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Hu J, Wu J, Jiang Q, Wang Y, Yuan Y, Cheng X, Li K, Shen Y, Zhang J, Wang F, Liu J, Liu C, Dai Y, Mao C. Changes in slow-wave sleep characteristics in Parkinson's disease patients with mild-moderate depression. Sleep Med 2024; 121:219-225. [PMID: 39004012 DOI: 10.1016/j.sleep.2024.07.010] [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: 03/28/2024] [Revised: 06/08/2024] [Accepted: 07/09/2024] [Indexed: 07/16/2024]
Abstract
INTRODUCTION Depression and sleep disturbances are commonly seen non-motor symptoms in patients with Parkinson's disease (PD). This study used polysomnography to examine the relationship between mild-moderate depression in PD and sleep characteristics, particularly slow wave activities (SWA). METHODS 59 PD patients were split into two groups: nd-PD (n = 27) (patients with PD without depression) and d-PD (n = 32) (patients with PD with mild-moderate depression). Their clinical features, polysomnography parameters, and demographics were evaluated. Early and late sleep SWA spectrum densities and overnight SWA decline in different brain regions were particularly analyzed. RESULTS Non-rapid eye movement 3 (N3) sleep duration and percentage were greater in the d-PD group. N3 percentage was linked to depression (p = 0.014). During late sleep, higher SWA (0.5-4Hz) in the frontal and central regions, higher low-SWA (0.5-2Hz) in the whole brain, central and occipital regions, and higher high-SWA (2-4Hz) in the frontal region was observed in the d-PD group. During early sleep, there was also higher low-SWA (0.5-2Hz) in the occipital region. Patients in d-PD group exhibited reduced overnight high-SWA (2-4Hz) decline (Δhigh-SWA) in the whole brain and occipital regions. Δhigh-SWA(2-4Hz) in the occipital region were associated with depression (p = 0.049). CONCLUSION PD patients with mild-moderate depression have impaired slow wave sleep, exhibiting as increased N3 sleep, SWA, and reduced overnight SWA decline. This implies that synaptic strength reduction during sleep and impaired synaptic homeostasis regulation may be associated with depression in PD. Reduced overnight high-SWA decline in the occipital region may serve as a novel electrophysiological biomarker for indicating depression in PD.
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Affiliation(s)
- Jingzhe Hu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jiayu Wu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Qiming Jiang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yiming Wang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yuan Yuan
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoyu Cheng
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Kai Li
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yun Shen
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jinru Zhang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Fen Wang
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| | - Junyi Liu
- Department of Neurology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Chunfeng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China; Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, China
| | - Yongping Dai
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Chengjie Mao
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
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Tu PC, Chang WC, Su TP, Lin WC, Li CT, Bai YM, Tsai SJ, Chen MH. Thalamocortical functional connectivity and rapid antidepressant and antisuicidal effects of low-dose ketamine infusion among patients with treatment-resistant depression. Mol Psychiatry 2024:10.1038/s41380-024-02640-3. [PMID: 38971895 DOI: 10.1038/s41380-024-02640-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/08/2024]
Abstract
Previous studies have shown an association between the thalamocortical dysconnectivity and treatment-resistant depression (TRD). Whether a single subanesthetic dose of ketamine may change thalamocortical connectivity among patients with TRD is unclear. Whether these changes in thalamocortical connectivity is associated with the antidepressant and antisuicidal effects of ketamine treatment is also unclear. Two resting-state functional MRIs were collected in two clinical trials of 48 patients with TRD (clinical trial 1; 32 receiving ketamine, 16 receiving a normal saline placebo) and 48 patients with TRD and strong suicidal ideation (clinical trial 2; 24 receiving ketamine, 24 receiving midazolam), respectively. All participants underwent rs-fMRI before and 3 days after infusion. Seed-based functional connectivity (FC) was analyzed in the left/right thalamus. FCs between the bilateral thalamus and right middle frontal cortex (BA46) and between the left thalamus and left anterior paracingulate gyrus (BA8) increased among patients in the ketamine group in clinical trials 1 and 2, respectively. FCs between the right thalamus and bilateral frontal pole (BA9) and between the right thalamus and left rostral paracingulate gyrus (BA10) decreased among patients in the ketamine group in clinical trials 1 and 2, respectively. However, the associations between those FC changes and clinical symptom changes did not survive statistical significance after multiple comparison corrections. Whether ketamine-related changes in thalamocortical connectivity may be associated with ketamine's antidepressant and antisuicidal effects would need further investigation. Clinical trials registration: UMIN Clinical Trials Registry (UMIN-CTR): Registration number: UMIN000016985 and UMIN000033916.
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Affiliation(s)
- Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wan-Chen Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of biomedical engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
- Division of Psychiatry, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Colombo F, Calesella F, Bravi B, Fortaner-Uyà L, Monopoli C, Tassi E, Carminati M, Zanardi R, Bollettini I, Poletti S, Lorenzi C, Spadini S, Brambilla P, Serretti A, Maggioni E, Fabbri C, Benedetti F, Vai B. Multimodal brain-derived subtypes of Major depressive disorder differentiate patients for anergic symptoms, immune-inflammatory markers, history of childhood trauma and treatment-resistance. Eur Neuropsychopharmacol 2024; 85:45-57. [PMID: 38936143 DOI: 10.1016/j.euroneuro.2024.05.015] [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: 11/21/2023] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 06/29/2024]
Abstract
An estimated 30 % of Major Depressive Disorder (MDD) patients exhibit resistance to conventional antidepressant treatments. Identifying reliable biomarkers of treatment-resistant depression (TRD) represents a major goal of precision psychiatry, which is hampered by the clinical and biological heterogeneity. To uncover biologically-driven subtypes of MDD, we applied an unsupervised data-driven framework to stratify 102 MDD patients on their neuroimaging signature, including extracted measures of cortical thickness, grey matter volumes, and white matter fractional anisotropy. Our novel analytical pipeline integrated different machine learning algorithms to harmonize data, perform data dimensionality reduction, and provide a stability-based relative clustering validation. The obtained clusters were characterized for immune-inflammatory peripheral biomarkers, TRD, history of childhood trauma and depressive symptoms. Our results indicated two different clusters of patients, differentiable with 67 % of accuracy: one cluster (n = 59) was associated with a higher proportion of TRD, and higher scores of energy-related depressive symptoms, history of childhood abuse and emotional neglect; this cluster showed a widespread reduction in cortical thickness (d = 0.43-1.80) and volumes (d = 0.45-1.05), along with fractional anisotropy in the fronto-occipital fasciculus, stria terminalis, and corpus callosum (d = 0.46-0.52); the second cluster (n = 43) was associated with cognitive and affective depressive symptoms, thicker cortices and wider volumes. Multivariate analyses revealed distinct brain-inflammation relationships between the two clusters, with increase in pro-inflammatory markers being associated with decreased cortical thickness and volumes. Our stratification of MDD patients based on structural neuroimaging identified clinically-relevant subgroups of MDD with specific symptomatic and immune-inflammatory profiles, which can contribute to the development of tailored personalized interventions for MDD.
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Affiliation(s)
- Federica Colombo
- University Vita-Salute San Raffaele, Milano, Italy; Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy.
| | - Federico Calesella
- Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy
| | - Beatrice Bravi
- University Vita-Salute San Raffaele, Milano, Italy; Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy
| | - Lidia Fortaner-Uyà
- University Vita-Salute San Raffaele, Milano, Italy; Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy
| | - Camilla Monopoli
- Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy
| | - Emma Tassi
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Politecnico di Milano, Department of Electronics, Information and Bioengineering, Milan, Italy
| | | | - Raffaella Zanardi
- University Vita-Salute San Raffaele, Milano, Italy; Mood Disorders Unit, Scientific Institute IRCCS San Raffaele Hospital, Milan, Italy
| | - Irene Bollettini
- Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy
| | - Sara Poletti
- University Vita-Salute San Raffaele, Milano, Italy; Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy
| | - Cristina Lorenzi
- Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy
| | - Sara Spadini
- Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Eleonora Maggioni
- Politecnico di Milano, Department of Electronics, Information and Bioengineering, Milan, Italy
| | - Chiara Fabbri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Francesco Benedetti
- University Vita-Salute San Raffaele, Milano, Italy; Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy
| | - Benedetta Vai
- University Vita-Salute San Raffaele, Milano, Italy; Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Hospital, Milano, Italy
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Qiu H, Zhang L, Gao Y, Zhou Z, Li H, Cao L, Wang Y, Hu X, Liang K, Tang M, Kuang W, Huang X, Gong Q. Functional connectivity of the default mode network in first-episode drug-naïve patients with major depressive disorder. J Affect Disord 2024; 361:489-496. [PMID: 38901692 DOI: 10.1016/j.jad.2024.06.063] [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: 11/29/2023] [Revised: 06/05/2024] [Accepted: 06/17/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Alterations in the default mode network (DMN) have been reported in major depressive disorder (MDD), well-replicated robust alterations of functional connectivity (FC) of DMN remain to be established. Investigating the functional connections of DMN at the overall and subsystem level in early MDD patients has the potential to advance our understanding of the physiopathology of this disorder. METHODS We recruited 115 first-episode drug-naïve patients with MDD and 137 demographic-matched healthy controls (HCs). We first compared FC within the DMN, within/between the DMN subsystems, and from DMN subsystems to the whole brain between groups. Subsequently, we explored correlations between clinical features and identified alterations in FC. RESULTS First-episode drug-naïve patients with MDD showed significantly increased FC within the DMN, dorsal DMN and medial DMN. Each subsystem showed a distinct FC pattern with other brain networks. Increased FC between the subsystems (core DMN, dorsal DMN) and other networks was associated with more severe depressive symptoms, while medial DMN-related connectivity correlated with memory performance. LIMITATIONS The relatively large "pure" MDD sample could only be generalized to a limited population. And, atypical asymmetric FCs in the DMN related to MDD might be missed for only left-lateralized ROIs were used to avoid strong correlations between mirrored (right/left) seed regions. CONCLUSION These findings suggest patients with early MDD showed distinct patterns of FC alterations throughout DMN and its subsystems, which were related to illness severity and illness-associated cognitive impairment, highlighting their clinical significance.
