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Wang L, Ma Q, Sun X, Xu Z, Zhang J, Liao X, Wang X, Wei D, Chen Y, Liu B, Huang CC, Zheng Y, Wu Y, Chen T, Cheng Y, Xu X, Gong Q, Si T, Qiu S, Lin CP, Cheng J, Tang Y, Wang F, Qiu J, Xie P, Li L, He Y, Xia M, Zhang Y, Li L, Cheng J, Gong Q, Li L, Lin CP, Qiu J, Qiu S, Si T, Tang Y, Wang F, Xie P, Xu X, Xia M. Frequency-resolved connectome alterations in major depressive disorder: A multisite resting fMRI study. J Affect Disord 2023; 328:47-57. [PMID: 36781144 DOI: 10.1016/j.jad.2023.01.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND Functional connectome studies have revealed widespread connectivity alterations in major depressive disorder (MDD). However, the low frequency bandpass filtering (0.01-0.08 Hz or 0.01-0.1 Hz) in most studies have impeded our understanding on whether and how these alterations are affected by frequency of interest. METHODS Here, we performed frequency-resolved (0.01-0.06 Hz, 0.06-0.16 Hz and 0.16-0.24 Hz) connectome analyses using a large-sample resting-state functional MRI dataset of 1002 MDD patients and 924 healthy controls from seven independent centers. RESULTS We reported significant frequency-dependent connectome alterations in MDD in left inferior parietal, inferior temporal, precentral, and fusiform cortices and bilateral precuneus. These frequency-dependent connectome alterations are mainly derived by abnormalities of medium- and long-distance connections and are brain network-dependent. Moreover, the connectome alteration of left precuneus in high frequency band (0.16-0.24 Hz) is significantly associated with illness duration. LIMITATIONS Multisite harmonization model only removed linear site effects. Neurobiological underpinning of alterations in higher frequency (0.16-0.24 Hz) should be further examined by combining fMRI data with respiration, heartbeat and blood flow recordings in future studies. CONCLUSIONS These results highlight the frequency-dependency of connectome alterations in MDD and the benefit of examining connectome alteration in MDD under a wider frequency band.
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Affiliation(s)
- Lei Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Qing Ma
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China; MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Xiaoyi Sun
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; School of Systems Science, Beijing Normal University, Beijing, China
| | - Zhilei Xu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Jiaying Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xuhong Liao
- School of Systems Science, Beijing Normal University, Beijing, China
| | - Xiaoqin Wang
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China
| | - Dongtao Wei
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China
| | - Yuan Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bangshan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Chu-Chung Huang
- Shanghai Key Laboratory of Brain Functional Genomics (Ministry of Education), Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Yanting Zheng
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yankun Wu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Taolin Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Tianmei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Shijun Qiu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ching-Po Lin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK; Institute of Neuroscience, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China; Department of Psychology, Southwest University, Chongqing, China
| | - Peng Xie
- Chongqing Key Laboratory of Neurobiology, Chongqing, China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lingjiang Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; Mental Health Institute of Central South University, China National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Yong He
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; Chinese Institute for Brain Research, Beijing, China
| | | | - Mingrui Xia
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
| | - Yihe Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
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Smith GS, Kuwabara H, Gould NF, Nassery N, Savonenko A, Joo JH, Bigos KL, Kraut M, Brasic J, Holt DP, Hall AW, Mathews WB, Dannals RF, Nandi A, Workman CI. Molecular imaging of the serotonin transporter availability and occupancy by antidepressant treatment in late-life depression. Neuropharmacology 2021; 194:108447. [PMID: 33450276 PMCID: PMC8716112 DOI: 10.1016/j.neuropharm.2021.108447] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/04/2020] [Accepted: 12/30/2020] [Indexed: 12/17/2022]
Abstract
Patients with late-life depression (LLD) have a more variable response to pharmacotherapy relative to patients with mid-life depression. Degeneration of the serotonergic system and lower occupancy of the initial target for antidepressant medications, the serotonin transporter (5-HTT), may contribute to variability in treatment response. The focus of this study was to test the hypotheses that lower cortical and limbic serotonin transporter (5-HTT) availability in LLD patients relative to controls and less 5-HTT occupancy by antidepressant medications would be associated with less improvement in mood and cognition with treatment in LLD patients. Twenty LLD patients meeting DSM-IV criteria for a current major depressive episode and 20 non-depressed controls underwent clinical and neuropsychological assessments, magnetic resonance imaging to measure gray matter volumes and high-resolution positron emission tomography (PET) scanning to measure 5-HTT before and after 10-12 weeks of treatment with Citalopram or Sertraline (patients only). Prior to treatment, 5-HTT was lower in LLD patients relative to controls in mainly temporal cortical and limbic (amygdala and hippocampus) regions. Gray matter volumes were not significantly different between groups. 5-HTT occupancy was detected throughout cortical, striatal, thalamic and limbic regions. The magnitude of regional 5-HTT occupancy by antidepressants was 70% or greater across cortical and sub-cortical regions, consistent with the magnitude of 5-HTT occupancy observed in mid-life depressed patients. Greater regional 5-HTT occupancy correlated with greater improvement in depressive symptoms and visual-spatial memory performance. These data support the hypothesis that serotonin degeneration and variability in 5-HTT occupancy may contribute to heterogeneity in treatment response in LLD patients.
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Affiliation(s)
- Gwenn S Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Hiroto Kuwabara
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Neda F Gould
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Najilla Nassery
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alena Savonenko
- Department of Pathology (Neuropathology), Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jin Hui Joo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kristin L Bigos
- Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Kraut
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James Brasic
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel P Holt
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew W Hall
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - William B Mathews
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert F Dannals
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ayon Nandi
- Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clifford I Workman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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3
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Ding YD, Yang R, Yan CG, Chen X, Bai TJ, Bo QJ, Chen GM, Chen NX, Chen TL, Chen W, Cheng C, Cheng YQ, Cui XL, Duan J, Fang YR, Gong QY, Hou ZH, Hu L, Kuang L, Li F, Li T, Liu YS, Liu ZN, Long YC, Luo QH, Meng HQ, Peng DH, Qiu HT, Qiu J, Shen YD, Shi YS, Tang Y, Wang CY, Wang F, Wang K, Wang L, Wang X, Wang Y, Wu XP, Wu XR, Xie CM, Xie GR, Xie HY, Xie P, Xu XF, Yang H, Yang J, Yao JS, Yao SQ, Yin YY, Yuan YG, Zhang AX, Zhang H, Zhang KR, Zhang L, Zhang ZJ, Zhou RB, Zhou YT, Zhu JJ, Zou CJ, Si TM, Zang YF, Zhao JP, Guo WB. Disrupted hemispheric connectivity specialization in patients with major depressive disorder: Evidence from the REST-meta-MDD Project. J Affect Disord 2021; 284:217-228. [PMID: 33609956 DOI: 10.1016/j.jad.2021.02.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/18/2021] [Accepted: 02/07/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Functional specialization is a feature of human brain for understanding the pathophysiology of major depressive disorder (MDD). The degree of human specialization refers to within and cross hemispheric interactions. However, most previous studies only focused on interhemispheric connectivity in MDD, and the results varied across studies. Hence, brain functional connectivity asymmetry in MDD should be further studied. METHODS Resting-state fMRI data of 753 patients with MDD and 451 healthy controls were provided by REST-meta-MDD Project. Twenty-five project contributors preprocessed their data locally with the Data Processing Assistant State fMRI software and shared final indices. The parameter of asymmetry (PAS), a novel voxel-based whole-brain quantitative measure that reflects inter- and intrahemispheric asymmetry, was reported. We also examined the effects of age, sex and clinical variables (including symptom severity, illness duration and three depressive phenotypes). RESULTS Compared with healthy controls, patients with MDD showed increased PAS scores (decreased hemispheric specialization) in most of the areas of default mode network, control network, attention network and some regions in the cerebellum and visual cortex. Demographic characteristics and clinical variables have significant effects on these abnormalities. LIMITATIONS Although a large sample size could improve statistical power, future independent efforts are needed to confirm our results. CONCLUSIONS Our results highlight the idea that many brain networks contribute to broad clinical pathophysiology of MDD, and indicate that a lateralized, efficient and economical brain information processing system is disrupted in MDD. These findings may help comprehensively clarify the pathophysiology of MDD in a new hemispheric specialization perspective.
