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Hagen J, Ramkiran S, Schnellbächer GJ, Rajkumar R, Collee M, Khudeish N, Veselinović T, Shah NJ, Neuner I. Phenomena of hypo- and hyperconnectivity in basal ganglia-thalamo-cortical circuits linked to major depression: a 7T fMRI study. Mol Psychiatry 2024:10.1038/s41380-024-02669-4. [PMID: 39020104 DOI: 10.1038/s41380-024-02669-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 07/19/2024]
Abstract
Major depressive disorder (MDD) typically manifests itself in depressed affect, anhedonia, low energy, and additional symptoms. Despite its high global prevalence, its pathophysiology still gives rise to questions. Current research places alterations in functional connectivity among MDD's most promising biomarkers. However, given the heterogeneity of previous findings, the use of higher-resolution imaging techniques, like ultra-high field (UHF) fMRI (≥7 Tesla, 7T), may offer greater specificity in delineating fundamental impairments. In this study, 7T UHF fMRI scans were conducted on 31 MDD patients and 27 age-gender matched healthy controls to exploratorily contrast cerebral resting-state functional connectivity patterns between both groups. The CONN toolbox was used to generate functional network connectivity (FNC) analysis based on the region of interest (ROI)-to-ROI correlations in order to enable the identification of clusters of significantly different connections. Correction for multiple comparisons was implemented at the cluster level using a false discovery rate (FDR). The analysis revealed three significant clusters differentiating MDD patients and healthy controls. In Clusters 1 and 2, MDD patients exhibited between-network hypoconnectivity in basal ganglia-cortical pathways as well as hyperconnectivity in thalamo-cortical pathways, including several individual ROI-to-ROI connections. In Cluster 3, they showed increased occipital interhemispheric within-network connectivity. These findings suggest that alterations in basal ganglia-thalamo-cortical circuits play a substantial role in the pathophysiology of MDD. Furthermore, they indicate potential MDD-related deficits relating to a combination of perception (vision, audition, and somatosensation) as well as more complex functions, especially social-emotional processing, modulation, and regulation. It is anticipated that these findings might further inform more accurate clinical procedures for addressing MDD.
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Affiliation(s)
- Jana Hagen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, Aachen, Germany
- Institute of Neuroscience and Medicine - 4, Forschungszentrum Jülich, Jülich, Germany
| | - Shukti Ramkiran
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, Aachen, Germany
- Institute of Neuroscience and Medicine - 4, Forschungszentrum Jülich, Jülich, Germany
| | - Gereon J Schnellbächer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, Aachen, Germany
- Institute of Neuroscience and Medicine - 4, Forschungszentrum Jülich, Jülich, Germany
| | - Ravichandran Rajkumar
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, Aachen, Germany
- Institute of Neuroscience and Medicine - 4, Forschungszentrum Jülich, Jülich, Germany
| | - Maria Collee
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, Aachen, Germany
| | - Nibal Khudeish
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, Aachen, Germany
- Institute of Neuroscience and Medicine - 4, Forschungszentrum Jülich, Jülich, Germany
| | - Tanja Veselinović
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, Aachen, Germany
- Institute of Neuroscience and Medicine - 4, Forschungszentrum Jülich, Jülich, Germany
| | - N Jon Shah
- Institute of Neuroscience and Medicine - 4, Forschungszentrum Jülich, Jülich, Germany
- Department of Neurology, Uniklinik RWTH Aachen, Aachen, Germany
- Institute of Neuroscience and Medicine - 11, Forschungszentrum Jülich, Jülich, Germany
| | - Irene Neuner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, Aachen, Germany.
- Institute of Neuroscience and Medicine - 4, Forschungszentrum Jülich, Jülich, Germany.
