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Yang Y, Ye H, Yan H, Zhang C, Li W, Li Z, Jing H, Li X, Liang J, Xie G, Liang W, Ou Y, Li X, Guo W. Potential correlations between asymmetric disruption of functional connectivity and metabolism in major depressive disorder. Brain Res 2024; 1838:148977. [PMID: 38705556 DOI: 10.1016/j.brainres.2024.148977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/14/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE Previous research has suggested a connection between major depressive disorder (MDD) and certain comorbidities, including gastrointestinal issues, thyroid dysfunctions, and glycolipid metabolism abnormalities. However, the relationships between these factors and asymmetrical alterations in functional connectivity (FC) in adults with MDD remain unclear. METHOD We conducted a study on a cohort of 42 MDD patients and 42 healthy controls (HCs). Participants underwent comprehensive clinical assessments, including evaluations of blood lipids and thyroid hormone levels, as well as resting-state functional magnetic resonance imaging (Rs-fMRI) scans. Data analysis involved correlation analysis to compute the parameter of asymmetry (PAS) for the entire brain's functional connectome. We then examined the interrelationships between abnormal PAS regions in the brain, thyroid hormone levels, and blood lipid levels. RESULTS The third-generation ultra-sensitive thyroid stimulating hormone (TSH3UL) level was found to be significantly lower in MDD patients compared to HCs. The PAS score of the left inferior frontal gyrus (IFG) decreased, while the bilateral posterior cingulate cortex (Bi-PCC) PAS increased in MDD patients relative to HCs. Notably, the PAS score of the left IFG negatively correlated with both TSH and total cholesterol (CHOL) levels. However, these correlations lose significance after the Bonferroni correction. CONCLUSION MDD patients demonstrated abnormal asymmetry in resting-state FC (Rs-FC) within the fronto-limbic system, which may be associated with CHOL and thyroid hormone levels.
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Affiliation(s)
- Yu Yang
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Haibiao Ye
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Chunguo Zhang
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Wenxuan Li
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Zhijian Li
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Huang Jing
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Xiaoling Li
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Jiaquan Liang
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Guojun Xie
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Wenting Liang
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Yangpan Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xuesong Li
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan, Guangdong 528000, China.
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Ahn JY, Kang Y, Kim A, Tae WS, Han KM, Ham BJ. Association Between White Matter Tract Integrity and Frontal-Executive Function in Non-Geriatric Adult Patients With Major Depressive Disorder. Psychiatry Investig 2024; 21:133-141. [PMID: 38321889 PMCID: PMC10910163 DOI: 10.30773/pi.2023.0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/09/2023] [Accepted: 10/25/2023] [Indexed: 02/08/2024] Open
Abstract
OBJECTIVE This study investigated the association between white matter tract integrity and frontal executive function in adult non-geriatric patients with major depressive disorder (MDD) and healthy controls (HCs) using diffusion tensor imaging (DTI). METHODS In total, 57 patients with MDD and 115 HCs participated in this study. We calculated the integrity of the white matter tracts using the Tracts Constrained by Underlying Anatomy tool (TRACULA) from FreeSurfer. We performed cognitive function tests. Oneway analysis of covariance was used to investigate the DTI parameters as dependent variables; diagnosis of MDD as an independent variable; and age, sex, and education level as covariates. For correlation analysis between the DTI parameters and cognitive function tests, Pearson's partial correlation analyses were performed in the MDD and HC groups. RESULTS The patients with MDD showed significantly decreased axial diffusivity (AD) in forceps major (FMajor), left corticospinal tract (CST), left superior longitudinal fasciculus-parietal bundle (SLFP), right anterior thalamic radiation (ATR), right CST, right inferior longitudinal fasciculus (ILF) and right superior longitudinal fasciculus-temporal bundle (SLFT) and mean diffusivity (MD) in the left CST, right CST, and right SLFT compared to HCs. We found that non-geriatric patients with MDD showed a significant negative correlation between the response time in the Stroop task and the AD value of the FMajor. CONCLUSION Our findings suggest that impaired structural connectivity in the FMajor may be associated with cognitive dysfunction in non-geriatric patients with MDD.
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Affiliation(s)
- Joo-Yeon Ahn
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youbin Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Aram Kim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo-Suk Tae
- Brain Convergence Research Center, Korea University, Seoul, Republic of Korea
| | - Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Brain Convergence Research Center, Korea University, Seoul, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Brain Convergence Research Center, Korea University, Seoul, Republic of Korea
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Marawi T, Ainsworth NJ, Zhukovsky P, Rashidi-Ranjbar N, Rajji TK, Tartaglia MC, Voineskos AN, Mulsant BH. Brain-cognition relationships in late-life depression: a systematic review of structural magnetic resonance imaging studies. Transl Psychiatry 2023; 13:284. [PMID: 37598228 PMCID: PMC10439902 DOI: 10.1038/s41398-023-02584-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 08/06/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023] Open
Abstract
BACKGROUND Most patients with late-life depression (LLD) have cognitive impairment, and at least one-third meet diagnostic criteria for mild cognitive impairment (MCI), a prodrome to Alzheimer's dementia (AD) and other neurodegenerative diseases. However, the mechanisms linking LLD and MCI, and brain alterations underlying impaired cognition in LLD and LLD + MCI remain poorly understood. METHODS To address this knowledge gap, we conducted a systematic review of studies of brain-cognition relationships in LLD or LLD + MCI to identify circuits underlying impaired cognition in LLD or LLD + MCI. We searched MEDLINE, PsycINFO, EMBASE, and Web of Science databases from inception through February 13, 2023. We included studies that assessed cognition in patients with LLD or LLD + MCI and acquired: (1) T1-weighted imaging (T1) measuring gray matter volumes or thickness; or (2) diffusion-weighted imaging (DWI) assessing white matter integrity. Due to the heterogeneity in studies, we only conducted a descriptive synthesis. RESULTS Our search identified 51 articles, resulting in 33 T1 studies, 17 DWI studies, and 1 study analyzing both T1 and DWI. Despite limitations, reviewed studies suggest that lower thickness or volume in the frontal and temporal regions and widespread lower white matter integrity are associated with impaired cognition in LLD. Lower white matter integrity in the posterior cingulate region (precuneus and corpus callosum sub-regions) was more associated with impairment executive function and processing speed than with memory. CONCLUSION Future studies should analyze larger samples of participants with various degrees of cognitive impairment and go beyond univariate statistical models to assess reliable brain-cognition relationships in LLD.
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Affiliation(s)
- Tulip Marawi
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nicholas J Ainsworth
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Zhukovsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Neda Rashidi-Ranjbar
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Tarek K Rajji
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Maria Carmela Tartaglia
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Neurology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Aristotle N Voineskos
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Benoit H Mulsant
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada.
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Han S, Cui Q, Zheng R, Li S, Zhou B, Fang K, Sheng W, Wen B, Liu L, Wei Y, Chen H, Chen Y, Cheng J, Zhang Y. Parsing altered gray matter morphology of depression using a framework integrating the normative model and non-negative matrix factorization. Nat Commun 2023; 14:4053. [PMID: 37422463 PMCID: PMC10329663 DOI: 10.1038/s41467-023-39861-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 06/27/2023] [Indexed: 07/10/2023] Open
Abstract
The high inter-individual heterogeneity in individuals with depression limits neuroimaging studies with case-control approaches to identify promising biomarkers for individualized clinical decision-making. We put forward a framework integrating the normative model and non-negative matrix factorization (NMF) to quantitatively assess altered gray matter morphology in depression from a dimensional perspective. The proposed framework parses altered gray matter morphology into overlapping latent disease factors, and assigns patients distinct factor compositions, thus preserving inter-individual variability. We identified four robust disease factors with distinct clinical symptoms and cognitive processes in depression. In addition, we showed the quantitative relationship between the group-level gray matter morphological differences and disease factors. Furthermore, this framework significantly predicted factor compositions of patients in an independent dataset. The framework provides an approach to resolve neuroanatomical heterogeneity in depression.
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Affiliation(s)
- Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China.
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China.
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China.
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China.
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China.
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China.
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China.
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China.
| | - Qian Cui
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Ruiping Zheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China
| | - Shuying Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
| | - Bingqian Zhou
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China
| | - Keke Fang
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Henan Province, China
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Baohong Wen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China
| | - Liang Liu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China
| | - Huafu Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China.
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
| | - Yuan Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China.
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China.
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China.
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China.
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China.
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China.
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China.
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China.
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China.
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China.
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China.
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China.
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China.
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China.
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China.
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China.
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China
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Shaked D, Katzel LI, Davatzikos C, Gullapalli RP, Seliger SL, Erus G, Evans MK, Zonderman AB, Waldstein SR. White matter integrity as a mediator between socioeconomic status and executive function. Front Hum Neurosci 2022; 16:1021857. [PMID: 36466616 PMCID: PMC9716285 DOI: 10.3389/fnhum.2022.1021857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/04/2022] [Indexed: 11/03/2023] Open
Abstract
Introduction Lower socioeconomic status (SES) is associated with poorer executive function, but the neural mechanisms of this association remain unclear. As healthy brain communication is essential to our cognitive abilities, white matter integrity may be key to understanding socioeconomic disparities. Methods Participants were 201 African American and White adults (ages 33-72) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) SCAN study. Diffusion tensor imaging was used to estimate regional fractional anisotropy as a measure of white matter integrity. Adjusting for age, analyses examined if integrity of the anterior limb of the internal capsule (ALIC), external capsule (EC), superior longitudinal fasciculus (SLF), and cingulum mediated SES-executive function relations. Results Lower SES was related to poorer cognitive performance and white matter integrity. Lower Trails B performance was related to poorer integrity of the ALIC, EC, and SLF, and lower Stroop performance was associated with poorer integrity of the ALIC and EC. ALIC mediated the SES-Trails B relation, and EC mediated the SES-Trails B and SES-Stroop relations. Sensitivity analyses revealed that (1) adjustment for race rendered the EC mediations non-significant, (2) when using poverty status and continuous education as predictors, results were largely the same, (3) at least some of the study's findings may generalize to processing speed, (4) mediations are not age-dependent in our sample, and (5) more research is needed to understand the role of cardiovascular risk factors in these models. Discussion Findings demonstrate that poorer white matter integrity helps explain SES disparities in executive function and highlight the need for further clarification of the biopsychosocial mechanisms of the SES-cognition association.
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Affiliation(s)
- Danielle Shaked
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, United States
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD, United States
- Department of Psychology, VA Boston Health Care System, Boston, MA, United States
| | - Leslie I. Katzel
- Division of Gerontology, Geriatrics, and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
- Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, United States
| | - Christos Davatzikos
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Rao P. Gullapalli
- Department of Diagnostic Radiology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Stephen L. Seliger
- Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, United States
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Guray Erus
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD, United States
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD, United States
| | - Shari R. Waldstein
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, United States
- Division of Gerontology, Geriatrics, and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
- Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, United States
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Yan DD, Zhao LL, Song XW, Zang XH, Yang LC. Automated detection of clinical depression based on convolution neural network model. BIOMED ENG-BIOMED TE 2022; 67:131-142. [PMID: 35142145 DOI: 10.1515/bmt-2021-0232] [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: 07/24/2021] [Accepted: 01/24/2022] [Indexed: 11/15/2022]
Abstract
As a common mental disorder, depression is placing an increasing burden on families and society. However, the current methods of depression detection have some limitations, and it is essential to find an objective and efficient method. With the development of automation and artificial intelligence, computer-aided diagnosis has attracted more and more attention. Therefore, exploring the use of deep learning (DL) to detect depression has valuable potential. In this paper, convolutional neural network (CNN) is applied to build a diagnostic model for depression based on electroencephalogram (EEG). EEG recordings are analyzed by three different CNN structures, namely EEGNet, DeepConvNet and ShallowConvNet, to dichotomize depression patients and healthy controls. EEG data were collected in the resting state from three electrodes (Fp1, Fz, Fp2) among 80 subjects (40 depressive patients and 40 normal subjects). After the preprocessing step, the DL structures are employed to classify the data, and their recognition performance is evaluated by comparing the classification results. The classification performance shows that depression was effectively detected using EEGNet with 93.74% accuracy, 94.85% sensitivity and 92.61% specificity. In the process of optimizing the parameters of EEGNet structure, the highest accuracy can reach 94.27%. Compared with traditional diagnostic methods, EEGNet is highly worthy for the future depression detection and valuable in terms of accuracy and speed.