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Key Words
- DLPFC, Dorsolateral prefrontal cortex
- DMN, Default mode network
- DPARSF, Data Processing Assistant for Resting-State fMRI
- DSM, Diagnosic and Statistical Manual of Mental Disorders
- EEG, Electroencephalographic
- FC, Functional connectivity
- FDR, False discovery rate
- FEDN, First-episode, drug-naive
- FEF, Frontal eye fields
- HAMD, Hamilton Depression Rating Scale
- HC, Healthy control
- IFG, Inferior frontal gyrus
- IPL, Inferior parietal lobule
- IPS/SPL, Intraparietal sulcus/superior parietal lobule
- LMM, Linear mixed model
- MDD, Major depressive disorder
- MFG, Middle frontal gyrus
- MTG, Middle temporal gyrus
- Major depressive disorder
- PAS, Parameter of asymmetry
- PCC, Posterior cingulate cortex
- PET, Positron emission tomography
- ROIs, Regions of interest
- STS, Superior temporal sulcus
- VMHC, Voxel-mirrored homotopic connectivity
- fMRI Abbreviations ACC, Anterior cingulate gyrus
- fMRI, Functional magnetic resonance imaging
- hemispheric asymmetry
- parameter of asymmetry
- rTMS, repetitive transcranial magnetic stimulation
- rs-fMRI, Resting-state fMRI
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Affiliation(s)
- Yu-Dan Ding
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University. Changsha, Hunan 410011, China
| | - Ru Yang
- Department of Radiology, The Second Xiangya Hospital of Central South University. Changsha, Hunan 410011, China
| | - Chao-Gan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China; Magnetic Resonance Imaging Research Center and Research Center for Lifespan Development of Mind and Brain (CLIMB), Institute of Psychology, Chinese Academy of Sciences, Beijing, China; International Big-Data Center for Depression Research, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Xiao Chen
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | | | - Qi-Jing Bo
- Beijing Anding Hospital, Capital Medical University, Beijing 100054, China
| | - Guan-Mao Chen
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Ning-Xuan Chen
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Tao-Lin Chen
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Psychoradiology Research Unit of Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei Chen
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, China
| | - Chang Cheng
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University. Changsha, Hunan 410011, China
| | - Yu-Qi Cheng
- First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650221, China
| | - Xi-Long Cui
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University. Changsha, Hunan 410011, China
| | - Jia Duan
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Yi-Ru Fang
- Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai 200240, China
| | - Qi-Yong Gong
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Psychoradiology Research Unit of Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Zheng-Hua Hou
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210096, China
| | - Lan Hu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Kuang
- Mental Health Center, West China Hospital, Sichuan University Chengdu, Sichuan, China
| | - Feng Li
- Beijing Anding Hospital, Capital Medical University, Beijing 100054, China
| | - Tao Li
- Mental Health Center, West China Hospital, Sichuan University Chengdu, Sichuan, China
| | - Yan-Song Liu
- Department of Clinical Psychology, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Zhe-Ning Liu
- The Institute of Mental Health, Second Xiangya Hospital of Central South University, Changsha, Hunan 410008, China
| | - Yi-Cheng Long
- Faculty of Psychology, Southwest University, Chongqing 400716, China
| | - Qing-Hua Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hua-Qing Meng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dai-Hui Peng
- Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai 200240, China
| | - Hai-Tang Qiu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiang Qiu
- Faculty of Psychology, Southwest University, Chongqing 400716, China
| | - Yue-Di Shen
- Department of Diagnostics, Affiliated Hospital, Hangzhou Normal University Medical School, Hangzhou, Zhejiang 311121, China
| | - Yu-Shu Shi
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Yanqing Tang
- Beijing Anding Hospital, Capital Medical University, Beijing 100054, China
| | - Chuan-Yue Wang
- Beijing Anding Hospital, Capital Medical University, Beijing 100054, China
| | - Fei Wang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Kai Wang
- Anhui Medical University, Hefei, Anhui, China
| | - Li Wang
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, China; Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing 100191, China
| | - Xiang Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University. Changsha, Hunan 410011, China
| | - Ying Wang
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | | | - Xin-Ran Wu
- Faculty of Psychology, Southwest University, Chongqing 400716, China
| | - Chun-Ming Xie
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, Jiangsu 210009, China
| | - Guang-Rong Xie
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University. Changsha, Hunan 410011, China
| | - Hai-Yan Xie
- Department of Psychiatry, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Peng Xie
- Institute of Neuroscience, Chongqing Medical University, Chongqing 400016, China; Chongqing Key Laboratory of Neurobiology, Chongqing 400016, China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiu-Feng Xu
- First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650221, China
| | - Hong Yang
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Jian Yang
- The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi 710061, China
| | - Jia-Shu Yao
- First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650221, China
| | - Shu-Qiao Yao
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University. Changsha, Hunan 410011, China
| | - Ying-Ying Yin
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210096, China
| | - Yong-Gui Yuan
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210096, China
| | - Ai-Xia Zhang
- The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi 710061, China
| | - Hong Zhang
- Xi'an Central Hospital, Xi'an, Shaanxi, China
| | - Ke-Rang Zhang
- First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030006, China
| | - Lei Zhang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhi-Jun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, Jiangsu 210009, China
| | - Ru-Bai Zhou
- Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai 200240, China
| | - Yi-Ting Zhou
- Mental Health Center, West China Hospital, Sichuan University Chengdu, Sichuan, China
| | - Jun-Juan Zhu
- Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai 200240, China
| | - Chao-Jie Zou
- First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650221, China
| | - Tian-Mei Si
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing 100191, China; Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing 100191, China
| | - Yu-Feng Zang
- Center for Cognition and Brain Disorders, Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, Zhejiang 311121, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang 311121, China
| | - Jing-Ping Zhao
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University. Changsha, Hunan 410011, China
| | - Wen-Bin Guo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University. Changsha, Hunan 410011, China.
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4
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Cheng B, Meng Y, Zuo Y, Guo Y, Wang X, Wang S, Zhang R, Deng W, Guo Y, Ning G. Functional connectivity patterns of the subgenual anterior cingulate cortex in first-episode refractory major depressive disorder. Brain Imaging Behav 2021; 15:2397-2405. [PMID: 33432537 DOI: 10.1007/s11682-020-00436-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2020] [Indexed: 02/05/2023]
Abstract
Although accumulating evidence has been elucidating the neuronal basis of refractory/nonrefractory major depressive disorder (rMDD/nrMDD), the results are inconsistent, and little is known about the distinct neural mechanisms underlying rMDD. Here, we explored the convergent/divergent brain networks between first-episode MDD subtypes using the resting-state functional connectivity (RSFC) approach. In total, 33 healthy controls (HCs), 31 first-episode rMDD patients and 33 first-episode nrMDD patients were enrolled and underwent MRI scanning. The left subgenual anterior cingulate cortex (sgACC) was selected as the seed region, and RSFC was employed to evaluate associations between the seed and other regions in the whole brain. Both MDD subtypes exhibited convergent left sgACC-based neural networks, including increased RSFC with the dorsal prefrontal cortex (DPFC) and decreased RSFC with the bilateral orbitofrontal cortex (OFC) and right parahippocampus. rMDD patients exhibited increased left sgACC-OFC RSFC relative to nrMDD patients, and RSFC with the bilateral OFC in rMDD patients was negatively correlated with HAMD scores. These findings confirmed our speculation that convergent and divergent neural networks exist between rMDD and nrMDD. Cortical-limbic circuits, especially the prefrontal-limbic circuit, may serve as the convergent dysfunctional neural circuitry in MDD subtypes. As an important biomarker, a unique OFC-sgACC circuit abnormality was identified in rMDD patients, which might help elucidate the underlying mechanism regarding treatment responses in rMDD patients.
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Affiliation(s)
- Bochao Cheng
- Department of Radiology, West China Second University Hospital, Sichuan University, South Renmin Road, Chengdu, Sichuan province, People's Republic of China, 610041
| | - Yajing Meng
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Yan Zuo
- Maternity clinic, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yi Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, South Renmin Road, Chengdu, Sichuan province, People's Republic of China, 610041
| | - Xiuli Wang
- Department of Psychiatry, the Fourth People's Hospital of Chengdu, University of Electronic Science and Technology of China, Chengdu, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Ran Zhang
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Deng
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Yingkun Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, South Renmin Road, Chengdu, Sichuan province, People's Republic of China, 610041. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
| | - Gang Ning
- Department of Radiology, West China Second University Hospital, Sichuan University, South Renmin Road, Chengdu, Sichuan province, People's Republic of China, 610041.
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5
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Long Z, Du L, Zhao J, Wu S, Zheng Q, Lei X. Prediction on treatment improvement in depression with resting state connectivity: A coordinate-based meta-analysis. J Affect Disord 2020; 276:62-68. [PMID: 32697717 DOI: 10.1016/j.jad.2020.06.072] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/15/2020] [Accepted: 06/23/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Previous neuroimaging studies revealed abnormal resting-state functional connectivity between distributed brain areas in patients with major depressive disorder. Those abnormalities were normalized after treatment. Moreover, the functional connectivity could predict clinical response to those treatments. However, there has currently been no meta-analysis to verify these findings. METHODS The current study aimed to investigate how the resting-state connectivity patterns predict antidepressant response to various treatments across depressive studies by using coordinate-based meta-analysis named activation likelihood estimation. The relevant articles were obtained by searching on PubMed and Web of Science. RESULTS Following exclusion criteria of inappropriate studies, seventeen papers with 392 individual depressive patients were included. Those articles contained repetitive transcranial magnetic stimulation (rTMS) treatment, pharmacotherapy, cognitive behavioral therapy (CBT), electroconvulsive therapy (ECT) and transcutaneous vagus nerve stimulation in patients with depression. Meta-analysis revealed that clinical response to all treatments could be predicted by baseline default mode network connectivity in patients with depression. The rTMS treatment had larger effect size compared to other treatment strategies. Furthermore, subgroup meta-analysis showed that the baseline connectivity of perigenual anterior cingulate cortex (pgACC) and ventral medial prefrontal cortex could predict symptoms improvement of rTMS treatment. LIMITATIONS More resting-state connectivity studies of CBT and ECT treatment are needed. CONCLUSIONS This study highlighted crucial role of DMN, especially the pgACC, in understanding the underlying treatment mechanism of depression.
