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Zhang C, Zhang X, Li W, Zhang T, Zhang Z, Lu L, Didonna F, Fan Q. Pallidum volume as a predictor for the effectiveness of mindfulness-based cognitive therapy and psycho-education in unmedicated patients with obsessive-compulsive disorder. Compr Psychiatry 2024; 131:152462. [PMID: 38354586 DOI: 10.1016/j.comppsych.2024.152462] [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: 10/21/2023] [Revised: 02/03/2024] [Accepted: 02/09/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Mindfulness-based cognitive therapy (MBCT) has been documented to be effective in treating obsessive-compulsive disorder (OCD). However, the neurobiological basis of MBCT remains largely elusive, which makes it clinically challenging to predict which patients are more likely to respond poorly. Hence, identifying biomarkers for predicting treatment outcomes holds both scientific and clinical values. This prognostic study aims to investigate whether pre-treatment brain morphological metrics can predict the effectiveness of MBCT, compared with psycho-education (PE) as an active placebo, among patients with OCD. METHODS A total of 32 patients with OCD were included in this prognostic study. They received magnetic resonance imaging (MRI) brain scans before treatment. Subsequently, 16 patients received 10 weeks of MBCT, while the other 16 patients underwent a 10-week PE program. The effectiveness of the treatments was primarily assessed by the reduction rate of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) total score before and after the treatment. We investigated whether several predefined OCD-associated brain morphological metrics, selected based on prior published studies by the ENIGMA Consortium, could predict the treatment effectiveness. RESULTS Both the MBCT and PE groups exhibited substantial reductions in Y-BOCS scores over 10 weeks of treatment, with the MBCT group showing a larger reduction. Notably, the pallidum total volume was associated with treatment effectiveness, irrespective of the intervention group. Specifically, a linear regression model utilizing the pre-treatment pallidum volume to predict the treatment effectiveness suggested that a one-cubic-centimeter increase in pallidum volume corresponded to a 22.3% decrease in the Y-BOCS total score reduction rate. CONCLUSIONS Pallidum volume may serve as a promising predictor for the effectiveness of MBCT and PE, and perhaps, other treatments with the shared mechanisms by MBCT and PE, among patients with OCD.
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Affiliation(s)
- Chen Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaochen Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenqing Li
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Tianran Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
| | - Zongfeng Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Psychiatry, Ningbo Kangning Hospital & Affiliated Mental Health Centre, Ningbo University, Ningbo, Zhejiang, China
| | - Lu Lu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Clinical Psychology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Qing Fan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; Mental Health Branch, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China.
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Blömer S, Hingerl L, Marjańska M, Bogner W, Motyka S, Hangel G, Klauser A, Andronesi OC, Strasser B. Proton Free Induction Decay MRSI at 7T in the Human Brain Using an Egg-Shaped Modified Rosette K-Space Trajectory. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.26.24304840. [PMID: 38645249 PMCID: PMC11027556 DOI: 10.1101/2024.03.26.24304840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Purpose 1.1 Proton ( 1 H)-MRSI via spatial-spectral encoding poses high demands on gradient hardware at ultra-high fields and high-resolutions. Rosette trajectories help alleviate these problems, but at reduced SNR-efficiency due to their k-space densities not matching any desired k-space filter. We propose modified rosette trajectories, which more closely match a Hamming filter, and thereby improve SNR performance while still staying within gradient hardware limitations and without prolonging scan time. Methods 1.2Analytical and synthetic simulations were validated with phantom and in vivo measurements at 7 T. The rosette and modified rosette trajectories were measured in five healthy volunteers in six minutes in a 2D slice in the brain. A 3D sequence was measured in one volunteer within 19 minutes. The SNR, linewidth, CRLBs, lipid contamination and data quality of the proposed modified rosette trajectory were compared to the rosette trajectory. Results 1.3Using the modified rosette trajectories, an improved k-space weighting function was achieved resulting in an increase of up to 12% in SNR compared to rosette's dependent on the two additional trajectory parameters. Similar results were achieved for the theoretical SNR calculation based on k-space densities, as well as when using the pseudo-replica method for simulated, in-vivo and phantom data. The CRLBs improved slightly, but non-significantly for the modified rosette trajectories, while the linewidths and lipid contamination remained similar. Conclusion 1.4By improving the rosette trajectory's shape, modified rosette trajectories achieved higher SNR at the same scan time and data quality.
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Sim S, Maldonado IL, Castelnau P, Barantin L, El-Hage W, Andersson F, Cottier JP. Neural correlates of mindfulness meditation and hypnosis on magnetic resonance imaging: similarities and differences. A scoping review. J Neuroradiol 2024; 51:131-144. [PMID: 37981196 DOI: 10.1016/j.neurad.2023.11.002] [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: 07/27/2023] [Revised: 10/23/2023] [Accepted: 11/12/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Mindfulness meditation (MM) and hypnosis practices are gaining interest in mental health, but their physiological mechanisms remain poorly understood. This study aimed to synthesize the functional, morphometric and metabolic changes associated with each practice using magnetic resonance imaging (MRI), and to identify their similarities and differences. METHODS MRI studies investigating MM and hypnosis in mental health, specifically stress, anxiety, and depression, were systematically screened following PRISMA guidelines from four research databases (PubMed, Web of Science, Embase, PsycINFO) between 2010 and 2022. RESULTS In total, 97 references met the inclusion criteria (84 for MM and 13 for hypnosis). This review showed common and divergent points regarding the regions involved and associated brain connectivity during MM practice and hypnosis. The primary commonality between mindfulness and hypnosis was decreased default mode network intrinsic activity and increased central executive network - salience network connectivity. Increased connectivity between the default mode network and the salience network was observed in meditative practice and mindfulness predisposition, but not in hypnosis. CONCLUSIONS While MRI studies provide a better understanding of the neural basis of hypnosis and meditation, this review underscores the need for more rigorous studies.
