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Ahern E, White J, Slattery E. Change in Cognitive Function over the Course of Major Depressive Disorder: A Systematic Review and Meta-analysis. Neuropsychol Rev 2024:10.1007/s11065-023-09629-9. [PMID: 38315296 DOI: 10.1007/s11065-023-09629-9] [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: 04/21/2023] [Accepted: 11/29/2023] [Indexed: 02/07/2024]
Abstract
Major depressive disorder (MDD) is associated with significant cognitive deficits during the acute and remitted stages. The aim of this systematic review and meta-analysis was to examine the course of cognitive function whilst considering demographic, treatment, or clinical features of MDD that could moderate the extent of cognitive change. Databases were searched to identify studies that reported on cognitive function in MDD with a ≥12-week test-retest interval. Relevant studies were pooled using random effects modelling to generate an inverse-variance, weighted, mean effect size estimate (Hedges' g) of cognitive change for each cognitive variable and for an overall composite cognitive domain. Of 6898 records, 99 eligible studies were identified from which 69 were meta-analysed, consisting of 4639 MDD patients (agemean = 40.25 years, female% = 64.62%) across 44 cognitive variables. In over 95% of cognitive variables, improvements were either of non-significant, negligible, or of a small magnitude, and when compared to matched healthy controls, the possibility of practice effects could not be precluded. Depressive symptom improvement and the number of previous depressive episodes moderated the extent of cognitive change, demonstrating state- and scar-like features for one-quarter of the cognitive domains. Further longitudinal studies are required to elucidate the MDD cognitive trajectory from initial onset. Findings nonetheless suggest that following pharmacological and non-pharmacological treatment, cognitive change in MDD is typically small, but the capacity for change may be less with episode recurrence. Targeting cognition early in the course of illness may facilitate better prognosis and support a more complete functional recovery.
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Affiliation(s)
- Elayne Ahern
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Ireland.
- Department of Psychology, University of Limerick, Castletroy, Limerick, V94 T9PX, Ireland.
| | - Jessica White
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Ireland
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Eadaoin Slattery
- Department of Applied Social Sciences, Technological University of the Shannon Midwest, Limerick, Ireland
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Pilozzi A, Foster S, Mischoulon D, Fava M, Huang X. A Brief Review on the Potential of Psychedelics for Treating Alzheimer's Disease and Related Depression. Int J Mol Sci 2023; 24:12513. [PMID: 37569888 PMCID: PMC10419627 DOI: 10.3390/ijms241512513] [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: 01/06/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
Alzheimer's disease (AD), the most common form of senile dementia, is poised to place an even greater societal and healthcare burden as the population ages. With few treatment options for the symptomatic relief of the disease and its unknown etiopathology, more research into AD is urgently needed. Psychedelic drugs target AD-related psychological pathology and symptoms such as depression. Using microdosing, psychedelic drugs may prove to help combat this devastating disease by eliciting psychiatric benefits via acting through various mechanisms of action such as serotonin and dopamine pathways. Herein, we review the studied benefits of a few psychedelic compounds that may show promise in treating AD and attenuating its related depressive symptoms. We used the listed keywords to search through PubMed for relevant preclinical, clinical research, and review articles. The putative mechanism of action (MOA) for psychedelics is that they act mainly as serotonin receptor agonists and induce potential beneficial effects for treating AD and related depression.
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Affiliation(s)
- Alexander Pilozzi
- Neurochemistry Laboratory, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Simmie Foster
- Neurochemistry Laboratory, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
- Depression Clinical & Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - David Mischoulon
- Depression Clinical & Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Maurizio Fava
- Depression Clinical & Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Xudong Huang
- Neurochemistry Laboratory, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
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Liu EY, Yang CL, Tsai JC, Cheng HY, Peng WH. Antidepressive mechanisms of rhynchophylline in mice with chronic unpredictable stress-induced depression. JOURNAL OF ETHNOPHARMACOLOGY 2023; 309:116302. [PMID: 36842720 DOI: 10.1016/j.jep.2023.116302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Uncaria rhynchophylla ([Mi] Jack) (gouteng) exerts antidepressive effects. Rhynchophylline (RH), a major component of U. rhynchophylla, exerts similar pharmacological effects to those of gouteng. Thus, RH may have antidepressive effects. AIM OF THE STUDY To investigate the anti-depressive effects of RH in chronic unpredictable mild stress (CUMS)-induced depressive mice. The anti-depressive mechanism of RH determined by measuring the 5-HT levels, the expressions of cAMP-response element binding protein (CREB) and brain-derived neurotrophic factor (BDNF) in cortex and hippocampus. MATERIALS AND METHODS The behaviors of CUMS-induced depressive mice were measured using an open field test (OFT), forced swimming test (FST), and tail suspension test (TST). 5-HT levels were measured using an ELISA kits. The expressions of BDNF and CREB were determined using western blot test. RESULTS RH increased the frequency of rearing and grooming in the OFT and decreased the immobility time in the FST and TST. RH effectively increased the 5-HT level and BDNF and CREB expressions in the cortex and hippocampus. CONCLUSION Our findings indicate that the antidepressive mechanism of RH is related to increased levels of 5-HT from regulating CREB and BDNF expressions in cortex and hippocampus.
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Affiliation(s)
- En-Yu Liu
- Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, College of Chinese Medicines, China Medical University, Taichung, 40402, Taiwan.
| | - Chao-Lin Yang
- Ph.D. Program for Biotechnology Industry, College of Biopharmaceutical and Food Sciences, China Medical University, Taichung, 40402, Taiwan.
| | - Jen-Chieh Tsai
- Department of Medicinal Botanical and Health Applications, Da-Yeh University, Dacun, Changhua, 51500, Taiwan.
| | - Hao-Yuan Cheng
- Department of Nursing, Chung-Jen Junior College of Nursing, Health Sciences and Management, Chia-Yi City, 62241, Taiwan.
| | - Wen-Huang Peng
- Department of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, College of Chinese Medicines, China Medical University, Taichung, 40402, Taiwan.
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Jørgensen JL, Macoveanu J, Petersen JZ, Knudsen GM, Kessing LV, Jørgensen MB, Miskowiak KW. Association of childhood trauma with cognitive impairment and structural brain alterations in remitted patients with bipolar disorder. J Affect Disord 2023:S0165-0327(23)00719-X. [PMID: 37236273 DOI: 10.1016/j.jad.2023.05.078] [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: 12/18/2022] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Cognitive impairment affects many patients with bipolar disorder (BD). No pro-cognitive treatment with robust efficacy exists partly due to limited insight into underlying neurobiological abnormalities. METHODS This magnetic resonance imaging (MRI) study investigates structural neuronal correlates of cognitive impairment in BD by comparing brain measures in a large sample of cognitively impaired versus cognitively intact patients with BD or cognitively impaired patients with major depressive disorder (MDD) and healthy controls (HC). Participants underwent neuropsychological assessments and MRI scans. The cognitively impaired and - intact BD and MDD patient groups were compared with each other and HC regarding prefrontal cortex measures, hippocampus shape/volume, and total cerebral white (WM) and grey matter (GM). RESULTS Cognitively impaired BD patients showed lower total cerebral WM volume than HC, which scaled with poorer global cognitive performance and more childhood trauma. Cognitively impaired BD patients also showed lower adjusted GM volume and thickness in the frontopolar cortex than HC but greater adjusted GM volume in the temporal cortex than cognitively normal BD patients. Cognitively impaired BD patients showed decreased cingulate volume than cognitively impaired MDD patients. Hippocampal measures were similar across all groups. LIMITATIONS The cross-sectional study design prevented insights into causal relationships. CONCLUSIONS Lower total cerebral WM and regional frontopolar and temporal GM abnormalities may constitute structural neuronal correlates of cognitive impairment in BD, of which the WM deficits scale with the degree of childhood trauma. The results deepen the understanding of cognitive impairment in BD and provide a neuronal target for pro-cognitive treatment development.
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Affiliation(s)
- Josefine Lærke Jørgensen
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Julian Macoveanu
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jeff Zarp Petersen
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Denmark
| | - Martin Balslev Jørgensen
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
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Pine JG, Paul SE, Johnson E, Bogdan R, Kandala S, Barch DM. Polygenic Risk for Schizophrenia, Major Depression, and Post-traumatic Stress Disorder and Hippocampal Subregion Volumes in Middle Childhood. Behav Genet 2023; 53:279-291. [PMID: 36720770 PMCID: PMC10875985 DOI: 10.1007/s10519-023-10134-1] [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: 11/02/2022] [Accepted: 01/17/2023] [Indexed: 02/02/2023]
Abstract
Studies demonstrate that individuals with diagnoses for Major Depressive Disorder (MDD), Post-traumatic Stress Disorder (PTSD), and Schizophrenia (SCZ) may exhibit smaller hippocampal gray matter relative to otherwise healthy controls, although the effect sizes vary in each disorder. Existing work suggests that hippocampal abnormalities in each disorder may be attributable to genetic liability and/or environmental variables. The following study uses baseline data from the Adolescent Brain and Cognitive Development[Formula: see text] Study (ABCD Study[Formula: see text]) to address three open questions regarding the relationship between genetic risk for each disorder and hippocampal volume reductions: (a) whether polygenic risk scores (PGRS) for MDD, PTSD, and SCZ are related to hippocampal volume; (b) whether PGRS for MDD, PTSD, and SCZ are differentially related to specific hippocampal subregions along the longitudinal axis; and (c) whether the association between PGRS for MDD, PTSD, and SCZ and hippocampal volume is moderated by sex and/or environmental adversity. In short, we did not find associations between PGRS for MDD, PTSD, and SCZ to be significantly related to any hippocampal subregion volumes. Furthermore, neither sex nor enviornmental adversity significantly moderated these associations. Our study provides an important null finding on the relationship genetic risk for MDD, PTSD, and SCZ to measures of hippocampal volume.
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Affiliation(s)
- Jacob G Pine
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA.
| | - Sarah E Paul
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Emma Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Ryan Bogdan
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Sridhar Kandala
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
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Memory and processing speed impairments in first-episode drug-naïve patients with major depressive disorder. J Affect Disord 2023; 322:99-107. [PMID: 36368425 DOI: 10.1016/j.jad.2022.10.048] [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: 01/25/2022] [Revised: 09/16/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cognitive impairment, an intrinsic feature of major depressive disorder (MDD), affects daily and social functioning in depression patients. However, the cognitive impairment profile in MDD remains ambiguous because of the high heterogeneity of previous studies. METHODS Four cognitive domains, including memory, processing speed, executive function (EF), and attention, were assessed in 184 first-episode drug-naïve (FEDN) MDD patients and matched 71 healthy controls (HCs). The effects of demographic and depressive factors on cognitive performance were analyzed using various statistical methods, including multi-factor analysis of variance, Mann-Whitney U test, and Spearman's rank correlation. In addition, the impact of depression severity on cognitive function was further assessed using subgroup analyses and partial correlation analyses. RESULTS Age and education significantly impacted most cognitive performances, and depression severity appeared to influence processing speed. Moreover, cognitive scores in memory and processing speed, rather than in EF and attention, were significantly different between FEDN MDD patients and HCs after controlling for sex, age, educational attainment, household income, and body mass index. LIMITATIONS The number of HCs was relatively small, which may have slightly reduced the study's statistical power. CONCLUSIONS Age and educational attainment have confirmative confounding effects greater than those of depression in most cognitive functions. More importantly, memory and processing speed were impaired in MDD after strictly controlling for confounders. These findings provide new information for understanding the pattern of cognitive impairment and offer clues for further exploring the pathogenesis of cognitive abnormalities in MDD.
