, Zhang LM, Wang JX, Shao JJ, Guo XG, Wang LY, Kang LQ, Zheng WC, Xin Y, Song RX, Guo W, Zhang DX. Abdominal surgery plus sevoflurane exposure induces abnormal emotional changes and cognitive dysfunction in aged rats. Behav Brain Res 2023; 442:114328. [PMID: 36740076 DOI: 10.1016/j.bbr.2023.114328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cognitive impairment, which includes perioperative psychological distress and cognitive dysfunction, can be determined by preoperative and post-operative neuropsychological tests. Several mechanisms have been proposed regarding the two-way communication between the immune system and the brain after surgery. We aimed to understand the mechanisms underlying perioperative neurocognitive disorders (PND) in elderly rats using an experimental abdominal surgery model. METHODS 24-month-old SD rats were exposed to the abdominal surgery model (AEL) under 3% anesthesia. On day 15 and day 30 post-surgery, fractional anisotropy (FA) using diffusion kurtosis imaging (DKI) was measured. From day 25 to day 30 post-surgery, behavioral tests, including open field test (OFT), Morris water maze (MWM), novel object recognition (NOR), force swimming test (FST), and elevated plus maze (EPM), were performed. Then, the rats were euthanized to perform pathological analysis and western blot measurement. RESULTS The rats exposed to AEL surgical treatment demonstrated significantly decreased time crossing the platform in the MWM, decreased recognition index in the NOR, reduced time in the open arm in the EPM, increased immobility time in the FST, and increased number of crossings in the OFT. Aged rats, after AEL exposure, further demonstrated decreased FA in the mPFC, nucleus accumbens (NAc), and hippocampus, together with reduced MAP2 intensity, attenuation of GAD65, VGlut2, CHAT, and phosphorylated P38MAPK expression, and increased reactive astrocytes and microglia. CONCLUSIONS In this study, the aged rats exposed to abdominal surgery demonstrated both emotional changes and cognitive dysfunction, which may be associated with neuronal degeneration and reduced phosphorylated P38MAPK.
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Affiliation(s)
- Jin-Meng Lv
- Department of Anesthesia and Trauma Research, Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, Cangzhou, China.
| | - Li-Min Zhang
- Department of Anesthesiology, Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, Cangzhou, China.
| | - Jie-Xia Wang
- Department of Anesthesiology, Cangzhou Central Hospital, Hebei Medical University, Cangzhou, China.
| | - Jing-Jing Shao
- Department of Anesthesiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Xin-Gui Guo
- Department of Medical Iconography, Cangzhou Central Hospital, Hebei Medical University, Cangzhou, China.
| | - Lu-Ying Wang
- Department of Anesthesia and Trauma Research, Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, Cangzhou, China.
| | - Li-Qing Kang
- Department of Medical Iconography, Cangzhou Central Hospital, Hebei Medical University, Cangzhou, China.
| | - Wei-Chao Zheng
- Department of Anesthesiology, Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, Cangzhou, China.
| | - Yue Xin
- Department of Anesthesiology, Cangzhou Central Hospital, Hebei Medical University, Cangzhou, China.
| | - Rong-Xin Song
- Department of Anesthesiology, Cangzhou Central Hospital, Hebei Medical University, Cangzhou, China.
| | - Wei Guo
- Department of Orthopedics, Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, Cangzhou, China.
| | - Dong-Xue Zhang
- Department of Gerontology, Cangzhou Central Hospital, Cangzhou, China.
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8
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Long X, Zhou Y, Zhang F, Li F, Wang X, Meng Y, Roberts N, Cheng B, Jia Z. Altered MRI Diffusion Properties of the White Matter Tracts Connecting Frontal and Thalamic Brain Regions in First-Episode, Drug-Naïve Patients With Postpartum Depression. J Magn Reson Imaging 2023; 57:899-906. [PMID: 35796680 DOI: 10.1002/jmri.28346] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although progress has been made in exploring postpartum depression (PPD), the involvement of cerebral structure connectivity in PPD patients keeps unclear. PURPOSE To explore structural connectivity alternations in mothers with PPD, diffusion tensor imaging (DTI) and automated fiber quantification (AFQ) were used to calculate brain white matter microstructure properties. STUDY TYPE Cross-sectional. POPULATION A total of 51 women with first-episode, treatment-näive PPD, and 49 matched healthy postpartum women (HPW) controls. FIELD STRENGTH A 3.0 T; single-shot echo-planar imaging sequence. ASSESSMENT DTI measurements of fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) were obtained for 18 specific white matter tracts. The relationship between PDD symptoms, hormone levels, and postpartum days was also investigated. STATISTICAL TESTS Two sample t test and Pearson's correlation analysis. The analysis was performed by using a permutation-based multiple-comparison correction approach, with the threshold of P < 0.05 (family wise error corrected [FWE-corrected]) separately across the four different outcome measures. RESULTS Women with PPD showed significantly increased FA and AD in right anterior thalamic radiation (ATR) tract and significantly increased FA and significantly reduced RD in the cingulum tract, compared to women without PPD. The RD values of right cingulum were significantly positively correlated with postpartum days in HPW (r = 0.39). There were no significant relationships between brain measures and hormone levels in either patients or controls. DATA CONCLUSIONS DTI measures have revealed altered integrity in the white matter of the cortical-thalamic circuits in women with PPD compared to HPW. Damage to these circuits may be a structural basis for the impaired emotional regulation and blunted mother-infant bonding in mothers with PPD and a potential target for the development of new treatments. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Xipeng Long
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.,Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yushan Zhou
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Feifei Zhang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xiuli Wang
- Department of Clinical Psychology, the Fourth People's Hospital of Chengdu, Chengdu, China
| | - Yajing Meng
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Neil Roberts
- School of Clinical Sciences, the Queens Medical Research Institute (QMRI), University of Edinburgh, Edinburgh, UK
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China.,Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
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9
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Breit S, Mazza E, Poletti S, Benedetti F. White matter integrity and pro-inflammatory cytokines as predictors of antidepressant response in MDD. J Psychiatr Res 2023; 159:22-32. [PMID: 36657311 DOI: 10.1016/j.jpsychires.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 11/12/2022] [Accepted: 12/10/2022] [Indexed: 01/13/2023]
Abstract
Major depressive disorder (MDD) is a multifactorial, serious and heterogeneous mental disorder that can lead to chronic recurrent symptoms, treatment resistance and suicidal behavior. MDD often involves immune dysregulation with high peripheral levels of inflammatory cytokines that might have an influence on the clinical course and treatment response. Moreover, patients with MDD show brain volume changes as well as white matter (WM) alterations that are already existing in the early stage of illness. Mounting evidence suggests that both neuroimaging markers, such as WM integrity and blood markers, such as inflammatory cytokines might serve as predictors of treatment response in MDD. However, the relationship between peripheral inflammation, WM structure and antidepressant response is not yet clearly understood. The aim of the present review is to elucidate the association between inflammation and WM integrity and its impact on the pathophysiology and progression of MDD as well as the role of possible novel biomarkers of treatment response to improve MDD prevention and treatment strategies.
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Affiliation(s)
- Sigrid Breit
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy; Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - Elena Mazza
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Sara Poletti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
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10
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Chen Q, Bi Y, Zhao X, Lai Y, Yan W, Xie L, Gao T, Xie S, Zeng T, Li J, Kuang S, Gao L, Lv Z. Regional amplitude abnormities in the major depressive disorder: A resting-state fMRI study and support vector machine analysis. J Affect Disord 2022; 308:1-9. [PMID: 35398104 DOI: 10.1016/j.jad.2022.03.079] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE Major depressive disorder (MDD) is a common mood disorder. However, it still remains challenging to select sensitive biomarkers and establish reliable diagnosis methods currently. This study aimed to investigate the abnormalities of the spontaneous brain activity in the MDD and explore the clinical diagnostic value of three amplitude metrics in altered regions by applying the support vector machine (SVM) method. METHODS A total of fifty-two HCs and forty-eight MDD patients were recruited in the study. The amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuation (fALFF) and percent amplitude of fluctuation (PerAF) metrics were calculated to assess local spontaneous brain activity. Then we performed correlation analysis to examine the association between cerebral abnormalities and clinical characteristics. Finally, SVM analysis was applied to conduct the classification model for evaluating the diagnostic value. RESULTS Two-sample t-test exhibited that MDD patients had increased ALFF value in the right caudate and corpus callosum, increased fALFF value in the same regions and increased PerAF value in the inferior parietal lobule and right caudate compared to HCs. Moreover, PerAF value in the inferior parietal lobule was negatively correlated with the slow factor scores. The SVM results showed that a combination of mean ALFF and fALFF in the right caudate and corpus callosum selected as features achieved a highest area under curve (AUC) value (0.89), accuracy (79.79%), sensitivity (65.12%) and specificity (92.16%). CONCLUSION Collectively, we found increased mean ALFF and fALFF may serve as a potential neuroimaging marker to discriminate MDD and HCs.