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Affiliation(s)
- Hui Qiu
- 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 Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, 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
| | - 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
| | - 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
| | - 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
| | - Lingxiao 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
| | - Yingying Wang
- 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
| | - 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
| | - 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
| | - Mengyue Tang
- 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
| | - Weihong Kuang
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, 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.
| | - Qiyong Gong
- 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, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China.
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Ayache SS, Biabani M, Chalah MA. Editorial: Rising stars in brain imaging and stimulation 2023. Front Hum Neurosci 2024; 18:1437975. [PMID: 38911225 PMCID: PMC11190356 DOI: 10.3389/fnhum.2024.1437975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 05/29/2024] [Indexed: 06/25/2024] Open
Affiliation(s)
- Samar S. Ayache
- Department of Neurology, Gilbert and Rose-Marie Chagoury School of Medicine, Byblos, Lebanon
- Institut de la Colonne Vertébrale et des NeuroSciences (ICVNS), Centre Médico-Chirurgical Bizet, Paris, France
- EA4391 Excitabilité Nerveuse and Thérapeutique, Université Paris Est Créteil, Créteil, France
- Department of Clinical Neurophysiology, DMU FIxIT, Henri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Créteil, France
| | - Mana Biabani
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Moussa A. Chalah
- Department of Neurology, Gilbert and Rose-Marie Chagoury School of Medicine, Byblos, Lebanon
- Institut de la Colonne Vertébrale et des NeuroSciences (ICVNS), Centre Médico-Chirurgical Bizet, Paris, France
- Pôle Hospitalo-Universitaire Psychiatrie Paris 15, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
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Haniff ZR, Bocharova M, Mantingh T, Rucker JJ, Velayudhan L, Taylor DM, Young AH, Aarsland D, Vernon AC, Thuret S. Psilocybin for dementia prevention? The potential role of psilocybin to alter mechanisms associated with major depression and neurodegenerative diseases. Pharmacol Ther 2024; 258:108641. [PMID: 38583670 DOI: 10.1016/j.pharmthera.2024.108641] [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: 09/05/2023] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
Major depression is an established risk factor for subsequent dementia, and depression in late life may also represent a prodromal state of dementia. Considering current challenges in the clinical development of disease modifying therapies for dementia, the focus of research is shifting towards prevention and modification of risk factors to alter the neurodegenerative disease trajectory. Understanding mechanistic commonalities underlying affective symptoms and cognitive decline may reveal biomarkers to aid early identification of those at risk of progressing to dementia during the preclinical phase of disease, thus allowing for timely intervention. Adult hippocampal neurogenesis (AHN) is a phenomenon that describes the birth of new neurons in the dentate gyrus throughout life and it is associated with spatial learning, memory and mood regulation. Microglia are innate immune system macrophages in the central nervous system that carefully regulate AHN via multiple mechanisms. Disruption in AHN is associated with both dementia and major depression and microgliosis is a hallmark of several neurodegenerative diseases. Emerging evidence suggests that psychedelics promote neuroplasticity, including neurogenesis, and may also be immunomodulatory. In this context, psilocybin, a serotonergic agonist with rapid-acting antidepressant properties has the potential to ameliorate intersecting pathophysiological processes relevant for both major depression and neurodegenerative diseases. In this narrative review, we focus on the evidence base for the effects of psilocybin on adult hippocampal neurogenesis and microglial form and function; which may suggest that psilocybin has the potential to modulate multiple mechanisms of action, and may have implications in altering the progression from major depression to dementia in those at risk.
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Affiliation(s)
- Zarah R Haniff
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Mariia Bocharova
- Department of Old Age Psychiatry, Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Tim Mantingh
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - James J Rucker
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, United Kingdom
| | - Latha Velayudhan
- Department of Old Age Psychiatry, Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - David M Taylor
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, United Kingdom
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, United Kingdom
| | - Dag Aarsland
- Department of Old Age Psychiatry, Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Wolfson Centre for Age Related Diseases, Division of Neuroscience of the Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Stavanger University Hospital, Stavanger, Norway
| | - Anthony C Vernon
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; MRC Centre for Neurodevelopmental Disorders, King's College London, United Kingdom.
| | - Sandrine Thuret
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
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Imbert L, Neige C, Moirand R, Piva G, Bediou B, Vallet W, Brunelin J. Eye-tracking evidence of a relationship between attentional bias for emotional faces and depression severity in patients with treatment-resistant depression. Sci Rep 2024; 14:12000. [PMID: 38796509 PMCID: PMC11127986 DOI: 10.1038/s41598-024-62251-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/15/2024] [Indexed: 05/28/2024] Open
Abstract
In a retrospective study, 54 patients with treatment-resistant major depressive disorder (TRD) completed a free-viewing task in which they had to freely explore pairs of faces (an emotional face (happy or sad) opposite to a neutral face). Attentional bias to emotional faces was calculated for early and sustained attention. We observed a significant negative correlation between depression severity as measured by the 10-item Montgomery-Åsberg Depression Rating Scale (MADRS) and sustained attention to happy faces. In addition, we observed a positive correlation between depression severity and sustained attention to sad faces. No significant correlation between depression severity and early attention was found for either happy or sad faces. Although conclusions from the current study are limited by the lack of comparison with a control group, the eye-tracking free-viewing task appears to be a relevant, accessible and easy-to-use tool for measuring depression severity through emotional attentional biases in TRD.
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Affiliation(s)
- Laetitia Imbert
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, 69500, Bron, France
| | - Cécilia Neige
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, 69500, Bron, France
- Centre Hospitalier Le Vinatier, Bat 416 1st floor, 95 boulevard Pinel, 696500, Bron, France
| | - Rémi Moirand
- Centre Hospitalier Le Vinatier, Bat 416 1st floor, 95 boulevard Pinel, 696500, Bron, France
| | - Giulia Piva
- Centre Hospitalier Le Vinatier, Bat 416 1st floor, 95 boulevard Pinel, 696500, Bron, France
| | - Benoit Bediou
- Faculté de Psychologie et Sciences de l'Education Campus Biotech, Université de Genève, 9 chemin des mines, 1211, Geneva, Switzerland
| | - William Vallet
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, 69500, Bron, France
- Centre Hospitalier Le Vinatier, Bat 416 1st floor, 95 boulevard Pinel, 696500, Bron, France
| | - Jerome Brunelin
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, 69500, Bron, France.
- Centre Hospitalier Le Vinatier, Bat 416 1st floor, 95 boulevard Pinel, 696500, Bron, France.
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Tong X, Zhao K, Fonzo GA, Xie H, Carlisle NB, Keller CJ, Oathes DJ, Sheline Y, Nemeroff CB, Williams LM, Trivedi M, Etkin A, Zhang Y. Optimizing Antidepressant Efficacy: Multimodal Neuroimaging Biomarkers for Prediction of Treatment Response. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.11.24305583. [PMID: 38645124 PMCID: PMC11030479 DOI: 10.1101/2024.04.11.24305583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Major depressive disorder (MDD) is a common and often severe condition that profoundly diminishes quality of life for individuals across ages and demographic groups. Unfortunately, current antidepressant and psychotherapeutic treatments exhibit limited efficacy and unsatisfactory response rates in a substantial number of patients. The development of effective therapies for MDD is hindered by the insufficiently understood heterogeneity within the disorder and its elusive underlying mechanisms. To address these challenges, we present a target-oriented multimodal fusion framework that robustly predicts antidepressant response by integrating structural and functional connectivity data (sertraline: R2 = 0.31; placebo: R2 = 0.22). Through the model, we identify multimodal neuroimaging biomarkers of antidepressant response and observe that sertraline and placebo show distinct predictive patterns. We further decompose the overall predictive patterns into constitutive network constellations with generalizable structural-functional co-variation, which exhibit treatment-specific association with personality traits and behavioral/cognitive task performance. Our innovative and interpretable multimodal framework provides novel insights into the intricate neuropsychopharmacology of antidepressant treatment and paves the way for advances in precision medicine and development of more targeted antidepressant therapeutics.
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Affiliation(s)
- Xiaoyu Tong
- Department of Bioengineering, Lehigh University, Bethlehem, PA, USA
| | - Kanhao Zhao
- Department of Bioengineering, Lehigh University, Bethlehem, PA, USA
| | - Gregory A. Fonzo
- Center for Psychedelic Research and Therapy, Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Hua Xie
- Center for Neuroscience Research, Children’s National Hospital, Washington, DC, USA
| | | | - Corey J. Keller
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Sierra-Pacific Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Desmond J. Oathes
- Center for Brain Imaging and Stimulation, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Center for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Yvette Sheline
- Center for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Charles B. Nemeroff
- Center for Psychedelic Research and Therapy, Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Leanne M. Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Sierra-Pacific Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Madhukar Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Alto Neuroscience, Inc., Los Altos, CA, USA
| | - Yu Zhang
- Department of Bioengineering, Lehigh University, Bethlehem, PA, USA
- Department of Electrical and Computer Engineering, Lehigh University, Bethlehem, PA, USA
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9
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Song EJ, Tozzi L, Williams LM. Brain Circuit-Derived Biotypes for Treatment Selection in Mood Disorders: A Critical Review and Illustration of a Functional Neuroimaging Tool for Clinical Translation. Biol Psychiatry 2024:S0006-3223(24)01175-2. [PMID: 38552866 DOI: 10.1016/j.biopsych.2024.03.016] [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: 10/18/2023] [Revised: 03/16/2024] [Accepted: 03/20/2024] [Indexed: 05/12/2024]
Abstract
Although the lifetime burden due to major depressive disorder is increasing, we lack tools for selecting the most effective treatments for each patient. One-third to one-half of patients with major depressive disorder do not respond to treatment, and we lack strategies for selecting among available treatments or expediting access to new treatment options. This critical review concentrates on functional neuroimaging as a modality of measurement for precision psychiatry. We begin by summarizing the current landscape of how functional neuroimaging-derived circuit predictors can forecast treatment outcomes in depression. Then, we outline the opportunities and challenges in integrating circuit predictors into clinical practice. We highlight one standardized and reproducible approach for quantifying brain circuit function at an individual level, which could serve as a model for clinical translation. We conclude by evaluating the prospects and practicality of employing neuroimaging tools, such as the one that we propose, in routine clinical practice.