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Affiliation(s)
- Zhiliang Long
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, PR China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, PR China.
| | - Lian Du
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Jia Zhao
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, PR China
| | - Shiyang Wu
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, PR China
| | - Qiaoqiao Zheng
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, PR China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, PR China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of psychology, Southwest University, Chongqing, PR China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, PR China
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Stapel B, Gorinski N, Gmahl N, Rhein M, Preuss V, Hilfiker-Kleiner D, Frieling H, Bleich S, Ponimaskin E, Kahl KG. Fluoxetine induces glucose uptake and modifies glucose transporter palmitoylation in human peripheral blood mononuclear cells. Expert Opin Ther Targets 2019; 23:883-891. [DOI: 10.1080/14728222.2019.1675639] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Britta Stapel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Nataliya Gorinski
- Institute of Cellular Neurophysiology, Hannover Medical School, Hanover, Germany
| | - Noëmi Gmahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
- Institute of Cellular Neurophysiology, Hannover Medical School, Hanover, Germany
| | - Mathias Rhein
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Vanessa Preuss
- Institute of Legal Medicine, Hannover Medical School, Hanover, Germany
| | | | - Helge Frieling
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Evgeni Ponimaskin
- Institute of Legal Medicine, Hannover Medical School, Hanover, Germany
| | - Kai G. Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
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7
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Xia M, Si T, Sun X, Ma Q, Liu B, Wang L, Meng J, Chang M, Huang X, Chen Z, Tang Y, Xu K, Gong Q, Wang F, Qiu J, Xie P, Li L, He Y. Reproducibility of functional brain alterations in major depressive disorder: Evidence from a multisite resting-state functional MRI study with 1,434 individuals. Neuroimage 2019; 189:700-714. [DOI: 10.1016/j.neuroimage.2019.01.074] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/18/2019] [Accepted: 01/30/2019] [Indexed: 01/14/2023] Open
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8
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Rajkumar R, Dawe GS. OBscure but not OBsolete: Perturbations of the frontal cortex in common between rodent olfactory bulbectomy model and major depression. J Chem Neuroanat 2018; 91:63-100. [DOI: 10.1016/j.jchemneu.2018.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 03/02/2018] [Accepted: 04/04/2018] [Indexed: 02/08/2023]
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9
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Gao Y, Wang M, Yu R, Li Y, Yang Y, Cui X, Zheng J. Abnormal Default Mode Network Homogeneity in Treatment-Naive Patients With First-Episode Depression. Front Psychiatry 2018; 9:697. [PMID: 30618871 PMCID: PMC6305293 DOI: 10.3389/fpsyt.2018.00697] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 11/30/2018] [Indexed: 11/13/2022] Open
Abstract
Background and Objective: The default mode network (DMN) may be an important component involved in the broad-scale cognitive problems seen in patients with first-episode treatment-naive depression. Nevertheless, information is scarce regarding the changes in network homogeneity (NH) found in the DMN of these patients. Therefore, in this study, we explored the NH of the DMN in patients with first-episode treatment-naive depression. Methods: The study included 66 patients and 74 control participants matched by age, gender, educational level and health status who underwent resting-state functional magnetic resonance imaging (rs-fMRI) and the attentional network test (ANT). To assess data, the study utilizes NH and independent component analysis (ICA). Additionally, Spearman's rank correlation analysis is performed among significantly abnormal NH in depression patients and clinical measurements and executive control reaction time (ECRT). Results: In comparison with the control group, patients with first-episode treatment-naive depression showed lower NH in the bilateral angular gyrus (AG), as well as increased NH in the bilateral precuneus (PCu) and posterior cingulate cortex (PCC). Likewise, patients with first-episode treatment-naive depression had longer ECRT. No significant relation was found between abnormal NH values and the measured clinical variables. Conclusions: Our results suggest patients with first-episode treatment-naive depression have abnormal NH values in the DMN. This highlights the significance of DMN in the pathophysiology of cognitive problems in depression. Our study also found alterations in executive functions in patients with first-episode treatment-naive depression.
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Affiliation(s)
- Yujun Gao
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Menglin Wang
- Department of Otorhinolaryngology and Head and Neck Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - RenQiang Yu
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yaping Li
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Ying Yang
- The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Xiangxiang Cui
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
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10
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De Crescenzo F, Ciliberto M, Menghini D, Treglia G, Ebmeier KP, Janiri L. Is 18F-FDG-PET suitable to predict clinical response to the treatment of geriatric depression? A systematic review of PET studies. Aging Ment Health 2017; 21:889-894. [PMID: 27792402 DOI: 10.1080/13607863.2016.1247413] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Geriatric depression is one of the most common psychiatric disorders in later life. It differs from earlier depression in its presentation, etiology, risk factors, protective factors and outcome. Positron emission tomography (PET) can be used to detect changes in neural circuitry in neuropsychiatric disorders, and several authors have assessed its role in the diagnosis and follow-up of patients with geriatric depression. We reviewed the current evidence on the use of fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) in geriatric depressed patients to find predictors of treatment response. METHODS We searched PubMed/MEDLINE, Scopus, Embase, Cochrane Library, CINAHL and the PsycINFO databases to find relevant peer-reviewed articles on PET in geriatric depression using the search terms ('PET' or 'positron emission tomography') and ('mood' or 'affective disorder' or 'affective disorders' or 'depression' or 'dysthymia' or 'seasonal affective disorder'). RESULTS Eleven articles comprising 128 patients were included. We extracted data on glucose uptake of depressed patients and controls at baseline and after different types of intervention (total sleep deprivation followed by a recovery sleep and treatment with selective serotonin reuptake inhibitors). CONCLUSIONS 18F-FDG-PET showed significant alterations of glucose uptake in several brain areas, in particular the anterior cingulate cortex, which showed reduced metabolism after treatment, and was a predictor of treatment response.
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Affiliation(s)
- Franco De Crescenzo
- a Department of Psychiatry , Catholic University of Sacred Heart , Rome , Italy
| | - Mario Ciliberto
- b Department of Radiology , Catholic University of Sacred Heart , Rome , Italy
| | - Deny Menghini
- c Department of Neuroscience , Bambino Gesù Children's Hospital , Rome , Italy
| | - Giorgio Treglia
- d Department of Nuclear Medicine and PET/CT Center , Oncology Institute of Southern Switzerland , Bellinzona , Switzerland
| | - Klaus P Ebmeier
- e Department of Psychiatry , University of Oxford , Oxford , United Kingdom
| | - Luigi Janiri
- a Department of Psychiatry , Catholic University of Sacred Heart , Rome , Italy
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11
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Molecular imaging of serotonin degeneration in mild cognitive impairment. Neurobiol Dis 2017; 105:33-41. [PMID: 28511918 DOI: 10.1016/j.nbd.2017.05.007] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/02/2017] [Accepted: 05/12/2017] [Indexed: 01/17/2023] Open
Abstract
Neuropathological and neuroimaging studies have consistently demonstrated degeneration of monoamine systems, especially the serotonin system, in normal aging and Alzheimer's disease. The evidence for degeneration of the serotonin system in mild cognitive impairment is limited. Thus, the goal of the present study was to measure the serotonin transporter in vivo in mild cognitive impairment and healthy controls. The serotonin transporter is a selective marker of serotonin terminals and of the integrity of serotonin projections to cortical, subcortical and limbic regions and is found in high concentrations in the serotonergic cell bodies of origin of these projections (raphe nuclei). Twenty-eight participants with mild cognitive impairment (age 66.6±6.9, 16 males) and 28 healthy, cognitively normal, demographically matched controls (age 66.2±7.1, 15 males) underwent magnetic resonance imaging for measurement of grey matter volumes and high-resolution positron emission tomography with well-established radiotracers for the serotonin transporter and regional cerebral blood flow. Beta-amyloid imaging was performed to evaluate, in combination with the neuropsychological testing, the likelihood of subsequent cognitive decline in the participants with mild cognitive impairment. The following hypotheses were tested: 1) the serotonin transporter would be lower in mild cognitive impairment compared to controls in cortical and limbic regions, 2) in mild cognitive impairment relative to controls, the serotonin transporter would be lower to a greater extent and observed in a more widespread pattern than lower grey matter volumes or lower regional cerebral blood flow and 3) lower cortical and limbic serotonin transporters would be correlated with greater deficits in auditory-verbal and visual-spatial memory in mild cognitive impairment, not in controls. Reduced serotonin transporter availability was observed in mild cognitive impairment compared to controls in cortical and limbic areas typically affected by Alzheimer's disease pathology, as well as in sensory and motor areas, striatum and thalamus that are relatively spared in Alzheimer's disease. The reduction of the serotonin transporter in mild cognitive impairment was greater than grey matter atrophy or reductions in regional cerebral blood flow compared to controls. Lower cortical serotonin transporters were associated with worse performance on tests of auditory-verbal and visual-spatial memory in mild cognitive impairment, not in controls. The serotonin system may represent an important target for prevention and treatment of MCI, particularly the post-synaptic receptors (5-HT4 and 5-HT6), which may not be as severely affected as presynaptic aspects of the serotonin system, as indicated by the observation of lower serotonin transporters in MCI relative to healthy controls.
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12
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Feng Z, Xu S, Huang M, Shi Y, Xiong B, Yang H. Disrupted causal connectivity anchored on the anterior cingulate cortex in first-episode medication-naive major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2016; 64:124-30. [PMID: 26234517 DOI: 10.1016/j.pnpbp.2015.07.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 07/07/2015] [Accepted: 07/23/2015] [Indexed: 12/30/2022]
Abstract
In recent years, major depressive disorder (MDD) has been demonstrated to be associated with abnormalities in neural networks, particularly the prefrontal-limbic network (PLN). However, there are few current studies that have examined information flow in the PLN. In this study, Granger causality analysis (GCA), based on signed regression coefficient, was used to explore changes in causal connectivity in resting-state PLNs of MDD patients. A total of 23 first-episode medication-naïve MDD patients and 20 normal control participants were subjected to resting-state functional magnetic resonance imaging (RS-fMRI) scans. Increased causal effects of the right insular cortex, right putamen and right caudate on the rostral anterior cingulate cortex (rACC) and reduced causal effects of bilateral dorsolateral prefrontal cortex (DLPFC) and left orbitofrontal cortex (OFC) on the rACC were found in MDD patients compared to normal controls. The extensive reduction in the causal effect of the prefrontal cortex (PFC) demonstrates impaired top-down cognitive control in MDD patients. Changes in the causal relationship between the right insula and rACC suggest problems in coordination of the default mode network by the right anterior insular cortex (rAI). These findings provide valuable insight into MDD-related neural network disorders reported in previous RS-fMRI studies and may potentially guide clinical treatment of MDD in the future.