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Affiliation(s)
- Qing Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Yanmeng Bi
- College of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, China
| | - Xiaohua Zhao
- School of Beauty, Yichun University, Yichun, China
| | - Yuqi Lai
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Weixin Yan
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lingpeng Xie
- Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Tingting Gao
- Department of General medicine, The first affiliated hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Shuwen Xie
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Ting Zeng
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Jun Li
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Shanshan Kuang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Lei Gao
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.
| | - Zhiping Lv
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.
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11
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He E, Liu M, Gong S, Fu X, Han Y, Deng F. White Matter Alterations in Depressive Disorder. Front Immunol 2022; 13:826812. [PMID: 35634314 PMCID: PMC9133348 DOI: 10.3389/fimmu.2022.826812] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Depressive disorder is the most prevalent affective disorder today. Depressive disorder has been linked to changes in the white matter. White matter changes in depressive disorder could be a result of impaired cerebral blood flow (CBF) and CBF self-regulation, impaired blood-brain barrier function, inflammatory factors, genes and environmental factors. Additionally, white matter changes in patients with depression are associated with clinical variables such as differential diagnosis, severity, treatment effect, and efficacy assessment. This review discusses the characteristics, possible mechanisms, clinical relevance, and potential treatment of white matter alterations caused by depressive disorders.
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12
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Zheng G, Yingli Z, Shengli C, Zhifeng Z, Bo P, Gangqiang H, Yingwei Q. Aberrant Inter-hemispheric Connectivity in Patients With Recurrent Major Depressive Disorder: A Multimodal MRI Study. Front Neurol 2022; 13:852330. [PMID: 35463118 PMCID: PMC9028762 DOI: 10.3389/fneur.2022.852330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/11/2022] [Indexed: 01/19/2023] Open
Abstract
Objective Inter-hemispheric network dysconnectivity has been well-documented in patients with recurrent major depressive disorder (MDD). However, it has remained unclear how structural networks between bilateral hemispheres relate to inter-hemispheric functional dysconnectivity and depression severity in MDD. Our study attempted to investigate the alterations in corpus callosum macrostructural and microstructural as well as inter-hemispheric homotopic functional connectivity (FC) in patients with recurrent MDD and to determine how these alterations are related with depressive severity. Materials and Methods Resting-state functional MRI (fMRI), T1WI anatomical images and diffusion tensor MRI of the whole brain were performed in 140 MDD patients and 44 normal controls matched for age, sex, years of education. We analyzed the macrostructural and microstructural integrity as well as voxel-mirrored homotopic functional connectivity (VMHC) of corpus callosum (CC) and its five subregion. Two-sample t-test was used to investigate the differences between the two groups. Significant subregional metrics were correlated with depression severity by spearman's correlation analysis, respectively. Results Compared with control subjects, MDD patients had significantly attenuated inter-hemispheric homotopic FC in the bilateral medial prefrontal cortex, and impaired anterior CC microstructural integrity (each comparison had a corrected P < 0.05), whereas CC macrostructural measurements remained stable. In addition, disruption of anterior CC microstructural integrity correlated with a reduction in FC in the bilateral medial prefrontal cortex, which correlated with depression severity in MDD patients. Furthermore, disruption of anterior CC integrity exerted an indirect influence on depression severity in MDD patients through an impairment of inter-hemispheric homotopic FC. Conclusion These findings may help to advance our understanding of the neurobiological basis of depression by identifying region-specific interhemispheric dysconnectivity.
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Affiliation(s)
- Guo Zheng
- Department of Hematology and Oncology, International Cancer Center, Shenzhen Key Laboratory, Hematology Institution of Shenzhen University, Shenzhen University General Hospital, Shenzhen University Health Science Center, Shenzhen University, Shenzhen, China
| | - Zhang Yingli
- Department of Depressive Disorder, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Chen Shengli
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Zhou Zhifeng
- Department of Radiology, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Peng Bo
- Department of Depressive Disorder, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Hou Gangqiang
- Department of Radiology, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
- *Correspondence: Hou Gangqiang
| | - Qiu Yingwei
- Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- Qiu Yingwei
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13
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Mertse N, Denier N, Walther S, Breit S, Grosskurth E, Federspiel A, Wiest R, Bracht T. Associations between anterior cingulate thickness, cingulum bundle microstructure, melancholia and depression severity in unipolar depression. J Affect Disord 2022; 301:437-444. [PMID: 35026360 DOI: 10.1016/j.jad.2022.01.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/04/2022] [Accepted: 01/08/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Structural and functional alterations of the anterior cingulate cortex (ACC) have been related to emotional, cognitive and behavioral domains of major depressive disorder. In this study, we investigate cortical thickness of rostral and caudal ACC. In addition, we explore white matter microstructure of the cingulum bundle (CB), a white matter pathway connecting multiple segments of the ACC. We hypothesized reduced cortical thickness and reduced white matter microstructure of the CB in MDD, in particular in the melancholic subtype. In addition, we expect an association between depression severity and CB microstructure. METHODS Fifty-four patients with a current depressive episode and 22 healthy controls matched for age, gender and handedness underwent structural and diffusion-weighted MRI-scans. Cortical thickness of rostral and caudal ACC were computed. The CB was reconstructed bilaterally using manual tractography. Cortical thickness and fractional anisotropy (FA) of bilateral CB were compared first between all patients and healthy controls and second between healthy controls, melancholic and non-melancholic patients. Correlations between FA and depression severity were calculated. RESULTS We found no group differences in rostral and caudal ACC cortical thickness or in FA of the CB comparing all patients with healthy controls. Melancholic patients had reduced cortical thickness of bilateral caudal ACC compared to non-melancholic patients and compared to healthy controls. Across all patients, depression severity was associated with reduced FA in bilateral CB. LIMITATIONS Impact of medication CONCLUSIONS: Cortical thickness of the caudal ACC is associated with the melancholic syndrome. CB microstructure may represent a marker of depression severity.
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Affiliation(s)
- Nicolas Mertse
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Bern, Switzerland
| | - Niklaus Denier
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Bern, Switzerland
| | - Sigrid Breit
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Bern, Switzerland
| | - Elmar Grosskurth
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Bern, Switzerland
| | - Roland Wiest
- Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland
| | - Tobias Bracht
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Bern, Switzerland.
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14
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Luttenbacher I, Phillips A, Kazemi R, Hadipour AL, Sanghvi I, Martinez J, Adamson MM. Transdiagnostic role of glutamate and white matter damage in neuropsychiatric disorders: A Systematic Review. J Psychiatr Res 2022; 147:324-348. [PMID: 35151030 DOI: 10.1016/j.jpsychires.2021.12.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/08/2021] [Accepted: 12/19/2021] [Indexed: 12/09/2022]
Abstract
Neuropsychiatric disorders including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ) have been considered distinct categories of diseases despite their overlapping characteristics and symptomatology. We aimed to provide an in-depth review elucidating the role of glutamate/Glx and white matter (WM) abnormalities in these disorders from a transdiagnostic perspective. The PubMed online database was searched for studies published between 2010 and 2021. After careful screening, 401 studies were included. The findings point to decreased levels of glutamate in the Anterior Cingulate Cortex in both SZ and BD, whereas Glx is elevated in the Hippocampus in SZ and MDD. With regard to WM abnormalities, the Corpus Callosum and superior Longitudinal Fascicle were the most consistently identified brain regions showing decreased fractional anisotropy (FA) across all the reviewed disorders, except GAD. Additionally, the Uncinate Fasciculus displayed decreased FA in all disorders, except OCD. Decreased FA was also found in the inferior Longitudinal Fasciculus, inferior Fronto-Occipital Fasciculus, Thalamic Radiation, and Corona Radiata in SZ, BD, and MDD. Decreased FA in the Fornix and Corticospinal Tract were found in BD and SZ patients. The Cingulum and Anterior Limb of Internal Capsule exhibited decreased FA in MDD and SZ patients. The results suggest a gradual increase in severity from GAD to SZ defined by the number of brain regions with WM abnormality which may be partially caused by abnormal glutamate levels. WM damage could thus be considered a potential marker of some of the main neuropsychiatric disorders.