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Mlili NE, Ahabrach H, Cauli O. Hair Cortisol Concentration as a Biomarker of Symptoms of Depression in the Perinatal Period. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2023; 22:71-83. [PMID: 35297354 DOI: 10.2174/1871527321666220316122605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/20/2021] [Accepted: 12/29/2021] [Indexed: 12/16/2022]
Abstract
Pregnancy is a sensitive period when women experience major hormonal and psychological changes. A high prevalence of the symptoms of depression and manifested major depression rates have been reported during this period, leading to negative outcomes both for mothers and the offspring. Despite its prevalence, the aetiology of depression is not yet fully understood. Nonetheless, alterations in cortisol levels have been proposed as a reliable biomarker to identify pregnant women at risk of perinatal depression. Hair cortisol has recently been extensively used in bio-psychological studies as a suitable non-invasive biomarker for several neuropsychiatric disorders. Various studies have published evidence regarding the relationship between cortisol fluctuations during the perinatal period, measured both in hair and in other substrates, and the onset of perinatal symptoms of depression. This current review provides an overview of cortisol level changes measured in women's hair during pregnancy or the postpartum period and its association with perinatal symptoms of depression. Further studies, including repetitive measurement of both hair cortisol and depression throughout the prenatal period, must be performed to clarify the relationship between cortisol levels and perinatal symptoms of depression.
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Affiliation(s)
- Nisrin El Mlili
- Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS), Tetouan, Morocco
- Department of Physiology and Physiopathology, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan, Morocco
| | - Hanan Ahabrach
- Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS), Tetouan, Morocco
- Department of Physiology and Physiopathology, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan, Morocco
| | - Omar Cauli
- Department of Nursing, University of Valencia, Valencia 46010, Spain
- Frailty and Cognitive Impairment Group (FROG), University of Valencia, Valencia 46010, Spain
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Variation in Thyroid-Stimulating Hormone and Cognitive Disorders in Unmedicated Middle-Aged Patients with Major Depressive Disorder: A Proton Magnetic Resonance Spectroscopy Study. Mediators Inflamm 2022; 2022:1623478. [PMID: 36105682 PMCID: PMC9467792 DOI: 10.1155/2022/1623478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 01/10/2023] Open
Abstract
Background Middle-aged (45-59 years old) patients with major depressive disorder (MDD) have a predilection for dementia and cognitive disorders (CDs); however, the characteristics and mechanisms of CDs in these patients remain unclear. There are also known connections between thyroid-stimulating hormone (TSH), brain biochemical metabolism, and cognitive function (CF); however, there is scanty of information about these connections in middle-aged MDD patients. Methods Cognitive assessment was performed on 30 first-episode, untreated middle-aged patients with MDD and 30 well-matched healthy controls (HCs) using the MATRICS Consensus Cognitive Battery (MCCB). N-acetyl aspartate (NAA)/creatine (Cr) and choline (Cho)/Cr ratios in the prefrontal cortex (PFC) and cerebellum were also obtained via proton magnetic resonance spectroscopy (1H-MRS), and the TSH level was measured by chemiluminescence analysis. Results MDD patients presented significantly lower processing speed, working memory, verbal learning, reasoning problem-solving, visual learning, and composite cognition scores than controls, with a statistically lower NAA/Cr ratio in the right cerebellum. Age was positively related to reasoning problem-solving in the MDD group (r = 0.6249, p = 0.0220). Education also showed a positive association with visual learning, social cognition, and composite cognition. The 24-item Hamilton Depression Rating Scale (HDRS-24) score was negatively related to all domains of CF. TSH levels were markedly decreased in the MDD group, and a positive connection was determined between the NAA/Cr ratio in the right PFC and the TSH level. Conclusions Middle-aged MDD patients have multidimensional CDs. There are changes in PFC and cerebellar biochemical metabolism in middle-aged patients with MDD, which may be related to CDs or altered TSH levels.
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Kuga N, Sasaki T. Memory-related neurophysiological mechanisms in the hippocampus underlying stress susceptibility. Neurosci Res 2022:S0168-0102(22)00213-9. [PMID: 35931215 DOI: 10.1016/j.neures.2022.07.010] [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: 07/30/2022] [Accepted: 07/31/2022] [Indexed: 11/16/2022]
Abstract
Stress-induced psychiatric symptoms, such as increased anxiety, decreased sociality, and depression, differ considerably across individuals. The cognitive model of depression proposes that biased negative memory is a crucial determinant in the development of mental stress-induced disorders. Accumulating evidence from both clinical and animal studies has demonstrated that such biased memory processing could be triggered by the hippocampus, a region well known to be involved in declarative memories. This review mainly describes how memory-related neurophysiological mechanisms in the hippocampus and their interactions with other related brain regions are involved in the regulation of stress susceptibility and discusses potential interventions to prevent and treat stress-related psychiatric symptoms. Further neurophysiological insights based on memory mechanisms are expected to devise personalized prevention and therapy to confer stress resilience.
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Affiliation(s)
- Nahoko Kuga
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aramaki-Aoba, Aoba-Ku, Sendai 980-8578, Japan
| | - Takuya Sasaki
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aramaki-Aoba, Aoba-Ku, Sendai 980-8578, Japan.
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Can integrating the Memory Support Intervention into cognitive therapy improve depression outcome? A randomized controlled trial. Behav Res Ther 2022; 157:104167. [DOI: 10.1016/j.brat.2022.104167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/12/2022] [Accepted: 07/22/2022] [Indexed: 11/18/2022]
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Sumiyoshi T, Hoshino T, Mishiro I, Hammer-Helmich L, Ge H, Moriguchi Y, Fujikawa K, Fernandez JL. Prediction of residual cognitive disturbances by early response of depressive symptoms to antidepressant treatments in patients with major depressive disorder. J Affect Disord 2022; 296:95-102. [PMID: 34597893 DOI: 10.1016/j.jad.2021.09.025] [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: 04/22/2021] [Revised: 08/16/2021] [Accepted: 09/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patients with major depressive disorder (MDD) frequently retain cognitive disturbances after recovery from mood symptoms. We investigated the relationship between early response of mood symptoms and/or remission, and residual cognitive disturbances after 6 months of antidepressant treatment. METHODS 518 patients with MDD were followed up for 6 months after antidepressant treatment initiation (first-line or switch from a previous drug). Subjective and objective cognitive disturbances were assessed by the Perceived Deficits Questionnaire - Depression (PDQ-D) and digit symbol substitution test (DSST), respectively. Depressive symptoms, as well as remission and early response to treatment, were assessed using the Montgomery-Asberg Depression Rating Scale (MADRS). Multivariable linear and logistic regression models were used to adjust for confounders. RESULTS Early response of depressive mood (≥50% reduction in MADRS score at month 1) was related with fewer residual subjective cognitive symptoms, as evaluated by the PDQ-D at month 6 (p<0.001). Likewise, early remission status at month 2 was inversely associated with PDQ-D scores at month 6 (p<0.001). Among patients with baseline DSST scores of ≥1 standard deviation below the norm, early response/remission was associated with better performance on the DSST at month 6 (p<0.05). LIMITATIONS The cohort may not be representative of the general MDD patient population, and the possible influence of concomitant medications was not evaluated. CONCLUSIONS These findings suggest that early improvements in depressive symptoms predict better cognitive outcomes in patients with MDD. Grouping of patients by mood and cognition status in early stages of antidepressant treatments may facilitate efforts to improve long-term functional outcomes.
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Affiliation(s)
- Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Tatsuya Hoshino
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Izumi Mishiro
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | | | - Holly Ge
- Health Economics & Epidemiology Statistics, Lundbeck Singapore Pte Limited, Singapore
| | | | - Keita Fujikawa
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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Jayan D, deRoon-Cassini TA, Sauber G, Hillard CJ, Fitzgerald JM. A cluster analytic approach to examining the role of cortisol in the development of post-traumatic stress and dysphoria in adult traumatic injury survivors. Psychoneuroendocrinology 2022; 135:105450. [PMID: 34775251 PMCID: PMC8686692 DOI: 10.1016/j.psyneuen.2021.105450] [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: 05/14/2021] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 01/03/2023]
Abstract
Identification of specific risk factors for posttraumatic stress disorder (PTSD) versus depression after trauma has been challenging, in part due to the high comorbidity of these disorders. As exposure to trauma triggers activation of the hypothalamic-pituitary-adrenal (HPA)-axis, examining atypical stress responses via HPA-axis hormones, namely cortisol, may help in the delineation of these disorders. Indeed, extant research demonstrates that, following stress, individuals with chronic PTSD exhibit hypocortisolism (e.g., lower cortisol response than controls), while those with chronic depression exhibit hypercortisolism (e.g., higher response than controls). Less is known about the role of cortisol and these seemingly disparate profiles immediately following traumatic injury as well as whether cortisol can be used as a predictor of future development of PTSD versus depression symptoms. In this study cortisol was measured blood from 172 traumatic injury survivors during hospitalization (on average 2.5 days post-injury). PTSD and depression severity were assessed from Clinician Assessed PTSD Scale (CAPS-5) six-eight months later using a two-factor dimensional approach that measures trauma-specific symptoms of PTSD versus dysphoria (akin to depression). Cluster analysis was used to group individuals based on post-injury cortisol, PTSD, and dysphoria. Results demonstrated that trauma survivors who only developed symptoms of dysphoria at six months (with minimal symptoms of PTSD) were differentiated by high post-injury cortisol compared to other groups. By contrast, individuals who developed symptoms of both PTSD and dysphoria were differentiated by low post-injury cortisol and most severe symptoms of PTSD. Findings provide support for the presence of subgroups of trauma survivors defined, in part, by post-trauma cortisol.
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Affiliation(s)
- Devi Jayan
- Department of Psychology, Marquette University, 317 Cramer Hall, Milwaukee, 53233, USA
| | - Terri A. deRoon-Cassini
- Departments of Trauma & Acute Care Surgery, Psychiatry & Behavioral Medicine, and the Institute for Health & Equity, Comprehensive Injury Center, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Garrett Sauber
- Department of Pharmacology and Toxicology and Neuroscience Research Center, Medical College of Wisconsin, 8701 Watertown Plank Rd. Milwaukee, WI 53226, USA
| | - Cecilia J. Hillard
- Department of Pharmacology and Toxicology and Neuroscience Research Center, Medical College of Wisconsin, 8701 Watertown Plank Rd. Milwaukee, WI 53226, USA
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Myoraku A, Lang A, Taylor CT, Scott Mackin R, Meyerhoff DJ, Mueller S, Strigo IA, Tosun D. Age-dependent brain morphometry in Major Depressive disorder. Neuroimage Clin 2021; 33:102924. [PMID: 34959051 PMCID: PMC8718744 DOI: 10.1016/j.nicl.2021.102924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 12/01/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a complex disorder that affects nearly 264 million people worldwide. Structural brain abnormalities in multiple neuroanatomical networks have been implicated in the etiology of MDD, but the degree to which MDD affects brain structure during early to late adulthood is unclear. METHODS We examined morphometry of brain regions commonly implicated in MDD, including the amygdala, hippocampus, anterior cingulate gyrus, lateral orbitofrontal gyrus, subgenual cortex, and insular cortex subregions, from early to late adulthood. Harmonized measures for gray matter (GM) volume and cortical thickness of each region were estimated cross-sectionally for 305 healthy controls (CTLs) and 247 individuals with MDD (MDDs), collated from four research cohorts. We modeled the nonlinear associations of age with GM volume and cortical thickness using generalized additive modeling and tested for age-dependent group differences. RESULTS Overall, all investigated regions exhibited smaller GM volume and thinner cortical measures with increasing age. Compared to age matched CTLs, MDDs had thicker cortices and greater GM volume from early adulthood until early middle age (average 35 years), but thinner cortices and smaller GM volume during and after middle age in the lateral orbital gyrus and all insular subregions. Deviations of the MDD and CTL models for both GM volume and cortical thickness in these regions started as early as age 18. CONCLUSIONS The analyses revealed that brain morphometry differences between MDDs and CTLs are dependent on age and brain region. The significant age-by-group interactions in the lateral orbital frontal gyrus and insular subregions make these regions potential targets for future longitudinal studies of MDD.