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Tesic I, Pigoni A, Moltrasio C, Brambilla P, Delvecchio G. How does feeling pain look like in depression: A review of functional neuroimaging studies. J Affect Disord 2023; 339:400-411. [PMID: 37459979 DOI: 10.1016/j.jad.2023.07.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023]
Abstract
INTRODUCTION Major Depression Disorder (MDD) and pain appear to be reciprocal risk factors and sharing common neuroanatomical pathways and biological substrates. However, the role of MDD on pain processing remains still unclear. Therefore, this review aims to focus on the effect of depression on pain anticipation, and perception, before and after treatment, through functional magnetic resonance imaging (fMRI). METHODS A bibliographic search was conducted on PubMed, Scopus and Web of Science, looking for fMRI studies exploring pain processing in MDD patients. RESULTS Amongst the 602 studies retrieved, 12 met the inclusion criteria. In terms of pain perception, studies evidenced that MDD patients generally presented increased activation in brain regions within the prefrontal cortex, insula and in the limbic system (such as amygdala, hippocampus) and occipital cortex. The studies investigating the effect of antidepressant treatment evidenced a reduced activation in areas such as insula, anterior cingulate, and prefrontal cortices. In terms of pain anticipation, contrasting results were evidenced in MDD patients, which presented both increased and decreased activity in the prefrontal cortex, the insula and the temporal lobe, alongside with increased activity in the anterior cingulate cortex, the frontal gyrus and occipital lobes. LIMITATIONS The small number of included studies, the heterogeneous approaches of the studies might limit the conclusions of this review. CONCLUSIONS Acute pain processing in MDD patients seems to involve numerous and different brain areas. However, more specific fMRI studies with a more homogeneous population and rigorous approach should be conducted to better highlight the effect of depression on pain processing.
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Affiliation(s)
- Isidora Tesic
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandro Pigoni
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Zhu H, Zhu H, Liu X, Wei F, Li H, Guo Z. The Characteristics of Entorhinal Cortex Functional Connectivity in Alzheimer's Disease Patients with Depression. Curr Alzheimer Res 2023; 19:CAR-EPUB-129980. [PMID: 36872356 DOI: 10.2174/1567205020666230303093112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Depression is one of the most common neuropsychiatric symptoms of Alzheimer's disease (AD) which decreases the life quality of both patients and caregivers. There are currently no effective drugs. It is therefore important to explore the pathogenesis of depression in AD patients. OBJECTIVE The present study aimed to investigate the characteristics of the entorhinal cortex (EC) functional connectivity (FC) in the whole brain neural network of AD patients with depression (D-AD). METHODS Twenty-four D-AD patients, 14 AD patients without depression (nD-AD), and 20 healthy controls underwent resting-state functional magnetic resonance imaging. We set the EC as the seed and used FC analysis. One-way analysis of variance was used to examine FC differences among the three groups. RESULTS Using the left EC as the seed point, there were FC differences among the three groups in the left EC-inferior occipital gyrus. Using the right EC as the seed point, there were FC differences among the three groups in the right EC-middle frontal gyrus, -superior parietal gyrus, -superior medial frontal gyrus, and -precentral gyrus. Compared with the nD-AD group, the D-AD group had increased FC between the right EC and right postcentral gyrus. CONCLUSION Asymmetry of FC in the EC and increased FC between the EC and right postcentral gyrus may be important in the pathogenesis of depression in AD.
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Affiliation(s)
- Haokai Zhu
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Zhejiang 310000, China
| | - Hong Zhu
- Tongde Hospital of Zhejiang Province, Zhejiang Mental Health Center, Hangzhou, Zhejiang 310012, China
| | - Xiaozheng Liu
- Department of Radiology of the Second Affiliated Hospital, China-USA Neuroimaging Research Institute, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Fuquan Wei
- Tongde Hospital of Zhejiang Province, Zhejiang Mental Health Center, Hangzhou, Zhejiang 310012, China
| | - Huichao Li
- Tongde Hospital of Zhejiang Province, Zhejiang Mental Health Center, Hangzhou, Zhejiang 310012, China
| | - Zhongwei Guo
- Tongde Hospital of Zhejiang Province, Zhejiang Mental Health Center, Hangzhou, Zhejiang 310012, China
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Zheng CJ, Van Drunen S, Egorova-Brumley N. Neural correlates of co-occurring pain and depression: an activation-likelihood estimation (ALE) meta-analysis and systematic review. Transl Psychiatry 2022; 12:196. [PMID: 35545623 PMCID: PMC9095719 DOI: 10.1038/s41398-022-01949-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 11/09/2022] Open
Abstract
The relationship between pain and depression is thought to be bidirectional and the underlying neurobiology 'shared' between the two conditions. However, these claims are often based on qualitative comparisons of brain regions implicated in pain or depression, while focused quantitative studies of the neurobiology of pain-depression comorbidity are lacking. Particularly, the direction of comorbidity, i.e., pain with depression vs. depression with pain, is rarely addressed. In this systematic review (PROSPERO registration CRD42020219876), we aimed to delineate brain correlates associated with primary pain with concomitant depression, primary depression with concurrent pain, and equal pain and depression comorbidity, using activation likelihood estimation (ALE) meta-analysis. Neuroimaging studies published in English until the 28th of September 2021 were evaluated using PRISMA guidelines. A total of 70 studies were included, of which 26 reported stereotactic coordinates and were analysed with ALE. All studies were assessed for quality by two authors, using the National Institute of Health Quality Assessment Tool. Our results revealed paucity of studies that directly investigated the neurobiology of pain-depression comorbidity. The ALE analysis indicated that pain with concomitant depression was associated with the right amygdala, while depression with concomitant pain was related primarily to the left dorsolateral prefrontal cortex (DLPFC). We provide evidence that pain and depression have a cumulative negative effect on a specific set of brain regions, distinct for primary diagnosis of depression vs. pain.