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Affiliation(s)
- Evelyn Jiayi Song
- Stanford Center for Precision Mental Health and Wellness, Psychiatry and Behavioral Sciences, Stanford, California; Stanford School of Engineering, Stanford, California
| | - Leonardo Tozzi
- Stanford Center for Precision Mental Health and Wellness, Psychiatry and Behavioral Sciences, Stanford, California
| | - Leanne M Williams
- Stanford Center for Precision Mental Health and Wellness, Psychiatry and Behavioral Sciences, Stanford, California; Mental Illness Research, Education and Clinical Center of Excellence (MIRECC), VA Palo Alto Health Care System, Palo Alto, California.
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10
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Rai S, Graff K, Tansey R, Bray S. How do tasks impact the reliability of fMRI functional connectivity? Hum Brain Mapp 2024; 45:e26535. [PMID: 38348730 PMCID: PMC10884875 DOI: 10.1002/hbm.26535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/13/2023] [Accepted: 11/01/2023] [Indexed: 02/24/2024] Open
Abstract
While there is growing interest in the use of functional magnetic resonance imaging-functional connectivity (fMRI-FC) for biomarker research, low measurement reliability of conventional acquisitions may limit applications. Factors known to impact FC reliability include scan length, head motion, signal properties, such as temporal signal-to-noise ratio (tSNR), and the acquisition state or task. As tasks impact signal in a region-wise fashion, they likely impact FC reliability differently across the brain, making task an important decision in study design. Here, we use the densely sampled Midnight Scan Club (MSC) dataset, comprising 5 h of rest and 6 h of task fMRI data in 10 healthy adults, to investigate regional effects of tasks on FC reliability. We further considered how BOLD signal properties contributing to tSNR, that is, temporal mean signal (tMean) and temporal standard deviation (tSD), vary across the brain, associate with FC reliability, and are modulated by tasks. We found that, relative to rest, tasks enhanced FC reliability and increased tSD for specific task-engaged regions. However, FC signal variability and reliability is broadly dampened during tasks outside task-engaged regions. From our analyses, we observed signal variability was the strongest driver of FC reliability. Overall, our findings suggest that the choice of task can have an important impact on reliability and should be considered in relation to maximizing reliability in networks of interest as part of study design.
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Affiliation(s)
- Shefali Rai
- Child and Adolescent Imaging Research ProgramUniversity of CalgaryCalgaryAlbertaCanada
- Alberta Children's Hospital Research InstituteUniversity of CalgaryCalgaryAlbertaCanada
- Hotchkiss Brain InstituteUniversity of CalgaryCalgaryAlbertaCanada
- Department of NeuroscienceUniversity of CalgaryCalgaryAlbertaCanada
| | - Kirk Graff
- Child and Adolescent Imaging Research ProgramUniversity of CalgaryCalgaryAlbertaCanada
- Alberta Children's Hospital Research InstituteUniversity of CalgaryCalgaryAlbertaCanada
- Hotchkiss Brain InstituteUniversity of CalgaryCalgaryAlbertaCanada
- Department of NeuroscienceUniversity of CalgaryCalgaryAlbertaCanada
| | - Ryann Tansey
- Child and Adolescent Imaging Research ProgramUniversity of CalgaryCalgaryAlbertaCanada
- Alberta Children's Hospital Research InstituteUniversity of CalgaryCalgaryAlbertaCanada
- Hotchkiss Brain InstituteUniversity of CalgaryCalgaryAlbertaCanada
- Department of NeuroscienceUniversity of CalgaryCalgaryAlbertaCanada
| | - Signe Bray
- Child and Adolescent Imaging Research ProgramUniversity of CalgaryCalgaryAlbertaCanada
- Alberta Children's Hospital Research InstituteUniversity of CalgaryCalgaryAlbertaCanada
- Hotchkiss Brain InstituteUniversity of CalgaryCalgaryAlbertaCanada
- Department of RadiologyUniversity of CalgaryCalgaryAlbertaCanada
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11
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Verdijk JPAJ, van de Mortel LA, Ten Doesschate F, Pottkämper JCM, Stuiver S, Bruin WB, Abbott CC, Argyelan M, Ousdal OT, Bartsch H, Narr K, Tendolkar I, Calhoun V, Lukemire J, Guo Y, Oltedal L, van Wingen G, van Waarde JA. Longitudinal resting-state network connectivity changes in electroconvulsive therapy patients compared to healthy controls. Brain Stimul 2024; 17:140-147. [PMID: 38101469 PMCID: PMC11145948 DOI: 10.1016/j.brs.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/28/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE Electroconvulsive therapy (ECT) is effective for major depressive episodes. Understanding of underlying mechanisms has been increased by examining changes of brain connectivity but studies often do not correct for test-retest variability in healthy controls (HC). In this study, we investigated changes in resting-state networks after ECT in a multicenter study. METHODS Functional resting-state magnetic resonance imaging data, acquired before start and within one week after ECT, from 90 depressed patients were analyzed, as well as longitudinal data of 24 HC. Group-information guided independent component analysis (GIG-ICA) was used to spatially restrict decomposition to twelve canonical resting-state networks. Selected networks of interest were the default mode network (DMN), salience network (SN), and left and right frontoparietal network (LFPN, and RFPN). Whole-brain voxel-wise analyses were used to assess group differences at baseline, group by time interactions, and correlations with treatment effectiveness. In addition, between-network connectivity and within-network strengths were computed. RESULTS Within-network strength of the DMN was lower at baseline in ECT patients which increased after ECT compared to HC, after which no differences were detected. At baseline, ECT patients showed lower whole-brain voxel-wise DMN connectivity in the precuneus. Increase of within-network strength of the LFPN was correlated with treatment effectiveness. We did not find whole-brain voxel-wise or between-network changes. CONCLUSION DMN within-network connectivity normalized after ECT. Within-network increase of the LFPN in ECT patients was correlated with higher treatment effectiveness. In contrast to earlier studies, we found no whole-brain voxel-wise changes, which highlights the necessity to account for test-retest effects.
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Affiliation(s)
- Joey P A J Verdijk
- Rijnstate Hospital, Department of Psychiatry, P.O. Box 9555, 6800 TA Arnhem, the Netherlands; University of Twente, Department of Clinical Neurophysiology, Enschede, the Netherlands.
| | - Laurens A van de Mortel
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Freek Ten Doesschate
- Rijnstate Hospital, Department of Psychiatry, P.O. Box 9555, 6800 TA Arnhem, the Netherlands; Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Julia C M Pottkämper
- Rijnstate Hospital, Department of Psychiatry, P.O. Box 9555, 6800 TA Arnhem, the Netherlands; University of Twente, Department of Clinical Neurophysiology, Enschede, the Netherlands
| | - Sven Stuiver
- Rijnstate Hospital, Department of Psychiatry, P.O. Box 9555, 6800 TA Arnhem, the Netherlands; University of Twente, Department of Clinical Neurophysiology, Enschede, the Netherlands
| | - Willem B Bruin
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Christopher C Abbott
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Miklos Argyelan
- Center for Psychiatric Neuroscience at the Feinstein Institute for Medical Research, New York, NY, USA
| | - Olga T Ousdal
- Department of Biomedicine, University of Bergen, Bergen, Norway; Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Hauke Bartsch
- Department of Computer Science, University of Bergen, Bergen, Norway; Mohn Medical Imaging and Visualization Center, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Katherine Narr
- Departments of Neurology, Psychiatry, and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Indira Tendolkar
- Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands
| | - Vince Calhoun
- Tri-institutional center for Translational Research in Neuroimaging and Data Science (TReNDS) Center, Emory University, USA
| | - Joshua Lukemire
- Emory Center for Biomedical Imaging Statistics, Emory University, USA
| | - Ying Guo
- Emory Center for Biomedical Imaging Statistics, Emory University, USA
| | - Leif Oltedal
- Mohn Medical Imaging and Visualization Center, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Guido van Wingen
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Jeroen A van Waarde
- Rijnstate Hospital, Department of Psychiatry, P.O. Box 9555, 6800 TA Arnhem, the Netherlands
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12
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Rajkumar RP. Immune-inflammatory markers of response to repetitive transcranial magnetic stimulation in depression: A scoping review. Asian J Psychiatr 2024; 91:103852. [PMID: 38070319 DOI: 10.1016/j.ajp.2023.103852] [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] [Received: 10/31/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is a safe, effective and non-invasive form of neuromodulatory therapy in patients with major depressive disorder (MDD). MDD is associated with increased peripheral and brain inflammation. The current paper aims to provide an overview of research examining the relationship between immune and inflammatory markers and response to rTMS in MDD. METHODS A scoping review method was adopted in keeping with the PRISMA-ScR guidelines. Twelve relevant studies were retrieved from the PubMed and Scopus databases and rated for study quality using a modified version of the BIOCROSS tool. RESULTS Response to rTMS in MDD was associated with basal and post-treatment levels of the inflammatory markers amyloid A, antithrombin III, oxidised phosphatidylcholine, and the microRNA miR-146a-5p. Inconsistent results were observed for the cytokines interleukin-1β, interleukin-2 and tumour necrosis factor-α. Increased baseline levels of interleukin-6 and C-reactive protein were linked to a poorer response to rTMS. DISCUSSION These results suggest that rTMS may have effects on immune-inflammatory pathways that are distinct from those of antidepressants and electroconvulsive therapy. Because of certain methodological limitations in the included studies, these results should be interpreted with caution.
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Affiliation(s)
- Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
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13
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Kong Y, Zhou J, Zhao M, Zhang Y, Tan T, Xu Z, Hou Z, Yuan Y, Tan L, Song R, Shi Y, Feng H, Wu W, Zhao Y, Zhang Z. Non-inferiority of intermittent theta burst stimulation over the left V 1 vs. classical target for depression: A randomized, double-blind trial. J Affect Disord 2023; 343:59-70. [PMID: 37751801 DOI: 10.1016/j.jad.2023.09.024] [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] [Received: 05/26/2023] [Revised: 08/27/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) targeting the visual cortex (VC) has shown antidepressant effects for major depressive disorder (MDD) in sham-controlled trials, but comparisons with rTMS targeting the left dorsolateral prefrontal cortex (DLPFC) are lacking. We aimed to determine the non-inferiority of intermittent theta-burst stimulation (iTBS) over VC vs DLPFC for MDD. METHODS Participants randomly received navigated iTBS over the left V1 or the left DLPFC twice daily for 14 days with a 3-month follow-up. The primary outcome was change in Hamilton Depression Rating Scale (HAMD-17) score from baseline to treatment end, with 2.5 points as the non-inferiority margin. Secondary outcomes included: improvement in Montgomery-Asberg Depression Rating Scale (MADRS), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA); response and remission rates; suicidal ideation and adverse events. RESULTS Of 75 randomized patients, 67 completed full treatment, including 52 first-episode patients and 15 relapsers. The primary outcome indicated the non-inferiority of VC (adjusted difference 1.14, lower 97.5 % CI -1.24; p = .002), confirmed by improvements in objective cognitive task and protein levels, as did most secondary outcomes. Reduced suicidal ideation after treatment, incidence of eye discomfort and pain score were lower in the VC group. CONCLUSIONS Left VC iTBS has the potential to be non-inferior to DLPFC iTBS in most first-episode MDD in improving depressive symptoms and cognitive function, with less suicidal ideation and adverse events. LIMITATIONS Given the limited sample size, the lack of a sham control and the use of antidepressants, the findings should be interpreted with caution.