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Affiliation(s)
- Alison Myoraku
- Northern California Institute for Research and Education, San Francisco, CA 94121, United States; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, United States; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143, United States.
| | - Adam Lang
- Northern California Institute for Research and Education, San Francisco, CA 94121, United States
| | - Charles T Taylor
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA 92093, United States
| | - R Scott Mackin
- Northern California Institute for Research and Education, San Francisco, CA 94121, United States; Department of Psychiatry and Behavioral Sciences, Weill Institute for Neuroscience, University of California, San Francisco, San Francisco, CA 94143, United States
| | - Dieter J Meyerhoff
- Northern California Institute for Research and Education, San Francisco, CA 94121, United States; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143, United States
| | - Susanne Mueller
- Northern California Institute for Research and Education, San Francisco, CA 94121, United States; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143, United States
| | - Irina A Strigo
- Department of Psychiatry, University of California San Francisco, San Francisco, CA 94143, United States; Emotion and Pain Laboratory, San Francisco Veterans Affairs Health Care Center, San Francisco, CA 94121, United States
| | - Duygu Tosun
- Northern California Institute for Research and Education, San Francisco, CA 94121, United States; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143, United States
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14
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Green C, Stolicyn A, Harris MA, Shen X, Romaniuk L, Barbu MC, Hawkins EL, Wardlaw JM, Steele JD, Waiter GD, Sandu AL, Campbell A, Porteous DJ, Seckl JR, Lawrie SM, Reynolds RM, Cavanagh J, McIntosh AM, Whalley HC. Hair glucocorticoids are associated with childhood adversity, depressive symptoms and reduced global and lobar grey matter in Generation Scotland. Transl Psychiatry 2021; 11:523. [PMID: 34642301 PMCID: PMC8511057 DOI: 10.1038/s41398-021-01644-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/21/2021] [Accepted: 09/30/2021] [Indexed: 01/15/2023] Open
Abstract
Hypothalamic-pituitary-adrenal (HPA) axis dysregulation has been commonly reported in major depressive disorder (MDD), but with considerable heterogeneity of results; potentially due to the predominant use of acute measures of an inherently variable/phasic system. Chronic longer-term measures of HPA-axis activity have yet to be systematically examined in MDD, particularly in relation to brain phenotypes, and in the context of early-life/contemporaneous stress. Here, we utilise a temporally stable measure of cumulative HPA-axis function (hair glucocorticoids) to investigate associations between cortisol, cortisone and total glucocorticoids with concurrent measures of (i) lifetime-MDD case/control status and current symptom severity, (ii) early/current-life stress and (iii) structural neuroimaging phenotypes, in N = 993 individuals from Generation Scotland (mean age = 59.1 yrs). Increased levels of hair cortisol were significantly associated with reduced global and lobar brain volumes with reductions in the frontal, temporal and cingulate regions (βrange = -0.057 to -0.104, all PFDR < 0.05). Increased levels of hair cortisone were significantly associated with MDD (lifetime-MDD status, current symptoms, and severity; βrange = 0.071 to 0.115, all PFDR = < 0.05), with early-life adversity (β = 0.083, P = 0.017), and with reduced global and regional brain volumes (global: β = -0.059, P = 0.043; nucleus accumbens: β = -0.075, PFDR = 0.044). Associations with total glucocorticoids followed a similar pattern to the cortisol findings. In this large community-based sample, elevated glucocorticoids were significantly associated with MDD, with early, but not later-life stress, and with reduced global and regional brain phenotypes. These findings provide important foundations for future mechanistic studies to formally explore causal relationships between early adversity, chronic rather than acute measures of glucocorticoids, and neurobiological associations relevant to the aetiology of MDD.
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Affiliation(s)
- Claire Green
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK.
| | - Aleks Stolicyn
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Mathew A Harris
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Xueyi Shen
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Liana Romaniuk
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Miruna C Barbu
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Emma L Hawkins
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- UK Dementia Research Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J Douglas Steele
- Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, UK
| | - Gordon D Waiter
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Anca-Larisa Sandu
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - David J Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Jonathan R Seckl
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | | | - Rebecca M Reynolds
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Jonathan Cavanagh
- Institute of Infection, Immunity & Inflammation, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
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15
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Artin H, Zisook S, Ramanathan D. How do serotonergic psychedelics treat depression: The potential role of neuroplasticity. World J Psychiatry 2021; 11:201-214. [PMID: 34168967 PMCID: PMC8209538 DOI: 10.5498/wjp.v11.i6.201] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/07/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
Depression is a common mental disorder and one of the leading causes of disability around the world. Monoaminergic antidepressants often take weeks to months to work and are not effective for all patients. This has led to a search for a better understanding of the pathogenesis of depression as well as to the development of novel antidepressants. One such novel antidepressant is ketamine, which has demonstrated both clinically promising results and contributed to new explanatory models of depression, including the potential role of neuroplasticity in depression. Early clinical trials are now showing promising results of serotonergic psychedelics for depression; however, their mechanism of action remains poorly understood. This paper seeks to review the effect of depression, classic antidepressants, ketamine, and serotonergic psychedelics on markers of neuroplasticity at a cellular, molecular, electrophysiological, functional, structural, and psychological level to explore the potential role that neuroplasticity plays in the treatment response of serotonergic psychedelics.
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Affiliation(s)
- Hewa Artin
- Department of Psychiatry, UC San Diego, La Jolla, CA 92093, United States
| | - Sidney Zisook
- Department of Psychiatry, UC San Diego, San Diego, CA 92093, United States
| | - Dhakshin Ramanathan
- Department of Psychiatry, VA San Diego Healthcare System, San Diego, CA 92161, United States
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16
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Zhang Y, Zhang X, Liu N, Ren S, Xia C, Yang X, Lou Y, Wang H, Zhang N, Yan X, Zhang Z, Zhang Y, Wang Z, Chen N. Comparative Proteomic Characterization of Ventral Hippocampus in Susceptible and Resilient Rats Subjected to Chronic Unpredictable Stress. Front Neurosci 2021; 15:675430. [PMID: 34220431 PMCID: PMC8249003 DOI: 10.3389/fnins.2021.675430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/10/2021] [Indexed: 12/19/2022] Open
Abstract
Chronic stress is an essential factor leading to depression. However, there exist individual differences in people exposed to the same stressful stimuli. Some people display negative psychology and behavior, while others are normal. Given the importance of individual difference, finding differentially expressed proteins in stress-resistant and stress-susceptible groups has great significance for the study of pathogenesis and treatment of depression. In this study, stress-susceptible rats and stress-resilient rats were first distinguished by sucrose preference test. These stress-susceptible rats also displayed depression-like behaviors in forced swimming test and open field test. Then, we employed label-free quantitative proteomics to analyze proteins in the ventral hippocampus. There were 4,848 proteins totally identified. Based on statistical analysis, we found 276 differentially expressed proteins. Bioinformatics analysis revealed that the biological processes of these differential proteins were related to mitochondrion organization, protein localization, coenzyme metabolic process, cerebral cortex tangential migration, vesicle-mediated transport, and so on. The KEGG pathways were mainly involved in metabolic pathways, axon guidance, autophagy, and tight junction. Furthermore, we ultimately found 20 stress-susceptible proteins and two stress-resilient proteins. These stress-related proteins could not only be potential biomarkers for depression diagnosis but also contribute to finding new therapeutic targets and providing personalized medicine.
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Affiliation(s)
- Yani Zhang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China.,Institute of Clinical Pharmacology and Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaoling Zhang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nuo Liu
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China
| | - Siyu Ren
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China
| | - Congyuan Xia
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiong Yang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuxia Lou
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huiqin Wang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ningning Zhang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xu Yan
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhao Zhang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Zhang
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zhenzhen Wang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China
| | - Naihong Chen
- State Key Laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica and Neuroscience Center, Chinese Academy Medical Sciences and Peking Union Medical College, Beijing, China.,Institute of Clinical Pharmacology and Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China
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17
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Reckziegel D, Abdullah T, Wu B, Wu B, Huang L, Schnitzer TJ, Apkarian AV. Hippocampus shape deformation: a potential diagnostic biomarker for chronic back pain in women. Pain 2021; 162:1457-1467. [PMID: 33181581 PMCID: PMC8049947 DOI: 10.1097/j.pain.0000000000002143] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/03/2020] [Indexed: 02/06/2023]
Abstract
ABSTRACT Sex differences in the quality and prevalence of chronic pain are manifold, with women generally presenting higher incidence and severity. Uncovering chronic pain-related sex differences inform neural mechanisms and may lead to novel treatment routes. In a multicenter morphological study (total n = 374), we investigated whether the shape of subcortical regions would reflect sex differences in back pain. Given the hormone-dependent functions of the hippocampus, and its role in the transition to chronic pain, this region constituted our primary candidate. We found that the anterior part of the left hippocampus (alHP) presented outer deformation in women with chronic back pain (CBP), identified in CBP in the United States (n = 77 women vs n = 78 men) and validated in a Chinese data set (n = 29 women vs n = 58 men with CBP, in contrast to n = 53 female and n = 43 male healthy controls). Next, we examined this region in subacute back pain who persisted with back pain a year later (SBPp; n = 18 women vs n = 18 men) and in a subgroup with persistent back pain for 3 years. Weeks after onset of back pain, there was no deformation within alHP, but at 1 and 3 years women exhibited a trend for outer deformation. The alHP partly overlapped with the subiculum and entorhinal cortex, whose functional connectivity, in healthy subjects, was associated with emotional and episodic memory related terms (Neurosynth, reverse inference). These findings suggest that in women the alHP undergoes anatomical changes with pain persistence, highlighting sexually dimorphic involvement of emotional and episodic memory-related circuitry with chronic pain.
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Affiliation(s)
- Diane Reckziegel
- Center for Chronic Pain and Drug Abuse, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Taha Abdullah
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, USA
- Touro College of Osteopathic Medicine, New York, USA
| | - Binbin Wu
- Department of Pain Medicine, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Bo Wu
- Department of Information, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Lejian Huang
- Center for Chronic Pain and Drug Abuse, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Thomas J Schnitzer
- Center for Chronic Pain and Drug Abuse, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Rheumatology, Northwestern University, Feinberg School of Medicine, Chicago, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - A Vania Apkarian
- Center for Chronic Pain and Drug Abuse, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Anesthesia, Northwestern University Feinberg School of Medicine, Chicago, USA
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18
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Piers RJ, Liu Y, Ang TFA, Tao Q, Au R, Qiu WQ. Association Between Elevated Depressive Symptoms and Cognitive Function Moderated by APOE4 Status: Framingham Offspring Study. J Alzheimers Dis 2021; 80:1269-1279. [PMID: 33646152 DOI: 10.3233/jad-200998] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depression and Apolipoprotein E4 (APOE4) are associated with decreased cognitive function and differences in brain structure. OBJECTIVE This study investigated whether APOE4 status moderates the association between elevated depressive symptoms, cognitive function, and brain structure. METHODS Stroke- and dementia-free participants (n = 1,968) underwent neuropsychological evaluation, brain MRI, and depression screening. Linear and logistic regression was used to examine all associations. Secondary analyses were performed using interaction terms to assess effect modification by APOE4 status. RESULTS Elevated depressive symptoms were associated with lower cognitive performance in several domains. In stratified analyses, elevated depressive symptoms were associated with poorer visual short- and long-term memory performance for APOE4 + participants. Elevated depressive symptoms were not associated with any brain structure in this study sample. CONCLUSION Elevated depressive symptoms impact cognitive function in non-demented individuals. Having the APOE4 allele may exacerbate the deleterious effects of elevated depressive symptoms on visual memory performance. Screening for elevated depressive symptoms in both research studies and clinical practice may be warranted to avoid false positive identification of neurodegeneration, particularly among those who are APOE4 + .
