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Bremner JD, Ortego RA, Campanella C, Nye JA, Davis LL, Fani N, Vaccarino V. Neural correlates of PTSD in women with childhood sexual abuse with and without PTSD and response to paroxetine treatment: A placebo-controlled, double-blind trial. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 14:100615. [PMID: 38088987 PMCID: PMC10715797 DOI: 10.1016/j.jadr.2023.100615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Objective Childhood sexual abuse is the leading cause of posttraumatic stress disorder (PTSD) in women, and is a prominent cause of morbidity and loss of function for which limited treatments are available. Understanding the neurobiology of treatment response is important for developing new treatments. The purpose of this study was to assess neural correlates of personalized traumatic memories in women with childhood sexual abuse with and without PTSD, and to assess response to treatment. Methods Women with childhood sexual abuse with (N = 28) and without (N = 17) PTSD underwent brain imaging with High-Resolution Positron Emission Tomography scanning with radiolabeled water for brain blood flow measurements during exposure to personalized traumatic scripts and memory encoding tasks. Women with PTSD were randomized to paroxetine or placebo followed by three months of double-blind treatment and repeat imaging with the same protocol. Results Women with PTSD showed decreases in areas involved in the Default Mode Network (DMN), a network of brain areas usually active when the brain is at rest, hippocampus and visual processing areas with exposure to traumatic scripts at baseline while women without PTSD showed increased activation in superior frontal gyrus and other areas (p < 0.005). Treatment of women with PTSD with paroxetine resulted in increased anterior cingulate activation and brain areas involved in the DMN and visual processing with scripts compared to placebo (p < 0.005). Conclusion PTSD related to childhood sexual abuse in women is associated with alterations in brain areas involved in memory and the stress response and treatment with paroxetine results in modulation of these areas.
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Affiliation(s)
- J Douglas Bremner
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
- Atlanta VA Medical Center, Decatur, GA
| | - Rebeca Alvarado Ortego
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Carolina Campanella
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Jonathon A Nye
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
| | - Lori L Davis
- Department of Psychiatry, University of Alabama School of Medicine, Birmingham, AL
- Tuscaloosa VA Medical Center, Tuscaloosa AL
| | - Negar Fani
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta GA
- Department of Medicine (Cardiology), Emory University School of Medicine, Atlanta, GA
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2
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Changes in resting-state functional connectivity in patients with congenital adrenal hyperplasia. NEUROIMAGE: CLINICAL 2022; 35:103081. [PMID: 35700599 PMCID: PMC9194649 DOI: 10.1016/j.nicl.2022.103081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/03/2022] [Accepted: 06/05/2022] [Indexed: 11/25/2022] Open
Abstract
Patients with CAH showed increased functional connectivity during rest in the precuneus compared with controls. This change may reflect a functional reorganisation in response to the CAH disease. The change in functional connectivity may also depend on the severity of CAH.
Context Patients with congenital adrenal hyperplasia (CAH) are treated with life-long glucocorticoid (GC) replacement therapy. Negative effects on cognition, brain structure and function during working memory tasks have been identified. To date, no studies on functional connectivity during rest have been performed in patients with CAH. Objective To investigate resting-state functional connectivity in patients with CAH compared with healthy untreated controls and the association between functional connectivity in the precuneus and disease severity, dose of GC and working memory (WM). Design, Setting and Participants Thirty-one patients with CAH (18 females) and 38 healthy controls (24 females), aged 16–33 years, from a single research institute, underwent functional magnetic resonance imaging of the brain during rest. Results Patients with CAH showed increased functional connectivity in the precuneus compared with controls. Post-hoc tests within the precuneus showed that only patients with simple virilising CAH had stronger connectivity compared to controls. Further, while both patients with salt-wasting and simple virilising CAH performed worse on a WM task compared to controls, functional connectivity in the precuneus was not associated with executive function performance. Conclusion Patients with CAH demonstrated altered functional connectivity during rest in the precuneus. Such a change may reflect a functional reorganisation in response to the CAH disease. The change in functional connectivity may depend on the severity of CAH.
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3
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Wang Z, Zhu H, Yuan M, Li Y, Qiu C, Ren Z, Yuan C, Lui S, Gong Q, Zhang W. The resting-state functional connectivity of amygdala subregions associated with post-traumatic stress symptom and sleep quality in trauma survivors. Eur Arch Psychiatry Clin Neurosci 2021; 271:1053-1064. [PMID: 32052123 DOI: 10.1007/s00406-020-01104-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 02/03/2020] [Indexed: 02/05/2023]
Abstract
Neuroimaging findings suggest that the amygdala plays a primary role in both the psychopathology of posttraumatic stress disorder (PTSD) and poor sleep quality, which are common in trauma survivors. However, the neural mechanisms of these two problems in trauma survivors associated with amygdala remain unclear. In the current study, we aimed to explore the role of functional connectivity of amygdala subregions in both PTSD symptoms and poor sleep quality. A total of 94 trauma-exposed subjects were scanned on a 3T MR system using resting-state functional magnetic resonance imaging. Both Pittsburgh Sleep Quality Index and Clinician-Administered PTSD Scale scores were negatively correlated with the resting-state functional connectivity between the left basolateral amygdala-left medial prefrontal cortex and the right basolateral amygdala-right medial prefrontal cortex. Our findings suggest a shared amygdala subregional neural circuitry underlying the neuropathological mechanisms of PTSD symptoms and poor sleep quality in trauma survivors.
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Affiliation(s)
- Zuxing Wang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
- Sichuan Provincial Center for Mental Healthy, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Hongru Zhu
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
- Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Minlan Yuan
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Yuchen Li
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Changjian Qiu
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Zhengjia Ren
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
- Department of Clinical Psychology, Southwest Hospital, Army Medical University (The Third Military Medical University), Chongqing, China
| | - Cui Yuan
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wei Zhang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.
