1
|
Caspani G, Ruffell SGD, Tsang W, Netzband N, Rohani-Shukla C, Swann JR, Jefferies WA. Mind over matter: the microbial mindscapes of psychedelics and the gut-brain axis. Pharmacol Res 2024; 207:107338. [PMID: 39111558 DOI: 10.1016/j.phrs.2024.107338] [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: 07/16/2024] [Revised: 07/31/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024]
Abstract
Psychedelics have emerged as promising therapeutics for several psychiatric disorders. Hypotheses around their mechanisms have revolved around their partial agonism at the serotonin 2 A receptor, leading to enhanced neuroplasticity and brain connectivity changes that underlie positive mindset shifts. However, these accounts fail to recognise that the gut microbiota, acting via the gut-brain axis, may also have a role in mediating the positive effects of psychedelics on behaviour. In this review, we present existing evidence that the composition of the gut microbiota may be responsive to psychedelic drugs, and in turn, that the effect of psychedelics could be modulated by microbial metabolism. We discuss various alternative mechanistic models and emphasize the importance of incorporating hypotheses that address the contributions of the microbiome in future research. Awareness of the microbial contribution to psychedelic action has the potential to significantly shape clinical practice, for example, by allowing personalised psychedelic therapies based on the heterogeneity of the gut microbiota.
Collapse
Affiliation(s)
- Giorgia Caspani
- Michael Smith Laboratories, University of British Columbia, 2185 East Mall, East Mall, BC V6T 1Z4, Canada; Department of Microbiology and Immunology, University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC V6T 1Z4, Canada; Centre for Blood Research, University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC V6T 1Z4, Canada; The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z4, Canada; The Vancouver Prostate Centre, Vancouver General Hospital, 2660 Oak Street, Vancouver, BC V6H 3Z6, Canada; Department of Medical Genetics, University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC V6T 1Z4, Canada; Department of Urologic Sciences, University of British Columbia, Gordon & Leslie Diamond Health Care Centre, Level 6, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada.
| | - Simon G D Ruffell
- Psychae Institute, Melbourne, Australia; School of Population and Global Health, University of Melbourne, 207 Bouverie St, Carlton, VIC 3053, Australia
| | - WaiFung Tsang
- Institute of Psychiatry, Psychology & Neuroscience, King'sCollege London, Department of Psychology, De Crespigny Park, London SE5 8AF, UK
| | - Nigel Netzband
- University of West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, UK
| | - Cyrus Rohani-Shukla
- Centre for Psychedelic Research, Imperial College London, Hammersmith Hospital, Du Cane Rd, London W12 0HS, UK
| | - Jonathan R Swann
- School of Human Development and Health, Faculty of Medicine, University of Southampton, 12 University Rd, Southampton SO17 1BJ, UK; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Wilfred A Jefferies
- Michael Smith Laboratories, University of British Columbia, 2185 East Mall, East Mall, BC V6T 1Z4, Canada; Department of Microbiology and Immunology, University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC V6T 1Z4, Canada; Centre for Blood Research, University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC V6T 1Z4, Canada; The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z4, Canada; The Vancouver Prostate Centre, Vancouver General Hospital, 2660 Oak Street, Vancouver, BC V6H 3Z6, Canada; Department of Medical Genetics, University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC V6T 1Z4, Canada; Department of Urologic Sciences, University of British Columbia, Gordon & Leslie Diamond Health Care Centre, Level 6, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada.
| |
Collapse
|
2
|
Berchio C, Kumar SS, Micali N. EEG Spatial-temporal Dynamics of Resting-state Activity in Young Women with Anorexia Nervosa: Preliminary Evidence. Brain Topogr 2024; 37:447-460. [PMID: 37615798 DOI: 10.1007/s10548-023-01001-7] [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: 05/12/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023]
Abstract
The aim of this study was to provide preliminary evidence on temporal dynamics of resting-state brain networks in youth with anorexia nervosa (AN) using electroencephalography (EEG). Resting-state EEG data were collected in 18 young women with AN and 18 healthy controls (HC). Between-group differences in brain networks were assessed using microstates analyses. Five microstates were identified across all subjects (A, B, C, D, E). Using a single set of maps representative of the whole dataset, group differences were identified for microstates A, C, and E. A common-for-all template revealed a relatively high degree of consistency in results for reduced time coverage of microstate C, but also an increased presence of microstate class E. AN and HC had different microstate transition probabilities, largely involving microstate A. Using LORETA, for microstate D, we found that those with AN had augmented activations in the left frontal inferior operculum, left insula, and bilateral paracentral lobule, compared with HC. For microstate E, AN had augmented activations in the para-hippocampal gyrus, caudate, pallidum, cerebellum, and cerebellar vermis. Our findings suggest altered microstates in young women with AN associated with integration of sensory and bodily signals, monitoring of internal/external mental states, and self-referential processes. Future research should examine how EEG-derived microstates could be applied to develop diagnostic and prognostic models of AN.
Collapse
Affiliation(s)
- Cristina Berchio
- Group of Psychiatric Neuroscience, Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Piazza Giulio Cesare, 11, 70121, Bari, Italy.
| | - Samika S Kumar
- Department of Psychology, University of Cambridge, Cambridge, UK
- Section on Functional Imaging Methods, Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD, USA
| | - Nadia Micali
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Centre Ballerup, Ballerup, Denmark
- Institute of biological Psychiatry, Psykiatrisk Center Sct. Hans, Region Hovedstaden, Denmark
| |
Collapse
|
3
|
Sudo Y, Ota J, Takamura T, Kamashita R, Hamatani S, Numata N, Chhatkuli RB, Yoshida T, Takahashi J, Kitagawa H, Matsumoto K, Masuda Y, Nakazato M, Sato Y, Hamamoto Y, Shoji T, Muratsubaki T, Sugiura M, Fukudo S, Kawabata M, Sunada M, Noda T, Tose K, Isobe M, Kodama N, Kakeda S, Takahashi M, Takakura S, Gondo M, Yoshihara K, Moriguchi Y, Shimizu E, Sekiguchi A, Hirano Y. Comprehensive elucidation of resting-state functional connectivity in anorexia nervosa by a multicenter cross-sectional study. Psychol Med 2024:1-14. [PMID: 38500410 DOI: 10.1017/s0033291724000485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
BACKGROUND Previous research on the changes in resting-state functional connectivity (rsFC) in anorexia nervosa (AN) has been limited by an insufficient sample size, which reduced the reliability of the results and made it difficult to set the whole brain as regions of interest (ROIs). METHODS We analyzed functional magnetic resonance imaging data from 114 female AN patients and 135 healthy controls (HC) and obtained self-reported psychological scales, including eating disorder examination questionnaire 6.0. One hundred sixty-four cortical, subcortical, cerebellar, and network parcellation regions were considered as ROIs. We calculated the ROI-to-ROI rsFCs and performed group comparisons. RESULTS Compared to HC, AN patients showed 12 stronger rsFCs mainly in regions containing dorsolateral prefrontal cortex (DLPFC), and 33 weaker rsFCs primarily in regions containing cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between anterior cingulate cortex (ACC) and thalamus (p < 0.01, false discovery rate [FDR] correction). Comparisons between AN subtypes showed that there were stronger rsFCs between right lingual gyrus and right supracalcarine cortex and between left temporal occipital fusiform cortex and medial part of visual network in the restricting type compared to the binge/purging type (p < 0.01, FDR correction). CONCLUSION Stronger rsFCs in regions containing mainly DLPFC, and weaker rsFCs in regions containing primarily cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between ACC and thalamus, may represent categorical diagnostic markers discriminating AN patients from HC.
Collapse
Affiliation(s)
- Yusuke Sudo
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Department of Cognitive Behavioral Physiology, Chiba University, Chiba, Japan
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Junko Ota
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Tsunehiko Takamura
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Rio Kamashita
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Sayo Hamatani
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
- Research Center for Child Mental Development, Fukui University, Eiheizi, Japan
| | - Noriko Numata
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Ritu Bhusal Chhatkuli
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Tokiko Yoshida
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Jumpei Takahashi
- Department of Psychiatry, Chiba Aoba Municipal Hospital, Chiba, Japan
| | - Hitomi Kitagawa
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Koji Matsumoto
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Yoshitada Masuda
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Michiko Nakazato
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Yasuhiro Sato
- Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan
| | - Yumi Hamamoto
- Department of Psychology, Northumbria University, Newcastle-upon-Tyne, UK
- Department of Human Brain Science, Institute of Development, Aging, and Cancer, Tohoku University, Sendai, Japan
| | - Tomotaka Shoji
- Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan
- Department of Internal Medicine, Nagamachi Hospital, Sendai, Japan
- Department of Psychosomatic Medicine, Tohoku University School of Medicine, Sendai, Japan
| | - Tomohiko Muratsubaki
- Department of Psychosomatic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Motoaki Sugiura
- Department of Human Brain Science, Institute of Development, Aging, and Cancer, Tohoku University, Sendai, Japan
- Cognitive Sciences Lab, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Shin Fukudo
- Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan
- Department of Psychosomatic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Michiko Kawabata
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Momo Sunada
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomomi Noda
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keima Tose
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masanori Isobe
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naoki Kodama
- Division of Psychosomatic Medicine, Department of Neurology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shingo Kakeda
- Department of Radiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masatoshi Takahashi
- Division of Psychosomatic Medicine, Department of Neurology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shu Takakura
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Motoharu Gondo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Kazufumi Yoshihara
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yoshiya Moriguchi
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Department of Cognitive Behavioral Physiology, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Atsushi Sekiguchi
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Center for Eating Disorder Research and Information, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| |
Collapse
|
4
|
Thapaliya G, Eldeghaidy S, Radford SJ, Francis ST, Moran GW. An examination of resting-state functional connectivity in patients with active Crohn's disease. Front Neurosci 2023; 17:1265815. [PMID: 38125406 PMCID: PMC10731262 DOI: 10.3389/fnins.2023.1265815] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Background Alterations in resting state functional connectivity (rs-FC) in Crohn's Disease (CD) have been documented in default mode network (DMN) and frontal parietal network (FPN) areas, visual, cerebellar, salience and attention resting-state-networks (RSNs), constituting a CD specific neural phenotype. To date, most studies are in patients in remission, with limited studies in active disease. Methods Twenty five active CD cases and 25 age-, BMI- and gender-matched healthy controls (HC) were recruited to a resting-state-functional Magnetic Resonance Imaging (rs-fMRI) study. Active disease was defined as C-reactive protein>5 mg/dL, faecal calprotectin>250 μg/g, or through ileocolonoscopy or MRE. rs-fMRI data were analysed using independent component analysis (ICA) and dual regression. Differences in RSNs between HCs and active CD were assessed, and rs-FC was associated with disease duration and abdominal pain. Results Increased connectivity in the FPN (fusiform gyrus, thalamus, caudate, posterior cingulate cortex, postcentral gyrus) and visual RSN (orbital frontal cortex) were observed in CD versus HC. Decreased activity was observed in the salience network (cerebellum, postcentral gyrus), DMN (parahippocampal gyrus, cerebellum), and cerebellar network (occipital fusiform gyrus, cerebellum) in CD versus HCs. Greater abdominal pain scores were associated with lower connectivity in the precuneus (visual network) and parietal operculum (salience network), and higher connectivity in the cerebellum (frontal network). Greater disease duration was associated with greater connectivity in the middle temporal gyrus and planum temporale (visual network). Conclusion Alterations in rs-FC in active CD in RSNs implicated in cognition, attention, emotion, and pain may represent neural correlates of chronic systemic inflammation, abdominal pain, disease duration, and severity.
Collapse
Affiliation(s)
- Gita Thapaliya
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Sally Eldeghaidy
- Division of Food, Nutrition and Dietetics, School of Biosciences, The University of Nottingham, Loughborough, United Kingdom
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and School of Medicine, The University of Nottingham, Nottingham, United Kingdom
| | - Shellie J. Radford
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and School of Medicine, The University of Nottingham, Nottingham, United Kingdom
| | - Susan T. Francis
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and School of Medicine, The University of Nottingham, Nottingham, United Kingdom
| | - Gordon William Moran
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and School of Medicine, The University of Nottingham, Nottingham, United Kingdom
- Translational Medical Sciences Unit, University of Nottingham, Nottingham, United Kingdom
| |
Collapse
|
5
|
Miles S, Nedeljkovic M, Phillipou A. Investigating differences in cognitive flexibility, clinical perfectionism, and eating disorder-specific rumination across anorexia nervosa illness states. Eat Disord 2023; 31:610-631. [PMID: 37128671 DOI: 10.1080/10640266.2023.2206751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
INTRODUCTION Cognitive inflexibility, clinical perfectionism, and eating disorder (ED)-specific rumination are common characteristics reported in anorexia nervosa (AN) and may contribute to the maintenance of the illness. It is suggested that clinical perfectionism and rumination may mediate the relationship between cognitive flexibility and AN pathology; however, research to date has not investigated all these factors together. The aim of the current study was to explore the relationships between these factors and how they may relate to ED symptoms in AN. METHODS Participants included 15 women with a current diagnosis of AN, 12 women who had a past diagnosis of AN and were currently weight-restored, and 15 healthy controls (HCs). RESULTS The results revealed that participants with both acute and weight-restored AN self-reported poorer cognitive flexibility than HCs, but the groups did not differ in performance on objective assessments of cognitive flexibility. Participants with AN also reported significantly greater clinical perfectionism and ED-specific rumination than HC. A parallel mediation analysis found that ED-specific rumination mediated the relationship between subjective cognitive flexibility and ED symptoms. Further, subjective cognitive flexibility directly influenced ED symptoms. However, the mediation model was not significant for objective cognitive flexibility. CONCLUSION The findings of this study have implications for potential treatment barriers and factors which might contribute to the risk of relapse.