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Affiliation(s)
- Ryan J Piers
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Yulin Liu
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Ting F A Ang
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.,Slone Epidemiology Center, Boston University School of Medicine, Boston, MA, USA
| | - Qiushan Tao
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Rhoda Au
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.,Slone Epidemiology Center, Boston University School of Medicine, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.,Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA
| | - Wei Qiao Qiu
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA.,Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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19
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Differential Susceptibility to the Impact of the COVID-19 Pandemic on Working Memory, Empathy, and Perceived Stress: The Role of Cortisol and Resilience. Brain Sci 2021; 11:brainsci11030348. [PMID: 33803413 PMCID: PMC7998983 DOI: 10.3390/brainsci11030348] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 12/17/2022] Open
Abstract
There are important individual differences in adaptation and reactivity to stressful challenges. Being subjected to strict social confinement is a distressful psychological experience leading to reduced emotional well-being, but it is not known how it can affect the cognitive and empathic tendencies of different individuals. Cortisol, a key glucocorticoid in humans, is a strong modulator of brain function, behavior, and cognition, and the diurnal cortisol rhythm has been postulated to interact with environmental stressors to predict stress adaptation. The present study investigates in 45 young adults (21.09 years old, SD = 6.42) whether pre-pandemic diurnal cortisol indices, overall diurnal cortisol secretion (AUCg) and cortisol awakening response (CAR) can predict individuals' differential susceptibility to the impact of strict social confinement during the Coronavirus Disease 2019 (COVID-19) pandemic on working memory, empathy, and perceived stress. We observed that, following long-term home confinement, there was an increase in subjects' perceived stress and cognitive empathy scores, as well as an improvement in visuospatial working memory. Moreover, during confinement, resilient coping moderated the relationship between perceived stress scores and pre-pandemic AUCg and CAR. In addition, in mediation models, we observed a direct effect of AUCg and an indirect effect of both CAR and AUCg, on change in perceived self-efficacy. These effects were parallelly mediated by the increase in working memory span and cognitive empathy. In summary, our findings reveal the role of the diurnal pattern of cortisol in predicting the emotional impact of the COVID-19 pandemic, highlighting a potential biomarker for the identification of at-risk groups following public health crises.
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20
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Chenji S, Cox E, Jaworska N, Swansburg RM, MacMaster FP. Body mass index and variability in hippocampal volume in youth with major depressive disorder. J Affect Disord 2021; 282:415-425. [PMID: 33422817 DOI: 10.1016/j.jad.2020.12.176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/31/2020] [Accepted: 12/24/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND The hippocampus has been implicated in major depressive disorder (MDD), in both adults and youth. However, possible sources of variability for the hippocampus have not been well delineated. Here, we explored the relationship between body mass index (BMI) and hippocampal volume in youth with MDD. METHODS Twenty-two controls (9 male, 13 female, 12-24 years), 24 youth with MDD and normal BMI (12 male, 12 female, 14-24 years), and 20 youth with MDD and high BMI (14 male, 6 female, 13-22 years) underwent magnetic resonance (MR) imaging and spectroscopy (1H-MRS). Hippocampal volume was determined through manual tracing of high-resolution anatomical T1 scans, and LCModel quantified neurochemical concentrations. Intracranial volume was used as a covariate in analysis to control for effects of brain volume on hippocampus. RESULTS In youth with MDD and normal BMI, right hippocampal volume was reduced (p = 0.006, Bonferroni) and a trend for reduced left hippocampal volume was noted when compared to healthy controls (p = 0.054, Bonferroni). Left hippocampal volumes were negatively associated with BMI in youth with MDD and high BMI group (r = -0.593, p = 0.006). No associations were found between the right hippocampus and BMI and there were no group differences for metabolite concentrations. LIMITATIONS Larger sample sizes would enable researchers to explore overweight vs obese groups and effect of sex in MDD-BMI groups. CONCLUSIONS BMI may account for some of the variability observed in previous studies of hippocampal volume in MDD, and therefore BMI impacts should be considered in future analyses.
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Affiliation(s)
- Sneha Chenji
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Emily Cox
- Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
| | - Natalia Jaworska
- University of Ottawa Institute of Mental Health Research, Ontario, Canada
| | - Rose M Swansburg
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Frank P MacMaster
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Alberta, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta, Canada; Addictions and Mental Health Strategic Clinical Network, Alberta, Canada.
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21
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Bourin M. Neurogenesis and Neuroplasticity in Major Depression: Its Therapeutic Implication. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1305:157-173. [PMID: 33834400 DOI: 10.1007/978-981-33-6044-0_10] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The neurochemical model of depression, based on monoaminergic theories, does not allow on its own to understand the mechanism of action of antidepressants. This approach does not explain the gap between the immediate biochemical modulations induced by antidepressants and the time required for their clinical action. Several hypotheses have been developed to try to explain more precisely the action of these molecules, each of them involving mechanisms of receptor regulation. At the same time, data on the neuroanatomy of depression converge toward the existence of specific lesions of this pathology. This chapter aims to provide an overview of recent advances in understanding the mechanisms of neural plasticity involved in pathophysiology depression and in its treatment.
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Affiliation(s)
- Michel Bourin
- Neurobiology of Mood Disorders, University of Nantes, Nantes, France.
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22
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Barry DN, Clark IA, Maguire EA. The relationship between hippocampal subfield volumes and autobiographical memory persistence. Hippocampus 2020; 31:362-374. [PMID: 33320970 PMCID: PMC8048905 DOI: 10.1002/hipo.23293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/30/2020] [Accepted: 12/06/2020] [Indexed: 12/11/2022]
Abstract
Structural integrity of the human hippocampus is widely acknowledged to be necessary for the successful encoding and retrieval of autobiographical memories. However, evidence for an association between hippocampal volume and the ability to recall such memories in healthy individuals is mixed. Here we examined this issue further by combining two approaches. First, we focused on the anatomically distinct subregions of the hippocampus where more nuanced associations may be expressed compared to considering the whole hippocampal volume. A manual segmentation protocol of hippocampal subregions allowed us to separately calculate the volumes of the dentate gyrus/CA4, CA3/2, CA1, subiculum, pre/parasubiculum and uncus. Second, a critical feature of autobiographical memories is that they can span long time periods, and so we sought to consider how memory details persist over time by conducting a longitudinal study whereby participants had to recall the same autobiographical memories on two visits spaced 8 months apart. Overall, we found that there was no difference in the total number of internal (episodic) details produced at Visits 1 and 2. However, further probing of detail subcategories revealed that specifically the amount of subjective thoughts and emotions included during recall had declined significantly by the second visit. We also observed a strong correlation between left pre/parasubiculum volume and the amount of autobiographical memory internal details produced over time. This positive relationship was evident for particular facets of the memories, with remembered events, perceptual observations and thoughts and emotions benefitting from greater volume of the left pre/parasubiculum. These preliminary findings expand upon existing functional neuroimaging evidence by highlighting a potential link between left pre/parasubiculum volume and autobiographical memory. A larger pre/parasubiculum appears not only to protect against memory decay, but may possibly enhance memory persistence, inviting further scrutiny of the role of this brain region in remote autobiographical memory retrieval.
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Affiliation(s)
- Daniel N Barry
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Ian A Clark
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Eleanor A Maguire
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK
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23
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Pigoni A, Delvecchio G, Squarcina L, Bonivento C, Girardi P, Finos L, Crisanti C, Balestrieri M, D'Agostini S, Stanley JA, Brambilla P. Sex differences in brain metabolites in anxiety and mood disorders. Psychiatry Res Neuroimaging 2020; 305:111196. [PMID: 33010582 DOI: 10.1016/j.pscychresns.2020.111196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 01/16/2023]
Abstract
Gender differences in mood and anxiety disorders are well-established. However, the neural basis of these differences is not clear yet, especially in terms of brain metabolism. Indeed, although several proton Magnetic Resonance Spectroscopy (¹H MRS) investigations reported different metabolic levels in both depression and anxiety disorders, which have been also linked to symptoms severity and response to treatment, the role of gender on these differences have not been explored yet. Therefore, this study aims at investigating the role of sex in neurometabolic alterations associated with both mood and anxiety disorders. A 3T single-voxel ¹H MRS acquisition of the dorsolateral prefrontal cortex was acquired from 14 Major Depressive Disorder, 10 Generalized Anxiety Disorder (GAD), 11 Panic Disorder (PD), patients and 16 healthy controls (HC). Among males, PD patients showed significantly lower GPC+PC (also observed in GAD+PD) and Glu levels compared to HC. Finally, a significant group x sex interaction effect was observed in the GPC+PC and Glu levels. We proved the presence of an association between sex and brain metabolites in anxiety spectrum.
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Affiliation(s)
- Alessandro Pigoni
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Carolina Bonivento
- Scientific Institute, IRCCS E. Medea, via della Bontà 7, San Vito al Tagliamento, Pordenone, Italy
| | - Paolo Girardi
- Department of Developmental Psychology and Socialization, University of Padua, Italy
| | - Livio Finos
- Department of Developmental Psychology and Socialization, University of Padua, Italy
| | - Camilla Crisanti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Serena D'Agostini
- Department of Neuroradiology, Azienda Ospedaliero Universitaria 'S.Maria della Misericordia', P.za S. Maria della Misericordia, Udine, Italy
| | - Jeffrey A Stanley
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI,USA
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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Espinoza Oyarce DA, Shaw ME, Alateeq K, Cherbuin N. Volumetric brain differences in clinical depression in association with anxiety: a systematic review with meta-analysis. J Psychiatry Neurosci 2020; 45:406-429. [PMID: 32726102 PMCID: PMC7595741 DOI: 10.1503/jpn.190156] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Structural differences associated with depression have not been confirmed in brain regions apart from the hippocampus. Comorbid anxiety has been inconsistently assessed, and may explain discrepancies in previous findings. We investigated the link between depression, comorbid anxiety and brain structure. METHODS We followed Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines (PROSPERO CRD42018089286). We searched the Cochrane Library, MEDLINE, PsycInfo, PubMed and Scopus, from database inception to Sept. 13, 2018, for MRI case-control studies that reported brain volumes in healthy adults and adults with clinical depression. We summarized mean volumetric differences using meta-analyses, and we assessed demographics, depression factors and segmentation procedure as moderators using meta-regressions. RESULTS We included 112 studies in the meta-analyses, assessing 4911 healthy participants and 5934 participants with depression (mean age 49.8 yr, 68.2% female). Volume effects were greater in late-onset depression and in multiple episodes of depression. Adults with depression and no comorbidity showed significantly lower volumes in the putamen, pallidum and thalamus, as well as significantly lower grey matter volume and intracranial volume; the largest effects were in the hippocampus (6.8%, p < 0.001). Adults with depression and comorbid anxiety showed significantly higher volumes in the amygdala (3.6%, p < 0.001). Comorbid anxiety lowered depression effects by 3% on average. Sex moderated reductions in intracranial volume. LIMITATIONS High heterogeneity in hippocampus effects could not be accounted for by any moderator. Data on symptom severity and medication were sparse, but other factors likely made significant contributions. CONCLUSION Depression-related differences in brain structure were modulated by comorbid anxiety, chronicity of symptoms and onset of illness. Early diagnosis of anxiety symptomatology will prove crucial to ensuring effective, tailored treatments for improving long-term mental health and mitigating cognitive problems, given the effects in the hippocampus.
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Affiliation(s)
- Daniela A Espinoza Oyarce
- From the Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia (Espinoza Oyarce, Alateeq, Cherbuin); and the College of Engineering and Computer Science, The Australian National University, Canberra, ACT, Australia (Shaw)
| | - Marnie E Shaw
- From the Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia (Espinoza Oyarce, Alateeq, Cherbuin); and the College of Engineering and Computer Science, The Australian National University, Canberra, ACT, Australia (Shaw)
| | - Khawlah Alateeq
- From the Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia (Espinoza Oyarce, Alateeq, Cherbuin); and the College of Engineering and Computer Science, The Australian National University, Canberra, ACT, Australia (Shaw)
| | - Nicolas Cherbuin
- From the Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia (Espinoza Oyarce, Alateeq, Cherbuin); and the College of Engineering and Computer Science, The Australian National University, Canberra, ACT, Australia (Shaw)
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Sex differences in the cognitive function of first-diagnosed, drug-naïve depressed patients: An observational case-control study. J Affect Disord 2020; 276:461-466. [PMID: 32871678 DOI: 10.1016/j.jad.2020.07.114] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/02/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a severe mental illness with high prevalence and recurrence rates. Cognitive impairments are found in most depressed patients, but systematic assessment of sex differences in cognitive deficits remains to be investigated. METHODS A total of 69 first-diagnosed, drug-naïve depressed outpatients (males/females = 28/41; average age: 27.51±8.82 years) and 57 healthy controls (HCs) (males/females = 26/31; average age: 29.05±8.69 years) were recruited. Cognitive function, measured by repeatable battery for the assessment of neuropsychological status [RBANS] scores, was compared between depressed patients and healthy controls in males and females. RESULTS Immediate memory, delayed memory and RBANS total score were significantly decreased in depressed patients compared with healthy controls. Moreover, among patients with first-diagnosed, drug-naïve depression, females had lower visuospatial and constructional scores than males, whereas among controls, females had higher language scores than males. Interestingly, impaired attention was negatively associated with the Beck Depression Inventory-II (BDI-II) score in female patients, but not in male patients. CONCLUSION Female patients with first-diagnosed, drug-naïve depression had more serious cognitive impairment than male patients in the visuospatial and constructional categories. Cognitive impairment was associated with depression severity only in female patients. These observations build the basis for future investigation of sex differences in cognitive impairment of depressed patients.