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Affiliation(s)
- Dan-Dan Yan
- School of Control Science and Engineering, Shandong University, Jinan, China
| | - Lu-Lu Zhao
- School of Control Science and Engineering, Shandong University, Jinan, China.,School of Instrument Science and Engineering, Southeast University, Nanjing, China
| | - Xin-Wang Song
- School of Control Science and Engineering, Shandong University, Jinan, China
| | - Xiao-Han Zang
- School of Control Science and Engineering, Shandong University, Jinan, China
| | - Li-Cai Yang
- School of Control Science and Engineering, Shandong University, Jinan, China
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Diaz-Galvan P, Cedres N, Figueroa N, Barroso J, Westman E, Ferreira D. Cerebrovascular Disease and Depressive Symptomatology in Individuals With Subjective Cognitive Decline: A Community-Based Study. Front Aging Neurosci 2021; 13:656990. [PMID: 34385912 PMCID: PMC8353130 DOI: 10.3389/fnagi.2021.656990] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/28/2021] [Indexed: 12/31/2022] Open
Abstract
Subjective cognitive decline (SCD) may be the first sign of Alzheimer's disease (AD), but it can also reflect other pathologies such as cerebrovascular disease or conditions like depressive symptomatology. The role of depressive symptomatology in SCD is controversial. We investigated the association between depressive symptomatology, cerebrovascular disease, and SCD. We recruited 225 cognitively unimpaired individuals from a prospective community-based study [mean age (SD) = 54.64 (10.18); age range 35-77 years; 55% women; 123 individuals with one or more subjective cognitive complaints, 102 individuals with zero complaints]. SCD was assessed with a scale of 9 memory and non-memory subjective complaints. Depressive symptomatology was assessed with established questionnaires. Cerebrovascular disease was assessed with magnetic resonance imaging markers of white matter signal abnormalities (WMSA) and mean diffusivity (MD). We combined correlation, multiple regression, and mediation analyses to investigate the association between depressive symptomatology, cerebrovascular disease, and SCD. We found that SCD was associated with more cerebrovascular disease, older age, and increased depressive symptomatology. In turn, depressive symptomatology was not associated with cerebrovascular disease. Variability in MD was mediated by WMSA burden, presumably reflecting cerebrovascular disease. We conclude that, in our community-based cohort, depressive symptomatology is associated with SCD but not with cerebrovascular disease. In addition, depressive symptomatology did not influence the association between cerebrovascular disease and SCD. We suggest that therapeutic interventions for depressive symptomatology could alleviate the psychological burden of negative emotions in people with SCD, and intervening on vascular risk factors to reduce cerebrovascular disease should be tested as an opportunity to minimize neurodegeneration in SCD individuals from the community.
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Affiliation(s)
- Patricia Diaz-Galvan
- Department of Neurobiology, Care Sciences, and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet (KI), Stockholm, Sweden
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Nira Cedres
- Department of Neurobiology, Care Sciences, and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet (KI), Stockholm, Sweden
| | - Nerea Figueroa
- Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology, University of La Laguna, San Cristóbal de La Laguna, Tenerife, Spain
| | - Jose Barroso
- Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology, University of La Laguna, San Cristóbal de La Laguna, Tenerife, Spain
| | - Eric Westman
- Department of Neurobiology, Care Sciences, and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet (KI), Stockholm, Sweden
- Department of Neuroimaging, Center for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Daniel Ferreira
- Department of Neurobiology, Care Sciences, and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet (KI), Stockholm, Sweden
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
- Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology, University of La Laguna, San Cristóbal de La Laguna, Tenerife, Spain
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What does hand motor function tell us about our aging brain in association with WMH? Aging Clin Exp Res 2021; 33:1577-1584. [PMID: 32860625 PMCID: PMC8203504 DOI: 10.1007/s40520-020-01683-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/11/2020] [Indexed: 11/26/2022]
Abstract
Background White matter hyperintensities (WMH) are a common cerebral finding in older people. WMH are usually asymptomatic, but excessive WMH are associated with cognitive decline and dementia. WMH are also among the neurological findings most consistently associated with declining motor performance in healthy ageing. Aims To determine if WMH load is associated with simple and complex motor movements in dominant and non-dominant hands in cognitively intact older subjects. Methods Hand motor performance was assessed with the Purdue Pegboard and Finger-tapping tests on 44 healthy right-handed participants, mean age 70.9 years (range 59–84 years). Participants also underwent magnetic resonance (MR) imaging, which were used to quantify WMH volume. The effect of WMH on the motor parameters was assessed via mediation analyses. Results WMH load increased significantly with age, while the motor scores decreased significantly with age. WMH load mediated only the relationship between age and left-hand pegboard scores. Discussion WMH mediated only the more complex Purdue Pegboard task for the non-dominant hand. This is likely because complex movements in the non-dominant hand recruit a larger cerebral network, which is more vulnerable to WMH. Conclusions Complex hand movements in the non-dominant hand are mediated by WMH. Subtle loss of motor movements of non-dominant hand might predict future excessive white matter atrophy.
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9
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Masuda Y, Okada G, Takamura M, Shibasaki C, Yoshino A, Yokoyama S, Ichikawa N, Okuhata S, Kobayashi T, Yamawaki S, Okamoto Y. White matter abnormalities and cognitive function in euthymic patients with bipolar disorder and major depressive disorder. Brain Behav 2020; 10:e01868. [PMID: 33009714 PMCID: PMC7749556 DOI: 10.1002/brb3.1868] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 08/12/2020] [Accepted: 09/14/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES In recent years, a growing number of diffusion tensor imaging (DTI) studies have compared white matter integrity between patients with major depressive disorder (MDD) and bipolar disorder (BD). However, few studies have examined the pathophysiological significance of different degrees of white matter abnormalities between the two disorders. The present study comprehensively assessed white matter integrity among healthy controls (HC) and euthymic patients with MDD and BD using whole-brain tractography and examined associations between white matter integrity and cognitive functioning. METHODS We performed neurocognitive examinations and DTI with 30 HCs, 30 patients with MDD, and 30 patients with BD. We statistically evaluated white matter integrity and cognitive function differences across the three groups, assessing associations between white matter integrities and cognitive function. RESULTS The BD group showed lower fractional anisotropy (FA) for the corpus callosum body, as well as lower, sustained attention and set-shifting scores compared to the other groups. FA for the left body of the corpus callosum was correlated with sustained attention in patients with BD. CONCLUSIONS The significant reduction of white matter integrity in the corpus callosum in BD, compared to MDD, was associated with an impairment of sustained attention. This result promotes the understanding of the significance of white matter integrity in mood disorders.
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Affiliation(s)
- Yoshikazu Masuda
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Go Okada
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Masahiro Takamura
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Chiyo Shibasaki
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Atsuo Yoshino
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Satoshi Yokoyama
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Naho Ichikawa
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Shiho Okuhata
- Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | | | - Shigeto Yamawaki
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neuroscience, Hiroshima University, Hiroshima, Japan
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10
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Major depressive disorder and schizophrenia are associated with a disturbed experience of temporal memory. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2020. [DOI: 10.1016/j.jadr.2020.100049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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11
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Bessette KL, Karstens AJ, Crane NA, Peters AT, Stange JP, Elverman KH, Morimoto SS, Weisenbach SL, Langenecker SA. A Lifespan Model of Interference Resolution and Inhibitory Control: Risk for Depression and Changes with Illness Progression. Neuropsychol Rev 2020; 30:477-498. [PMID: 31942706 PMCID: PMC7363517 DOI: 10.1007/s11065-019-09424-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 12/06/2019] [Indexed: 12/20/2022]
Abstract
The cognitive processes involved in inhibitory control accuracy (IC) and interference resolution speed (IR) or broadly - inhibition - are discussed in this review, and both are described within the context of a lifespan model of mood disorders. Inhibitory control (IC) is a binary outcome (success or no for response selection and inhibition of unwanted responses) for any given event that is influenced to an extent by IR. IR refers to the process of inhibition, which can be manipulated by task design in earlier and later stages through use of distractors and timing, and manipulation of individual differences in response proclivity. We describe the development of these two processes across the lifespan, noting factors that influence this development (e.g., environment, adversity and stress) as well as inherent difficulties in assessing IC/IR prior to adulthood (e.g., cross-informant reports). We use mood disorders as an illustrative example of how this multidimensional construct can be informative to state, trait, vulnerability and neuroprogression of disease. We present aggregated data across numerous studies and methodologies to examine the lifelong development and degradation of this subconstruct of executive function, particularly in mood disorders. We highlight the challenges in identifying and measuring IC/IR in late life, including specificity to complex, comorbid disease processes. Finally, we discuss some potential avenues for treatment and accommodation of these difficulties across the lifespan, including newer treatments using cognitive remediation training and neuromodulation.
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Affiliation(s)
- Katie L Bessette
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, USA
- Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Aimee J Karstens
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Natania A Crane
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Amy T Peters
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Jonathan P Stange
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Kathleen H Elverman
- Neuropsychology Center, Aurora St. Luke's Medical Center, Milwaukee, WI, USA
| | - Sarah Shizuko Morimoto
- Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Sara L Weisenbach
- Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT, 84108, USA
- Mental Health Services, VA Salt Lake City, Salt Lake City, UT, USA
| | - Scott A Langenecker
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, USA.
- Department of Psychiatry, University of Utah, 501 Chipeta Way, Salt Lake City, UT, 84108, USA.
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12
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Disruption of the structural and functional connectivity of the frontoparietal network underlies symptomatic anxiety in late-life depression. NEUROIMAGE-CLINICAL 2020; 28:102398. [PMID: 32919365 PMCID: PMC7491145 DOI: 10.1016/j.nicl.2020.102398] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 12/31/2022]
Abstract
LLD patients present lower functional connectivity in the right FPN. LLD patients present impaired white matter integrity in tracts to the right FPN. FPN alterations were negatively correlated with anxiety severity in LLD patients. The right IFG might be a crucial hub underlying the neuropathology of LLD.
The present study investigated functional connectivity and white matter integrity of the fronto-parietal network (FPN) to reveal the neural mechanisms that underlie late-life depression (LLD). Fifty patients with LLD and 40 non-depressed controls were included in the study. A multi-parametric approach was used by applying independent component analysis (ICA) to estimate functional connectivity of the FPN and by applying tractbased spatial statistics to examine white-matter integrity in tracts to the FPN. Patients with LLD exhibited functional abnormalities in the right inferior frontal gyrus, middle frontal gyrus, and inferior parietal gyrus and lower white matter fractional anisotropy in the right inferior fronto-occipital fasciculus, anterior thalamic radiation, and uncinate fasciculus. Alterations of functional connectivity and white matter fractional anisotropy in these regions were negatively correlated with the severity of symptomatic anxiety in LLD patients. The right inferior frontal gyrus might be a crucial hub in transferring information between these abnormal regions. Significant correlations were found between anxiety symptoms and brain alterations, suggesting that impairments in the FPN network might be involved in symptomatic anxiety in elderly individuals with depression.
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13
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Rushia SN, Shehab AAS, Motter JN, Egglefield DA, Schiff S, Sneed JR, Garcon E. Vascular depression for radiology: A review of the construct, methodology, and diagnosis. World J Radiol 2020; 12:48-67. [PMID: 32549954 PMCID: PMC7288775 DOI: 10.4329/wjr.v12.i5.48] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/05/2020] [Accepted: 05/12/2020] [Indexed: 02/06/2023] Open
Abstract
Vascular depression (VD) as defined by magnetic resonance imaging (MRI) has been proposed as a unique subtype of late-life depression. The VD hypothesis posits that cerebrovascular disease, as characterized by the presence of MRI-defined white matter hyperintensities, contributes to and increases the risk for depression in older adults. VD is also accompanied by cognitive impairment and poor antidepressant treatment response. The VD diagnosis relies on MRI findings and yet this clinical entity is largely unfamiliar to neuroradiologists and is rarely, if ever, discussed in radiology journals. The primary purpose of this review is to introduce the MRI-defined VD construct to the neuroradiology community. Case reports are highlighted in order to illustrate the profile of VD in terms of radiological, clinical, and neuropsychological findings. A secondary purpose is to elucidate and elaborate on the measurement of cerebrovascular disease through visual rating scales and semi- and fully-automated volumetric methods. These methods are crucial for determining whether lesion burden or lesion severity is the dominant pathological contributor to VD. Additionally, these rating methods have implications for the growing field of computer assisted diagnosis. Since VD has been found to have a profile that is distinct from other types of late-life depression, neuroradiologists, in conjunction with psychiatrists and psychologists, should consider VD in diagnosis and treatment planning.