Collapse
Affiliation(s)
- Stephanie Miles
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Maja Nedeljkovic
- Centre for Mental Health & Brain Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Andrea Phillipou
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
- Department of Mental Health, St Vincent's Hospital, Melbourne, Australia
- Department of Mental Health, Austin Health, Melbourne, Australia
| |
Collapse
|
6
|
De la Cruz F, Teed AR, Lapidus RC, Upshaw V, Schumann A, Paulus MP, Bär KJ, Khalsa SS. Central Autonomic Network Alterations in Anorexia Nervosa Following Peripheral Adrenergic Stimulation. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:720-730. [PMID: 37055325 PMCID: PMC10285030 DOI: 10.1016/j.bpsc.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Anorexia nervosa (AN) is characterized by low body weight, disturbed eating, body image disturbance, anxiety, and interoceptive dysfunction. However, the neural processes underlying these dysfunctions in AN are unclear. This investigation combined an interoceptive pharmacological probe, the peripheral β-adrenergic agonist isoproterenol, with resting-state functional magnetic resonance imaging to examine whether individuals with AN relative to healthy comparison participants show dysregulated neural coupling in central autonomic network brain regions. METHODS Resting-state functional magnetic resonance imaging was performed in 23 weight-restored female participants with AN and 23 age- and body mass index-matched healthy comparison participants before and after receiving isoproterenol infusions. Whole-brain functional connectivity (FC) changes were examined using central autonomic network seeds in the amygdala, anterior insular cortex, posterior cingulate cortex, and ventromedial prefrontal cortex after performing physiological noise correction procedures. RESULTS Relative to healthy comparison participants, adrenergic stimulation caused widespread FC reductions in the AN group between central autonomic network regions and motor, premotor, frontal, parietal, and visual brain regions. Across both groups, these FC changes were inversely associated with trait anxiety (State-Trait Anxiety Inventory-Trait), trait depression (9-item Patient Health Questionnaire), and negative body image perception (Body Shape Questionnaire) measures, but not with changes in resting heart rate. These results were not accounted for by baseline group FC differences. CONCLUSIONS Weight-restored females with AN show a widespread state-dependent disruption of signaling between central autonomic, frontoparietal, and sensorimotor brain networks that facilitate interoceptive representation and visceromotor regulation. Additionally, trait associations between central autonomic network regions and these other brain networks suggest that dysfunctional processing of interoceptive signaling may contribute to affective and body image disturbance in AN.
Collapse
Affiliation(s)
- Feliberto De la Cruz
- Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Adam R Teed
- Laureate Institute for Brain Research, Tulsa, Oklahoma
| | - Rachel C Lapidus
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Eating Disorders Center for Treatment and Research, University of California San Diego, San Diego, California
| | | | - Andy Schumann
- Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma
| | - Karl-Jürgen Bär
- Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma.
| |
Collapse
|
7
|
Dai YR, Wu YK, Chen X, Zeng YW, Li K, Li JT, Su YA, Zhu LL, Yan CG, Si TM. Eight-week antidepressant treatment changes intrinsic functional brain topology in first-episode drug-naïve patients with major depressive disorder. J Affect Disord 2023; 329:225-234. [PMID: 36858265 DOI: 10.1016/j.jad.2023.02.126] [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: 11/15/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND A recent study revealed disrupted topological organization of whole-brain networks in patients with major depressive disorder (MDD); however, these results were mostly driven by recurrent MDD patients, rather than first-episode drug-naïve (FEDN) patients. Furthermore, few longitudinal studies have explored the effects of antidepressant therapy on the topological organization of whole-brain networks. METHODS We collected clinical and neuroimaging data from 159 FEDN MDD patients and 152 normal controls (NCs). A total of 115 MDD patients completed an eight-week antidepressant treatment procedure. Topological features of brain networks were calculated using graph theory-based methods and compared between FEDN MDD patients and NCs, as well as before and after treatment. RESULTS Decreased global efficiency, local efficiency, small-worldness, and modularity were found in pretreatment FEDN MDD patients compared with NCs. Nodal degrees, betweenness, and efficiency decreased in several networks compared with NCs. After antidepressant treatment, the global efficiency increased, while the local efficiency, the clustering coefficient of the network, the path length, and the normalized characteristic path length decreased. Moreover, the reduction rate of the normalized characteristic path length was positively correlated with the reduction rate of retardation factor scores. LIMITATIONS The interaction effects of groups and time on the topological features were not explored because of absence of the eighth-week data of NC group. CONCLUSIONS The topological architecture of functional brain networks is disrupted in FEDN MDD patients. After antidepressant therapy, the global efficiency shifted toward recovery, but the local efficiency deteriorated, suggesting a correlation between recovery of retardation symptoms and global efficiency.
Collapse
Affiliation(s)
- You-Ran Dai
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Yan-Kun Wu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Xiao Chen
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
| | - Ya-Wei Zeng
- PLA Strategic support Force Characteristic Medical Center, Beijing 100101, China
| | - Ke Li
- PLA Strategic support Force Characteristic Medical Center, Beijing 100101, China
| | - Ji-Tao Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Yun-Ai Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Lin-Lin Zhu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
| | - Chao-Gan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
| | - Tian-Mei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
| |
Collapse
|
8
|
Kaufmann LK, Hänggi J, Jäncke L, Baur V, Piccirelli M, Kollias S, Schnyder U, Martin-Soelch C, Milos G. Disrupted longitudinal restoration of brain connectivity during weight normalization in severe anorexia nervosa. Transl Psychiatry 2023; 13:136. [PMID: 37117179 PMCID: PMC10147636 DOI: 10.1038/s41398-023-02428-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/03/2023] [Accepted: 04/06/2023] [Indexed: 04/30/2023] Open
Abstract
Altered intrinsic brain connectivity of patients with anorexia nervosa has been observed in the acute phase of the disorder, but it remains unclear to what extent these alterations recover during weight normalization. In this study, we used functional imaging data from three time points to probe longitudinal changes in intrinsic connectivity patterns in patients with severe anorexia nervosa (BMI ≤ 15.5 kg/m2) over the course of weight normalization. At three distinct stages of inpatient treatment, we examined resting-state functional connectivity in 27 women with severe anorexia nervosa and 40 closely matched healthy controls. Using network-based statistics and graph-theoretic measures, we examined differences in global network strength, subnetworks with altered intrinsic connectivity, and global network topology. Patients with severe anorexia nervosa showed weakened intrinsic connectivity and altered network topology which did not recover during treatment. The persistent disruption of brain networks suggests sustained alterations of information processing in weight-recovered severe anorexia nervosa.
Collapse
Affiliation(s)
- Lisa-Katrin Kaufmann
- Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland.
| | - Jürgen Hänggi
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) "Dynamic of Healthy Aging", University of Zurich, Zurich, Switzerland
| | - Volker Baur
- Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Spyros Kollias
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Chantal Martin-Soelch
- Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Gabriella Milos
- Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
9
|
Elwyn R, Mitchell J, Kohn MR, Driver C, Hay P, Lagopoulos J, Hermens DF. Novel ketamine and zinc treatment for anorexia nervosa and the potential beneficial interactions with the gut microbiome. Neurosci Biobehav Rev 2023; 148:105122. [PMID: 36907256 DOI: 10.1016/j.neubiorev.2023.105122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/04/2023] [Accepted: 03/07/2023] [Indexed: 03/13/2023]
Abstract
Anorexia nervosa (AN) is a severe illness with diverse aetiological and maintaining contributors including neurobiological, metabolic, psychological, and social determining factors. In addition to nutritional recovery, multiple psychological and pharmacological therapies and brain-based stimulations have been explored; however, existing treatments have limited efficacy. This paper outlines a neurobiological model of glutamatergic and γ-aminobutyric acid (GABA)-ergic dysfunction, exacerbated by chronic gut microbiome dysbiosis and zinc depletion at a brain and gut level. The gut microbiome is established early in development, and early exposure to stress and adversity contribute to gut microbial disturbance in AN, early dysregulation to glutamatergic and GABAergic networks, interoceptive impairment, and inhibited caloric harvest from food (e.g., zinc malabsorption, competition for zinc ions between gut bacteria and host). Zinc is a key part of glutamatergic and GABAergic networks, and also affects leptin and gut microbial function; systems dysregulated in AN. Low doses of ketamine in conjunction with zinc, could provide an efficacious combination to act on NMDA receptors and normalise glutamatergic, GABAergic and gut function in AN.
Collapse
Affiliation(s)
- Rosiel Elwyn
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia; SouthWest Sydney Local Health District, Liverpool Hospital, Liverpool, NSW, Australia.
| | - Jules Mitchell
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia; SouthWest Sydney Local Health District, Liverpool Hospital, Liverpool, NSW, Australia
| | - Michael R Kohn
- AYA Medicine Westmead Hospital, CRASH (Centre for Research into Adolescent's Health) Western Sydney Local Health District, Sydney University, Australia; SouthWest Sydney Local Health District, Liverpool Hospital, Liverpool, NSW, Australia
| | - Christina Driver
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia; SouthWest Sydney Local Health District, Liverpool Hospital, Liverpool, NSW, Australia
| | - Phillipa Hay
- Translational Health Research Institute (THRI) School of Medicine, Western Sydney University, Campbelltown, NSW, Australia; SouthWest Sydney Local Health District, Liverpool Hospital, Liverpool, NSW, Australia
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia; SouthWest Sydney Local Health District, Liverpool Hospital, Liverpool, NSW, Australia
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia; SouthWest Sydney Local Health District, Liverpool Hospital, Liverpool, NSW, Australia
| |
Collapse
|
10
|
Via E, Calvo A, de la Serna E, Blázquez A, Lázaro L, Andrés-Perpiñá S, Plana MT, Flamarique I, Martínez E, Pariente J, Moreno E, Bargallo N, Castro-Fornieles J. Longitudinal study in adolescent anorexia nervosa: evaluation of cortico-striatal and default mode network resting-state brain circuits. Eur Child Adolesc Psychiatry 2023; 32:513-526. [PMID: 34604924 DOI: 10.1007/s00787-021-01880-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
Anorexia nervosa (AN) typically emerges in adolescence. The cortico-striatal system (CSTS) and the default mode network (DMN) are brain circuits with a crucial development during this period. These circuits underlie cognitive functions that are impaired in AN, such as cognitive flexibility and inhibition, among others. Little is known about their involvement in adolescent AN and how weight and symptom improvement might modulate potential alterations in these circuits. Forty-seven adolescent females (30 AN, 17 healthy control) were clinically/neuropsychologically evaluated and scanned during a 3T-MRI resting-state session on two occasions, before and after a 6-month multidisciplinary treatment of the AN patients. Baseline and baseline-to-follow-up between-group differences in CSTS and DMN resting-state connectivity were evaluated, as well as their association with clinical/neuropsychological variables. Increased connectivity between the left dorsal putamen and the left precuneus was found in AN at baseline. At follow-up, body mass index and clinical symptoms had improved in the AN group. An interaction effect was found in the connectivity between the right dorsal caudate to right mid-anterior insular cortex, with lower baseline AN connectivity that improved at follow-up; this improvement was weakly associated with changes in neuropsychological (Stroop test) performance. These results support the presence of CSTS connectivity alterations in adolescents with AN, which improve with weight and symptom improvement. In addition, at the level of caudate-insula connectivity, they might be associated with inhibitory processing performance. Alterations in CSTS pathways might be involved in AN from the early stages of the disorder.
Collapse
Affiliation(s)
- Esther Via
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain.
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
- Mental Health Department, Unitat de Neurociència Traslacional, Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Anna Calvo
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Anna Blázquez
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Luisa Lázaro
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Susana Andrés-Perpiñá
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - María Teresa Plana
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Itziar Flamarique
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Esteve Martínez
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Jose Pariente
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena Moreno
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Nuria Bargallo
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Image Diagnostic Center, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| |
Collapse
|
11
|
Chen Z, Feng T. Neural connectome features of procrastination: Current progress and future direction. Brain Cogn 2022; 161:105882. [PMID: 35679698 DOI: 10.1016/j.bandc.2022.105882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 11/02/2022]
Abstract
Procrastination refers to an irrationally delay for intended courses of action despite of anticipating a negative consequence due to this delay. Previous studies tried to reveal the neural substrates of procrastination in terms of connectome-based biomarkers. Based on this, we proposed a unified triple brain network model for procrastination and pinpointed out what challenges we are facing in understanding neural mechanism of procrastination. Specifically, based on neuroanatomical features, the unified triple brain network model proposed that connectome-based underpinning of procrastination could be ascribed to the abnormalities of self-control network (i.e., dorsolateral prefrontal cortex, DLPFC), emotion-regulation network (i.e., orbital frontal cortex, OFC), and episodic prospection network (i.e., para-hippocampus cortex, PHC). Moreover, based on the brain functional features, procrastination had been attributed to disruptive neural circuits on FPN (frontoparietal network)-SCN (subcortical network) and FPN-SAN (salience network), which led us to hypothesize the crucial roles of interplay between these networks on procrastination in unified triple brain network model. Despite of these findings, poor interpretability and computational model limited further understanding for procrastination from theoretical and neural perspectives. On balance, the current study provided an overview to show current progress on the connectome-based biomarkers for procrastination, and proposed the integrative neurocognitive model of procrastination.
Collapse
Affiliation(s)
- Zhiyi Chen
- Faculty of Psychology, Southwest University, Chongqing, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Tingyong Feng
- Faculty of Psychology, Southwest University, Chongqing, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China.
| |
Collapse
|
12
|
Ragnhildstveit A, Slayton M, Jackson LK, Brendle M, Ahuja S, Holle W, Moore C, Sollars K, Seli P, Robison R. Ketamine as a Novel Psychopharmacotherapy for Eating Disorders: Evidence and Future Directions. Brain Sci 2022; 12:brainsci12030382. [PMID: 35326338 PMCID: PMC8963252 DOI: 10.3390/brainsci12030382] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 02/01/2023] Open
Abstract
Eating disorders (EDs) are serious, life-threatening psychiatric conditions associated with physical and psychosocial impairment, as well as high morbidity and mortality. Given the chronic refractory nature of EDs and the paucity of evidence-based treatments, there is a pressing need to identify novel approaches for this population. The noncompetitive N-methyl-D-aspartate receptor (NMDAr) antagonist, ketamine, has recently been approved for treatment-resistant depression, exerting rapid and robust antidepressant effects. It is now being investigated for several new indications, including obsessive–compulsive, post-traumatic, and substance use disorder, and shows transdiagnostic potential for EDs, particularly among clinical nonresponders. Hence, the aim of this review is to examine contemporary findings on the treatment of EDs with ketamine, whether used as a primary, adjunctive, or combination psychopharmacotherapy. Avenues for future research are also discussed. Overall, results are encouraging and point to therapeutic value; however, are limited to case series and reports on anorexia nervosa. Further empirical research is thus needed to explore ketamine efficacy across ED subgroups, establish safety profiles and optimize dosing, and develop theory-driven, targeted treatment strategies at the individual patient level.