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Kluczniok D, Bertsch K, Hindi Attar C, Neukel C, Fuchs A, Jaite C, Dittrich K, Bödeker K, Heinz A, Winter S, Brunner R, Herpertz SC, Bermpohl F. Early life maltreatment and depression: Mediating effect of maternal hair cortisol concentration on child abuse potential. Psychoneuroendocrinology 2020; 120:104791. [PMID: 32683140 DOI: 10.1016/j.psyneuen.2020.104791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/02/2020] [Accepted: 07/02/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Maternal early life maltreatment (ELM) and history of depression can bear a risk for adverse development in the child. One neurobiological pathway for the transmission of both maternal ELM and remitted depression (MDD) might be altered maternal cortisol levels. In the present study, we examine (1) main and interacting effects of maternal ELM and remitted MDD on hair cortisol concentration (HCC) in mothers, whether (2) maternal HCC explains the association between maternal ELM or remitted MDD and maternal child abuse potential, and (3) whether maternal child abuse potential as well as maternal HCC are associated with maternal report of child well-being. METHODS The current study involved 127 mother-child dyads. Maternal history of ELM and psychopathology were assessed via the Mini International Neuropsychiatric Interview (M.I.N.I.) and Childhood Experience and Care (CECA) interview. The Child Abuse Potential Inventory (CAPI) was used to assess maternal child abuse and neglect potential. We applied the Kidscreen-27 parent report to study child well-being. To assess HCC, hair strands were taken from the mothers. To test the research questions, a two-factorial analysis of covariance, mediation analysis using ordinary least squares regressions with bootstrapping, and Pearson correlations were calculated. RESULTS Mothers with ELM had significantly increased HCC. There was no effect of remitted MDD on HCC, nor an interaction effect of both factors. HCC was a significant mediator of the association between maternal ELM and maternal child abuse potential. Maternal child abuse potential as well as HCC were significantly associated with reduced child well-being. DISCUSSION Our data suggest that adverse experiences in childhood are associated with altered HPA-axis functioning reflected in increased levels of HCC. HPA-axis activity is not altered in mothers with remitted MDD. From a clinical point of view, one might speculate that the partially mediating effect of maternal HCC could indicate a starting point in the prevention of the intergenerational cycle of abuse.
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Affiliation(s)
- Dorothea Kluczniok
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Germany.
| | - Katja Bertsch
- Department of Psychology, Ludwig Maximilian University Munich, Germany; Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Catherine Hindi Attar
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - Corinne Neukel
- Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Anna Fuchs
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany; Department of Psychology, Pennsylvania State University, University Park, PA, USA
| | - Charlotte Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Campus Virchow, Charité - Universitätsmedizin Berlin, Germany
| | - Katja Dittrich
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Campus Virchow, Charité - Universitätsmedizin Berlin, Germany
| | - Katja Bödeker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Campus Virchow, Charité - Universitätsmedizin Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - Sibylle Winter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Campus Virchow, Charité - Universitätsmedizin Berlin, Germany
| | - Romuald Brunner
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Sabine C Herpertz
- Department for General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Germany
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DeRosse P, Barber AD. Overlapping Neurobiological Substrates for Early-Life Stress and Resilience to Psychosis. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:144-153. [PMID: 33097471 DOI: 10.1016/j.bpsc.2020.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
Early-life stress, such as childhood maltreatment, is a well-known etiological factor in psychopathology, including psychosis. Exposure to early-life stress disrupts the neurodevelopment of widespread brain systems, including key components of the hypothalamic-pituitary-adrenal axis stress response, such as the amygdala, hippocampus, and medial prefrontal cortex, as well as key components of the brain's reward system, such as the nucleus accumbens and orbitofrontal cortex. These disruptions have a considerable impact on the function of emotion and reward circuitry, which play a central role in the emergence and severity of psychosis. While this overlap may provide insight into the pathophysiology of psychosis, it also provides unique opportunities to elucidate neurobiological substrates that may promote resilience to psychosis. In this review, we discuss the hypothalamic-pituitary-adrenal axis stress response, discuss the disruption in the neurodevelopment of emotion and reward processing associated with early stress exposures, and examine how this circuitry may contribute to resilience to psychotic disorders.
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Affiliation(s)
- Pamela DeRosse
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, New York; Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York.
| | - Anita D Barber
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, New York; Division of Psychiatry Research, The Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York
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Bremner JD, Gurel NZ, Wittbrodt MT, Shandhi MH, Rapaport MH, Nye JA, Pearce BD, Vaccarino V, Shah AJ, Park J, Bikson M, Inan OT. Application of Noninvasive Vagal Nerve Stimulation to Stress-Related Psychiatric Disorders. J Pers Med 2020; 10:E119. [PMID: 32916852 PMCID: PMC7563188 DOI: 10.3390/jpm10030119] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vagal Nerve Stimulation (VNS) has been shown to be efficacious for the treatment of depression, but to date, VNS devices have required surgical implantation, which has limited widespread implementation. METHODS New noninvasive VNS (nVNS) devices have been developed which allow external stimulation of the vagus nerve, and their effects on physiology in patients with stress-related psychiatric disorders can be measured with brain imaging, blood biomarkers, and wearable sensing devices. Advantages in terms of cost and convenience may lead to more widespread implementation in psychiatry, as well as facilitate research of the physiology of the vagus nerve in humans. nVNS has effects on autonomic tone, cardiovascular function, inflammatory responses, and central brain areas involved in modulation of emotion, all of which make it particularly applicable to patients with stress-related psychiatric disorders, including posttraumatic stress disorder (PTSD) and depression, since dysregulation of these circuits and systems underlies the symptomatology of these disorders. RESULTS This paper reviewed the physiology of the vagus nerve and its relevance to modulating the stress response in the context of application of nVNS to stress-related psychiatric disorders. CONCLUSIONS nVNS has a favorable effect on stress physiology that is measurable using brain imaging, blood biomarkers of inflammation, and wearable sensing devices, and shows promise in the prevention and treatment of stress-related psychiatric disorders.
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Affiliation(s)
- James Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA; (M.T.W.); (M.H.R.)
- Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322, USA;
- Atlanta VA Medical Center, Decatur, GA 30033, USA; (A.J.S.); (J.P.)
| | - Nil Z. Gurel
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA; (N.Z.G.); (M.H.S.); (O.T.I.)
| | - Matthew T. Wittbrodt
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA; (M.T.W.); (M.H.R.)
| | - Mobashir H. Shandhi
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA; (N.Z.G.); (M.H.S.); (O.T.I.)
| | - Mark H. Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA; (M.T.W.); (M.H.R.)
| | - Jonathon A. Nye
- Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | - Bradley D. Pearce
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322, USA; (B.D.P.); (V.V.)
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322, USA; (B.D.P.); (V.V.)
- Department of Medicine, Cardiology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Amit J. Shah
- Atlanta VA Medical Center, Decatur, GA 30033, USA; (A.J.S.); (J.P.)
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322, USA; (B.D.P.); (V.V.)
- Department of Medicine, Cardiology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Jeanie Park
- Atlanta VA Medical Center, Decatur, GA 30033, USA; (A.J.S.); (J.P.)
- Department of Medicine, Renal Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Marom Bikson
- Department of Biomedical Engineering, City University of New York, New York, NY 10010, USA;
| | - Omer T. Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA; (N.Z.G.); (M.H.S.); (O.T.I.)
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
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Kafetzopoulos V, Kokras N, Sousa N, Antoniou K, Sotiropoulos I, Dalla C. Nucleus Reuniens Lesion and Antidepressant Treatment Prevent Hippocampal Neurostructural Alterations Induced by Chronic Mild Stress in Male Rats. Neuroscience 2020; 454:85-93. [PMID: 32828941 DOI: 10.1016/j.neuroscience.2020.08.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/06/2020] [Accepted: 08/13/2020] [Indexed: 12/21/2022]
Abstract
The hippocampus-prefrontal cortex circuit plays a major role in stress and in the neurobiology of depression and its treatment. Disruption of this circuit by lesioning the thalamic nucleus reuniens (RE) has been shown to prevent the detrimental effects of chronic mild stress on prefrontal cortex neuroplasticity indices in male rats. However, it remains unknown whether hippocampal neurostructural response to stress is modified by RE lesion. In the present study, adult male rats were subjected to the chronic mild stress model of depression and were treated with either vehicle or an antidepressant (i.e. sertraline). Moreover, a group of animals was subjected to RE lesion before stress exposure with or without sertraline treatment. We demonstrated that chronic mild stress induced hippocampal CA1 dendritic atrophy and this was prevented by pre-stress RE lesion to the same extent that antidepressant treatment reversed it. The present findings highlight the importance of hippocampal-prefrontal cortex communication in chronic stress effects on hippocampal neuroplasticity and contribute to the elucidation of the role of RE in neurostructural changes underlying stress-driven depression and its treatment.
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Affiliation(s)
- Vasilios Kafetzopoulos
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Kokras
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece; First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal
| | - Katerina Antoniou
- Department of Pharmacology, Medical School, University of Ioannina, Ioannina, Greece
| | - Ioannis Sotiropoulos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal
| | - Christina Dalla
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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Rothe N, Steffen J, Penz M, Kirschbaum C, Walther A. Examination of peripheral basal and reactive cortisol levels in major depressive disorder and the burnout syndrome: A systematic review. Neurosci Biobehav Rev 2020; 114:232-270. [DOI: 10.1016/j.neubiorev.2020.02.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/27/2020] [Accepted: 02/19/2020] [Indexed: 12/15/2022]
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Sandstrom A, Daoust AR, Russell E, Koren G, Hayden EP. Hair cortisol concentrations predict change in girls’ depressive symptoms. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2020. [DOI: 10.1080/17405629.2020.1774359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Andrea Sandstrom
- Department of Psychology, University of Western Ontario, London, ON, Canada
| | - Andrew R. Daoust
- Department of Psychology, University of Western Ontario, London, ON, Canada
| | - Evan Russell
- Department of Physiology/Pharmacology, University of Western Ontario, London, ON, Canada
| | - Gideon Koren
- Department of Physiology/Pharmacology, University of Western Ontario, London, ON, Canada
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Kraus C, Kadriu B, Lanzenberger R, Zarate CA, Kasper S. Prognosis and Improved Outcomes in Major Depression: A Review. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2020; 18:220-235. [PMID: 33343240 DOI: 10.1176/appi.focus.18205] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
(Reprinted from Transl Psychiatry. 2019 Apr 3; 9(1):127. Open access; is licensed under a Creative Commons Attribution 4.0 International License).
