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Wang L, Xu H, Song Z, Wang H, Hu W, Gao Y, Zhang Z, Jiang J. fMRI signals in white matter rewire gray matter community organization. Neuroimage 2024; 297:120763. [PMID: 39084280 DOI: 10.1016/j.neuroimage.2024.120763] [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: 03/24/2024] [Revised: 07/17/2024] [Accepted: 07/29/2024] [Indexed: 08/02/2024] Open
Abstract
Human brain gray matter (GM) has usually been clustered into multiple functional networks. The white matter (WM) fiber bundles are known to interconnect these networks simultaneously, engaging in numerous cognitive functions. However, the exact interconnections between GM and WM are still unclear, whether functional signals in WM rewires GM community organization remains to be explored. In this study, we divided brain functional connections into three types by using edge-centric method, including intra-GM, intra-WM and GM-WM connections, and calculated the edge community evaluation indexes for quantifying GM community engagement. The results showed that the involvement of WM significantly enhanced community entropy in the heteromodal system, while the sensory-attention system remained barely changed. In addition, delta community entropy showed a significant correlation with clinical cognitive scale. Our results suggested that WM rewired GM community organization, enhancing the community engagement of brain regions in the heteromodal system. This involvement was observed to be disrupted in disease groups. Our study revealed that considering the functional signals of GM and WM simultaneously could better understand the brain's functional organization.
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Affiliation(s)
- Luyao Wang
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Huanyu Xu
- School of Communication and Information Engineering, Shanghai University, Shanghai 200444, China
| | - Ziyan Song
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Huanxin Wang
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Wenjing Hu
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Yiwen Gao
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Zhilin Zhang
- Research Center for Medical Artificial Intelligence, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China.
| | - Jiehui Jiang
- Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai 200444, China.
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Wang X, Xue L, Hua L, Shao J, Yan R, Yao Z, Lu Q. Structure-function coupling and hierarchy-specific antidepressant response in major depressive disorder. Psychol Med 2024:1-10. [PMID: 38571298 DOI: 10.1017/s0033291724000801] [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: 04/05/2024]
Abstract
BACKGROUND Extensive research has explored altered structural and functional networks in major depressive disorder (MDD). However, studies examining the relationships between structure and function yielded heterogeneous and inconclusive results. Recent work has suggested that the structure-function relationship is not uniform throughout the brain but varies across different levels of functional hierarchy. This study aims to investigate changes in structure-function couplings (SFC) and their relevance to antidepressant response in MDD from a functional hierarchical perspective. METHODS We compared regional SFC between individuals with MDD (n = 258) and healthy controls (HC, n = 99) using resting-state functional magnetic resonance imaging and diffusion tensor imaging. We also compared antidepressant non-responders (n = 55) and responders (n = 68, defined by a reduction in depressive severity of >50%). To evaluate variations in altered and response-associated SFC across the functional hierarchy, we ranked significantly different regions by their principal gradient values and assessed patterns of increase or decrease along the gradient axis. The principal gradient value, calculated from 219 healthy individuals in the Human Connectome Project, represents a region's position along the principal gradient axis. RESULTS Compared to HC, MDD patients exhibited increased SFC in unimodal regions (lower principal gradient) and decreased SFC in transmodal regions (higher principal gradient) (p < 0.001). Responders primarily had higher SFC in unimodal regions and lower SFC in attentional networks (median principal gradient) (p < 0.001). CONCLUSIONS Our findings reveal opposing SFC alterations in low-level unimodal and high-level transmodal networks, underscoring spatial variability in MDD pathology. Moreover, hierarchy-specific antidepressant effects provide valuable insights into predicting treatment outcomes.