Collapse
Affiliation(s)
- Anya Ragnhildstveit
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA; (M.S.); (P.S.)
- Integrated Research Literacy Group, Draper, UT 84020, USA; (L.K.J.); (M.B.); (W.H.)
- Correspondence: ; Tel.: +1-(801)-448-3331
| | - Matthew Slayton
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA; (M.S.); (P.S.)
- Integrated Research Literacy Group, Draper, UT 84020, USA; (L.K.J.); (M.B.); (W.H.)
| | - Laura Kate Jackson
- Integrated Research Literacy Group, Draper, UT 84020, USA; (L.K.J.); (M.B.); (W.H.)
- Novamind, Draper, UT 84020, USA; (S.A.); (C.M.); (K.S.); (R.R.)
| | - Madeline Brendle
- Integrated Research Literacy Group, Draper, UT 84020, USA; (L.K.J.); (M.B.); (W.H.)
- Novamind, Draper, UT 84020, USA; (S.A.); (C.M.); (K.S.); (R.R.)
- Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT 84112, USA
| | - Sachin Ahuja
- Novamind, Draper, UT 84020, USA; (S.A.); (C.M.); (K.S.); (R.R.)
| | - Willis Holle
- Integrated Research Literacy Group, Draper, UT 84020, USA; (L.K.J.); (M.B.); (W.H.)
| | - Claire Moore
- Novamind, Draper, UT 84020, USA; (S.A.); (C.M.); (K.S.); (R.R.)
| | - Kellie Sollars
- Novamind, Draper, UT 84020, USA; (S.A.); (C.M.); (K.S.); (R.R.)
| | - Paul Seli
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA; (M.S.); (P.S.)
| | - Reid Robison
- Novamind, Draper, UT 84020, USA; (S.A.); (C.M.); (K.S.); (R.R.)
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84108, USA
| |
Collapse
|
13
|
Mottarlini F, Targa G, Bottan G, Tarenzi B, Fumagalli F, Caffino L. Cortical reorganization of the glutamate synapse in the activity-based anorexia rat model: impact on cognition. J Neurochem 2022; 161:350-365. [PMID: 35257377 PMCID: PMC9313878 DOI: 10.1111/jnc.15605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 12/01/2022]
Abstract
Patients suffering from anorexia nervosa (AN) display altered neural activity, morphological, and functional connectivity in the fronto‐striatal circuit. In addition, hypoglutamatergic transmission and aberrant excitability of the medial prefrontal cortex (mPFC) observed in AN patients might underpin cognitive deficits that fuel the vicious cycle of dieting behavior. To provide a molecular mechanism, we employed the activity‐based anorexia (ABA) rat model, which combines the two hallmarks of AN (i.e., caloric restriction and intense physical exercise), to evaluate structural remodeling together with alterations in the glutamatergic signaling in the mPFC and their impact on temporal memory, as measured by the temporal order object recognition (TOOR) test. Our data indicate that the combination of caloric restriction and intense physical exercise altered the homeostasis of the glutamate synapse and reduced spine density in the mPFC. These events, paralleled by an impairment in recency discrimination in the TOOR test, are associated with the ABA endophenotype. Of note, after a 7‐day recovery period, body weight was recovered and the mPFC structure normalized but ABA rats still exhibited reduced post‐synaptic stability of AMPA and NMDA glutamate receptors associated with cognitive dysfunction. Taken together, these data suggest that the combination of reduced food intake and hyperactivity affects the homeostasis of the excitatory synapse in the mPFC contributing to maintain the aberrant behaviors observed in AN patients. Our findings, by identifying novel potential targets of AN, may contribute to more effectively direct the therapeutic interventions to ameliorate, at least, the cognitive effects of this psychopathology.
Collapse
Affiliation(s)
- Francesca Mottarlini
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milano, Italy
| | - Giorgia Targa
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milano, Italy
| | - Giorgia Bottan
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milano, Italy
| | - Benedetta Tarenzi
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milano, Italy
| | - Fabio Fumagalli
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milano, Italy
| | - Lucia Caffino
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milano, Italy
| |
Collapse
|
14
|
Roger C, Lasbleiz A, Guye M, Dutour A, Gaborit B, Ranjeva JP. The Role of the Human Hypothalamus in Food Intake Networks: An MRI Perspective. Front Nutr 2022; 8:760914. [PMID: 35047539 PMCID: PMC8762294 DOI: 10.3389/fnut.2021.760914] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/07/2021] [Indexed: 12/12/2022] Open
Abstract
Hypothalamus (HT), this small structure often perceived through the prism of neuroimaging as morphologically and functionally homogeneous, plays a key role in the primitive act of feeding. The current paper aims at reviewing the contribution of magnetic resonance imaging (MRI) in the study of the role of the HT in food intake regulation. It focuses on the different MRI techniques that have been used to describe structurally and functionally the Human HT. The latest advances in HT parcellation as well as perspectives in this field are presented. The value of MRI in the study of eating disorders such as anorexia nervosa (AN) and obesity are also highlighted.
Collapse
Affiliation(s)
- Coleen Roger
- Centre de Résonance Magnétique Biologique et Médicale (CRMBM), Centre National de la Recherche Scientifique (CNRS), Université Aix-Marseille, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Universitaire de la Timone, Marseille, France
| | - Adèle Lasbleiz
- Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Universitaire de la Timone, Marseille, France.,Département d'Endocrinologie, Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Marseille, France
| | - Maxime Guye
- Centre de Résonance Magnétique Biologique et Médicale (CRMBM), Centre National de la Recherche Scientifique (CNRS), Université Aix-Marseille, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Universitaire de la Timone, Marseille, France
| | - Anne Dutour
- Département d'Endocrinologie, Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Marseille, France
| | - Bénédicte Gaborit
- Département d'Endocrinologie, Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Marseille, France
| | - Jean-Philippe Ranjeva
- Centre de Résonance Magnétique Biologique et Médicale (CRMBM), Centre National de la Recherche Scientifique (CNRS), Université Aix-Marseille, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Universitaire de la Timone, Marseille, France
| |
Collapse
|
15
|
Sak LV, Khaustova OO, Avramenko OM, Papathanasiou IV. DEVELOPMENT OF ANOREXIA NERVOSA IN A FEMALE ADOLESCENT IN A DYSFUNCTIONAL FAMILY ENVIRONMENT WITH IMPAIRED ATTACHMENT AND EMOTIONAL REGULATION: A CASE REPORT. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1932-1937. [PMID: 36089882 DOI: 10.36740/wlek202208120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A 17-year-old female patient was admitted to the psychoneurological department of Kyiv Clinical Railway Hospital No. 1, due to deterioration of her mental state, a significant decrease in body weight, and no effect of outpatient treatment. The complex treatment program, directed on the correction of all multidimensional disorders with the preliminary psychodiagnostics examination of the patient and her parents according to the FACES-III, DERS, which were monitored in dynamics during the 3,6,9 and 12 months of treatment, was applied. The patient's parents were additionally assessed by TAS, HADS, and the CQLS. We noted that the functioning of the family as a whole influenced the emotional regulation of each of its members; in turn, the emotional regulation of the parents had a direct influence on the patient's emotional regulation, and the patient's emotional regulation influenced changes body weight. The patient's personal psychotherapy and ABFT allowed us to decrease the gap in the attachment relationship between parents and patient and create a safe emotional base for reducing the stress of the relationship with parents at home, which was confirmed by positive dynamics of FACES-III, decrease in difficulties of emotional regulation on DERS and restoration of the patient's normal weight.
Collapse
Affiliation(s)
- Lesia V Sak
- O. O. BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE
| | | | | | | |
Collapse
|
16
|
Neural basis responsible for episodic future thinking effects on procrastination: The interaction between the cognitive control pathway and emotional processing pathway. Cortex 2021; 145:250-263. [PMID: 34773842 DOI: 10.1016/j.cortex.2021.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/05/2021] [Accepted: 09/12/2021] [Indexed: 11/21/2022]
Abstract
Theories on procrastination have proposed that the trade-off between the episodic future thinking (EFT) of positive outcome and negative engagement determines whether to procrastinate. Yet, the neural substrates underlying EFT affects procrastination remain poorly understood. Thus, we adopt a free construction method to obtain individuals' EFT thoughts toward procrastination tasks, and coded these thoughts based on the 2 (emotional valence: positive vs negative) × 2 (imaginary direction: outcome vs engagement) model of EFT (2 × 2 model). Next, a regression analysis was utilized to test the relationship between each dimension in the 2 × 2 model and execution willingness. To explore the neuroanatomical structures underlying EFT, the voxel-based morphometry (VBM) analysis was conducted to find out brain regions responsible for EFT. In addition, the resting-state functional connectivity (RSFC) analysis was also utilized to examine the neural pathways underlying EFT affects procrastination. Behavioral results showed combine the anticipated positive outcome with anticipated negative engagement can best predict execution willingness. The VBM analysis revealed that the left dorsolateral prefrontal cortex (DLPFC) was positively correlated with anticipated positive outcome, while the right hippocampus was positively correlated with anticipated negative engagement. The RSFC results indicated that DLPFC functional connectivity with the right inferior frontal gyrus (RIFG) and left precuneus were positively associated with anticipated positive outcome, whereas the hippocampus connectivity with the left insula was positively associated with anticipated negative engagement. Structural equation model results suggest that EFT affects procrastination through the cognitive control pathway (DLPFC-IFG, DLPFC-precuneus) and emotional processing pathway (hippocampus-insula). Collectively, these findings suggest that task procrastination can be predicted by the interaction of the top-down cognitive control pathway and bottom-up emotional processing pathway.
Collapse
|
17
|
Su T, Gong J, Tang G, Qiu S, Chen P, Chen G, Wang J, Huang L, Wang Y. Structural and functional brain alterations in anorexia nervosa:A multimodal meta-analysis of neuroimaging studies. Hum Brain Mapp 2021; 42:5154-5169. [PMID: 34296492 PMCID: PMC8449099 DOI: 10.1002/hbm.25602] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 12/26/2022] Open
Abstract
Anorexia nervosa (AN) is a complex psychiatric disorder with poorly understood etiology. Numerous voxel‐based morphometry (VBM) and resting‐state functional imaging studies have provided strong evidence of abnormal brain structure and intrinsic and functional activities in AN, but with inconsistent conclusions. Herein, a whole‐brain meta‐analysis was conducted on VBM (660 patients with AN, and 740 controls) and resting‐state functional imaging (425 patients with AN, and 461 controls) studies that measured differences in the gray matter volume (GMV) and intrinsic functional activity between patients with AN and healthy controls (HCs). Overall, patients with AN displayed decreased GMV in the bilateral median cingulate cortex (extending to the bilateral anterior and posterior cingulate cortex), and left middle occipital gyrus (extending to the left inferior parietal lobe). In resting‐state functional imaging studies, patients with AN displayed decreased resting‐state functional activity in the bilateral anterior cingulate cortex and bilateral median cingulate cortex, and increased resting‐state functional activity in the right parahippocampal gyrus. This multimodal meta‐analysis identified reductions of gray matter and functional activity in the anterior and median cingulate in patients with AN, which contributes to further understanding of the pathophysiology of AN.
Collapse
Affiliation(s)
- Ting Su
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Jiaying Gong
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China.,Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Guixian Tang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Shaojuan Qiu
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China.,Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Junjing Wang
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| |
Collapse
|
18
|
Michaelian JC, Duffy SL, Mowszowski L, Guastella AJ, McCade D, McKinnon AC, Naismith SL. Poorer Theory of Mind in Amnestic Mild Cognitive Impairment Is Associated with Decreased Functional Connectivity in the Default Mode Network. J Alzheimers Dis 2021; 81:1079-1091. [PMID: 33843670 DOI: 10.3233/jad-201284] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Older adults living with amnestic mild cognitive impairment (aMCI) not only demonstrate impairments in Theory of Mind (ToM), relative to adults with non-amnestic MCI (naMCI), but are also at a higher risk of developing dementia. OBJECTIVE Our primary objective was to ascertain whether default mode network (DMN) functional connectivity was differentially associated with ToM abilities between MCI subgroups. METHODS Using functional magnetic resonance imaging, we investigated alterations in resting-state functional connectivity within the brain's DMN in a sample of 43 older adults with aMCI (n = 19) and naMCI (n = 24), previously reported to demonstrate poorer ToM abilities. RESULTS Compared to naMCI, the aMCI subgroup revealed a significant association between poorer ToM performance and reduced functional connectivity between the bilateral temporal pole (TempP) and the left lateral temporal cortex (LTC) (LTC_L-TempP_L: b = -0.06, t(33) = -3.53, p = 0.02; LTC_L-TempP_R: b = -0.07,t(33) = -3.20, p = 0.03); between the right TempP and the dorsal medial prefrontal cortex (dMPFC) (b = -0.04, t(33) = -3.02, p = 0.03) and between the left and right TempP (b = -0.05, t(33) = -3.26, p = 0.03). In the naMCI subgroup, the opposite relationship was present between the bilateral TempP and the left LTC (Combined correlation: r = -0.47, p = 0.02), however, not between the right TempP and the dMPFC (r = -0.14, p = 0.51) or the left and right TempP (r = -0.31, p = 0.14). CONCLUSION Our findings suggest that alterations in functional connectivity within the DMN involving temporal and frontal lobe regions are associated with ToM deficits in aMCI.