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Hájek T, Kopecek M, Preiss M, Alda M, Höschl C. Prospective study of hippocampal volume and function in human subjects treated with corticosteroids. Eur Psychiatry 2020; 21:123-8. [PMID: 16516109 DOI: 10.1016/j.eurpsy.2005.01.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2004] [Accepted: 01/14/2005] [Indexed: 12/27/2022] Open
Abstract
AbstractPurpose.Decreased hippocampal volume reported in neuropsychiatric and endocrine disorders is considered a result of putative neuronal damage mediated by corticosteroids. This is the first prospective study of hippocampal volume and function in patients treated with corticosteroids.Methods.14 subjects treated systemically with prednisone or betamethasone for dermatological or rheumatic disorders underwent prospective neurocognitive testing (Auditory Verbal Learning Test—AVLT, Trail Making Test—TMT, Digit Span—DS) and nine of them also repeated magnetic resonance volumetry.Results.The mean duration of treatment between the first and the second assessment was 73 ± 38 days with mean daily dose of 37 ± 17 mg prednisone and 193 ± 29 days, with mean daily dose of 24 ± 15 mg prednisone between the first and the third assessment. There was a trend towards decreases in total AVLT scores and an improvement in the TMT and DS, but no significant changes in the volumes of the right or the left hippocampi between the assessments. Prednisone dose did not correlate with the hippocampal volume change.Conclusion.We observed a trend for decline in verbal memory despite improvement in psychomotor speed, attention/working memory and no macroscopic hippocampal volume changes during 36–238 days of treatment with therapeutic doses of corticosteroids.
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Affiliation(s)
- Tomás Hájek
- Prague Psychiatric Center and Charles University, 3rd School of Medicine, Prague, Czech Republic.
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Pu M, Wang X, Zhang J. Impact of GRIK4 gene polymorphisms on cognitive dysfunction in patients with major depression. Rev Neurol (Paris) 2020; 176:823-828. [PMID: 32245654 DOI: 10.1016/j.neurol.2019.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/03/2019] [Accepted: 11/07/2019] [Indexed: 11/28/2022]
Abstract
An increasing body of research has focused on the functions of the glutamate receptor ionotropic kainate 4 (GRIK4) gene in treatment for depression, memory, as well as neurodegenerative diseases. It is widely recognized that major depressive disorder (MDD) patients often display cognitive dysfunctions, which do not strictly correlate with the severity of depressive symptoms, and in some individuals persist after clinical remission. However, little is known regarding the particular role of GRIK4 in cognitive functions of patients suffering from a MDD. The current study therefore sought to examine the impact of GRIK4 polymorphism on cognitive functions in MDD patients. A total of 217 MDD patients participated in this study. Their depressive severity was determined with the 17-item Hamilton Depression Rating Scale, and cognitive functions were evaluated using the Stroop Neuropsychological Screening Test, tests of visual reproduction and immediate logical memory, and the verbal fluency test (VFT). All patients were genotyped to determine GRIK4 polymorphisms. Results of VFT revealed statistical differences among all single-nucleotide polymorphism (SNP) genotypes. In the Stroop-color-word test, only rs6589847 was discovered to be statistically different. No significant difference was found in the Stroop-color task scores, the visual reproduction test, or the immediate logical memory test. GRIK4 polymorphism exerted a significant effect on long-term memory retrieval and selective attention, but did not affect immediate memory.
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Affiliation(s)
- M Pu
- Wuxi People's Hospital, No. 299 Qingyang road, 214000 Wuxi, China
| | - X Wang
- Wuxi People's Hospital, No. 299 Qingyang road, 214000 Wuxi, China
| | - J Zhang
- Wuxi People's Hospital, No. 299 Qingyang road, 214000 Wuxi, China.
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Investigating microstructural variation in the human hippocampus using non-negative matrix factorization. Neuroimage 2020; 207:116348. [DOI: 10.1016/j.neuroimage.2019.116348] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/05/2019] [Accepted: 11/08/2019] [Indexed: 11/23/2022] Open
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Blanchette CA, Kurdi V, Fouquet C, Schachar R, Boivin M, Hastings P, Robaey P, West GL, Bohbot VD. Opposing effects of cortisol on learning and memory in children using spatial versus response-dependent navigation strategies. Neurobiol Learn Mem 2020; 169:107172. [PMID: 31978550 DOI: 10.1016/j.nlm.2020.107172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 01/19/2020] [Indexed: 12/28/2022]
Abstract
Previous studies showed that healthy young adults who spontaneously use caudate nucleus-dependent strategies on a virtual navigation task, have significantly lower basal levels of cortisol compared with adults who use hippocampus-dependent spatial navigation strategies. In the current paper, we assessed the relation between basal cortisol levels and learning using a virtual navigation task in children. We show that basal cortisol level has a differential effect on learning and memory between children using spatial and response navigation strategies. Specifically, cortisol was found to be beneficial for learning performance in children using spatial strategies, such that higher levels of cortisol were associated with more efficient learning in a virtual maze. In contrast, cortisol had a deleterious effect on learning the virtual maze in children using response strategies, such that higher cortisol levels were associated with increased spatial working memory errors. Based on these results, individual differences in navigation strategy could help explain contradictory results in the literature showing that cortisol can have either a positive or negative association with learning and memory performance.
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Affiliation(s)
| | - Vanessa Kurdi
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Verdun, QC, Canada
| | - Celine Fouquet
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Verdun, QC, Canada
| | | | - Michel Boivin
- Dept. of Psychology, Laval University, Quebec, QC, Canada
| | - Paul Hastings
- Centre for Mind and Brain, University of California Davis, CA, United States
| | - Philippe Robaey
- Dept. of Psychiatry, Ste-Justine Res. Ctr., Montreal, QC, Canada
| | - Greg L West
- Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Veronique D Bohbot
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Verdun, QC, Canada.
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The importance of identifying functional Val158Met polymorphism in catechol-O- Methyltransferase when assessing MRI-based volumetric measurements in major depressive disorder. Brain Imaging Behav 2020; 14:2762-2770. [PMID: 31898087 DOI: 10.1007/s11682-019-00225-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Many studies have shown volumetric differences in the hippocampus between COMT gene polymorphisms and other studies have shown differences between depressed patients and controls; yet, few studies have been completed to identify the volumetric differences when taking both factors into consideration. Using voxel-based morphology (VBM) we investigated, in major depressive disorder (MDD) patients and healthy controls, the relationship between COMT gene polymorphism and volumetric abnormalities. Data from 60 MDD patients and 25 healthy controls were included in this study. Volumetric measurements and genotyping of COMTval158met polymorphism were conducted to determine its impact on gray matter volume (GMV) in the hippocampus and amygdala using a Met dominant model (Val/Val vs Met/Val & Met/Met). In the analysis, a significant difference in the right hippocampus (p = 0.015), right amygdala (p = 0.003) and entire amygdala (p = 0.019) was found between the interaction of diagnosis and genotype after MRI scanner, age and sex correction. Healthy controls (HC) with the Met dominant genotype exhibited a larger right hippocampal, right amygdalar and entire amydgalar volume than MDD patients with the Met dominant genotype. Conversely, HC with the Val/Val genotype displayed a lower right hippocampal, right amygdalar and entire amygdalar volume than their MDD counterparts. This study shows that COMT polymorphism and depression may have a confounding effect on neuroimaging studies.
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Chakraborty S, Tripathi SJ, Srikumar B, Raju T, Shankaranarayana Rao B. N-acetyl cysteine ameliorates depression-induced cognitive deficits by restoring the volumes of hippocampal subfields and associated neurochemical changes. Neurochem Int 2020; 132:104605. [DOI: 10.1016/j.neuint.2019.104605] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 11/11/2019] [Accepted: 11/15/2019] [Indexed: 12/14/2022]
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Nogovitsyn N, Muller M, Souza R, Hassel S, Arnott SR, Davis AD, Hall GB, Harris JK, Zamyadi M, Metzak PD, Ismail Z, Downar J, Parikh SV, Soares CN, Addington JM, Milev R, Harkness KL, Frey BN, Lam RW, Strother SC, Rotzinger S, Kennedy SH, MacQueen GM. Hippocampal tail volume as a predictive biomarker of antidepressant treatment outcomes in patients with major depressive disorder: a CAN-BIND report. Neuropsychopharmacology 2020; 45:283-291. [PMID: 31610545 PMCID: PMC6901577 DOI: 10.1038/s41386-019-0542-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/06/2019] [Accepted: 10/03/2019] [Indexed: 01/01/2023]
Abstract
Finding a clinically useful neuroimaging biomarker that can predict treatment response in patients with major depressive disorder (MDD) is challenging, in part because of poor reproducibility and generalizability of findings across studies. Previous work has suggested that posterior hippocampal volumes in depressed patients may be associated with antidepressant treatment outcomes. The primary purpose of this investigation was to examine further whether posterior hippocampal volumes predict remission following antidepressant treatment. Magnetic resonance imaging (MRI) scans from 196 patients with MDD and 110 healthy participants were obtained as part of the first study in the Canadian Biomarker Integration Network in Depression program (CAN-BIND 1) in which patients were treated for 16 weeks with open-label medication. Hippocampal volumes were measured using both a manual segmentation protocol and FreeSurfer 6.0. Baseline hippocampal tail (Ht) volumes were significantly smaller in patients with depression compared to healthy participants. Larger baseline Ht volumes were positively associated with remission status at weeks 8 and 16. Participants who achieved early sustained remission had significantly greater Ht volumes compared to those who did not achieve remission by week 16. Ht volume is a prognostic biomarker for antidepressant treatment outcomes in patients with MDD.