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van Rooij SJ, Sippel LM, McDonald WM, Holtzheimer PE. Defining focal brain stimulation targets for PTSD using neuroimaging. Depress Anxiety 2021; 38:10.1002/da.23159. [PMID: 33876868 PMCID: PMC8526638 DOI: 10.1002/da.23159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/17/2021] [Accepted: 04/02/2021] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Focal brain stimulation has potential as a treatment for posttraumatic stress disorder (PTSD). In this review, we aim to inform selection of focal brain stimulation targets for treating PTSD by examining studies of the functional neuroanatomy of PTSD and treatment response. We first briefly review data on brain stimulation interventions for PTSD. Although published data suggest good efficacy overall, the neurobiological rationale for each stimulation target is not always clear. METHODS Therefore, we assess pre- and post-treatment (predominantly psychotherapy) functional neuroimaging studies in PTSD to determine which brain changes seem critical to treatment response. Results of these studies are presented within a previously proposed functional neural systems model of PTSD. RESULTS While not completely consistent, research suggests that downregulating the fear learning and threat and salience detection circuits (i.e., amygdala, dorsal anterior cingulate cortex and insula) and upregulating the emotion regulation and executive function and contextual processing circuits (i.e., prefrontal cortical regions and hippocampus) may mediate PTSD treatment response. CONCLUSION This literature review provides some justification for current focal brain stimulation targets. However, the examination of treatment effects on neural networks is limited, and studies that include the stimulation targets are lacking. Further, additional targets, such as the cingulate, medial prefrontal cortex, and inferior parietal lobe, may also be worth investigation, especially when considering how to achieve network level changes. Additional research combining PTSD treatment with functional neuroimaging will help move the field forward by identifying and validating novel targets, providing better rationale for specific treatment parameters and personalizing treatment for PTSD.
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Affiliation(s)
- Sanne J.H. van Rooij
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA
| | - Lauren M. Sippel
- National Center for PTSD, U.S. Department of Veterans Affairs, White River Junction, VT
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - William M. McDonald
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA
| | - Paul E. Holtzheimer
- National Center for PTSD, U.S. Department of Veterans Affairs, White River Junction, VT
- Geisel School of Medicine at Dartmouth, Hanover, NH
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Zhao Q, Xu T, Wang Y, Chen D, Liu Q, Yang Z, Wang Z. Limbic cortico-striato-thalamo-cortical functional connectivity in drug-naïve patients of obsessive-compulsive disorder. Psychol Med 2021; 51:70-82. [PMID: 31640827 DOI: 10.1017/s0033291719002988] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND The pathophysiology of obsessive-compulsive disorder (OCD) remains unclear despite extensive neuroimaging work on the disorder. Exposure to medication and comorbid mental disorders can confound the results of OCD studies. The goal of this study was to explore differences in brain functional connectivity (FC) within the cortico-striato-thalamo-cortical (CSTC) loop of drug-naïve and drug-free OCD patients and healthy controls (HCs). METHODS A total of 29 drug-naïve OCD patients, 22 drug-free OCD patients, and 25 HCs matched on age, gender and education level underwent functional magnetic resonance imaging scanning at resting state. Seed-based connectivity analyses were conducted among the three groups. The Yale Brown Obsessive Compulsive Scale and clinical inventories were used to assess the clinical symptoms. RESULTS Compared with HCs, the drug-naïve OCD patients had reduced FC within the limbic CSTC loop. In the drug-naïve OCD participants, we also found hyperconnectivity between the supplementary motor area and ventral and dorsal putamen (p < 0.05, corrected for multiple comparisons). CONCLUSIONS Exposure to antidepressants such as selective serotonin reuptake inhibitors may affect the function of some brain regions. Future longitudinal studies could help to reveal the pharmacotherapeutic mechanisms in these loops.
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Affiliation(s)
- Qing Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Tingting Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Yuan Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Dandan Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Qiang Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Zhi Yang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, P.R. China
- Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
- Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, P.R. China
- Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
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Suo X, Lei D, Li W, Yang J, Li L, Sweeney JA, Gong Q. Individualized Prediction of PTSD Symptom Severity in Trauma Survivors From Whole-Brain Resting-State Functional Connectivity. Front Behav Neurosci 2020; 14:563152. [PMID: 33408617 PMCID: PMC7779396 DOI: 10.3389/fnbeh.2020.563152] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/23/2020] [Indexed: 02/05/2023] Open
Abstract
Previous studies have demonstrated relations between spontaneous neural activity evaluated by resting-state functional magnetic resonance imaging (fMRI) and symptom severity in post-traumatic stress disorder. However, few studies have used brain-based measures to identify imaging associations with illness severity at the level of individual patients. This study applied connectome-based predictive modeling (CPM), a recently developed data-driven and subject-level method, to identify brain function features that are related to symptom severity of trauma survivors. Resting-state fMRI scans and clinical ratings were obtained 10-15 months after the earthquake from 122 earthquake survivors. Symptom severity of post-traumatic stress disorder features for each survivor was evaluated using the Clinician Administered Post-traumatic Stress Disorder Scale (CAPS-IV). A functionally pre-defined atlas was applied to divide the human brain into 268 regions. Each individual's functional connectivity 268 × 268 matrix was created to reflect correlations of functional time series data across each pair of nodes. The relationship between CAPS-IV scores and brain functional connectivity was explored in a CPM linear model. Using a leave-one-out cross-validation (LOOCV) procedure, findings showed that the positive network model predicted the left-out individual's CAPS-IV scores from resting-state functional connectivity. CPM predicted CAPS-IV scores, as indicated by a significant correspondence between predicted and actual values (r = 0.30, P = 0.001) utilizing primarily functional connectivity between visual cortex, subcortical-cerebellum, limbic, and motor systems. The current study provides data-driven evidence regarding the functional brain features that predict symptom severity based on the organization of intrinsic brain networks and highlights its potential application in making clinical evaluation of symptom severity at the individual level.