Collapse
Affiliation(s)
- Johannes C Michaelian
- School of Psychology, University of Sydney, Sydney, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, Australia.,Brain and Mind Centre, University of Sydney, Sydney, Australia.,Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Shantel L Duffy
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, Australia.,Charles Perkins Centre, University of Sydney, Sydney, Australia.,School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Loren Mowszowski
- School of Psychology, University of Sydney, Sydney, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, Australia.,Brain and Mind Centre, University of Sydney, Sydney, Australia.,Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Adam J Guastella
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Donna McCade
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Andrew C McKinnon
- School of Psychology, University of Sydney, Sydney, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, Australia.,Brain and Mind Centre, University of Sydney, Sydney, Australia.,Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Sharon L Naismith
- School of Psychology, University of Sydney, Sydney, Australia.,Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Sydney, Australia.,Brain and Mind Centre, University of Sydney, Sydney, Australia.,Charles Perkins Centre, University of Sydney, Sydney, Australia
| |
Collapse
|
19
|
The costs of over-control in anorexia nervosa: evidence from fMRI and ecological momentary assessment. Transl Psychiatry 2021; 11:304. [PMID: 34016948 PMCID: PMC8138008 DOI: 10.1038/s41398-021-01405-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 04/01/2021] [Accepted: 04/22/2021] [Indexed: 01/15/2023] Open
Abstract
A growing body of evidence suggests that a high level of self-control may, despite its positive effects, influence cognitive processing in an unfavorable manner. However, the affective costs of self-control have only rarely been investigated. Anorexia nervosa (AN) is an eating disorder that is often characterized by excessive self-control. Here, we used fMRI to explore whether over-control in AN may have negative affective consequences. 36 predominantly adolescent female AN patients and 36 age-matched healthy controls (HC) viewed negative and neutral pictures during two separate fMRI sessions before and after 10 min of rest. We tested whether abnormally elevated neural activity during the initial presentation in a brain region broadly implicated in top-down control, the dorsolateral prefrontal cortex (dlPFC), could predict subsequent activation in limbic areas relevant to bottom-up affective processing. Using ecological momentary assessment (EMA), we also tested for associations between the aforementioned neuroimaging markers and negative affective states in the two weeks following the experiment. fMRI data revealed that higher initial activation of the dlPFC in AN predicted increased amygdala reactivity during the second fMRI session, which in turn was related to increased self-reported tension during two weeks following the scan. These data suggest that over-control in AN patients may come at a cost including negative affective states on a short (minutes) as well as a longer time scale (days). This mechanism may significantly contribute to the persistence of AN.
Collapse
|
20
|
Malcolm A, Phillipou A. Current directions in biomarkers and endophenotypes for anorexia nervosa: A scoping review. J Psychiatr Res 2021; 137:303-310. [PMID: 33735721 DOI: 10.1016/j.jpsychires.2021.02.063] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/17/2021] [Accepted: 02/26/2021] [Indexed: 12/30/2022]
Abstract
There are currently no validated biomarkers for anorexia nervosa (AN), though recent literature suggests an increased research interest in this area. Biomarkers are objective, measurable indicators of illness that can be used to assist with diagnosis, risk assessment, and tracking of illness state. Related to biomarkers are endophenotypes, which are quantifiable phenomena that are distinct from symptoms and which link genes to manifest illness. In this scoping review, we sought to provide a summary of recent research conducted in the pursuit of biomarkers and endophenotypes for AN. The findings indicate that a number of possible biomarkers which can assess the presence or severity of AN independently of weight status, including psychophysical (e.g., eye-tracking) and biological (e.g., immune, endocrine, metabolomic, neurobiological) markers, are currently under investigation. However, this research is still in early phases and lacking in replication studies. Endophenotype research has largely been confined to the study of several neurocognitive features, with mixed evidence to support their classification as possible endophenotypes for the disorder. The study of biomarkers and endophenotypes in AN involves significant challenges due to confounding factors of illness-related sequalae, such as starvation. Future research in these areas must prioritise direct evaluation of the sensitivity, specificity and test-retest reliability of proposed biomarkers and enhanced control of confounding physical consequences of AN in the study of biomarkers and endophenotypes.
Collapse
Affiliation(s)
- Amy Malcolm
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia.
| | - Andrea Phillipou
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia; Department of Mental Health, Austin Health, Melbourne, Australia
| |
Collapse
|
21
|
Chen X, Gao X, Qin J, Wang C, Xiao M, Tian Y, Luo YJ, Qiu J, Feng T, He Q, Lei X, Chen H. Resting-state functional network connectivity underlying eating disorder symptoms in healthy young adults. NEUROIMAGE-CLINICAL 2021; 30:102671. [PMID: 33892431 PMCID: PMC8082688 DOI: 10.1016/j.nicl.2021.102671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/25/2021] [Accepted: 04/08/2021] [Indexed: 12/12/2022]
Abstract
This study examined the resting-state functional network connectivity underlying eating disorder symptoms in a large sample of healthy young adults (n = 693). Individuals with higher levels of eating disorder symptoms displayed weaker intra-network connectivity of the executive control network and basal ganglia network, as well as weaker inter-network connectivity in the three examined networks (i.e., the executive control network, basal ganglia network, and default mode network). The findings suggest that these neural circuits may play a key role in symptoms of disordered eating in healthy adults. They further reveal that the less efficient information exchange within and between intrinsic networks associated with self-referential thinking, inhibitory control, and reward sensitivity are strongly related to eating disorder symptoms.
Previous neuroimaging research of eating disorders such as anorexia nervosa and bulimia nervosa has mainly focused on clinical patients, indicating the crucial role of intrinsic connectivity networks involved in aberrant behavioral control (i.e., executive control network), reward reactivity (i.e., basal ganglia network), and excessive self-focused and body-focused ruminations (i.e., default mode network) in the onset and maintenance of eating disturbances. However, examinations of large-scale resting-state networks that support the role of cognitive control, reward sensitivity, and self-directed thinking in disordered eating have rarely involved non-clinical samples from the general population. This study, involving a total of 693 healthy young adults (68.69% females; mean age, 18.37 years), investigated these issues by using pre-defined functional regions of interest from the executive control network, basal ganglia network, default mode network, and a seed-based region of interest-to-region of interest approach. After statistically controlling for differences in age, sex, body mass index, and head motion, we observed significant associations of higher levels of eating disorder symptoms, especially bulimia-type eating (i.e., binge eating and a combination of binge eating and compensatory behaviors, such as purging via self-induced vomiting or laxative use, and compulsive exercise), with weaker intra-network and inter-network functional synchrony. These results remained significant after excluding underweight, overweight, and obese participants. These findings suggest that these neural circuits may play a key role in the symptoms of disordered eating in healthy adults. They further reveal that the less efficient information exchange within and between intrinsic networks associated with self-referential thinking, inhibitory control, and reward sensitivity are strongly related to eating disorder symptoms.
Collapse
Affiliation(s)
- Ximei Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Xiao Gao
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Jingmin Qin
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Chuan Wang
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Mingyue Xiao
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Yun Tian
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China; Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
| | - Yi-Jun Luo
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China; Southwest University Branch, Collaborative Innovation Center of Assessment Toward Basic Education Quality at Beijing Normal University, Chongqing, China
| | - Tingyong Feng
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China; Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Chongqing, China
| | - Qinghua He
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China; Southwest University Branch, Collaborative Innovation Center of Assessment Toward Basic Education Quality at Beijing Normal University, Chongqing, China
| | - Xu Lei
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China; Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China; Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Chongqing, China.
| |
Collapse
|
22
|
Recovery-Associated Resting-State Activity and Connectivity Alterations in Anorexia Nervosa. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:1023-1033. [PMID: 33766777 DOI: 10.1016/j.bpsc.2021.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/16/2021] [Accepted: 03/04/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Previous studies provided controversial insight on the impact of starvation, disease status, and underlying gray matter volume (GMV) changes on resting-state functional magnetic resonance imaging alterations in anorexia nervosa (AN). Here, we adapt a combined longitudinal and cross-sectional approach to disentangle the effects of these factors on resting-state alterations in AN. METHODS Overall, 87 female subjects were included in the study: adolescent patients with acute AN scanned at inpatient admission (n = 22, mean age 15.3 years) and at discharge (n = 21), patients who recovered from AN (n = 21, mean age 22.3 years), and two groups of healthy age-matched control subjects (both n = 22, mean age 16.0 and 22.5 years, respectively). Whole-brain measures of resting-state activity and functional connectivity were computed (network-based statistics, global correlation, integrated local correlation, and fractional amplitude of low-frequency fluctuations) to assess resting-state functional magnetic resonance imaging alterations over the course of AN treatment before and after controlling for underlying GMV. RESULTS Patients with acute AN displayed strong and widespread prefrontal, sensorimotor, parietal, temporal, precuneal, and insular reductions of resting-state connectivity and activity. All alterations were independent of GMV and were largely normalized in short-term recovered AN and absent in long-term recovered patients. CONCLUSIONS Resting-state functional magnetic resonance imaging alterations in AN constitute acute and GMV-independent, presumably starvation-related, phenomena. The majority of alterations found here normalized over the course of recovery without evidence for possible preexisting trait- or remaining "scar" effects.
Collapse
|
23
|
Monko MM, Heilbronner SR. Retrosplenial Cortical Connectivity with Frontal Basal Ganglia Networks. J Cogn Neurosci 2021; 33:1096-1105. [PMID: 33656393 DOI: 10.1162/jocn_a_01699] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Previous studies of the retrosplenial cortex (RSC) have focused on its role in navigation and memory, consistent with its well-established medial temporal connections, but recent evidence also suggests a role for this region in reward and decision making. Because function is determined largely by anatomical connections, and to better understand the anatomy of RSC, we used tract-tracing methods to examine the anatomical connectivity between the rat RSC and frontostriatal networks (canonical reward and decision-making circuits). We find that, among frontal cortical regions, RSC bidirectionally connects most strongly with the ACC, but also with an area of the central-medial orbito-frontal cortex. RSC projects to the dorsomedial striatum, and its terminal fields are virtually encompassed by the frontal-striatal projection zone, suggestive of functional convergence through the basal ganglia. This overlap is driven by ACC, prelimbic cortex, and orbito-frontal cortex, all of which contribute to goal-directed decision making, suggesting that the RSC is involved in similar processes.
Collapse
|
24
|
Borserio BJ, Sharpley CF, Bitsika V, Sarmukadam K, Fourie PJ, Agnew LL. Default mode network activity in depression subtypes. Rev Neurosci 2021; 32:597-613. [PMID: 33583166 DOI: 10.1515/revneuro-2020-0132] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/12/2021] [Indexed: 01/07/2023]
Abstract
Depression continues to carry a major disease burden worldwide, with limitations on the success of traditional pharmacological or psychological treatments. Recent approaches have therefore focused upon the neurobiological underpinnings of depression, and on the "individualization" of depression symptom profiles. One such model of depression has divided the standard diagnostic criteria into four "depression subtypes", with neurological and behavioral pathways. At the same time, attention has been focused upon the region of the brain known as the "default mode network" (DMN) and its role in attention and problem-solving. However, to date, no review has been published of the links between the DMN and the four subtypes of depression. By searching the literature studies from the last 20 years, 62 relevant papers were identified, and their findings are described for the association they demonstrate between aspects of the DMN and the four depression subtypes. It is apparent from this review that there are potential positive clinical and therapeutic outcomes from focusing upon DMN activation and connectivity, via psychological therapies, transcranial magnetic stimulation, and some emerging pharmacological models.
Collapse
Affiliation(s)
- Bernard J Borserio
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia
| | - Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia.,School of Science and Technology, University of New England, Queen Elizabeth Drive, Armidale, NSW2351, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia
| | - Kimaya Sarmukadam
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia
| | - Phillip J Fourie
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia
| | - Linda L Agnew
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, Australia
| |
Collapse
|
25
|
Kappou K, Ntougia M, Kourtesi A, Panagouli E, Vlachopapadopoulou E, Michalacos S, Gonidakis F, Mastorakos G, Psaltopoulou T, Tsolia M, Bacopoulou F, Sergentanis TN, Tsitsika A. Neuroimaging Findings in Adolescents and Young Adults with Anorexia Nervosa: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2021; 8:137. [PMID: 33673193 PMCID: PMC7918703 DOI: 10.3390/children8020137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Anorexia nervosa (AN) is a serious, multifactorial mental disorder affecting predominantly young females. This systematic review examines neuroimaging findings in adolescents and young adults up to 24 years old, in order to explore alterations associated with disease pathophysiology. METHODS Eligible studies on structural and functional brain neuroimaging were sought systematically in PubMed, CENTRAL and EMBASE databases up to 5 October 2020. RESULTS Thirty-three studies were included, investigating a total of 587 patients with a current diagnosis of AN and 663 healthy controls (HC). Global and regional grey matter (GM) volume reduction as well as white matter (WM) microstructure alterations were detected. The mainly affected regions were the prefrontal, parietal and temporal cortex, hippocampus, amygdala, insula, thalamus and cerebellum as well as various WM tracts such as corona radiata and superior longitudinal fasciculus (SLF). Regarding functional imaging, alterations were pointed out in large-scale brain networks, such as default mode network (DMN), executive control network (ECN) and salience network (SN). Most findings appear to reverse after weight restoration. Specific limitations of neuroimaging studies in still developing individuals are also discussed. CONCLUSIONS Structural and functional alterations are present in the early course of the disease, most of them being partially or totally reversible. Nonetheless, neuroimaging findings have been open to many biological interpretations. Thus, more studies are needed to clarify their clinical significance.