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Affiliation(s)
- Xinyi Wang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing, China
| | - Li Xue
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing, China
| | - Lingling Hua
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Junneng Shao
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing, China
| | - Rui Yan
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing, China
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3
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Zhu Y, Huang T, Li R, Yang Q, Zhao C, Yang M, Lin B, Li X. Distinct resting-state effective connectivity of large-scale networks in first-episode and recurrent major depression disorder: evidence from the REST-meta-MDD consortium. Front Neurosci 2023; 17:1308551. [PMID: 38148946 PMCID: PMC10750394 DOI: 10.3389/fnins.2023.1308551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/24/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction Previous studies have shown disrupted effective connectivity in the large-scale brain networks of individuals with major depressive disorder (MDD). However, it is unclear whether these changes differ between first-episode drug-naive MDD (FEDN-MDD) and recurrent MDD (R-MDD). Methods This study utilized resting-state fMRI data from 17 sites in the Chinese REST-meta-MDD project, consisting of 839 patients with MDD and 788 normal controls (NCs). All data was preprocessed using a standardized protocol. Then, we performed a granger causality analysis to calculate the effectivity connectivity (EC) within and between brain networks for each participant, and compared the differences between the groups. Results Our findings revealed that R-MDD exhibited increased EC in the fronto-parietal network (FPN) and decreased EC in the cerebellum network, while FEDN-MDD demonstrated increased EC from the sensorimotor network (SMN) to the FPN compared with the NCs. Importantly, the two MDD subgroups displayed significant differences in EC within the FPN and between the SMN and visual network. Moreover, the EC from the cingulo-opercular network to the SMN showed a significant negative correlation with the Hamilton Rating Scale for Depression (HAMD) score in the FEDN-MDD group. Conclusion These findings suggest that first-episode and recurrent MDD have distinct effects on the effective connectivity in large-scale brain networks, which could be potential neural mechanisms underlying their different clinical manifestations.
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Affiliation(s)
- Yao Zhu
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Tianming Huang
- Department of General Psychiatry, Shanghai Changning Mental Health Center, Shanghai, China
| | - Ruolin Li
- Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Qianrong Yang
- Department of General Psychiatry, Shanghai Changning Mental Health Center, Shanghai, China
| | - Chaoyue Zhao
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Ming Yang
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Bin Lin
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Xuzhou Li
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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4
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Chen K, Zhuang W, Zhang Y, Yin S, Liu Y, Chen Y, Kang X, Ma H, Zhang T. Alteration of the large-scale white-matter functional networks in autism spectrum disorder. Cereb Cortex 2023; 33:11582-11593. [PMID: 37851712 DOI: 10.1093/cercor/bhad392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023] Open
Abstract
Autism spectrum disorder is a neurodevelopmental disorder whose core deficit is social dysfunction. Previous studies have indicated that structural changes in white matter are associated with autism spectrum disorder. However, few studies have explored the alteration of the large-scale white-matter functional networks in autism spectrum disorder. Here, we identified ten white-matter functional networks on resting-state functional magnetic resonance imaging data using the K-means clustering algorithm. Compared with the white matter and white-matter functional network connectivity of the healthy controls group, we found significantly decreased white matter and white-matter functional network connectivity mainly located within the Occipital network, Middle temporo-frontal network, and Deep network in autism spectrum disorder. Compared with healthy controls, findings from white-matter gray-matter functional network connectivity showed the decreased white-matter gray-matter functional network connectivity mainly distributing in the Occipital network and Deep network. Moreover, we compared the spontaneous activity of white-matter functional networks between the two groups. We found that the spontaneous activity of Middle temporo-frontal and Deep network was significantly decreased in autism spectrum disorder. Finally, the correlation analysis showed that the white matter and white-matter functional network connectivity between the Middle temporo-frontal network and others networks and the spontaneous activity of the Deep network were significantly correlated with the Social Responsiveness Scale scores of autism spectrum disorder. Together, our findings indicate that changes in the white-matter functional networks are associated behavioral deficits in autism spectrum disorder.