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Affiliation(s)
- Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Du Lei
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - Wenbin Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Yang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
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7
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Yuan M, Pantazatos SP, Zhu H, Li Y, Miller JM, Rubin-Falcone H, Zanderigo F, Ren Z, Yuan C, Lui S, Gong Q, Qiu C, Zhang W, John Mann J. Altered amygdala subregion-related circuits in treatment-naïve post-traumatic stress disorder comorbid with major depressive disorder. Eur Neuropsychopharmacol 2019; 29:1092-1101. [PMID: 31488341 PMCID: PMC7434633 DOI: 10.1016/j.euroneuro.2019.07.238] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/18/2019] [Accepted: 07/27/2019] [Indexed: 02/05/2023]
Abstract
Individuals with both post-traumatic stress disorder and major depressive disorder (PTSD+MDD) often show greater social and occupational impairment and poorer treatment response than individuals with PTSD alone. Increasing evidence reveals that the amygdala, a brain region implicated in the pathophysiology of both of these conditions, is a complex of structurally and functionally heterogeneous nuclei. Quantifying the functional connectivity of two key amygdala subregions, the basolateral (BLA) and centromedial (CMA), in PTSD+MDD and PTSD-alone could advance our understanding of the neurocircuitry of these conditions. 18 patients with PTSD+MDD, 28 with PTSD-alone, and 50 trauma exposed healthy controls (TEHC), all from a cohort who survived the same large earthquake in China, underwent resting-state functional magnetic resonance imaging. Bilateral BLA and CMA functional connectivity (FC) maps were created using a seed-based approach for each participant. The analysis of covariance of FC was used to determine between-group differences. A significant interaction between amygdala subregion and diagnostic group suggested that differences in connectivity patterns between the two seeds were mediated by diagnosis. Post-hoc analyses revealed that PTSD+MDD patients showed weaker connectivity between right BLA and (a) left anterior cingulate cortex/supplementary motor area, and (b) bilateral putamen/pallidum, compared with PTSD-alone patients. Higher CMA connectivities left ACC/SMA were also observed in PTSD+MDD compared with PTSD-alone. An inverse relationship between the connectivity of right BLA with right putamen/pallidum and MDD symptoms was found in PTSD+MDD. These findings indicate a relationship between the neural pathophysiology of PTSD+MDD compared with PTSD-alone and TEHC and may inform future clinical interventions.
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Affiliation(s)
- Minlan Yuan
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States
| | - Spiro P Pantazatos
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States
| | - Hongru Zhu
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuchen Li
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jeffrey M Miller
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States
| | - Harry Rubin-Falcone
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States
| | - Francesca Zanderigo
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States
| | - Zhengjia Ren
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Cui Yuan
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Radiology Department of the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Changjian Qiu
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
| | - Wei Zhang
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
| | - J John Mann
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States; Department of Radiology, Columbia University College of Physicians and Surgeons, New York, NY
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8
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Zhu H, Li Y, Yuan M, Ren Z, Yuan C, Meng Y, Wang J, Deng W, Qiu C, Huang X, Gong Q, Lui S, Zhang W. Increased functional segregation of brain network associated with symptomatology and sustained attention in chronic post-traumatic stress disorder. J Affect Disord 2019; 247:183-191. [PMID: 30684892 DOI: 10.1016/j.jad.2019.01.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 12/25/2018] [Accepted: 01/13/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Traditional regional or voxel-based analyses only focus on specific brain regions or connectivity rather than the whole brain's functional organization. Using resting state functional magnetic resonance imaging (rs-fMRI), we aimed to explore the altered topological metrics, clinical symptoms and cognitive function in chronic post-traumatic stress disorder (PTSD) in order to identify the brain network mechanisms underlying these clinical and cognitive symptoms. METHODS Forty patients with unmedicated chronic PTSD and forty-two matched trauma-exposed healthy controls (TEHCs) underwent rs-fMRI, and the topological organization of the whole-brain network was calculated using graph theory. The Rapid Visual Information Processing (RVP) task and Wechsler Memory Scale-IV (WMS-IV) were used to evaluate the subjects' sustained attention and memory capacity. All clinical and cognitive measures and topological parameters of the PTSD patients and TEHCs were compared, and the relationships between altered network metrics and symptom severity were explored. RESULTS Compared with the TEHCs, the patients showed increases in the normalized clustering coefficient, small-worldness, normalized local efficiency and efficiency-based small-worldness. The left middle occipital gyrus showed increases in nodal global efficiency and nodal degree that were negatively correlated with the severity of PTSD symptoms. The altered connections in PTSD only involved the default mode network (DMN) and the occipital network. LIMITATIONS Comorbid conditions were included, and current cross-sectional study cannot conclude on causality. CONCLUSIONS Patients with chronic PTSD showed increased functional brain network segregation, mainly in the occipital cortex, which could be a protective or compensatory mechanism to alleviate clinical symptoms.
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Affiliation(s)
- Hongru Zhu
- Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford 94305, CA, United States
| | - Yuchen Li
- Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Minlan Yuan
- Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Zhengjia Ren
- Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Cui Yuan
- Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Yajing Meng
- Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Jian Wang
- Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Wei Deng
- Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Changjian Qiu
- Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China.
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Wei Zhang
- Mental Health Center and psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.
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9
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Zhao P, Yan R, Wang X, Geng J, Chattun MR, Wang Q, Yao Z, Lu Q. Reduced Resting State Neural Activity in the Right Orbital Part of Middle Frontal Gyrus in Anxious Depression. Front Psychiatry 2019; 10:994. [PMID: 32038329 PMCID: PMC6987425 DOI: 10.3389/fpsyt.2019.00994] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/17/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Anxious depression (AD), which is generally recognized as a common clinical subtype of major depressive disorder (MDD), holds distinctive features compared with unanxious depression (UAD). However, the neural mechanism of AD still remains unrevealed. To give insight to it, we compared resting-state functional magnetic resonance amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC) between AD and UAD patients. METHOD The data were collected from 60 AD patients, 38 UAD patients, and 60 matched healthy controls. The ALFF and seed-based FC were examined. Pearson correlations were computed between ALFF/FC and clinical measures. RESULTS In Comparison with the UAD group, the ALFF value of the right orbital part of middle frontal gyrus (RO-MFG) decreased in AD group. Specifically, the ALFF values of the RO-MFG were negatively correlated with retardation factor scores in AD group (r = -0.376, p = 0.003). CONCLUSIONS AD patients exhibited disturbed intrinsic brain function compared with UAD patients. The decreased activity of the RO-MFG is indicative of the alterations involved in the neural basis of AD.