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Affiliation(s)
- Nikita Nogovitsyn
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada. .,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
| | - Meghan Muller
- 0000 0004 1936 7697grid.22072.35Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Roberto Souza
- 0000 0004 1936 7697grid.22072.35Department of Radiology and Clinical Neuroscience, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada
| | - Stefanie Hassel
- 0000 0004 1936 7697grid.22072.35Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB Canada ,0000 0004 1936 7697grid.22072.35Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB Canada
| | - Stephen R. Arnott
- 0000 0001 2157 2938grid.17063.33Rotman Research Institute, Baycrest, Toronto, ON Canada
| | - Andrew D. Davis
- 0000 0004 1936 8227grid.25073.33Department of Psychology, Neuroscience & Behaviour, McMaster University, and St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
| | - Geoffrey B. Hall
- 0000 0004 1936 8227grid.25073.33Department of Psychology, Neuroscience & Behaviour, McMaster University, and St. Joseph’s Healthcare Hamilton, Hamilton, ON Canada
| | - Jacqueline K. Harris
- grid.17089.37Department of Computer Science, University of Alberta, Edmonton, AB Canada
| | - Mojdeh Zamyadi
- 0000 0001 2157 2938grid.17063.33Rotman Research Institute, Baycrest, Toronto, ON Canada
| | - Paul D. Metzak
- 0000 0004 1936 7697grid.22072.35Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB Canada ,0000 0004 1936 7697grid.22072.35Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB Canada
| | - Zahinoor Ismail
- 0000 0004 1936 7697grid.22072.35Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Jonathan Downar
- 0000 0001 2157 2938grid.17063.33Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,0000 0004 0474 0428grid.231844.8Krembil Research Institute and Centre for Mental Health, University Health Network, Toronto, ON Canada ,0000 0001 2157 2938grid.17063.33Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,0000 0001 2157 2938grid.17063.33Department of Psychiatry, Krembil Research Centre, University Health Network, University of Toronto, Toronto, ON Canada
| | - Sagar V. Parikh
- 0000000086837370grid.214458.eDepartment of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - Claudio N. Soares
- 0000 0004 1936 8331grid.410356.5Department of Psychiatry, Queen’s University and Providence Care Hospital, Kingston, ON Canada
| | - Jean M. Addington
- 0000 0004 1936 7697grid.22072.35Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB Canada ,0000 0004 1936 7697grid.22072.35Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB Canada
| | - Roumen Milev
- 0000 0004 1936 8331grid.410356.5Department of Psychiatry, Queen’s University and Providence Care Hospital, Kingston, ON Canada ,0000 0004 1936 8331grid.410356.5Department of Psychology, Queen’s University, Kingston, ON Canada
| | - Kate L. Harkness
- 0000 0004 1936 8331grid.410356.5Department of Psychology, Queen’s University, Kingston, ON Canada
| | - Benicio N. Frey
- 0000 0004 1936 8227grid.25073.33Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada ,Mood Disorders Program and Women’s Health Concerns Clinic, St. Joseph’s Healthcare, Hamilton, ON Canada
| | - Raymond W. Lam
- 0000 0001 2288 9830grid.17091.3eDepartment of Psychiatry, University of British Columbia, Vancouver, BC Canada
| | - Stephen C. Strother
- 0000 0001 2157 2938grid.17063.33Rotman Research Institute, Baycrest and Department of Medical Biophysics, University of Toronto, Toronto, ON Canada
| | - Susan Rotzinger
- 0000 0001 2157 2938grid.17063.33Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,0000 0001 2157 2938grid.17063.33Department of Psychiatry, Krembil Research Centre, University Health Network, University of Toronto, Toronto, ON Canada ,0000 0001 2157 2938grid.17063.33Department of Psychiatry, St. Michael’s Hospital, University of Toronto, Toronto, ON Canada
| | - Sidney H. Kennedy
- 0000 0001 2157 2938grid.17063.33Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON Canada ,0000 0001 2157 2938grid.17063.33Department of Psychiatry, Krembil Research Centre, University Health Network, University of Toronto, Toronto, ON Canada ,0000 0001 2157 2938grid.17063.33Department of Psychiatry, St. Michael’s Hospital, University of Toronto, Toronto, ON Canada ,grid.415502.7Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON Canada
| | - Glenda M. MacQueen
- 0000 0004 1936 7697grid.22072.35Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
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Enneking V, Leehr EJ, Dannlowski U, Redlich R. Brain structural effects of treatments for depression and biomarkers of response: a systematic review of neuroimaging studies. Psychol Med 2020; 50:187-209. [PMID: 31858931 DOI: 10.1017/s0033291719003660] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Antidepressive pharmacotherapy (AD), electroconvulsive therapy (ECT) and cognitive behavioural therapy (CBT) are effective treatments for major depressive disorder. With our review, we aim to provide a systematic overview of neuroimaging studies that investigate the effects of AD, ECT and CBT on brain grey matter volume (GMV) and biomarkers associated with response. After a systematic database research on PubMed, we included 50 studies using magnetic resonance imaging and investigating (1) changes in GMV, (2) pre-treatment GMV biomarkers associated with response, or (3) the accuracy of predictions of response to AD, ECT or CBT based on baseline GMV data. The strongest evidence for brain structural changes was found for ECT, showing volume increases within the temporal lobe and subcortical structures - such as the hippocampus-amygdala complex, anterior cingulate cortex (ACC) and striatum. For AD, the evidence is heterogeneous as only 4 of 11 studies reported significant changes in GMV. The results are not sufficient in order to draw conclusions about the structural brain effects of CBT. The findings show consistently that higher pre-treatment ACC volume is associated with response to AD, ECT and CBT. An association of higher pre-treatment hippocampal volume and response has only been reported for AD. Machine learning approaches based on pre-treatment whole brain patterns reach accuracies of 64-90% for predictions of AD or ECT response on the individual patient level. The findings underline the potential of brain biomarkers for the implementation in clinical practice as an additive feature within the process of treatment selection.
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Affiliation(s)
- Verena Enneking
- Department of Psychiatry, University of Münster, Münster, Germany
| | | | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Ronny Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
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Lever-van Milligen BA, Verhoeven JE, Schmaal L, van Velzen LS, Révész D, Black CN, Han LKM, Horsfall M, Batelaan NM, van Balkom AJLM, van Schaik DJF, van Oppen P, Penninx BWJH. The impact of depression and anxiety treatment on biological aging and metabolic stress: study protocol of the MOod treatment with antidepressants or running (MOTAR) study. BMC Psychiatry 2019; 19:425. [PMID: 31888565 PMCID: PMC6937704 DOI: 10.1186/s12888-019-2404-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/11/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Depressive and anxiety disorders have shown to be associated to premature or advanced biological aging and consequently to adversely impact somatic health. Treatments with antidepressant medication or running therapy are both found to be effective for many but not all patients with mood and anxiety disorders. These interventions may, however, work through different pathophysiological mechanisms and could differ in their impact on biological aging and somatic health. This study protocol describes the design of an unique intervention study that examines whether both treatments are similarly effective in reducing or reversing biological aging (primary outcome), psychiatric status, metabolic stress and neurobiological indicators (secondary outcomes). METHODS The MOod Treatment with Antidepressants or Running (MOTAR) study will recruit a total of 160 patients with a current major depressive and/or anxiety disorder in a mental health care setting. Patients will receive a 16-week treatment with either antidepressant medication or running therapy (3 times/week). Patients will undergo the treatment of their preference and a subsample will be randomized (1:1) to overcome preference bias. An additional no-disease-no-treatment group of 60 healthy controls without lifetime psychopathology, will be included as comparison group for primary and secondary outcomes at baseline. Assessments are done at week 0 for patients and controls, and at week 16 and week 52 for patients only, including written questionnaires, a psychiatric and medical examination, blood, urine and saliva collection and a cycle ergometer test, to gather information about biological aging (telomere length and telomerase activity), mental health (depression and anxiety disorder characteristics), general fitness, metabolic stress-related biomarkers (inflammation, metabolic syndrome, cortisol) and genetic determinants. In addition, neurobiological alterations in brain processes will be assessed using structural and functional Magnetic Resonance Imaging (MRI) in a subsample of at least 25 patients per treatment arm and in all controls. DISCUSSION This intervention study aims to provide a better understanding of the impact of antidepressant medication and running therapy on biological aging, metabolic stress and neurobiological indicators in patients with depressive and anxiety disorders in order to guide a more personalized medicine treatment. TRIAL REGISTRATION Trialregister.nl Number of identification: NTR3460, May 2012.
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Affiliation(s)
- Bianca A. Lever-van Milligen
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Josine E. Verhoeven
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Lianne Schmaal
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Laura S. van Velzen
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Dóra Révész
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Catherine N. Black
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Laura K. M. Han
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Melany Horsfall
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M. Batelaan
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Anton J. L. M. van Balkom
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Digna J. F. van Schaik
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Patricia van Oppen
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Brenda W. J. H. Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
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Xu J, Tang Y, Cecilio Baro C, Zhang X, Meng Z, Li Y. Left fimbria atrophy is associated with hippocampal metabolism in female major depressive disorder patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2018:1136-1139. [PMID: 30440590 DOI: 10.1109/embc.2018.8512472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Despite the high incidence of major depressive disorder (MDD) in females, the detailed neurobiology mechanism remains not fully understood. Increasing evidence showed that MDD was associated with hippocampal volumetric abnormality with different subfields demonstrating various alteration features. However, the linkage between hippocampal atrophy with its biochemical information remains unclear. In this study, we aim to investigate the relationship between bilateral hippocampal subfields volumetric and metabolic information in female MDD patients, using a combined T1weighted magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (H-MRS) technology. There are 15 female MDD patients and 12 matched healthy controls involved in the study. We found a significant decrease in left fimbria volume in MDD group, which was negatively correlated with left hippocampal choline level. In addition, the left hippocampal creatine concentration in patients was negatively correlated with left fimbria volume. Moreover, the NAA level in left hippocampus was negatively correlated with MDD clinical symptomology including anxiety and depression scores. Our findings suggest that the altered coupling between hippocampal structural and metabolic features might contribute to the etiology of female MDD patients.
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Hillerer KM, Slattery DA, Pletzer B. Neurobiological mechanisms underlying sex-related differences in stress-related disorders: Effects of neuroactive steroids on the hippocampus. Front Neuroendocrinol 2019; 55:100796. [PMID: 31580837 PMCID: PMC7115954 DOI: 10.1016/j.yfrne.2019.100796] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 12/19/2022]
Abstract
Men and women differ in their vulnerability to a variety of stress-related illnesses, but the underlying neurobiological mechanisms are not well understood. This is likely due to a comparative dearth of neurobiological studies that assess male and female rodents at the same time, while human neuroimaging studies often don't model sex as a variable of interest. These sex differences are often attributed to the actions of sex hormones, i.e. estrogens, progestogens and androgens. In this review, we summarize the results on sex hormone actions in the hippocampus and seek to bridge the gap between animal models and findings in humans. However, while effects of sex hormones on the hippocampus are largely consistent in animals and humans, methodological differences challenge the comparability of animal and human studies on stress effects. We summarise our current understanding of the neurobiological mechanisms that underlie sex-related differences in behavior and discuss implications for stress-related illnesses.
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Affiliation(s)
- Katharina M Hillerer
- Department of Obstetrics and Gynaecology, Salzburger Landeskrankenhaus (SALK), Paracelsus Medical University (PMU), Clinical Research Center Salzburg (CRCS), Salzburg, Austria.
| | - David A Slattery
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Belinda Pletzer
- Department of Psychology, University of Salzburg, Salzburg, Austria; Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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Bremner JD, Fani N, Cheema FA, Ashraf A, Vaccarino V. Effects of a mental stress challenge on brain function in coronary artery disease patients with and without depression. Health Psychol 2019; 38:910-924. [PMID: 31380683 PMCID: PMC6746592 DOI: 10.1037/hea0000742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Coronary artery disease (CAD) patients with comorbid depression show an increase in mortality compared to cardiac patients without depression, but the mechanisms mediating this effect remain obscure. One possible explanation for this finding is that depressed patients with CAD exhibit an increased vulnerability to stress. The purpose of this study was to assess the effects of stress and depression on brain function and to explore its relationship with myocardial ischemia in CAD patients. METHODS Patients with CAD and depression (N = 13) and CAD without depression (N = 15) underwent imaging of the brain with positron emission tomography and [O-15] water and imaging of the heart with single photon emission computed tomography (SPECT) and [Tc-99m] sestamibi under mental stress task and control conditions. RESULTS CAD patients with depression compared to nondepressed showed decreased function with mental stress in the rostral anterior cingulate, the hippocampus, parts of the dorsolateral temporal and parietal cortex, the cerebellum, and the uncus, with increased blood flow in the parahippocampus, visual association cortex, and posterior cingulate. Depressed CAD patients who became ischemic during a mental stress task had relative decreases in the caudal and posterior cingulate, orbitofrontal cortex, and cerebellum, and increased activation in the parietal cortex and precuneus/visual association cortex compared to nonischemic depressed CAD patients. CONCLUSIONS These findings are consistent with dysfunction in a network of brain regions involved in the stress response in patients with comorbid CAD and depression that has direct and indirect links to the heart, suggesting a pathway by which stress and depression could lead to increased risk of heart disease related morbidity and mortality. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences
| | | | - Ali Ashraf
- Department of Psychiatry and Behavioral Sciences
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Kraus C, Seiger R, Pfabigan DM, Sladky R, Tik M, Paul K, Woletz M, Gryglewski G, Vanicek T, Komorowski A, Kasper S, Lamm C, Windischberger C, Lanzenberger R. Hippocampal Subfields in Acute and Remitted Depression-an Ultra-High Field Magnetic Resonance Imaging Study. Int J Neuropsychopharmacol 2019; 22:513-522. [PMID: 31175352 PMCID: PMC6672627 DOI: 10.1093/ijnp/pyz030] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 04/29/2019] [Accepted: 06/05/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Studies investigating hippocampal volume changes after treatment with serotonergic antidepressants in patients with major depressive disorder yielded inconsistent results, and effects on hippocampal subfields are unclear. METHODS To detail treatment effects on total hippocampal and subfield volumes, we conducted an open-label study with escitalopram followed by venlafaxine upon nonresponse in 20 unmedicated patients with major depressive disorder. Before and after 12 weeks treatment, we measured total hippocampal formation volumes and subfield volumes with ultra-high field (7 Tesla), T1-weighted, structural magnetic resonance imaging, and FreeSurfer. Twenty-eight remitted patients and 22 healthy subjects were included as controls. We hypothesized to detect increased volumes after treatment in major depressive disorder. RESULTS We did not detect treatment-related changes of total hippocampal or subfield volumes in patients with major depressive disorder. Secondary results indicated that the control group of untreated, stable remitted patients, compared with healthy controls, had larger volumes of the right hippocampal-amygdaloid transition area and right fissure at both measurement time points. Depressed patients exhibited larger volumes of the right subiculum compared with healthy controls at MRI-2. Exploratory data analyses indicated lower baseline volumes in the subgroup of remitting (n = 10) vs nonremitting (n = 10) acute patients. CONCLUSIONS The results demonstrate that monoaminergic antidepressant treatment in major depressive disorder patients was not associated with volume changes in hippocampal subfields. Studies with larger sample sizes to detect smaller effects as well as other imaging modalities are needed to further assess the impact of antidepressant treatment on hippocampal subfields.