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Affiliation(s)
- Sindy Sim
- CHRU de Tours, service de radiologie, Tours, France
| | | | - Pierre Castelnau
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Service de Neuropédiatrie et Handicaps, Hôpital Clocheville, CHRU, Tours, France; CUMIC, Collège Universitaire des Médecines Intégratives et Complémentaires, Nantes, France
| | | | - Wissam El-Hage
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CHRU de Tours, Clinique Psychiatrique Universitaire, Tours, France
| | | | - Jean-Philippe Cottier
- CHRU de Tours, service de radiologie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CUMIC, Collège Universitaire des Médecines Intégratives et Complémentaires, Nantes, France.
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Vaziri S, Liu H, Xie E, Ratiney H, Sdika M, Lupo JM, Xu D, Li Y. Evaluation of deep learning models for quality control of MR spectra. Front Neurosci 2023; 17:1219343. [PMID: 37706154 PMCID: PMC10495580 DOI: 10.3389/fnins.2023.1219343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/10/2023] [Indexed: 09/15/2023] Open
Abstract
Purpose While 3D MR spectroscopic imaging (MRSI) provides valuable spatial metabolic information, one of the hurdles for clinical translation is its interpretation, with voxel-wise quality control (QC) as an essential and the most time-consuming step. This work evaluates the accuracy of machine learning (ML) models for automated QC filtering of individual spectra from 3D healthy control and patient datasets. Methods A total of 53 3D MRSI datasets from prior studies (30 neurological diseases, 13 brain tumors, and 10 healthy controls) were included in the study. Three ML models were evaluated: a random forest classifier (RF), a convolutional neural network (CNN), and an inception CNN (ICNN) along with two hybrid models: CNN + RF, ICNN + RF. QC labels used for training were determined manually through consensus of two MRSI experts. Normalized and cropped real-valued spectra was used as input. A cross-validation approach was used to separate datasets into training/validation/testing sets of aggregated voxels. Results All models achieved a minimum AUC of 0.964 and accuracy of 0.910. In datasets from neurological disease and controls, the CNN model produced the highest AUC (0.982), while the RF model achieved the highest AUC in patients with brain tumors (0.976). Within tumor lesions, which typically exhibit abnormal metabolism, the CNN AUC was 0.973 while that of the RF was 0.969. Data quality inference times were on the order of seconds for an entire 3D dataset, offering drastic time reduction compared to manual labeling. Conclusion ML methods accurately and rapidly performed automated QC. Results in tumors highlights the applicability to a variety of metabolic conditions.
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Affiliation(s)
- Sana Vaziri
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Huawei Liu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Emily Xie
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Hélène Ratiney
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, Lyon, France
| | - Michaël Sdika
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, Lyon, France
| | - Janine M. Lupo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- UC San Francisco/UC Berkeley Graduate Program in Bioengineering, San Francisco, CA, United States
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- UC San Francisco/UC Berkeley Graduate Program in Bioengineering, San Francisco, CA, United States
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
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Liu H, Autry AW, Larson PEZ, Xu D, Li Y. Atlas-Based Adaptive Hadamard-Encoded MR Spectroscopic Imaging at 3T. Tomography 2023; 9:1592-1602. [PMID: 37736980 PMCID: PMC10514830 DOI: 10.3390/tomography9050127] [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: 06/27/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND This study aimed to develop a time-efficient method of acquiring simultaneous, dual-slice MR spectroscopic imaging (MRSI) for the evaluation of brain metabolism. METHODS Adaptive Hadamard-encoded pulses were developed and integrated with atlas-based automatic prescription. The excitation profiles were evaluated via simulation, phantom and volunteer experiments. The feasibility of γ-aminobutyric acid (GABA)-edited dual-slice MRSI was also assessed. RESULTS The signal between slices in the dual-band MRSI was less than 1% of the slice profiles. Data from a homemade phantom containing separate, interfacing compartments of creatine and acetate solutions demonstrated ~0.4% acetate signal contamination relative to the amplitude in the excited creatine compartment. The normalized signal-to-noise ratios from atlas-based acquisitions in volunteers were found to be comparable between dual-slice, Hadamard-encoded MRSI and 3D acquisitions. The mean and standard deviation of the coefficients of variation for NAA/Cho from the repeated volunteer scans were 8.2% ± 0.8% and 10.1% ± 3.7% in the top and bottom slices, respectively. GABA-edited, dual-slice MRSI demonstrated simultaneous detection of signals from GABA and coedited macromolecules (GABA+) from both superior grey and deep grey regions of volunteers. CONCLUSION This study demonstrated a fully automated dual-slice MRSI acquisition using atlas-based automatic prescription and adaptive Hadamard-encoded pulses.
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Affiliation(s)
- Huawei Liu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107, USA (A.W.A.); (P.E.Z.L.); (D.X.)
| | - Adam W. Autry
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107, USA (A.W.A.); (P.E.Z.L.); (D.X.)
| | - Peder E. Z. Larson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107, USA (A.W.A.); (P.E.Z.L.); (D.X.)