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Affiliation(s)
- Sara N Rushia
- Department of Psychology, The Graduate Center, City University of New York, New York, NY 10016, United States
- Department of Psychology, Queens College, City University of New York, Queens, NY 11367, United States
| | - Al Amira Safa Shehab
- Department of Psychology, The Graduate Center, City University of New York, New York, NY 10016, United States
- Department of Psychology, Queens College, City University of New York, Queens, NY 11367, United States
| | - Jeffrey N Motter
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY 10032, United States
- Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, United States
| | - Dakota A Egglefield
- Department of Psychology, The Graduate Center, City University of New York, New York, NY 10016, United States
- Department of Psychology, Queens College, City University of New York, Queens, NY 11367, United States
| | - Sophie Schiff
- Department of Psychology, The Graduate Center, City University of New York, New York, NY 10016, United States
- Department of Psychology, Queens College, City University of New York, Queens, NY 11367, United States
| | - Joel R Sneed
- Department of Psychology, The Graduate Center, City University of New York, New York, NY 10016, United States
- Department of Psychology, Queens College, City University of New York, Queens, NY 11367, United States
- Division of Geriatric Psychiatry, New York State Psychiatric Institute, New York, NY 10032, United States
- Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, United States
| | - Ernst Garcon
- Department of Radiology, Columbia University Medical Center, New York, NY 10032, United States
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14
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Garcia-Egan PM, Preston-Campbell RN, Salminen LE, Heaps-Woodruff JM, Balla L, Cabeen RP, Laidlaw DH, Conturo TE, Paul RH. Behavioral inhibition corresponds to white matter fiber bundle integrity in older adults. Brain Imaging Behav 2020; 13:1602-1611. [PMID: 31209835 DOI: 10.1007/s11682-019-00144-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Little is known about the contribution of white matter integrity to inhibitory cognitive control, particularly in healthy aging. The present study examines the correspondence between white matter fiber bundle length and behavioral inhibition in 37 community-dwelling older adults (aged 51-78 years). Participants underwent neuroimaging with 3 Tesla MRI, and completed a behavioral test of inhibition (i.e., Go/NoGo task). Quantitative tractography derived from diffusion tensor imaging (qtDTI) was used to measure white matter fiber bundle lengths (FBLs) in tracts known to innervate frontal brain regions, including the anterior corpus callosum (AntCC), the cingulate gyrus segment of the cingulum bundle (CING), uncinate fasciculus (UNC), and the superior longitudinal fasciculus (SLF). Performance on the Go/NoGo task was measured by the number of commission errors standardized to reaction time. Hierarchical regression models revealed that shorter FBLs in the CING (p < 0.05) and the bilateral UNC (p < 0.01) were associated with lower inhibitory performance after adjusting for multiple comparisons, supporting a disconnection model of response inhibition in older adults. Prospective longitudinal studies are needed to examine the evolution of inhibitory errors in older adult populations and potential for therapeutic intervention.
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Affiliation(s)
- Paola M Garcia-Egan
- Department of Psychological Sciences, University of Missouri, St. Louis, MO, 63121, USA
| | | | - Lauren E Salminen
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, 90292, USA
| | | | - Lila Balla
- Missouri Institute of Mental Health, St. Louis, MO, 63134, USA
| | - Ryan P Cabeen
- Laboratory of Neuro Imaging, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, LosAngeles, CA, 90033, USA
| | - David H Laidlaw
- Department of Computer Science, Brown University, Providence, RI, 02906, USA
| | - Thomas E Conturo
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Robert H Paul
- Department of Psychological Sciences, University of Missouri, St. Louis, MO, 63121, USA.
- Missouri Institute of Mental Health, St. Louis, MO, 63134, USA.
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15
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Johnson LA, Large SE, Izurieta Munoz H, Hall JR, O'Bryant SE. Vascular Depression and Cognition in Mexican Americans. Dement Geriatr Cogn Disord 2019; 47:68-78. [PMID: 30861514 DOI: 10.1159/000494272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/02/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mexican Americans are at increased risk of developing mild cognitive impairment (MCI) and Alzheimer's disease compared to non-Hispanic whites. This study sought to examine the relationship between vascular risk, depression, and cognition in Mexican American elders. METHODS Data from 470 (390 normal controls, 80 MCI patients) Mexican Americans enrolled in the Health and Aging Brain among Latino Elders (HABLE) study were used. The cardiovascular risk was assessed by the Framingham Risk Score. Cognition was assessed with a neuropsychological battery, and depression was assessed based on scores from the Geriatric Depression Scale (GDS). ANOVAs were utilized to determine the differences in neuropsychological scores of normal controls with and without depression and CVD risk (low vs. high). Follow-up logistic regression was conducted to determine MCI risk. RESULTS The results of this study indicated that comorbid depression and a high CVD risk were associated with poorer cognitive performance in Mexican Americans. Depressed women with high CVD risk were more likely to have executive dysfunction, language deficits, and poorer global cognition than nondepressed women with a high CVD risk. In Mexican American men, those with a high vascular risk and depression were more likely to have executive dysfunction and poorer immediate memory than the nondepressed high-risk group. Higher GDS scores (OR = 1.10; 95% CI 1.02-1.10, p = 0.001) and higher vascular risk scores (OR = 1.05; 95% CI 1.02-1.10, p = 0.001) significantly predicted MCI status in Mexican Americans. CONCLUSION The results of this study indicated that comorbid depression and a high CVD risk were associated with poorer cognitive performance and increased risk of MCI in Mexican Americans.
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Affiliation(s)
- Leigh Ann Johnson
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA,
| | - Stephanie Ellen Large
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Haydee Izurieta Munoz
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - James Richard Hall
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Sid E O'Bryant
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA
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16
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Levman J, Fang Z, Zumwalt K, Cogger L, Vasung L, MacDonald P, Lim A, Takahashi E. Asymmetric Insular Connectomics Revealed by Diffusion Magnetic Resonance Imaging Analysis of Healthy Brain Development. Brain Connect 2019; 9:2-12. [PMID: 30501515 DOI: 10.1089/brain.2018.0582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The insula has been implicated in playing important roles in various brain functions including consciousness, homeostasis, perception, self-awareness, language processing, and interpersonal experience. Abnormalities of the insula have been observed in patients suffering from addiction, deteriorating language function, anorexia, and emotional dysregulation. We analyzed typical development of insular connections in a large-scale pediatric population using 642 magnetic resonance imaging examinations. Interpreting large quantities of acquired data is one of the major challenges in connectomics. This article focuses its analysis on the connectivity observed between the insula and many other regions throughout the brain and performs a hemispheric asymmetry analysis comparing localized connectome measurements. Results demonstrate asymmetries in the pathways connecting the insula to the superior temporal region, pars opercularis, etc. that may be representative of language lateralization in the brain. Results also demonstrate multiple fiber pathways that exhibit hemispheric dominance in tract length and an inverted hemispheric dominance in tract counts, implying the presence of asymmetric lateralization of some of the brain's insular pathways. This study illustrates the investigative potential of performing connectomics-style analyses in a clinical context across a large population of children as part of routine imaging, demonstrating the feasibility of using current technologies to perform regionally focused clinical connectivity studies.
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Affiliation(s)
- Jacob Levman
- 1 Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.,2 Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts.,3 Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,4 Department of Mathematics, Statistics and Computer Science, St. Francis Xavier University, Antigonish, Canada
| | - Zihang Fang
- 1 Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Katarina Zumwalt
- 5 OceanPath Fellow, Coady International Institute, St. Francis Xavier University, Antigonish, Canada
| | - Liam Cogger
- 4 Department of Mathematics, Statistics and Computer Science, St. Francis Xavier University, Antigonish, Canada
| | - Lana Vasung
- 1 Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.,3 Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Patrick MacDonald
- 1 Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Ashley Lim
- 1 Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Emi Takahashi
- 1 Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.,2 Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts.,3 Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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17
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Manning K, Wang L, Steffens D. Recent advances in the use of imaging in psychiatry: functional magnetic resonance imaging of large-scale brain networks in late-life depression. F1000Res 2019; 8:F1000 Faculty Rev-1366. [PMID: 31448089 PMCID: PMC6685449 DOI: 10.12688/f1000research.17399.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2019] [Indexed: 11/20/2022] Open
Abstract
Advances in neuroimaging have identified neural systems that contribute to clinical symptoms that occur across various psychiatric disorders. This transdiagnostic approach to understanding psychiatric illnesses may serve as a precise guide to identifying disease mechanisms and informing successful treatments. While this work is ongoing across multiple psychiatric disorders, in this article we emphasize recent findings pertaining to major depression in the elderly, or late-life depression (LLD), a common and debilitating neuropsychiatric illness. We discuss how neural functioning of three networks is linked to symptom presentation, illness course, and cognitive decline in LLD. These networks are (1) an executive control network responsible for complex cognitive processing, (2) a default mode network normally deactivated during cognitive demanding when individuals are at rest, and a (3) salience network relevant to attending to internal and external emotional and physiological sensations. We discuss how dysfunction in multiple networks contributes to common behavioral syndromes, and we present an overview of the cognitive control, default mode, and salience networks observed in LLD.
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Affiliation(s)
- Kevin Manning
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - Lihong Wang
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
| | - David Steffens
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
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18
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Lissemore JI, Shanks HRC, Butters MA, Bhandari A, Zomorrodi R, Rajji TK, Karp JF, Reynolds CF, Lenze EJ, Daskalakis ZJ, Mulsant BH, Blumberger DM. An inverse relationship between cortical plasticity and cognitive inhibition in late-life depression. Neuropsychopharmacology 2019; 44:1659-1666. [PMID: 31071718 PMCID: PMC6785107 DOI: 10.1038/s41386-019-0413-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 04/27/2019] [Accepted: 05/01/2019] [Indexed: 11/08/2022]
Abstract
Executive dysfunction is a common and disabling component of late-life depression (LLD), yet its neural mechanisms remain unclear. In particular, it is not yet known how executive functioning in LLD relates to measures of cortical physiology that may change with age and illness, namely cortical inhibition/excitation and plasticity. Here, we used transcranial magnetic stimulation (TMS) to measure cortical inhibition/excitation (n = 51), and the potentiation of cortical activity following paired associative stimulation, which is thought to reflect long-term potentiation (LTP)-like cortical plasticity (n = 32). We assessed the correlation between these measures of cortical physiology and two measures of executive functioning: cognitive inhibition, assessed using the Delis-Kaplan Executive Function System Color-Word Interference ["Stroop"] Test, and cognitive flexibility, assessed using the Trail Making Test. Correlations with recall memory and processing speed were also performed to assess the specificity of any associations to executive functioning. A significant correlation was found between greater LTP-like cortical plasticity and poorer cognitive inhibition, a core executive function (rp = -0.56, p < 0.001). We did not observe significant associations between cortical inhibition/excitation and executive functioning, or between any neurophysiological measure and cognitive flexibility, memory, or processing speed. Our finding that elevated cortical plasticity is associated with diminished cognitive inhibition emphasizes the importance of balanced synaptic strengthening to healthy cognition. More specifically, our findings suggest that hyper-excitability of cortical circuits following repeated cortical activation may promote inappropriate prepotent responses in LLD. LTP-like cortical plasticity might therefore represent a neural mechanism underlying an inhibitory control cognitive endophenotype of LLD.
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Affiliation(s)
- Jennifer I Lissemore
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada
| | - Hayley R C Shanks
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H4, Canada
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Apoorva Bhandari
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H4, Canada
| | - Reza Zomorrodi
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H4, Canada
| | - Tarek K Rajji
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5T 1R8, Canada
| | - Jordan F Karp
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- VAPHS, Geriatric Research Education and Clinical Center, Pittsburgh, PA, USA
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Eric J Lenze
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Zafiris J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5T 1R8, Canada
| | - Benoit H Mulsant
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5T 1R8, Canada
| | - Daniel M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H4, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M5T 1R8, Canada.
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Rimkus CM, Schoonheim MM, Steenwijk MD, Vrenken H, Eijlers AJ, Killestein J, Wattjes MP, Leite CC, Barkhof F, Tijms BM. Gray matter networks and cognitive impairment in multiple sclerosis. Mult Scler 2018; 25:382-391. [PMID: 29320933 PMCID: PMC6393954 DOI: 10.1177/1352458517751650] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Coordinated patterns of gray matter morphology can be represented as networks, and network disruptions may explain cognitive dysfunction related to multiple sclerosis (MS). OBJECTIVE To investigate whether single-subject gray matter network properties are related to impaired cognition in MS. METHODS We studied 148 MS patients (99 female) and 33 healthy controls (HC, 21 female). Seven network parameters were computed and compared within MS between cognitively normal and impaired subjects, and associated with performance on neuropsychological tests in six cognitive domains with regression models. Analyses were controlled for age, gender, whole-brain gray matter volumes, and education level. RESULTS Compared to MS subjects with normal cognition, MS subjects with cognitive impairment showed a more random network organization as indicated by lower lambda values (all p < 0.05). Worse average cognition and executive function were associated with lower lambda values. Impaired information processing speed, working memory, and attention were associated with lower clustering values. CONCLUSION Our findings indicate that MS subjects with a more randomly organized gray matter network show worse cognitive functioning, suggesting that single-subject gray matter graphs may capture neurological dysfunction due to MS.