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Affiliation(s)
- Kai Chen
- Mental Health Education Center and School of Big Health Management, Xihua University, Jinniu District, Chengdu, Sichuan, China
| | - Wenwen Zhuang
- Mental Health Education Center and School of Big Health Management, Xihua University, Jinniu District, Chengdu, Sichuan, China
| | - Yanfang Zhang
- Department of Ultrasonic Medicine, Baiyun Branch, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Shunjie Yin
- Mental Health Education Center and School of Big Health Management, Xihua University, Jinniu District, Chengdu, Sichuan, China
| | - Yinghua Liu
- Mental Health Education Center and School of Big Health Management, Xihua University, Jinniu District, Chengdu, Sichuan, China
| | - Yuan Chen
- Mental Health Education Center and School of Big Health Management, Xihua University, Jinniu District, Chengdu, Sichuan, China
| | - Xiaodong Kang
- The Department of Sichuan 81 Rehabilitation Center, Chengdu University of TCM, No. 81 Bayi Road, Yongning Street, Wenjiang District, Chengdu City 610075, China
| | - Hailin Ma
- Plateau Brain Science Research Center, Tibet University, 10 Zangda East Road, Lhasa City 510631, China
| | - Tao Zhang
- Mental Health Education Center and School of Big Health Management, Xihua University, Jinniu District, Chengdu, Sichuan, China
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5
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Li Y, Zhang B, Liu Z, Wang R. Neural energy computations based on Hodgkin-Huxley models bridge abnormal neuronal activities and energy consumption patterns of major depressive disorder. Comput Biol Med 2023; 166:107500. [PMID: 37797488 DOI: 10.1016/j.compbiomed.2023.107500] [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: 07/12/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 10/07/2023]
Abstract
Limited by the current experimental techniques and neurodynamical models, the dysregulation mechanisms of decision-making related neural circuits in major depressive disorder (MDD) are still not clear. In this paper, we proposed a neural coding methodology using energy to further investigate it, which has been proven to strongly complement the neurodynamical methodology. We augmented the previous neural energy calculation method, and applied it to our VTA-NAc-mPFC neurodynamical H-H models. We particularly focused on the peak power and energy consumption of abnormal ion channel (ionic) currents under different concentrations of dopamine input, and investigated the abnormal energy consumption patterns for the MDD group. The results revealed that the energy consumption of medium spiny neurons (MSNs) in the NAc region were lower in the MDD group than that of the normal control group despite having the same firing frequencies, peak action potentials, and average membrane potentials in both groups. Dopamine concentration was also positively correlated with the energy consumption of the pyramidal neurons, but the patterns of different interneuron types were distinct. Additionally, the ratio of mPFC's energy consumption to total energy consumption of the whole network in MDD group was lower than that in normal control group, revealing that the mPFC region in MDD group encoded less neural information, which matched the energy consumption patterns of BOLD-fMRI results. It was also in line with the behavioral characteristics that MDD patients demonstrated in the form of reward insensitivity during decision-making tasks. In conclusion, the model in this paper was the first neural network energy computational model for MDD, which showed success in explaining its dynamical mechanisms with an energy consumption perspective. To build on this, we demonstrated that energy consumption levels can be used as a potential indicator for MDD, which also showed a promising pipeline to use an energy methodology for studying other neuropsychiatric disorders.
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Affiliation(s)
- Yuanxi Li
- Institute for Cognitive Neurodynamics, School of Mathematics, East China University of Science and Technology, Shanghai, China; Department of Neurology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA.
| | - Bing Zhang
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Zhiqiang Liu
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China; Anesthesia and Brain Function Research Institute, Tongji University School of Medicine, Shanghai, China.
| | - Rubin Wang
- Institute for Cognitive Neurodynamics, School of Mathematics, East China University of Science and Technology, Shanghai, China.
