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Ge R, Sassi R, Yatham LN, Frangou S. Neuroimaging profiling identifies distinct brain maturational subtypes of youth with mood and anxiety disorders. Mol Psychiatry 2023; 28:1072-1078. [PMID: 36577839 PMCID: PMC10005933 DOI: 10.1038/s41380-022-01925-9] [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: 08/31/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022]
Abstract
Mood and anxiety disorders typically begin in adolescence and have overlapping clinical features but marked inter-individual variation in clinical presentation. The use of multimodal neuroimaging data may offer novel insights into the underlying brain mechanisms. We applied Heterogeneity Through Discriminative Analysis (HYDRA) to measures of regional brain morphometry, neurite density, and intracortical myelination to identify subtypes of youth, aged 9-10 years, with mood and anxiety disorders (N = 1931) compared to typically developing youth (N = 2823). We identified three subtypes that were robust to permutation testing and sample composition. Subtype 1 evidenced a pattern of imbalanced cortical-subcortical maturation compared to the typically developing group, with subcortical regions lagging behind prefrontal cortical thinning and myelination and greater cortical surface expansion globally. Subtype 2 displayed a pattern of delayed cortical maturation indicated by higher cortical thickness and lower cortical surface area expansion and myelination compared to the typically developing group. Subtype 3 showed evidence of atypical brain maturation involving globally lower cortical thickness and surface coupled with higher myelination and neural density. Subtype 1 had superior cognitive function in contrast to the other two subtypes that underperformed compared to the typically developing group. Higher levels of parental psychopathology, family conflict, and social adversity were common to all subtypes, with subtype 3 having the highest burden of adverse exposures. These analyses comprehensively characterize pre-adolescent mood and anxiety disorders, the biopsychosocial context in which they arise, and lay the foundation for the examination of the longitudinal evolution of the subtypes identified as the study sample transitions through adolescence.
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Affiliation(s)
- Ruiyang Ge
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Roberto Sassi
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital, Vancouver, BC, Canada
| | - Lakshmi N Yatham
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Sophia Frangou
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. .,Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. .,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Associations between cortical thickness and anxious/depressive symptoms differ by the quality of early care. Dev Psychopathol 2023; 35:73-84. [PMID: 35045914 PMCID: PMC9023591 DOI: 10.1017/s0954579421000845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A variety of childhood experiences can lead to anxious/depressed (A/D) symptoms. The aim of the present study was to explore the brain morphological (cortical thickness and surface area) correlates of A/D symptoms and the extent to which these phenotypes vary depending on the quality of the parenting context in which children develop. Structural magnetic resonance imaging (MRI) scans were acquired on 45 children with Child Protective Services (CPS) involvement due to risk of not receiving adequate care (high-risk group) and 25 children without CPS involvement (low-risk group) (rangeage = 8.08-12.14; Mage = 10.05) to assess cortical thickness (CT) and cortical surface area (SA). A/D symptoms were measured using the Child Behavioral Checklist. The association between A/D symptoms and CT, but not SA, differed by risk status such that high-risk children showed decreasing CT as A/D scores increased, whereas low-risk children showed increasing CT as A/D scores increased. This interaction was specific to CT in prefrontal, frontal, temporal, and parietal cortical regions. The groups had marginally different A/D scores, in the direction of higher risk being associated with lower A/D scores. Results suggest that CT correlates of A/D symptoms are differentially shaped by the quality of early caregiving experiences and should be distinguished between high- and low-risk children.