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Affiliation(s)
| | | | - Natalia Egorova-Brumley
- The University of Melbourne, Parkville, VIC, Australia.
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.
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Psychiatric Disease Susceptibility and Pain in Chronic Pancreatitis: Association or Causation? Am J Gastroenterol 2021; 116:2026-2028. [PMID: 34459451 DOI: 10.14309/ajg.0000000000001491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/04/2021] [Indexed: 12/11/2022]
Abstract
Pain perception in chronic pancreatitis (CP) is governed by the transmission of nociceptive inputs into the pain processing centers of the brain. These regions of the brain overlap with those that regulate and process emotions and cognition. Disorders in these regions also result in psychiatric conditions such as depression, anxiety, and posttraumatic stress disorder. The present study by Dunbar et al. evaluated 24 single nucleotide polymorphisms associated with anxiety and/or posttraumatic stress disorder and found correlations with constant and severe pain phenotypes in CP patients from a large cross-sectional cohort study. Although causation cannot be proven, the findings suggest that there may be a role for neuromodulator drugs for the treatment of pain in CP based on individual genetic susceptibility.
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Sun F, Liu Z, Yang J, Fan Z, Yang J. Differential Dynamical Pattern of Regional Homogeneity in Bipolar and Unipolar Depression: A Preliminary Resting-State fMRI Study. Front Psychiatry 2021; 12:764932. [PMID: 34966303 PMCID: PMC8710770 DOI: 10.3389/fpsyt.2021.764932] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Bipolar depression (BD) and unipolar depression (UD) are both characterized by depressive moods, which are difficult to distinguish in clinical practice. Human brain activity is time-varying and dynamic. Investigating dynamical pattern alterations of depressed brains can provide deep insights into the pathophysiological features of depression. This study aimed to explore similar and different abnormal dynamic patterns between BD and UD. Methods: Brain resting-state functional magnetic resonance imaging data were acquired from 36 patients with BD type I (BD-I), 38 patients with UD, and 42 healthy controls (HCs). Analysis of covariance was adopted to examine the differential pattern of the dynamical regional homogeneity (dReHo) temporal variability across 3 groups, with gender, age, and education level as covariates. Post-hoc analyses were employed to obtain the different dynamic characteristics between any 2 groups. We further applied the machine-learning methods to classify BD-I from UD by using the detected distinct dReHo pattern. Results: Compared with patients with UD, patients with BD-I demonstrated decreased dReHo variability in the right postcentral gyrus and right parahippocampal gyrus. By using the dReHo variability pattern of these two regions as features, we achieved the 91.89% accuracy and 0.92 area under curve in classifying BD-I from UD. Relative to HCs, patients with UD showed increased dReHo variability in the right postcentral gyrus, while there were no dReHo variability differences in patients with BD-I. Conclusions: The results of this study mainly report the differential dynamic pattern of the regional activity between BD-I and UD, particular in the mesolimbic system, and show its promising potential in assisting the diagnosis of these two depression groups.
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Affiliation(s)
- Fuping Sun
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhening Liu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun Yang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zebin Fan
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jie Yang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
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