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Affiliation(s)
- Ines Luttenbacher
- Department of Social & Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands; Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Angela Phillips
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Reza Kazemi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran
| | - Abed L Hadipour
- Department of Cognitive Sciences, University of Messina, Messina, Italy
| | - Isha Sanghvi
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neuroscience, University of Southern California, Los Angeles, CA, USA
| | - Julian Martinez
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Palo Alto University, Palo Alto, CA, USA
| | - Maheen M Adamson
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
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15
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Diaz AP, Fernandes BS, Teixeira AL, Mwangi B, Hasan KM, Wu MJ, Selvaraj S, Suen P, Zanao TA, Brunoni AR, Sanches M, Soares JC. White matter microstructure associated with anhedonia among individuals with bipolar disorders and high-risk for bipolar disorders. J Affect Disord 2022; 300:91-98. [PMID: 34936916 PMCID: PMC8828704 DOI: 10.1016/j.jad.2021.12.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/09/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Anhedonia - a key symptom of depression - is highly associated with poorer outcomes and suicidal behavior. Alterations in the circuitry of reward-related brain regions have been robustly associated with anhedonia in unipolar depression, but not bipolar disorder (BD). We investigated white matter microstructures associated with anhedonia in participants with BD types I and II and first-degree relatives of patients with BD (BD-siblings). METHODS Eighty participants (BD types I and II: 56 [70%], and BD-siblings: 24 [30%]) underwent diffusion tensor imaging (DTI); Fractional anisotropy (FA) of different tracts were computed. Anhedonia was assessed using item 8, ("inability to feel'') of the MADRS scale. General linear models were used to compare the FA of different tracts in participants with and without anhedonia controlling for several clinical and demographic variables. RESULTS The mean age of the sample was 37 (± 11) years old, and 68.8% were female. Participants with anhedonia (32.5%) presented lower mean FA in the left uncinate fasciculus (UF) (p = 0.005), right temporal endings of the superior longitudinal fasciculus (SLFT) (p = 0.04), and in the left and right parietal endings of the superior longitudinal fasciculus (SLFP) (p = 0.003, and p = 0.04, respectively). Similar comparisons between participants with or without current depressive episodes and between participants with or without inner tension according to the MADRS did not show significant differences, specificity of the findings for anhedonia. CONCLUSIONS Lower FA in the left UF and SLF are potential neuroimaging markers of anhedonia in individuals with BD and high-risk for BD.
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Affiliation(s)
- Alexandre Paim Diaz
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Road, Suite 3130, Houston, TX 77054, United States.
| | - Brisa S. Fernandes
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
| | - Antonio Lucio Teixeira
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
| | - Benson Mwangi
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
| | - Khader M. Hasan
- The University of Texas Health Science Center at Houston, Department of Diagnostic and Interventional Imaging, Diffusion MRI Research Lab, Houston, Texas
| | - Mon-Ju Wu
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
| | - Sudhakar Selvaraj
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
| | - Paulo Suen
- Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Tamires Araujo Zanao
- Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Andre R. Brunoni
- Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marsal Sanches
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
| | - Jair C. Soares
- The University of Texas Health Science Center at Houston, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, Houston, Texas
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16
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Gu X, Dubol M, Stiernman L, Wikström J, Hahn A, Lanzenberger R, Epperson CN, Bixo M, Sundström-Poromaa I, Comasco E. White matter microstructure and volume correlates of premenstrual dysphoric disorder. J Psychiatry Neurosci 2022; 47:E67-E76. [PMID: 35197364 PMCID: PMC9259386 DOI: 10.1503/jpn.210143] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/18/2021] [Accepted: 12/20/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Premenstrual dysphoric disorder (PMDD) is a mood disorder characterized by psychological and physical symptoms. Differences in white matter have been associated with affective and anxiety disorders, which share some symptoms with PMDD. However, whether white matter structure differs between the brains of individuals with PMDD and healthy controls is not known, nor is its relation to symptom severity. METHODS We performed tract-based spatial statistics and voxel-based morphometry analyses of diffusion tensor imaging metrics and white matter volume, using 2 neuroimaging data sets (n = 67 and n = 131) and a combined whole-brain and region-of-interest approach. We performed correlation analyses to investigate the relationship between regions with different white matter microstructure and volume and PMDD symptom severity. RESULTS We found greater fractional anisotropy in the left uncinate fasciculus (d = 0.69) in individuals with PMDD compared to controls. Moreover, the volume of the right uncinate fasciculus was higher in individuals with PMDD compared to controls (d = 0.40). As well, the severity of premenstrual depression was positively correlated with fractional anisotropy in the right superior longitudinal fasciculus (r = 0.35). LIMITATIONS It is challenging to interpret group differences in diffusion tensor imaging metrics in terms of their underlying biophysical properties. The small size of the control group in the diffusion tensor imaging study may have prevented effects of interest from being detected. CONCLUSION The findings of the present study provide evidence of differential cerebral white matter structure associated with PMDD and its symptoms.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Erika Comasco
- From the Department of Neuroscience, Science for Life Laboratory, Uppsala University, Sweden (Gu, Dubol, Comasco); the Department of Clinical Sciences, Umeå University, Umeå, Sweden (Stiernman, Bixo); the Department of Surgical Sciences, Neuroradiology, Uppsala University, Sweden (Wikström); the Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria (Hahn, Lanzenberger); the Department of Psychiatry, University of Colorado School of Medicine, USA (Epperson); the Department of Women's and Children's Health, Uppsala University, Sweden (Sundström-Poromaa)
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17
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Ning L, Rathi Y, Barbour T, Makris N, Camprodon JA. White matter markers and predictors for subject-specific rTMS response in major depressive disorder. J Affect Disord 2022; 299:207-214. [PMID: 34875281 PMCID: PMC8766915 DOI: 10.1016/j.jad.2021.12.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has established therapeutic efficacy for major depressive disorder (MDD). While translational research has focused primarily on understanding the mechanism of action of TMS on functional activation and connectivity, the effects on structural connectivity remain largely unknown especially when rTMS is applied using subject-specific brain targets. This study aims to use novel diffusion magnetic resonance imaging (dMRI) analysis to examine microstructural changes related to rTMS treatment response using a unique cohort of 21 patients with MDD treated using rTMS with subject-specific targets. White matter dMRI microstructural measures and clinical scores were captured before and after the full course of treatment. We defined disease-relevant fiber bundles connected to different subregions of the left prefrontal cortex and analyzed changes in diffusion properties as well as correlations between the changes of dMRI measures and the changes in Hamilton Depression Rating Scale (HAMD). No significant changes were observed in tracts connected to the TMS targets. rTMS significantly increased the extra-axonal free-water volume, fractional anisotropy and decreased the radial diffusivity in anterior-medial prefrontal fiber bundles but did not lead to raw changes in lateral prefrontal tracts. That said, the microstructural changes in the lateral prefrontal white matter were significantly correlated with treatment response. Moreover, pre-rTMS dMRI measures of the dorsal anterior cingulate cortex and lateral prefrontal cortex connections are correlated with changes in HAMD scores. Microstructural changes in the anterior-medial and lateral prefrontal white matter are potentially involved in treatment response to TMS, though further investigation is needed using larger datasets.