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California San Francisco, San Francisco, CA 94107, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107, USA (A.W.A.); (P.E.Z.L.); (D.X.)
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California San Francisco, San Francisco, CA 94107, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107, USA (A.W.A.); (P.E.Z.L.); (D.X.)
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Jakary A, Lupo JM, Mackin S, Yin A, Murray D, Yang T, Mukherjee P, Larson P, Xu D, Eisendrath S, Luks T, Li Y. Evaluation of major depressive disorder using 7 Tesla phase sensitive neuroimaging before and after mindfulness-based cognitive therapy. J Affect Disord 2023; 335:383-391. [PMID: 37192691 DOI: 10.1016/j.jad.2023.05.038] [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: 10/04/2022] [Revised: 04/21/2023] [Accepted: 05/12/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVE We applied 7 Tesla phase sensitive imaging to evaluate the impact of brain iron levels on depression severity and cognitive function in individuals with major depressive disorder (MDD) treated with mindfulness-based cognitive therapy (MBCT). METHODS Seventeen unmedicated MDD participants underwent MRI, evaluation of depression severity, and cognitive testing before and after receiving MBCT, compared to fourteen healthy controls (HC). Local field shift (LFS) values, measures of brain iron levels, were derived from phase images in the putamen, caudate, globus pallidus (GP), anterior cingulate cortex (ACC) and thalamus. RESULTS Compared to the HC group, the MDD group had significantly lower baseline LFS (indicative of higher iron) in the left GP and left putamen and had a higher number of subjects with impairment in a test of information processing speed. In the MDD group, lower LFS values in the left and right ACC, right putamen, right GP, and right thalamus were significantly associated with depression severity; and lower LFS in the right GP was correlated with worse performance on measures of attention. All MBCT participants experienced depression relief. MBCT treatment also significantly improved executive function and attention. MBCT participants with lower baseline LFS values in the right caudate experienced significantly greater improvement in depression severity with treatment; and those with lower LFS values in the right ACC, right caudate, and right GB at baseline performed better on measures of verbal learning and memory after MBCT. CONCLUSIONS Our study highlights the potential contribution of subtle differences in brain iron to MDD symptoms and their successful treatment.
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Affiliation(s)
- Angela Jakary
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Janine M Lupo
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Scott Mackin
- Department of Psychiatry and Behavioral Sciences, UCSF, San Francisco, CA, United States of America
| | - Audrey Yin
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Donna Murray
- Department of Psychiatry and Behavioral Sciences, UCSF, San Francisco, CA, United States of America
| | - Tony Yang
- Department of Psychiatry and Behavioral Sciences, UCSF, San Francisco, CA, United States of America
| | - Pratik Mukherjee
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Peder Larson
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Stuart Eisendrath
- Department of Psychiatry and Behavioral Sciences, UCSF, San Francisco, CA, United States of America
| | - Tracy Luks
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America
| | - Yan Li
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States of America.
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Hong C, Ding C, Zhu Y, Chen S, Zhang Y, Yuan H, Yang D. 正念干预改善抑郁个体执行功能及其神经机制. CHINESE SCIENCE BULLETIN-CHINESE 2022. [DOI: 10.1360/tb-2022-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Hangel G, Niess E, Lazen P, Bednarik P, Bogner W, Strasser B. Emerging methods and applications of ultra-high field MR spectroscopic imaging in the human brain. Anal Biochem 2022; 638:114479. [PMID: 34838516 DOI: 10.1016/j.ab.2021.114479] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/15/2021] [Accepted: 11/16/2021] [Indexed: 12/21/2022]
Abstract
Magnetic Resonance Spectroscopic Imaging (MRSI) of the brain enables insights into the metabolic changes and fluxes in diseases such as tumors, multiple sclerosis, epilepsy, or hepatic encephalopathy, as well as insights into general brain functionality. However, the routine application of MRSI is mostly hampered by very low signal-to-noise ratios (SNR) due to the low concentrations of metabolites, about 10000 times lower than water. Furthermore, MRSI spectra have a dense information content with many overlapping metabolite resonances, especially for proton MRSI. MRI scanners at ultra-high field strengths, like 7 T or above, offer the opportunity to increase SNR, as well as the separation between resonances, thus promising to solve both challenges. Yet, MRSI at ultra-high field strengths is challenged by decreased B0- and B1-homogeneity, shorter T2 relaxation times, stronger chemical shift displacement errors, and aggravated lipid contamination. Therefore, to capitalize on the advantages of ultra-high field strengths, these challenges must be overcome. This review focuses on the challenges MRSI of the human brain faces at ultra-high field strength, as well as the possible applications to this date.
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Affiliation(s)
- Gilbert Hangel
- High Field MR Centre, Department of Medical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria; Department of Neurosurgery, Medical University of Vienna, Austria
| | - Eva Niess
- High Field MR Centre, Department of Medical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria
| | - Philipp Lazen
- High Field MR Centre, Department of Medical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria
| | - Petr Bednarik
- High Field MR Centre, Department of Medical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria
| | - Wolfgang Bogner
- High Field MR Centre, Department of Medical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria
| | - Bernhard Strasser
- High Field MR Centre, Department of Medical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria.
