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Wu YK, Su YA, Zhu LL, Yan C, Li JT, Lin JY, Chen J, Chen L, Li K, Stein DJ, Si TM. A distinctive subcortical functional connectivity pattern linking negative affect and treatment outcome in major depressive disorder. Transl Psychiatry 2024; 14:136. [PMID: 38443354 PMCID: PMC10915152 DOI: 10.1038/s41398-024-02838-7] [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: 03/11/2023] [Revised: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 03/07/2024] Open
Abstract
Major depressive disorder (MDD) is associated with functional disturbances in subcortical regions. In this naturalistic prospective study (NCT03294525), we aimed to investigate relationships among subcortical functional connectivity (FC), mood symptom profiles and treatment outcome in MDD using multivariate methods. Medication-free participants with MDD (n = 135) underwent a functional magnetic resonance imaging scan at baseline and completed posttreatment clinical assessment after 8 weeks of antidepressant monotherapy. We used partial least squares (PLS) correlation analysis to explore the association between subcortical FC and mood symptom profiles. FC score, reflecting the weighted representation of each individual in this association, was computed. Replication analysis was undertaken in an independent sample (n = 74). We also investigated the relationship between FC score and treatment outcome in the main sample. A distinctive subcortical connectivity pattern was found to be associated with negative affect. In general, higher FC between the caudate, putamen and thalamus was associated with greater negative affect. This association was partly replicated in the independent sample (similarity between the two samples: r = 0.66 for subcortical connectivity, r = 0.75 for mood symptom profile). Lower FC score predicted both remission and response to treatment after 8 weeks of antidepressant monotherapy. The emphasis here on the role of dorsal striatum and thalamus consolidates prior work of subcortical connectivity in MDD. The findings provide insight into the pathogenesis of MDD, linking subcortical FC with negative affect. However, while the FC score significantly predicted treatment outcome, the low odds ratio suggests that finding predictive biomarkers for depression remains an aspiration.
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Affiliation(s)
- Yan-Kun Wu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Yun-Ai Su
- 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), Beijing, 100191, China.
| | - Lin-Lin Zhu
- 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), Beijing, 100191, China
| | - ChaoGan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
| | - Ji-Tao 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), Beijing, 100191, China
| | - Jing-Yu 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), Beijing, 100191, China
| | - JingXu Chen
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, China
| | - Lin Chen
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, China
| | - Ke Li
- PLA Strategic support Force Characteristic Medical Center, Beijing, 100101, China
| | - Dan J Stein
- Neuroscience Institute, Department of Psychiatry and Mental Health, South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Tian-Mei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
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Hearne LJ, Breakspear M, Harrison BJ, Hall CV, Savage HS, Robinson C, Sonkusare S, Savage E, Nott Z, Marcus L, Naze S, Burgher B, Zalesky A, Cocchi L. Revisiting deficits in threat and safety appraisal in obsessive-compulsive disorder. Hum Brain Mapp 2023; 44:6418-6428. [PMID: 37853935 PMCID: PMC10681637 DOI: 10.1002/hbm.26518] [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: 04/19/2023] [Revised: 08/22/2023] [Accepted: 10/02/2023] [Indexed: 10/20/2023] Open
Abstract
Current behavioural treatment of obsessive-compulsive disorder (OCD) is informed by fear conditioning and involves iteratively re-evaluating previously threatening stimuli as safe. However, there is limited research investigating the neurobiological response to conditioning and reversal of threatening stimuli in individuals with OCD. A clinical sample of individuals with OCD (N = 45) and matched healthy controls (N = 45) underwent functional magnetic resonance imaging. While in the scanner, participants completed a well-validated fear reversal task and a resting-state scan. We found no evidence for group differences in task-evoked brain activation or functional connectivity in OCD. Multivariate analyses encompassing all participants in the clinical and control groups suggested that subjective appraisal of threatening and safe stimuli were associated with a larger difference in brain activity than the contribution of OCD symptoms. In particular, we observed a brain-behaviour continuum whereby heightened affective appraisal was related to increased bilateral insula activation during the task (r = 0.39, pFWE = .001). These findings suggest that changes in conditioned threat-related processes may not be a core neurobiological feature of OCD and encourage further research on the role of subjective experience in fear conditioning.