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Gonsalves MA, Beck QM, Fukuda AM, Tirrell E, Kokdere F, Kronenberg EF, Iadarola ND, Hagberg S, Carpenter LL, Barredo J. Mechanical Affective Touch Therapy for Anxiety Disorders: Effects on Resting State Functional Connectivity. Neuromodulation 2022; 25:1431-1442. [PMID: 35088729 PMCID: PMC9256848 DOI: 10.1016/j.neurom.2021.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 09/08/2021] [Accepted: 09/27/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Mechanical Affective Touch Therapy (MATT) is a safe, novel form of noninvasive peripheral nerve stimulation. Although mechanical stimulation activates nerves, we know little about its impact on psychiatric symptoms and their underlying cortical mechanisms. We examined the effects of open-label MATT on resting state functional connectivity (RSFC) and its relationship with anxiety and affective symptomatology (clinical results in separate report). MATERIALS AND METHODS A total of 22 adults with an Axis I anxiety disorder were recruited from the community. After two initial sessions assisted by research staff, participants self-administered 20-minute sessions of MATT at home at least twice daily for four weeks. Self-report measures of mood and anxiety severity were collected at baseline, two weeks, and four weeks. Resting state functional magnetic resonance imaging was collected before the initial MATT session (n = 20), immediately after the first session (n = 18), and following four weeks of MATT (n = 14). Seed-based whole-brain functional connectivity analyses identified brain connectivity patterns correlated with responsiveness to MATT. Seeds were based on Neurosynth meta-analytic maps for "anxiety" and "pain" given MATT's hypothesized role in anxiety symptom amelioration and potential mechanism of action through C-tactile afferents, which play an important role in detecting pain and its affective components. Connectivity results were corrected for multiple comparisons (voxel p < 0.005, cluster p-FDR < 0.05). RESULTS Baseline RSFC is predictive of symptom improvement with chronic MATT. Acute increases in insula connectivity were observed between mid-cingulate cortex and postcentral motor regions following the first MATT session. Chronic MATT was associated with increased connectivity between pain and anxiety regions of interest (ROIs) and posterior default mode network (DMN) regions involved in memory and self-reflection; the connectivity changes correlated with decreases in stress and depression symptoms. CONCLUSIONS MATT is associated with alterations in RSFC in the DMN of anxiety disorder patients both acutely and after long-term administration, and baseline RSFC is predictive of post-treatment symptom improvement.
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Affiliation(s)
- Meghan A Gonsalves
- Neuroscience Graduate Program, Department of Neuroscience, Brown University, Providence, RI, USA; Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Providence, RI, USA.
| | - Quincy M Beck
- Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Providence, RI, USA
| | - Andrew M Fukuda
- Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Providence, RI, USA; Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Eric Tirrell
- Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Providence, RI, USA
| | - Fatih Kokdere
- Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Providence, RI, USA; Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Eugenia F Kronenberg
- Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Providence, RI, USA
| | - Nicolas D Iadarola
- Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Providence, RI, USA; University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Sean Hagberg
- AffectNeuro, Inc, Brooklyn, NY, USA; Department of Neurosurgery, School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Linda L Carpenter
- Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Providence, RI, USA; Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Jennifer Barredo
- Butler Hospital Mood Disorders Research Program and Neuromodulation Research Facility, Providence, RI, USA; Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA; Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, RI, USA
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Wang R, Mo F, Shen Y, Song Y, Cai H, Zhu J. Functional connectivity gradients of the insula to different cerebral systems. Hum Brain Mapp 2022; 44:790-800. [PMID: 36206289 PMCID: PMC9842882 DOI: 10.1002/hbm.26099] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/16/2022] [Accepted: 09/24/2022] [Indexed: 01/25/2023] Open
Abstract
The diverse functional roles of the insula may emerge from its heavy connectivity to an extensive network of cortical and subcortical areas. Despite several previous attempts to investigate the hierarchical organization of the insula by applying the recently developed gradient approach to insula-to-whole brain connectivity data, little is known about whether and how there is variability across connectivity gradients of the insula to different cerebral systems. Resting-state functional MRI data from 793 healthy subjects were used to discover and validate functional connectivity gradients of the insula, which were computed based on its voxel-wise functional connectivity profiles to distinct cerebral systems. We identified three primary patterns of functional connectivity gradients of the insula to distinct cerebral systems. The connectivity gradients to the higher-order transmodal associative systems, including the prefrontal, posterior parietal, temporal cortices, and limbic lobule, showed a ventroanterior-dorsal axis across the insula; those to the lower-order unimodal primary systems, including the motor, somatosensory, and occipital cortices, displayed radiating transitions from dorsoanterior toward both ventroanterior and dorsoposterior parts of the insula; the connectivity gradient to the subcortical nuclei exhibited an organization along the anterior-posterior axis of the insula. Apart from complementing and extending previous literature on the heterogeneous connectivity patterns of insula subregions, the presented framework may offer ample opportunities to refine our understanding of the role of the insula in many brain disorders.