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Affiliation(s)
- Carolina M Rimkus
- Department of Radiology and Nuclear Medicine, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands/Department of Radiology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Menno M Schoonheim
- Department of Anatomy and Neurosciences, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn D Steenwijk
- Department of Anatomy and Neurosciences, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands/Department of Neurology, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Hugo Vrenken
- Department of Radiology and Nuclear Medicine, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Anand Jc Eijlers
- Department of Anatomy and Neurosciences, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Joep Killestein
- Department of Neurology, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Mike P Wattjes
- Department of Radiology and Nuclear Medicine, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Claudia C Leite
- Department of Radiology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands/Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Betty M Tijms
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
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Funes CM, Lavretsky H, Ercoli L, St Cyr N, Siddarth P. Apathy Mediates Cognitive Difficulties in Geriatric Depression. Am J Geriatr Psychiatry 2018; 26:100-106. [PMID: 28755989 PMCID: PMC5725249 DOI: 10.1016/j.jagp.2017.06.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 06/09/2017] [Accepted: 06/14/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Cognitive impairment associated with late-life depression can persist after remission of mood symptoms. Apathy, a common symptom of late-life depression, often leads to worse clinical outcomes. We examined if severity of apathy mediates cognitive difficulties in a cohort of older adults with major depression. METHODS One hundred thirty-eight older adults with depression (54.4% female; mean [SD] age: 69.7 [7.4] years; mean [SD] education:15.6 [2.7] years) were recruited to participate in a treatment study, and only baseline data were analyzed. All participants received a comprehensive evaluation of depression, apathy, and cognition. We examined whether apathy mediated the relationship between depression and cognition, focusing our attention on memory and cognitive control. We then explored whether the mediation effects differed across women and men. RESULTS Increased apathy was significantly associated with worse depression and lower performance in the cognitive control domain but not in memory. Higher depressive scores were significantly associated with worse cognitive control but not memory. Mediation analyses revealed a significant indirect effect on cognitive control by depression through increased apathy scores with the mediator accounting for 21% of the total effect. Stratifying by sex, we found that women exhibited a significant indirect effect, with the mediator accounting for 47% of the total effect, whereas there was no mediation by apathy in men. CONCLUSIONS The findings imply that increased apathy mediates the relationship between cognition and depression. The identification of mediating effects may inform future treatment strategies and preventive interventions that can focus on decreasing apathy to improve cognition in late-life depression.
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Affiliation(s)
- Cynthia M Funes
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Helen Lavretsky
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA.
| | - Linda Ercoli
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Natalie St Cyr
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Prabha Siddarth
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA
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21
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Rizk MM, Rubin-Falcone H, Keilp J, Miller JM, Sublette ME, Burke A, Oquendo MA, Kamal AM, Abdelhameed MA, Mann JJ. White matter correlates of impaired attention control in major depressive disorder and healthy volunteers. J Affect Disord 2017; 222:103-111. [PMID: 28688263 PMCID: PMC5659839 DOI: 10.1016/j.jad.2017.06.066] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/02/2017] [Accepted: 06/26/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is associated with impaired attention control and alterations in frontal-subcortical connectivity. We hypothesized that attention control as assessed by Stroop task interference depends on white matter integrity in fronto-cingulate regions and assessed this relationship using diffusion tensor imaging (DTI) in MDD and healthy volunteers (HV). METHODS DTI images and Stroop task were acquired in 29 unmedicated MDD patients and 16 HVs, aged 18-65 years. The relationship between Stroop interference and fractional anisotropy (FA) was examined using region-of-interest (ROI) and tract-based spatial statistics (TBSS) analyses. RESULTS ROI analysis revealed that Stroop interference correlated positively with FA in left caudal anterior cingulate cortex (cACC) in HVs (r = 0.62, p = 0.01), but not in MDD (r = -0.05, p= 0.79) even after controlling for depression severity. The left cACC was among 4 ROIs in fronto-cingulate network where FA was lower in MDD relative to HVs (F(1,41) = 8.87, p = 0.005). Additionally, TBSS showed the same group interaction of differences and correlations, although only at a statistical trend level. LIMITATIONS The modest sample size limits the generalizability of the findings. CONCLUSIONS Structural connectivity of white matter network of cACC correlated with magnitude of Stroop interference in HVs, but not MDD. The cACC-frontal network, sub-serving attention control, may be disrupted in MDD. Less cognitive control may include enhanced effects of salience in HVs, or less effective response inhibition in MDD. Further studies of salience and inhibition components of executive function may better elucidate the relationship between brain white matter changes and executive dysfunction in MDD.
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Affiliation(s)
- Mina M Rizk
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States; Department of Psychiatry, Faculty of Medicine, Minia University, Egypt.
| | - Harry Rubin-Falcone
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States
| | - John Keilp
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States
| | - Jeffrey M Miller
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States
| | - M Elizabeth Sublette
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States
| | - Ainsley Burke
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, PA, United States
| | - Ahmed M Kamal
- Department of Psychiatry, Faculty of Medicine, Minia University, Egypt
| | | | - J John Mann
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States; Department of Radiology, Columbia University, New York, NY, United States
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22
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Vascular Cognitive Impairment through the Looking Glass of Transcranial Magnetic Stimulation. Behav Neurol 2017. [PMID: 28348458 DOI: 10.1155/2017/1421326.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In the last years, there has been a significant growth in the literature exploiting transcranial magnetic stimulation (TMS) with the aim at gaining further insights into the electrophysiological and neurochemical basis underlying vascular cognitive impairment (VCI). Overall, TMS points at enhanced brain cortical excitability and synaptic plasticity in VCI, especially in patients with overt dementia, and neurophysiological changes seem to correlate with disease process and progress. These findings have been interpreted as part of a glutamate-mediated compensatory effect in response to vascular lesions. Although a single TMS parameter owns low specificity, a panel of measures can support the VCI diagnosis, predict progression, and possibly identify early markers of "brain at risk" for future dementia, thus making VCI a potentially preventable cause of both vascular and degenerative dementia in late life. Moreover, TMS can be also exploited to select and evaluate the responders to specific drugs, as well as to become an innovative rehabilitative tool in the attempt to restore impaired neural plasticity. The present review provides a perspective of the different TMS techniques by further understanding the cortical electrophysiology and the role of distinctive neurotransmission pathways and networks involved in the pathogenesis and pathophysiology of VCI and its subtypes.
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23
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Lanza G, Bramanti P, Cantone M, Pennisi M, Pennisi G, Bella R. Vascular Cognitive Impairment through the Looking Glass of Transcranial Magnetic Stimulation. Behav Neurol 2017; 2017:1421326. [PMID: 28348458 PMCID: PMC5350538 DOI: 10.1155/2017/1421326] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/30/2017] [Accepted: 02/05/2017] [Indexed: 02/07/2023] Open
Abstract
In the last years, there has been a significant growth in the literature exploiting transcranial magnetic stimulation (TMS) with the aim at gaining further insights into the electrophysiological and neurochemical basis underlying vascular cognitive impairment (VCI). Overall, TMS points at enhanced brain cortical excitability and synaptic plasticity in VCI, especially in patients with overt dementia, and neurophysiological changes seem to correlate with disease process and progress. These findings have been interpreted as part of a glutamate-mediated compensatory effect in response to vascular lesions. Although a single TMS parameter owns low specificity, a panel of measures can support the VCI diagnosis, predict progression, and possibly identify early markers of "brain at risk" for future dementia, thus making VCI a potentially preventable cause of both vascular and degenerative dementia in late life. Moreover, TMS can be also exploited to select and evaluate the responders to specific drugs, as well as to become an innovative rehabilitative tool in the attempt to restore impaired neural plasticity. The present review provides a perspective of the different TMS techniques by further understanding the cortical electrophysiology and the role of distinctive neurotransmission pathways and networks involved in the pathogenesis and pathophysiology of VCI and its subtypes.
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Affiliation(s)
- Giuseppe Lanza
- 1Department of Neurology IC, I.R.C.C.S. “Oasi” Institute for Research on Mental Retardation and Brain Aging, 73 Via Conte Ruggero, 94018 Troina, Italy
- *Giuseppe Lanza:
| | - Placido Bramanti
- 2I.R.C.C.S. Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy
| | - Mariagiovanna Cantone
- 1Department of Neurology IC, I.R.C.C.S. “Oasi” Institute for Research on Mental Retardation and Brain Aging, 73 Via Conte Ruggero, 94018 Troina, Italy
| | - Manuela Pennisi
- 3Spinal Unit, Emergency Hospital “Cannizzaro”, 829 Via Messina, 95126 Catania, Italy
| | - Giovanni Pennisi
- 4Department of Surgery and Medical-Surgical Specialties, University of Catania, 78 Via S. Sofia, 95123 Catania, Italy
| | - Rita Bella
- 5Department of Medical and Surgical Sciences and Advanced Technology, Section of Neurosciences, University of Catania, 78 Via S. Sofia, 95123 Catania, Italy
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Harper DG, Joe EB, Jensen JE, Ravichandran C, Forester BP. Brain levels of high-energy phosphate metabolites and executive function in geriatric depression. Int J Geriatr Psychiatry 2016; 31:1241-1249. [PMID: 26891040 DOI: 10.1002/gps.4439] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 12/29/2015] [Accepted: 01/05/2016] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Depression in late life has been associated with difficulties in cognitive processing, particularly in the domains of executive function, processing speed and memory, and increases the risk of developing dementia suggesting a neurodegenerative phenotype. Mitochondrial dysfunction is frequently an early event in neurodegenerative illnesses and may be operative in patients with late life depression. Phosphorus magnetic resonance spectroscopy (31P MRS) allows for the quantification of bioenergetic molecules produced by mitochondria. METHODS Ten patients with late life depression and eight normal elderly controls were studied with Stroop color and interference tests, which are widely used measures of processing speed and executive function, respectively, followed by (31P) MRS 3-dimensional chemical-shift imaging measuring levels of adenosine triphosphate, phosphocreatine, inorganic phosphate, and pH over the whole brain. RESULTS In all subjects, gray matter phosphocreatine was positively associated with Stroop interference. Levels of white matter adenosine triphosphate were associated with Stroop interference in subjects with late life depression but not normal elderly. There was also a complementary association between white matter inorganic phosphate and Stroop interference in late life depression patients. CONCLUSIONS These findings suggest two independent sources of executive function dependence on bioenergetic state in the aging brain. The dependence of executive function performance in subjects with late life depression on ATP in white matter may be associated with mitochondrial impairment and is consistent with predictions of the vascular depression hypothesis. Further research with wider neuropsychological testing targeting bioenergetic markers could help clarify the scope of these effects. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- David G Harper
- Geriatric Psychiatry Program, McLean Hospital, Belmont, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | | | - J Eric Jensen
- Neuroimaging Center, McLean Hospital, Belmont, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Caitlin Ravichandran
- Laboratory for Psychiatric Biostatistics, McLean Hospital, Belmont, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Brent P Forester
- Geriatric Psychiatry Program, McLean Hospital, Belmont, MA, USA.,Harvard Medical School, Boston, MA, USA
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25
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Ursache A, Noble KG. Socioeconomic status, white matter, and executive function in children. Brain Behav 2016; 6:e00531. [PMID: 27781144 PMCID: PMC5064342 DOI: 10.1002/brb3.531] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 05/31/2016] [Accepted: 06/03/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND A growing body of evidence links socioeconomic status (SES) to children's brain structure. Few studies, however, have specifically investigated relations of SES to white matter structure. Further, although several studies have demonstrated that family SES is related to development of brain areas that support executive functions (EF), less is known about the role that white matter structure plays in the relation of SES to EF. One possibility is that white matter differences may partially explain SES disparities in EF (i.e., a mediating relationship). Alternatively, SES may differentially shape brain-behavior relations such that the relation of white matter structure to EF may differ as a function of SES (i.e., a moderating relationship). METHOD In a diverse sample of 1082 children and adolescents aged 3-21 years, we examined socioeconomic disparities in white matter macrostructure and microstructure. We further investigated relations between family SES, children's white matter volume and integrity in tracts supporting EF, and performance on EF tasks. RESULTS Socioeconomic status was associated with fractional anisotropy (FA) and volume in multiple white matter tracts. Additionally, family income moderated the relation between white matter structure and cognitive flexibility. Specifically, across multiple tracts of interest, lower FA or lower volume was associated with reduced cognitive flexibility among children from lower income families. In contrast, children from higher income families showed preserved cognitive flexibility in the face of low white matter FA or volume. SES factors did not mediate or moderate links between white matter and either working memory or inhibitory control. CONCLUSIONS This work adds to a growing body of literature suggesting that the socioeconomic contexts in which children develop not only shape cognitive functioning and its underlying neurobiology, but may also shape the relations between brain and behavior.