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Affiliation(s)
- Peng Zhao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Department of Medical Psychology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Rui Yan
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xinyi Wang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China.,Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, China
| | - Jiting Geng
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Department of Psychiatry, Hangzhou Seventh People's Hospital, Hangzhou, China
| | - Mohammad Ridwan Chattun
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qiang Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Department of Medical Psychology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China.,Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, China
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10
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Disturbed effective connectivity patterns in an intrinsic triple network model are associated with posttraumatic stress disorder. Neurol Sci 2018; 40:339-349. [PMID: 30448966 DOI: 10.1007/s10072-018-3638-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/07/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Disturbance of the triple network model was recently proposed to be associated with the occurrence of posttraumatic stress disorder (PTSD) symptoms. Based on resting-state dynamic causal modeling (rs-DCM) analysis, we investigated the neurobiological model at a neuronal level along with potential neuroimaging biomarkers for identifying individuals with PTSD. METHODS We recruited survivors of a devastating typhoon including 27 PTSD patients, 33 trauma-exposed controls (TECs), and 30 healthy controls without trauma exposure. All subjects underwent resting-state functional magnetic resonance imaging. Independent components analysis was used to identify triple networks. Detailed effective connectivity patterns were estimated by rs-DCM analysis. Spearman correlation analysis was performed on aberrant DCM parameters with clinical assessment results relevant to PTSD diagnosis. We also carried out step-wise binary logistic regression and receiver operating characteristic curve (ROC) analysis to confirm the capacity of altered effective connectivity parameters to distinguish PTSD patients. RESULTS Within the executive control network, enhanced positive connectivity from the left posterior parietal cortex to the left dorsolateral prefrontal cortex was correlated with intrusion symptoms and showed good performance (area under the receiver operating characteristic curve = 0.879) in detecting PTSD patients. In the salience network, we observed a decreased causal flow from the right amygdala to the right insula and a lower transit value for the right amygdala in PTSD patients relative to TECs. CONCLUSION Altered effective connectivity patterns in the triple network may reflect the occurrence of PTSD symptoms, providing a potential biomarker for detecting patients. Our findings shed new insight into the neural pathophysiology of PTSD.
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11
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Misaki M, Phillips R, Zotev V, Wong CK, Wurfel BE, Krueger F, Feldner M, Bodurka J. Real-time fMRI amygdala neurofeedback positive emotional training normalized resting-state functional connectivity in combat veterans with and without PTSD: a connectome-wide investigation. NEUROIMAGE-CLINICAL 2018; 20:543-555. [PMID: 30175041 PMCID: PMC6118041 DOI: 10.1016/j.nicl.2018.08.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 08/08/2018] [Accepted: 08/17/2018] [Indexed: 11/18/2022]
Abstract
Self-regulation of brain activation using real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) is an emerging approach for treating mood and anxiety disorders. The effect of neurofeedback training on resting-state functional connectivity warrants investigation as changes in spontaneous brain activation could reflect the association between sustained symptom relief and brain alteration. We investigated the effect of amygdala-focused rtfMRI-nf training on resting-state functional connectivity in combat veterans with and without posttraumatic stress disorder (PTSD) who were trained to increase a feedback signal reflecting left amygdala activity while recalling positive autobiographical memories (Zotev et al., 2018). The analysis was performed in three stages: i) first, we investigated the connectivity in the left amygdala region; ii) next, we focused on the abnormal resting-state functional connectivity identified in our previous analysis of this data (Misaki et al., 2018); and iii) finally, we performed a novel data-driven longitudinal connectome-wide analysis. We introduced a longitudinal multivariate distance matrix regression (MDMR) analysis to comprehensively examine neurofeedback training effects beyond those associated with abnormal baseline connectivity. These comprehensive exploratory analyses suggested that abnormal resting-state connectivity for combat veterans with PTSD was partly normalized after the training. This included hypoconnectivities between the left amygdala and the left ventrolateral prefrontal cortex (vlPFC) and between the supplementary motor area (SMA) and the dorsal anterior cingulate cortex (dACC). The increase of SMA-dACC connectivity was associated with PTSD symptom reduction. Longitudinal MDMR analysis found a connectivity change between the precuneus and the left superior frontal cortex. The connectivity increase was associated with a decrease in hyperarousal symptoms. The abnormal connectivity for combat veterans without PTSD - such as hypoconnectivity in the precuneus with a superior frontal region and hyperconnectivity in the posterior insula with several regions - could also be normalized after the training. These results suggested that the rtfMRI-nf training effect was not limited to a feedback target region and symptom relief could be mediated by brain modulation in several regions other than in a feedback target area. While further confirmatory research is needed, the results may provide valuable insight into treatment effects on the whole brain resting-state connectivity. fMRI neurofeedback training effect on resting-state connectivity was examined Left amygdala activity was trained to increase with positive memory Neurofeedback normalized altered connectivity in veterans with and without PTSD PTSD symptom reductions were significant but not specific to group (exp/ctrl) Connectivity-symptom association was seen in mPFC and precuneus
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Affiliation(s)
- Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Raquel Phillips
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Vadim Zotev
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Chung-Ki Wong
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Brent E Wurfel
- Laureate Institute for Brain Research, Tulsa, OK, United States; Laureate Psychiatric Clinic and Hospital, Tulsa, OK, United States
| | - Frank Krueger
- Neuroscience Dept., George Mason University, Fairfax, VA, United States
| | - Matthew Feldner
- Dept. of Psychological Science, University of Arkansas, Fayetteville, AR, United States
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK, United States; Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, United States.
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12
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Yuan M, Zhu H, Qiu C, Meng Y, Zhang Y, Ren Z, Li Y, Yuan C, Gao M, Lui S, Gong Q, Zhang W. Altered regional and integrated resting-state brain activity in general social anxiety disorder patients before and after group cognitive behavior therapy. Psychiatry Res Neuroimaging 2018; 272:30-37. [PMID: 29275125 DOI: 10.1016/j.pscychresns.2017.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/26/2017] [Accepted: 12/14/2017] [Indexed: 12/11/2022]
Abstract
We aimed to investigate the recovery neuromechanism underlying the treatment efficacy in generalized social anxiety disorder (GSAD). We recruited fifteen patients with GSAD and nineteen healthy control (HC) participants, all of whom underwent a baseline resting-state fMRI scan. The GSAD patients underwent an additional fMRI scan after group cognitive behavior therapy (GCBT). Amplitude of low-frequency fluctuation (ALFF) and degree centrality (DC) measures were used to examine altered regional and integrated spontaneous brain activity in group comparisons. After GCBT, ALFF of the right precuneus decreased. At baseline, the GSAD group showed higher ALFF in the left precuneus and the left middle temporal gyrus (MTG) and lower ALFF in the lingual gyrus compared with the HC group. The DC of the left precuneus and the MTG were attenuated and the right putamen increased in the post-treatment group. The changes in DC in the precuneus were positively correlated with changes in clinical symptom. The abnormal ALFF of the precuneus, MTG and lingual gyrus may be the neural underpinning of GSAD, whereas the neural response to symptom remission after GCBT was achieved by a rebalance within the default mode network.