Collapse
Affiliation(s)
- Kalliopi Kappou
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
| | - Myrto Ntougia
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
| | - Aikaterini Kourtesi
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
| | - Eleni Panagouli
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
| | - Elpis Vlachopapadopoulou
- Department of Endocrinology-Growth and Development, “P. & A. Kyriakou” Children’s Hospital, 115 27 Athens, Greece; (E.V.); (S.M.)
| | - Stefanos Michalacos
- Department of Endocrinology-Growth and Development, “P. & A. Kyriakou” Children’s Hospital, 115 27 Athens, Greece; (E.V.); (S.M.)
| | - Fragiskos Gonidakis
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 115 28 Athens, Greece;
| | - Georgios Mastorakos
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece;
| | - Theodora Psaltopoulou
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
- Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Maria Tsolia
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair Adolescent Health Care, First Department of Pediatrics, “Agia Sophia” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
| | - Theodoros N. Sergentanis
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
- Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Artemis Tsitsika
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
| |
Collapse
|
26
|
de la Cruz F, Schumann A, Suttkus S, Helbing N, Zopf R, Bär KJ. Cortical thinning and associated connectivity changes in patients with anorexia nervosa. Transl Psychiatry 2021; 11:95. [PMID: 33542197 PMCID: PMC7862305 DOI: 10.1038/s41398-021-01237-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 01/30/2023] Open
Abstract
Structural brain abnormalities are a consistent finding in anorexia nervosa (AN) and proposed as a state biomarker of the disorder. Yet little is known about how regional structural changes affect intrinsic resting-state functional brain connectivity (rsFC). Using a cross-sectional, multimodal imaging approach, we investigated the association between regional cortical thickness abnormalities and rsFC in AN. Twenty-two acute AN patients and twenty-six age- and gender-matched healthy controls underwent a resting-state functional magnetic resonance imaging scan and cognitive tests. We performed group comparisons of whole-brain cortical thickness, seed-based rsFC, and network-based statistical (NBS) analyses. AN patients showed cortical thinning in the precuneus and inferior parietal lobules, regions involved in visuospatial memory and imagery. Cortical thickness in the precuneus correlated with nutritional state and cognitive functions in AN, strengthening the evidence for a critical role of this region in the disorder. Cortical thinning was accompanied by functional connectivity reductions in major brain networks, namely default mode, sensorimotor and visual networks. Similar to the seed-based approach, the NBS analysis revealed a single network of reduced functional connectivity in patients, comprising mainly sensorimotor- occipital regions. Our findings provide evidence that structural and functional brain abnormalities in AN are confined to specific regions and networks involved in visuospatial and somatosensory processing. We show that structural changes of the precuneus are linked to nutritional and functional states in AN, and future longitudinal research should assess how precuneus changes might be related to the evolution of the disorder.
Collapse
Affiliation(s)
- Feliberto de la Cruz
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Andy Schumann
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Stefanie Suttkus
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Nadin Helbing
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Regine Zopf
- Department of Cognitive Science, Perception in Action Research Centre, Faculty of Medical, Health & Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Karl-Jürgen Bär
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany.
| |
Collapse
|
27
|
Seidel M, Geisler D, Borchardt V, King JA, Bernardoni F, Jaite C, Roessner V, Calhoun V, Walter M, Ehrlich S. Evaluation of spontaneous regional brain activity in weight-recovered anorexia nervosa. Transl Psychiatry 2020; 10:395. [PMID: 33177499 PMCID: PMC7658198 DOI: 10.1038/s41398-020-01081-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 09/14/2020] [Accepted: 10/21/2020] [Indexed: 02/08/2023] Open
Abstract
Whereas research using structural magnetic resonance imaging (sMRI) reports sizable grey matter reductions in patients suffering from acute anorexia nervosa (AN) to be largely reversible already after short-term weight gain, many task-based and resting-state functional connectivity (RSFC) studies suggest persistent brain alterations even after long-term weight rehabilitation. First investigations into spontaneous regional brain activity using voxel-wise resting-state measures found widespread abnormalities in acute AN, but no studies have compared intrinsic brain activity properties in weight-recovered individuals with a history of AN (recAN) with healthy controls (HCs). SMRI and RSFC data were analysed from a sample of 130 female volunteers: 65 recAN and 65 pairwise age-matched HC. Cortical grey matter thickness was assessed using FreeSurfer software. Fractional amplitude of low-frequency fluctuations (fALFFs), mean-square successive difference (MSSD), regional homogeneity (ReHo), voxel-mirrored homotopic connectivity (VHMC), and degree centrality (DC) were calculated. SMRI and RSFC data were analysed from a sample of 130 female volunteers: 65 recAN and 65 pairwise age-matched HCs. Cortical grey matter thickness was assessed using FreeSurfer software. Fractional amplitude of low-frequency fluctuations (fALFF), mean-square successive difference (MSSD), regional homogeneity (ReHo), voxel-mirrored homotopic connectivity (VHMC), and degree centrality (DC) were calculated. Abnormal regional homogeneity found in acute AN seems to normalize in recAN, supporting assumptions of a state rather than a trait marker. Aberrant fALFF values in the cerebellum and the infertior temporal gyrus could possibly hint towards trait factors or a scar (the latter, e.g., from prolonged periods of undernutrition), warranting further longitudinal research.
Collapse
Affiliation(s)
- Maria Seidel
- grid.4488.00000 0001 2111 7257Faculty of Medicine, Division of Psychological and Social Medicine, and Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
| | - Daniel Geisler
- grid.4488.00000 0001 2111 7257Faculty of Medicine, Division of Psychological and Social Medicine, and Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
| | - Viola Borchardt
- grid.5807.a0000 0001 1018 4307Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany ,grid.418723.b0000 0001 2109 6265Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Joseph A. King
- grid.4488.00000 0001 2111 7257Faculty of Medicine, Division of Psychological and Social Medicine, and Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
| | - Fabio Bernardoni
- grid.4488.00000 0001 2111 7257Faculty of Medicine, Division of Psychological and Social Medicine, and Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
| | - Charlotte Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité–Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Veit Roessner
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, University Hospital C. G. Carus, Technische Universität Dresden, Dresden, Germany
| | - Vince Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA USA
| | - Martin Walter
- grid.5807.a0000 0001 1018 4307Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany ,grid.418723.b0000 0001 2109 6265Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany ,grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Stefan Ehrlich
- Faculty of Medicine, Division of Psychological and Social Medicine, and Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany. .,Faculty of Medicine, Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Dresden, Germany.
| |
Collapse
|
28
|
Seidel M, Ehrlich S, Breithaupt L, Welch E, Wiklund C, Hübel C, Thornton LM, Savva A, Fundin BT, Pege J, Billger A, Abbaspour A, Schaefer M, Boehm I, Zvrskovec J, Rosager EV, Hasselbalch KC, Leppä V, Sjögren M, Nergårdh R, Feusner JD, Ghaderi A, Bulik CM. Study protocol of comprehensive risk evaluation for anorexia nervosa in twins (CREAT): a study of discordant monozygotic twins with anorexia nervosa. BMC Psychiatry 2020; 20:507. [PMID: 33054774 PMCID: PMC7557028 DOI: 10.1186/s12888-020-02903-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/29/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Anorexia nervosa (AN) is a severe disorder, for which genetic evidence suggests psychiatric as well as metabolic origins. AN has high somatic and psychiatric comorbidities, broad impact on quality of life, and elevated mortality. Risk factor studies of AN have focused on differences between acutely ill and recovered individuals. Such comparisons often yield ambiguous conclusions, as alterations could reflect different effects depending on the comparison. Whereas differences found in acutely ill patients could reflect state effects that are due to acute starvation or acute disease-specific factors, they could also reflect underlying traits. Observations in recovered individuals could reflect either an underlying trait or a "scar" due to lasting effects of sustained undernutrition and illness. The co-twin control design (i.e., monozygotic [MZ] twins who are discordant for AN and MZ concordant control twin pairs) affords at least partial disambiguation of these effects. METHODS Comprehensive Risk Evaluation for Anorexia nervosa in Twins (CREAT) will be the largest and most comprehensive investigation of twins who are discordant for AN to date. CREAT utilizes a co-twin control design that includes endocrinological, neurocognitive, neuroimaging, genomic, and multi-omic approaches coupled with an experimental component that explores the impact of an overnight fast on most measured parameters. DISCUSSION The multimodal longitudinal twin assessment of the CREAT study will help to disambiguate state, trait, and "scar" effects, and thereby enable a deeper understanding of the contribution of genetics, epigenetics, cognitive functions, brain structure and function, metabolism, endocrinology, microbiology, and immunology to the etiology and maintenance of AN.
Collapse
Affiliation(s)
- Maria Seidel
- grid.4488.00000 0001 2111 7257Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany ,Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Lauren Breithaupt
- grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, Boston, MA USA ,grid.32224.350000 0004 0386 9924Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA USA
| | - Elisabeth Welch
- grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden ,grid.467087.a0000 0004 0442 1056Stockholm Health Care Services, Region Stockholm, Stockholm Centre for Eating Disorders, Stockholm, Sweden
| | - Camilla Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Christopher Hübel
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden ,grid.13097.3c0000 0001 2322 6764Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839UK National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust, London, UK ,grid.7048.b0000 0001 1956 2722National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Laura M. Thornton
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Androula Savva
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Bengt T. Fundin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Jessica Pege
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Annelie Billger
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Afrouz Abbaspour
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Martin Schaefer
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ilka Boehm
- grid.4488.00000 0001 2111 7257Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Johan Zvrskovec
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden ,grid.13097.3c0000 0001 2322 6764Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Emilie Vangsgaard Rosager
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Virpi Leppä
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Magnus Sjögren
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark ,Eating Disorder Research Unit, Mental Health Center Ballerup, Ballerup, Denmark
| | - Ricard Nergårdh
- grid.4714.60000 0004 1937 0626Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Jamie D. Feusner
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA USA
| | - Ata Ghaderi
- grid.13097.3c0000 0001 2322 6764Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden ,grid.10698.360000000122483208Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC USA ,grid.10698.360000000122483208Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| |
Collapse
|
29
|
Altered habenula to locus coeruleus functional connectivity in past anorexia nervosa suggests correlation with suicidality: a pilot study. Eat Weight Disord 2020; 25:1475-1480. [PMID: 31376112 PMCID: PMC6995421 DOI: 10.1007/s40519-019-00746-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/03/2019] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Despite anorexia nervosa having the highest mortality rate of mental illnesses, little is known regarding the brain mechanisms involved. Given that lack of interest for food in anorexic patients is related to alterations in the reward system, we tested the hypothesis that patients with past anorexia nervosa (pAN) have altered resting state functional connectivity (RSFC) between the habenula (a major component of the reward system) and its targets. METHODS RSFC between the habenula and major targets (locus coeruleus, median and dorsal raphe nuclei, substantia nigra, and ventral tegmental area) was studied in 14 psychiatric inpatients with pAN and 14 psychiatric inpatient controls (PC, never-anorexic patients in same clinic, matched for comorbidities). Next, we tested possible correlations between RSFC and suicidal ideation, depression, and anxiety as determined by self-report questionnaires. RESULTS Left habenula/locus coeruleus RSFC was lower in pAN patients compared to PC. The left habenula/locus coeruleus RSFC was positively correlated with suicidal ideation (past 2 months) in pAN patients, but not in controls. CONCLUSIONS pAN patients showed long lasting alterations in habenular connectivity. This may have clinical implications, possibly including future evaluation of the habenula as a therapeutic target and the need to carefully monitor suicidality in pAN patients. NO LEVEL OF EVIDENCE Basic science.
Collapse
|
30
|
Alfano V, Mele G, Cotugno A, Longarzo M. Multimodal neuroimaging in anorexia nervosa. J Neurosci Res 2020; 98:2178-2207. [PMID: 32770570 DOI: 10.1002/jnr.24674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/26/2020] [Accepted: 05/25/2020] [Indexed: 12/13/2022]
Abstract
Anorexia nervosa (AN) is a severe and complex psychiatric disorder characterized by intense fear about weight gain and finalized to food-related control behaviors. Growing interest has been demonstrated about neurobiological processes subtend to AN physiopathology. The present review aimed to collect neurostructural and neurofunctional available data from 2010 to 2019. Results have been organized according to the neuroimaging technique employed, also including a specific section on electroencephalographic results, mostly neglected in previous reviews. Diffuse cerebral vulnerability has been demonstrated and the contribution of several structures has been identified. Insula, cingulate cortex, parietal and frontal areas are primarily involved both by structural and functional perspectives. Moreover, consistent alterations in white matter integrity and brain electrical activity have been reported. Neuroimaging findings give a substantial contribution to AN pathophysiological description, also in order to understand altered but reversible processes in the passage from acute illness phase to disorder's remission, useful also for defining therapy.
Collapse
|
31
|
Galusca B, Traverse B, Costes N, Massoubre C, Le Bars D, Estour B, Germain N, Redouté J. Decreased cerebral opioid receptors availability related to hormonal and psychometric profile in restrictive-type anorexia nervosa. Psychoneuroendocrinology 2020; 118:104711. [PMID: 32460196 DOI: 10.1016/j.psyneuen.2020.104711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 04/27/2020] [Accepted: 05/05/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The opioid system role in anorexia nervosa (AN) pathophysiology is still unclear since conflicting results were reported on peripheral and cerebrospinal fluid opioids levels. The study main aim was to evaluate cerebral AN opiate receptor availability by using [11C] diprenorphine, a ligand with non-selective binding. METHODS In vivo [11C]diprenorphine cerebral non-displaceable binding potential (BPND) evaluated by PET imaging was compared between three groups : 17 undernourished restrictive-type AN patients (LeanAN), 15 AN patients having regained normal weight (RecAN) and 15 controls. A lower BPND may account for an increased opioid tone and vice versa. Serum hormones and endogenous opioids levels, eating-related and unspecific psychological traits were also evaluated. RESULTS Compared to controls, LeanAN and RecAN patients had decreased [11C]diprenorphine BPND in middle frontal gyrus, temporo-parietal cortices, anterior cingulate cortex and in left accumbens nucleus. Hypothalamo-pituitary (H-P), left amygdala and insula BPND was found decreased only in LeanAN and that of putamen only in RecAN. LeanAN presented higher dynorphin A and enkephalin serum levels than in controls or RecAN. Inverse correlations were found in total group between : 24 h mean serum cortisol levels and anterior cingulate gyrus or insula BPND; eating concern score and left amygdala BPND. Positive correlation were found between leptin and hypothamus BPND; LH and pituitary BPND. CONCLUSIONS Low opiate receptor availability may be interpreted as an increased opioid tone in areas associated with both reward/aversive system in both AN groups. The relationship between the opioid receptors activity and hypercorticism or specific psychometric scores in some of these regions suggests adaptive mechanisms facing anxiety but also may play a role in the disease perpetuation.
