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Maksyutynska K, Stogios N, Prasad F, Gill J, Hamza Z, De R, Smith E, Horta A, Goldstein BI, Korczak D, Graff-Guerrero A, Hahn MK, Agarwal SM. Neurocognitive correlates of metabolic dysregulation in individuals with mood disorders: a systematic review and meta-analysis. Psychol Med 2024; 54:1245-1271. [PMID: 38450447 DOI: 10.1017/s0033291724000345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Individuals with mood disorders are predisposed to metabolic dysfunction, while those with metabolic dysregulation such as diabetes and obesity experience more severe depressive symptoms. Both metabolic dysfunction and mood disorders are independently associated with cognitive deficits. Therefore, given their close association, this study aimed to explore the association between metabolic dysfunction in individuals with mood disorders in relation to cognitive outcomes. A comprehensive search comprised of these three domains was carried out; a random-effects meta-analysis pooling mean cognitive outcomes was conducted (PROSPERO ID: CRD42022295765). Sixty-three studies were included in this review; 26 were synthesized in a quantitative meta-analysis. Comorbid metabolic dysregulation was associated with significantly lower global cognition among individuals with mood disorders. These trends were significant within each mood disorder subgroup, including major depressive disorder, bipolar disorder, and self-report depression/depressive symptoms. Type 2 diabetes was associated with the lowest cognitive performance in individuals with mood disorders, followed by peripheral insulin resistance, body mass index ⩾25 kg/m2, and metabolic syndrome. Significant reduction in scores was also observed among individual cognitive domains (in descending order) of working memory, attention, executive function, processing speed, verbal memory, and visual memory. These findings demonstrate the detrimental effects of comorbid metabolic dysfunction in individuals with mood disorders. Further research is required to understand the underlying mechanisms connecting mood disorders, metabolism, and cognition.
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Affiliation(s)
- Kateryna Maksyutynska
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nicolette Stogios
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Femin Prasad
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jashan Gill
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Faculty of Science, McMaster University, Hamilton, ON, Canada
| | - Zaineb Hamza
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Riddhita De
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Emily Smith
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Angelina Horta
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Benjamin I Goldstein
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Daphne Korczak
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
| | - Ariel Graff-Guerrero
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Margaret K Hahn
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sri Mahavir Agarwal
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Jiang H, Zhang Y, Wang ZZ, Chen NH. Connexin 43: An Interface Connecting Neuroinflammation to Depression. Molecules 2023; 28:molecules28041820. [PMID: 36838809 PMCID: PMC9961786 DOI: 10.3390/molecules28041820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
Major depressive disorder (MDD) is a leading chronic mental illness worldwide, characterized by anhedonia, pessimism and even suicidal thoughts. Connexin 43 (Cx43), mainly distributed in astrocytes of the brain, is by far the most widely and ubiquitously expressed connexin in almost all vital organs. Cx43 forms gap junction channels in the brain, which mediate energy exchange and effectively maintain physiological homeostasis. Increasing evidence suggests the crucial role of Cx43 in the pathogenesis of MDD. Neuroinflammation is one of the most common pathological features of the central nervous system dysfunctions. Inflammatory factors are abnormally elevated in patients with depression and are closely related to nearly all links of depression. After activating the inflammatory pathway in the brain, the release and uptake of glutamate and adenosine triphosphate, through Cx43 in the synaptic cleft, would be affected. In this review, we have summarized the association between Cx43 and neuroinflammation, the cornerstones linking inflammation and depression, and Cx43 abnormalities in depression. We also discuss the significant association of Cx43 in inflammation and depression, which will help to explore new antidepressant drug targets.
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Affiliation(s)
- Hong Jiang
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica & Neuroscience Center, Chinese Academy of Medical, Science and Peking Union Medical College, Beijing 100050, China
| | - Yi Zhang
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China
| | - Zhen-Zhen Wang
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica & Neuroscience Center, Chinese Academy of Medical, Science and Peking Union Medical College, Beijing 100050, China
- Correspondence: (Z.-Z.W.); (N.-H.C.); Tel.: +86-10-6316-5182 (Z.-Z.W.); +86-10-63165177 (N.-H.C.)
| | - Nai-Hong Chen
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica & Neuroscience Center, Chinese Academy of Medical, Science and Peking Union Medical College, Beijing 100050, China
- Correspondence: (Z.-Z.W.); (N.-H.C.); Tel.: +86-10-6316-5182 (Z.-Z.W.); +86-10-63165177 (N.-H.C.)