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Li Y, Vigneron DB, Xu D. Current human brain applications and challenges of dynamic hyperpolarized carbon-13 labeled pyruvate MR metabolic imaging. Eur J Nucl Med Mol Imaging 2021; 48:4225-4235. [PMID: 34432118 PMCID: PMC8566394 DOI: 10.1007/s00259-021-05508-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/27/2021] [Indexed: 12/17/2022]
Abstract
The ability of hyperpolarized carbon-13 MR metabolic imaging to acquire dynamic metabolic information in real time is crucial to gain mechanistic insights into metabolic pathways, which are complementary to anatomic and other functional imaging methods. This review presents the advantages of this emerging functional imaging technology, describes considerations in clinical translations, and summarizes current human brain applications. Despite rapid development in methodologies, significant technological and physiological related challenges continue to impede broader clinical translation.
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Affiliation(s)
- Yan Li
- Department of Radiology and Biomedical Imaging, UCSF Radiology, University of California, 185 Berry Street, Ste 350, Box 0946, San Francisco, CA, 94107, USA.
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, UCSF Radiology, University of California, 185 Berry Street, Ste 350, Box 0946, San Francisco, CA, 94107, USA
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, UCSF Radiology, University of California, 185 Berry Street, Ste 350, Box 0946, San Francisco, CA, 94107, USA
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Maudsley AA, Andronesi OC, Barker PB, Bizzi A, Bogner W, Henning A, Nelson SJ, Posse S, Shungu DC, Soher BJ. Advanced magnetic resonance spectroscopic neuroimaging: Experts' consensus recommendations. NMR IN BIOMEDICINE 2021; 34:e4309. [PMID: 32350978 PMCID: PMC7606742 DOI: 10.1002/nbm.4309] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 02/01/2020] [Accepted: 03/10/2020] [Indexed: 05/04/2023]
Abstract
Magnetic resonance spectroscopic imaging (MRSI) offers considerable promise for monitoring metabolic alterations associated with disease or injury; however, to date, these methods have not had a significant impact on clinical care, and their use remains largely confined to the research community and a limited number of clinical sites. The MRSI methods currently implemented on clinical MRI instruments have remained essentially unchanged for two decades, with only incremental improvements in sequence implementation. During this time, a number of technological developments have taken place that have already greatly benefited the quality of MRSI measurements within the research community and which promise to bring advanced MRSI studies to the point where the technique becomes a true imaging modality, while making the traditional review of individual spectra a secondary requirement. Furthermore, the increasing use of biomedical MR spectroscopy studies has indicated clinical areas where advanced MRSI methods can provide valuable information for clinical care. In light of this rapidly changing technological environment and growing understanding of the value of MRSI studies for biomedical studies, this article presents a consensus from a group of experts in the field that reviews the state-of-the-art for clinical proton MRSI studies of the human brain, recommends minimal standards for further development of vendor-provided MRSI implementations, and identifies areas which need further technical development.
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Affiliation(s)
- Andrew A Maudsley
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Ovidiu C Andronesi
- Department of Radiology, Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts
| | - Peter B Barker
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, and the Kennedy Krieger Institute, F.M. Kirby Center for Functional Brain Imaging, Baltimore, Maryland
| | - Alberto Bizzi
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Wolfgang Bogner
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria
| | - Anke Henning
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sarah J Nelson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Stefan Posse
- Department of Neurology, University of New Mexico, Albuquerque, New Mexico
| | - Dikoma C Shungu
- Department of Neuroradiology, Weill Cornell Medical College, New York, New York
| | - Brian J Soher
- Department of Radiology, Duke University Medical Center, Durham, North Carolina
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Krysko KM, Bischof A, Nourbakhsh B, Henry RG, Revirajan N, Manguinao M, Nguyen K, Akula A, Li Y, Waubant E. A pilot study of oxidative pathways in MS fatigue: randomized trial of N-acetyl cysteine. Ann Clin Transl Neurol 2021; 8:811-824. [PMID: 33675156 PMCID: PMC8045913 DOI: 10.1002/acn3.51325] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/17/2021] [Accepted: 02/03/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To assess feasibility, tolerability, and safety of N‐acetyl cysteine (NAC) for fatigue in progressive MS. Secondary objectives evaluated changes in fatigue and oxidative pathway biomarkers on NAC versus placebo. Methods Individuals with progressive MS with Modified Fatigue Impact Scale (MFIS) > t38 were randomized 2:1 to NAC 1250mg TID or placebo for 4 weeks. The primary outcome was tolerability and safety. The secondary outcome to evaluate efficacy was MFIS change from baseline to week 4 between groups. Exploratory biomarker outcomes included change in blood GSH/GSSG ratio (reduced‐to‐oxidized glutathione (GSH)) and in vivo relative GSH using 7T MR spectroscopy (MRS) between groups. Fisher exact test was used for categorical and rank sum for continuous outcomes. Results Fifiteen were randomized (10 NAC, 5 placebo; mean age 56.1 years, 80% female, median EDSS 6.0). At least one adverse event (AE) occurred in 60% on NAC versus 80% on placebo (p = 0.75). There were two AEs attributed to NAC in one patient (abdominal pain and constipation), with 94% adherence to NAC. MFIS decreased in both groups at week 4, with the mean improvement of 11‐points on NAC versus 18‐points on placebo (p = 0.33). GSH/GSSG ratio decreased on placebo (−0.6) and NAC (−0.1) (p = 0.18). Change in GSH levels to total creatine in anterior and posterior cingulate cortex, insula, caudate, putamen, and thalamus did not differ between groups. Interpretation NAC was well‐tolerated in progressive MS, although reduction in fatigue on NAC was similar to placebo. Antioxidant blood and MRS biomarkers were not significantly altered by NAC, which could be due to dose, route of administration, time of sample collection, short half‐life, or lack of effect. Registered clinicaltrials.gov NCT02804594.