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6
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Zhang X, Li Y, Guan Q, Dong D, Zhang J, Meng X, Chen F, Luo Y, Zhang H. Distance-dependent reconfiguration of hubs in Alzheimer's disease: a cross-tissue functional network study. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.24.532772. [PMID: 36993290 PMCID: PMC10055319 DOI: 10.1101/2023.03.24.532772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
The hubs of the intra-grey matter (GM) network were sensitive to anatomical distance and susceptible to neuropathological damage. However, few studies examined the hubs of cross-tissue distance-dependent networks and their changes in Alzheimer's disease (AD). Using resting-state fMRI data of 30 AD patients and 37 normal older adults (NC), we constructed the cross-tissue networks based on functional connectivity (FC) between GM and white matter (WM) voxels. In the full-ranged and distance-dependent networks (characterized by gradually increased Euclidean distances between GM and WM voxels), their hubs were identified with weight degree metrics (frWD and ddWD). We compared these WD metrics between AD and NC; using the resultant abnormal WDs as the seeds, we performed seed-based FC analysis. With increasing distance, the GM hubs of distance-dependent networks moved from the medial to lateral cortices, and the WM hubs spread from the projection fibers to longitudinal fascicles. Abnormal ddWD metrics in AD were primarily located in the hubs of distance-dependent networks around 20-100mm. Decreased ddWDs were located in the left corona radiation (CR), which had decreased FCs with the executive network's GM regions in AD. Increased ddWDs were located in the posterior thalamic radiation (PTR) and the temporal-parietal-occipital junction (TPO), and their FCs were larger in AD. Increased ddWDs were shown in the sagittal striatum, which had larger FCs with the salience network's GM regions in AD. The reconfiguration of cross-tissue distance-dependent networks possibly reflected the disruption in the neural circuit of executive function and the compensatory changes in the neural circuits of visuospatial and social-emotional functions in AD.
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Affiliation(s)
- Xingxing Zhang
- Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Yingjia Li
- Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Qing Guan
- Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Debo Dong
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, 400715, China
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Jianfeng Zhang
- Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Xianghong Meng
- Department of Neurosurgery, Shenzhen University General Hospital, Shenzhen University, Shenzhen, China
| | - Fuyong Chen
- Department of Neurosurgery, Shenzhen Hospital of University of Hong Kong, Shenzhen, China
| | - Yuejia Luo
- Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Haobo Zhang
- Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
- School of Psychology, Shenzhen University, Shenzhen, China
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7
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Fu CHY, Erus G, Fan Y, Antoniades M, Arnone D, Arnott SR, Chen T, Choi KS, Fatt CC, Frey BN, Frokjaer VG, Ganz M, Garcia J, Godlewska BR, Hassel S, Ho K, McIntosh AM, Qin K, Rotzinger S, Sacchet MD, Savitz J, Shou H, Singh A, Stolicyn A, Strigo I, Strother SC, Tosun D, Victor TA, Wei D, Wise T, Woodham RD, Zahn R, Anderson IM, Deakin JFW, Dunlop BW, Elliott R, Gong Q, Gotlib IH, Harmer CJ, Kennedy SH, Knudsen GM, Mayberg HS, Paulus MP, Qiu J, Trivedi MH, Whalley HC, Yan CG, Young AH, Davatzikos C. AI-based dimensional neuroimaging system for characterizing heterogeneity in brain structure and function in major depressive disorder: COORDINATE-MDD consortium design and rationale. BMC Psychiatry 2023; 23:59. [PMID: 36690972 PMCID: PMC9869598 DOI: 10.1186/s12888-022-04509-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Efforts to develop neuroimaging-based biomarkers in major depressive disorder (MDD), at the individual level, have been limited to date. As diagnostic criteria are currently symptom-based, MDD is conceptualized as a disorder rather than a disease with a known etiology; further, neural measures are often confounded by medication status and heterogeneous symptom states. METHODS We describe a consortium to quantify neuroanatomical and neurofunctional heterogeneity via the dimensions of novel multivariate coordinate system (COORDINATE-MDD). Utilizing imaging harmonization and machine learning methods in a large cohort of medication-free, deeply phenotyped MDD participants, patterns of brain alteration are defined in replicable and neurobiologically-based dimensions and offer the potential to predict treatment response at the individual level. International datasets are being shared from multi-ethnic community populations, first episode and recurrent MDD, which are medication-free, in a current depressive episode with prospective longitudinal treatment outcomes and in remission. Neuroimaging data consist of de-identified, individual, structural MRI and resting-state functional MRI with additional positron emission tomography (PET) data at specific sites. State-of-the-art analytic methods include automated image processing for extraction of anatomical and functional imaging variables, statistical harmonization of imaging variables to account for site and scanner variations, and semi-supervised machine learning methods that identify dominant patterns associated with MDD from neural structure and function in healthy participants. RESULTS We are applying an iterative process by defining the neural dimensions that characterise deeply phenotyped samples and then testing the dimensions in novel samples to assess specificity and reliability. Crucially, we aim to use machine learning methods to identify novel predictors of treatment response based on prospective longitudinal treatment outcome data, and we can externally validate the dimensions in fully independent sites. CONCLUSION We describe the consortium, imaging protocols and analytics using preliminary results. Our findings thus far demonstrate how datasets across many sites can be harmonized and constructively pooled to enable execution of this large-scale project.