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Affiliation(s)
- Luke J. Hearne
- QIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
| | - Michael Breakspear
- College of Engineering Science and Environment, College of Health and MedicineUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Ben J. Harrison
- Melbourne Neuropsychiatry Centre, Department of PsychiatryThe University of Melbourne & Melbourne HealthMelbourneVictoriaAustralia
| | - Caitlin V. Hall
- QIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
| | - Hannah S. Savage
- College of Engineering Science and Environment, College of Health and MedicineUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Conor Robinson
- QIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
| | | | - Emma Savage
- QIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
| | - Zoie Nott
- QIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
| | - Leo Marcus
- QIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
| | - Sebastien Naze
- QIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
| | - Bjorn Burgher
- QIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of PsychiatryThe University of Melbourne & Melbourne HealthMelbourneVictoriaAustralia
| | - Luca Cocchi
- QIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
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Adams TG, Kelmendi B, George JR, Forte J, Hubert TJJ, Wild H, Rippey CS, Pittenger C. Frontopolar multifocal transcranial direct current stimulation reduces conditioned fear reactivity during extinction training: A pilot randomized controlled trial. Neurobiol Learn Mem 2023; 205:107825. [PMID: 37699439 PMCID: PMC10872945 DOI: 10.1016/j.nlm.2023.107825] [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: 01/03/2023] [Revised: 08/16/2023] [Accepted: 09/03/2023] [Indexed: 09/14/2023]
Abstract
Exposure-based therapies for anxiety and related disorders are believed to depend on fear extinction learning and corresponding changes in extinction circuitry. Frontopolar multifocal transcranial direct current stimulation (tDCS) has been shown to improve therapeutic safety learning during in vivo exposure and may modulate functional connectivity of networks implicated in fear processing and inhibition. A pilot randomized controlled trial was completed to determine the effects of frontopolar tDCS on extinction learning and memory. Community volunteers (n = 35) completed a 3-day fear extinction paradigm with measurement of electrodermal activity. Participants were randomized (single-blind) to 20-min of sham (n = 17, 30 s. ramp in/out) or active (n = 18) frontopolar (anode over Fpz, 10-10 EEG) multifocal tDCS (20-min, 1.5 mA) prior to extinction training. Mixed ANOVAs revealed a significant group*trial effect on skin conductance response (SCR) to the conditioned stimulus (CS + ) during extinction training (p = 0.007, Cohen's d = 0.55). The effects of frontopolar tDCS were greatest during the first two extinction trials, suggesting that tDCS may have promoted fear inhibition prior to safety learning. Return of fear to the CS + during tests were comparable across conditions (ps > 0.50). These findings suggest that frontopolar tDCS may modulate the processing of threat cues and associated circuitry or promote the inhibition of fear. This has clear implications for the treatment of anxiety and related disorders with therapeutic exposure.
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Affiliation(s)
- Thomas G Adams
- Department of Psychology, University of Kentucky, United States; Department of Psychiatry, Yale University School of Medicine, United States.
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, United States; Clinical Neuroscience Division of the National Center for PTSD, West Haven VA Medical Center, United States
| | - Jamilah R George
- Department of Psychiatry, Yale University School of Medicine, United States; Department of Psychological Sciences, University of Connecticut, United States
| | - Jennifer Forte
- Department of Psychiatry, Yale University School of Medicine, United States; Department of Psychology, Binghamton University, United States
| | - Troy J J Hubert
- Department of Psychology, University of Kentucky, United States
| | - Hannah Wild
- Department of Psychology, University of Kentucky, United States
| | - Colton S Rippey
- Department of Psychology, University of Kentucky, United States
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, United States; Child Study Center, Yale University, United States; Department of Psychology, Center for Brain and Mind Health, Yale University, United States
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Laing PAF, Felmingham KL, Davey CG, Harrison BJ. The neurobiology of Pavlovian safety learning: Towards an acquisition-expression framework. Neurosci Biobehav Rev 2022; 142:104882. [PMID: 36150453 DOI: 10.1016/j.neubiorev.2022.104882] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/19/2022]
Abstract
Safety learning creates associations between conditional stimuli and the absence of threat. Studies of human fear conditioning have accumulated evidence for the neural signatures of safety over various paradigms, aligning on several common brain systems. While these systems are often interpreted as underlying safety learning in a generic sense, they may instead reflect the expression of learned safety, pertaining to processes of fear inhibition, positive affect, and memory. Animal models strongly suggest these can be separable from neural circuits implicated in the conditioning process itself (or safety acquisition). While acquisition-expression distinctions are ubiquitous in behavioural science, this lens has not been applied to safety learning, which remains a novel area in the field. In this mini-review, we overview findings from prevalent safety paradigms in humans, and synthesise these with insights from animal models to propose that the neurobiology of safety learning be conceptualised along an acquisition-expression model, with the aim of stimulating richer brain-based characterisations of this important process.