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Affiliation(s)
- Kristen M Krysko
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, California, USA.,Division of Neurology, Department of Medicine, St. Michael's Hospital, Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, Canada
| | - Antje Bischof
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Bardia Nourbakhsh
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Roland G Henry
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Nisha Revirajan
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Michael Manguinao
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Khang Nguyen
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Amit Akula
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Emmanuelle Waubant
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, California, USA
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Turpyn CC, Chaplin TM, Fischer S, Thompson JC, Fedota JR, Baer RA, Martelli AM. Affective Neural Mechanisms of a Parenting-Focused Mindfulness Intervention. Mindfulness (N Y) 2021; 12:392-404. [PMID: 33737986 PMCID: PMC7962669 DOI: 10.1007/s12671-019-01118-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Behavioral evidence suggests that parenting-focused mindfulness interventions can improve parenting practices and enhance family wellbeing, potentially operating through altered emotional processing in parents. However, the mechanisms through which parent mindfulness interventions achieve their positive benefits have not yet been empirically tested, knowledge which is key to refine and maximize intervention effects. Thus, as part of a randomized controlled trial, the present study examined the affective mechanisms of an 8-week parenting-focused mindfulness intervention, the Parenting Mindfully (PM) intervention, versus a minimal-intervention parent education control. METHODS Twenty highly stressed mothers of adolescents completed pre- and post-intervention behavioral and fMRI sessions, in which mothers completed a parent-adolescent conflict interaction, fMRI emotion task, and fMRI resting state scan. Mothers reported on their mindful parenting, and maternal emotional reactivity to the parent-adolescent conflict task was assessed via observed emotion expression, self-reported negative emotion, and salivary cortisol reactivity. RESULTS Results indicated that the PM intervention increased brain responsivity in left posterior insula in response to negative affective stimuli, and altered resting state functional connectivity in regions involved in self-reference, behavioral regulation, and social-emotional processing. Changes in mothers' brain function and connectivity were associated with increased mindful parenting and decreased emotional reactivity to the parent-adolescent conflict task. CONCLUSIONS Findings suggest that mindfulness-based changes in maternal emotional awareness at the neurobiological level are associated with decreased emotional reactivity in parenting interactions, illuminating potential neurobiological targets for future parent-focused intervention.
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Affiliation(s)
- Caitlin C Turpyn
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Tara M Chaplin
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Sarah Fischer
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - James C Thompson
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - John R Fedota
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Ruth A Baer
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Alexandra M Martelli
- Caitlin Turpyn, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Tara Chaplin, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; Sarah Fischer, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; James Thompson, Department of Psychology, George Mason University, Fairfax, VA 22030, USA; John Fedota, Neuroimaging Research Branch, National Institute on Drug Abuse, Baltimore, MD, 21224, USA; Ruth Baer, Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA; Alexandra Martelli, Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
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M M, Z RS, R A, A RJ. Proton Magnetic Resonance Spectroscopy to Detect Correlations between Clinical Symptoms and Brain Metabolite Levels in Patients with Tension-type Headache. J Biomed Phys Eng 2020; 10:583-588. [PMID: 33134217 PMCID: PMC7557467 DOI: 10.31661/jbpe.v0i0.1039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 11/05/2018] [Indexed: 11/16/2022]
Abstract
Background: Proton magnetic resonance spectroscopy (1HMRS) is a noninvasive method to quantify pain. A 1HMRS spectrum is a group of peaks at different radiofrequencies, showing proton nuclei in various chemical environments. These MR spectra provide information about metabolite concentrations, and make MRS a useful procedure to monitor metabolic fluctuations due to disease, and to track the efficacy of treatment. Objective: This study aims to identify correlations between clinical symptoms in patients with tension-type headache (TTH) and concentrations of brain metabolites. Material and Methods: In this observational study, twenty-four patients (4 men and 20 women) with chronic TTH were included. To evaluate their clinical symptoms,
the number of trigger points, headache frequency and headache intensity were recorded. The levels of anxiety and depression were recorded with the Beck Anxiety Inventory (BAI) and Beck Depression Inventory II (BDI- II). Concentrations of brain metabolites were determined in the anterior cingulate cortex, thalamus and primary somatosensory cortex of left hemisphere with 1HMRS. Results: There was a negative correlation between trigger point count and choline/creatine (Cho/Cr) ratio in the primary somatosensory cortex [r= −0.509, n= 24, p= 0.01].
There were no correlations between other clinical symptoms of TTH and concentrations of brain metabolites. Conclusion: Patients with more trigger points had a lower Cho/Cr ratio, which may indicate alterations in brain metabolic activity.