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Affiliation(s)
- Cynthia H Y Fu
- Department of Psychological Sciences, University of East London, London, UK.
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Guray Erus
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Yong Fan
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Mathilde Antoniades
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Danilo Arnone
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Taolin Chen
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Ki Sueng Choi
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Cherise Chin Fatt
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, USA
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Mood Disorders Treatment and Research Centre and Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Vibe G Frokjaer
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Melanie Ganz
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Jose Garcia
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Beata R Godlewska
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Stefanie Hassel
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Keith Ho
- Department of Psychiatry, University Health Network, Toronto, Canada
| | - Andrew M McIntosh
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Kun Qin
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Susan Rotzinger
- Department of Psychiatry, University Health Network, Toronto, Canada
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, Canada
| | - Matthew D Sacchet
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | | | - Haochang Shou
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Penn Statistics in Imaging and Visualization Endeavor (PennSIVE) Center, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, USA
| | - Ashish Singh
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Aleks Stolicyn
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Irina Strigo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | - Stephen C Strother
- Rotman Research Institute, Baycrest Centre, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, USA
| | | | - Dongtao Wei
- School of Psychology, Southwest University, Chongqing, China
| | - Toby Wise
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rachel D Woodham
- Department of Psychological Sciences, University of East London, London, UK
| | - Roland Zahn
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Ian M Anderson
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - J F William Deakin
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA
| | - Rebecca Elliott
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, USA
| | | | - Sidney H Kennedy
- Department of Psychiatry, University Health Network, Toronto, Canada
- Centre for Depression and Suicide Studies, Unity Health Toronto, Toronto, Canada
- Unity Health Toronto, Toronto, Canada
| | - Gitte M Knudsen
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Jiang Qiu
- School of Psychology, Southwest University, Chongqing, China
| | - Madhukar H Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, USA
| | - Heather C Whalley
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Chao-Gan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, London, UK
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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8
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Abnormal dynamic functional network connectivity in first-episode, drug-naïve patients with major depressive disorder. J Affect Disord 2022; 319:336-343. [PMID: 36084757 DOI: 10.1016/j.jad.2022.08.072] [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: 04/18/2022] [Revised: 06/25/2022] [Accepted: 08/22/2022] [Indexed: 11/20/2022]
Abstract
Dynamic functional network connectivity (dFNC) could capture temporal features of spontaneous brain activity during MRI scanning, and it might be a powerful tool to examine functional brain network alters in major depressive disorder (MDD). Therefore, this study investigated the changes in temporal properties of dFNC of first-episode, drug-naïve patients with MDD. A total of 48 first-episode, drug-naïve MDD patients and 46 age- and gender-matched healthy controls were recruited in this study. Sliding windows were implied to construct dFNC. We assessed the relationships between altered dFNC temporal properties and depressive symptoms. Receiver operating characteristic (ROC) curve analyses were used to examine the diagnostic performance of these altered temporal properties. The results showed that patients with MDD have more occurrences and spent more time in a weak connection state, but with fewer occurrences and shorter dwell time in a strong connection state. Importantly, the fractional time and mean dwell time of state 2 was negatively correlated with Hamilton Depression Rating Scale (HDRS) scores. ROC curve analysis demonstrated that these temporal properties have great identified power including the fractional time and mean dwell time in state 2, and the AUC is 0.872, 0.837, respectively. The AUC of the combination of fractional time and mean dwell time in state 2 with age, gender is 0.881. Our results indicated the temporal properties of dFNC are altered in first-episode, drug-naïve patients with MDD, and these changes' properties could serve as a potential biomarker in MDD.