Collapse
Affiliation(s)
- Bogdan Galusca
- Endocrinology Department, CHU Saint Etienne, 42055 Saint Etienne Cedex 2, France; TAPE Reaserch Unit, EA 7423, Jean Monnet University, Saint Etienne, France.
| | - Bastien Traverse
- Endocrinology Department, CHU Saint Etienne, 42055 Saint Etienne Cedex 2, France; TAPE Reaserch Unit, EA 7423, Jean Monnet University, Saint Etienne, France
| | | | - Catherine Massoubre
- Psychiatry Department, CHU Saint Etienne Saint Etienne, France; TAPE Reaserch Unit, EA 7423, Jean Monnet University, Saint Etienne, France
| | | | - Bruno Estour
- Endocrinology Department, CHU Saint Etienne, 42055 Saint Etienne Cedex 2, France; TAPE Reaserch Unit, EA 7423, Jean Monnet University, Saint Etienne, France
| | - Natacha Germain
- Endocrinology Department, CHU Saint Etienne, 42055 Saint Etienne Cedex 2, France; TAPE Reaserch Unit, EA 7423, Jean Monnet University, Saint Etienne, France
| | | |
Collapse
|
32
|
Impact of literacy on the functional connectivity of vision and language related networks. Neuroimage 2020; 213:116722. [DOI: 10.1016/j.neuroimage.2020.116722] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 11/15/2022] Open
|
33
|
Strengthened Default Mode Network Activation During Delay Discounting in Adolescents with Anorexia Nervosa After Partial Weight Restoration: A Longitudinal fMRI Study. J Clin Med 2020; 9:jcm9040900. [PMID: 32218141 PMCID: PMC7230250 DOI: 10.3390/jcm9040900] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/17/2020] [Accepted: 03/21/2020] [Indexed: 02/06/2023] Open
Abstract
The capacity of patients with anorexia nervosa (AN) to resist food-based rewards is often assumed to reflect excessive self-control. Previous cross-sectional functional magnetic resonance imaging (fMRI) studies utilizing the delay discounting (DD) paradigm, an index of impulsivity and self-control, suggested altered neural efficiency of decision-making in acutely underweight patients (acAN) and a relative normalization in long-term, weight-recovered individuals with a history of AN (recAN). The current longitudinal study tested for changes in functional magnetic resonance imaging (fMRI) activation during DD associated with intensive weight restoration treatment. A predominately adolescent cohort of 22 female acAN patients (mean age—15.5 years) performed an established DD paradigm during fMRI at the beginning of hospitalization and again after partial weight restoration (≥12% body mass index (BMI) increase). Analyses investigated longitudinal changes in both reward valuation and executive decision-making processes. Additional exploratory analyses included comparisons with data acquired in aged-matched healthy controls (HC) as well as probes of functional connectivity between empirically identified nodes of the “task-positive” frontoparietal control network (FPN) and “task-negative” default-mode network (DMN). While treatment was not associated with changes in behavioral DD parameters or activation, specific to reward processing, deactivation of the DMN during decision-making was significantly less pronounced following partial weight restoration. Strengthened DMN activation during DD might reflect a relative relaxation of cognitive overcontrol or improved self-referential, decision-making. Together, our findings present further evidence that aberrant decision-making in AN might be remediable by treatment and, therefore, might constitute an acute effect rather than a core trait variable of the disorder.
Collapse
|
34
|
King JA, Bernardoni F, Geisler D, Ritschel F, Doose A, Pauligk S, Pásztor K, Weidner K, Roessner V, Smolka MN, Ehrlich S. Intact value-based decision-making during intertemporal choice in women with remitted anorexia nervosa? An fMRI study. J Psychiatry Neurosci 2020; 45:108-116. [PMID: 31595737 PMCID: PMC7828910 DOI: 10.1503/jpn.180252] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Extreme restrictive food choice in anorexia nervosa is thought to reflect excessive self-control and/or abnormal reward sensitivity. Studies using intertemporal choice paradigms have suggested an increased capacity to delay reward in anorexia nervosa, and this may explain an unusual ability to resist immediate temptation and override hunger in the long-term pursuit of thinness. It remains unclear, however, whether altered delay discounting in anorexia nervosa constitutes a state effect of acute illness or a trait marker observable after recovery. METHODS We repeated the analysis from our previous fMRI investigation of intertemporal choice in acutely underweight patients with anorexia nervosa in a sample of weight-recovered women with anorexia nervosa (n = 36) and age-matched healthy controls (n = 36) who participated in the same study protocol. Follow-up analyses explored functional connectivity separately in both the weight-recovered/healthy controls sample and the acute/healthy controls sample. RESULTS In contrast to our previous findings in acutely underweight patients with anorexia nervosa, we found no differences between weight-recovered patients with anorexia nervosa and healthy controls at either behavioural or neural levels. New analysis of data from the acute/healthy controls sample sample revealed increased coupling between dorsal anterior cingulate cortex and posterior brain regions as a function of decision difficulty, supporting the hypothesis of altered neural efficiency in the underweight state. LIMITATIONS This was a cross-sectional study, and the results may be task-specific. CONCLUSION Although our results underlined previous demonstrations of divergent temporal reward discounting in acutely underweight patients with anorexia nervosa, we found no evidence of alteration in patients with weight-recovered anorexia nervosa. Together, these findings suggest that impaired valuebased decision-making may not constitute a defining trait variable or “scar” of the disorder.
Collapse
Affiliation(s)
- Joseph A. King
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (King, Bernardoni, Geisler, Ritschel, Doose, Pauligk, Pásztor, Ehrlich); the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Ritschel, Roessner, Ehrlich); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); and the Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany (Smolka)
| | - Fabio Bernardoni
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (King, Bernardoni, Geisler, Ritschel, Doose, Pauligk, Pásztor, Ehrlich); the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Ritschel, Roessner, Ehrlich); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); and the Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany (Smolka)
| | - Daniel Geisler
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (King, Bernardoni, Geisler, Ritschel, Doose, Pauligk, Pásztor, Ehrlich); the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Ritschel, Roessner, Ehrlich); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); and the Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany (Smolka)
| | - Franziska Ritschel
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (King, Bernardoni, Geisler, Ritschel, Doose, Pauligk, Pásztor, Ehrlich); the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Ritschel, Roessner, Ehrlich); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); and the Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany (Smolka)
| | - Arne Doose
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (King, Bernardoni, Geisler, Ritschel, Doose, Pauligk, Pásztor, Ehrlich); the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Ritschel, Roessner, Ehrlich); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); and the Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany (Smolka)
| | - Sophie Pauligk
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (King, Bernardoni, Geisler, Ritschel, Doose, Pauligk, Pásztor, Ehrlich); the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Ritschel, Roessner, Ehrlich); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); and the Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany (Smolka)
| | - Konrad Pásztor
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (King, Bernardoni, Geisler, Ritschel, Doose, Pauligk, Pásztor, Ehrlich); the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Ritschel, Roessner, Ehrlich); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); and the Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany (Smolka)
| | - Kerstin Weidner
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (King, Bernardoni, Geisler, Ritschel, Doose, Pauligk, Pásztor, Ehrlich); the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Ritschel, Roessner, Ehrlich); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); and the Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany (Smolka)
| | - Veit Roessner
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (King, Bernardoni, Geisler, Ritschel, Doose, Pauligk, Pásztor, Ehrlich); the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Ritschel, Roessner, Ehrlich); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); and the Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany (Smolka)
| | - Michael N. Smolka
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (King, Bernardoni, Geisler, Ritschel, Doose, Pauligk, Pásztor, Ehrlich); the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Ritschel, Roessner, Ehrlich); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); and the Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany (Smolka)
| | - Stefan Ehrlich
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (King, Bernardoni, Geisler, Ritschel, Doose, Pauligk, Pásztor, Ehrlich); the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Ritschel, Roessner, Ehrlich); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); and the Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany (Smolka)
| |
Collapse
|
35
|
Lai J, Xu T, Zhang H, Xi C, Zhou H, Du Y, Jiang J, Wu L, Zhang P, Xu Y, Hu S, Xu D. Fractional amplitude of low frequency fluctuation in drug-naïve first-episode patients with anorexia nervosa: A resting-state fMRI study. Medicine (Baltimore) 2020; 99:e19300. [PMID: 32118747 PMCID: PMC7478752 DOI: 10.1097/md.0000000000019300] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To characterize the fractional amplitude of low-frequency fluctuation (fALFF) in drug-naïve first-episode female patients with anorexia nervosa (AN) using resting-state functional magnetic resonance imaging (rs-fMRI).Whole brain rs-fMRI data were collected from 7 drug-naïve first-episode female patients with DSM-5 AN and 14 age-matched healthy female controls. fALFF values were calculated and compared between the two groups using a two-sample t test. Correlation analysis between the fALFF values in the entire brain and body mass index (BMI) was performed.Compared with the healthy controls, increased fALFF values were observed in the AN patients in their right hippocampus and left superior frontal gyrus, while decreased fALFF values were observed in their left rectus and left middle occipital gyrus. Moreover, low BMI was significantly associated with decreased fALFF in the left inferior frontal gyrus but increased fALFF in the left calcarine. In particular, the z-standardized fALFF (zfALFF) value of the left rectus was positive associated with BMI.Our findings suggest that spontaneous brain activity in the frontal region, hippocampus and rectus, characterized by fALFF values, was altered in drug-naïve, first-episode female patients with AN.
Collapse
Affiliation(s)
- Jianbo Lai
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- The Key Laboratory of Mental Disorder's Management in Zhejiang Province
- Brain Research Institute of Zhejiang University
| | - Tingting Xu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine
- Mental Health Centre, Xiaoshan Hospital of Zhejiang Province, Hangzhou
| | - Haorong Zhang
- Shanghai Key Laboratory of Magnetic Resonance Imaging & Institute of Cognitive Neuroscience, East China Normal University, Shanghai, China
| | - Caixi Xi
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine
| | - Hetong Zhou
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- The Key Laboratory of Mental Disorder's Management in Zhejiang Province
- Brain Research Institute of Zhejiang University
| | - Yanli Du
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine
| | - Jiajun Jiang
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine
| | - Lingling Wu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine
| | - Peifen Zhang
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- Zhejiang University School of Medicine
| | - Yi Xu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- The Key Laboratory of Mental Disorder's Management in Zhejiang Province
- Brain Research Institute of Zhejiang University
| | - Shaohua Hu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine
- The Key Laboratory of Mental Disorder's Management in Zhejiang Province
- Brain Research Institute of Zhejiang University
| | - Dongrong Xu
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University & New York State Psychiatric Institute, New York, NY 10032
| |
Collapse
|
36
|
Geisler D, Borchardt V, Boehm I, King JA, Tam FI, Marxen M, Biemann R, Roessner V, Walter M, Ehrlich S. Altered global brain network topology as a trait marker in patients with anorexia nervosa. Psychol Med 2020; 50:107-115. [PMID: 30621808 DOI: 10.1017/s0033291718004002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Resting state functional magnetic resonance imaging studies have identified functional connectivity patterns associated with acute undernutrition in anorexia nervosa (AN), but few have investigated recovered patients. Thus, a trait connectivity profile characteristic of the disorder remains elusive. Using state-of-the-art graph-theoretic methods in acute AN, the authors previously found abnormal global brain network architecture, possibly driven by local network alterations. To disentangle trait from starvation effects, the present study examines network organization in recovered patients. METHODS Graph-theoretic metrics were used to assess resting-state network properties in a large sample of female patients recovered from AN (recAN, n = 55) compared with pairwise age-matched healthy controls (HC, n = 55). RESULTS Indicative of an altered global network structure, recAN showed increased assortativity and reduced global clustering as well as small-worldness compared with HC, while no group differences at an intermediate or local network level were evident. However, using support-vector classifier on local metrics, recAN and HC could be separated with an accuracy of 70.4%. CONCLUSIONS This pattern of results suggests that long-term recovered patients have an aberrant global brain network configuration, similar to acutely underweight patients. While the finding of increased assortativity may represent a trait marker of AN, the remaining findings could be seen as a scar following prolonged undernutrition.
Collapse
Affiliation(s)
- Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Viola Borchardt
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Friederike I Tam
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Child and Adolescent Psychiatry, Eating Disorder Treatment and Research Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Michael Marxen
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Ronald Biemann
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke University, Magdeburg, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Eating Disorder Treatment and Research Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
- Clinic for Psychiatry and Psychotherapy, Eberhard-Karls University, Tuebingen, Germany
- Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Child and Adolescent Psychiatry, Eating Disorder Treatment and Research Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
37
|
Jimenez-Marin A, Rivera D, Boado V, Diez I, Labayen F, Garrido I, Ramos-Usuga D, Benito-Sánchez I, Rasero J, Cabrera-Zubizarreta A, Gabilondo I, Stramaglia S, Arango-Lasprilla JC, Cortes JM. Brain connectivity and cognitive functioning in individuals six months after multiorgan failure. Neuroimage Clin 2019; 25:102137. [PMID: 31931402 PMCID: PMC6957787 DOI: 10.1016/j.nicl.2019.102137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/03/2019] [Accepted: 12/21/2019] [Indexed: 01/05/2023]
Abstract
Multiorgan failure (MOF) is a life-threating condition that affects two or more systems of organs not involved in the disorder that motivates admission to an Intensive Care Unit (ICU). Patients who survive MOF frequently present long-term functional, neurological, cognitive, and psychiatric sequelae. However, the changes to the brain that explain such symptoms remain unclear. OBJECTIVE To determine brain connectivity and cognitive functioning differences between a group of MOF patients six months after ICU discharge and healthy controls (HC). METHODS 22 MOF patients and 22 HC matched by age, sex, and years of education were recruited. Both groups were administered a 3T magnetic resonance imaging (MRI), including structural T1 and functional BOLD, as well as a comprehensive neuropsychological evaluation that included tests of learning and memory, speed of information processing and attention, executive function, visual constructional abilities, and language. Voxel-based morphometry was used to analyses T1 images. For the functional data at rest, functional connectivity (FC) analyses were performed. RESULTS There were no significant differences in structural imaging and neuropsychological performance between groups, even though patients with MOF performed worse in all the cognitive tests. Functional neuroimaging in the default mode network (DMN) showed hyper-connectivity towards sensory-motor, cerebellum, and visual networks. DMN connectivity had a significant association with the severity of MOF during ICU stay and with the neuropsychological scores in tests of attention and visual constructional abilities. CONCLUSIONS In MOF patients without structural brain injury, DMN connectivity six months after ICU discharge is associated with MOF severity and neuropsychological impairment, which supports the use of resting-state functional MRI as a potential tool to predict the onset of long-term cognitive deficits in these patients. Similar to what occurs at the onset of other pathologies, the observed hyper-connectivity might suggest network re-adaptation following MOF.