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Affiliation(s)
- Zhan Feng
- Department of Radiology, First Affiliated Hospital of College of Medical Science, Zhejiang University, Hangzhou, Zhejiang, China; The key laboratory of mental disorder's management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Shunliang Xu
- Department of Radiology, First Affiliated Hospital of College of Medical Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Manli Huang
- Department of Psychiatry, First Affiliated Hospital of College of Medical Science, Zhejiang University, Hangzhou, Zhejiang, China; The key laboratory of mental disorder's management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yushu Shi
- Department of Radiology, First Affiliated Hospital of College of Medical Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Bing Xiong
- Department of Radiology, First Affiliated Hospital of College of Medical Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hong Yang
- Department of Radiology, First Affiliated Hospital of College of Medical Science, Zhejiang University, Hangzhou, Zhejiang, China.
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13
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Prabhakar V, Gupta D, Kanade P, Radhakrishnan M. Diabetes-associated depression: the serotonergic system as a novel multifunctional target. Indian J Pharmacol 2015; 47:4-10. [PMID: 25821303 PMCID: PMC4375817 DOI: 10.4103/0253-7613.150305] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 11/16/2013] [Accepted: 12/05/2014] [Indexed: 12/26/2022] Open
Abstract
Diabetes associated depression is a largely understudied field which nonetheless carries a significant disease burden. The very low therapeutic efficacy of the existing conventional drugs with poor outcome may be, in part, due to uncertainty of the mechanism involved that clearly explains the existing comorbidity. The main purpose of this review was to address the sophisticated mechanisms of this comorbidity with a view of developing potential novel targets with higher efficacy and specificity. Data were collected from database searches including PubMed, references from relevant English language research/review articles and other official publications. Articles from 1990 to 2013 were included, and a broad search term criteria were followed for data mining so that relevant information was not missed out. Some of the search terms used included; diabetes-induced depression, diabetes and serotonin, hypothalamic-pituitary-adrenal (HPA) axis and diabetes and glucocorticoids in diabetes. Neuropathologically, depletion of brain monoaminergic activity specifically the serotonin (5-hydroxytryptamine [5-HT]) system, due to chronically persisting diabetic state may lead to the mood and behavioral complications that further add on worsening the quality life years. The 5-HT system through multifunctional tasks regulates neurogenesis and plasticity and by complex receptor mechanism controls the emotional and behavioral activity. Persisting hyperglycemia leads to impaired neurogenesis, decreased synaptic plasticity, undesired neuro-anatomical alterations, neurochemical deficits, and reduced neurotransmitter activity. The neurotrophic factors and secondary messenger functions affected at molecular and genetic levels indicate the impact of diabetes-mediated dysregulation on neuronal circuits. HPA activity, glycogen synthase kinase 3, and insulin signaling controls were also found to be hampered, interlinked to 5-HT system following diabetic progression.
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Affiliation(s)
- Visakh Prabhakar
- Department of Pharmacy and, Birla Institute of Technology and Science, Pilani, Rajasthan, India
| | - Deepali Gupta
- Department of Pharmacy and, Birla Institute of Technology and Science, Pilani, Rajasthan, India
| | - Prateek Kanade
- Department of Pharmacy and, Birla Institute of Technology and Science, Pilani, Rajasthan, India
| | - Mahesh Radhakrishnan
- Department of Pharmacy and, Birla Institute of Technology and Science, Pilani, Rajasthan, India
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Brendel M, Pogarell O, Xiong G, Delker A, Bartenstein P, Rominger A. Depressive symptoms accelerate cognitive decline in amyloid-positive MCI patients. Eur J Nucl Med Mol Imaging 2015; 42:716-24. [PMID: 25631614 PMCID: PMC5849231 DOI: 10.1007/s00259-014-2975-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/09/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Late-life depression even in subsyndromal stages is strongly associated with Alzheimer's disease (AD). Furthermore, brain amyloidosis is an early biomarker in subjects who subsequently suffer from AD and can be sensitively detected by amyloid PET. Therefore, we aimed to compare amyloid load and glucose metabolism in subsyndromally depressed subjects with mild cognitive impairment (MCI). METHODS [(18)F]AV45 PET, [(18)F]FDG PET and MRI were performed in 371 MCI subjects from the Alzheimer's Disease Neuroimaging Initiative Subjects were judged β-amyloid-positive (Aβ+; 206 patients) or β-amyloid-negative (Aβ-; 165 patients) according to [(18)F]AV45 PET. Depressive symptoms were assessed by the Neuropsychiatric Inventory Questionnaire depression item 4. Subjects with depressive symptoms (65 Aβ+, 41 Aβ-) were compared with their nondepressed counterparts. Conversion rates to AD were analysed (mean follow-up time 21.5 ± 9.1 months) with regard to coexisting depressive symptoms and brain amyloid load. RESULTS Aβ+ depressed subjects showed large clusters with a higher amyloid load in the frontotemporal and insular cortices (p < 0.001) with coincident hypermetabolism (p < 0.001) in the frontal cortices than nondepressed subjects. Faster progression to AD was observed in subjects with depressive symptoms (p < 0.005) and in Aβ+ subjects (p < 0.001). Coincident depressive symptoms additionally shortened the conversion time in all Aβ+ subjects (p < 0.005) and to a greater extent in those with a high amyloid load (p < 0.001). CONCLUSION Our results clearly indicate that Aβ+ MCI subjects with depressive symptoms have an elevated amyloid load together with relative hypermetabolism of connected brain areas compared with cognitively matched nondepressed individuals. MCI subjects with high amyloid load and coexistent depressive symptoms are at high risk of faster conversion to AD.
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Affiliation(s)
| | | | - Guoming Xiong
- Dept. of Nuclear Medicine, University of Munich, Germany
| | - Andreas Delker
- Dept. of Nuclear Medicine, University of Munich, Germany
| | | | - Axel Rominger
- Dept. of Nuclear Medicine, University of Munich, Germany
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15
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Yeh YW, Ho PS, Kuo SC, Chen CY, Liang CS, Yen CH, Huang CC, Ma KH, Shiue CY, Huang WS, Shyu JF, Wan FJ, Lu RB, Huang SY. Disproportionate Reduction of Serotonin Transporter May Predict the Response and Adherence to Antidepressants in Patients with Major Depressive Disorder: A Positron Emission Tomography Study with 4-[18F]-ADAM. Int J Neuropsychopharmacol 2015; 18:pyu120. [PMID: 25568284 PMCID: PMC4540099 DOI: 10.1093/ijnp/pyu120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/23/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Many lines of evidence suggest the role of serotonin transporter (SERT)-mediated reuptake of serotonin in the pathophysiology and treatment of major depressive disorder (MDD). This study aimed to examine whether the pretreatment of SERT binding potential or SERT binding ratio between terminal projection regions relative to the midbrain raphe nuclei was associated with treatment outcomes to SERT-targeted antidepressants. METHODS We recruited 39 antidepressant-naïve patients with MDD and 39 heathy controls. Positron emission tomography with N,N-dimethyl-2-(2-amino-4-[(18)F]fluorophenylthio)benzylamine (4-[(18)F]-ADAM) was used to measure in vivo SERT availability prior to antidepressant treatment. The 21-item Hamilton Depression Rating Scale (HDRS) was use to assess the severity of depression from baseline to week 6. All the patients with MDD had HDRS scores of 18 or more. RESULTS Pretreatment SERT binding in the thalamus and striatum positively correlated with an early reduction in HDRS scores at week 3. Nonresponders and dropout patients showed a proportionate reduction in SERT binding in the terminal projection regions and midbrain compared to healthy controls. In contrast, a disproportionate reduction in SERT binding in the terminal projection regions relative to midbrain was observed in responders. CONCLUSIONS The results of this study suggested that a disproportionate reduction in SERT binding between terminal projection regions and midbrain may predict better treatment outcomes in patients with MDD.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - San-Yuan Huang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Kuo, Chen, Liang, and S-Y Huang); Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Drs Yeh, Kuo, Chen, Shyu, Wan, and S-Y Huang); Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Drs Ho and Liang); Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Dr Yen); Department of Psychiatry, Taipei Branch, Buddhist Tzu Chi General Hospital, New Taipei, Taiwan (Dr C-C Huang); Department of Biology & Anatomy, National Defense Medical Center, Taipei, Taiwan (Professor Ma and Dr Shyu); Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Professor Shiue and Dr W-S Huang); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan (Dr W-S Huang); Department of Psychiatry, National Cheng Kung University, Tainan, Taiwan (Dr Lu).
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Marano CM, Workman CI, Lyman CH, Kramer E, Hermann CR, Ma Y, Dhawan V, Chaly T, Eidelberg D, Smith GS. The relationship between fasting serum glucose and cerebral glucose metabolism in late-life depression and normal aging. Psychiatry Res 2014; 222:84-90. [PMID: 24650451 PMCID: PMC4388739 DOI: 10.1016/j.pscychresns.2014.01.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 12/15/2013] [Accepted: 01/21/2014] [Indexed: 12/16/2022]
Abstract
Evidence exists for late-life depression (LLD) as both a prodrome of and risk factor for Alzheimer׳s disease (AD). The underlying neurobiological mechanisms are poorly understood. Impaired peripheral glucose metabolism may explain the association between depression and AD given the connection between type 2 diabetes mellitus with both depression and AD. Positron emission tomography (PET) measures of cerebral glucose metabolism are sensitive to detecting changes in neural circuitry in LLD and AD. Fasting serum glucose (FSG) in non-diabetic young (YC; n=20) and elderly controls (EC; n=12) and LLD patients (n=16) was correlated with PET scans of cerebral glucose metabolism on a voxel-wise basis. The negative correlations were more extensive in EC versus YC and in LLD patients versus EC. Increased FSG correlated with decreased cerebral glucose metabolism in LLD patients to a greater extent than in EC in heteromodal association cortices involved in mood symptoms and cognitive deficits observed in LLD and dementia. Negative correlations in YC were observed in sensory and motor regions. Understanding the neurobiological consequences of diabetes and associated conditions will have substantial public health significance given that this is a modifiable risk factor for which prevention strategies could have an important impact on lowering dementia risk.