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Affiliation(s)
- Yan Kong
- Department of Neurology, Affiliated Zhongda Hospital, School of Medicine, Institution of Neuropsychiatry, Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing 210009, China; Department of Clinical Psychology, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China
| | - Jiawei Zhou
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Mingge Zhao
- Department of Nursing, Affiliated Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Yuhua Zhang
- Department of Psychosomatics and Psychiatry, Affiliated of Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Tingting Tan
- Department of Psychosomatics and Psychiatry, Affiliated of Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Zhi Xu
- Department of Psychosomatics and Psychiatry, Affiliated of Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Zhenghua Hou
- Department of Psychosomatics and Psychiatry, Affiliated of Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Affiliated of Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Liangliang Tan
- Department of Psychosomatics and Psychiatry, Affiliated of Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Ruize Song
- Department of Neurology, Affiliated Zhongda Hospital, School of Medicine, Institution of Neuropsychiatry, Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing 210009, China
| | - Yachen Shi
- Department of Neurology, Affiliated Zhongda Hospital, School of Medicine, Institution of Neuropsychiatry, Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing 210009, China
| | - Haixia Feng
- Department of Nursing, Affiliated Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Wei Wu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford 94305, USA
| | - Yang Zhao
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| | - Zhijun Zhang
- Department of Neurology, Affiliated Zhongda Hospital, School of Medicine, Institution of Neuropsychiatry, Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing 210009, China; Department of Mental Health and Public Health, Faculty of Life and Health Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Research Center for Brain Health, Pazhou Lab, Guangzhou 510330, China.
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14
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Tsuchiyagaito A, Misaki M, Cochran G, Philip NS, Paulus MP, Guinjoan SM. Thalamo-cortical circuits associated with trait- and state-repetitive negative thinking in major depressive disorder. J Psychiatr Res 2023; 168:184-192. [PMID: 37913745 PMCID: PMC10872862 DOI: 10.1016/j.jpsychires.2023.10.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/10/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Repetitive negative thinking (RNT), often referred to as rumination in the mood disorders literature, is a symptom dimension associated with poor prognosis and suicide in major depressive disorder (MDD). Given the transdiagnostic nature of RNT, this study aimed to evaluate the hypothesis that neurobiological substrates of RNT in MDD may share the brain mechanisms underlying obsessions, particularly those involving cortico-striatal-thalamic-cortical (CSTC) circuits. METHODS Thirty-nine individuals with MDD underwent RNT induction during fMRI. Trait-RNT was measured by the Ruminative Response Scale (RRS) and state-RNT was measured by a visual analogue scale. We employed a connectome-wide association analysis examining the association between RNT intensity with striatal and thalamic connectivity. RESULTS A greater RRS score was associated with hyperconnectivity of the right mediodorsal thalamus with prefrontal cortex, including lateral orbitofrontal cortex, along with Wernicke's area and posterior default mode network nodes (t = 4.66-6.70). A greater state-RNT score was associated with hyperconnectivity of the right laterodorsal thalamus with bilateral primary sensory and motor cortices, supplementary motor area, and Broca's area (t = 4.51-6.57). Unexpectedly, there were no significant findings related to the striatum. CONCLUSIONS The present results suggest RNT in MDD is subserved by abnormal connectivity between right thalamic nuclei and cortical regions involved in both visceral and higher order cognitive processing. Emerging deep-brain neuromodulation methods may be useful to establish causal relationships between dysfunction of right thalamic-cortical circuits and RNT in MDD.
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Affiliation(s)
- Aki Tsuchiyagaito
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA; Research Center for Child Mental Development, Chiba University, Chiba, Japan.
| | - Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
| | - Gabe Cochran
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Noah S Philip
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA
| | | | - Salvador M Guinjoan
- Laureate Institute for Brain Research, Tulsa, OK, USA; Department of Psychiatry, Oklahoma University Health Sciences Center at Tulsa, Tulsa, OK, USA; Laureate Psychiatric Hospital and Clinic, Tulsa, OK, USA
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15
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Scherer M, Harmsen IE, Samuel N, Elias GJB, Germann J, Boutet A, MacLeod CE, Giacobbe P, Rowland NC, Lozano AM, Milosevic L. Oscillatory network markers of subcallosal cingulate deep brain stimulation for depression. Brain Stimul 2023; 16:1764-1775. [PMID: 38061548 PMCID: PMC10947774 DOI: 10.1016/j.brs.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/12/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
Identifying functional biomarkers related to treatment success can aid in expediting therapy optimization, as well as contribute to a better understanding of the neural mechanisms of the treatment-resistant depression (TRD) and subcallosal cingulate deep brain stimulation (SCC-DBS). Magnetoencephalography data were obtained from 16 individuals with SCC-DBS for TRD and 25 healthy subjects. The first objective of the study was to identify region-specific oscillatory modulations that both (i) discriminate individuals with TRD (with SCC-DBS OFF) from healthy controls, and (ii) discriminate TRD treatment responders from non-responders (with SCC-DBS ON). The second objective of this work was to further explore the effects of stimulation intensity and frequency on oscillatory activity in the identified brain regions of interest. Oscillatory power analyses led to the identification of brain regions that differentiated responders from non-responders based on modulations of increased alpha (8-12 Hz) and decreased gamma (32-116 Hz) power within nodes of the default mode, central executive, and somatomotor networks, Broca's area, and lingual gyrus. Within these nodes, it was also found that low stimulation frequency had stronger effects on oscillatory modulation than increased stimulation intensity. The identified functional network biomarkers implicate modulation of TRD-related activity in brain regions involved in emotional control/processing, motor control, and the interaction between speech, vision, and memory, which have all been implicated in depression. These electrophysiological biomarkers have the potential to be used as functional proxies for therapy optimization. Additional stimulation parameter analyses revealed that oscillatory modulations can be strengthened by increasing stimulation intensity or reducing frequency, which may represent potential avenues of direction in non-responders.
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Affiliation(s)
- M Scherer
- Krembil Brain Institute, University Health Network, Toronto, Canada; Institute of Biomedical Engineering, University of Toronto, Canada
| | - I E Harmsen
- Krembil Brain Institute, University Health Network, Toronto, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada; Mitchell Goldhar MEG Unit, University Health Network, Toronto, Canada
| | - N Samuel
- Krembil Brain Institute, University Health Network, Toronto, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - G J B Elias
- Krembil Brain Institute, University Health Network, Toronto, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - J Germann
- Krembil Brain Institute, University Health Network, Toronto, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - A Boutet
- Krembil Brain Institute, University Health Network, Toronto, Canada; Joint Department of Medical Imaging, University of Toronto, Canada
| | - C E MacLeod
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - P Giacobbe
- Department of Psychiatry, Sunnybrook Health Sciences, University of Toronto, Toronto, Ontario, Canada
| | - N C Rowland
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA; Murray Center for Research on Parkinson's Disease and Related Disorders, Medical University of South Carolina, Charleston, SC, USA
| | - A M Lozano
- Krembil Brain Institute, University Health Network, Toronto, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada; Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, Canada
| | - L Milosevic
- Krembil Brain Institute, University Health Network, Toronto, Canada; Institute of Biomedical Engineering, University of Toronto, Canada; Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, Canada; KITE Research Institute, University Health Network, Toronto, Canada.
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16
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Wang L, Zhao P, Zhang J, Zhang R, Liu J, Duan J, Zhang X, Zhu R, Wang F. Functional connectivity between the cerebellar vermis and cerebrum distinguishes early treatment response for major depressive episodes in adolescents. J Affect Disord 2023; 339:256-263. [PMID: 37437740 DOI: 10.1016/j.jad.2023.07.054] [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] [Received: 04/06/2023] [Revised: 07/01/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND The absence of biomarkers for predicting treatment response in adolescent mood disorder calls for further research. The vermis, a component of the cerebellum, is involved in mood disorder pathophysiology and relates to clinical symptoms and treatment outcomes. We investigated vermis functional connectivity (FC) as an early marker for treatment response identification. METHOD One hundred thirty-two adolescents with mood disorders including major depressive disorder or bipolar disorder, were recruited, who were experiencing a major depressive episode. All adolescents underwent baseline and 2-week treatment resting-state MRI scans. Hamilton Rating Scale for Depression (HAMD) assessments were completed to assess the severity of symptoms. Patients were divided into treatment-responsive (≥50 % HAMD reduction, n = 75) and treatment-unresponsive subgroups (n = 57). Vermis FCs were compared between subgroups at baseline. And we compared the pre- and post-treatment FC differences within subgroups. RESULT Higher vermis-left temporal lobe FC in treatment-responsive group compared to treatment-unresponsive group at baseline. The FC value showed positive prognosis for the efficacy, with the area under the curve (AUC) of 0.760 (95 % confidence interval: 0.678-0.843, p < 0.001), suggesting higher vermis-temporal FC is benefit to improve treatment-response. Furthermore, post-treatment analysis showed significant increases in the vermis-right frontal lobe FC values between in all patients, suggesting that vermis-frontal FCs were independent of treatment-outcome. LIMITATION Sample size was relatively small, which may limit the generalizability of our results. CONCLUSION Our study revealed that the FC between the vermis and the cortex is not only associated with symptom alleviation but also predictive of treatment outcomes.