Collapse
Affiliation(s)
- Antonio Jimenez-Marin
- Biocruces-Bizkaia Health Research Institute, Barakaldo, Spain; Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Diego Rivera
- Biocruces-Bizkaia Health Research Institute, Barakaldo, Spain
| | - Victoria Boado
- Intensive Care Unit. Cruces University Hospital, Barakaldo, Spain
| | - Ibai Diez
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Neurotechnology Laboratory, Tecnalia Health Department, Derio, Spain
| | - Fermin Labayen
- Intensive Care Unit. Cruces University Hospital, Barakaldo, Spain
| | - Irati Garrido
- Intensive Care Unit. Cruces University Hospital, Barakaldo, Spain
| | - Daniela Ramos-Usuga
- Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Itziar Benito-Sánchez
- Biocruces-Bizkaia Health Research Institute, Barakaldo, Spain; Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Javier Rasero
- Biocruces-Bizkaia Health Research Institute, Barakaldo, Spain
| | | | - Iñigo Gabilondo
- Biocruces-Bizkaia Health Research Institute, Barakaldo, Spain; IKERBASQUE, The Basque Foundation for Science, Bilbao, Spain
| | - Sebastiano Stramaglia
- Dipartamento Interateneo di Fisica, Universita di Bari, and INFN, Sezione di Bari, Italy
| | - Juan Carlos Arango-Lasprilla
- Biocruces-Bizkaia Health Research Institute, Barakaldo, Spain; IKERBASQUE, The Basque Foundation for Science, Bilbao, Spain; Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Jesus M Cortes
- Biocruces-Bizkaia Health Research Institute, Barakaldo, Spain; IKERBASQUE, The Basque Foundation for Science, Bilbao, Spain; Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, Spain.
| |
Collapse
|
38
|
Seidel M, Borchardt V, Geisler D, King JA, Boehm I, Pauligk S, Bernardoni F, Biemann R, Roessner V, Walter M, Ehrlich S. Abnormal Spontaneous Regional Brain Activity in Young Patients With Anorexia Nervosa. J Am Acad Child Adolesc Psychiatry 2019; 58:1104-1114. [PMID: 30768380 DOI: 10.1016/j.jaac.2019.01.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 01/18/2019] [Accepted: 02/11/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Functional magnetic resonance imaging (fMRI) studies have repeatedly shown alterations in patients with anorexia nervosa (AN). These alterations might be driven by baseline signal characteristics such as the (fractional) amplitude of low frequency fluctuations (fALFF/ALFF), as well as regional signal consistency (ie, regional homogeneity [ReHo]) within circumscribed brain regions. Previous studies have also demonstrated gray matter (pseudo-) atrophy in underweight individuals with AN. Here we study fALFF/ALFF and ReHo in predominantly adolescent patients with AN, while taking gray matter changes into consideration. METHOD Resting state fMRI data were acquired from a sample of 148 female volunteers: 74 underweight patients with AN and 74 age-matched female healthy controls (HC). RESULTS Group differences for fALFF and ReHo measures were found in several AN-relevant brain regions, including networks related to cognitive control, habit formation, and the ventral visual stream. Furthermore, the magnitude of correlation between gray matter volume/thickness and fALFF and ReHo were reduced in AN compared to HC. CONCLUSION Abnormal local resting state characteristics in AN-related brain-networks as well as reduced structure-function relationships may help to explain previously reported task-related and classical resting state neural alterations in underweight AN. Patients with AN may serve as a valuable population for investigating dynamic changes in the relationships between brain structure and function.
Collapse
Affiliation(s)
- Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Viola Borchardt
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany, and the Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sophie Pauligk
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Fabio Bernardoni
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ronald Biemann
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke University, Magdeburg, Germany
| | - Veit Roessner
- Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany, and the Leibniz Institute for Neurobiology, Magdeburg, Germany; Clinic for Psychiatry and Psychotherapy, Eberhard-Karls University, Tuebingen, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
| |
Collapse
|
39
|
Abstract
PURPOSE OF REVIEW This article reviews new research in the context of existing literature to identify approaches that will advance understanding of the persistence of anorexia nervosa. RECENT FINDINGS Neuroscience research in anorexia nervosa has yielded disparate findings: no definitive neural mechanism underlying illness vulnerability or persistence has been identified and no clear neural target for intervention has emerged. Recent advances using structural and functional neuroimaging research, as well as new techniques for applying and combining these approaches, have led to a refined understanding of changes in neural architecture among individuals who are acutely ill, have undergone renourishment, or are in recovery/remission. In particular, advances have come from the incorporation of computational and translational approaches, as well as efforts to link experimental paradigms with illness-relevant behavior. Recent findings converge to suggest abnormalities in systems involved in reward learning and processing among individuals with anorexia nervosa. SUMMARY Anorexia nervosa is associated with neurobiological abnormalities. Aberrant learning and reward processing may contribute to the persistence of illness. To better utilize new techniques to understand the neural mechanisms of persistent anorexia nervosa, it may help to distinguish stages of illness and to link neurobiology with maladaptive behavior.
Collapse
|
40
|
Abstract
Eating disorders are severe psychiatric illnesses with a typical age of onset in adolescence. Brain research in youth and young adults may help us identify specific neurobiology that contributes to onset and maintenance of those disorders. This article provides a state-of-the-art review of our current understanding of the neurobiology of anorexia nervosa and bulimia nervosa. This includes brain structure and function studies to understand food restriction, binge-eating or purging behaviors, cognitive and emotional factors, as well as interoception. Binge-eating disorder and avoidant restrictive food intake disorder are also discussed, but the literature is still very small.
Collapse
|
41
|
Uniacke B, Wang Y, Biezonski D, Sussman T, Lee S, Posner J, Steinglass J. Resting-state connectivity within and across neural circuits in anorexia nervosa. Brain Behav 2019; 9:e01205. [PMID: 30590873 PMCID: PMC6373651 DOI: 10.1002/brb3.1205] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Obsessional thoughts and ritualized eating behaviors are characteristic of Anorexia Nervosa (AN), leading to the common suggestion that the illness shares neurobiology with obsessive-compulsive disorder (OCD). Resting-state functional connectivity MRI (rs-fcMRI) is a measure of functional neural architecture. This longitudinal study examined functional connectivity in AN within the limbic cortico-striato-thalamo-cortical (CSTC) loop, as well as in the salience network, the default mode network, and the executive control network (components of the triple network model of psychopathology). METHODS Resting-state functional connectivity MRI scans were collected in unmedicated female inpatients with AN (n = 25) and healthy controls (HC; n = 24). Individuals with AN were scanned before and after weight restoration and followed for one month after hospital discharge. HC were scanned twice over the same timeframe. RESULTS Using a seed-based correlation approach, individuals with AN had increased connectivity within the limbic CSTC loop when underweight, only. There was no significant association between limbic CSTC connectivity and obsessive-compulsive symptoms or prognosis. Exploratory analyses of functional network connectivity within the triple network model showed reduced connectivity between the salience network and left executive control network among AN relative to HC. These abnormalities persisted following weight restoration. CONCLUSIONS The CSTC findings suggest that the neural underpinnings of obsessive-compulsive symptoms may differ from those of OCD. The inter-network abnormalities warrant examination in relation to illness-specific behaviors, namely abnormal eating behavior. This longitudinal study highlights the complexity of the neural underpinnings of AN.
Collapse
Affiliation(s)
- Blair Uniacke
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.,Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Yun Wang
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.,Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | | | - Tamara Sussman
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.,Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Seonjoo Lee
- Division of Mental Health Data Science, New York State Psychiatric Institute, New York, New York.,Department of Biostatistics, Columbia University Irving Medical Center, New York, New York
| | - Jonathan Posner
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.,Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Joanna Steinglass
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.,Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| |
Collapse
|
42
|
Bohon C, Weinbach N, Lock J. A Protocol for Integrating Neuroscience Into Studies of Family-Based Treatment for Anorexia Nervosa: An Approach to Research and Potential Benefits for Clinical Care. Front Psychiatry 2019; 10:919. [PMID: 31920765 PMCID: PMC6930315 DOI: 10.3389/fpsyt.2019.00919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 11/19/2019] [Indexed: 11/16/2022] Open
Abstract
Anorexia nervosa (AN) is a life-threatening disorder with peak onset during adolescence. Prior research supports the effectiveness of family-based treatment (FBT) for AN in adolescents, but studies do not regularly include neuroimaging to investigate the effects of FBT on the brain. This is important because we know that malnutrition has a detrimental impact on brain volume, cortical thickness, and function, which often recover with weight restoration. Additionally, early weight gain in FBT has emerged as a robust predictor of treatment outcome, yet it is unclear whether it is associated with neural change. Understanding neural change during treatment, particularly in the early weeks, has the potential to improve outcome by enhancing motivation for rapid behavior change, while also highlighting mechanisms by which early treatment response leads to improved outcome. This manuscript describes a study protocol and discusses both challenges and implications for this type of integrative research.
Collapse
Affiliation(s)
- Cara Bohon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Noam Weinbach
- Department Psychology, University of Haifa, Haifa, Israel
| | - James Lock
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| |
Collapse
|
43
|
Abstract
PURPOSE OF REVIEW Poor treatment response is a hallmark of major depressive disorder. To tackle this problem, recent neuroimaging studies have sought to characterize antidepressant response in terms of pretreatment differences in intrinsic functional brain networks. Our aim is to review recent studies that predict antidepressant response using intrinsic network connectivity. We discuss current methodological limitations and directions for future antidepressant biomarker studies. RECENT FINDINGS Functional connectivity stemming from the subgenual and rostral anterior cingulate has shown particular consistency in predicting antidepressant response. Differences in this connectivity may prove fruitful in differentiating treatment responders to many antidepressant interventions. Future biomarker studies should integrate biological MDD subtypes to address the disorder's inherent clinical heterogeneity. These clinical and scientific advancements have the potential to address this population marked by limited treatment response. Methodological considerations, including patient selection, response criteria, and model overfitting, will require future investigation to ensure that biomarkers generalize for prospective prediction of treatment response.
Collapse
Affiliation(s)
- Katharine Dunlop
- Brain and Mind Research Institute, Weill Cornell Medicine, 413 East 69th Street, Box 240, New York, NY, 10021, USA.
| | - Aleksandr Talishinsky
- 000000041936877Xgrid.5386.8Brain and Mind Research Institute, Weill Cornell Medicine, 413 East 69th Street, Box 240, New York, NY 10021 USA
| | - Conor Liston
- 000000041936877Xgrid.5386.8Brain and Mind Research Institute, Weill Cornell Medicine, 413 East 69th Street, Box 240, New York, NY 10021 USA ,000000041936877Xgrid.5386.8Department of Psychiatry, Weill Cornell Medicine, New York, NY USA
| |
Collapse
|
44
|
Rzepa E, McCabe C. Anhedonia and depression severity dissociated by dmPFC resting-state functional connectivity in adolescents. J Psychopharmacol 2018; 32:1067-1074. [PMID: 30260258 PMCID: PMC6380625 DOI: 10.1177/0269881118799935] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Given the heterogeneity within depression, in this study we aim to examine how resting-state functional connectivity (RSFC) in adolescents is related to anhedonia and depression severity on a continuum in line with the research domain criteria (RDoC) approach. METHODS We examined how RSFC in the dorsal medial prefrontal cortex (dmPFC), nucleus accumbens (NAcc) and pregenual anterior cingulate cortex (pgACC) was related to anhedonia and depression severity in 86 adolescents (13-21 years). RESULTS We found both anhedonia and depression severity related to decreased dmPFC RSFC with the precuneus, a part of the default mode network. However we also found that increased dmPFC connectivity with the ACC/paracingulate gyrus related to anhedonia whereas increased RSFC with the frontal pole related to depression severity. DISCUSSION This work extends the view that the dmPFC is a potential therapeutic target for depression in two ways: 1. We report dmPFC connectivity in adolescents; and 2. We show different dmPFC RSFC specific to anhedonia and depression severity, providing neural targets for intervention in young people at risk of depression.
Collapse
Affiliation(s)
| | - Ciara McCabe
- Ciara McCabe, Associate Professor of Neuroscience,
School of Psychology and Clinical Language Sciences, University of Reading, Reading RG6
6AL, UK.
| |
Collapse
|
45
|
Schultz DH, Ito T, Solomyak LI, Chen RH, Mill RD, Anticevic A, Cole MW. Global connectivity of the fronto-parietal cognitive control network is related to depression symptoms in the general population. Netw Neurosci 2018; 3:107-123. [PMID: 30793076 PMCID: PMC6326740 DOI: 10.1162/netn_a_00056] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/04/2018] [Indexed: 12/22/2022] Open
Abstract
We all vary in our mental health, even among people not meeting diagnostic criteria for mental illness. Understanding this individual variability may reveal factors driving the risk for mental illness, as well as factors driving subclinical problems that still adversely affect quality of life. To better understand the large-scale brain network mechanisms underlying this variability, we examined the relationship between mental health symptoms and resting-state functional connectivity patterns in cognitive control systems. One such system is the fronto-parietal cognitive control network (FPN). Changes in FPN connectivity may impact mental health by disrupting the ability to regulate symptoms in a goal-directed manner. Here we test the hypothesis that FPN dysconnectivity relates to mental health symptoms even among individuals who do not meet formal diagnostic criteria but may exhibit meaningful symptom variation. We found that depression symptoms severity negatively correlated with between-network global connectivity (BGC) of the FPN. This suggests that decreased connectivity between the FPN and the rest of the brain is related to increased depression symptoms in the general population. These findings complement previous clinical studies to support the hypothesis that global FPN connectivity contributes to the regulation of mental health symptoms across both health and disease.