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Affiliation(s)
- Christopher M. Marano
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224
| | - Clifford I. Workman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224
| | - Christopher H. Lyman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224
| | - Elisse Kramer
- Department of Geriatric Psychiatry, the Zucker Hillside Hospital, Glen Oaks, New York 11004
| | - Carol R. Hermann
- Department of Geriatric Psychiatry, the Zucker Hillside Hospital, Glen Oaks, New York 11004
| | - Yilong Ma
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore - Long Island Jewish Health System, Manhasset, New York 11030
| | - Vijay Dhawan
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore - Long Island Jewish Health System, Manhasset, New York 11030
| | - Thomas Chaly
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore - Long Island Jewish Health System, Manhasset, New York 11030
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore - Long Island Jewish Health System, Manhasset, New York 11030
| | - Gwenn S. Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224
,Corresponding Author: Gwenn S. Smith, Ph.D., Department of Psychiatry and Behavioral Sciences, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, 5300 Alpha Commons Drive, Fourth Floor, Baltimore, MD 21224, 410-550-8696 (phone), 410-550-1407 (fax),
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Suetens K, Nuttin B, Gabriëls L, Van Laere K. Differences in metabolic network modulation between capsulotomy and deep-brain stimulation for refractory obsessive-compulsive disorder. J Nucl Med 2014; 55:951-9. [PMID: 24722531 DOI: 10.2967/jnumed.113.126409] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 01/01/2014] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Around 7%-10% of patients with obsessive-compulsive disorder (OCD) are refractory to first-line treatment. Neurosurgical approaches are available such as capsulotomy or deep-brain stimulation (DBS). There is strong evidence for central involvement of the corticostriatopallidothalamocortical (CSPTC) circuit in OCD, but the exact mechanism through which these interventions lead to clinical improvement and potential differences in network modulation are not fully understood. METHODS In total, 13 capsulotomy patients (aged 29-59 y, 10 men and 3 women) and 16 DBS patients (aged 25-56 y, 6 men and 10 women) were prospectively included. (18)F-FDG PET was performed before and after capsulotomy and before and after DBS in both stimulation-on and stimulation-off conditions. Presurgical scans were compared with scans of healthy volunteers using SPM8 and global scaling, and metabolic changes after DBS were compared with changes after capsulotomy. Correlations with clinical improvements were investigated using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Hamilton Depression Rating Scale (HAM-D). RESULTS Both groups had similar pretreatment clinical morbidity as assessed by Y-BOCS and the Hamilton Depression Rating Scale. Preoperative superior frontal and supplementary motor cortex hypometabolism was common to both patient groups, and the subgenual anterior cingulate, occipital cortex (cuneus), and posterior cerebellum were relatively hypermetabolic. Postoperative metabolic decreases were common to both interventions in the anterior cingulate and the prefrontal and orbitofrontal cortices. Compared with DBS, capsulotomy resulted in more intense metabolic changes, with additional significant decreases in the mediodorsal thalamus, caudate nucleus, and cerebellum as well as increases in the precuneus and the fusiform and lingual gyrus. The stimulation-off condition of DBS patients showed no significant differences from the preoperative state. Improvement in Y-BOCS scores correlated with metabolic changes in the occipital cortex. Baseline metabolism in the subgenual anterior cingulate and superior temporal cortices were related to postoperative improvement of depressive symptoms. CONCLUSION Capsulotomy and DBS lead to similar clinical improvement and similar metabolic network changes in the CSPTC circuit, with a prominent role for the subgenual anterior cingulate and other core structures of the CSPTC. However, metabolic changes are more pronounced and extended in capsulotomy than in DBS. Furthermore, cortical regions outside the CSPTC may also play an important role in OCD symptomatology.
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Affiliation(s)
- Kristin Suetens
- Nuclear Medicine and Molecular Imaging, University Hospital and KU Leuven, Leuven, Belgium
| | - Bart Nuttin
- Department of Neurosurgery, University Hospital and KU Leuven, Leuven, Belgium; and
| | - Loes Gabriëls
- Department of Psychiatry, University Hospital and KU Leuven, Leuven, Belgium
| | - Koen Van Laere
- Nuclear Medicine and Molecular Imaging, University Hospital and KU Leuven, Leuven, Belgium
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Guo W, Liu F, Zhang J, Zhang Z, Yu L, Liu J, Chen H, Xiao C. Abnormal default-mode network homogeneity in first-episode, drug-naive major depressive disorder. PLoS One 2014; 9:e91102. [PMID: 24609111 PMCID: PMC3946684 DOI: 10.1371/journal.pone.0091102] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 02/07/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Default mode network (DMN) is one of the most commonly recognized resting-state networks in major depressive disorder (MDD). However, the homogeneity of this network in MDD is poorly understood. As such, this study was conducted to determine whether or not an abnormal network homogeneity (NH) of DMN is observed in patients with first-episode and drug-naive MDD. METHODS Twenty-four first-episode drug-naive patients with MDD and twenty-four healthy control subjects participated in the study. NH and independent component analysis (ICA) methods were used to analyze data. RESULTS Depressed patients exhibited a significantly increased NH in the left dorsal medial prefrontal cortex (MPFC) and decreased NH in the right inferior temporal gyrus (ITG) compared with the healthy control subjects. Receiver operating characteristic curves (ROC) were analyzed and results revealed that the NH values of MPFC and ITG could be applied as candidate markers with relatively high sensitivity and specificity to distinguish patients from healthy control subjects. No correlation was observed between the NH values of the two regions and clinical variables. CONCLUSIONS Our findings suggested that an abnormal DMN homogeneity could be observed in MDD, which highlight the importance of the DMN in the pathophysiology of MDD.
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Affiliation(s)
- Wenbin Guo
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
- * E-mail:
| | - Feng Liu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jian Zhang
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Zhikun Zhang
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Liuyu Yu
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Jianrong Liu
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Huafu Chen
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Changqing Xiao
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
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Abstract
Molecular imaging represents a bridge between basic and clinical neuroscience observations and provides many opportunities for translation and identifying mechanisms that may inform prevention and intervention strategies in late-life depression (LLD). Substantial advances in instrumentation and radiotracer chemistry have resulted in improved sensitivity and spatial resolution and the ability to study in vivo an increasing number of neurotransmitters, neuromodulators, and, importantly, neuropathological processes. Molecular brain imaging studies in LLD will be reviewed, with a primary focus on positron emission tomography. Future directions for the field of molecular imaging in LLD will be discussed, including integrating molecular imaging with genetic, neuropsychiatric, and cognitive outcomes and multimodality neuroimaging.
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Affiliation(s)
- Kentaro Hirao
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Gwenn S. Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
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20
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Guo W, Liu F, Zhang J, Zhang Z, Yu L, Liu J, Chen H, Xiao C. Dissociation of regional activity in the default mode network in first-episode, drug-naive major depressive disorder at rest. J Affect Disord 2013; 151:1097-101. [PMID: 24074717 DOI: 10.1016/j.jad.2013.09.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 08/06/2013] [Accepted: 09/03/2013] [Indexed: 01/31/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is associated with altered neural activity in the default mode network (DMN). In the present study, we used a fractional amplitude of low-frequency fluctuations (fALFF) approach to directly investigate the features of spontaneous brain activity of the DMN in patients with the first-episode, drug-naive MDD at rest. METHODS Twenty-four first-episode, drug-naive patients with MDD and 24 age-, gender-, and education-matched healthy subjects participated in the study. The fALFF and independent component analysis (ICA) approaches were utilized to analyze the data. RESULTS Patients with MDD exhibited a dissociation pattern of resting-state fALFF in the DMN, with increased fALFF in the left dorsal medial prefrontal cortex (MPFC) and decreased fALFF in the left parahippocampal gyrus (PHG). The increased fALFF values of the left dorsal MPFC were positively correlated to the Hamilton Rating Scale for Depression (HRSD) scores. CONCLUSIONS Our results first suggested that there was a dissociation pattern of resting-state fALFF in the DMN in patient with MDD, which highlighted the importance of the DMN in the pathogenesis of MDD.
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Affiliation(s)
- Wenbin Guo
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, China.
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21
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Geda YE, Schneider LS, Gitlin LN, Miller DS, Smith GS, Bell J, Evans J, Lee M, Porsteinsson A, Lanctôt KL, Rosenberg PB, Sultzer DL, Francis PT, Brodaty H, Padala PP, Onyike CU, Ortiz LA, Ancoli-Israel S, Bliwise DL, Martin JL, Vitiello MV, Yaffe K, Zee PC, Herrmann N, Sweet RA, Ballard C, Khin NA, Alfaro C, Murray PS, Schultz S, Lyketsos CG. Neuropsychiatric symptoms in Alzheimer's disease: past progress and anticipation of the future. Alzheimers Dement 2013; 9:602-8. [PMID: 23562430 PMCID: PMC3766403 DOI: 10.1016/j.jalz.2012.12.001] [Citation(s) in RCA: 247] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) are widespread and disabling. This has been known since Dr. Alois Alzheimer's first case, Frau Auguste D., presented with emotional distress and delusions of infidelity/excessive jealousy, followed by cognitive symptoms. Being cognizant of this, in 2010 the Alzheimer's Association convened a research roundtable on the topic of NPS in AD. A major outcome of the roundtable was the founding of a Professional Interest Area (PIA) within the International Society to Advance Alzheimer's Research and Treatment (ISTAART). The NPS-PIA has prepared a series of documents that are intended to summarize the literature and provide more detailed specific recommendations for NPS research. This overview paper is the first of these living documents that will be updated periodically as the science advances. The overview is followed by syndrome-specific synthetic reviews and recommendations prepared by NPS-PIA workgroups on depression, apathy, sleep, agitation, and psychosis.