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Meng L, Wang H, Zou T, Wang X, Chen H, Xie F, Li R. Attenuated brain white matter functional network interactions in Parkinson's disease. Hum Brain Mapp 2022; 43:4567-4579. [PMID: 35674466 PMCID: PMC9491278 DOI: 10.1002/hbm.25973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/24/2022] [Accepted: 05/29/2022] [Indexed: 01/21/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by extensive structural abnormalities in cortical and subcortical brain areas. However, an association between changes in the functional networks in brain white matter (BWM) and Parkinson's symptoms remains unclear. With confirming evidence that resting-state functional magnetic resonance imaging (rs-fMRI) of BWM signals can effectively describe neuronal activity, this study investigated the interactions among BWM functional networks in PD relative to healthy controls (HC). Sixty-eight patients with PD and sixty-three HC underwent rs-fMRI. Twelve BWM functional networks were identified by K-means clustering algorithm, which were further classified as deep, middle, and superficial layers. Network-level interactions were examined via coefficient Granger causality analysis. Compared with the HC, the patients with PD displayed significantly weaker functional interaction strength within the BWM networks, particularly excitatory influences from the superficial to deep networks. The patients also showed significantly weaker inhibitory influences from the deep to superficial networks. Additionally, the sum of the absolutely positive/negative regression coefficients of the tri-layered networks in the patients was lower relative to HC (p < .05, corrected for false discovery rate). Moreover, we found the functional interactions involving the deep BWM networks negatively correlated with part III of the Unified Parkinson's Disease Rating Scales and Hamilton Depression Scales. Taken together, we demonstrated attenuated BWM interactions in PD and these abnormalities were associated with clinical motor and nonmotor symptoms. These findings may aid understanding of the neuropathology of PD and its progression throughout the nervous system from the perspective of BWM function.
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Affiliation(s)
- Li Meng
- Department of Radiology, Xiangya HospitalCentral South UniversityChangshaPeople's Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya HospitalCentral South UniversityChangshaHunanChina
| | - Hongyu Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduPeople's Republic of China
| | - Ting Zou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduPeople's Republic of China
| | - Xuyang Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduPeople's Republic of China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduPeople's Republic of China
| | - Fangfang Xie
- Department of Radiology, Xiangya HospitalCentral South UniversityChangshaPeople's Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya HospitalCentral South UniversityChangshaHunanChina
| | - Rong Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduPeople's Republic of China
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10
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Xie H, Zhang F, Cao Y, Long X, Wu B, Gong Q, Jia Z. Brain default mode network mediates the association between negative perfectionism and exercise dependence. J Behav Addict 2022; 11:928-940. [PMID: 36112490 PMCID: PMC9872538 DOI: 10.1556/2006.2022.00067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/11/2022] [Accepted: 08/19/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND AIMS Perfectionism is correlated with the occurrence of exercise dependence. We aim to reveal the role of functional connectivity (FC) between gray matter (GM) and white matter (WM) networks in the association between perfectionism and exercise dependence. METHODS In this cross-sectional study, one hundred ten participants with exercise dependence underwent behavioral evaluation and resting-state functional magnetic resonance imaging. Perfectionism and exercise dependence were quantified using the Frost Multidimensional Perfectionism Scale (FMPS) and Exercise Dependence Scale (EDS). We used a K-means clustering algorithm to identify functional GM and WM networks and obtained the FCs of the GM-GM, GM-WM, and WM-WM networks. Partial correlation and mediation analyses were performed to explore the relationships among FCs, FMPS, and EDS. RESULTS We identified ten stable GM networks and nine WM networks. Of these, FCs existed between the corona radiata network (WM1) and default mode network (DMN, GM8), WM1 network and WM DMN (WM4), WM1 network and midbrain WM network (WM7), and WM4 network and inferior longitudinal fasciculus network (WM9). The WM1-GM8 and WM1-WM4 FCs were positively correlated with the EDS and negative FMPS. The mediating effects of the WM1-GM8 and WM1-WM4 FCs were established in the association between the negative dimensional FMPS and EDS. DISCUSSION AND CONCLUSIONS The WM1 network anatomically linked the subregions within the GM8 and WM4 networks, and WM1-GM8 and WM1-WM4 FCs mediated the association between negative dimensional FMPS and EDS. These findings indicated that DMN function might be involved in the increased risks of exercise dependence promoted by negative perfectionism.