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Affiliation(s)
- Minlan Yuan
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Hongru Zhu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Changjian Qiu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yajing Meng
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yan Zhang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Zhengjia Ren
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuchen Li
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Cui Yuan
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Meng Gao
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China; Radiology Department of the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Zhang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
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13
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Maron E, Lan CC, Nutt D. Imaging and Genetic Approaches to Inform Biomarkers for Anxiety Disorders, Obsessive-Compulsive Disorders, and PSTD. Curr Top Behav Neurosci 2018; 40:219-292. [PMID: 29796838 DOI: 10.1007/7854_2018_49] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Anxiety disorders are the most common mental health problem in the world and also claim the highest health care cost among various neuropsychiatric disorders. Anxiety disorders have a chronic and recurrent course and cause significantly negative impacts on patients' social, personal, and occupational functioning as well as quality of life. Despite their high prevalence rates, anxiety disorders have often been under-diagnosed or misdiagnosed, and consequently under-treated. Even with the correct diagnosis, anxiety disorders are known to be difficult to treat successfully. In order to implement better strategies in diagnosis, prognosis, treatment decision, and early prevention for anxiety disorders, tremendous efforts have been put into studies using genetic and neuroimaging techniques to advance our understandings of the underlying biological mechanisms. In addition to anxiety disorders including panic disorder, generalised anxiety disorder (GAD), specific phobias, social anxiety disorders (SAD), due to overlapping symptom dimensions, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) (which were removed from the anxiety disorder category in DSM-5 to become separate categories) are also included for review of relevant genetic and neuroimaging findings. Although the number of genetic or neuroimaging studies focusing on anxiety disorders is relatively small compare to other psychiatric disorders such as psychotic disorders or mood disorders, various structural abnormalities in the grey or white matter, functional alterations of activity during resting-state or task conditions, molecular changes of neurotransmitter receptors or transporters, and genetic associations have all been reported. With continuing effort, further genetic and neuroimaging research may potentially lead to clinically useful biomarkers for the prevention, diagnosis, and management of these disorders.
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Affiliation(s)
- Eduard Maron
- Neuropsychopharmacology Unit, Centre for Academic Psychiatry, Division of Brain Sciences, Imperial College London, London, UK.
- Department of Psychiatry, University of Tartu, Tartu, Estonia.
- Department of Psychiatry, North Estonia Medical Centre, Tallinn, Estonia.
| | - Chen-Chia Lan
- Neuropsychopharmacology Unit, Centre for Academic Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - David Nutt
- Neuropsychopharmacology Unit, Centre for Academic Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
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14
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Yuan M, Qiu C, Meng Y, Ren Z, Yuan C, Li Y, Gao M, Lui S, Zhu H, Gong Q, Zhang W. Pre-treatment Resting-State Functional MR Imaging Predicts the Long-Term Clinical Outcome After Short-Term Paroxtine Treatment in Post-traumatic Stress Disorder. Front Psychiatry 2018; 9:532. [PMID: 30425661 PMCID: PMC6218594 DOI: 10.3389/fpsyt.2018.00532] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 10/08/2018] [Indexed: 02/05/2023] Open
Abstract
Background: The chronic phase of post-traumatic stress disorder (PTSD) and the limited effectiveness of existing treatments creates the need for the development of potential biomarkers to predict response to antidepressant medication at an early stage. However, findings at present focus on acute therapeutic effect without following-up the long-term clinical outcome of PTSD. So far, studies predicting the long-term clinical outcome of short-term treatment based on both pre-treatment and post-treatment functional MRI in PTSD remains limited. Methods: Twenty-two PTSD patients were scanned using resting-state functional MRI (rs-fMRI) before and after 12 weeks of treatment with paroxetine. Twenty patients were followed up using the same psychopathological assessments 2 years after they underwent the second MRI scan. Based on clinical outcome, the follow-up patients were divided into those with remitted PTSD or persistent PTSD. Amplitude of low-frequency fluctuations (ALFF) and degree centrality (DC) derived from pre-treatment and post-treatment rs-fMRI were used as classification features in a support vector machine (SVM) classifier. Results: Prediction of long-term clinical outcome by combined ALFF and DC features derived from pre-treatment rs-fMRI yielded an accuracy rate of 72.5% (p < 0.005). The most informative voxels for outcome prediction were mainly located in the precuneus, superior temporal area, insula, dorsal medial prefrontal cortex, frontal orbital cortex, supplementary motor area, lingual gyrus, and cerebellum. Long-term outcome could not be successfully classified by post-treatment imaging features with accuracy rates <50%. Conclusions: Combined information from ALFF and DC from rs-fMRI data before treatment could predict the long-term clinical outcome of PTSD, which is critical for defining potential biomarkers to customize PTSD treatment and improve the prognosis.