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Affiliation(s)
- Lipeng Ning
- Brigham and Women's Hospital, Boston, MA, United States of America; Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.
| | - Yogesh Rathi
- Brigham and Women’s Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Tracy Barbour
- Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Nikos Makris
- Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Joan A. Camprodon
- Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
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18
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Liang S, Wu Y, Hanxiaoran L, Greenshaw AJ, Li T. Anhedonia in Depression and Schizophrenia: Brain Reward and Aversion Circuits. Neuropsychiatr Dis Treat 2022; 18:1385-1396. [PMID: 35836582 PMCID: PMC9273831 DOI: 10.2147/ndt.s367839] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/28/2022] [Indexed: 11/23/2022] Open
Abstract
Anhedonia, which is defined as markedly diminished interest or pleasure, is a prominent symptom of psychiatric disorders, most notably major depressive disorder (MDD) and schizophrenia. Anhedonia is considered a transdiagnostic symptom that is associated with deficits in neural reward and aversion functions. Here, we review the characteristics of anhedonia in depression and schizophrenia as well as shared or disorder-specific anhedonia-related alterations in reward and aversion pathways of the brain. In particular, we highlight that anhedonia is characterized by impairments in anticipatory pleasure and integration of reward-related information in MDD, whereas anhedonia in schizophrenia is associated with neurocognitive deficits in representing the value of rewards. Dysregulation of the frontostriatal circuit and mesocortical and mesolimbic circuit systems may be the transdiagnostic neurobiological basis of reward and aversion impairments underlying anhedonia in these two disorders. Blunted aversion processing in depression and relatively strong aversion in schizophrenia are primarily attributed to the dysfunction of the habenula, insula, amygdala, and anterior cingulate cortex. Furthermore, patients with schizophrenia appear to exhibit greater abnormal activation and extended functional coupling than those with depression. From a transdiagnostic perspective, understanding the neural mechanisms underlying anhedonia in patients with psychiatric disorders may help in the development of more targeted and efficacious treatment and intervention strategies.
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Affiliation(s)
- Sugai Liang
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, People's Republic of China
| | - Yue Wu
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, People's Republic of China
| | - Li Hanxiaoran
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, People's Republic of China
| | - Andrew J Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, AB, T6G 2B7, Canada
| | - Tao Li
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, People's Republic of China
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19
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Wendel KM, Short AK, Noarbe BP, Haddad E, Palma AM, Yassa MA, Baram TZ, Obenaus A. Early life adversity in male mice sculpts reward circuits. Neurobiol Stress 2021; 15:100409. [PMID: 34746338 PMCID: PMC8554344 DOI: 10.1016/j.ynstr.2021.100409] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/24/2021] [Accepted: 10/12/2021] [Indexed: 01/08/2023] Open
Abstract
Early life adversity (ELA) comprises a wide variety of negative experiences during early life and has been linked to cognitive impairments, reduced experiences of pleasure (anhedonia), and other long-term consequences implying that ELA impacts the reward circuitry. In this study, we focused on the projections from the dorsal raphe (DR) to the ventral tegmental area (VTA) and on to the nucleus accumbens (NAcc), an important pathway within the reward circuit. We hypothesized that ELA alters connectivity within the DR-VTA-NAcc pathway, associated with deficient reward seeking behaviors in adulthood. We used the limited bedding and nesting model to induce ELA in mice and measured reward-related behaviors in adulthood using the three-chamber social interaction and sucrose preference tests. High resolution ex vivo diffusion tensor imaging (DTI) was acquired and processed for regional DTI metrics, including tractography to assess circuit organization. We found brain-wide changes in radial diffusivity (RD) and altered connectivity of the reward circuit in the ELA group. DR-VTA-NAcc circuit tractography and axial diffusivity (AD) along this tract exhibited dispersed organization where AD was increased in the VTA segment. Behaviorally, ELA elicited a social anhedonia-like phenotype in adulthood with decreased direct social approach and time spent with peers in the three-chamber task, and no overt differences in sucrose preference. Our findings suggest that reward circuits, assessed using DTI, are altered following ELA and that these changes may reflect enduring reward deficits.
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Affiliation(s)
- Kara M. Wendel
- Department of Anatomy and Neurobiology, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Annabel K. Short
- Department of Pediatrics, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Brenda P. Noarbe
- Department of Pediatrics, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Elizabeth Haddad
- Department of Pediatrics, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Anton M. Palma
- Institute for Clinical and Translational Science, University of California, Irvine, CA, USA
| | - Michael A. Yassa
- Department of Neurobiology and Behavior, University of California, Irvine School of Biological Sciences, Irvine, CA, USA
| | - Tallie Z. Baram
- Department of Anatomy and Neurobiology, University of California, Irvine School of Medicine, Irvine, CA, USA
- Department of Pediatrics, University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Andre Obenaus
- Department of Anatomy and Neurobiology, University of California, Irvine School of Medicine, Irvine, CA, USA
- Department of Pediatrics, University of California, Irvine School of Medicine, Irvine, CA, USA
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20
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Wang S, Leri F, Rizvi SJ. Anhedonia as a central factor in depression: Neural mechanisms revealed from preclinical to clinical evidence. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110289. [PMID: 33631251 DOI: 10.1016/j.pnpbp.2021.110289] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/25/2021] [Accepted: 02/16/2021] [Indexed: 12/21/2022]
Abstract
Anhedonia is one of the core symptoms of major depressive disorder (MDD), which is often inadequately treated by traditional antidepressants. The modern framework of anhedonia extends the definition from impaired consummatory pleasure or interest in rewards to a broad spectrum of deficits that impact functions such as reward anticipation, approach motivation, effort expenditure, reward valuation, expectation, and reward-cue association learning. Substantial preclinical and clinical research has explored the neural basis of reward deficits in the context of depression, and has implicated mesocorticolimbic reward circuitry comprising the nucleus accumbens, ventral pallidum, ventral tegmental area, amygdala, hippocampus, anterior cingulate, insula, orbitofrontal cortex, and other prefrontal cortex regions. Dopamine modulates several reward facets including anticipation, motivation, effort, and learning. As well, serotonin, norepinephrine, opioids, glutamate, Gamma aminobutyric acid (GABA), and acetylcholine are also involved in anhedonia, and medications targeting these systems may also potentially normalize reward processing in depression. Unfortunately, whereas reward anticipation and reward outcome are extensively explored by both preclinical and clinical studies, translational gaps remain in reward motivation, effort, valuation, and learning, where clinical neuroimaging studies are in the early stages. This review aims to synthesize the neurobiological mechanisms underlying anhedonia in MDD uncovered by preclinical and clinical research. The translational difficulties in studying the neural basis of reward are also discussed.
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Affiliation(s)
- Shijing Wang
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Francesco Leri
- Department of Psychology, University of Guelph, Ontario, Canada
| | - Sakina J Rizvi
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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21
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Zaninotto AL, Grassi DC, Duarte D, Rodrigues PA, Cardoso E, Feltrin FS, Guirado VMDP, Macruz FBDC, Otaduy MCG, da Costa Leite C, Paiva WS, Andrade CS. DTI-derived parameters differ between moderate and severe traumatic brain injury and its association with psychiatric scores. Neurol Sci 2021; 43:1343-1350. [PMID: 34264413 DOI: 10.1007/s10072-021-05455-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM Diffusion tensor imaging (DTI) parameters in the corpus callosum have been suggested to be a biomarker for prognostic outcomes in individuals with diffuse axonal injury (DAI). However, differences between the DTI parameters on moderate and severe trauma in DAI over time are still unclear. A secondary goal was to study the association between the changes in the DTI parameters, anxiety, and depressive scores in DAI over time. METHODS Twenty subjects were recruited from a neurological outpatient clinic and evaluated at 2, 6, and 12 months after the brain injury and compared to matched age and sex healthy controls regarding the DTI parameters in the corpus callosum. State-Trace Anxiety Inventory and Beck Depression Inventory were used to assess psychiatric outcomes in the TBI group over time. RESULTS Differences were observed in the fractional anisotropy and mean diffusivity of the genu, body, and splenium of the corpus callosum between DAI and controls (p < 0.02). Differences in both parameters in the genu of the corpus callosum were also detected between patients with moderate and severe DAI (p < 0.05). There was an increase in the mean diffusivity values and the fractional anisotropy decrease in the DAI group over time (p < 0.02). There was no significant correlation between changes in the fractional anisotropy and mean diffusivity across the study and psychiatric outcomes in DAI. CONCLUSION DTI parameters, specifically the mean diffusivity in the corpus callosum, may provide reliable characterization and quantification of differences determined by the brain injury severity. No correlation was observed with DAI parameters and the psychiatric outcome scores.