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Affiliation(s)
- Yonas E Geda
- Departments of Psychiatry and Neurology, College of Medicine, Mayo Clinic, Scottsdale, AZ, USA
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Zuo C, Ma Y, Sun B, Peng S, Zhang H, Eidelberg D, Guan Y. Metabolic imaging of bilateral anterior capsulotomy in refractory obsessive compulsive disorder: an FDG PET study. J Cereb Blood Flow Metab 2013; 33:880-7. [PMID: 23443174 PMCID: PMC3677106 DOI: 10.1038/jcbfm.2013.23] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The therapeutic benefits of bilateral capsulotomy for the treatment of refractory obsessive compulsive disorder (OCD) are probably attributed to interruption of the cortico-striato-thalamo-cortical circuitry. We evaluated resting brain metabolism and treatment response in OCD patients using positron emission tomography (PET) imaging. [(18)F]-fluoro-deoxy-glucose PET was performed in eight OCD patients precapsulotomy and postcapsulotomy. We determined metabolic differences between preoperative images in patients and those in eight age-matched healthy volunteers, and postoperative changes and clinical correlations in the patients. The OCD patients showed widespread metabolic increases in normalized glucose metabolism in the bilateral orbitofrontal cortex and inferior frontal gyrus, cingulate gyrus, and bilateral pons/cerebellum, and metabolic decreases bilaterally in the precentral and lingual gyri. Bilateral capsulotomy resulted in significant metabolic decreases bilaterally in the prefrontal cortical regions, especially in the dorsal anterior cingulate cortex (ACC) and in the medial dorsal thalamus and caudate nucleus. In contrast, metabolism increased bilaterally in the precentral and lingual gyri. Clinical improvement in patients correlated with metabolic changes in the bilateral dorsal ACC and in the right middle occipital gyrus after capsulotomy. This study underscores the importance of the internal capsule in modulating ventral prefrontal and dorsal anterior cingulate neuronal activity in the neurosurgical management of OCD patients.
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Affiliation(s)
- ChuanTao Zuo
- Department of Nuclear Medicine, PET Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China.
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Marano CM, Workman CI, Kramer E, Hermann CR, Ma Y, Dhawan V, Chaly T, Eidelberg D, Smith GS. Longitudinal studies of cerebral glucose metabolism in late-life depression and normal aging. Int J Geriatr Psychiatry 2013; 28:417-23. [PMID: 22740289 PMCID: PMC3974580 DOI: 10.1002/gps.3840] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 05/01/2012] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Late-life depression (LLD) has a substantial public health impact and is both a risk factor for and a prodrome of dementia. Positron emission tomography (PET) studies of cerebral glucose metabolism have demonstrated sensitivity in evaluating neural circuitry involved in depression, aging, incipient cognitive decline, and dementia. The present study evaluated the long term effects of a course of antidepressant treatment on glucose metabolism in LLD patients. METHODS Nine LLD patients and seven non-depressed control subjects underwent clinical and cognitive evaluations as well as brain magnetic resonance imaging and PET studies of cerebral glucose metabolism at baseline, after 8 weeks of treatment with citalopram for a major depressive episode (patients only), and at an approximately 2-year follow-up. RESULTS The majority of LLD patients were remitted at follow-up (7/9). Neither patients nor controls showed significant cognitive decline. The patients showed greater increases in glucose metabolism than the controls in regions associated with mood symptoms (anterior cingulate and insula). Both groups showed decreases in metabolism in posterior association cortices implicated in dementia. CONCLUSIONS Longitudinal changes in cerebral glucose metabolism are observed in controls and in LLD patients without significant cognitive decline that are more extensive than the decreases in brain volume. Longer duration follow-up studies and the integration of other molecular imaging methods will have implications for understanding the clinical and neurobiological significance of these metabolic changes.
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Affiliation(s)
- Christopher M. Marano
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224
| | - Clifford I. Workman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224
| | - Elisse Kramer
- Department of Geriatric Psychiatry, the Zucker Hillside Hospital, Glen Oaks, New York 11004
| | - Carol R. Hermann
- Department of Geriatric Psychiatry, the Zucker Hillside Hospital, Glen Oaks, New York 11004
| | - Yilong Ma
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore - Long Island Jewish Health System, Manhasset, New York 11030
| | - Vijay Dhawan
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore - Long Island Jewish Health System, Manhasset, New York 11030
| | - Thomas Chaly
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore - Long Island Jewish Health System, Manhasset, New York 11030
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore - Long Island Jewish Health System, Manhasset, New York 11030
| | - Gwenn S. Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224
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24
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Guo W, Liu F, Dai Y, Jiang M, Zhang J, Yu L, Long L, Chen H, Gao Q, Xiao C. Decreased interhemispheric resting-state functional connectivity in first-episode, drug-naive major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2013; 41:24-9. [PMID: 23159796 DOI: 10.1016/j.pnpbp.2012.11.003] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 11/05/2012] [Accepted: 11/06/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is shown to have structural and functional abnormalities in specific brain areas and connections by recent neuroimaging studies. However, little is known about the alterations of the interhemispheric resting-state functional connectivity (FC) in patients with MDD. In the present study, we used a newly developed voxel-mirrored homotopic connectivity (VMHC) method to investigate the interhemispheric FC of the whole brain in patients with MDD at rest. METHODS Twenty-four first-episode, drug-naive patients with MDD and 24 age-, gender-, and education-matched healthy subjects underwent a resting-state functional magnetic resonance imaging (fMRI). An automated VMHC approach was used to analyze the data. RESULTS Patients with MDD showed lower VMHC than healthy subjects in the medial prefrontal cortex (MPFC) and the posterior cingulate cortex/precuneus (PCC/PCu), two core regions within default mode network (DMN). Both left and right MPFC showed reduced FC with the other frontal areas and with right anterior cingulate gyrus (ACC), while PCC/PCu exhibited abnormal FC with the frontal areas and thalamus in patient group. Significant positive correlation was observed between VMHC in MPFC and persistent error response of Wisconsin Card Sorting Test (WCST-Pre) in patients. Further ROC analysis revealed that VMHC in the MPFC and PCC/PCu could be used to differentiate the patients from healthy subjects with relatively high sensitivity and specificity. CONCLUSIONS Our results suggest that decreased VMHC in brain regions within DMN may underlie the pathogenesis of MDD.
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Affiliation(s)
- Wenbin Guo
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, China.
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25
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Munro CA, Workman CI, Kramer E, Hermann C, Ma Y, Dhawan V, Chaly T, Eidelberg D, Smith GS. Serotonin modulation of cerebral glucose metabolism: sex and age effects. Synapse 2012; 66:955-64. [PMID: 22836227 DOI: 10.1002/syn.21590] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Revised: 07/12/2012] [Accepted: 07/18/2012] [Indexed: 01/11/2023]
Abstract
The serotonin system is implicated in a variety of psychiatric disorders whose clinical presentation and response to treatment differ between males and females, as well as with aging. However, human neurobiological studies are limited. Sex differences in the cerebral metabolic response to an increase in serotonin concentrations were measured, as well as the effect of aging, in men compared to women. Thirty-three normal healthy individuals (14 men/19 women, age range 20-79 years) underwent two resting positron emission tomography studies with the radiotracer [18F]-2-deoxy-2-fluoro-D-glucose ([(18)F]-FDG) after placebo and selective serotonin reuptake inhibitor (SSRI, citalopram) infusions on two separate days. Results indicated that women demonstrated widespread areas of increased cortical glucose metabolism with fewer areas of decrease in metabolism in response to citalopram. Men, in contrast, demonstrated several regions of decreased cortical metabolism, but no regions of increased metabolism. Age was associated with greater increases in women and greater decreases in men in most brain regions. These results support prior studies indicating that serotonin function differs in men and women across the lifespan. Future studies aimed at characterizing the influences of age and sex on the serotonin system in patients with psychiatric disorders are needed to elucidate the relationship between sex and age differences in brain chemistry and associated differences in symptom presentation and treatment response.
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Affiliation(s)
- Cynthia A Munro
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA
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26
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Lyketsos CG, Carrillo MC, Ryan JM, Khachaturian AS, Trzepacz P, Amatniek J, Cedarbaum J, Brashear R, Miller DS. Neuropsychiatric symptoms in Alzheimer's disease. Alzheimers Dement 2012. [PMID: 21889116 DOI: 10.1016/j.jalz.2011.05.2410; 10.1016/j.jalz.2011.05.2410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Neuropsychiatric symptoms (NPS) are core features of Alzheimer's disease and related dementias. Once thought to emerge primarily in people with late-stage disease, these symptoms are currently known to manifest commonly in very early disease and in prodromal phases, such as mild cognitive impairment. Despite decades of research, reliable treatments for dementia-associated NPS have not been found, and those that are in widespread use present notable risks for people using these medications. An Alzheimer's Association Research Roundtable was convened in the spring of 2010 to review what is known about NPS in Alzheimer's disease, to discuss classification and underlying neuropathogenesis and vulnerabilities, and to formulate recommendations for new approaches to tailored therapeutics.
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27
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Lyketsos CG, Carrillo MC, Ryan JM, Khachaturian AS, Trzepacz P, Amatniek J, Cedarbaum J, Brashear R, Miller DS. Neuropsychiatric symptoms in Alzheimer's disease. Alzheimers Dement 2012; 7:532-9. [PMID: 21889116 DOI: 10.1016/j.jalz.2011.05.2410] [Citation(s) in RCA: 614] [Impact Index Per Article: 51.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Accepted: 05/16/2011] [Indexed: 10/17/2022]
Abstract
Neuropsychiatric symptoms (NPS) are core features of Alzheimer's disease and related dementias. Once thought to emerge primarily in people with late-stage disease, these symptoms are currently known to manifest commonly in very early disease and in prodromal phases, such as mild cognitive impairment. Despite decades of research, reliable treatments for dementia-associated NPS have not been found, and those that are in widespread use present notable risks for people using these medications. An Alzheimer's Association Research Roundtable was convened in the spring of 2010 to review what is known about NPS in Alzheimer's disease, to discuss classification and underlying neuropathogenesis and vulnerabilities, and to formulate recommendations for new approaches to tailored therapeutics.