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Affiliation(s)
- Minlan Yuan
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Changjian Qiu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yajing Meng
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Zhengjia Ren
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Cui Yuan
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuchen Li
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Meng Gao
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Su Lui
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China.,Radiology Department of the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hongru Zhu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Zhang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China.,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
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15
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Misaki M, Phillips R, Zotev V, Wong CK, Wurfel BE, Krueger F, Feldner M, Bodurka J. Connectome-wide investigation of altered resting-state functional connectivity in war veterans with and without posttraumatic stress disorder. NEUROIMAGE-CLINICAL 2017. [PMID: 29527476 PMCID: PMC5842755 DOI: 10.1016/j.nicl.2017.10.032] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Altered resting-state functional connectivity in posttraumatic stress disorder (PTSD) suggests neuropathology of the disorder. While seed-based fMRI connectivity analysis is often used for the studies, such analysis requires defining a seed location a priori, which restricts search scope and could bias findings toward presupposed areas. Recently, a comprehensive exploratory voxel-wise connectivity analysis, the connectome-wide association approach, has been introduced using multivariate distance matrix regression (MDMR) for resting-state functional connectivity analysis. The current study performed a connectome-wide investigation of resting-state functional connectivity for war veterans with and without PTSD compared to non-trauma-exposed healthy controls using MDMR. Thirty-five male combat veterans with PTSD (unmedicated), 18 male combat veterans without PTSD (veterans control, VC), and 28 age-matched non-trauma-exposed healthy males (NC) participated in a resting-state fMRI scan. MDMR analysis was used to identify between-groups differences in regions with altered connectivity. The identified regions were used as a seed for post-hoc functional connectivity analysis. The analysis revealed that PTSD patients had hypoconnectivity between the left lateral prefrontal regions and the salience network regions as well as hypoconnectivity between the parahippocampal gyrus and the visual cortex areas. Connectivity between the ventromedial prefrontal cortex and the middle frontal gyrus and between the parahippocampal gyrus and the anterior insula were negatively correlated with PTSD symptom severity. VC subjects also had altered functional connectivity compared to NC, including increased connectivity between the posterior insula and several brain regions and decreased connectivity between the precuneus region and several other brain areas. The decreased connectivity between the lateral prefrontal regions and the salience network regions in PTSD was consistent with previous reports that indicated lowered emotion-regulation function in these regions. The decreased connectivity between the parahippocampal gyrus and visual cortex supported the dual representation theory of PTSD, which suggests dissociation between sensory and contextual memory representations in PTSD. The theory also supposes that the precuneus is a region that triggers retrieval of sensory memory of traumatic events. The decreased connectivity at the precuneus for VC might be associated with suppressing such a process.
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Affiliation(s)
- Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Raquel Phillips
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Vadim Zotev
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Chung-Ki Wong
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Brent E Wurfel
- Laureate Institute for Brain Research, Tulsa, OK, United States; Laureate Psychiatric Clinic and Hospital, Tulsa, OK, United States
| | - Frank Krueger
- School of Systems Biology, George Mason University, Fairfax, VA, United States
| | - Matthew Feldner
- Dept. of Psychological Science, University of Arkansas, Fayetteville, AR, United States
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK, United States; Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, United States.
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16
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Zhu H, Qiu C, Meng Y, Yuan M, Zhang Y, Ren Z, Li Y, Huang X, Gong Q, Lui S, Zhang W. Altered Topological Properties of Brain Networks in Social Anxiety Disorder: A Resting-state Functional MRI Study. Sci Rep 2017; 7:43089. [PMID: 28266518 PMCID: PMC5339829 DOI: 10.1038/srep43089] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 01/19/2017] [Indexed: 02/05/2023] Open
Abstract
Recent studies involving connectome analysis including graph theory have yielded potential biomarkers for mental disorders. In this study, we aimed to investigate the differences of resting-state network between patients with social anxiety disorder (SAD) and healthy controls (HCs), as well as to distinguish between individual subjects using topological properties. In total, 42 SAD patients and the same number of HCs underwent resting functional MRI, and the topological organization of the whole-brain functional network was calculated using graph theory. Compared with the controls, the patients showed a decrease in 49 positive connections. In the topological analysis, the patients showed an increase in the area under the curve (AUC) of the global shortest path length of the network (Lp) and a decrease in the AUC of the global clustering coefficient of the network (Cp). Furthermore, the AUCs of Lp and Cp were used to effectively discriminate the individual SAD patients from the HCs with high accuracy. This study revealed that the neural networks of the SAD patients showed changes in topological characteristics, and these changes were prominent not only in both groups but also at the individual level. This study provides a new perspective for the identification of patients with SAD.
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Affiliation(s)
- Hongru Zhu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Changjian Qiu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yajing Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Minlan Yuan
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yan Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zhengjia Ren
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yuchen Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.,Radiology Department of the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027 China
| | - Wei Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
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17
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Bandelow B, Baldwin D, Abelli M, Altamura C, Dell'Osso B, Domschke K, Fineberg NA, Grünblatt E, Jarema M, Maron E, Nutt D, Pini S, Vaghi MM, Wichniak A, Zai G, Riederer P. Biological markers for anxiety disorders, OCD and PTSD - a consensus statement. Part I: Neuroimaging and genetics. World J Biol Psychiatry 2016; 17:321-65. [PMID: 27403679 DOI: 10.1080/15622975.2016.1181783] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Biomarkers are defined as anatomical, biochemical or physiological traits that are specific to certain disorders or syndromes. The objective of this paper is to summarise the current knowledge of biomarkers for anxiety disorders, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). METHODS Findings in biomarker research were reviewed by a task force of international experts in the field, consisting of members of the World Federation of Societies for Biological Psychiatry Task Force on Biological Markers and of the European College of Neuropsychopharmacology Anxiety Disorders Research Network. RESULTS The present article (Part I) summarises findings on potential biomarkers in neuroimaging studies, including structural brain morphology, functional magnetic resonance imaging and techniques for measuring metabolic changes, including positron emission tomography and others. Furthermore, this review reports on the clinical and molecular genetic findings of family, twin, linkage, association and genome-wide association studies. Part II of the review focuses on neurochemistry, neurophysiology and neurocognition. CONCLUSIONS Although at present, none of the putative biomarkers is sufficient and specific as a diagnostic tool, an abundance of high-quality research has accumulated that will improve our understanding of the neurobiological causes of anxiety disorders, OCD and PTSD.