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26
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Repetitive transcranial magnetic stimulation for treatment resistant depression: Re-establishing connections. Clin Neurophysiol 2016; 127:3394-3405. [PMID: 27672727 DOI: 10.1016/j.clinph.2016.08.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/28/2016] [Accepted: 08/17/2016] [Indexed: 12/21/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a relatively recent addition to the neurostimulation armamentarium for treating individuals suffering from treatment refractory depression and has demonstrated efficacy in clinical trials. One of the proposed mechanisms of action underlying the therapeutic effects of rTMS for depression involves the modulation of depression-associated dysfunctional activity in distributed brain networks involving frontal cortical and subcortical limbic regions, via changes to aberrant functional and structural connectivity. Although there is currently a paucity of published data, we review changes to functional and structural connectivity following rTMS for depression. Current evidence suggests an rTMS-induced normalisation of depression-associated dysfunction within and between large scale functional networks, including the default mode, central executive and salience networks, associated with an amelioration of depressive symptoms. Additionally, changes to measures of white matter microstructure, primarily in the dorsolateral prefrontal cortex, have also been reported following rTMS for depression, possibly reversing depression-associated abnormalities. We argue that measures of functional and structural connectivity can be used to optimise rTMS targeting within the dorsolateral prefrontal cortex and also to explore novel rTMS targets for depression. Finally, we discuss the utility of measures of brain connectivity as predictive biomarkers of rTMS treatment response in guiding therapeutic decisions.
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27
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Li X, Steffens DC, Potter GG, Guo H, Song S, Wang L. Decreased between-hemisphere connectivity strength and network efficiency in geriatric depression. Hum Brain Mapp 2016; 38:53-67. [PMID: 27503772 DOI: 10.1002/hbm.23343] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/29/2016] [Indexed: 12/25/2022] Open
Abstract
White matter (WM) lesions have been recognized as a key etiological factor in geriatric depression. However, little is known about the topological pattern changes of WM in geriatric depression in the remitted state (RGD) and its relationship to depressive episodes. To address these questions, we acquired diffusion tensor images in 24 RGD and 24 healthy participants. Among them, 10 patients and 19 healthy controls completed a 1-year follow up. Between-hemisphere connectivity and graph theoretical methods were used to analyze the data. We found significantly reduced WM connectivity between the left and right hemisphere in the RGD group compared with the control group. Those with multiple depression episodes had greater reduction in between-hemisphere connectivity strength than those with fewer episodes. In addition, the RGD group had a reduced global clustering coefficient, global efficiency, and network strength, and an increased shortest path length compared with the controls. A lower clustering coefficient was correlated with poorer memory function. The reduction of nodal clustering coefficient, global efficiency, and network strength in several regions were associated with slower information processing speed. At 1-year follow up, the network properties in the RGD subjects were significantly changed suggesting instability of WM network properties of depressed patients. Together, our study provides direct evidence of reduced between-hemisphere WM connectivity with greater depressive episodes, and of alterations of network properties with cognitive dysfunction in geriatric depression. Hum Brain Mapp 38:53-67, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Xuesong Li
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - David C Steffens
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Guy G Potter
- Department of Psychiatry and Behavioral Science, Duke University, Durham, North Carolina
| | - Hua Guo
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Sen Song
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Lihong Wang
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut.,Department of Psychiatry and Behavioral Science, Duke University, Durham, North Carolina
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Tatham EL, Ramasubbu R, Gaxiola-Valdez I, Cortese F, Clark D, Goodyear B, Foster J, Hall GB. White matter integrity in major depressive disorder: Implications of childhood trauma, 5-HTTLPR and BDNF polymorphisms. Psychiatry Res Neuroimaging 2016; 253:15-25. [PMID: 27261564 DOI: 10.1016/j.pscychresns.2016.04.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 04/22/2016] [Accepted: 04/25/2016] [Indexed: 11/24/2022]
Abstract
This study examined the impact of childhood neglect, serotonin transporter (5-HTTLPR) and brain derived neurotrophic factor (BDNF) polymorphisms on white matter (WM) integrity in major depressive disorder (MDD) using diffusion tensor imaging (DTI). Fifty-five medication-free MDD patients and 18 controls underwent diffusion tensor imaging scanning, genotyping and completed the Childhood Trauma Questionnaire. Tract based spatial statistics (TBSS) findings revealed reduced fractional anisotropy (FA) in the MDD group in the anterior internal capsule. 5-HTTLPR-S'L' heterozygotes in the MDD group exhibited reduced FA in the internal capsule relative to S'S' and reduced FA in corona radiata compared to L'L'. Probabilistic tractography revealed higher FA in the uncinate fasciculus (UF) for BDNF val/val genotype relative to met-carriers, particularly in individuals with high depression severity. High depression severity and experiences of childhood physical or emotional neglect predicted higher FA in the UF and superior longitudinal fasciculus. Reductions in FA were identified for subgroups of MDD patients who were 5-HTTLPR heterozygotes and BDNF-met carriers. An association between emotional/physical neglect and FA was observed in subjects with high depressive symptoms. Our findings suggest that WM connectivity within frontal and limbic regions are affected by depression and influenced by experiences of neglect and genetic risk factors.
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Affiliation(s)
- Erica L Tatham
- McMaster Integrative Neuroscience Discovery and Study Program, McMaster University, Hamilton, Ontario, Canada
| | - Rajamannar Ramasubbu
- Department of Psychiatry, and Clinical Neurosciences, Hotchkiss Brain Institute, Mathison Center for Mental Health Research and Education, University of Calgary, Alberta, Canada
| | | | | | - Darren Clark
- Department of Psychiatry, and Clinical Neurosciences, Hotchkiss Brain Institute, Mathison Center for Mental Health Research and Education, University of Calgary, Alberta, Canada
| | | | - Jane Foster
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Geoffrey B Hall
- McMaster Integrative Neuroscience Discovery and Study Program, McMaster University, Hamilton, Ontario, Canada; Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada.
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Empathy in depression: Egocentric and altercentric biases and the role of alexithymia. J Affect Disord 2016; 199:23-9. [PMID: 27060429 DOI: 10.1016/j.jad.2016.03.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 02/20/2016] [Accepted: 03/06/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) has been associated with empathy deficits. The exact nature of these deficits and their relation to concurrent alexithymia remain unknown. Here we tested under which conditions MDD patients with high and low alexithymia show deficient empathy, particularly investigating empathic abilities when inhibition of self-related emotional states is needed and when it is not. METHODS Healthy controls (low: n=28, high: n=14) and currently depressed MDD patients (low: n=11, high: n=18) with low or high alexithymia performed an emotional egocentricity paradigm based on tactile stimulation. This task measures empathic judgements, when emotional states of self and other differ and inhibition of self-related emotional states is needed, and when they do not and thus empathic judgments can be based on simple projection mechanisms. RESULTS Only alexithymia but not depression decreased empathy, in situations when simple projection sufficed. However, when inhibition of self-related emotional states was needed, MDD patients showed an egocentric bias during empathic judgments and an altercentric bias during self emotion judgments, the latter suggesting heightened emotional contagion, both independent of alexithymia. Across the entire sample, alexithymia decreased the size of the egocentric bias. LIMITATIONS This study was based on a relatively sample size. CONCLUSIONS These results suggest that MDD patients show intact empathic judgments, when simple projection is required and no concurrent alexithymia is present. In situations when incongruent emotional states of self and other have to be resolved, MDD patients are prone to egocentric and altercentric biases.
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30
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Chhetry BT, Hezghia A, Miller JM, Lee S, Rubin-Falcone H, Cooper TB, Oquendo MA, Mann JJ, Sublette ME. Omega-3 polyunsaturated fatty acid supplementation and white matter changes in major depression. J Psychiatr Res 2016; 75:65-74. [PMID: 26802812 PMCID: PMC4948754 DOI: 10.1016/j.jpsychires.2015.12.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 11/02/2015] [Accepted: 12/07/2015] [Indexed: 01/15/2023]
Abstract
White matter abnormalities are implicated in major depressive disorder (MDD). As omega-3 polyunsaturated fatty acids (PUFAs) are low in MDD and affect myelination, we hypothesized that PUFA supplementation may alleviate depression through improving white matter integrity. Acutely depressed MDD patients (n = 16) and healthy volunteers (HV, n = 12) had 25-direction diffusion tensor imaging before and after 6 weeks of fish oil supplementation. Plasma phospholipid omega-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and omega-6 PUFA arachidonic acid (AA) levels were determined before and after supplementation using high-throughput extraction and gas chromatography and expressed as a percentage of total phospholipids (PUFA%). Fractional anisotropy (FA) was computed using a least-squares-fit diffusion tensor with non-linear optimization. Regression analyses were performed with changes in PUFA levels or Hamilton Depression Rating Scale scores as predictors, voxel-wise difference maps of FA as outcome, covariates age and sex, with family-wise correction for multiple comparisons. Increases in plasma phospholipid DHA% (but not EPA% or AA%) after fish oil predicted increases in FA in MDD but not HV, in a cluster including genu and body of the corpus callosum, and anterior corona radiata and cingulum (cluster-level p < 0.001, peak t-score = 8.10, p = 0.002). There was a trend for greater change in FA in MDD responders over nonresponders (t = -1.874, df = 13.56, p = 0.08). Decreased depression severity predicted increased FA in left corticospinal tract and superior longitudinal fasciculus (cluster-level p < 0.001, peak t-score = 5.04, p = 0.0001). Increased FA correlated with increased DHA% and decreased depression severity after fish oil supplementation suggests therapeutic effects of omega-3 PUFAs may be related to improvements in white matter integrity.
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Affiliation(s)
- Binod Thapa Chhetry
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA,Division of Molecular Imaging & Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 42, New York, NY 10032, USA
| | - Adrienne Hezghia
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA
| | - Jeffrey M. Miller
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA,Division of Molecular Imaging & Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 42, New York, NY 10032, USA
| | - Seonjoo Lee
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA,Department of Biostatistics, Columbia University, 722 West 168th St., New York, NY 10032, USA
| | - Harry Rubin-Falcone
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA,Division of Molecular Imaging & Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 42, New York, NY 10032, USA
| | - Thomas B. Cooper
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA,Division of Molecular Imaging & Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 42, New York, NY 10032, USA,Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA
| | - Maria A. Oquendo
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA,Division of Molecular Imaging & Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 42, New York, NY 10032, USA
| | - J. John Mann
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA,Division of Molecular Imaging & Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 42, New York, NY 10032, USA,Department of Radiology, Columbia University, 622 West 168th St, New York, NY, USA
| | - M. Elizabeth Sublette
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA,Division of Molecular Imaging & Neuropathology, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 42, New York, NY 10032, USA,To whom correspondence should be addressed: New York State Psychiatric Institute, 1051 Riverside Drive, Unit 42, New York, NY 10032, TEL 646 774-7514, FAX 646 774-7589,
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van Uden IWM, Tuladhar AM, de Laat KF, van Norden AGW, Norris DG, van Dijk EJ, Tendolkar I, de Leeuw FE. White matter integrity and depressive symptoms in cerebral small vessel disease: The RUN DMC study. Am J Geriatr Psychiatry 2015; 23:525-35. [PMID: 25151438 DOI: 10.1016/j.jagp.2014.07.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 07/01/2014] [Accepted: 07/12/2014] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Depressive symptoms are common in elderly with cerebral small vessel disease (SVD). As not every individual with SVD experiences depressive symptoms, other factors might play a role. We therefore investigated the white matter (WM) integrity of the white matter tracts in elderly with depressive symptoms, independent of global cognitive function, by applying the tract-based spatial statistics (TBSS). DESIGN Prospective cohort study with cross-sectional baseline data. SETTING Radboud University Nijmegen Medical Centre, The Netherlands. PARTICIPANTS 438 individuals aged between 50-85 years, with SVD without dementia. MEASUREMENTS Diffusion tensor imaging parameters and depressive symptoms, assessed with the Center for Epidemiologic Studies Depression Scale. RESULTS Compared with non-depressed participants (N = 287), those with depressive symptoms (N = 151) had lower fractional anisotropy in the genu and body of the corpus callosum, bilateral inferior fronto-occipital fasciculus, uncinate fasciculus, and corona radiata. These differences disappeared after adjustment for white matter hyperintensities (WMH) and lacunar infarcts. Mean-, axial- and radial diffusivity were higher in these areas in participants with depressive symptoms. After additional adjustment for WMH and lacunar infarcts, the changes observed in radial diffusivity also disappeared. Adding global cognition as confounding variable altered the diffusion parameters only slightly. CONCLUSION This study indicates that elderly with depressive symptoms show a lower WM integrity, independent of global cognitive function, and that the presence of SVD is mostly responsible, affecting the fronto-subcortical regions and hereby disrupting the neural circuitry involved in mood regulation.