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Affiliation(s)
- Lifei Wang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, PR China.
| | - Pengfei Zhao
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, PR China.
| | - Jing Zhang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, PR China.
| | - Ran Zhang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, PR China.
| | - Juan Liu
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, PR China.
| | - Jia Duan
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, PR China.
| | - Xizhe Zhang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, PR China; School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Rongxin Zhu
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, PR China.
| | - Fei Wang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, PR China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, PR China.
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17
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Sanchez SM, Tsuchiyagaito A, Kuplicki R, Park H, Postolski I, Rohan M, Paulus MP, Guinjoan SM. Repetitive Negative Thinking-Specific and -Nonspecific White Matter Tracts Engaged by Historical Psychosurgical Targets for Depression. Biol Psychiatry 2023; 94:661-671. [PMID: 36965550 PMCID: PMC10517085 DOI: 10.1016/j.biopsych.2023.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND Repetitive negative thinking (RNT) is a frequent symptom of major depressive disorder (MDD) that is associated with poor outcomes and treatment resistance. While most studies on RNT have focused on structural and functional characteristics of gray matter, this study aimed to examine the association between white matter (WM) tracts and interindividual variability in RNT. METHODS A probabilistic tractography approach was used to characterize differences in the size and anatomical trajectory of WM fibers traversing psychosurgery targets historically useful in the treatment of MDD (anterior capsulotomy, anterior cingulotomy, and subcaudate tractotomy) in patients with MDD and low (n = 53) or high (n = 52) RNT, and healthy control subjects (n = 54). MDD samples were propensity matched on depression and anxiety severity and demographics. RESULTS WM tracts traversing left hemisphere targets and reaching the ventral anterior body of the corpus callosum (thus extending to contralateral regions) were larger in the high-RNT MDD group compared with low-RNT (effect size D = 0.27, p = .042) and healthy control (D = 0.23, p = .02) groups. MDD was associated with greater size of tracts that converge onto the right medial orbitofrontal cortex regardless of RNT intensity. Other RNT-nonspecific findings in MDD involved tracts reaching the left primary motor and right primary somatosensory cortices. CONCLUSIONS This study provides the first evidence to our knowledge that WM connectivity patterns, which could become targets of intervention, differ between high- and low-RNT participants with MDD. These WM differences extend to circuits that are not specific to RNT, possibly subserving reward mechanisms and psychomotor activity.
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Affiliation(s)
| | - Aki Tsuchiyagaito
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | | | - Heekyeong Park
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Department of Psychology, University of North Texas, Dallas, Texas
| | - Ivan Postolski
- Institute for Research in Computational Sciences, National Scientific and Technical Research Council-University of Buenos Aires, Buenos Aires, Argentina
| | - Michael Rohan
- Laureate Institute for Brain Research, Tulsa, Oklahoma
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma
| | - Salvador M Guinjoan
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Department of Psychiatry, Oklahoma University Health Sciences Center, Tulsa, Oklahoma.
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18
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Orrico-Sanchez A, Guiard BP, Manta S, Callebert J, Launay JM, Louis F, Paccard A, Gruszczynski C, Betancur C, Vialou V, Gautron S. Organic cation transporter 2 contributes to SSRI antidepressant efficacy by controlling tryptophan availability in the brain. Transl Psychiatry 2023; 13:302. [PMID: 37775532 PMCID: PMC10542329 DOI: 10.1038/s41398-023-02596-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/15/2023] [Accepted: 09/15/2023] [Indexed: 10/01/2023] Open
Abstract
Selective serotonin reuptake inhibitors (SSRI) are common first-line treatments for major depression. However, a significant number of depressed patients do not respond adequately to these pharmacological treatments. In the present preclinical study, we demonstrate that organic cation transporter 2 (OCT2), an atypical monoamine transporter, contributes to the effects of SSRI by regulating the routing of the essential amino acid tryptophan to the brain. Contrarily to wild-type mice, OCT2-invalidated mice failed to respond to prolonged fluoxetine treatment in a chronic depression model induced by corticosterone exposure recapitulating core symptoms of depression, i.e., anhedonia, social withdrawal, anxiety, and memory impairment. After corticosterone and fluoxetine treatment, the levels of tryptophan and its metabolites serotonin and kynurenine were decreased in the brain of OCT2 mutant mice compared to wild-type mice and reciprocally tryptophan and kynurenine levels were increased in mutants' plasma. OCT2 was detected by immunofluorescence in several structures at the blood-cerebrospinal fluid (CSF) or brain-CSF interface. Tryptophan supplementation during fluoxetine treatment increased brain concentrations of tryptophan and, more discreetly, of 5-HT in wild-type and OCT2 mutant mice. Importantly, tryptophan supplementation improved the sensitivity to fluoxetine treatment of OCT2 mutant mice, impacting chiefly anhedonia and short-term memory. Western blot analysis showed that glycogen synthase kinase-3β (GSK3β) and mammalian/mechanistic target of rapamycin (mTOR) intracellular signaling was impaired in OCT2 mutant mice brain after corticosterone and fluoxetine treatment and, conversely, tryptophan supplementation recruited selectively the mTOR protein complex 2. This study provides the first evidence of the physiological relevance of OCT2-mediated tryptophan transport, and its biological consequences on serotonin homeostasis in the brain and SSRI efficacy.
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Affiliation(s)
| | - Bruno P Guiard
- Université Paul Sabatier, CNRS, Research Center on Animal Cognition, Toulouse, France
| | - Stella Manta
- Université Paul Sabatier, CNRS, Research Center on Animal Cognition, Toulouse, France
| | - Jacques Callebert
- Sorbonne Paris Cité, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Jean-Marie Launay
- Sorbonne Paris Cité, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Franck Louis
- Sorbonne Université, INSERM, CNRS, Neuroscience Paris Seine, Paris, France
| | - Antoine Paccard
- Sorbonne Université, INSERM, CNRS, Neuroscience Paris Seine, Paris, France
| | | | - Catalina Betancur
- Sorbonne Université, INSERM, CNRS, Neuroscience Paris Seine, Paris, France
| | - Vincent Vialou
- Sorbonne Université, INSERM, CNRS, Neuroscience Paris Seine, Paris, France.
| | - Sophie Gautron
- Sorbonne Université, INSERM, CNRS, Neuroscience Paris Seine, Paris, France.
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19
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Detcheverry F, Senthil S, Narayanan S, Badhwar A. Changes in levels of the antioxidant glutathione in brain and blood across the age span of healthy adults: A systematic review. Neuroimage Clin 2023; 40:103503. [PMID: 37742519 PMCID: PMC10520675 DOI: 10.1016/j.nicl.2023.103503] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/22/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023]
Abstract
Aging is characterized by a gradual decline of the body's biological functions, which can lead to increased production of reactive oxygen species (ROS). Antioxidants neutralize ROS and maintain balance between oxidation and reduction. If ROS production exceeds the ability of antioxidant systems to neutralize, a damaging state of oxidative stress (OS) may exist. The reduced form of glutathione (GSH) is the most abundant antioxidant, and decline of GSH is considered a marker of OS. Our review summarizes the literature on GSH variations with age in healthy adults in brain (in vivo, ex vivo) and blood (plasma, serum), and reliability of in vivo magnetic resonance spectroscopy (MRS) measurement of GSH. A systematic PubMed search identified 35 studies. All in vivo MRS studies (N = 13) reported good to excellent reproducibility of GSH measures. In brain, 3 out of 4 MRS studies reported decreased GSH with age, measured in precuneus, cingulate, and occipital regions, while 1 study reported increased GSH with age in frontal and sensorimotor regions. In post-mortem brain, out of 3 studies, 2 reported decreased GSH with age in hippocampal and frontal regions, while 1 study reported increased GSH with age in a frontal region. Oxidized glutathione disulfide (GSSG) was reported to be increased in caudate with age in 1 study, suggesting OS. Although findings in the brain lacked a clear consensus, the majority of studies suggested a decline of GSH with age. The low number of studies (particularly ex vivo) and potential regional differences may have contributed to variability in the findings in brain. In blood, in contrast, GSH levels predominately were reported to decrease with advancing age (except in the oldest-old, who may represent a select group of particularly successful agers), while GSSG findings lacked consensus. The larger number of studies assessing age-specific GSH level changes in blood (N = 16) allowed for more robust consensus across studies than in brain. Overall, the literature suggests that aging is associated with increased OS in brain and body, but the timing and regional distribution of changes in the brain require further study. The contribution of brain OS to brain aging, and the effect of interventions to raise brain GSH levels on decline of brain function, remain understudied. Given that reliable tools to measure brain GSH exist, we hope this paper will serve as a catalyst to stimulate more work in this field.
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Affiliation(s)
- Flavie Detcheverry
- Multiomics Investigation of Neurodegenerative Diseases (MIND) lab, Montreal, QC, Canada; Département de Pharmacologie et Physiologie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada; Institut de Génie Biomédical, Université de Montréal, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, QC, Canada
| | - Sneha Senthil
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada; McConnell Brain Imaging Centre, Montreal Neurological Institute-Hospital, Montreal, QC, Canada
| | - Sridar Narayanan
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada; McConnell Brain Imaging Centre, Montreal Neurological Institute-Hospital, Montreal, QC, Canada
| | - AmanPreet Badhwar
- Multiomics Investigation of Neurodegenerative Diseases (MIND) lab, Montreal, QC, Canada; Département de Pharmacologie et Physiologie, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada; Institut de Génie Biomédical, Université de Montréal, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, QC, Canada.
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20
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Kotoula V, Evans JW, Punturieri C, Johnson SC, Zarate CA. Functional MRI markers for treatment-resistant depression: Insights and challenges. PROGRESS IN BRAIN RESEARCH 2023; 278:117-148. [PMID: 37414490 PMCID: PMC10501192 DOI: 10.1016/bs.pbr.2023.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Imaging studies of treatment-resistant depression (TRD) have examined brain activity, structure, and metabolite concentrations to identify critical areas of investigation in TRD as well as potential targets for treatment interventions. This chapter provides an overview of the main findings of studies using three imaging modalities: structural magnetic resonance imaging (MRI), functional MRI (fMRI), and magnetic resonance spectroscopy (MRS). Decreased connectivity and metabolite concentrations in frontal brain areas appear to characterize TRD, although results are not consistent across studies. Treatment interventions, including rapid-acting antidepressants and transcranial magnetic stimulation (TMS), have shown some efficacy in reversing these changes while alleviating depressive symptoms. However, comparatively few TRD imaging studies have been conducted, and these studies often have relatively small sample sizes or employ different methods to examine a variety of brain areas, making it difficult to draw firm conclusions from imaging studies about the pathophysiology of TRD. Larger studies with more unified hypotheses, as well as data sharing, could help TRD research and spur better characterization of the illness, providing critical new targets for treatment intervention.