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Affiliation(s)
- Hongsheng Xie
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Feifei Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China,Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi Province, China
| | - Yuan Cao
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, 610041, China
| | - Xipeng Long
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Baolin Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China,Functional and Molecular Imaging Key Laboratory of Sichuan University, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China,Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, 361021, Fujian Province, China,Corresponding authors. E-mail: ,
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, 610041, China,Functional and Molecular Imaging Key Laboratory of Sichuan University, West China Hospital of Sichuan University, Chengdu, 610041, China,Corresponding authors. E-mail: ,
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11
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Interleukin-6-white matter network differences explained the susceptibility to depression after stressful life events. J Affect Disord 2022; 305:122-132. [PMID: 35271870 DOI: 10.1016/j.jad.2022.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Stressful life events (SLEs) are well-established proximal predictors of the onset of depression. However, the fundamental causes of interindividual differences in depression outcomes are poorly understood. This study addressed this depression susceptibility mechanism using a well-powered sample of adults living in China. METHODS Healthy participants with SLEs (n = 185; mean = 47.51 years, 49.73% female), drawn from a longitudinal study on the development of depression, underwent diffusion tensor imaging, interleukin-6 (IL-6) level measurement, and trimonthly standardized clinical and scale evaluations within a two-year period. RESULTS Receiver operating characteristic analyses indicated that reduced feeder connection and HIP.R nodal efficiency improved the predictive accuracy of post-SLEs depression (ORfeeder = 0.623, AUC = 0.869, P < 0.001; ORHIP = 0.459, AUC = 0.855, P < 0.001). The successfully established path analysis model confirmed the significant partial effect of SLEs-IL-6-white matter (WM) network differences-depression (onset and severity) (x2/8 = 1.453, goodness-of-fit [GFI] = 0.935, standard root-mean-square error of approximation [SRMR] = 0.024). Females, individuals with lower exercise frequency (EF) or annual household income (AHI) were more likely to have higher IL-6 level after SLEs (βint-female⁎SLEs = -0.420, P < 0.001; βint-exercise⁎SLEs = -0.412, P < 0.001; βint-income⁎SLEs = -0.302, P = 0.005). LIMITATIONS The sample size was restricted due to the limited incidence rate and prospective follow-up design. CONCLUSIONS Our results suggested that among healthy adults after SLEs, those who exhibited abnormal IL-6-WM differences were susceptible to developing depression. Females, lower AHI or EF might account for an increased risk of developing these abnormal IL-6-WM differences.
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Zhang X, Guan Q, Li Y, Zhang J, Zhu W, Luo Y, Zhang H. Aberrant Cross-Tissue Functional Connectivity in Alzheimer’s Disease: Static, Dynamic, and Directional Properties. J Alzheimers Dis 2022; 88:273-290. [DOI: 10.3233/jad-215649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: BOLD signals in the gray matter (GM) and white matter (WM) are tightly coupled. However, our understanding of the cross-tissue functional network in Alzheimer’s disease (AD) is limited. Objective: We investigated the changes of cross-tissue functional connectivity (FC) metrics for the GM regions susceptible to AD damage. Methods: For each GM region in the default mode (DMN) and limbic networks, we obtained its low-order static FC with any WM region, and the high-order static FC between any two WM regions based on their FC pattern similarity with multiple GM regions. The dynamic and directional properties of cross-tissue FC were then acquired, specifically for the regional pairs whose low- or high-order static FCs showed significant differences between AD and normal control (NC). Moreover, these cross-tissue FC metrics were correlated with voxel-based GM volumes and MMSE in all participants. Results: Compared to NC, AD patients showed decreased low-order static FCs between the intra-hemispheric GM-WM pairs (right ITG-right fornix; left MoFG-left posterior corona radiata), and increased low-order static, dynamic, and directional FCs between the inter-hemispheric GM-WM pairs (right MTG-left superior/posterior corona radiata). The high-order static and directional FCs between the left cingulate bundle-left tapetum were increased in AD, based on their FCs with the GMs of DMN. Those decreased and increased cross-tissue FC metrics in AD had opposite correlations with memory-related GM volumes and MMSE (positive for the decreased and negative for the increased). Conclusion: Cross-tissue FC metrics showed opposite changes in AD, possibly as useful neuroimaging biomarkers to reflect neurodegenerative and compensatory mechanisms.