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Affiliation(s)
- Rui Wang
- Department of RadiologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina,Research Center of Clinical Medical Imaging, Anhui ProvinceHefeiChina,Anhui Provincial Institute of Translational MedicineHefeiChina
| | - Fan Mo
- Department of RadiologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina,Research Center of Clinical Medical Imaging, Anhui ProvinceHefeiChina,Anhui Provincial Institute of Translational MedicineHefeiChina
| | - Yuhao Shen
- Department of RadiologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina,Research Center of Clinical Medical Imaging, Anhui ProvinceHefeiChina,Anhui Provincial Institute of Translational MedicineHefeiChina
| | - Yu Song
- Department of RadiologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina,Research Center of Clinical Medical Imaging, Anhui ProvinceHefeiChina,Anhui Provincial Institute of Translational MedicineHefeiChina
| | - Huanhuan Cai
- Department of RadiologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina,Research Center of Clinical Medical Imaging, Anhui ProvinceHefeiChina,Anhui Provincial Institute of Translational MedicineHefeiChina
| | - Jiajia Zhu
- Department of RadiologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina,Research Center of Clinical Medical Imaging, Anhui ProvinceHefeiChina,Anhui Provincial Institute of Translational MedicineHefeiChina
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Sobral M, Morgado S, Moreira H, Guiomar R, Ganho-Ávila A. Association between cortical thickness and anxiety measures: A scoping review. Psychiatry Res Neuroimaging 2022; 319:111423. [PMID: 34896960 DOI: 10.1016/j.pscychresns.2021.111423] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 10/19/2021] [Accepted: 11/05/2021] [Indexed: 11/17/2022]
Abstract
Cortical thickness has been increasingly studied in the context of structural-brain-behavior associations, such as anxiety; however, the literature is scattered across methods and research fields. This scoping review aims to summarize the available data concerning the association between cortical thickness and anxiety-related measures and identify the current research gaps. Searches were conducted in PubMed, PsycINFO/PsycARTICLES, Web of Science, OpenGrey and Networked Digital Library of Theses and Dissertations, and reference lists of key studies. Two researchers independently screened the abstracts and full-text reports according to the eligibility criteria, as well as extracted and charted the data. Quantitative and descriptive syntheses were conducted. The included publications (n = 18) reported cross-sectional studies, and 17 used surface-based approaches to estimate cortical thickness. Differences in regional cortical thickness were found to be associated with different anxiety-related measures/processes. Brain regions of interest include the medial orbitofrontal cortex, the ventromedial prefrontal cortex, the insula, the temporo-parietal areas, and the anterior cingulate cortex. However, caution should be warranted when interpreting the available results, as there is high variability in the field across anxiety-related measures, distinctive anxiety disorders, and data processing conditions and analysis. More research into this association is needed, to replicate and clarify existing findings.