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Affiliation(s)
- Christoph Kraus
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Rene Seiger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Daniela M Pfabigan
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Ronald Sladky
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Martin Tik
- MR Centre of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
| | - Katharina Paul
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Michael Woletz
- MR Centre of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
| | - Gregor Gryglewski
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Thomas Vanicek
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Arkadiusz Komorowski
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Claus Lamm
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Christian Windischberger
- MR Centre of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
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Maharaj S, Lees T, Lal S. Negative Mental States and Their Association to the Cognitive Function of Nurses. J PSYCHOPHYSIOL 2019. [DOI: 10.1027/0269-8803/a000223] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abstract. Nurses’ inherently stressful occupation leaves them at a higher risk of developing negative mental states (stress, anxiety, and depression). However, research examining the effect of negative mental states on these health professionals’ cognitive performance is sparse. Thus, the present study aimed to assess the link between negative mental states and cognitive performance in nurses ( n = 53). Negative mental state data was obtained using the Depression Anxiety Stress Scale, brain activity was measured using electroencephalography, and finally, cognitive performance was assessed using the Cognistat and the Mini-Mental State Examination. Significant negative correlations ( p < .05) were observed between anxiety and attention, and all three negative mental states and memory performance. Electroencephalographic changes indicated that increases in anxiety were significantly associated ( p < .05) with decreases in gamma reactivity at fronto-central sites. The current study suggests that higher levels of negative mental states are associated with domain-specific cognitive impairments, and variations in gamma reactivity; possibly reflecting less optimal cortical functioning.
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Affiliation(s)
- Shamona Maharaj
- Neuroscience Research Unit, School of Life Sciences, University of Technology Sydney, New South Wales, Australia
| | - Ty Lees
- Neuroscience Research Unit, School of Life Sciences, University of Technology Sydney, New South Wales, Australia
| | - Sara Lal
- Neuroscience Research Unit, School of Life Sciences, University of Technology Sydney, New South Wales, Australia
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Karstens AJ, Korzun I, Avery ET, Kassel MT, Keelan R, Kales H, Abercrombie H, Eisenlohr-Moul T, Langenecker SA, Weisenbach S. Examining HPA-axis functioning as a mediator of the relationship between depression and cognition across the adult lifespan. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2019; 26:507-520. [PMID: 29993318 PMCID: PMC6329657 DOI: 10.1080/13825585.2018.1495309] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/22/2018] [Indexed: 10/28/2022]
Abstract
Altered HPA-axis functioning is a hypothesized mechanism for worsened cognition in depression. The current study examines the indirect effects of depression on processing speed, executive functioning, and memory as a function of the HPA-axis. 38 individuals with a depression diagnosis and 50 healthy controls (HCs) aged 18-86 underwent neuropsychological testing and at-home diurnal salivary cortisol collection. Depression was assessed via structured clinical interviews and rating scales. Cognitive composite scores were derived from factor analysis. Daytime cortisol exposure was estimated using area under the curve (AUC). Depression was associated with higher cortisol levels and slower processing speed . A significant suppression effect of AUC was present on the relationship between depression and processing speed. Limitations include the cross-sectional design and limited sample heterogeneity. Though poorly modulated HPA-axis is one proposed mechanism of cognitive alterations in depression, our results did not support this conclusion for processing speed. Alternative mechanisms should be considered to inform interventions to target cognitive alterations in depression.
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Affiliation(s)
- Aimee James Karstens
- University of Illinois at Chicago, Departments of Psychology & Psychiatry, Chicago, IL
| | - Inez Korzun
- University of Illinois at Chicago, Department of Neuroscience, Chicago, IL
| | - Erich T. Avery
- University of Michigan, Department of Psychiatry, Ann Arbor, MI
| | | | - Rachel Keelan
- University of Michigan, Department of Psychiatry, Ann Arbor, MI
- James A Haley VA, Tampa, FL
| | - Helen Kales
- University of Michigan, Department of Psychiatry, Ann Arbor, MI
| | | | - Tory Eisenlohr-Moul
- University of Illinois at Chicago, Departments of Psychology & Psychiatry, Chicago, IL
| | - Scott A. Langenecker
- University of Illinois at Chicago, Departments of Psychology & Psychiatry, Chicago, IL
- University of Michigan, Department of Psychiatry, Ann Arbor, MI
| | - Sara Weisenbach
- University of Illinois at Chicago, Departments of Psychology & Psychiatry, Chicago, IL
- University of Michigan, Department of Psychiatry, Ann Arbor, MI
- University of Utah, Department of Psychiatry, Salt Lake City, UT
- VA Salt Lake City, Mental Health Service, Salt Lake City, UT
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Functional disconnectivity of the hippocampal network and neural correlates of memory impairment in treatment-resistant depression. J Affect Disord 2019; 253:248-256. [PMID: 31060011 DOI: 10.1016/j.jad.2019.04.096] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/29/2019] [Accepted: 04/27/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a disabling neuropsychiatric condition associated with cognitive impairment. Neuroimaging studies have consistently linked memory deficits with hippocampal atrophy in MDD patients. However, there has been a paucity of research examining how the hippocampus functionally contributes to memory impairments in MDD. The present study examined whether hippocampal networks distinguish treatment-resistant depression (TRD) patients from healthy controls (HCs), and whether these networks underlie declarative memory deficits in TRD. We hypothesized that functional connectivity (FC) of the posterior hippocampus would correlate preferentially with memory in patients, whereas FC pattern of the anterior and intermediate hippocampus would correlate with emotion-mediated regions and show a significant correlation with memory. METHODS Resting-state functional magnetic resonance imaging (fMRI) scans were acquired in 56 patients and 42 age- and sex-matched HCs. We parcellated the hippocampus into three subregions based on a sparse representation-based method recently developed by our group. FC networks of hippocampal subregions were compared between patients and HCs and correlated with clinical measures and cognitive performance. RESULTS Decreased connectivity of the right intermediate hippocampus (RIH) with the limbic regions was a distinguishing feature between TRD and HCs. These functional abnormalities were present in the absence of structural volumetric differences. Furthermore, lower right amygdalar connectivity to the RIH related to a longer current depressive episode. Declarative memory deficits in TRD were significantly associated with left posterior and right intermediate hippocampal FC patterns. LIMITATIONS Our patient samples were treatment-resistant, the conclusions from this study cannot be generalized to all MDD patients directly. Task-based imaging studies are needed to demonstrate hippocampal engagement in the memory deficits of patients. Finally, our findings are strongly in need of replication in independent validation samples. CONCLUSIONS These findings demonstrate a transitional property of the intermediate hippocampal subregion between its anterior and posterior counterparts in TRD patients, and provide new insights into the neural network-level dysfunction of the hippocampus in TRD.
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Jamieson A, Goodwill AM, Termine M, Campbell S, Szoeke C. Depression related cerebral pathology and its relationship with cognitive functioning: A systematic review. J Affect Disord 2019; 250:410-418. [PMID: 30878653 DOI: 10.1016/j.jad.2019.03.042] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/26/2019] [Accepted: 03/04/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND Depression's relationship with cerebral abnormalities and cognitive decline is temporally dynamic. Despite clear clinical utility, understanding depression's effect on cerebral structures, cognitive impairment and the interaction between these symptoms has had limited consideration. METHODS This review summarised studies examining a clinical depression diagnosis or validated scales measuring depressive symptoms, data concerning amyloid-beta (Aβ) levels, brain structure and function focusing on hippocampal alterations, or white matter hyperintensities (WMH), and at least one validated neuropsychological test. Online database searches of: PsycINFO, EMBASE, MEDLINE, and Scopus were conducted to identify potential articles. RESULTS While depression was consistently associated with cross-sectionally cognitive decline across multiple domains, the neuropathological basis of this dysfunction remained unclear. Hippocampal, frontal, and limbic dysfunction as well as cortical thinning, WMH, and Aβ burden all provide inconsistent findings, likely due to depression subtypes. The consistency of these findings additionally decreases when examining this relationship longitudinally, as these results are further confounded by pre-dementia states. The therapeutic interventions examined were more efficacious in the younger compared with the older samples, who were characterised by greater WMH and Aβ burden. LIMITATIONS The limited number of longitudinal and interventional studies in addition to the heterogeneity of the samples restricts their generalisability. CONCLUSIONS Symptomatological differences between early-onset and late-onset depression (EOD and LOD) appear crucial in understanding whether late-life depression is the primary or secondary source of cerebral pathology. Though severe cognitive impairments and clearer neuropathological underpinnings are more characteristic of LOD than EOD, the inconsistency of valid biomarkers remains problematic.
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Affiliation(s)
- Alec Jamieson
- Centre for Medical Research, Royal Melbourne Hospital, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Alicia M Goodwill
- Centre for Medical Research, Royal Melbourne Hospital, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia; Healthy Brain Initiative, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mario Termine
- Centre for Medical Research, Royal Melbourne Hospital, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Stephen Campbell
- Australian Healthy Ageing Organisation (AHAO), Parkville, Victoria, Australia
| | - Cassandra Szoeke
- Centre for Medical Research, Royal Melbourne Hospital, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia; Healthy Brain Initiative, Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia; Australian Healthy Ageing Organisation (AHAO), Parkville, Victoria, Australia.
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Kraus C, Kadriu B, Lanzenberger R, Zarate Jr. CA, Kasper S. Prognosis and improved outcomes in major depression: a review. Transl Psychiatry 2019; 9:127. [PMID: 30944309 PMCID: PMC6447556 DOI: 10.1038/s41398-019-0460-3] [Citation(s) in RCA: 202] [Impact Index Per Article: 40.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/10/2019] [Accepted: 02/11/2019] [Indexed: 02/07/2023] Open
Abstract
Treatment outcomes for major depressive disorder (MDD) need to be improved. Presently, no clinically relevant tools have been established for stratifying subgroups or predicting outcomes. This literature review sought to investigate factors closely linked to outcome and summarize existing and novel strategies for improvement. The results show that early recognition and treatment are crucial, as duration of untreated depression correlates with worse outcomes. Early improvement is associated with response and remission, while comorbidities prolong course of illness. Potential biomarkers have been explored, including hippocampal volumes, neuronal activity of the anterior cingulate cortex, and levels of brain-derived neurotrophic factor (BDNF) and central and peripheral inflammatory markers (e.g., translocator protein (TSPO), interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor alpha (TNFα)). However, their integration into routine clinical care has not yet been fully elucidated, and more research is needed in this regard. Genetic findings suggest that testing for CYP450 isoenzyme activity may improve treatment outcomes. Strategies such as managing risk factors, improving clinical trial methodology, and designing structured step-by-step treatments are also beneficial. Finally, drawing on existing guidelines, we outline a sequential treatment optimization paradigm for selecting first-, second-, and third-line treatments for acute and chronically ill patients. Well-established treatments such as electroconvulsive therapy (ECT) are clinically relevant for treatment-resistant populations, and novel transcranial stimulation methods such as theta-burst stimulation (TBS) and magnetic seizure therapy (MST) have shown promising results. Novel rapid-acting antidepressants, such as ketamine, may also constitute a paradigm shift in treatment optimization for MDD.
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Affiliation(s)
- Christoph Kraus
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria ,0000 0001 2297 5165grid.94365.3dSection on Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Bashkim Kadriu
- 0000 0001 2297 5165grid.94365.3dSection on Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Rupert Lanzenberger
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Carlos A. Zarate Jr.
- 0000 0001 2297 5165grid.94365.3dSection on Neurobiology and Treatment of Mood Disorders, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
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