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Roy JC, Hédouin R, Desmidt T, Dam S, Mirea-Grivel I, Weyl L, Bannier E, Barantin L, Drapier D, Batail JM, David R, Coloigner J, Robert GH. Quantifying Apathy in Late-Life Depression: Unraveling Neurobehavioral Links Through Daily Activity Patterns and Brain Connectivity Analysis. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:639-649. [PMID: 38615911 DOI: 10.1016/j.bpsc.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/04/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Better understanding apathy in late-life depression would help improve prediction of poor prognosis of diseases such as dementia. Actimetry provides an objective and ecological measure of apathy from patients' daily motor activity. We aimed to determine whether patterns of motor activity were associated with apathy and brain connectivity in networks that underlie goal-directed behaviors. METHODS Resting-state functional magnetic resonance imaging and diffusion magnetic resonance imaging were collected from 38 nondemented participants with late-life depression. Apathy was evaluated using the diagnostic criteria for apathy, Apathy Evaluation Scale, and Apathy Motivation Index. Functional principal components (fPCs) of motor activity were derived from actimetry recordings taken for 72 hours. Associations between fPCs and apathy were estimated by linear regression. Subnetworks whose connectivity was significantly associated with fPCs were identified via threshold-free network-based statistics. The relationship between apathy and microstructure metrics was estimated along fibers by diffusion tensor imaging and a multicompartment model called neurite orientation dispersion and density imaging via tractometry. RESULTS We found 2 fPCs associated with apathy: mean diurnal activity, negatively associated with Apathy Evaluation Scale scores, and an early chronotype, negatively associated with Apathy Motivation Index scores. Mean diurnal activity was associated with increased connectivity in the default mode, cingulo-opercular, and frontoparietal networks, while chronotype was associated with a more heterogeneous connectivity pattern in the same networks. We did not find significant associations between microstructural metrics and fPCs. CONCLUSIONS Our findings suggest that mean diurnal activity and chronotype could provide indirect ambulatory measures of apathy in late-life depression, associated with modified functional connectivity of brain networks that underlie goal-directed behaviors.
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Affiliation(s)
- Jean-Charles Roy
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France; Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes, France; Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France.
| | - Renaud Hédouin
- Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
| | - Thomas Desmidt
- CHU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, INSERM, Tours, France; Centre d'Investigation Clinique 1415, CHU de Tours, INSERM, Tours, France
| | - Sébastien Dam
- Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
| | - Iris Mirea-Grivel
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France
| | - Louise Weyl
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France
| | - Elise Bannier
- Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France; CHU de Rennes, Service de Radiologie, Rennes, France
| | - Laurent Barantin
- CHU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, INSERM, Tours, France
| | - Dominique Drapier
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France; Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes, France; Faculté de Médecine, Rennes Université, Rennes, France
| | - Jean-Marie Batail
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France; Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes, France; Faculté de Médecine, Rennes Université, Rennes, France
| | - Renaud David
- CHU de Nice, Université Côte d'Azur, Nice, France
| | - Julie Coloigner
- Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France
| | - Gabriel H Robert
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, Rennes, France; Centre d'Investigation Clinique 1414, Centre Hospitalier Universitaire de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes, France; Université de Rennes, Inria, Centre National de la Recherche Scientifique, IRISA, INSERM, Empenn U1228 ERL, Rennes, France; Faculté de Médecine, Rennes Université, Rennes, France
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Minbay M, Khan A, Ghasemi AR, Ingram KK, Ay AA. Sex-specific associations between circadian-related genes and depression in UK Biobank participants highlight links to glucose metabolism, inflammation and neuroplasticity pathways. Psychiatry Res 2024; 337:115948. [PMID: 38788553 DOI: 10.1016/j.psychres.2024.115948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/18/2024] [Accepted: 05/01/2024] [Indexed: 05/26/2024]
Abstract
Depressive disorders have increased in global prevalence, making improved management of these disorders a public health priority. Prior research has linked circadian clock genes to depression, either through direct interactions with mood-related pathways in the brain or by modulating the phase of circadian rhythms. Using machine learning and statistical techniques, we explored associations between 157,347 SNP variants from 51 circadian-related genes and depression scores from the patient health questionnaire 9 (PHQ-9) in 99,939 UK Biobank participants. Our results highlight multiple pathways linking the circadian system to mood, including metabolic, monoamine, immune, and stress-related pathways. Notably, genes regulating glucose metabolism and inflammation (GSK3B, LEP, RORA, and NOCT) were prominent factors in females, in addition to DELEC1 and USP46, two genes of unknown function. In contrast, FBXL3 and DRD4 emerged as significant risk factors for male depression. We also found epistatic interactions involving RORA, NFIL3, and ZBTB20 as either risk or protective factors for depression, underscoring the importance of transcription factors (ZBTB20, NFIL3) and hormone receptors (RORA) in depression etiology. Understanding the complex, sex-specific links between circadian genes and mood disorders will facilitate the development of therapeutic interventions and enhance the efficacy of multi-target treatments for depression.