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Affiliation(s)
- Mohamadi M
- PhD, Student Research Committee, Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rojhani-Shirazi Z
- PhD, Rehabilitation Research Center, Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Asadsangabi R
- PhD, Department of Radiology, Davis School of Medicine, University of California, USA
| | - Rahimi-Jaberi A
- PhD, Department of Neurology, School of Medicine,Shiraz University of Medical Sciences, Shiraz, Iran
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Fisher E, Gillam J, Upthegrove R, Aldred S, Wood SJ. Role of magnetic resonance spectroscopy in cerebral glutathione quantification for youth mental health: A systematic review. Early Interv Psychiatry 2020; 14:147-162. [PMID: 31148383 PMCID: PMC7065077 DOI: 10.1111/eip.12833] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/27/2019] [Accepted: 04/14/2019] [Indexed: 01/01/2023]
Abstract
AIM Oxidative stress is strongly implicated in many psychiatric disorders, which has resulted in the development of new interventions to attempt to perturb this pathology. A great deal of attention has been paid to glutathione, which is the brain's dominant antioxidant and plays a fundamental role in removing free radicals and other reactive oxygen species. Measurement of glutathione concentration in the brain in vivo can provide information on redox status and potential for oxidative stress to develop. Glutathione might also represent a marker to assess treatment response. METHODS This paper systematically reviews studies that assess glutathione concentration (measured using magnetic resonance spectroscopy) in various mental health conditions. RESULTS There is limited evidence showing altered brain glutathione concentration in mental disorders; the best evidence suggests glutathione is decreased in depression, but is not altered in bipolar disorder. The review then outlines the various methodological options for acquiring glutathione data using spectroscopy. CONCLUSIONS Analysis of the minimum effect size measurable in existing studies indicates that increased number of participants is required to measure subtle but possibly important differences and move the field forward.
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Affiliation(s)
- Emily Fisher
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamEdgbastonUK
| | - John Gillam
- Orygenthe National Centre of Excellence in Youth Mental HealthMelbourneVictoriaAustralia
- Centre for Youth Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Rachel Upthegrove
- Institute for Mental HealthUniversity of BirminghamEdgbastonUK
- Department of PsychiatryUniversity of BirminghamBirminghamUK
| | - Sarah Aldred
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamEdgbastonUK
| | - Stephen J. Wood
- Orygenthe National Centre of Excellence in Youth Mental HealthMelbourneVictoriaAustralia
- Centre for Youth Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
- Institute for Mental HealthUniversity of BirminghamEdgbastonUK
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15
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Zavorotnyy M, Zöllner R, Rekate H, Dietsche P, Bopp M, Sommer J, Meller T, Krug A, Nenadić I. Intermittent theta-burst stimulation moderates interaction between increment of N-Acetyl-Aspartate in anterior cingulate and improvement of unipolar depression. Brain Stimul 2020; 13:943-952. [PMID: 32380445 DOI: 10.1016/j.brs.2020.03.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/31/2020] [Accepted: 03/24/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Intermittent theta-burst stimulation (iTBS), a novel repetitive transcranial magnetic stimulation (rTMS) technique, appears to have antidepressant effects when applied over left dorsolateral prefrontal cortex (DLPFC). However, its underlying neurobiological mechanisms are unclear. Proton magnetic resonance spectroscopy (1H-MRS) provides in vivo measurements of cerebral metabolites altered in major depressive disorder (MDD) like N-acetyl-aspartate (NAA) and choline-containing compounds (Cho). We used MRS to analyse effects of iTBS on the associations between the shifts in the NAA and Cho levels during therapy and MDD improvement. METHODS In-patients with unipolar MDD (N = 57), in addition to treatment as usual, were randomized to receive 20 iTBS or sham stimulations applied over left DLPFC over four weeks. Single-voxel 1H-MRS of the anterior cingulate cortex (ACC) was performed at baseline and follow-up. Increments of concentrations, as well as MDD improvement, were defined as endpoints. We tested a moderated mediation model of effects using the PROCESS macro (an observed variable ordinary least squares and logistic regression path analysis modeling tool) for SPSS. RESULTS Improvement of depressive symptoms was significantly associated with decrease of Cho/NAA ratio, mediated by NAA. iTBS had a significant moderating effect enhancing the relationship between NAA change and depression improvement. CONCLUSIONS Our findings suggest a potential neurochemical pathway and mechanisms of antidepressant action of iTBS, which may moderate the improvement of metabolic markers of neuronal viability. iTBS might increase neuroplasticity, thus facilitating normalization of neuronal circuit function.
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Affiliation(s)
- Maxim Zavorotnyy
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Academic Hospital of the University of Zurich, Brugg, Switzerland; Marburg Center for Mind, Brain and Behavior, MCMBB, University of Marburg, Germany.