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Affiliation(s)
- Ana Luiza Zaninotto
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions (MGHIHP), Boston, MA, USA. .,Department of Neurology, School of Medicine, University São Paulo (USP-SP), São Paulo, SP, Brazil.
| | - Daphine Centola Grassi
- Laboratory of Medical Investigation, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Department of Radiology, Faculdade de Medicina da Universidade de São Paulo, LIM 44 -HCFMUSP, São Paulo, Brazil
| | - Dante Duarte
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | | | - Ellison Cardoso
- Laboratory of Medical Investigation, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Department of Radiology, Faculdade de Medicina da Universidade de São Paulo, LIM 44 -HCFMUSP, São Paulo, Brazil
| | - Fabricio Stewan Feltrin
- Laboratory of Medical Investigation, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Department of Radiology, Faculdade de Medicina da Universidade de São Paulo, LIM 44 -HCFMUSP, São Paulo, Brazil.,Radiology Department, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Fabiola Bezerra de Carvalho Macruz
- Laboratory of Medical Investigation, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Department of Radiology, Faculdade de Medicina da Universidade de São Paulo, LIM 44 -HCFMUSP, São Paulo, Brazil
| | - Maria Concepción Garcia Otaduy
- Laboratory of Medical Investigation, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Department of Radiology, Faculdade de Medicina da Universidade de São Paulo, LIM 44 -HCFMUSP, São Paulo, Brazil
| | - Claudia da Costa Leite
- Laboratory of Medical Investigation, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Department of Radiology, Faculdade de Medicina da Universidade de São Paulo, LIM 44 -HCFMUSP, São Paulo, Brazil
| | - Wellingson Silva Paiva
- Department of Neurology, School of Medicine, University São Paulo (USP-SP), São Paulo, SP, Brazil
| | - Celi Santos Andrade
- Laboratory of Medical Investigation, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Department of Radiology, Faculdade de Medicina da Universidade de São Paulo, LIM 44 -HCFMUSP, São Paulo, Brazil
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22
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Robert G, Bannier E, Comte M, Domain L, Corouge I, Dondaine T, Batail JM, Ferre JC, Fakra E, Drapier D. Multimodal brain imaging connectivity analyses of emotional and motivational deficits in depression among women. J Psychiatry Neurosci 2021; 46:E303-E312. [PMID: 33844485 PMCID: PMC8061737 DOI: 10.1503/jpn.200074] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/28/2020] [Accepted: 11/01/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is characterized by impaired cortical-subcortical functional connectivity. Apathy adds to functional impairment, but its cerebral basis in MDD remains unknown. Our objective was to describe impairments in functional connectivity during emotional processing in MDD (with varying levels of congruency and attention), and to determine their correlation with apathy. METHODS We used the Variable Attention Affective Task during functional MRI, followed by diffusion-weighted MRI, to assess 55 right-handed women (30 with MDD and 25 healthy controls) between September 2012 and February 2015. We estimated functional connectivity using generalized psychophysiologic interaction and anatomic connectivity with tract-based spatial statistics. We measured apathy using the Apathy Evaluation Scale. RESULTS We found decreased functional connectivity between the left amygdala and the left anterior cingulate cortex (ACC) during negative stimuli in participants with MDD (t54 = 4.2; p = 0.035, family-wise error [FWE]-corrected). During high-attention stimuli, participants with MDD showed reduced functional connectivity between the right dorsolateral prefrontal cortex (dlPFC) and the right ACC (t54 = 4.06, pFWE = 0.02), but greater functional connectivity between the right dlPFC and the right amygdala (t54 = 3.35, p = 0.048). Apathy was associated with increased functional connectivity between the right dlPFC and the right ACC during high-attention stimuli (t28 = 5.2, p = 0.01) and increased fractional anisotropy in the right posterior cerebellum, the anterior and posterior cingulum and the bilateral internal capsule (all pFWE < 0.05). LIMITATIONS Limitations included a moderate sample size, concomitant antidepressant therapy and no directed connectivity. CONCLUSION We found that MDD was associated with impairments in cortical-subcortical functional connectivity during negative stimuli that might alter the recruitment of networks engaged in attention. Apathy-related features suggested networks similar to those observed in degenerative disorders, but possible different mechanisms.
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Affiliation(s)
- Gabriel Robert
- From the EA 4712 Comportement et noyaux gris centraux, Université de Rennes 1, France (Robert, Batail, Drapier); the Psychiatry Department, Centre Hospitalier Guillaume Régnier, 108 Boulevard Général Leclerc, 35000, Rennes, France (Robert, Domain, Batail, Drapier); the Radiology Department, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France (Bannier, Ferre); the University of Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, Empenn-ERL U 1228, 35000 Rennes, France (Bannier, Corouge, Ferre, Barillot); the Institut de Neurosciences de la Timone, Campus Santé Timone, 27, Bd Jean Moulin 13005 Marseille, France (Comte); the University of Lille & CHU Lille, Inserm, U1171, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France (Dondaine); and the Psychiatry Department, CHU Saint-Etienne, Team PsyR2-Centre de Recherche en Neuroscience de Lyon, (CRNL) CNRS UMR 5292-Inserm U1028, University of Lyon and Saint Etienne, France (Fakra)
| | - Elise Bannier
- From the EA 4712 Comportement et noyaux gris centraux, Université de Rennes 1, France (Robert, Batail, Drapier); the Psychiatry Department, Centre Hospitalier Guillaume Régnier, 108 Boulevard Général Leclerc, 35000, Rennes, France (Robert, Domain, Batail, Drapier); the Radiology Department, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France (Bannier, Ferre); the University of Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, Empenn-ERL U 1228, 35000 Rennes, France (Bannier, Corouge, Ferre, Barillot); the Institut de Neurosciences de la Timone, Campus Santé Timone, 27, Bd Jean Moulin 13005 Marseille, France (Comte); the University of Lille & CHU Lille, Inserm, U1171, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France (Dondaine); and the Psychiatry Department, CHU Saint-Etienne, Team PsyR2-Centre de Recherche en Neuroscience de Lyon, (CRNL) CNRS UMR 5292-Inserm U1028, University of Lyon and Saint Etienne, France (Fakra)
| | - Magali Comte
- From the EA 4712 Comportement et noyaux gris centraux, Université de Rennes 1, France (Robert, Batail, Drapier); the Psychiatry Department, Centre Hospitalier Guillaume Régnier, 108 Boulevard Général Leclerc, 35000, Rennes, France (Robert, Domain, Batail, Drapier); the Radiology Department, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France (Bannier, Ferre); the University of Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, Empenn-ERL U 1228, 35000 Rennes, France (Bannier, Corouge, Ferre, Barillot); the Institut de Neurosciences de la Timone, Campus Santé Timone, 27, Bd Jean Moulin 13005 Marseille, France (Comte); the University of Lille & CHU Lille, Inserm, U1171, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France (Dondaine); and the Psychiatry Department, CHU Saint-Etienne, Team PsyR2-Centre de Recherche en Neuroscience de Lyon, (CRNL) CNRS UMR 5292-Inserm U1028, University of Lyon and Saint Etienne, France (Fakra)
| | - Lea Domain
- From the EA 4712 Comportement et noyaux gris centraux, Université de Rennes 1, France (Robert, Batail, Drapier); the Psychiatry Department, Centre Hospitalier Guillaume Régnier, 108 Boulevard Général Leclerc, 35000, Rennes, France (Robert, Domain, Batail, Drapier); the Radiology Department, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France (Bannier, Ferre); the University of Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, Empenn-ERL U 1228, 35000 Rennes, France (Bannier, Corouge, Ferre, Barillot); the Institut de Neurosciences de la Timone, Campus Santé Timone, 27, Bd Jean Moulin 13005 Marseille, France (Comte); the University of Lille & CHU Lille, Inserm, U1171, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France (Dondaine); and the Psychiatry Department, CHU Saint-Etienne, Team PsyR2-Centre de Recherche en Neuroscience de Lyon, (CRNL) CNRS UMR 5292-Inserm U1028, University of Lyon and Saint Etienne, France (Fakra)
| | - Isabelle Corouge