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Affiliation(s)
- Ingeborg W M van Uden
- Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Anil M Tuladhar
- Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Karlijn F de Laat
- Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Department of Neurology, HagaZiekenhuis, The Hague, The Netherlands
| | - Anouk G W van Norden
- Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Department of Neurology, Amphia Ziekenhuis, Breda, The Netherlands
| | - David G Norris
- Centre for Cognitive Neuroimaging, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands; Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany
| | - Ewoud J van Dijk
- Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Indira Tendolkar
- Department of Psychiatry, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Radboudumc, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
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Bijanki KR, Hodis B, Magnotta VA, Zeien E, Andreasen NC. Effects of age on white matter integrity and negative symptoms in schizophrenia. Schizophr Res 2015; 161:29-35. [PMID: 24957354 PMCID: PMC4272674 DOI: 10.1016/j.schres.2014.05.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 05/05/2014] [Accepted: 05/09/2014] [Indexed: 11/30/2022]
Abstract
The current study examined the relationship between white matter integrity as indexed by diffusion tensor imaging and negative symptom severity in schizophrenia. The current study included statistical controls for age effects on the relationship of interest, a major weakness of the existing literature on the subject. Participants included 59 chronic schizophrenia patients, and 31 first-episode schizophrenia patients. Diffusion-weighted neuroimaging was used to calculate fractional anisotropy (FA) in each major brain region (frontal, temporal, parietal, and occipital lobes). Negative symptoms were measured using the Scale for the Assessment of Negative Symptoms (SANS) in all schizophrenia patients. Significant bivariate correlations were observed between global SANS scores and global FA, as well as in most brain regions. These relationships appeared to be driven by SANS items measuring facial expressiveness, poor eye contact, affective flattening, inappropriate affect, poverty of speech, poverty of speech content, alogia, and avolition. However, upon addition of age as a covariate, the observed relationships became non-significant. Further analysis revealed very strong age effects on both FA and SANS scores in the current sample. The findings of this study refute previous reports of significant relationships between DTI variables and negative symptoms in schizophrenia, and they suggest an important confounding variable to be considered in future studies in this population.
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Affiliation(s)
- Kelly Rowe Bijanki
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, United States
| | - Brendan Hodis
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, United States
| | - Vincent A Magnotta
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, United States; Department of Radiology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, United States
| | - Eugene Zeien
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, United States
| | - Nancy C Andreasen
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, United States.
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Cheng Y, Xu J, Yu H, Nie B, Li N, Luo C, Li H, Liu F, Bai Y, Shan B, Xu L, Xu X. Delineation of early and later adult onset depression by diffusion tensor imaging. PLoS One 2014; 9:e112307. [PMID: 25393297 PMCID: PMC4231105 DOI: 10.1371/journal.pone.0112307] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 09/12/2014] [Indexed: 11/23/2022] Open
Abstract
Background Due to a lack of evidence, there is no consistent age of onset to define early onset (EO) versus later onset (LO) major depressive disorder (MDD). Fractional anisotropy (FA), derived from diffusion tensor imaging (DTI), has been widely used to study neuropsychiatric disorders by providing information about the brain circuitry, abnormalities of which might facilitate the delineation of EO versus LO MDD. Method In this study, 61 pairs of untreated, non-elderly, first-episode MDD patients and healthy controls (HCs) aged 18–45 years old received DTI scans. The voxel-based analysis method (VBM), classification analysis, using the Statistical Package for the Social Sciences (SPSS), and regression analyses were used to determine abnormal FA clusters and their correlations with age of onset and clinical symptoms. Results Classification analysis suggested in the best model that there were two subgroups of MDD patients, delineated by an age of onset of 30 years old, by which MDD patients could be divided into EO (18–29 years old) and LO (30–45 years old) groups. LO MDD was characterized by decreased FA, especially in the white matter (WM) of the fronto-occipital fasciculus and posterior limb of internal capsule, with a negative correlation with the severity of depressive symptoms; in marked contrast, EO MDD showed increased FA, especially in the WM of the corpus callosum, corticospinal midbrain and inferior fronto-occipital fasciculus, while FA of the WM near the midbrain had a positive correlation with the severity of depressive symptoms. Conclusion Specific abnormalities of the brain circuitry in EO vs. LO MDD were delineated by an age of onset of 30 years old, as demonstrated by distinct abnormal FA clusters with opposite correlations with clinical symptoms. This DTI study supported the evidence of an exact age for the delineation of MDD, which could have broad multidisciplinary importance. Trial Registration ClinicalTrials.gov NCT00703742
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Affiliation(s)
- Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, PR China
| | - Jian Xu
- Department of Internal Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, PR China
| | - Hongjun Yu
- Magnetic Resonance Imaging Center, the First Hospital of Kunming City, Kunming, PR China
| | - Binbin Nie
- Key Laboratory of Nuclear Analysis Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, PR China
| | - Na Li
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, PR China
| | - Chunrong Luo
- Magnetic Resonance Imaging Center, the First Hospital of Kunming City, Kunming, PR China
| | - Haijun Li
- Magnetic Resonance Imaging Center, the First Hospital of Kunming City, Kunming, PR China
| | - Fang Liu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, PR China
| | - Yan Bai
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, PR China
| | - Baoci Shan
- Key Laboratory of Nuclear Analysis Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, PR China
| | - Lin Xu
- Key Laboratory of Animal Models and Human Disease Mechanisms, Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, PR China
- * E-mail: (LX); (XX)
| | - Xiufeng Xu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, PR China
- * E-mail: (LX); (XX)
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Du M, Liu J, Chen Z, Huang X, Li J, Kuang W, Yang Y, Zhang W, Zhou D, Bi F, Kendrick KM, Gong Q. Brain grey matter volume alterations in late-life depression. J Psychiatry Neurosci 2014; 39:397-406. [PMID: 24949867 PMCID: PMC4214874 DOI: 10.1503/jpn.130275] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Voxel-based morphometry (VBM) studies have demonstrated that grey matter abnormalities are involved in the pathophysiology of late-life depression (LLD), but the findings are inconsistent and have not been quantitatively reviewed. The aim of the present study was to conduct a meta-analysis that integrated the reported VBM studies, to determine consistent grey matter alterations in individuals with LLD. METHODS A systematic search was conducted to identify VBM studies that compared patients with LLD and healthy controls. We performed a meta-analysis using the effect size signed differential mapping method to quantitatively estimate regional grey matter abnormalities in patients with LLD. RESULTS We included 9 studies with 11 data sets comprising 292 patients with LLD and 278 healthy controls in our meta-analysis. The pooled and subgroup meta-analyses showed robust grey matter reductions in the right lentiform nucleus extending into the parahippocampus, the hippocampus and the amygdala, the bilateral medial frontal gyrus and the right subcallosal gyrus as well as a grey matter increase in the right lingual gyrus. Meta-regression analyses showed that mean age and the percentage of female patients with LLD were not significantly related to grey matter changes. LIMITATIONS The analysis techniques, patient characteristics and clinical variables of the studies included were heterogeneous, and most participants were medicated. CONCLUSION The present meta-analysis is, to our knowledge, the first to overcome previous inconsistencies in the VBM studies of LLD and provide robust evidence for grey matter alterations within fronto-striatal-limbic networks, thereby implicating them in the pathophysiology of LLD. The mean age and the percentage of female patients with LLD did not appear to have a measurable impact on grey matter changes, although we cannot rule out the contributory effects of medication.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Qiyong Gong
- Correspondence to: Q. Gong, Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, PR China;
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Diffusion tensor imaging in Alzheimer's disease and affective disorders. Eur Arch Psychiatry Clin Neurosci 2014; 264:467-83. [PMID: 24595744 DOI: 10.1007/s00406-014-0496-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 02/20/2014] [Indexed: 12/18/2022]
Abstract
The functional organization of the brain in segregated neuronal networks has become a leading paradigm in the study of brain diseases. Diffusion tensor imaging (DTI) allows testing the validity and clinical utility of this paradigm on the structural connectivity level. DTI in Alzheimer's disease (AD) suggests a selective impairment of intracortical projecting fiber tracts underlying the functional disorganization of neuronal networks supporting memory and other cognitive functions. These findings have already been tested for their utility as clinical markers of AD in large multicenter studies. Affective disorders, including major depressive disorder (MDD) and bipolar disorder (BP), show a high comorbidity with AD in geriatric populations and may even have a pathogenetic overlap with AD. DTI studies in MDD and BP are still limited to small-scale monocenter studies, revealing subtle abnormalities in cortico-subcortial networks associated with affect regulation and reward/aversion control. The clinical utility of these findings remains to be further explored. The present paper presents the methodological background of diffusion imaging, including DTI and diffusion spectrum imaging, and discusses key findings in AD and affective disorders. The results of our review strongly point toward the necessity of large-scale multicenter multimodal transnosological networks to study the structural and functional basis of neuronal disconnection underlying different neuropsychiatric diseases.
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Shu H, Yuan Y, Xie C, Bai F, You J, Li L, Li SJ, Zhang Z. Imbalanced hippocampal functional networks associated with remitted geriatric depression and apolipoprotein E ε4 allele in nondemented elderly: a preliminary study. J Affect Disord 2014; 164:5-13. [PMID: 24856546 PMCID: PMC4460794 DOI: 10.1016/j.jad.2014.03.048] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 03/26/2014] [Accepted: 03/26/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Apolipoprotein E (APOE) ε4 allele and a history of geriatric depression are confirmed risk factors of Alzheimer׳s disease (AD). Coexistence of both factors could notably enhance the risk of cognitive impairment in nondemented elderly. However, neural basis of the association remains unclear. METHODS Thirty-one remitted geriatric depression (RGD) patients and 29 cognitively normal subjects were recruited and underwent resting-state functional MRI scans. They were further divided into four groups according to their APOE genotypes. Hippocampal seed-based network analysis and two-way factorial analysis of covariance were employed to detect the main effects and interactive effects of RGD and APOE ε4 allele on the hippocampal functional connectivity (HFC) networks. Partial correlation analysis was applied to examine the cognitive significance of these altered HFC networks. RESULTS The HFC networks of RGD patients were decreased in the dorsal frontal and increased in the right temporal-occipital regions. For APOE ε4 carriers, the HFC networks were reduced primarily in medial prefrontal regions and enhanced in the bilateral insula. Additionally, when both factors coexisted, the left HFC network was significantly disrupted in the dorsal anterior cingulate cortex and increased in somatomotor and occipital regions. Importantly, the extent of network alterations was linked to inferior cognitive performances in RGD patients and APOE ε4 carriers. LIMITATIONS The small sample size may limit the generalizability of our findings. CONCLUSIONS RGD and APOE ε4 allele, and their interaction, are associated with the imbalanced HFC network, which may contribute to cognitive deterioration for subjects with a high risk of AD.
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Affiliation(s)
- Hao Shu
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, China,Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Yonggui Yuan
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, China
| | - Chunming Xie
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, China
| | - Feng Bai
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, China
| | - Jiayong You
- Department of Psychiatry, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Lingjiang Li
- Mental Health Institute, Second Xiangya Hospital of Central South University, Changsha, China
| | - Shi-Jiang Li
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Zhijun Zhang
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, China.