| | - Rebecca Zöllner
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Health Protection Authority, Frankfurt, Main, Germany
| | - Henning Rekate
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany
| | - Patricia Dietsche
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany
| | - Miriam Bopp
- Marburg Center for Mind, Brain and Behavior, MCMBB, University of Marburg, Germany; Department of Neurosurgery, University of Marburg, Germany
| | - Jens Sommer
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Marburg Center for Mind, Brain and Behavior, MCMBB, University of Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Marburg Center for Mind, Brain and Behavior, MCMBB, University of Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Marburg Center for Mind, Brain and Behavior, MCMBB, University of Marburg, Germany
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Chalah MA, Ayache SS. Disentangling the Neural Basis of Cognitive Behavioral Therapy in Psychiatric Disorders: A Focus on Depression. Brain Sci 2018; 8:brainsci8080150. [PMID: 30096948 PMCID: PMC6120051 DOI: 10.3390/brainsci8080150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 01/28/2023] Open
Abstract
Background: Major depressive disorder (MDD) stands among the most frequent psychiatric disorders. Cognitive behavioral therapy (CBT) has been shown to be effective for treating depression, yet its neural mechanisms of action are not well elucidated. The objective of this work is to assess the available neuroimaging studies exploring CBT’s effects in adult patients with MDD. Methods: Computerized databases were consulted till April 2018 and a research was conducted according to PRISMA guidelines in order to identify original research articles published at any time in English and French languages on this topic. Results: Seventeen studies were identified. Only one study was randomized comparing CBT to pharmacological interventions, and none included an effective control. Following CBT, changes occurred in cerebral areas that are part of the fronto-limbic system, namely the cingulate cortex, prefrontal cortex and amygdala-hippocampal complex. However, the pattern of activation and connectivity in these areas varied across the studies. Conclusion: A considerable heterogeneity exists with regard to study design, adapted CBT type and intensity, and employed neuroimaging paradigms, all of which may partly explain the difference in studies’ outcomes. The lack of randomization and effective controls in most of them makes it difficult to draw formal conclusion whether the observed effects are CBT mediated or due to spontaneous recovery. Despite the observed inconsistencies and dearth of data, CBT appears to exert its anti-depressant effects mainly by modulating the function of affective and cognitive networks devoted to emotions generation and control, respectively. This concept remains to be validated in large scale randomized controlled trials.
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Affiliation(s)
- Moussa A Chalah
- EA 4391 Excitabilité Nerveuse et Thérapeutique, Université Paris-Est, 94010 Créteil, France.
- Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, 94010 Créteil, France.
| | - Samar S Ayache
- EA 4391 Excitabilité Nerveuse et Thérapeutique, Université Paris-Est, 94010 Créteil, France.
- Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, 94010 Créteil, France.
- Neurology Division, Lebanese American University Medical Center-Rizk Hospital (LAUMC-RH), Beirut 1100, Lebanon.
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Godlewska BR, Masaki C, Sharpley AL, Cowen PJ, Emir UE. Brain glutamate in medication-free depressed patients: a proton MRS study at 7 Tesla. Psychol Med 2018; 48:1731-1737. [PMID: 29224573 PMCID: PMC6088784 DOI: 10.1017/s0033291717003373] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/22/2017] [Accepted: 10/24/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND The possible role of glutamate in the pathophysiology and treatment of depression is of intense current interest. Proton magnetic resonance spectroscopy (MRS) enables the detection of glutamate in the living human brain and meta-analyses of previous MRS studies in depressed patients have suggested that glutamate levels are decreased in anterior brain regions. Nevertheless, at conventional magnetic field strengths [1.5-3 Tesla (T)], it is difficult to separate glutamate from its metabolite and precursor, glutamine, with the two often being measured together as Glx. In contrast, MRS at 7 T allows clear spectral resolution of glutamate and glutamine. METHOD We studied 55 un-medicated depressed patients and 50 healthy controls who underwent MRS scanning at 7 T with voxels placed in anterior cingulate cortex, occipital cortex and putamen (PUT). Neurometabolites were calculated using the unsuppressed water signal as a reference. RESULTS Compared with controls, depressed patients showed no significant difference in glutamate in any of the three voxels studied; however, glutamine concentrations in the patients were elevated by about 12% in the PUT (p < 0.001). CONCLUSIONS The increase in glutamine in PUT is of interest in view of the postulated role of the basal ganglia in the neuropsychology of depression and is consistent with elevated activity in the descending cortical glutamatergic innervation to the PUT. The basal ganglia have rarely been the subject of MRS investigations in depressed patients and further MRS studies of these structures in depression are warranted.
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Affiliation(s)
- Beata R. Godlewska
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Charles Masaki
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Ann L. Sharpley
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Philip J. Cowen
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Uzay E. Emir
- Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
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18
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Vignaud P, Donde C, Sadki T, Poulet E, Brunelin J. Neural effects of mindfulness-based interventions on patients with major depressive disorder: A systematic review. Neurosci Biobehav Rev 2018; 88:98-105. [DOI: 10.1016/j.neubiorev.2018.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/19/2018] [Accepted: 03/06/2018] [Indexed: 12/16/2022]
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Mathias LK, Monette PJ, Harper DG, Forester BP. Application of magnetic resonance spectroscopy in geriatric mood disorders. Int Rev Psychiatry 2017; 29:597-617. [PMID: 29199890 DOI: 10.1080/09540261.2017.1397608] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The prevalence of mood disorders in the rapidly-growing older adult population merits attention due to the likelihood of increased medical comorbidities, risk of hospitalization or institutionalization, and strains placed on caregivers and healthcare providers. Magnetic resonance spectroscopy (MRS) quantifies biochemical compounds in vivo, and has been used specifically for analyses of neural metabolism and bioenergetics in older adults with mood disorders, usually via proton or phosphorous spectroscopy. While yet to be clinically implemented, data gathered from research subjects may help indicate potential biomarkers of disease state or trait or putative drug targets. Three prevailing hypotheses for these mood disorders are used as a framework for the present review, and the current biochemical findings within each are discussed with respect to particular metabolites and brain regions. This review covers studies of MRS in geriatric mood disorders and reveals persisting gaps in research knowledge, especially with regard to older age bipolar disorder. Further MRS work, using higher field strengths and larger sample sizes, is warranted in order to better understand the neurobiology of these prevalent late-life disorders.