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Affiliation(s)
- Borwin Bandelow
- a Department of Psychiatry and Psychotherapy , University of Göttingen , Germany
| | - David Baldwin
- b Faculty of Medicine , University of Southampton , Southampton , UK
| | - Marianna Abelli
- c Department of Clinical and Experimental Medicine , Section of Psychiatry, University of Pisa , Italy
| | - Carlo Altamura
- d Department of Psychiatry , University of Milan; Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico , Milan , Italy
| | - Bernardo Dell'Osso
- d Department of Psychiatry , University of Milan; Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico , Milan , Italy
| | - Katharina Domschke
- e Department of Psychiatry, Psychosomatics and Psychotherapy , University of Wuerzburg , Germany
| | - Naomi A Fineberg
- f Hertfordshire Partnership University NHS Foundation Trust and University of Hertfordshire , Rosanne House, Parkway , Welwyn Garden City , UK
| | - Edna Grünblatt
- e Department of Psychiatry, Psychosomatics and Psychotherapy , University of Wuerzburg , Germany ;,g Neuroscience Center Zurich , University of Zurich and the ETH Zurich , Zürich , Switzerland ;,h Department of Child and Adolescent Psychiatry and Psychotherapy , Psychiatric Hospital, University of Zurich , Zürich , Switzerland ;,i Zurich Center for Integrative Human Physiology , University of Zurich , Switzerland
| | - Marek Jarema
- j Third Department of Psychiatry , Institute of Psychiatry and Neurology , Warszawa , Poland
| | - Eduard Maron
- k North Estonia Medical Centre, Department of Psychiatry , Tallinn , Estonia ;,l Department of Psychiatry , University of Tartu , Estonia ;,m Faculty of Medicine, Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences , Imperial College London , UK
| | - David Nutt
- m Faculty of Medicine, Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences , Imperial College London , UK
| | - Stefano Pini
- c Department of Clinical and Experimental Medicine , Section of Psychiatry, University of Pisa , Italy
| | - Matilde M Vaghi
- n Department of Psychology and Behavioural and Clinical Neuroscience Institute , University of Cambridge , UK
| | - Adam Wichniak
- j Third Department of Psychiatry , Institute of Psychiatry and Neurology , Warszawa , Poland
| | - Gwyneth Zai
- n Department of Psychology and Behavioural and Clinical Neuroscience Institute , University of Cambridge , UK ;,o Neurogenetics Section, Centre for Addiction & Mental Health , Toronto , Canada ;,p Frederick W. Thompson Anxiety Disorders Centre, Department of Psychiatry, Sunnybrook Health Sciences Centre , Toronto , Canada ;,q Institute of Medical Science and Department of Psychiatry, University of Toronto , Toronto , Canada
| | - Peter Riederer
- e Department of Psychiatry, Psychosomatics and Psychotherapy , University of Wuerzburg , Germany ;,g Neuroscience Center Zurich , University of Zurich and the ETH Zurich , Zürich , Switzerland ;,h Department of Child and Adolescent Psychiatry and Psychotherapy , Psychiatric Hospital, University of Zurich , Zürich , Switzerland
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18
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Maron E, Nutt D. Biological predictors of pharmacological therapy in anxiety disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2016. [PMID: 26487811 PMCID: PMC4610615 DOI: 10.31887/dcns.2015.17.3/emaron] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
At least one third of patients with anxiety disorders do not adequately respond to available pharmacological treatment. The reason that some patients with anxiety disorders respond well, but others not, to the same classes of medication is not yet fully understood. It is suggested that several biological factors may influence treatment mechanisms in anxiety and therefore could be identified as possible biomarkers predicting treatment response. In this review, we look at current evidence exploring different types of treatment predictors, including neuroimaging, genetic factors, and blood-related measures, which could open up novel perspectives in clinical management of patients with anxiety disorders.
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Affiliation(s)
- Eduard Maron
- Department of Psychiatry, North Estonia Medical Centre, Tallinn, Estonia; Department of Psychiatry, University of Tartu, Tartu, Estonia ; Faculty of Medicine, Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| | - David Nutt
- Faculty of Medicine, Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
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19
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Koch SBJ, van Zuiden M, Nawijn L, Frijling JL, Veltman DJ, Olff M. ABERRANT RESTING-STATE BRAIN ACTIVITY IN POSTTRAUMATIC STRESS DISORDER: A META-ANALYSIS AND SYSTEMATIC REVIEW. Depress Anxiety 2016; 33:592-605. [PMID: 26918313 DOI: 10.1002/da.22478] [Citation(s) in RCA: 204] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 01/26/2016] [Accepted: 01/26/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND About 10% of trauma-exposed individuals develop PTSD. Although a growing number of studies have investigated resting-state abnormalities in PTSD, inconsistent results suggest a need for a meta-analysis and a systematic review. METHODS We conducted a systematic literature search in four online databases using keywords for PTSD, functional neuroimaging, and resting-state. In total, 23 studies matched our eligibility criteria. For the meta-analysis, we included 14 whole-brain resting-state studies, reporting data on 663 participants (298 PTSD patients and 365 controls). We used the activation likelihood estimation approach to identify concurrence of whole-brain hypo- and hyperactivations in PTSD patients during rest. Seed-based studies could not be included in the quantitative meta-analysis. Therefore, a separate qualitative systematic review was conducted on nine seed-based functional connectivity studies. RESULTS The meta-analysis showed consistent hyperactivity in the ventral anterior cingulate cortex and the parahippocampus/amygdala, but hypoactivity in the (posterior) insula, cerebellar pyramis and middle frontal gyrus in PTSD patients, compared to healthy controls. Partly concordant with these findings, the systematic review on seed-based functional connectivity studies showed enhanced salience network (SN) connectivity, but decreased default mode network (DMN) connectivity in PTSD. CONCLUSIONS Combined, these altered resting-state connectivity and activity patterns could represent neurobiological correlates of increased salience processing and hypervigilance (SN), at the cost of awareness of internal thoughts and autobiographical memory (DMN) in PTSD. However, several discrepancies between findings of the meta-analysis and systematic review were observed, stressing the need for future studies on resting-state abnormalities in PTSD patients.