- From the EA 4712 Comportement et noyaux gris centraux, Université de Rennes 1, France (Robert, Batail, Drapier); the Psychiatry Department, Centre Hospitalier Guillaume Régnier, 108 Boulevard Général Leclerc, 35000, Rennes, France (Robert, Domain, Batail, Drapier); the Radiology Department, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France (Bannier, Ferre); the University of Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, Empenn-ERL U 1228, 35000 Rennes, France (Bannier, Corouge, Ferre, Barillot); the Institut de Neurosciences de la Timone, Campus Santé Timone, 27, Bd Jean Moulin 13005 Marseille, France (Comte); the University of Lille & CHU Lille, Inserm, U1171, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France (Dondaine); and the Psychiatry Department, CHU Saint-Etienne, Team PsyR2-Centre de Recherche en Neuroscience de Lyon, (CRNL) CNRS UMR 5292-Inserm U1028, University of Lyon and Saint Etienne, France (Fakra)
| | - Thibaut Dondaine
- From the EA 4712 Comportement et noyaux gris centraux, Université de Rennes 1, France (Robert, Batail, Drapier); the Psychiatry Department, Centre Hospitalier Guillaume Régnier, 108 Boulevard Général Leclerc, 35000, Rennes, France (Robert, Domain, Batail, Drapier); the Radiology Department, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France (Bannier, Ferre); the University of Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, Empenn-ERL U 1228, 35000 Rennes, France (Bannier, Corouge, Ferre, Barillot); the Institut de Neurosciences de la Timone, Campus Santé Timone, 27, Bd Jean Moulin 13005 Marseille, France (Comte); the University of Lille & CHU Lille, Inserm, U1171, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France (Dondaine); and the Psychiatry Department, CHU Saint-Etienne, Team PsyR2-Centre de Recherche en Neuroscience de Lyon, (CRNL) CNRS UMR 5292-Inserm U1028, University of Lyon and Saint Etienne, France (Fakra)
| | - Jean-Marie Batail
- From the EA 4712 Comportement et noyaux gris centraux, Université de Rennes 1, France (Robert, Batail, Drapier); the Psychiatry Department, Centre Hospitalier Guillaume Régnier, 108 Boulevard Général Leclerc, 35000, Rennes, France (Robert, Domain, Batail, Drapier); the Radiology Department, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France (Bannier, Ferre); the University of Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, Empenn-ERL U 1228, 35000 Rennes, France (Bannier, Corouge, Ferre, Barillot); the Institut de Neurosciences de la Timone, Campus Santé Timone, 27, Bd Jean Moulin 13005 Marseille, France (Comte); the University of Lille & CHU Lille, Inserm, U1171, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France (Dondaine); and the Psychiatry Department, CHU Saint-Etienne, Team PsyR2-Centre de Recherche en Neuroscience de Lyon, (CRNL) CNRS UMR 5292-Inserm U1028, University of Lyon and Saint Etienne, France (Fakra)
| | - Jean-Christophe Ferre
- From the EA 4712 Comportement et noyaux gris centraux, Université de Rennes 1, France (Robert, Batail, Drapier); the Psychiatry Department, Centre Hospitalier Guillaume Régnier, 108 Boulevard Général Leclerc, 35000, Rennes, France (Robert, Domain, Batail, Drapier); the Radiology Department, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France (Bannier, Ferre); the University of Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, Empenn-ERL U 1228, 35000 Rennes, France (Bannier, Corouge, Ferre, Barillot); the Institut de Neurosciences de la Timone, Campus Santé Timone, 27, Bd Jean Moulin 13005 Marseille, France (Comte); the University of Lille & CHU Lille, Inserm, U1171, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France (Dondaine); and the Psychiatry Department, CHU Saint-Etienne, Team PsyR2-Centre de Recherche en Neuroscience de Lyon, (CRNL) CNRS UMR 5292-Inserm U1028, University of Lyon and Saint Etienne, France (Fakra)
| | - Eric Fakra
- From the EA 4712 Comportement et noyaux gris centraux, Université de Rennes 1, France (Robert, Batail, Drapier); the Psychiatry Department, Centre Hospitalier Guillaume Régnier, 108 Boulevard Général Leclerc, 35000, Rennes, France (Robert, Domain, Batail, Drapier); the Radiology Department, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France (Bannier, Ferre); the University of Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, Empenn-ERL U 1228, 35000 Rennes, France (Bannier, Corouge, Ferre, Barillot); the Institut de Neurosciences de la Timone, Campus Santé Timone, 27, Bd Jean Moulin 13005 Marseille, France (Comte); the University of Lille & CHU Lille, Inserm, U1171, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France (Dondaine); and the Psychiatry Department, CHU Saint-Etienne, Team PsyR2-Centre de Recherche en Neuroscience de Lyon, (CRNL) CNRS UMR 5292-Inserm U1028, University of Lyon and Saint Etienne, France (Fakra)
| | - Dominique Drapier
- From the EA 4712 Comportement et noyaux gris centraux, Université de Rennes 1, France (Robert, Batail, Drapier); the Psychiatry Department, Centre Hospitalier Guillaume Régnier, 108 Boulevard Général Leclerc, 35000, Rennes, France (Robert, Domain, Batail, Drapier); the Radiology Department, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France (Bannier, Ferre); the University of Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, Empenn-ERL U 1228, 35000 Rennes, France (Bannier, Corouge, Ferre, Barillot); the Institut de Neurosciences de la Timone, Campus Santé Timone, 27, Bd Jean Moulin 13005 Marseille, France (Comte); the University of Lille & CHU Lille, Inserm, U1171, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France (Dondaine); and the Psychiatry Department, CHU Saint-Etienne, Team PsyR2-Centre de Recherche en Neuroscience de Lyon, (CRNL) CNRS UMR 5292-Inserm U1028, University of Lyon and Saint Etienne, France (Fakra)
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Depression and Fatigue in Patients With Multiple Sclerosis Have No Influence on the Parameters of Cognitive Evoked Potentials. J Clin Neurophysiol 2021; 38:36-42. [PMID: 31725033 DOI: 10.1097/wnp.0000000000000640] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The purpose of this study was to examine if depression and fatigue affect event-related brain potentials (ERPs) in patients with relapsing-remitting multiple sclerosis, and to assess the significance of ERP as an indicator of cognitive impairment. METHODS A total of 81 relapsing-remitting multiple sclerosis patients and 32 healthy control subjects participated in the study. Cognitive functions were evaluated using a standard PASAT, the symbol digit modality test, and ERP. The degrees of depressive symptomatology and fatigue were assessed with Beck Depression Inventory, the Fatigue Severity Scale, and the Fatigue Impact Scale. RESULTS Fatigue and depression had a negative effect on the cognitive functions examined by neuropsychological tests. Depression and fatigue did not influence ERP amplitude and latency findings. Depression level was negatively correlated with symbol digit modality test score (r = -0.135, P < 0.05). Fatigue level was negatively correlated with the results for PASAT A (r = -0.225, P < 0.05) and PASAT B (r = -0.342, P < 0.01). Reaction time was positively associated with depression (r = 0.246, P = 0.01) and fatigue (r = 0.281, P = 0.01). CONCLUSIONS Depression and fatigue have no effect on ERP amplitude and latency, so they cannot participate in risk assessment for the development of cognitive impairment in patients with relapsing-remitting multiple sclerosis.
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Murck H, Luerweg B, Hahn J, Braunisch M, Jezova D, Zavorotnyy M, Konrad C, Jansen A, Kircher T. Ventricular volume, white matter alterations and outcome of major depression and their relationship to endocrine parameters - A pilot study. World J Biol Psychiatry 2021; 22:104-118. [PMID: 32306867 DOI: 10.1080/15622975.2020.1757754] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Brain morphology and its relation to endocrine parameters were examined, in order to determine the link of these parameters to treatment outcome to psychopharmacological treatment in depressed patients. METHODS We examined the potentially predictive value of Magnetic Resonance Imaging (MRI) parameters related to mineralocorticoid receptor (MR) function on the treatment outcome of depression. 16 inpatients with a major depressive episode (MDE) were studied at baseline and 14 of them approximately six weeks later. Physiological biomarkers and 3-T-structural MRI based volume measures, using FreeSurfer 6.0 software, were determined. RESULTS Non-responders (<50% reduction of HAMD-21; n = 6) had a significantly smaller volume of the right anterior cingulate cortex, a significantly larger ventricle to brain ratio (VBR) and third ventricle volume, and smaller volumes of the central and central-anterior corpus callosum (CC) in comparison to responders (n = 7; all p ≤ 0.05). Correlational analysis (Spearman) demonstrated that larger ventricle volume was correlated to a worse treatment outcome, higher body mass index (BMI) and smaller CC segment volume, whereas the total CC volume was negatively correlated to the saliva aldosterone/cortisol concentration ratio (AC-ratio). CONCLUSION Large ventricular volume may be a predictive marker for worse treatment response to standard antidepressant treatment, potentially via compression of white matter structures. A mediating role of the previously identified markers BMI and the AC-ratio, is suggested.