Collapse
Affiliation(s)
- Douglas H Schultz
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, USA
| | - Takuya Ito
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, USA
| | - Levi I Solomyak
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, USA
| | - Richard H Chen
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, USA
| | - Ravi D Mill
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, USA
| | - Alan Anticevic
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Michael W Cole
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, USA
| |
Collapse
|
46
|
Gaudio S, Olivo G, Beomonte Zobel B, Schiöth HB. Altered cerebellar-insular-parietal-cingular subnetwork in adolescents in the earliest stages of anorexia nervosa: a network-based statistic analysis. Transl Psychiatry 2018; 8:127. [PMID: 29980676 PMCID: PMC6035187 DOI: 10.1038/s41398-018-0173-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 03/11/2018] [Accepted: 05/11/2018] [Indexed: 12/22/2022] Open
Abstract
To date, few functional magnetic resonance imaging (fMRI) studies have explored resting-state functional connectivity (RSFC) in long-lasting anorexia nervosa (AN) patients via graph analysis. The aim of the present study is to investigate, via a graph approach (i.e., the network-based statistic), RSFC in a sample of adolescents at the earliest stages of AN (i.e., AN duration less than 6 months). Resting-state fMRI data was obtained from 15 treatment-naive female adolescents with AN restrictive type (AN-r) in its earliest stages and 15 age-matched healthy female controls. A network-based statistic analysis was used to isolate networks of interconnected nodes that differ between the two groups. Group comparison showed a decreased connectivity in a sub-network of connections encompassing the left and right rostral ACC, left paracentral lobule, left cerebellum (10th sub-division), left posterior insula, left medial fronto-orbital gyrus, and right superior occipital gyrus in AN patients. Results were not associated to alterations in intranodal or global connectivity. No sub-networks with an increased connectivity were identified in AN patients. Our findings suggest that RSFC may be specifically affected at the earliest stages of AN. Considering that the altered sub-network comprises areas mainly involved in somatosensory and interoceptive information and processing and in emotional processes, it could sustain abnormal integration of somatosensory and homeostatic signals, which may explain body image disturbances in AN. Further studies with larger samples and longitudinal designs are needed to confirm our findings and better understand the role and consequences of such functional alterations in AN.
Collapse
Affiliation(s)
- Santino Gaudio
- Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden. .,Eating Disorders Centre "La Cura del Girasole" ONLUS, Via Gregorio VII, 186/B, 00165, Rome, Italy. .,Area of Diagnostic Imaging, Departmental Faculty of Medicine and Surgery, Università "Campus Bio-Medico di Roma", via Alvaro del Portillo, 200, 00133, Rome, Italy.
| | - Gaia Olivo
- 0000 0004 1936 9457grid.8993.bDepartment of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24 Uppsala, Sweden
| | - Bruno Beomonte Zobel
- 0000 0004 1757 5329grid.9657.dArea of Diagnostic Imaging, Departmental Faculty of Medicine and Surgery, Università “Campus Bio-Medico di Roma”, via Alvaro del Portillo, 200, 00133 Rome, Italy
| | - Helgi B. Schiöth
- 0000 0004 1936 9457grid.8993.bDepartment of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24 Uppsala, Sweden
| |
Collapse
|
47
|
Beltz AM, Moser JS, Zhu DC, Burt SA, Klump KL. Using person-specific neural networks to characterize heterogeneity in eating disorders: Illustrative links between emotional eating and ovarian hormones. Int J Eat Disord 2018; 51:730-740. [PMID: 30132946 PMCID: PMC6186182 DOI: 10.1002/eat.22902] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 05/23/2018] [Accepted: 05/26/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Emotional eating has been linked to ovarian hormone functioning, but no studies to-date have considered the role of brain function. This knowledge gap may stem from methodological challenges: Data are heterogeneous, violating assumptions of homogeneity made by between-subjects analyses. The primary aim of this paper is to describe an innovative within-subjects analysis that models heterogeneity and has potential for filling knowledge gaps in eating disorder research. We illustrate its utility in an application to pilot neuroimaging, hormone, and emotional eating data across the menstrual cycle. METHOD Group iterative multiple model estimation (GIMME) is a person-specific network approach for estimating sample-, subgroup-, and individual-level connections between brain regions. To illustrate its potential for eating disorder research, we apply it to pilot data from 10 female twins (N = 5 pairs) discordant for emotional eating and/or anxiety, who provided two resting state fMRI scans and hormone assays. We then demonstrate how the multimodal data can be linked in multilevel models. RESULTS GIMME generated person-specific neural networks that contained connections common across the sample, shared between co-twins, and unique to individuals. Illustrative analyses revealed positive relations between hormones and default mode connectivity strength for control twins, but no relations for their co-twins who engage in emotional eating or who had anxiety. DISCUSSION This paper showcases the value of person-specific neuroimaging network analysis and its multimodal associations in the study of heterogeneous biopsychosocial phenomena, such as eating behavior.
Collapse
Affiliation(s)
| | | | - David C Zhu
- Michigan State University, East Lansing, Michigan
| | | | | |
Collapse
|
48
|
Park RJ, Scaife JC, Aziz TZ. Study Protocol: Using Deep-Brain Stimulation, Multimodal Neuroimaging and Neuroethics to Understand and Treat Severe Enduring Anorexia Nervosa. Front Psychiatry 2018; 9:24. [PMID: 29681866 PMCID: PMC5898619 DOI: 10.3389/fpsyt.2018.00024] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 01/22/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Research suggests that altered eating and the pursuit of thinness in anorexia nervosa (AN) are, in part, a consequence of aberrant reward circuitry. The neural circuits involved in reward processing and compulsivity overlap significantly, and this has been suggested as a transdiagnostic factor underpinning obsessive compulsive disorder, addictions and eating disorders. The nucleus accumbens (NAcc) is central to both reward processing and compulsivity. In previous studies, deep-brain stimulation (DBS) to the NAcc has been shown to result in neural and symptomatic improvement in both obsessive compulsive disorder and addictions. Moreover, in rats, DBS to the NAcc medial shell increases food intake. We hypothesise that this treatment may be of benefit in severe and enduring anorexia nervosa (SE-AN), but first, feasibility and ethical standards need to be established. The aims of this study are as follows: (1) to provide feasibility and preliminary efficacy data on DBS to the NAcc as a treatment for SE-AN; (2) to assess any subsequent neural changes and (3) to develop a neuroethical gold standard to guide applications of this treatment. METHOD This is a longitudinal study of six individuals with SE-AN of >7 years. It includes an integrated neuroethical sub-study. DBS will be applied to the NAcc and we will track the mechanisms underpinning AN using magnetoelectroencephalography, neuropsychological and behavioural measures. Serial measures will be taken on each intensively studied patient, pre- and post-DBS system insertion. This will allow elucidation of the processes involved in symptomatic change over a 15-month period, which includes a double-blind crossover phase of stimulator on/off. DISCUSSION Novel, empirical treatments for SE-AN are urgently required due to high morbidity and mortality costs. If feasible and effective, DBS to the NAcc could be game-changing in the management of this condition. A neuroethical gold standard is crucial to optimally underpin such treatment development. CLINICAL TRIAL REGISTRATION The study is ongoing and registered with www.ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT01924598, 22 July, 2013. It has full ethical and HRA approval (Project ID 128658).
Collapse
Affiliation(s)
- Rebecca J. Park
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Jessica C. Scaife
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Tipu Z. Aziz
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
49
|
Via E, Goldberg X, Sánchez I, Forcano L, Harrison BJ, Davey CG, Pujol J, Martínez-Zalacaín I, Fernández-Aranda F, Soriano-Mas C, Cardoner N, Menchón JM. Self and other body perception in anorexia nervosa: The role of posterior DMN nodes. World J Biol Psychiatry 2018; 19:210-224. [PMID: 27873550 DOI: 10.1080/15622975.2016.1249951] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Body image distortion is a core symptom of anorexia nervosa (AN), which involves alterations in self- (and other's) evaluative processes arising during body perception. At a neural level, self-related information is thought to rely on areas of the so-called default mode network (DMN), which, additionally, shows prominent synchronised activity at rest. METHODS Twenty female patients with AN and 20 matched healthy controls were scanned using magnetic resonance imaging when: (a) viewing video clips of their own body and another's body; (b) at rest. Between-group differences within the DMN during task performance were evaluated and further explored for task-related and resting-state-related functional connectivity alterations. RESULTS AN patients showed a hyperactivation of the dorsal posterior cingulate cortex during their own-body processing but a response failure to another's body processing at the precuneus and ventral PCC. Increased task-related connectivity was found between dPCC-dorsal anterior cingulate cortex and precuneus-mid-temporal cortex. Further, AN patients showed decreased resting-state connectivity between the dPCC and the angular gyrus. CONCLUSIONS The PCC and the precuneus are suggested as key components of a network supporting self-other-evaluative processes implicated in body distortion, while the existence of DMN alterations at rest might reflect a sustained, task-independent breakdown within this network in AN.
Collapse
Affiliation(s)
- Esther Via
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,b Department of Clinical Sciences , School of Medicine, University of Barcelona , Barcelona , Spain.,c Melbourne Neuropsychiatry Centre, The Department of Psychiatry , The University of Melbourne , Melbourne , Australia.,d Depression and Anxiety Program, Mental Health Department , Parc Taulí Sabadell University Hospital , Barcelona , Spain
| | - Ximena Goldberg
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,d Depression and Anxiety Program, Mental Health Department , Parc Taulí Sabadell University Hospital , Barcelona , Spain.,e CIBER Salud Mental (CIBERSAM) , Instituto de Salud Carlos III , Barcelona , Spain
| | - Isabel Sánchez
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain
| | - Laura Forcano
- f Clinical research group in human pharmacology and neuroscience , IMIM Research Institute at the Hospital de Mar , Barcelona , Spain.,g CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) , Instituto de Salud Carlos III , Barcelona , Spain
| | - Ben J Harrison
- c Melbourne Neuropsychiatry Centre, The Department of Psychiatry , The University of Melbourne , Melbourne , Australia
| | - Christopher G Davey
- c Melbourne Neuropsychiatry Centre, The Department of Psychiatry , The University of Melbourne , Melbourne , Australia.,h Orygen, The National Centre of Excellence in Youth Mental Health , Melbourne , Australia
| | - Jesús Pujol
- i MRI Research Unit , Hospital del Mar, CIBERSAM G21 , Barcelona , Spain
| | - Ignacio Martínez-Zalacaín
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain
| | - Fernando Fernández-Aranda
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,b Department of Clinical Sciences , School of Medicine, University of Barcelona , Barcelona , Spain.,g CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) , Instituto de Salud Carlos III , Barcelona , Spain
| | - Carles Soriano-Mas
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,e CIBER Salud Mental (CIBERSAM) , Instituto de Salud Carlos III , Barcelona , Spain.,j Department of Psychobiology and Methodology in Health Sciences , Universitat Autònoma de Barcelona , Spain
| | - Narcís Cardoner
- d Depression and Anxiety Program, Mental Health Department , Parc Taulí Sabadell University Hospital , Barcelona , Spain.,k Department of Psychiatry , Universitat Autònoma de Barcelona , Spain
| | - José M Menchón
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,b Department of Clinical Sciences , School of Medicine, University of Barcelona , Barcelona , Spain.,e CIBER Salud Mental (CIBERSAM) , Instituto de Salud Carlos III , Barcelona , Spain
| |
Collapse
|
50
|
Phillipou A, Rossell SL, Gurvich C, Castle DJ, Abel LA, Nibbs RG, Hughes ME. Differences in regional grey matter volumes in currently ill patients with anorexia nervosa. Eur J Neurosci 2018; 47:177-183. [PMID: 29244231 DOI: 10.1111/ejn.13793] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/29/2017] [Accepted: 12/01/2017] [Indexed: 01/03/2023]
Abstract
Neurobiological findings in anorexia nervosa (AN) are inconsistent, including differences in regional grey matter volumes. Methodological limitations often contribute to the inconsistencies reported. The aim of this study was to improve on these methodologies by utilising voxel-based morphometry (VBM) analysis with the use of diffeomorphic anatomic registration through an exponentiated lie algebra algorithm (DARTEL), in a relatively large group of individuals with AN. Twenty-six individuals with AN and 27 healthy controls underwent a T1-weighted magnetic resonance imaging (MRI) scan. AN participants were found to have reduced grey matter volumes in a number of areas including regions of the basal ganglia (including the ventral striatum), and parietal and temporal cortices. Body mass index (BMI) and global scores on the Eating Disorder Examination Questionnaire (EDE-Q) were also found to correlate with grey matter volumes in a region of the brainstem (including the substantia nigra and ventral tegmental area) in AN, and predicted 56% of the variance in grey matter volumes in this area. The brain regions associated with grey matter reductions in AN are consistent with regions responsible for cognitive deficits associated with the illness including anhedonia, deficits in affect perception and saccadic eye movement abnormalities. Overall, the findings suggest reduced grey matter volumes in AN that are associated with eating disorder symptomatology.
Collapse
Affiliation(s)
- Andrea Phillipou
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.,Department of Mental Health, The Austin Hospital, Melbourne, VIC, Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia.,Centre for Mental Health, Swinburne University of Technology, John St, Hawthorn, Melbourne, VIC, 3122, Australia
| | - Susan Lee Rossell
- Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia.,Centre for Mental Health, Swinburne University of Technology, John St, Hawthorn, Melbourne, VIC, 3122, Australia.,Monash Alfred Psychiatry Research Centre, Monash University & The Alfred Hospital, Melbourne, VIC, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Monash University & The Alfred Hospital, Melbourne, VIC, Australia
| | - David Jonathan Castle
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Larry Allen Abel
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Richard Grant Nibbs
- Centre for Mental Health, Swinburne University of Technology, John St, Hawthorn, Melbourne, VIC, 3122, Australia
| | - Matthew Edward Hughes
- Centre for Mental Health, Swinburne University of Technology, John St, Hawthorn, Melbourne, VIC, 3122, Australia
| |
Collapse
|