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Affiliation(s)
- Vasileia Kotoula
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, United States.
| | - Jennifer W Evans
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Claire Punturieri
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Sara C Johnson
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, United States
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21
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Runia N, Bergfeld IO, de Kwaasteniet BP, Luigjes J, van Laarhoven J, Notten P, Beute G, van den Munckhof P, Schuurman R, Denys D, van Wingen GA. Deep brain stimulation normalizes amygdala responsivity in treatment-resistant depression. Mol Psychiatry 2023; 28:2500-2507. [PMID: 36991129 DOI: 10.1038/s41380-023-02030-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 03/31/2023]
Abstract
Deep brain stimulation (DBS) of the ventral anterior limb of the internal capsule (vALIC) is a promising intervention for treatment-resistant depression (TRD). However, the working mechanisms of vALIC DBS in TRD remain largely unexplored. As major depressive disorder has been associated with aberrant amygdala functioning, we investigated whether vALIC DBS affects amygdala responsivity and functional connectivity. To investigate the long-term effects of DBS, eleven patients with TRD performed an implicit emotional face-viewing paradigm during functional magnetic resonance imaging (fMRI) before DBS surgery and after DBS parameter optimization. Sixteen matched healthy controls performed the fMRI paradigm at two-time points to control for test-retest effects. To investigate the short-term effects of DBS de-activation after parameter optimization, thirteen patients additionally performed the fMRI paradigm after double-blind periods of active and sham stimulation. Results showed that TRD patients had decreased right amygdala responsivity compared to healthy controls at baseline. Long-term vALIC DBS normalized right amygdala responsivity, which was associated with faster reaction times. This effect was not dependent on emotional valence. Furthermore, active compared to sham DBS increased amygdala connectivity with sensorimotor and cingulate cortices, which was not significantly different between responders and non-responders. These results suggest that vALIC DBS restores amygdala responsivity and behavioral vigilance in TRD, which may contribute to the DBS-induced antidepressant effect.
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Affiliation(s)
- Nora Runia
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Amsterdam, The Netherlands.
| | - Isidoor O Bergfeld
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Bart P de Kwaasteniet
- Isala Hospital, Department of Radiology and Nuclear Medicine, Zwolle, The Netherlands
| | - Judy Luigjes
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Jan van Laarhoven
- Department of Psychiatry, ETZ, location Elisabeth, Tilburg, The Netherlands
| | - Peter Notten
- Department of Psychiatry, ETZ, location Elisabeth, Tilburg, The Netherlands
| | - Guus Beute
- Department of Neurosurgery, ETZ, location Elisabeth, Tilburg, The Netherlands
| | - Pepijn van den Munckhof
- Amsterdam UMC location University of Amsterdam, Department of Neurosurgery, Amsterdam, The Netherlands
| | - Rick Schuurman
- Amsterdam UMC location University of Amsterdam, Department of Neurosurgery, Amsterdam, The Netherlands
| | - Damiaan Denys
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Guido A van Wingen
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Amsterdam, The Netherlands.
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22
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Grehl MM, Hameed S, Murrough JW. Brain Features of Treatment-Resistant Depression: A Review of Structural and Functional Connectivity Magnetic Resonance Imaging Studies. Psychiatr Clin North Am 2023; 46:391-401. [PMID: 37149352 DOI: 10.1016/j.psc.2023.02.009] [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] [Indexed: 05/08/2023]
Abstract
Increased awareness of the growing disease burden of treatment resistant depression (TRD), in combination with technological advances in MRI, affords the unique opportunity to research biomarkers that characterize TRD. We provide a narrative review of MRI studies investigating brain features associated with treatment-resistance and treatment outcome in those with TRD. Despite heterogeneity in methods and outcomes, relatively consistent findings include reduced gray matter volume in cortical regions and reduced white matter structural integrity in those with TRD. Alterations in resting state functional connectivity of the default mode network were also found. Larger studies with prospective designs are warranted.
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Affiliation(s)
- Mora M Grehl
- Department of Psychology and Neuroscience, 1701 North 13th Street, Temple University, Philadelphia, PA 19122, USA.
| | - Sara Hameed
- Depression and Anxiety Center for Discovery and Treatment, 1399 Park Avenue, 2nd Floor, New York, NY 10029
| | - James W Murrough
- Depression and Anxiety Center for Discovery and Treatment, 1399 Park Avenue, 2nd Floor, New York, NY 10029.
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23
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Erguler H, Ferreira N, Adonis M, Koushiou M. Moderating Impact of Dispositional Mindfulness in the Relationship Between Future Expectancies and Psychological Well-Being. Psychol Rep 2023:332941231175614. [PMID: 37202172 DOI: 10.1177/00332941231175614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVES Mindfulness has been studied under cultivated or dispositional divisions where the latter has strong implications for psychological well-being in meditators and non-meditators alike. In addition, future expectations, or prospections, regarding the occurrence of important events in a person's future have recently been hypothesized to be the main cause behind symptoms of major depression. There is, however, a lack of empirical research looking at possible links between dispositional mindfulness, as understood in its facet structure, and future expectations as understood via perceived risk of occurrence and vividness of mental imagery when prompted to imagine a given list of positive and negative prospective event item lists. Therefore, this research aimed at examining how dispositional mindfulness may be related to probabilistic risk assessments of positive and negative future events (Stage I); and how mental imagery vividness may be moderated by mindfulness facets (Stage II). METHODS Both stages included healthy participants and incorporated the PROCESS macro for moderated regression analysis done with the SPSS software. Stage I included 204 voluntary college students, and Stage II was conducted online with a public sample of 110 adults. RESULTS Although no interaction effect was found in Stage I, nonreactivity to inner experience facet of dispositional mindfulness moderated the relationship between negative imagery vividness and psychological distress in Stage II (F(1,103) = 4.00, R2 change=.018, p <.05). CONCLUSIONS This is a novel finding that could inform a future line of research looking into the relationship between prospection and mindfulness, holding a potential for informing research on mindfulness-based interventions.
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Affiliation(s)
- Hasan Erguler
- The Department of Psychology, Eastern Mediterranean University, Famagusta, Cyprus (Northern, via Mersin 10 Turkey)
| | - Nuno Ferreira
- The Department of Psychology, University of Nicosia, Nicosia, Cyprus
| | - Marios Adonis
- The Department of Psychology, University of Nicosia, Nicosia, Cyprus
| | - Maria Koushiou
- The Department of Psychology, University of Nicosia, Nicosia, Cyprus
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24
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Yang KC, Chou YH. Molecular imaging findings for treatment resistant depression. PROGRESS IN BRAIN RESEARCH 2023; 278:79-116. [PMID: 37414495 DOI: 10.1016/bs.pbr.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Approximately 40% of patients with major depressive disorder (MDD) had limited response to conventional antidepressant treatments, resulting in treatment-resistant depression (TRD), a debilitating subtype that yielded a significant disease burden worldwide. Molecular imaging techniques, such as positron emission tomography (PET) and single photon emission tomography (SPECT), can measure targeted macromolecules or biological processes in vivo. These imaging tools provide a unique possibility to explore the pathophysiology and treatment mechanisms underlying TRD. This work reviewed and summarized prior PET and SPECT studies to examine the neurobiology and treatment-induced changes of TRD. A total of 51 articles were included with supplementary information from studies for MDD and healthy controls (HC). We found that there were altered regional blood flow or metabolic activity in several brain regions, such as the anterior cingulate cortex, prefrontal cortex, insula, hippocampus, amygdala, parahippocampus, and striatum. These regions have been suggested to engage in the pathophysiology or treatment resistance of depression. There was also limited data to demonstrate the changes in the markers of serotonin, dopamine, amyloid, and microglia over some regions in TRD. Moreover, several observed abnormal imaging indices were linked to treatment outcomes, supporting their specificity and clinical relevance. To address the limitations of the included studies, we proposed that future studies needed longitudinal designs, multimodal approaches, and radioligands targeting specific neural substrates for TRD to evaluate their baseline and treatment-related alterations in TRD. Adequate data sharing and reproducible data analysis can facilitate advances in this field.
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Affiliation(s)
- Kai-Chun Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Yuan-Hwa Chou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Center for Quality Management, Taipei Veterans General Hospital, Taipei, Taiwan
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25
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Jing R, Lin X, Ding Z, Chang S, Shi L, Liu L, Wang Q, Si J, Yu M, Zhuo C, Shi J, Li P, Fan Y, Lu L. Heterogeneous brain dynamic functional connectivity patterns in first-episode drug-naive patients with major depressive disorder. Hum Brain Mapp 2023; 44:3112-3122. [PMID: 36919400 PMCID: PMC10171501 DOI: 10.1002/hbm.26266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 03/16/2023] Open
Abstract
It remains challenging to identify depression accurately due to its biological heterogeneity. As people suffering from depression are associated with functional brain network alterations, we investigated subtypes of patients with first-episode drug-naive (FEDN) depression based on brain network characteristics. This study included data from 91 FEDN patients and 91 matched healthy individuals obtained from the International Big-Data Center for Depression Research. Twenty large-scale functional connectivity networks were computed using group information guided independent component analysis. A multivariate unsupervised normative modeling method was used to identify subtypes of FEDN and their associated networks, focusing on individual-level variability among the patients for quantifying deviations of their brain networks from the normative range. Two patient subtypes were identified with distinctive abnormal functional network patterns, consisting of 10 informative connectivity networks, including the default mode network and frontoparietal network. 16% of patients belonged to subtype I with larger extreme deviations from the normal range and shorter illness duration, while 84% belonged to subtype II with weaker extreme deviations and longer illness duration. Moreover, the structural changes in subtype II patients were more complex than the subtype I patients. Compared with healthy controls, both increased and decreased gray matter (GM) abnormalities were identified in widely distributed brain regions in subtype II patients. In contrast, most abnormalities were decreased GM in subtype I. The informative functional network connectivity patterns gleaned from the imaging data can facilitate the accurate identification of FEDN-MDD subtypes and their associated neurobiological heterogeneity.