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Affiliation(s)
- Harald Murck
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.,Murck-Neuroscience, Westfield, NJ, USA
| | - Benjamin Luerweg
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Johannes Hahn
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Matthias Braunisch
- Department of Nephrology, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - Daniela Jezova
- Biomedical Research Center, Slovak Academy of Sciences, Institute of Experimental Endocrinology, Bratislava, Slovakia
| | - Maxim Zavorotnyy
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Carsten Konrad
- Agaplesion Diakonieklinikum Rotenburg, Rotenburg (Wuemme), Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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25
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Greenberg T, Bertocci MA, Versace A, Santos JPL, Chase HW, Siffler R, Aslam HA, Graur S, Bebko G, Lockovich JC, Phillips ML. Depression and anxiety mediate the relationship between frontotemporal white matter integrity and quality of life in distressed young adults. J Psychiatr Res 2021; 132:55-59. [PMID: 33039824 PMCID: PMC8407067 DOI: 10.1016/j.jpsychires.2020.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/23/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
Depression and anxiety have been linked to poor quality of life (QoL) - one's subjective perception of relationships, physical health, daily functioning, general sense of well-being and life satisfaction. Elucidating abnormal white matter microstructure associated with mood and other symptoms and QoL is important to facilitate treatment. Ninety-six young adults (18-25 years old) seeking help for psychological distress, irrespective of presence or absence of psychiatric diagnosis completed diffusion weighted and anatomical scans, clinical and behavioral measures, and QoL assessment. We examined relationships between diffusion imaging properties in major white matter tracts involved in emotion processing and regulation, symptoms, and QoL. Depression and general distress levels fully mediated the relationship between fractional anisotropy (FA), an indirect index of fiber collinearity, and radial diffusivity (RD), an index sensitive to axonal/myelin damage, in right uncinate fasciculus and QoL. The relationship between reduced FA (and increased RD) in right uncinate fasciculus and poor QoL was explained by greater severity of depression and general distress. These findings underscore the role of white matter microstructure in right uncinate fasciculus in relation to depressive and general distress symptoms and, in turn, QoL. Importantly, they suggest that measures of white matter microstructure in this tract can be used as putative objective markers of emotion dysregulation, to inform and monitor the impact of interventions to reduce affective symptoms and improve QoL in young adults.
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Affiliation(s)
- Tsafrir Greenberg
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States.
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26
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Khan AR, Geiger L, Wiborg O, Czéh B. Stress-Induced Morphological, Cellular and Molecular Changes in the Brain-Lessons Learned from the Chronic Mild Stress Model of Depression. Cells 2020; 9:cells9041026. [PMID: 32326205 PMCID: PMC7226496 DOI: 10.3390/cells9041026] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/14/2020] [Accepted: 04/19/2020] [Indexed: 02/07/2023] Open
Abstract
Major depressive disorder (MDD) is a severe illness imposing an increasing social and economic burden worldwide. Numerous rodent models have been developed to investigate the pathophysiology of MDD. One of the best characterized and most widely used models is the chronic mild stress (CMS) model which was developed more than 30 years ago by Paul Willner. More than 2000 published studies used this model, mainly to assess novel compounds with potential antidepressant efficacy. Most of these studies examined the behavioral consequences of stress and concomitant drug intervention. Much fewer studies focused on the CMS-induced neurobiological changes. However, the stress-induced cellular and molecular changes are important as they may serve as potential translational biomarkers and increase our understanding of the pathophysiology of MDD. Here, we summarize current knowledge on the structural and molecular alterations in the brain that have been described using the CMS model. We discuss the latest neuroimaging and postmortem histopathological data as well as molecular changes including recent findings on microRNA levels. Different chronic stress paradigms occasionally deliver dissimilar findings, but the available experimental data provide convincing evidence that the CMS model has a high translational value. Future studies examining the neurobiological changes in the CMS model in combination with clinically effective antidepressant drug intervention will likely deliver further valuable information on the pathophysiology of MDD.
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Affiliation(s)
- Ahmad Raza Khan
- Centre of Biomedical Research, Sanjay Gandhi Post Graduate Institute (SGPGI) Campus, Lucknow-226017, U.P, India;
| | - Lili Geiger
- Neurobiology of Stress Research Group, Szentágothai Research Centre, University of Pécs, 7624 Pécs, Hungary;
- Department of Laboratory Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Ove Wiborg
- Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark;
| | - Boldizsár Czéh
- Neurobiology of Stress Research Group, Szentágothai Research Centre, University of Pécs, 7624 Pécs, Hungary;
- Department of Laboratory Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
- Correspondence:
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Mithani K, Davison B, Meng Y, Lipsman N. The anterior limb of the internal capsule: Anatomy, function, and dysfunction. Behav Brain Res 2020; 387:112588. [PMID: 32179062 DOI: 10.1016/j.bbr.2020.112588] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 12/22/2019] [Accepted: 02/28/2020] [Indexed: 12/22/2022]
Abstract
The last two decades have seen a re-emergence of neurosurgery for severe, refractory psychiatric diseases, largely due to the advent of more precise and safe operative techniques. Nevertheless, the optimal targets for these surgeries remain a matter of debate, and are often grandfathered from experiences in the late 20th century. To better explore the rationale for one target in particular - the anterior limb of the internal capsule (ALIC) - we comprehensively reviewed all available literature on its role in the pathophysiology and treatment of mental illness. We first provide an overview of its functional anatomy, followed by a discussion on its role in several prevalent psychiatric diseases. Given its structural integration into the limbic system and involvement in a number of cognitive and emotional processes, the ALIC is a robust target for surgical treatment of refractory psychiatric diseases. The advent of novel neuroimaging techniques, coupled with image-guided therapeutics and neuromodulatory treatments, will continue to enable study on the ALIC in mental illness.
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Affiliation(s)
- Karim Mithani
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | | | - Ying Meng
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Nir Lipsman
- Sunnybrook Research Institute, Toronto, Ontario, Canada.
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Wei S, Womer FY, Edmiston EK, Zhang R, Jiang X, Wu F, Kong L, Zhou Y, Tang Y, Wang F. Structural alterations associated with suicide attempts in major depressive disorder and bipolar disorder: A diffusion tensor imaging study. Prog Neuropsychopharmacol Biol Psychiatry 2020; 98:109827. [PMID: 31778758 DOI: 10.1016/j.pnpbp.2019.109827] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/15/2019] [Accepted: 11/23/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) and bipolar disorder (BD) are major affective disorders associated with high risk for suicide. Neural mechanisms underlying suicide attempts are poorly understood in MDD and BD but likely relate to the structural abnormalities in brain regions. In this study, we explored structural alterations in MDD and BD with prior suicide attempts (SA) using diffusion tensor imaging (DTI). METHODS Participants consisted of 27 MDD patients with prior SA (men: 9; age means±sd: 28.04 ± 11.06 years), 49 MDD patients without prior SA (men: 11; age means±sd: 30.03 ± 0.91 years), 25 BD patients with prior SA (men: 7, age means±sd: 27.08 ± 8.40 years), 49 BD patients without prior SA (men: 26, means±sd: 27.69 ± 9.97 years),and 49 healthy controls (HC) (men: 18, means±sd: 31.12 ± 9.95 years). All participants underwent DTI to examine fractional anisotropy (FA) in brain regions. RESULTS FA in several major white matter (WM) bundles including bilateral inferior fronto-occipital fasciculus (IFOF), bilateral uncinate fasciculus (UF), and the corpus callosum (CC) was shown in MDD with prior SA, compared to MDD without prior SA and HC. Decreased FA was also found in bilateral IFOF, bilateral UF, and CC, as well as other WM bundles, in BD with prior SA, compared to BD without prior SA and HC. Significant diagnostic group by SA effects were shown in bilateral thalami with lowest mean FA values in MDD with prior SA. CONCLUSIONS Our findings support the involvement of structural alterations in suicide attempts in major affective disorders. Shared and distinct structural alterations were shown in MDD and BD with prior SA, suggesting common and differential neural pathways for suicide among major affective disorder.