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Affiliation(s)
- Patrick A F Laing
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia.
| | - Kim L Felmingham
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia
| | - Christopher G Davey
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia.
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Beckes L, Medina-DeVilliers SE, Gunderson EW, Coan JA. Mechanisms supporting the social regulation of neural threat responding with marital partners: A test of the opioid hypothesis. Psychophysiology 2022; 59:e14076. [PMID: 35438799 DOI: 10.1111/psyp.14076] [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: 02/10/2020] [Revised: 12/26/2021] [Accepted: 03/26/2022] [Indexed: 11/28/2022]
Abstract
Positive social contact predicts better health, but the mechanisms for this association remain debated. One way to explore this link is through the social regulation of emotion, particularly anticipatory anxiety. Previous research finds less neural threat response during partner handholding than when people are alone or stranger handholding. Various mechanistic accounts have been forwarded, including the hypothesis that this effect is mediated by endogenous opioid activity. This experiment critically tested the opioid hypothesis in 60 married participants and their partners. The study used a naltrexone opioid blockade in a double-blind placebo control with functional magnetic resonance imaging to determine whether endogenous opioids were necessary for handholding effects. Regulatory effects of supportive handholding manifested in threat network regions during opioid blockade, but not with placebo. Despite a surprising lack of effect in the placebo group, the overall study findings provide initial evidence that endogenous opioids may not be necessary for the social regulation of neural threat responding.
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Affiliation(s)
- Lane Beckes
- Department of Psychology, Bradley University, Peoria, Illinois, USA
| | | | - Erik W Gunderson
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - James A Coan
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
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Vinberg K, Rosén J, Kastrati G, Ahs F. Whole brain correlates of individual differences in skin conductance responses during discriminative fear conditioning to social cues. eLife 2022; 11:69686. [PMID: 36413209 PMCID: PMC9721615 DOI: 10.7554/elife.69686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 11/21/2022] [Indexed: 11/23/2022] Open
Abstract
Understanding the neural basis for individual differences in the skin conductance response (SCR) during discriminative fear conditioning may inform on our understanding of autonomic regulation in fear-related psychopathology. Previous region-of-interest (ROI) analyses have implicated the amygdala in regulating conditioned SCR, but whole brain analyses are lacking. This study examined correlations between individual differences in SCR during discriminative fear conditioning to social stimuli and neural activity throughout the brain, by using data from a large functional magnetic resonance imaging study of twins (N = 285 individuals). Results show that conditioned SCR correlates with activity in the dorsal anterior cingulate cortex/anterior midcingulate cortex, anterior insula, bilateral temporoparietal junction, right frontal operculum, bilateral dorsal premotor cortex, right superior parietal lobe, and midbrain. A ROI analysis additionally showed a positive correlation between amygdala activity and conditioned SCR in line with previous reports. We suggest that the observed whole brain correlates of SCR belong to a large-scale midcingulo-insular network related to salience detection and autonomic-interoceptive processing. Altered activity within this network may underlie individual differences in conditioned SCR and autonomic aspects of psychopathology.
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Affiliation(s)
- Kevin Vinberg
- Department of Psychology and Social Work, Mid Sweden UniversityÖstersundSweden
| | - Jörgen Rosén
- Department of Psychology and Social Work, Mid Sweden UniversityÖstersundSweden,Department of Psychology, Uppsala UniversityUppsalaSweden
| | - Granit Kastrati
- Department of Psychology and Social Work, Mid Sweden UniversityÖstersundSweden,Department of Clinical Neuroscience, Karolinska InstitutetStockholmSweden
| | - Fredrik Ahs
- Department of Psychology and Social Work, Mid Sweden UniversityÖstersundSweden
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