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Affiliation(s)
- Xingxing Zhang
- Center for Brain Disorders and Cognitive Sciences, School of Psychology, Shenzhen University, Shenzhen, China
| | - Qing Guan
- Center for Brain Disorders and Cognitive Sciences, School of Psychology, Shenzhen University, Shenzhen, China
- Shenzhen-Hong Kong Institute of Brain Science, Shenzhen, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Yingjia Li
- Center for Brain Disorders and Cognitive Sciences, School of Psychology, Shenzhen University, Shenzhen, China
| | - Jianfeng Zhang
- Center for Brain Disorders and Cognitive Sciences, School of Psychology, Shenzhen University, Shenzhen, China
| | - Wanlin Zhu
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuejia Luo
- Center for Brain Disorders and Cognitive Sciences, School of Psychology, Shenzhen University, Shenzhen, China
| | - Haobo Zhang
- Center for Brain Disorders and Cognitive Sciences, School of Psychology, Shenzhen University, Shenzhen, China
- Shenzhen-Hong Kong Institute of Brain Science, Shenzhen, China
- Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China
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Guo Q, Duan J, Cai S, Zhang J, Chen T, Yang H. Desynchronized white matter function and structure in drug-naive first-episode major depressive disorder patients. Front Psychiatry 2022; 13:1082052. [PMID: 36713909 PMCID: PMC9874158 DOI: 10.3389/fpsyt.2022.1082052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a highly prevalent mental disease. Using magnetic resonance imaging (MRI), although numerous studies have revealed the alterations in structure and function of grey matter (GM), few studies focused on the synchronization of white matter (WM) structure and function in MDD. The aim of this study was to investigate whether functional and structural abnormalities of WM play an essential role in the neurobiological mechanisms of MDD. METHODS Gradient-echo imaging sequences at 3.0T were used to gather resting state functional MRI (rsfMRI) data, which were performed on 33 drug-naive first-episode MDD patients and 34 healthy controls (HCs). After data preprocessed, amplitude of low frequency fluctuation (ALFF) of WM was calculated. ALFF values in different frequency bands were analyzed, including typical (0.01-0.15 Hz) band, slow-4 (0.027-0.073 Hz) and slow-5 (0.01-0.027 Hz) bands. In addition, the fractional anisotropy (FA) values in WM in 23 patients and 26 HCs were examined using tract-based spatial statistics (TBSS) and tractography based on diffusion tensor imaging (DTI). Pearson correlation analysis was applied to analyze the relationships between ALFF values and Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA). RESULTS Compared with the HCs, MDD patients showed decreased ALFF values in posterior thalamic radiation (PTR) and superior longitudinal fasciculus (SLF) in slow-5 frequency band, no significant differences of ALFF values were found in typical and slow-4 frequency bands. In addition, there were no significant differences in FA values with TBSS analysis as well as the number of fibers in PTR and SLF with tractography analysis between two groups. Further correlation analysis showed that the ALFF value in SLF was negatively correlated with HAMA-2 score (r = -0.548, p FDR = 0.037) in patients. CONCLUSION Our results indicated that WM dysfunction may be associated with the pathophysiological mechanism of depression. Our study also suggested that the functional damage of the WM may precedes the structural damage in first-episode MDD patients. Furthermore, for mental disorders, slow-5 frequency band may be a more sensitive functional indicator for early detection of abnormal spontaneous brain activity in WM.
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Affiliation(s)
- Qinger Guo
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jingfeng Duan
- Department of Psychiatry, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Shuyang Cai
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jiaxi Zhang
- School of Teacher Education, Zhejiang Normal University, Jinhua, China.,Key Laboratory of Intelligent Education Technology and Application of Zhejiang, Zhejiang Normal University, Jinhua, China
| | - Tao Chen
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Hong Yang
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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