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Affiliation(s)
- Saskia B J Koch
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Mirjam van Zuiden
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Laura Nawijn
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Jessie L Frijling
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Arq Psychotrauma Expert Center, Diemen, the Netherlands
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20
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Zhang Q, Wu Q, Zhu H, He L, Huang H, Zhang J, Zhang W. Multimodal MRI-Based Classification of Trauma Survivors with and without Post-Traumatic Stress Disorder. Front Neurosci 2016; 10:292. [PMID: 27445664 PMCID: PMC4919361 DOI: 10.3389/fnins.2016.00292] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 06/10/2016] [Indexed: 02/05/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder. It can be difficult to discern the symptoms of PTSD and obtain an accurate diagnosis. Different magnetic resonance imaging (MRI) modalities focus on different aspects, which may provide complementary information for PTSD discrimination. However, none of the published studies assessed the diagnostic potential of multimodal MRI in identifying individuals with and without PTSD. In the current study, we investigated whether the complementary information conveyed by multimodal MRI scans could be combined to improve PTSD classification performance. Structural and resting-state functional MRI (rs-fMRI) scans were conducted on 17 PTSD patients, 20 trauma-exposed controls without PTSD (TEC) and 20 non-traumatized healthy controls (HC). Gray matter volume (GMV), amplitude of low-frequency fluctuations (ALFF), and regional homogeneity were extracted as classification features, and in order to integrate the information of structural and functional MRI data, the extracted features were combined by a multi-kernel combination strategy. Then a support vector machine (SVM) classifier was trained to distinguish the subjects at individual level. The performance of the classifier was evaluated using the leave-one-out cross-validation (LOOCV) method. In the pairwise comparison of PTSD, TEC, and HC groups, classification accuracies obtained by the proposed approach were 2.70, 2.50, and 2.71% higher than the best single feature way, with the accuracies of 89.19, 90.00, and 67.57% for PTSD vs. HC, TEC vs. HC, and PTSD vs. TEC respectively. The proposed approach could improve PTSD identification at individual level. Additionally, it provides preliminary support to develop the multimodal MRI method as a clinical diagnostic aid.
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Affiliation(s)
- Qiongmin Zhang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University Chengdu, China
| | - Qizhu Wu
- Monash Medical Imaging, Monash University Clayton, VIC, Australia
| | - Hongru Zhu
- Mental Health Center, West China Hospital of Sichuan University Chengdu, China
| | - Ling He
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University Chengdu, China
| | - Hua Huang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University Chengdu, China
| | - Junran Zhang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University Chengdu, China
| | - Wei Zhang
- Mental Health Center, West China Hospital of Sichuan University Chengdu, China
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21
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Xiong X, Zhu H, Wang T, Ji Y. Altered intrinsic regional brain activity in female asthmatics with or without depressive symptoms: A resting-state functional magnetic resonance imaging study. J Asthma 2016; 53:922-9. [PMID: 27267695 DOI: 10.3109/02770903.2016.1161050] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Previous studies have suggested that asthma patients are more susceptible to anxiety or depression and have more specifically elevated depressive symptomology. These psychological factors are associated with anatomical brain changes. However, little is known about alterations in spontaneous brain activity in asthma patients with depressive symptoms. Here we hypothesized that asthma patients exhibit an altered regional spontaneous brain activity, which may contribute to their increased susceptibility to depression and poor perception of asthma symptoms. The purpose of this study was to examine spontaneous brain activity in female asthma patients using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS Eleven asthmatics without depressive symptoms (ASs), 14 asthmatics with depressive symptoms (ADs), and 15 age- and education-matched healthy controls (HCs) completed rs-fMRI. The regional homogeneity (ReHo) value was calculated based on rs-fMRI to assess local signal synchrony strength and compared among the groups. Correlation analyses were conducted between both ReHo values and clinical parameters. RESULT Compared with HCs, ASs showed a significantly increased ReHo in the right insula; whereas ADs showed a significantly decreased ReHo in the right insula, which positively correlated with nocturnal symptom score in the Asthma Control Test (r = 0.562, P = 0.036). No significant correlation was observed between the total ACT scores and right insula activities (r = 0.263, P = 0.364). CONCLUSION Decreased ReHo in the right insula may play an important role in depressive symptoms and abnormal asthma symptom perception.
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Affiliation(s)
- Xingyu Xiong
- a Department of Respiratory Medicine , West China Hospital of Sichuan University , Chengdu , Sichuan Province , China
| | - Hongru Zhu
- b Mental Health Center , West China Hospital of Sichuan University , Chengdu , Sichuan Province , China
| | - Ting Wang
- a Department of Respiratory Medicine , West China Hospital of Sichuan University , Chengdu , Sichuan Province , China
| | - Yulin Ji
- a Department of Respiratory Medicine , West China Hospital of Sichuan University , Chengdu , Sichuan Province , China
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Wang T, Liu J, Zhang J, Zhan W, Li L, Wu M, Huang H, Zhu H, Kemp GJ, Gong Q. Altered resting-state functional activity in posttraumatic stress disorder: A quantitative meta-analysis. Sci Rep 2016; 6:27131. [PMID: 27251865 PMCID: PMC4890007 DOI: 10.1038/srep27131] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 05/13/2016] [Indexed: 02/05/2023] Open
Abstract
Many functional neuroimaging studies have reported differential patterns of spontaneous brain activity in posttraumatic stress disorder (PTSD), but the findings are inconsistent and have not so far been quantitatively reviewed. The present study set out to determine consistent, specific regional brain activity alterations in PTSD, using the Effect Size Signed Differential Mapping technique to conduct a quantitative meta-analysis of resting-state functional neuroimaging studies of PTSD that used either a non-trauma (NTC) or a trauma-exposed (TEC) comparison control group. Fifteen functional neuroimaging studies were included, comparing 286 PTSDs, 203 TECs and 155 NTCs. Compared with NTC, PTSD patients showed hyperactivity in the right anterior insula and bilateral cerebellum, and hypoactivity in the dorsal medial prefrontal cortex (mPFC); compared with TEC, PTSD showed hyperactivity in the ventral mPFC. The pooled meta-analysis showed hypoactivity in the posterior insula, superior temporal, and Heschl’s gyrus in PTSD. Additionally, subgroup meta-analysis (non-medicated subjects vs. NTC) identified abnormal activation in the prefrontal-limbic system. In meta-regression analyses, mean illness duration was positively associated with activity in the right cerebellum (PTSD vs. NTC), and illness severity was negatively associated with activity in the right lingual gyrus (PTSD vs. TEC).
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Affiliation(s)
- Ting Wang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P. R. China.,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Jia Liu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Junran Zhang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P. R. China.,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Wang Zhan
- Neuroimaging Center, University of Maryland, College Park, Maryland, USA
| | - Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Min Wu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Hua Huang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, P. R. China
| | - Hongyan Zhu
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, P. R. China
| | - Graham J Kemp
- Magnetic Resonance and Image Analysis Research Centre (MARIARC) and Institute of Ageing and Chronic Disease, University of Liverpool, United Kingdom
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, P. R. China.,Department of Psychology, School of Public Administration, Sichuan University, Chengdu, P. R. China
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