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Affiliation(s)
- Liana K Mathias
- a Division of Geriatric Psychiatry , McLean Hospital , Belmont , MA , USA
| | - Patrick J Monette
- a Division of Geriatric Psychiatry , McLean Hospital , Belmont , MA , USA
| | - David G Harper
- a Division of Geriatric Psychiatry , McLean Hospital , Belmont , MA , USA.,b Department of Psychiatry , Harvard Medical School , Boston , MA , USA
| | - Brent P Forester
- a Division of Geriatric Psychiatry , McLean Hospital , Belmont , MA , USA.,b Department of Psychiatry , Harvard Medical School , Boston , MA , USA
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Niendorf T, Barth M, Kober F, Trattnig S. From ultrahigh to extreme field magnetic resonance: where physics, biology and medicine meet. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 29:309-11. [PMID: 27221262 DOI: 10.1007/s10334-016-0564-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrueck Center for Molecular Medicine in the Helmholtz Association, Robert Roessle Strasse 10, 13125, Berlin, Germany.
| | - Markus Barth
- Centre for Advanced Imaging, The University of Queensland, Building 57, Research Road, St Lucia, QLD, 4072, Australia
| | - Frank Kober
- Centre de Résonance Magnétique Biologique et Médicale (CRMBM), Aix-Marseille Université, CNRS UMR7339, 13385, Marseille Cedex 05, France
| | - Siegfried Trattnig
- High Field MR Center, Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
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21
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Tymofiyeva O, Connolly CG, Ho TC, Sacchet MD, Blom EH, LeWinn KZ, Xu D, Yang TT. DTI-based connectome analysis of adolescents with major depressive disorder reveals hypoconnectivity of the right caudate. J Affect Disord 2017; 207:18-25. [PMID: 27673479 PMCID: PMC5107159 DOI: 10.1016/j.jad.2016.09.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 09/18/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND Adolescence is a vulnerable period for the onset of major depressive disorder (MDD). While some studies have shown white matter alterations in adolescent MDD, there is still a gap in understanding how the brain is affected at a network level. METHODS We compared diffusion tensor imaging (DTI)-based brain networks in a cohort of 57 adolescents with MDD and 41 well-matched healthy controls who completed self-reports of depression symptoms and stressful life events. Using atlas-based brain regions as network nodes and tractography streamline count or mean fractional anisotropy (FA) as edge weights, we examined weighted local and global network properties and performed Network-Based Statistic (NBS) analysis. RESULTS While there were no significant group differences in the global network properties, the FA-weighted node strength of the right caudate was significantly lower in depressed adolescents and correlated positively with age across both groups. The NBS analysis revealed a cluster of lower FA-based connectivity in depressed subjects centered on the right caudate, including connections to frontal gyri, insula, and anterior cingulate. Within this cluster, the most robust difference between groups was the connection between the right caudate and middle frontal gyrus. This connection showed a significant diagnosis by stress interaction and a negative correlation with total stress in depressed adolescents. LIMITATIONS Use of DTI-based tractography, one atlas-based parcellation, and FA values to characterize brain networks represent this study's limitations. CONCLUSIONS Our results allowed us to suggest caudate-centric models of dysfunctional processes underlying adolescent depression, which might guide future studies and help better understand and treat this disorder.
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Affiliation(s)
- Olga Tymofiyeva
- Department of Radiology and Biomedical Imaging, University of California San Francisco, United States.
| | - Colm G. Connolly
- Department of Psychiatry, University of California San Francisco
| | - Tiffany C. Ho
- Department of Psychiatry, University of California San Francisco,Department of Psychology and Neurosciences Program, Stanford University
| | - Matthew D. Sacchet
- Department of Psychiatry, University of California San Francisco,Department of Psychology and Neurosciences Program, Stanford University
| | - Eva Henje Blom
- Department of Psychiatry, University of California San Francisco,Department of Clinical Neuroscience, Karolinska Institute
| | - Kaja Z. LeWinn
- Department of Psychiatry, University of California San Francisco
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Tony T. Yang
- Department of Psychiatry, University of California San Francisco
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22
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Godlewska BR, Clare S, Cowen PJ, Emir UE. Ultra-High-Field Magnetic Resonance Spectroscopy in Psychiatry. Front Psychiatry 2017; 8:123. [PMID: 28744229 PMCID: PMC5504194 DOI: 10.3389/fpsyt.2017.00123] [Citation(s) in RCA: 21] [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: 02/13/2017] [Accepted: 06/26/2017] [Indexed: 12/30/2022] Open
Abstract
The advantages of ultra-high-field (UHF ≥ 7T) MR have been demonstrated in a variety of MR acquisition modalities. Magnetic resonance spectroscopy (MRS) can particularly benefit from substantial gains in signal-to-noise ratio (SNR) and spectral resolution at UHF, enabling the quantification of numerous metabolites, including glutamate, glutamine, glutathione, and γ-aminobutyric acid that are relevant to psychiatric disorders. The aim of this review is to give an overview about the advantages and advances of UHF MRS and its application to psychiatric disorders. In order to provide a practical guide for potential applications of MRS at UHF, a literature review is given, surveying advantages and disadvantages of MRS at UHF. Key concepts, emerging technologies, practical considerations, and applications of UHF MRS are provided. Second, the strength of UHF MRS is demonstrated using some examples of its application in psychiatric disorders.
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Affiliation(s)
- Beata R Godlewska
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
| | - Stuart Clare
- Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Philip J Cowen
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
| | - Uzay E Emir
- Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
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