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Affiliation(s)
- Mete Minbay
- Department of Computer Science, Colgate University, Hamilton, NY, USA
| | - Ayub Khan
- Department of Computer Science, Colgate University, Hamilton, NY, USA; Department of Biology, Colgate University, Hamilton, NY, USA
| | - Ali R Ghasemi
- Department of Computer Science, Colgate University, Hamilton, NY, USA
| | - Krista K Ingram
- Department of Biology, Colgate University, Hamilton, NY, USA.
| | - Ahmet A Ay
- Department of Biology, Colgate University, Hamilton, NY, USA
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Wang H, Jülich ST, Lei X. Functional Connectivity Between Default Mode and Ventral Attention Networks Mediates the Effects of Chronotype on Daily Physical Activity. Neuroscience 2023; 535:194-202. [PMID: 37935345 DOI: 10.1016/j.neuroscience.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/09/2023]
Abstract
Daily physical activity (dPA) is closely related to circadian rhythm and chronotype. The functional connectivity (FC) within or between the default mode (DMN) and ventral attention network (vAN) were associated with dPA and chronotype. DMN-vAN FC was investigated for its role in chronotype and dPA. 153 participants completed the reduced version of the Morningness-Eveningness Questionnaire (rMEQ), dPA was measured via actigraphy (5-day), and then resting-state fMRI scans were performed. rMEQ scores and steps recorded by the actigraphic devices (with each hour as the time window to calculate steps for five consecutive days per hour, subsequently yielding the maximum number of steps and its corresponding time, ie, SM and SMT) represent chronotype and dPA respectively. The results found that the rMEQ scores were significantly negatively correlated with SMT. The positive correlation between the rMEQ scores and the DMN-vAN FC was significant. There were also significant positive correlations between SMT and DMN-vAN FC. Further analysis revealed that DMN-vAN mediates the relationship between chronotype and SMT. The FC of DMN-vAN may be the underlying neural mechanism through which chronotype influences dPA. These findings could support the development of reasonable activity schedules or specific intervention programs to improve physical health.
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Affiliation(s)
- Haien Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing 400715, China
| | - Simon Theodor Jülich
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing 400715, China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing 400715, China.
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Xia Y, Sun H, Hua L, Dai Z, Wang X, Tang H, Han Y, Du Y, Zhou H, Zou H, Yao Z, Lu Q. Spontaneous beta power, motor-related beta power and cortical thickness in major depressive disorder with psychomotor disturbance. Neuroimage Clin 2023; 38:103433. [PMID: 37216848 PMCID: PMC10209543 DOI: 10.1016/j.nicl.2023.103433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION The psychomotor disturbance is a common symptom in patients with major depressive disorder (MDD). The neurological mechanisms of psychomotor disturbance are intricate, involving alterations in the structure and function of motor-related regions. However, the relationship among changes in the spontaneous activity, motor-related activity, local cortical thickness, and psychomotor function remains unclear. METHOD A total of 140 patients with MDD and 68 healthy controls performed a simple right-hand visuomotor task during magnetoencephalography (MEG) scanning. All patients were divided into two groups according to the presence of psychomotor slowing. Spontaneous beta power, movement-related beta desynchronization (MRBD), absolute beta power during movement and cortical characteristics in the bilateral primary motor cortex were compared using general linear models with the group as a fixed effect and age as a covariate. Finally, the moderated mediation model was tested to examine the relationship between brain metrics with group differences and psychomotor performance. RESULTS The patients with psychomotor slowing showed higher spontaneous beta power, movement-related beta desynchronization and absolute beta power during movement than patients without psychomotor slowing. Compared with the other two groups, significant decreases were found in cortical thickness of the left primary motor cortex in patients with psychomotor slowing. Our moderated mediation model showed that the increased spontaneous beta power indirectly affected impaired psychomotor performance by abnormal MRBD, and the indirect effects were moderated by cortical thickness. CONCLUSION These results suggest that patients with MDD have aberrant cortical beta activity at rest and during movement, combined with abnormal cortical thickness, contributing to the psychomotor disturbance observed in this patient population.
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Affiliation(s)
- Yi Xia
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hao Sun
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing 210093, China
| | - Lingling Hua
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhongpeng Dai
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing 210096, China
| | - Xiaoqin Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hao Tang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yinglin Han
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yishan Du
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hongliang Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Haowen Zou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing 210093, China
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing 210093, China.