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Affiliation(s)
- Shengnan Wei
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Fay Y Womer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Elliot K Edmiston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ran Zhang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Xiaowei Jiang
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Feng Wu
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Lingtao Kong
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Yifang Zhou
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Geriatric Medicine, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China
| | - Yanqing Tang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Geriatric Medicine, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China.
| | - Fei Wang
- Brain Function Research Section, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Radiology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China; Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, PR China.
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29
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Heij GJ, Penninx BWHJ, van Velzen LS, van Tol MJ, van der Wee NJA, Veltman DJ, Aghajani M. White matter architecture in major depression with anxious distress symptoms. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94:109664. [PMID: 31158389 DOI: 10.1016/j.pnpbp.2019.109664] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/29/2019] [Accepted: 05/30/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Comorbid anxious distress is common in Major Depressive Disorder (MDD), and associated with significantly worse clinical course and treatment response. While DSM-5 recently introduced the Anxious Distress (AD) specifier as a potentially useful symptom-based subtyping scheme for MDD, its neurobiological underpinnings remain unclear. The current study hence uniquely probed whether MDD with co-occurring AD (MDD/AD+) relates to distinct perturbations in frontolimbic white matter (WM) pathways tentatively theorized in MDD/AD+ pathophysiology. METHODS Tract-based spatial statistics (TBSS) was therefore used to analyze diffusion tensor imaging data on WM microstructure, in MDD/AD+ patients (N = 20) relative to MDD patients without AD (MDD/AD-; N = 29) and healthy controls (HC; N = 39). Using TBSS, we probed fractional anisotropy and axial/radial/mean diffusivity as proxies for WM integrity. Categorical (between-groups) and dimensional (within-patients) analyses subsequently assessed how Anxious Distress in MDD impacts frontolimbic WM connectivity. Receiver-Operating Characteristics additionally assessed classification capabilities of between-groups WM effects. RESULTS Compared to MDD/AD- and HC participants, MDD/AD+ patients exhibited diminished integrity within the anterior thalamic radiation (ATR). Higher AD specifier scores within MDD patients additionally related to diminished integrity of the uncinate fasciculus and cingulum pathways. These effects were not confounded by key clinical (e.g., comorbid anxiety disorder) and sociodemographic (e.g., age/sex) factors, with altered ATR integrity moreover successfully classifying MDD/AD+ patients from MDD/AD- and HC participants (90% sensitivity | 73% specificity | 77% accuracy). CONCLUSIONS These findings collectively link MDD/AD+ to distinct WM anomalies in frontolimbic tracts important to adaptive emotional functioning, and may as such provide relevant, yet preliminary, clues on MDD/AD+ pathophysiology.
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Affiliation(s)
- Gijs J Heij
- VU University, Faculty of Earth and Life Sciences, the Netherlands; Amsterdam UMC, Location VUMC, Dept. of Psychiatry & Amsterdam Neuroscience, the Netherlands
| | - Brenda W H J Penninx
- Amsterdam UMC, Location VUMC, Dept. of Psychiatry & Amsterdam Neuroscience, the Netherlands; GGZ InGeest Specialized Mental Health Care, the Netherlands
| | - Laura S van Velzen
- Amsterdam UMC, Location VUMC, Dept. of Psychiatry & Amsterdam Neuroscience, the Netherlands; GGZ InGeest Specialized Mental Health Care, the Netherlands
| | - Marie-José van Tol
- University Medical Center Groningen, Dept. of Psychiatry, the Netherlands
| | | | - Dick J Veltman
- Amsterdam UMC, Location VUMC, Dept. of Psychiatry & Amsterdam Neuroscience, the Netherlands; GGZ InGeest Specialized Mental Health Care, the Netherlands
| | - Moji Aghajani
- Amsterdam UMC, Location VUMC, Dept. of Psychiatry & Amsterdam Neuroscience, the Netherlands; GGZ InGeest Specialized Mental Health Care, the Netherlands.
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30
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Westlund Schreiner M, Mueller BA, Klimes-Dougan B, Begnel ED, Fiecas M, Hill D, Lim KO, Cullen KR. White Matter Microstructure in Adolescents and Young Adults With Non-Suicidal Self-Injury. Front Psychiatry 2019; 10:1019. [PMID: 32038337 PMCID: PMC6992587 DOI: 10.3389/fpsyt.2019.01019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 12/23/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a growing public health concern that commonly begins in adolescence, and can persist into young adulthood. A promising approach for advancing our understanding of NSSI in youth is to examine white matter microstructure using diffusion magnetic resonance imaging (dMRI). METHOD The present study examined whole-brain group differences in structural connectivity (as measured by generalized fractional anisotropy [GFA]) between 28 female adolescents and young adults ages 13-21 years with NSSI and 22 age-matched healthy controls (HC). We also explored the association between clinical characteristics including NSSI severity and duration, impulsivity, emotion regulation and personality traits within the NSSI group and GFA of the uncinate fasciculus and cingulum. RESULTS Compared to the HC group, participants with NSSI had lower GFA in several white matter tracts, including the uncinate fasciculus, cingulum, bilateral superior and inferior longitudinal fasciculi, anterior thalamic radiation, callosal body, and corticospinal tract. When controlling for depressive symptoms, the NSSI group showed an association between NSSI duration (time since initiating NSSI behavior) and lower GFA in the left cingulum. Higher levels of attentional impulsivity were related to lower GFA in the left uncinate fasciculus within the NSSI group. CONCLUSIONS We found evidence suggesting widespread white matter microstructure deficits in adolescents and young adults with NSSI versus HC. We also report inverse associations between white matter integrity and clinical characteristics (duration of NSSI and attentional impulsivity). These white matter microstructural deficits may represent a possible neurobiologically-based vulnerability to developing maladaptive coping mechanisms, such as NSSI. Additionally, results suggest that this white matter disorganization may either worsen with prolonged engagement in NSSI or predict persistent NSSI; thereby highlighting the importance of early intervention targeting this behavior.
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Affiliation(s)
| | - Bryon A Mueller
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Bonnie Klimes-Dougan
- Department of Psychology, University of Minnesota College of Liberal Arts, Minneapolis, MN, United States
| | - Erin D Begnel
- Department of Psychology, University of Minnesota College of Liberal Arts, Minneapolis, MN, United States
| | - Mark Fiecas
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, United States
| | - Dawson Hill
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Kelvin O Lim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Kathryn R Cullen
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
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31
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Wu F, Tu Z, Sun J, Geng H, Zhou Y, Jiang X, Li H, Kong L. Abnormal Functional and Structural Connectivity of Amygdala-Prefrontal Circuit in First-Episode Adolescent Depression: A Combined fMRI and DTI Study. Front Psychiatry 2019; 10:983. [PMID: 32116814 PMCID: PMC7013238 DOI: 10.3389/fpsyt.2019.00983] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/11/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Abnormalities of functional and structural connectivity in the amygdala-prefrontal circuit which involved with emotion processing have been implicated in adults with major depressive disorder (MDD). Adolescent MDD may have severer dysfunction of emotion processing than adult MDD. In this study, we used resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI) to examine the potential functional and structural connectivity abnormalities within amygdala-prefrontal circuit in first-episode medication-naïve adolescents with MDD. METHODS Rs-fMRI and DTI data were acquired from 36 first-episode medication-naïve MDD adolescents and 37 healthy controls (HC). Functional connectivity between amygdala and the prefrontal cortex (PFC) and fractional anisotropy (FA) values of the uncinate fasciculus (UF) which connecting amygdala and PFC were compared between the MDD and HC groups. The correlation between the FA value of UF and the strength of the functional connectivity in the PFC showing significant differences between the two groups was identified. RESULTS Compared with the HC group, decreased functional connectivity between left amygdala and left ventral PFC was detected in the adolescent MDD group. FA values were significant lower in the left UF within the adolescent MDD group compared to the HC group. There was no significant correlation between the UF and FA, and the strength of functional connectivity within the adolescent MDD group. CONCLUSIONS First-episode medication-naïve adolescent MDD showed decreased functional and structural connectivity in the amygdala-prefrontal circuit. These findings suggest that both functional and structural abnormalities of the amygdala-prefrontal circuit may present in the early onset of adolescent MDD and play an important role in the neuropathophysiology of adolescent MDD.
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Affiliation(s)
- Feng Wu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhaoyuan Tu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jiaze Sun
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Haiyang Geng
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yifang Zhou
- Department of Gerontology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaowei Jiang
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Huizi Li
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Lingtao Kong
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
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