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28
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Fitzgerald PJ. Whose side are you on: does serotonin preferentially activate the right hemisphere and norepinephrine the left? Med Hypotheses 2012; 79:250-4. [PMID: 22647616 DOI: 10.1016/j.mehy.2012.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Accepted: 05/02/2012] [Indexed: 10/28/2022]
Abstract
Serotonin (5-HT) and norepinephrine (NE) innervate both the left and right hemispheres of the brain, but whether they affect lateralization of function is unknown. This paper concisely examines evidence that these two neurotransmitters differentially affect the two hemispheres, and puts forth the novel hypothesis 5-HT preferentially activates the right hemisphere (RH) and NE the left hemisphere (LH). The principal lines of evidence comprise studies of: (1) 5-HT and NE level measurement, (2) receptor binding, (3) functional brain imaging, (4) dichotic listening, and (5) electroencephalography and evoked potentials. In assessing these 5 lines, emphasis is placed on studies of pharmaceutical drugs that affect the 5-HT and NE systems. While all of the data do not support the hypothesis, they are generally consistent with it, or a variant of the hypothesis that there is a bias toward 5-HT preferentially activating a majority of brain areas or functions in the RH, and NE a majority of LH areas or functions. If this hypothesis, or a variant of it, is correct, it may be relevant to understanding the physiological basis of neuropsychiatric disorders that could involve dysfunction in brain monoaminergic systems, as well as understanding potential lateralization of the effects of drugs that act on these systems.
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Affiliation(s)
- Paul J Fitzgerald
- The Zanvyl Krieger Mind/Brain Institute, Solomon H. Snyder Department of Neuroscience, Johns Hopkins University, 338 Krieger Hall, 3400 N. Charles St., Baltimore, MD 21218, USA.
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Miao Q, Zhao XL, Zhang QY, Zhang ZY, Guan YH, Ye HY, Zhang S, Zeng MF, Zuo CT, Li YM. Stability in brain glucose metabolism following brown adipose tissue inactivation in chinese adults. AJNR Am J Neuroradiol 2012; 33:1464-9. [PMID: 22576895 DOI: 10.3174/ajnr.a3006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The thermogenesis of BAT is believed to be controlled through some pathways initiated in the brain, though the changes in brain activity among different states of BAT-positive subjects are still unclear. We hypothesized that some significant differences of regional cerebral metabolism between various groups were related to the BAT activities regardless of temperature changes. MATERIALS AND METHODS Relative regional cerebral glucose metabolism was compared between 15 healthy subjects with activated BAT and 30 healthy controls without activated BAT by using a brain FDG-PET scan. A follow-up PET scan was performed to assess metabolic changes of the brain when BAT activity was eliminated by heat exposure. RESULTS Compared with controls, BAT-positive subjects exhibited lower activity in the inferior parietal lobule, limbic system, and frontal lobe and higher activity in the precuneus before heat exposure. Compared with the BAT elimination status, subjects with activated BAT showed a decreased metabolism in the parietal lobe, frontal lobe, culmen, cingulate gyrus, and sublobar region. Compared with controls, BAT-positive subjects after BAT inactivation had significant hypometabolic areas in the temporal lobe and limbic lobe and hypermetabolic areas in the parietal lobe. CONCLUSIONS Our findings illustrate that changes of regional cerebral metabolism are related to BAT activities regardless of temperature changes. This before-after controlled study supports the finding that the brain responses appear to be active in modulating the metabolic function of BAT activity.
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Affiliation(s)
- Q Miao
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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Underwood MD, Kassir SA, Bakalian MJ, Galfalvy H, Mann JJ, Arango V. Neuron density and serotonin receptor binding in prefrontal cortex in suicide. Int J Neuropsychopharmacol 2012; 15:435-47. [PMID: 21733245 PMCID: PMC4167642 DOI: 10.1017/s1461145711000691] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Although serotonin receptor and cytoarchitectonic alterations are reported in prefrontal cortex (PFC) in suicide and depression, no study has considered binding relative to neuron density. Therefore, we measured neuron density and serotonin transporter (SERT), 5-HT1A and 5-HT2A binding in matched suicides and controls. Suicides and normal controls (n=15 matched pairs) were psychiatrically characterized. Neuron density and binding were determined in dorsal [Brodmann area (BA) 9] and ventral (BA 47) PFC by stereology and quantitative autoradiography in near-adjacent sections. Binding index was defined as the ratio of receptor binding to neuron density. Suicides had lower neuron density in the gyrus of both areas. The binding index was lower for SERT in BA 47 but not in BA9; the 5-HT1A binding index was higher in BA 9 but not in BA 47, while the 5-HT2A binding index was not different between groups. SERT binding was lower in suicides in BA 47 but not BA 9, while 5-HT1A binding was higher in BA 9 but not BA 47. SERT binding negatively correlated with 5-HT1A binding in BA 47 in suicides. Neuron density decreased with age. The 5-HT1A binding index was higher in females than males. We found lower neuron density and lower SERT binding index in both PFC regions in suicides. More 5-HT1A binding with less SERT binding and the negative correlation in depressed suicides suggests post-synaptic receptor up-regulation, and it is independent of the difference in neuron density. Thus, abnormalities in both cortical neurons and in their serotonergic innervation are present in suicides and future studies will need to determine whether cortical changes reflect the trophic effect of altered serotonin innervation.
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Affiliation(s)
- Mark D Underwood
- Department of Psychiatry, Columbia University, New York, NY 10032, USA.
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Smith GS, Kahn A, Sacher J, Rusjan P, van Eimeren T, Flint A, Wilson AA. Serotonin transporter occupancy and the functional neuroanatomic effects of citalopram in geriatric depression. Am J Geriatr Psychiatry 2011; 19:1016-25. [PMID: 21841458 PMCID: PMC3968900 DOI: 10.1097/jgp.0b013e318227f83f] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The functional neuroanatomic changes associated with selective serotonin reuptake inhibitor (SSRI) treatment have been the focus of positron emission tomography (PET) studies of cerebral glucose metabolism in geriatric depression. DESIGN To evaluate the underlying neurochemical mechanisms, both cerebral glucose metabolism and serotonin transporter (SERT) availability were measured before and during treatment with the SSRI, citalopram. It was hypothesized that SERT occupancy would be observed in cortical and limbic brain regions that have shown metabolic effects, as well as striatal and thalamic regions that have been implicated in prior studies in midlife patients. SETTING Psychiatric outpatient clinic. PARTICIPANTS Seven depressed patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for current major depressive episode were enrolled. INTERVENTION Patients underwent a 12-week open-label trial of the SSRI, citalopram. MEASUREMENTS Patients underwent high-resolution research tomography PET scans to measure changes in cerebral glucose metabolism and SERT occupancy by citalopram treatment (after 8-10 weeks of treatment). RESULTS Three different tracer kinetic models were applied to the [¹¹C]-DASB region-of-interest data and yielded similar results of an average of greater than 70% SERT occupancy in the striatum and thalamus during citalopram treatment. Voxel-wise analyses showed significant SERT occupancy in these regions, as well as cortical (e.g., anterior cingulate, superior and middle frontal, precuneus, and limbic (parahippocampal gyrus) areas that also showed reductions in glucose metabolism. CONCLUSION The findings suggest that cortical and limbic SERT occupancy may be an underlying mechanism for the regional cerebral metabolic effects of citalopram in geriatric depression.
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Affiliation(s)
- Gwenn S Smith
- Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
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Disrupted brain connectivity networks in drug-naive, first-episode major depressive disorder. Biol Psychiatry 2011; 70:334-42. [PMID: 21791259 DOI: 10.1016/j.biopsych.2011.05.018] [Citation(s) in RCA: 685] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2011] [Revised: 05/05/2011] [Accepted: 05/23/2011] [Indexed: 02/05/2023]
Abstract
BACKGROUND Neuroimaging studies have shown that major depressive disorder (MDD) is accompanied by structural and functional abnormalities in specific brain regions and connections; yet, little is known about alterations of the topological organization of whole-brain networks in MDD patients. METHODS Thirty drug-naive, first-episode MDD patients and 63 healthy control subjects underwent a resting-state functional magnetic resonance imaging scan. The whole-brain functional networks were constructed by thresholding partial correlation matrices of 90 brain regions, and their topological properties (e.g., small-world, efficiency, and nodal centrality) were analyzed using graph theory-based approaches. Nonparametric permutation tests were further used for group comparisons of topological metrics. RESULTS Both the MDD and control groups showed small-world architecture in brain functional networks, suggesting a balance between functional segregation and integration. However, compared with control subjects, the MDD patients showed altered quantitative values in the global properties, characterized by lower path length and higher global efficiency, implying a shift toward randomization in their brain networks. The MDD patients exhibited increased nodal centralities, predominately in the caudate nucleus and default-mode regions, including the hippocampus, inferior parietal, medial frontal, and parietal regions, and reduced nodal centralities in the occipital, frontal (orbital part), and temporal regions. The altered nodal centralities in the left hippocampus and the left caudate nucleus were correlated with disease duration and severity. CONCLUSIONS These results suggest that depressive disorder is associated with disruptions in the topological organization of functional brain networks and that this disruption may contribute to disturbances in mood and cognition in MDD patients.
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Abstract
Abnormalities in specific cerebral networks likely confer vulnerability that increases the susceptibility for development of geriatric depression and affect the course of symptoms. Functional neuroimaging enables the in vivo identification of alterations in cerebral function that characterize disease vulnerability and contribute to variability in depressive symptoms and antidepressant response. Judicious use of functional neuroimaging tools can advance pathophysiologic models of geriatric depression. Furthermore, geriatric depression provides a logical context within which to study the role of specific functional abnormalities in both antidepressant response and key behavioral and cognitive abnormalities of mood disorders.