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Wang M, Zhang D, Gao J, Qi F, Su Y, Lei Y, Shao Z, Ai K, Tang M, Zhang X. Abnormal functional connectivity in the right dorsal anterior insula associated with cognitive dysfunction in patients with type 2 diabetes mellitus. Brain Behav 2022; 12:e2553. [PMID: 35543304 PMCID: PMC9226846 DOI: 10.1002/brb3.2553] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 02/01/2022] [Accepted: 02/12/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Type 2 diabetes mellitus (T2DM) is a chronic disease with a high incidence worldwide. T2DM can cause cognitive impairment, but its neuropathological basis is unclear. A variety of neuropsychiatric studies have found that abnormal functional connectivity (FC) in the central executive network (CEN), default-mode network (DMN), and salience network (SN) may be the neuropathological basis of cognitive dysfunction. The right dorsal anterior insula (dAI) is the core SN area. It plays an important role in regulating the CEN and the DMN. However, few studies have explored the relationship between cognitive impairment and FC among the right dAI, CEN, and DMN in patients with T2DM. METHODS Resting-state functional magnetic resonance imaging was used to investigate FC between the right dAI and the CEN and DMN in 44 patients with T2DM and 41 sex-, age-, and education-matched healthy controls, as well as its relationship with clinical/cognitive variables. RESULTS In patients with T2DM, FC between the right dAI and multiple brain regions of the CEN and DMN was generally decreased, and FC strength between the right dAI and the inferior frontal gyrus negatively correlated with trail making test A score (r = -0.421, p = 0.004). CONCLUSIONS Patients with T2DM exhibit abnormal FC between the right dAI and the CEN and DMN. This may be one of the neuromechanisms of cognitive impairment in patients with T2DM. In addition, reduced FC between the right dAI and the right inferior frontal gyrus may be related to abnormal attention regulation in patients with T2DM.
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Affiliation(s)
- Man Wang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China
| | - Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China
| | - Jie Gao
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China
| | - Fei Qi
- Xi'an Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Yu Su
- Xi'an Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Yumeng Lei
- Xi'an Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Zhirong Shao
- Xi'an Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Kai Ai
- Philips Healthcare, Xi'an, Shaanxi, People's Republic of China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, People's Republic of China
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Chow YY, Verdonschot M, McEvoy CT, Peeters G. Associations between depression and cognition, mild cognitive impairment and dementia in persons with diabetes mellitus: A systematic review and meta-analysis. Diabetes Res Clin Pract 2022; 185:109227. [PMID: 35122905 DOI: 10.1016/j.diabres.2022.109227] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 12/14/2022]
Abstract
AIMS This systematic review aimed to examine whether persons with diabetes and depression had poorer cognition and higher dementia risk than persons with diabetes only. Moreover, the impact of timing, frequency of depressive episodes throughout life, and antidepressant treatment were examined. METHODS PubMed, Embase and PsycINFO were searched to obtain observational studies between August 2015 and June 2021 that examined the association between depression and cognition, mild cognitive impairment or dementia in people with diabetes. Studies published before August 2015 were retrieved from a previous systematic review. Findings were pooled using meta-analyses. RESULTS 10 out of 19 included articles were appropriate for the meta-analyses. Persons with diabetes and depression experienced greater declines in executive function (SMD = -0.39 (-0.69, -0.08)), language (SMD = -0.80 (-1.52, -0.09)), memory (SMD = -0.63 (-1.12, -0.14)) and overall cognition (SMD = -0.77 (-1.33, -0.20)), and greater dementia risk (HR = 1.82 (1.79, 1.85)) than persons with diabetes only. No significant differences were observed for complex attention. No studies examined the role of timing and frequency of depressive episodes and antidepressant treatment. CONCLUSION In persons with diabetes, depression is associated with worse cognition and higher dementia risk. The potential mitigating effect of antidepressant treatment remains unclear.
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Affiliation(s)
- Yeng Yan Chow
- Department of Geriatric Medicine, Radboud Institute for Health Sciences, Radboud University Medical Centre, Reinier Postlaan 4, 6500 HB Nijmegen, the Netherlands.
| | - Milou Verdonschot
- Department of Geriatric Medicine, Radboud Institute for Health Sciences, Radboud University Medical Centre, Reinier Postlaan 4, 6500 HB Nijmegen, the Netherlands.
| | - Claire T McEvoy
- Global Brain Health Institute, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, Dublin 2, Ireland; Centre for Public Health, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6 BJ Northern Ireland, United Kingdom.
| | - Geeske Peeters
- Department of Geriatric Medicine, Radboud Institute for Health Sciences, Radboud University Medical Centre, Reinier Postlaan 4, 6500 HB Nijmegen, the Netherlands; Global Brain Health Institute, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, Dublin 2, Ireland.
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