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing 210096, China.
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Cao L, Feng R, Gao Y, Bao W, Zhou Z, Liang K, Hu X, Li H, Zhang L, Li Y, Zhuo L, Huang G, Huang X. Suprachiasmatic nucleus functional connectivity related to insomnia symptoms in adolescents with major depressive disorder. Front Psychiatry 2023; 14:1154095. [PMID: 37260759 PMCID: PMC10228684 DOI: 10.3389/fpsyt.2023.1154095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/21/2023] [Indexed: 06/02/2023] Open
Abstract
Background Insomnia is a commonly seen symptom in adolescents with major depressive disorder (MDD). The suprachiasmatic nucleus (SCN), which is the circadian rhythm regulation center, plays a crucial role in the regulation of sleep-wake circulation. Nevertheless, how SCN function contributes to the exact neural mechanisms underlying the associations between insomnia and depressive symptoms has not been explored in adolescents. In the current study, we aimed to explore the relationship between SCN functional connectivity (FC) and insomnia symptoms in adolescents with MDD using a seed-based FC method. Methods In the current study, we recruited sixty-eight first-episode drug-naïve adolescents with MDD and classified them into high insomnia (MDD-HI) and low insomnia (MDD-LI) groups according to the sleep disturbance subscale of the Hamilton Depression Rating Scale (HAMD-S). Forty-three age/gender-matched healthy controls (HCs) were also recruited. SCN FC maps were generally for all subjects and compared among three groups using one-way ANOVA with age, gender and adjusted HAMD score as covariates. We used partial correlations to explore associations between altered FC and clinical symptoms, including sleep quality scores. Results Adolescents with MDD showed worse sleep quality, which positively correlated with the severity of depression. Compared to MDD-LI and HCs, MDD-HI adolescents demonstrated significantly decreased FC between the right SCN and bilateral precuneus, and there was no significant difference between the MDD-LI and HC groups. The HAMD-S scores were negatively correlated with bilateral SCN-precuneus connectivity, and the retardation factor score of HAMD was negatively correlated with right SCN-precuneus connectivity. Conclusion The altered FC between the SCN and precuneus may underline the neural mechanism of sleep-related symptoms in depressive adolescents and provide potential targets for personalized treatment strategies.
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Affiliation(s)
- Lingling Cao
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Department of Radiology, Sichuan Mianyang 404 Hospital, Mianyang, China
| | - Ruohan Feng
- Department of Radiology, Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Yingxue Gao
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Weijie Bao
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Zilin Zhou
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Kaili Liang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xinyue Hu
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Hailong Li
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Lianqing Zhang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Yang Li
- Department of Psychiatry, Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Lihua Zhuo
- Department of Radiology, Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Guoping Huang
- Department of Psychiatry, Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Xiaoqi Huang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
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Gao Y, Guo X, Zhong Y, Liu X, Tian S, Deng J, Lin X, Bao Y, Lu L, Wang G. Decreased dorsal attention network homogeneity as a potential neuroimaging biomarker for major depressive disorder. J Affect Disord 2023; 332:136-142. [PMID: 36990286 DOI: 10.1016/j.jad.2023.03.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 03/14/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Gaining insight into abnormal functional brain network homogeneity (NH) has the potential to aid efforts to target or otherwise study major depressive disorder (MDD). The NH of the dorsal attention network (DAN) in first-episode treatment-naive MDD patients, however, has yet to be studied. As such, the present study was developed to explore the NH of the DAN in order to determine the ability of this parameter to differentiate between MDD patients and healthy control (HC) individuals. METHODS This study included 73 patients with first-episode treatment-naive MDD and 73 age-, gender-, and educational level-matched healthy controls. All participants completed the attentional network test (ANT), Hamilton Rating Scale for Depression (HRSD), and resting-state functional magnetic resonance imaging (rs-fMRI) analyses. A group independent component analysis (ICA) was used to identify the DAN and to compute the NH of the DAN in patients with MDD. Spearman's rank correlation analyses were used to explore relationships between significant NH abnormalities in MDD patients, clinical parameters, and executive control reaction time. RESULTS Relative to HCs, patients exhibited reduced NH in the left supramarginal gyrus (SMG). Support vector machine (SVM) analyses and receiver operating characteristic curves indicated that the NH of the left SMG could be used to differentiate between HCs and MDD patients with respective accuracy, specificity, sensitivity, and AUC values of 92.47 %, 91.78 %, 93.15 %, and 65.39 %. A significant positive correlation was observed between the left SMG NH values and HRSD scores among MDD patients. CONCLUSIONS These results suggest that NH changes in the DAN may offer value as a neuroimaging biomarker capable of differentiating between MDD patients and healthy individuals.