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Affiliation(s)
- Rixing Jing
- School of Instrument Science and Opto-Electronics Engineering, Beijing Information Science and Technology University, Beijing, 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), Chinese Academy of Medical Sciences Research Unit, Peking University, Beijing, China
| | - Zengbo Ding
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing, China
| | - Suhua Chang
- 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), Chinese Academy of Medical Sciences Research Unit, Peking University, Beijing, China
| | - Le Shi
- 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), Chinese Academy of Medical Sciences Research Unit, Peking University, Beijing, China
| | - Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing, China
| | - Qiandong Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Juanning Si
- School of Instrument Science and Opto-Electronics Engineering, Beijing Information Science and Technology University, Beijing, China
| | - Mingxin Yu
- School of Instrument Science and Opto-Electronics Engineering, Beijing Information Science and Technology University, Beijing, China
| | - Chuanjun Zhuo
- Key Laboratory of Real-Time Tracing of Brain Circuits of Neurology and Psychiatry (RTBNB_Lab), Tianjin Fourth Centre Hospital, Tianjin Medical University Affiliated Tianjin Fourth Centre Hospital, Nankai University Affiliated Fourth Hospital, Tianjin, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing, China
| | - Peng Li
- 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), Chinese Academy of Medical Sciences Research Unit, Peking University, Beijing, China
| | - Yong Fan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lin Lu
- 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), Chinese Academy of Medical Sciences Research Unit, Peking University, Beijing, China.,National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, Beijing, China.,Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
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26
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Miola A, Meda N, Perini G, Sambataro F. Structural and functional features of treatment-resistant depression: A systematic review and exploratory coordinate-based meta-analysis of neuroimaging studies. Psychiatry Clin Neurosci 2023; 77:252-263. [PMID: 36641802 DOI: 10.1111/pcn.13530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/16/2023]
Abstract
OBJECTIVES A third of people suffering from major depressive disorder do not experience a significant improvement in their symptoms even after adequate treatment with two different antidepressant medications. This common condition, termed treatment-resistant depression (TRD), severely affects the quality of life of millions of people worldwide, causing long-lasting interpersonal problems and social costs. Given its epidemiological and clinical relevance and the little consensus on whether the neurobiological underpinnings of TRD differ from treatment-sensitive depression (TSD), we sought to highlight the convergent morphometric and functional neuroimaging correlates of TRD. METHODS We systematically reviewed the published literature on structural and resting-state functional neuroimaging of TRD compared to TSD and healthy controls (HC) and performed exploratory coordinate-based meta-analyses (CBMA) of significant results separately for each modality and multimodally ("all-effects"). CBMAs were also performed for each direction and combining both directions of group contrasts. RESULTS Out of the initial 1929 studies, only eight involving 555 participants (189 patients with TRD, 156 with TSD, and 210 HC) were included. In all-effects CBMA, precentral/superior frontal gyrus showed a significant difference between TRD and HC. Functional and structural imaging meta-analyses did not yield statistically significant results. A marginally significant cluster of altered intrinsic activity was found between TRD and HC in the cerebellum/pons. CONCLUSIONS Frontal, cerebellar, and brainstem functions can be involved in the pathophysiology of TRD. However, the design and heterogeneity of the (scarce) published literature hinder the generalizability of the findings.
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Affiliation(s)
- Alessandro Miola
- Department of Neuroscience, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy.,Casa di Cura Parco dei Tigli, Padova, Italy
| | - Nicola Meda
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Giulia Perini
- Department of Neuroscience, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy.,Casa di Cura Parco dei Tigli, Padova, Italy
| | - Fabio Sambataro
- Department of Neuroscience, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy.,Padova University Hospital, Padova, Italy
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27
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Sun J, Ma Y, Guo C, Du Z, Chen L, Wang Z, Li X, Xu K, Luo Y, Hong Y, Yu X, Xiao X, Fang J, Lu J. Distinct patterns of functional brain network integration between treatment-resistant depression and non treatment-resistant depression: A resting-state functional magnetic resonance imaging study. Prog Neuropsychopharmacol Biol Psychiatry 2023; 120:110621. [PMID: 36031163 DOI: 10.1016/j.pnpbp.2022.110621] [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: 06/09/2022] [Revised: 08/13/2022] [Accepted: 08/21/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Previous neuroimaging has paid little attention to the differences in brain network integration between patients with treatment-resistant depression(TRD) and non-TRD (nTRD), and the relationship between their impaired brain network integration and clinical symptoms has not been elucidated. METHOD Eighty one major depressive disorder (MDD) patients (40 in TRD, 41 in nTRD) and 40 healthy controls (HCs) were enrolled for the functional magnetic resonance imaging (fMRI) scans. A seed-based functional connectivity (FC) method was used to investigate the brain network abnormalities of default mode network (DMN), affective network (AN), salience network (SN) and cognitive control network (CCN) for the MDD. Finally, the correlation was analyzed between the abnormal FCs and 17-item Hamilton Rating Scale for Depression scale (HAMD-17) scores. RESULTS Compared with the HC group, the FCs in DMN, AN, SN, CCN were altered in both the TRD and nTRD groups. Compared with the nTRD group, FC alterations in the AN and CCN were more abnormal in the TRD group, and the FC alterations were generally decreased at the SN in the TRD group. In addition, the FC values of right dorsolateral prefrontal cortices and left caudate nucleus in the TRD group and the FC values of right subgenual anterior cingulate cortex and left middle temporal gyrus in the nTRD group were positively correlated with HAMD-17 scale scores. CONCLUSIONS Abnormal FCs are present in four brain networks (DMN, AN, SN, CCN) in both the TRD and nTRD groups. Except of DMN, FCs in AN, SN and CCN maybe underlay the neurobiological mechanism in differentiating TRD from nTRD.
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Affiliation(s)
- Jifei Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Yue Ma
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Chunlei Guo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Zhongming Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, 100700 Beijing, China
| | - Limei Chen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Zhi Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Xiaojiao Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Ke Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Yi Luo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Yang Hong
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China
| | - Xue Yu
- Beijing First Hospital of Integrated Chinese and Western Medicine, 100026 Beijing, China
| | - Xue Xiao
- Beijing First Hospital of Integrated Chinese and Western Medicine, 100026 Beijing, China
| | - Jiliang Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 100053 Beijing, China.
| | - Jie Lu
- Xuanwu Hospital, Capital Medical University, 100053 Beijing, China.
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28
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Migalina VV, Omelchenko MA, Lebedeva IS, Kaleda VG. [Application of the biofeedback method in the therapy of depression]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:122-126. [PMID: 38127712 DOI: 10.17116/jnevro2023123112122] [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] [Indexed: 12/23/2023]
Abstract
In order to systematize the modern literature data on the effectiveness of biofeedback in the treatment of patients with depressive disorders, clinical efficacy and prospects for use in psychiatric practice, publications in the MEDLINE / PubMed, eLibrary databases from 2013 to 2023, as well as relevant references in the reference lists of the analyzed articles, were selected by the keywords «biofeedback», «depression», «depression therapy», «electroencephalogram», «non-drug treatments for depression». The analysis of data has shown that the biofeedback method demonstrates a certain therapeutic potential in the treatment of depression. It can be used to augment therapy in case of insufficient therapeutic effect, with low patient compliance, as well as poor tolerability of psychopharmacotherapy and in the presence of residual symptoms after pharmacological treatment. The method allows the correction of the psycho-emotional state, improves the balance between the parasympathetic and sympathetic divisions of the autonomic nervous system, and contributes to a more stable clinical effect. At the same time, further studies are needed, with the inclusion of large samples of patients from various nosological groups and with an analysis of the comparability of the effects of various biofeedback protocols.
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Affiliation(s)
| | | | | | - V G Kaleda
- Mental Health Research Center, Moscow, Russia
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29
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Sun J, Xu L, Ma Y, Guo C, Du Z, Gao S, Luo Y, Chen Q, Hong Y, Yu X, Xiao X, Fang J. Different characteristics of striatal resting-state functional conectivity in treatment-resistant and non-treatment-resistant depression. Psychiatry Res Neuroimaging 2023; 328:111567. [PMID: 36462466 DOI: 10.1016/j.pscychresns.2022.111567] [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] [Received: 09/11/2022] [Revised: 10/25/2022] [Accepted: 11/08/2022] [Indexed: 11/23/2022]
Abstract
Major depressive disorder is associated with a reward deficit manifested by abnormal striatal function. However, differences between treatment-resistant depression (TRD) and non TRD (nTRD) in striatal whole-brain functional connectivity (FC) have not been elucidated. Thirty-eight patients with TRD, 42 patients with nTRD, and 39 healthy controls (HCs) were recruited for this study. A seed-based FC approach was used to analyze abnormalities in six predefined striatal subregion circuits in the three groups of subjects, and further explore the correlation between abnormal FC and clinical symptoms. Results revealed that compared with the nTRD group, the TRD group showed increased FC of the inferior ventral striatum with the bilateral orbital area of the middle frontal gyrus, right cerebellum posterior lobe, left parahippocampal gyrus, left middle occipital gyrus and left lingual gyrus. Compared with the HC group, the TRD group showed a wider range of altered striatal function than the nTRD group. In the TRD group, the HAMD-17 scores were positively correlated with the FC between the right VRP and the left caudate. This study provides new insights into understanding the specificity of TRD striatal circuits.
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Affiliation(s)
- Jifei Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Linjie Xu
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Yue Ma
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Chunlei Guo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Zhongming Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Shanshan Gao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Yi Luo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Qingyan Chen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Yang Hong
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Xue Yu
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing 100026, China
| | - Xue Xiao
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing 100026, China
| | - Jiliang Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
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30
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Genetics of antidepressant response and treatment-resistant depression. PROGRESS IN BRAIN RESEARCH 2023. [DOI: 10.1016/bs.pbr.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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31
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The Downstaging Concept in Treatment-Resistant Depression: Spotlight on Ketamine. Int J Mol Sci 2022; 23:ijms232314605. [PMID: 36498934 PMCID: PMC9738502 DOI: 10.3390/ijms232314605] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
Treatment-resistant depression is a pleomorphic phenomenon occurring in 30% of patients with depression. The chance to achieve remission decreases with every subsequent episode. It constitutes a significant part of the global disease burden, causes increased morbidity and mortality, and is associated with poor quality of life. It involves multiple difficult-to-treat episodes, with increasing resistance over time. The concept of staging captures the process of changes causing increasing treatment resistance and global worsening of functioning in all areas of life. Ketamine is a novel rapid-acting antidepressant with neuroplastic potential. Here, we argue that ketamine use as an add-on treatment of resistant major depressive disorder, based on its unique pharmacological properties, can reverse this process, give hope to patients, and prevent therapeutic nihilism.