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Affiliation(s)
- Faith M. Gunning
- Institute of Geriatric Psychiatry, Weill Cornell Medical College, 21 Bloomingdale Road; White Plains, N.Y. 10605; Tel. (914) 997-8643; Fax Number (914) 682-6979
| | - Gwenn S. Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview Medical Center, Alpha Commons Bldg. 4th floor, 5300 Alpha Commons Drive, Baltimore, MD 21224, USA. Phone Number: 410-550-8696, Fax Number: 410-550-0564
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Miao Q, Zhang S, Guan YH, Ye HY, Zhang ZY, Zhang QY, Xue RD, Zeng MF, Zuo CT, Li YM. Reversible changes in brain glucose metabolism following thyroid function normalization in hyperthyroidism. AJNR Am J Neuroradiol 2011; 32:1034-42. [PMID: 21596814 DOI: 10.3174/ajnr.a2449] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Patients with hyperthyroidism frequently present with regional cerebral metabolic changes, but the consequences of endocrine-induced brain changes after thyroid function normalization are unclear. We hypothesized that the changes of regional cerebral glucose metabolism are related to thyroid hormone levels in patients with hyperthyroid, and some of these changes can be reversed with antithyroid therapy. MATERIALS AND METHODS Relative regional cerebral glucose metabolism was compared between 10 new-onset untreated patients with hyperthyroidism and 20 healthy control participants by using brain FDG-PET scans. Levels of emotional distress were evaluated by using the SAS and SDS. Patients were treated with methimazole. A follow-up PET scan was performed to assess metabolic changes of the brain when thyroid functions normalized. RESULTS Compared with controls, patients exhibited lower activity in the limbic system, frontal lobes, and temporal lobes before antithyroid treatment. There were positive correlations between scores of depression and regional metabolism in the cingulate and paracentral lobule. The severity of depression and anxiety covaried negatively with pretreatment activity in the inferior temporal and inferior parietal gyri respectively. Compared with the hyperthyroid status, patients with normalized thyroid functions showed an increased metabolism in the left parahippocampal, fusiform, and right superior frontal gyri. The decrease in both FT3 and FT4 was associated with increased activity in the left parahippocampal and right superior frontal gyri. CONCLUSIONS The changes of regional cerebral glucose metabolism are related to thyroid hormone levels in patients with hyperthyroidism, and some cerebral hypometabolism can be improved after antithyroid therapy.
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Affiliation(s)
- Q Miao
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, China
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Abstract
Brain serotonergic circuitries interact with other neurotransmitter systems on a multitude of different molecular levels. In humans, as in other mammalian species, serotonin (5-HT) plays a modulatory role in almost every physiological function. Furthermore, serotonergic dysfunction is thought to be implicated in several psychiatric and neurodegenerative disorders. We describe the neuroanatomy and neurochemistry of brain serotonergic circuitries. The contribution of emergent in vivo imaging methods to the regional localization of binding site receptors and certain aspects of their functional connectivity in correlation to behavior is also discussed. 5-HT cell bodies, mainly localized in the raphe nuclei, send axons to almost every brain region. It is argued that the specificity of the local chemocommunication between 5-HT and other neuronal elements mainly depends on mechanisms regulating the extracellular concentration of 5-HT the diversity of high-affinity membrane receptors, and their specific transduction modalities.
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Affiliation(s)
- Yves Charnay
- Hôpitaux Universitaires de Genève, Département de Psychiatrie, Service de Neuropsychiatrie, Ch. Du Petit-Bel-Air, 2, CH-1225 Chêne-Bourg, Switzerland.
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The relationship between the acute cerebral metabolic response to citalopram and chronic citalopram treatment outcome. Am J Geriatr Psychiatry 2011; 19:53-63. [PMID: 21218565 PMCID: PMC3058257 DOI: 10.1097/jgp.0b013e3181eafde4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Given the challenges in the clinical management of geriatric depression, research over the past decade has focused on developing early neurobiological markers of antidepressant treatment response. This study tested the hypothesis that lower baseline glucose metabolism and greater acute cerebral metabolic responses to a single, intravenous (IV) dose of the selective serotonin reuptake inhibitor (SSRI) citalopram would be associated with greater improvement of depressive symptoms after 12 weeks of citalopram treatment in geriatric depression. METHODS sixteen geriatric depressed patients underwent two scans to measure cerebral glucose metabolism after administration of either a saline placebo or citalopram infusion (40 mg, IV). Then, the patients were treated with the oral citalopram medication for 12 weeks. RESULTS greater improvement of depressive symptoms was associated with lower baseline metabolism in anterior cingulate, superior, middle, and inferior frontal gyri (bilaterally), inferior parietal lobule (bilaterally), precuneus (right), insula (left), parahippocampal gyrus (right), caudate (bilaterally), and putamen (left) regions. Greater improvement of depressive symptoms was associated with greater reductions in metabolism after acute citalopram administration in similar brain regions, including additional posterior cortical regions. CONCLUSIONS lower baseline cerebral metabolism and greater decreases with acute citalopram administration are associated with better antidepressant response to chronic citalopram treatment. These data are consistent with previous studies of total sleep deprivation and suggest that dynamic, early adaptive changes or normalization of cerebral metabolism may represent early neurobiological markers of chronic SSRI treatment response in geriatric depression.
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Abstract
The aetiology of psychiatric diseases such as depression or schizophrenia remains largely unknown, even though multiple theories have been proposed. Although monoamine theory is the cornerstone of available pharmacological therapies, relapses, incomplete control of symptoms or failure in treatment occur frequently. From an inflammatory/immune point of view, both entities share several common hallmarks in their pathophysiology, e.g. neuroendocrine/immune alterations, structural/functional abnormalities in particular brain areas, and cognitive deficits, suggesting a dysregulated inflammatory-related component of these diseases that better explains the myriad of symptoms presented by affected individuals. In this review we aimed to explore the role and relevance of inflammatory related lipids (prostanoids) derived from arachidonic acid metabolism by identification of new inflammatory markers and possible pharmacological/dietary modulation of these compounds, with the aim of improving some of the symptoms developed by individuals affected with psychiatric diseases (a critical review of basic and clinical studies about inflammatory-related arachidonic acid metabolism on neuropsychiatric diseases is included). As a specific candidate, one of these immunoregulatory lipids, the anti-inflammatory prostaglandin 15d-PGJ₂ and its nuclear receptor peroxisome proliferator-activated nuclear receptor (PPARγ) could be used as a biological marker for psychiatric diseases. In addition, its pharmacological activation can be considered as a multi-faceted therapeutic target due to its anti-inflammatory/antioxidant/anti-excitotoxic/pro-energetic profile, reported in some inflammatory-related scenarios (neurological and stress-related diseases). PPARs are activated by a great variety of compounds, the most relevant being the currently prescribed group of anti-diabetic drugs thiazolidinediones, and some cannabinoids (both endocannabinoids, phytocannabinoids or synthetic), as possible novel therapeutical strategy.
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Diaconescu AO, Kramer E, Hermann C, Ma Y, Dhawan V, Chaly T, Eidelberg D, McIntosh AR, Smith GS. Distinct functional networks associated with improvement of affective symptoms and cognitive function during citalopram treatment in geriatric depression. Hum Brain Mapp 2010; 32:1677-91. [PMID: 20886575 DOI: 10.1002/hbm.21135] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Revised: 06/09/2010] [Accepted: 07/06/2010] [Indexed: 01/12/2023] Open
Abstract
Variability in the affective and cognitive symptom response to antidepressant treatment has been observed in geriatric depression. The underlying neural circuitry is poorly understood. This study evaluated the cerebral glucose metabolic effects of citalopram treatment and applied multivariate, functional connectivity analyses to identify brain networks associated with improvements in affective symptoms and cognitive function. Sixteen geriatric depressed patients underwent resting positron emission tomography (PET) studies of cerebral glucose metabolism and assessment of affective symptoms and cognitive function before and after 8 weeks of selective serotonin reuptake inhibitor treatment (citalopram). Voxel-wise analyses of the normalized glucose metabolic data showed decreased cerebral metabolism during citalopram treatment in the anterior cingulate gyrus, middle temporal gyrus, precuneus, amygdala, and parahippocampal gyrus. Increased metabolism was observed in the putamen, occipital cortex, and cerebellum. Functional connectivity analyses revealed two networks which were uniquely associated with improvement of affective symptoms and cognitive function during treatment. A subcortical-limbic-frontal network was associated with improvement in affect (depression and anxiety), while a medial temporal-parietal-frontal network was associated with improvement in cognition (immediate verbal learning/memory and verbal fluency). The regions that comprise the cognitive network overlap with the regions that are affected in Alzheimer's dementia. Thus, alterations in specific brain networks associated with improvement of affective symptoms and cognitive function are observed during citalopram treatment in geriatric depression.
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Charnay Y, Léger L. Brain serotonergic circuitries. DIALOGUES IN CLINICAL NEUROSCIENCE 2010; 12:471-87. [PMID: 21319493 PMCID: PMC3181988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2023]
Abstract
Brain serotonergic circuitries interact with other neurotransmitter systems on a multitude of different molecular levels. In humans, as in other mammalian species, serotonin (5-HT) plays a modulatory role in almost every physiological function. Furthermore, serotonergic dysfunction is thought to be implicated in several psychiatric and neurodegenerative disorders. We describe the neuroanatomy and neurochemistry of brain serotonergic circuitries. The contribution of emergent in vivo imaging methods to the regional localization of binding site receptors and certain aspects of their functional connectivity in correlation to behavior is also discussed. 5-HT cell bodies, mainly localized in the raphe nuclei, send axons to almost every brain region. It is argued that the specificity of the local chemocommunication between 5-HT and other neuronal elements mainly depends on mechanisms regulating the extracellular concentration of 5-HT the diversity of high-affinity membrane receptors, and their specific transduction modalities.
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Affiliation(s)
- Yves Charnay
- Hôpitaux Universitaires de Genève, Département de Psychiatrie, Service de Neuropsychiatrie, Ch. Du Petit-Bel-Air, 2, CH-1225 Chêne-Bourg, Switzerland.
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