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Ugwu ID, Amico F, Carballedo A, Fagan AJ, Frodl T. Childhood adversity, depression, age and gender effects on white matter microstructure: a DTI study. Brain Struct Funct 2014; 220:1997-2009. [PMID: 24744150 DOI: 10.1007/s00429-014-0769-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 04/01/2014] [Indexed: 11/26/2022]
Abstract
Previous diffusion tensor imaging (DTI) studies have shown that various factors can affect white matter (WM) tract diffusivity. The aim of the present study was to investigate the effects of childhood adversity (CA), age and gender on WM diffusivity in tracts that are thought to be involved in emotional regulation in individuals with major depressive disorder (MDD) and healthy controls (HC). DTI was obtained from 46 subjects with MDD and 46 HC subjects. Data were pre-processed and deterministic tractography was applied in the cingulum, uncinate fasciculus (UF), fornix, superior longitudinal fasciculus (SLF) and fronto-occipital fasciculus (FOF). In subjects with a history of CA, fractional anisotropy (FA) was greater in the rostral cingulum (RC) and dorsal cingulum, whereas radial diffusivity (RD) was smaller in the RC when compared with subjects with no history of CA. In the UF, FOF and parahippocampal cingulum, FA was greater in the left hemisphere in the subjects with CA when compared with those without CA. Age affected FA, longitudinal diffusivity and RD in the UF, fornix, FOF and SLF, reflecting axonal and myelin degeneration with increasing age. Depression or gender did not have any effects on the diffusivity measures. Due to the cross-sectional nature of the study, a recall bias for CA and possible effects of medical treatment on diffusivity measures could have played a role. CA and age could increase the likelihood to develop WM microstructural anomalies in the brain affective network. Moreover, subjects with CA could be more vulnerable to FA changes.
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Affiliation(s)
- Izuchukwu D Ugwu
- Adelaide and Meath Hospital Incorporating the National Children's Hospital, Tallaght, Dublin 24, Dublin, Ireland
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Li W, Muftuler LT, Chen G, Ward BD, Budde MD, Jones JL, Franczak MB, Antuono PG, Li SJ, Goveas JS. Effects of the coexistence of late-life depression and mild cognitive impairment on white matter microstructure. J Neurol Sci 2014; 338:46-56. [PMID: 24387897 PMCID: PMC4428544 DOI: 10.1016/j.jns.2013.12.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 12/04/2013] [Accepted: 12/09/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE Late-life depression (LLD) and amnestic mild cognitive impairment (aMCI) are associated with white matter (WM) disruptions of the fronto-limbic and interhemispheric tracts implicated in mood regulation and episodic memory functions. This work investigates the extent of these WM abnormalities in patients LLD and aMCI when these diseases occur alone and when they coexist. MATERIALS AND METHODS Eighty-four subjects separated into cognitively normal (n=33), LLD (n=20), aMCI (n=18), and comorbid aMCI and LLD (n=13) completed Diffusion Tensor Imaging (DTI) scans. Tract-based spatial statistics was employed to skeletonize multiple DTI indices of the cingulum, corpus callosum, fornix and uncinate fasciculus. Analysis of covariance and post-hoc tests compared group differences. Multiple linear regressions were performed between DTI and behavioral measures for the whole sample and within individual patient groups. RESULTS Divergent microstructural disruptions were identified in LLD- and aMCI-only groups, whereas the comorbid group showed widespread abnormalities especially in the hippocampal cingulum and fornix tracts. The LLD groups also showed significant disruptions in the uncinate fasciculus and corpus callosal tracts. Higher depressive symptom and lower episodic memory scores were associated with increased diffusivity measures in the fornix and hippocampal cingulum across all subjects. CONCLUSIONS Widespread WM microstructural disruptions are present when LLD and aMCI are comorbid -especially in the medial temporal lobe tracts. These WM disruptions may be a marker of disease severity. Also, multiple DTI parameters should be used when evaluating the WM fiber integrity in LLD and aMCI.
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Affiliation(s)
- Wenjun Li
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - L Tugan Muftuler
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Gang Chen
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - B Douglas Ward
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Matthew D Budde
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Jennifer L Jones
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
| | | | - Piero G Antuono
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Shi-Jiang Li
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Joseph S Goveas
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
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Smolker HR, Depue BE, Reineberg AE, Orr JM, Banich MT. Individual differences in regional prefrontal gray matter morphometry and fractional anisotropy are associated with different constructs of executive function. Brain Struct Funct 2014; 220:1291-306. [PMID: 24562372 DOI: 10.1007/s00429-014-0723-y] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 01/29/2014] [Indexed: 12/30/2022]
Abstract
Although the relationship between structural differences within the prefrontal cortex (PFC) and executive function (EF) has been widely explored in cognitively impaired populations, little is known about this relationship in healthy young adults. Using optimized voxel-based morphometry (VBM), surface-based morphometry (SBM), and fractional anisotropy (FA) we determined the association between regional PFC grey matter (GM) morphometry and white matter tract diffusivity with performance on tasks that tap different aspects of EF as drawn from Miyake et al.'s three-factor model of EF. Reductions in both GM volume (VBM) and cortical folding (SBM) in the ventromedial PFC (vmPFC), ventrolateral PFC (vlPFC), and dorsolateral PFC (dlPFC) predicted better common EF, shifting-specific, and updating-specific performance, respectively. Despite capturing different components of GM morphometry, voxel- and surface-based findings were highly related, exhibiting regionally overlapping relationships with EF. Increased white matter FA in fiber tracts that connect the vmPFC and vlPFC with posterior regions of the brain also predicted better common EF and shifting-specific performance, respectively. These results suggest that the neural mechanisms supporting distinct aspects of EF may differentially rely on distinct regions of the PFC, and at least in healthy young adults, are influenced by regional morphometry of the PFC and the FA of major white matter tracts that connect the PFC with posterior cortical and subcortical regions.
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Affiliation(s)
- H R Smolker
- The Institute of Cognitive Science, University of Colorado, Boulder, USA
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Oertel-Knöchel V, Reinke B, Alves G, Jurcoane A, Wenzler S, Prvulovic D, Linden D, Knöchel C. Frontal white matter alterations are associated with executive cognitive function in euthymic bipolar patients. J Affect Disord 2014; 155:223-33. [PMID: 24295601 DOI: 10.1016/j.jad.2013.11.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/06/2013] [Accepted: 11/07/2013] [Indexed: 01/07/2023]
Abstract
BACKGROUND Bipolar affective disorder (BD) is often associated with cognitive dysfunction in executive domains. However the biological underpinnings of cognitive deficits in BD are not sufficiently understood. A growing body of evidence indicates a loss of microstructural integrity in various white matter (WM) fiber tracts in BD. The aim of the current study was to assess potential links between WM structural abnormalities and cognitive performance in euthymic middle-aged BD patients (n=30) and matched healthy controls (n=32). METHODS Diffusion tensor imaging (DTI) data was carried out with both voxelwise (tract based spatial statistics, TBSS) and region-of-interest (ROI) based analysis. We compared multiple indices of diffusion including fractional anisotropy (FA), radial (DR), axial (DA) and mean diffusivities (MD). RESULTS Increased mean diffusivity was found in the fornix, anterior thalamic radiation, splenium and the truncus of the corpus callosum in BD patients compared with controls. These diffusion changes were significantly associated with poorer performance in executive tasks in BD patients. CONCLUSIONS Our results indicate a direct link between executive cognitive functioning and abnormal WM microstructural integrity of fronto-limbic tracts in remitted BD patients, and add evidence to the neuronal disruption that underlies the residual symptomatology of BD.
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Affiliation(s)
- Viola Oertel-Knöchel
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main 60528, Germany.
| | - Britta Reinke
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main 60528, Germany
| | - Gilberto Alves
- Center for Alzheimer's Disease and Related Disorders, Universidade Federal, do Rio de Janeiro, Brazil
| | - Alina Jurcoane
- Institute for Neuroradiology, Goethe University, Frankfurt/Main, Germany; Center for Individual Development and Adaptive Education of Children at Risk, Frankfurt, Germany
| | - Sofia Wenzler
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main 60528, Germany
| | - David Prvulovic
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main 60528, Germany
| | - David Linden
- MRC Centre for Neuropsychiatric Genetics & Genomics, Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, CF, United Kingdom
| | - Christian Knöchel
- Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main 60528, Germany
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Lebedev AV, Beyer MK, Fritze F, Westman E, Ballard C, Aarsland D. Cortical changes associated with depression and antidepressant use in Alzheimer and Lewy body dementia: an MRI surface-based morphometric study. Am J Geriatr Psychiatry 2014; 22:4-13.e1. [PMID: 23880336 DOI: 10.1016/j.jagp.2013.02.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Revised: 10/19/2012] [Accepted: 12/10/2012] [Indexed: 11/29/2022]
Abstract
CONTEXT Depression is common in dementia, especially in the early stages, with important clinical implications, but the etiology is unknown and most likely heterogeneous. Antidepressant use in the elderly without dementia has previously been shown to be associated with high risks of adverse events and with structural brain alterations. OBJECTIVE To investigate cortical changes associated with depression and antidepressant use in patients with mild Alzheimer's disease (AD) and Lewy body dementia (LBD). METHODS 74 subjects with mild AD and LBD from geriatric and psychiatry outpatient clinics in Western Norway were included. The Montgomery-Asberg Depression Rating Scale (MADRS) was used to assess depression. Automatic preprocessing using Freesurfer included steps for white and grey matter surface reconstruction. The resulting cortical thickness was analyzed using linear modeling. RESULTS Clusters of depression-associated thinning were found in prefrontal and temporal areas. Treatment-associated thinning was observed in the parahippocampal region and was significant even after correction for age, sex, AD/LBD diagnosis, and MADRS scores. CONCLUSION Depression in mild AD and LBD is associated with cortical thinning in prefrontal and temporal areas. The findings suggest that depressive symptoms in mild dementia could develop due to neurodegeneration in the same neural circuits that are critical for depression across different brain disorders. Antidepressant use in patients with mild AD and LBD is associated with parahippocampal thinning. Taken together with low efficacy of antidepressants in cognitively impaired patients and high risks of adverse events, our results suggest a need to re-evaluate the treatment approaches for depression and the role of antidepressants in patients with dementia.
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Affiliation(s)
- Alexander V Lebedev
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.
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Morimoto SS, Alexopoulos GS. Cognitive deficits in geriatric depression: clinical correlates and implications for current and future treatment. Psychiatr Clin North Am 2013; 36:517-31. [PMID: 24229654 PMCID: PMC3830452 DOI: 10.1016/j.psc.2013.08.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The purpose of this article is to identify the cognitive deficits commonly associated with geriatric depression and describe their clinical significance. The complex relationship between geriatric depression and dementia is summarized and possible shared mechanisms discussed. Evidence regarding whether the cognitive deficits in depression may be mitigated with medication or with computerized cognitive remediation is presented.
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Affiliation(s)
- Sarah Shizuko Morimoto
- Department of Psychiatry, Institute of Geriatric Psychiatry, Weill Cornell Medical College, 21 Bloomingdale Road, White Plains, NY 10605, USA.
| | - George S. Alexopoulos
- Stephen P. Tobin and Dr. Arnold M. Cooper Professor of Psychiatry, Weill Cornell Medical College, White Plains, NY
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Buchanan BG, Rossell SL, Maller JJ, Toh WL, Brennan S, Castle DJ. Brain connectivity in body dysmorphic disorder compared with controls: a diffusion tensor imaging study. Psychol Med 2013; 43:2513-2521. [PMID: 23473554 DOI: 10.1017/s0033291713000421] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Several neuroimaging studies have investigated brain grey matter in people with body dysmorphic disorder (BDD), showing possible abnormalities in the limbic system, orbitofrontal cortex, caudate nuclei and temporal lobes. This study takes these findings forward by investigating white matter properties in BDD compared with controls using diffusion tensor imaging. It was hypothesized that the BDD sample would have widespread significantly reduced white matter connectivity as characterized by fractional anisotropy (FA). METHOD A total of 20 participants with BDD and 20 healthy controls matched on age, gender and handedness underwent diffusion tensor imaging. FA, a measure of water diffusion within a voxel, was compared between groups on a voxel-by-voxel basis across the brain using tract-based spatial statistics within the FSL package. RESULTS Results showed that, compared with healthy controls, BDD patients demonstrated significantly lower FA (p < 0.05) in most major white matter tracts throughout the brain, including in the superior longitudinal fasciculus, inferior fronto-occipital fasciculus and corpus callosum. Lower FA levels could be accounted for by increased radial diffusivity as characterized by eigenvalues 2 and 3. No area of higher FA was found in BDD. CONCLUSIONS This study provided the first evidence of compromised white matter integrity within BDD patients. This suggests that there are inefficient connections between different brain areas, which may explain the cognitive and emotion regulation deficits within BDD patients.