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Affiliation(s)
- Mónica Sobral
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
| | - Sara Morgado
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Helena Moreira
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Raquel Guiomar
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Ana Ganho-Ávila
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
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Zugman A, Winkler AM, Pine DS. Recent advances in understanding neural correlates of anxiety disorders in children and adolescents. Curr Opin Psychiatry 2021; 34:617-623. [PMID: 34475352 PMCID: PMC8490291 DOI: 10.1097/yco.0000000000000743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW Anxiety disorders are some of the most common psychiatric diagnoses in children and adolescents, but attempts to improve outcome prediction and treatment have stalled. This review highlights recent findings on neural indices related to fear and anxiety that provide novel directions for attempts to create such improvements. RECENT FINDINGS Stimuli capable of provoking fear engage many brain regions, including the amygdala, medial prefrontal cortex, hippocampus, and bed nucleus of the stria terminalis. Studies in rodents suggest that sustained, low-level threats are particularly likely to engage the bed nucleus of the stria terminalis, which appears to malfunction in anxiety disorders. However, anxiety disorders, like most mental illnesses, appear less likely to arise from alterations in isolated brain regions than in distributed brain circuitry. Findings from large-scale studies of brain connectivity may reveal signs of such broadly distributed dysfunction, though available studies report small effect sizes. Finally, we review novel approaches with promise for using such large-scale data to detect clinically relevant, broadly distributed circuitry dysfunction. SUMMARY Recent work maps neural circuitry related to fear and anxiety. This circuitry may malfunction in anxiety disorders. Integrating findings from animal studies, big datasets, and novel analytical approaches may generate clinically relevant insights based on this recent work.
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Affiliation(s)
- Andre Zugman
- Section on Development and Affective Neuroscience, Emotion and Development Branch. National Institute of Mental Health, National Institutes of Health - Bethesda, MD
| | - Anderson M. Winkler
- Section on Development and Affective Neuroscience, Emotion and Development Branch. National Institute of Mental Health, National Institutes of Health - Bethesda, MD
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch. National Institute of Mental Health, National Institutes of Health - Bethesda, MD
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Collins MA, Chung Y, Addington J, Bearden CE, Cadenhead KS, Cornblatt BA, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Cannon TD. Discriminatory experiences predict neuroanatomical changes and anxiety among healthy individuals and those at clinical high risk for psychosis. Neuroimage Clin 2021; 31:102757. [PMID: 34273790 PMCID: PMC8283423 DOI: 10.1016/j.nicl.2021.102757] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/23/2021] [Accepted: 07/03/2021] [Indexed: 01/14/2023]
Abstract
Individuals face discrimination based on characteristics including race/ethnicity, gender, age, and disability. Discriminatory experiences (DE) are associated with poor psychological health in the general population and with worse outcomes among individuals at clinical high risk for psychosis (CHR). Though the brain is sensitive to stress, and brain structural change is a well-documented precursor to psychosis, potential relationships between DE and brain structure among CHR or healthy individuals are not known. This report assessed whether lifetime DE are associated with cortical thinning and clinical outcomes across time, after controlling for discrimination-related demographic factors among CHR individuals who ultimately do (N = 57) and do not convert to psychosis (N = 451), and healthy comparison (N = 208) participants in the North American Prodrome Longitudinal Study 2. Results indicate that DE are associated with thinner cortex across time in several cortical areas. Thickness in several right hemisphere regions partially mediates associations between DE and subsequent anxiety symptoms, but not attenuated positive symptoms of psychosis. This report provides the first evidence to date of an association between DE and brain structure in both CHR and healthy comparison individuals. Results also suggest that thinner cortex across time in areas linked with DE may partially explain associations between DE and cross-diagnostic indicators of psychological distress.
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Affiliation(s)
| | - Yoonho Chung
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Belmont, MA, USA
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior & Department of Psychology, University of California, Los Angeles, USA
| | | | | | - Daniel H Mathalon
- Department of Psychiatry, University of California, San Francisco, USA; San Francisco VA Medical Center, San Francisco, CA, USA
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, USA
| | - Larry J Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ming T Tsuang
- Department of Psychiatry, University of California, San Diego, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA; Department of Psychiatry, Yale University, New Haven, CT, USA
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