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Affiliation(s)
- Yujun Gao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430000, China
| | - Xin Guo
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430000, China
| | - Yi Zhong
- Peking University, Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Peking University, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Xiaoxin Liu
- Peking University, Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Peking University, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Shanshan Tian
- Peking University, Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Peking University, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Jiahui Deng
- Peking University, Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Peking University, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Xiao Lin
- Peking University, Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Peking University, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Yanpin Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China.
| | - Lin Lu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430000, China; Peking University, Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Peking University, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing 100191, China; National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China.
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430000, China.
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Guan M, Wang Z, Shi Y, Xie Y, Ma Z, Liu Z, Liu J, Gao X, Tan Q, Wang H. Altered Brain Function and Causal Connectivity Induced by Repetitive Transcranial Magnetic Stimulation Treatment for Major Depressive Disorder. Front Neurosci 2022; 16:855483. [PMID: 35368283 PMCID: PMC8964457 DOI: 10.3389/fnins.2022.855483] [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: 01/15/2022] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Repetitive transcranial magnetic stimulation (rTMS) can effectively improve depression symptoms in patients with major depressive disorder (MDD); however, its mechanism of action remains obscure. This study explored the neuralimaging mechanisms of rTMS in improving depression symptoms in patients with MDD. Methods In this study, MDD patients with first-episode, drug-naive (n = 29) and healthy controls (n = 33) were enrolled. Depression symptoms before and after rTMS treatment were assessed using the Hamilton Depression Rating Scale (HAMD-17). Resting-state functional magnetic resonance imaging (rs-fMRI) data were collected both before and after the treatment. Changes in the brain function after the treatment were compared using the following two indices: the amplitude of the low-frequency fluctuation (ALFF) and regional homogeneity (ReHo), which are sensitive for evaluating spontaneous neuronal activity. The brain region with synchronous changes was selected as the seed point, and the differences in the causal connectivity between the seed point and whole brain before and after rTMS treatment were investigated via Granger causality analysis (GCA). Results Before treatment, patients with MDD had significantly lower ALFF in the left superior frontal gyrus (p < 0.01), higher ALFF in the left middle frontal gyrus and left precuneus (p < 0.01), and lower ReHo in the left middle frontal and left middle occipital gyri (p < 0.01) than the values observed in healthy controls. After the rTMS treatment, the ALFF was significantly increased in the left superior frontal gyrus (p < 0.01) and decreased in the left middle frontal gyrus and left precuneus (p < 0.01). Furthermore, ReHo was significantly increased in the left middle frontal and left middle occipital gyri (p < 0.01) in patients with MDD. Before treatment, GCA using the left middle frontal gyrus (the brain region with synchronous changes) as the seed point revealed a weak bidirectional causal connectivity between the middle and superior frontal gyri as well as a weak causal connectivity from the inferior temporal to the middle frontal gyri. After treatment, these causal connectivities were strengthened. Moreover, the causal connectivity from the inferior temporal gyrus to the middle frontal gyri negatively correlated with the total HAMD-17 score (r = −0.443, p = 0.021). Conclusion rTMS treatment not only improves the local neural activity in the middle frontal gyrus, superior frontal gyrus, and precuneus but also strengthens the bidirectional causal connectivity between the middle and superior frontal gyri and the causal connectivity from the inferior temporal to the middle frontal gyri. Changes in these neuroimaging indices may represent the neural mechanisms underlying rTMS treatment in MDD. Clinical Trial Registration This study was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR1800019761).
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Affiliation(s)
- Muzhen Guan
- Department of Mental Health, Xi’an Medical University, Xi’an, China
- Deptartment of Psychiatry, Xijing Hospital, Air Force Medical University, Xi’an, China
- *Correspondence: Huaning Wang,
| | - Zhongheng Wang
- Deptartment of Psychiatry, Xijing Hospital, Air Force Medical University, Xi’an, China
| | - Yanru Shi
- Deptartment of Psychiatry, Xijing Hospital, Air Force Medical University, Xi’an, China
| | - Yuanjun Xie
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Zhujing Ma
- Deptartment of Psychology, Air Force Medical University, Xi’an, China
| | - Zirong Liu
- Deptartment of Psychiatry, Yulin Fifth Hospital, Yuling, China
| | - Junchang Liu
- Deptartment of Psychiatry, Xijing Hospital, Air Force Medical University, Xi’an, China
| | - Xinyu Gao
- Deptartment of Psychology, Air Force Medical University, Xi’an, China
| | - Qingrong Tan
- Deptartment of Psychiatry, Xijing Hospital, Air Force Medical University, Xi’an, China
| | - Huaning Wang
- Deptartment of Psychiatry, Xijing Hospital, Air Force Medical University, Xi’an, China
- Muzhen Guan,
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