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Affiliation(s)
- B G Buchanan
- Monash Alfred Psychiatry Research Centre, School of Psychology and Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia
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Wolf D, Zschutschke L, Scheurich A, Schmitz F, Lieb K, Tüscher O, Fellgiebel A. Age-related increases in Stroop interference: delineation of general slowing based on behavioral and white matter analyses. Hum Brain Mapp 2013; 35:2448-58. [PMID: 24038539 DOI: 10.1002/hbm.22340] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 05/16/2013] [Accepted: 05/19/2013] [Indexed: 11/09/2022] Open
Abstract
The Stroop interference task is a widely used paradigm to examine cognitive inhibition, which is a key component of goal-directed behavior. With increasing age, reaction times in the Stroop interference task are usually slowed. However, to date it is still under debate if age-related increases in reaction times are merely an artifact of general slowing. The current study was conducted to investigate the role of general slowing, as measured by Trail-Making-Test-A, in age-related alterations of Stroop interference. We applied Diffusion Tensor Imaging (DTI) to determine the topography of neuronal networks underlying Stroop interference under control of general slowing. On the behavioral level, linear regression analysis demonstrated that age accounted for significant variance on Stroop interference, whereas TMT-A performance did not. Controlling for TMT-A, DTI based white matter analyses demonstrated a strong association of Stroop interference with integrity measures of genu of corpus callosum, bilateral anterior corona radiata, and bilateral anterior limb of capsula interna. These pathways are associated with frontal brain regions by either connecting the bilateral dorsolateral prefrontal cortex or the anterior cingulate cortex with frontal and subcortical regions or by containing fibers which are part of cortico-thalamic circuits that cross prefrontal regions. Importantly, results expand our knowledge of the neural basis of Stroop interference and emphasize the importance of white matter integrity of frontal pathways in the modulation of Stroop interference. Combining behavioral and DTI findings our results further suggest that cognitive inhibition, as measured by Stroop task, is a qualitatively distinct cognitive process that declines with age.
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Affiliation(s)
- Dominik Wolf
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
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Noble KG, Korgaonkar MS, Grieve SM, Brickman AM. Higher education is an age-independent predictor of white matter integrity and cognitive control in late adolescence. Dev Sci 2013; 16:653-64. [PMID: 24033571 PMCID: PMC3775010 DOI: 10.1111/desc.12077] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 04/11/2013] [Indexed: 11/28/2022]
Abstract
Socioeconomic status is an important predictor of cognitive development and academic achievement. Late adolescence provides a unique opportunity to study how the attainment of socioeconomic status (in the form of years of education) relates to cognitive and neural development, during a time when age-related cognitive and neural development is ongoing. During late adolescence it is possible to disambiguate age- and education-related effects on the development of these processes. Here we assessed the degree to which higher educational attainment was related to performance on a cognitive control task, controlling for age. We then used diffusion tensor imaging (DTI) to assess the degree to which white matter microstructure might mediate this relationship. When covarying age, significant associations were found between educational attainment and fractional anisotropy (FA) in the superior longitudinal fasciculus (SLF) and cingulum bundle (CB). Further, when covarying age, FA in these regions was associated with cognitive control. Finally, mediation analyses revealed that the age-independent association between educational attainment and cognitive control was completely accounted for by FA in these regions. The uncinate fasciculus, a late-myelinated control region not implicated in cognitive control, did not mediate this effect.
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Affiliation(s)
- Kimberly G Noble
- Department of Pediatrics, College of Physicians and Surgeons, Columbia University, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, USA
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Taylor WD, Aizenstein HJ, Alexopoulos GS. The vascular depression hypothesis: mechanisms linking vascular disease with depression. Mol Psychiatry 2013; 18:963-74. [PMID: 23439482 PMCID: PMC3674224 DOI: 10.1038/mp.2013.20] [Citation(s) in RCA: 551] [Impact Index Per Article: 50.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 01/09/2013] [Accepted: 01/18/2013] [Indexed: 02/07/2023]
Abstract
The 'Vascular Depression' hypothesis posits that cerebrovascular disease may predispose, precipitate or perpetuate some geriatric depressive syndromes. This hypothesis stimulated much research that has improved our understanding of the complex relationships between late-life depression (LLD), vascular risk factors, and cognition. Succinctly, there are well-established relationships between LLD, vascular risk factors and cerebral hyperintensities, the radiological hallmark of vascular depression. Cognitive dysfunction is common in LLD, particularly executive dysfunction, a finding predictive of poor antidepressant response. Over time, progression of hyperintensities and cognitive deficits predicts a poor course of depression and may reflect underlying worsening of vascular disease. This work laid the foundation for examining the mechanisms by which vascular disease influences brain circuits and influences the development and course of depression. We review data testing the vascular depression hypothesis with a focus on identifying potential underlying vascular mechanisms. We propose a disconnection hypothesis, wherein focal vascular damage and white matter lesion location is a crucial factor, influencing neural connectivity that contributes to clinical symptomatology. We also propose inflammatory and hypoperfusion hypotheses, concepts that link underlying vascular processes with adverse effects on brain function that influence the development of depression. Testing such hypotheses will not only inform the relationship between vascular disease and depression, but also provide guidance on the potential repurposing of pharmacological agents that may improve LLD outcomes.
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Affiliation(s)
- W D Taylor
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University, Nashville, TN 37212, USA.
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Osoba A, Hänggi J, Li M, Horn DI, Metzger C, Eckert U, Kaufmann J, Zierhut K, Steiner J, Schiltz K, Heinze HJ, Bogerts B, Walter M. Disease severity is correlated to tract specific changes of fractional anisotropy in MD and CM thalamus--a DTI study in major depressive disorder. J Affect Disord 2013; 149:116-28. [PMID: 23489404 DOI: 10.1016/j.jad.2012.12.026] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 12/06/2012] [Accepted: 12/30/2012] [Indexed: 12/29/2022]
Abstract
BACKGROUND Depression is commonly conceptualized as corticolimbic dysregulation. Due to insufficient studies in normal aged populations especially subcortical sources of disconnection are unclear in contrast to potentially general parietal white matter (WM) deficits. This may be due to important influences of variable patient characteristics, most importantly episode severity. Especially thalamic disconnections have been functionally revealed, however, their structural correlates have not been distinctly investigated for its highly diverse subnuclei. METHODS We compared 20 major depressive disorder (MDD) patients with mixed Hamilton depression rating scale (HAMD) severity to matched controls in fractional anisotropy (FA) derived from diffusion tensor imaging (DTI). Robust acquisition of 4 repetitions restricted to twelve directions, also to match the same parameters used by Eckert et al. (2011) who described a preferential architecture of centromedian (CM) and mediodorsal (MD) thalamic connections. Second to whole brain analysis, we tested for group differences within the preferred structural network of these two nuclei using a tract of interest (TOI) approach. RESULTS Significant FA deficits in a whole brain analysis were only found in right parietal WM (p<0.05, corrected). Effects of severity were found for increasing thalamic FA. Post hoc analysis revealed this effect to be restricted to CM specific tracts. In contrast, we found MD to dorsolateral prefrontal cortex (DLPFC) tracts to be decreased in FA. Unspecific decreases between MD and CM towards amygdala were paralleled by primary amygdala FA reductions. LIMITATIONS Specificity of the TOI approach and heterogenous sample. CONCLUSIONS Robust parietal FA reductions, controlled for age effects were found in MDD. Further we revealed subcortical disease state dependency of FA in thalamic tracts, specific to predescribed preferential connections.
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Affiliation(s)
- Annemarie Osoba
- Department of Psychiatry, Otto-von-Guericke University, Magdeburg, Germany.
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Tanaka M, Ishii A, Yamano E, Ogikubo H, Okazaki M, Kamimura K, Konishi Y, Emoto S, Watanabe Y. Cognitive dysfunction in elderly females with depressive symptoms. Med Sci Monit 2013. [PMID: 23197231 PMCID: PMC3560791 DOI: 10.12659/msm.883596] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background A depressive state is a common symptom in the elderly and often accompanies cognitive impairment. The coexistence of depressive symptoms and cognitive impairment is a serious problem, as it increases adverse outcomes for health, functional status, and mortality. It would thus be of great value to clarify the cognitive dysfunction associated with depressive symptoms. We aimed to identify the cognitive dysfunction, in particular, impairment of the response inhibition component of executive function, associated with depressive symptoms in elderly females using the Simple Color Reaction Test and Modified Stroop Color-Word Test. Material/Methods The study group consisted of 35 elderly women. They performed cognitive function task trials for 9 min. Univariate logistic regression analyses were performed to identify factors associated with the prevalence of the depressive state. Results Longer reaction time and lower correction rate of response inhibition trials were related to the prevalence of the depressive symptoms. Conclusions Impaired function of response inhibition may be a specific feature of the depressive state. Our findings may help clarify the neural mechanisms underlying the depressive state of elderly females.
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Affiliation(s)
- Masaaki Tanaka
- Department of Physiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
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Neural correlates of successful response inhibition in unmedicated patients with late-life depression. Am J Geriatr Psychiatry 2012; 20:1057-69. [PMID: 21997605 DOI: 10.1097/jgp.0b013e318235b728] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Accumulating evidence implicates a strong association between abnormal frontostriatal-limbic brain circuits, executive dysfunction, and late-life depression (LLD). The stop signal task (SST) was designed by Rubia et al. for use with functional magnetic resonance imaging (fMRI) to identify the neural correlates of motor response inhibition, a well-characterized executive function. In this study, we compared brain activation between a group of unmedicated participants with LLD and an unmedicated healthy cohort during SST performance. METHODS Participants 55-85 years of age were screened, clinically evaluated, and entered into either the LLD (n = 15) or healthy comparison group (n = 13). Both groups underwent neuroimaging while performing the SST under similar conditions. The brain circuitry of successful motor inhibition was evaluated by contrasting the condition of correctly inhibiting responses with the condition of correctly responding to Go signals. Differential areas of brain activation between the LLD and comparison groups were determined with FMRIB Software Library. RESULTS Despite comparable SST performance measures, LLD participants demonstrated greater blood oxygen level dependent activation relative to the comparison group in predominantly left-lateralized frontostriatal-limbic circuitry that included the bilateral superior frontal cortices and left-hemispheric orbitofrontal gyri, insular cortex, cingulate cortex, caudate, and putamen. Conversely, the healthy comparison group did not exhibit any areas of greater activation than the LLD group. CONCLUSION Unmedicated participants with LLD activate additional areas within frontostriatal-limbic brain circuitry when performing the SST at a level comparable to a healthy cohort.
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Morimoto SS, Wexler BE, Alexopoulos GS. Neuroplasticity-based computerized cognitive remediation for geriatric depression. Int J Geriatr Psychiatry 2012; 27:1239-47. [PMID: 22451346 PMCID: PMC3387346 DOI: 10.1002/gps.3776] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 12/21/2011] [Accepted: 01/05/2012] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This article describes a novel treatment model designed to target specific neurocognitive deficits in geriatric depression with neuroplasticity-based computerized cognitive remediation (NBCCR). METHOD The recent National Institute of Mental Health (NIMH) report "From Discovery to Cure" calls for studies focusing on mechanisms of treatment response with the goal of arriving at new interventions for those who do not respond to existing treatments. We describe the process that led to the identification of specific executive deficits and their underlying neurobiology, as well as the rationale for targeting these symptoms as a part of a strategy intended to improve both executive dysfunction and depression. We then propose a strategy for further research in this emerging area. RESULTS AND CONCLUSIONS Despite significant developments, conventional antidepressant treatments leave many older adults still depressed and suffering. Psychotherapy may be effective in some depressed elders, although a recent review concluded that none of the available treatment studies meets stringent criteria for efficacy in the acute treatment of geriatric depression. Appropriately developed and targeted NBCCR, has the potential to serve as a novel treatment intervention for geriatric depression. Pathophysiological changes associated with executive dysfunction may be an appropriate target for NBCCR. Examining both behavioral changes and indices of structural integrity and functional change of networks related to cognitive and emotional regulation may lead to a novel treatment and elucidate the role of specific cerebral networks in geriatric depression.
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Affiliation(s)
- Sarah Shizuko Morimoto
- Department of Psychiatry, Institute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, NY, USA.
| | - Bruce E. Wexler
- Yale Medical School, Department of Psychiatry, New Haven, CT
| | - George S. Alexopoulos
- Weill Cornell Medical College, Department of Psychiatry, Institute of Geriatric Psychiatry, White Plains, NY
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