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32
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Jin K, Zhang S, Jiang C, Liu R, Chen B, Zhao H, Zhang Q, Shen Z, Xu P, Hu X, Jiao J, Lu J, Huang M. The role of reelin in the pathological mechanism of depression from clinical to rodents. Psychiatry Res 2022; 317:114838. [PMID: 36103758 DOI: 10.1016/j.psychres.2022.114838] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/13/2022] [Accepted: 09/04/2022] [Indexed: 01/04/2023]
Abstract
Major depressive disorder (MDD) is a devastating mental illness and the leading cause of disability worldwide. Previous studies have suggested that synaptic plasticity in the hippocampus plays an important role in depression pathogenesis. Reelin is expressed mainly in the frontal lobe and hippocampus, and is closely associated with neurodevelopment and synaptic plasticity. However, few studies have investigated its role in MDD combining clinical trials and animal experiments. We show that in a clinical trial, plasma reelin levels decreased in patients with first-episode drug-naïve MDD and increased after treatment; further, plasma reelin levels allowed to distinguish drug-naïve patients with first-episode MDD from healthy individuals. In rats, chronic mild and unpredictable stress led to a decrease in both reelin mRNA and protein levels in the hippocampus, which could be reversed by vortioxetine. Subsequent experiments confirmed that the reelin-ApoER2-NR2A /NR2B pathway regulates hippocampal synaptic plasticity and may be involved in depression or antidepressant responses. Our work contributes to a deeper understanding of MDD pathogenesis and provides new evidence that reelin should be considered a potential therapeutic target for MDD.
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Affiliation(s)
- Kangyu Jin
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou 310003, China
| | - Shiyi Zhang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou 310003, China
| | - Chaonan Jiang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou 310003, China
| | - Ripeng Liu
- College of First Clinical College, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou 310053, China
| | - Bing Chen
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou 310003, China
| | - Haoyang Zhao
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou 310003, China
| | - Qin Zhang
- College of First Clinical College, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou 310053, China
| | - Zhe Shen
- Department of Child Psychology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China
| | - Pengfeng Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou 310003, China
| | - Xiaohan Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou 310003, China
| | - Jianping Jiao
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou 310003, China
| | - Jing Lu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou 310003, China.
| | - Manli Huang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou 310003, China.
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33
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Wu GR, Baeken C. Lateralized subgenual ACC metabolic connectivity patterns in refractory melancholic depression: does it matter? Cereb Cortex 2022; 33:3490-3497. [PMID: 35984291 DOI: 10.1093/cercor/bhac286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
Although treatment resistance to antidepressant pharmacotherapy is quite common, the phenomenon of refractory major depressive disorder (rMDD) is not well understood. Nevertheless, the metabolic activity of the subgenual anterior cingulate cortex (sgACC) has been put forward as a possible metabolic biomarker of clinical prediction and response, albeit sgACC lateralization differences in functional connectivity have not yet been extensively examined. Also not in the refractory depressed state. To examine sgACC lateralization differences in metabolic connectivity, we recruited 43 right-handed antidepressant-free unipolar melancholic rMDD patients and 32 right-handed healthy controls to participate in this 18FDG PET study and developed a searchlight-based interregional covariance connectivity approach. Compared to non-depressed individuals, sgACC covariance analysis showed stronger metabolic connections with frontolimbic brain regions known to be affected in the depressed state. Furthermore, whereas the left sgACC showed stronger metabolic connections with ventromedial prefrontal cortical regions, implicated in anhedonia, suicidal ideation, and self-referential processes, the right sgACC showed significantly stronger metabolic connections with posterior hippocampal and cerebellar regions, respectively specialized in memory and social processing. Overall, our results substantiate earlier research that the sgACC is a metabolic key player when clinically depressed and that distinct lateralized sgACC metabolic connectivity patterns are present.
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Affiliation(s)
- Guo-Rong Wu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Southwest University, Chongqing 400715, China.,School of Psychology, Jiangxi Normal University, Nanchang 330022, China.,Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent 9000, Belgium
| | - Chris Baeken
- Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent 9000, Belgium.,Department of Psychiatry, University Hospital (UZBrussel), Brussels 1090, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, 5600 MB, The Netherlands
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34
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Lewis V, Rodrigue B, Arsenault E, Zhang M, Taghavi-Abkuh FF, Silva WCC, Myers M, Matta-Camacho E, Aguilar-Valles A. Translational control by ketamine and its implications for comorbid cognitive deficits in depressive disorders. J Neurochem 2022. [PMID: 35680556 DOI: 10.1111/jnc.15652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/19/2022] [Accepted: 05/26/2022] [Indexed: 11/29/2022]
Abstract
Ketamine has shown antidepressant effects in patients with major depressive disorder (MDD) resistant to first-line treatments and approved for use in this patient population. Ketamine induces several forms of synaptic plasticity, which are proposed to underlie its antidepressant effects. However, the molecular mechanism of action directly responsible for ketamine's antidepressant effects remains under active investigation. It was recently demonstrated that the effectors of the mammalian target of rapamycin complex 1 (mTORC1) signalling pathway, namely, eukaryotic initiation factor 4E (eIF4E) binding proteins 1 and 2 (4E-BP1 and 4E-BP2), are central in mediating ketamine-induced synaptic plasticity and behavioural antidepressant-like effect. 4E-BPs are a family of messenger ribonucleic acid (mRNA) translation repressors inactivated by mTORC1. We observed that their expression in inhibitory interneurons mediates ketamine's effects in the forced swim and novelty suppressed feeding tests and the long-lasting inhibition of GABAergic neurotransmission in the hippocampus. In addition, another effector pathway that regulates translation elongation downstream of mTORC1, the eukaryotic elongation factor 2 kinase (eEF2K), has been implicated in ketamine's behavioural effects. We will discuss how ketamine's rapid antidepressant effect depends on the activation of neuronal mRNA translation through 4E-BP1/2 and eEF2K. Furthermore, given that these pathways also regulate cognitive functions, we will discuss the evidence of ketamine's effect on cognitive function in MDD. Overall, the data accrued from pre-clinical research have implicated the mRNA translation pathways in treating mood symptoms of MDD. However, it is yet unclear whether the pro-cognitive potential of subanesthetic ketamine in rodents also engages these pathways and whether such an effect is consistently observed in the treatment-resistant MDD population.
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Affiliation(s)
- Vern Lewis
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Brandon Rodrigue
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Emily Arsenault
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Molly Zhang
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | | | | | - Mysa Myers
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Edna Matta-Camacho
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
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35
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Rubart AK, Zurowski B, Veer IM, Schön D, Göttlich M, Klein JP, Schramm E, Wenzel JG, Haber C, Schoepf D, Sommer J, Konrad C, Schnell K, Walter H. Precuneus connectivity and symptom severity in chronic depression ✰. Psychiatry Res Neuroimaging 2022; 322:111471. [PMID: 35378340 DOI: 10.1016/j.pscychresns.2022.111471] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 02/24/2022] [Accepted: 03/28/2022] [Indexed: 11/28/2022]
Abstract
Although abnormal resting state connectivity within several brain networks has been repeatedly reported in depression, little is known about connectivity in patients with early onset chronic depression. We compared resting state connectivity in a homogenous sample of 32 unmedicated patients with early onset chronic depression and 40 healthy control participants in a seed-to-voxel-analysis. According to previous meta-analyses on resting state connectivity in depression, 12 regions implicated in default mode, limbic, frontoparietal and ventral attention networks were chosen as seeds. We also investigated associations between connectivity values and severity of depression. Patients with chronic depression exhibited stronger connectivity between precuneus and right pre-supplementary motor area than healthy control participants, possibly reflecting aberrant information processing and emotion regulation deficits in depression. Higher depression severity scores (Hamilton Rating Scale for Depression) were strongly and selectively associated with weaker connectivity between the precuneus and the subcallosal anterior cingulate. Our findings correspond to results obtained in studies including both episodic and chronic depression. This suggests that there may be no strong differences between subtypes of depression regarding the seeds analyzed here. To further clarify this issue, future studies should directly compare patients with different courses of depression.
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Affiliation(s)
- Antonie K Rubart
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
| | - Bartosz Zurowski
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Ilya M Veer
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Daniela Schön
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Martin Göttlich
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Jan Philipp Klein
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Elisabeth Schramm
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Julia G Wenzel
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Charlotte Haber
- Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Dieter Schoepf
- Department of Psychiatry and Psychotherapy, CBASP Center of Competence, University of Bonn, Bonn, Germany
| | - Jens Sommer
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Psychosocial Medicine, Agaplesion Diakonieklinikum Rotenburg, Rotenburg, Germany
| | - Knut Schnell
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Psychiatry and Psychotherapy, CBASP Center of Competence, University of Bonn, Bonn, Germany
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36
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Psychopharmacology: past, present and future. Int Clin Psychopharmacol 2022; 37:82-83. [PMID: 35258034 DOI: 10.1097/yic.0000000000000402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The origin of modern psychopharmacology dates to the 50s, with the discovery of imipramine and chlorpromazine. At present, we can choose among over 100 different compounds, which are effective in many psychiatric disturbances but are far from perfect in terms of efficacy and tolerability. The main limitation of available treatments is their lack in specificity, both in terms of pharmacologic targets and regional brain specificity. Several new compounds with innovative mechanisms of action have been recently approved; however, pharmacologic treatments targeted for specific tissues are still not available. Recent imaging and genetic findings suggest that we may be close to discovering the regional pathophysiologic mechanisms of psychiatric disorders. Targeted treatment to specific proteins or even genes may be possible using monoclonal antibodies, RNA silencing, gene editing or drug repurposing. We may be therefore close to a shift of paradigm in the treatment of psychiatric disorders, with innovative and targeted treatments.
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37
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Witkin JM. The romantic age of pharmacological science. Pharmacol Biochem Behav 2022; 214:173354. [DOI: 10.1016/j.pbb.2022.173354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 11/25/2022]
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