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Asch RH, Worhunsky PD, Davis MT, Holmes SE, Cool R, Boster S, Carson RE, Blumberg HP, Esterlis I. Deficits in prefrontal metabotropic glutamate receptor 5 are associated with functional alterations during emotional processing in bipolar disorder. J Affect Disord 2024; 361:415-424. [PMID: 38876317 PMCID: PMC11250898 DOI: 10.1016/j.jad.2024.06.025] [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: 02/22/2024] [Revised: 05/23/2024] [Accepted: 06/10/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Elucidating biological mechanisms contributing to bipolar disorder (BD) is key to improved diagnosis and treatment development. With converging evidence implicating the metabotropic glutamate receptor 5 (mGlu5) in the pathology of BD, here, we therefore test the hypothesis that recently identified deficits in mGlu5 are associated with functional brain differences during emotion processing in BD. METHODS Positron emission tomography (PET) with [18F]FPEB was used to measure mGlu5 receptor availability and functional imaging (fMRI) was performed while participants completed an emotion processing task. Data were analyzed from 62 individuals (33 ± 12 years, 45 % female) who completed both PET and fMRI, including individuals with BD (n = 18), major depressive disorder (MDD: n = 20), and psychiatrically healthy comparisons (HC: n = 25). RESULTS Consistent with some prior reports, the BD group displayed greater activation during fear processing relative to MDD and HC, notably in right lateralized frontal and parietal brain regions. In BD, (but not MDD or HC) lower prefrontal mGlu5 availability was associated with greater activation in bilateral pre/postcentral gyri and cuneus during fear processing. Furthermore, greater prefrontal mGlu5-related brain activity in BD was associated with difficulties in psychomotor function (r≥0.904, p≤0.005) and attention (r≥0.809, p≤0.028). LIMITATIONS The modest sample size is the primary limitation. CONCLUSIONS Deficits in prefrontal mGlu5 in BD were linked to increased cortical activation during fear processing, which in turn was associated with impulsivity and attentional difficulties. These data further implicate an mGlu5-related mechanism unique to BD. More generally these data suggest integrating PET and fMRI can provide novel mechanistic insights.
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Affiliation(s)
- Ruth H. Asch
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
| | | | - Margaret T. Davis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
| | - Sophie E. Holmes
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
- Department of Neurology, Yale School of Medicine, New Haven, CT 06511
| | - Ryan Cool
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
| | - Sarah Boster
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
| | - Richard E. Carson
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06511
- Department of Biomedical Engineering, Yale School of Engineering and Applied Science, New Haven, CT 06511
| | - Hilary P. Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06511
- Child Study Center, Yale School of Medicine, New Haven, CT 06511
| | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06511
- Department of Psychology, Yale University, New Haven, CT 06511
- U.S. Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT 06516
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Hu X, Cheng B, Tang Y, Long T, Huang Y, Li P, Song Y, Song X, Li K, Yin Y, Chen X. Gray matter volume and corresponding covariance connectivity are biomarkers for major depressive disorder. Brain Res 2024; 1837:148986. [PMID: 38714227 DOI: 10.1016/j.brainres.2024.148986] [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: 10/13/2023] [Revised: 04/06/2024] [Accepted: 05/04/2024] [Indexed: 05/09/2024]
Abstract
The major depressive disorder (MDD) is a common and severe mental disorder. To identify a reliable biomarker for MDD is important for early diagnosis and prevention. Given easy access and high reproducibility, the structural magnetic resonance imaging (sMRI) is an ideal method to identify the biomarker for depression. In this study, sMRI data of first episode, treatment-naïve 66 MDD patients and 54 sex-, age-, and education-matched healthy controls (HC) were used to identify the differences in gray matter volume (GMV), group-level, individual-level covariance connections. Finally, the abnormal GMV and individual covariance connections were applied to classify MDD from HC. MDD patients showed higher GMV in middle occipital gyrus (MOG) and precuneus (PCun), and higher structural covariance connections between MOG and PCun. In addition, the Allen Human Brain Atlas (AHBA) was applied and revealed the genetic basis for the changes of gray matter volume. Importantly, we reported that GMV in MOG, PCun and structural covariance connectivity between MOG and PCun are able to discriminate MDD from HC. Our results revealed structural underpinnings for MDD, which may contribute towards early discriminating for depression.
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Affiliation(s)
- Xiao Hu
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yuying Tang
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Tong Long
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Yan Huang
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Pei Li
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Yu Song
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Xiyang Song
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Kun Li
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yijie Yin
- School of Sociality and Psychology, Southwest Minzu University, Chengdu 610041, China
| | - Xijian Chen
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
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Xiao H, Cao Y, Lizano P, Li M, Sun H, Zhou X, Deng G, Li J, Chand T, Jia Z, Qiu C, Walter M. Interleukin-1β moderates the relationships between middle frontal-mACC/insular connectivity and depressive symptoms in bipolar II depression. Brain Behav Immun 2024; 120:44-53. [PMID: 38777282 DOI: 10.1016/j.bbi.2024.05.029] [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: 02/26/2024] [Revised: 05/02/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024] Open
Abstract
The functional alterations of the brain in bipolar II depression (BDII-D) and their clinical and inflammatory associations are understudied. We aim to investigate the functional brain alterations in BDII-D and their relationships with inflammation, childhood adversity, and psychiatric symptoms, and to examine the moderating effects among these factors. Using z-normalized amplitude of low-frequency fluctuation (zALFF), we assessed the whole-brain resting-state functional activity between 147 BDII-D individuals and 150 healthy controls (HCs). Differential ALFF regions were selected as seeds for functional connectivity analysis to observe brain connectivity alterations resulting from abnormal regional activity. Four inflammatory cytokines including interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP) and five clinical scales including Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Positive and Negative Syndrome Scale (PANSS), Columbia-Suicide Severity Rating Scale (C-SSRS), and Childhood Trauma Questionnaire (CTQ) were tested and assessed in BDII-D. Partial correlations with multiple comparison corrections identified relationships between brain function and inflammation, childhood adversity, and psychiatric symptoms. Moderation analysis was conducted based on correlation results and previous findings. Compared to HCs, BDII-D individuals displayed significantly lower zALFF in the superior and middle frontal gyri (SFG and MFG) and insula, but higher zALFF in the occipital-temporal area. Only the MFG and insula-related connectivity exhibited significant differences between groups. Within BDII-D, lower right insula zALFF value correlated with higher IL-6, CRP, and emotional adversity scores, while lower right MFG zALFF was related to higher CRP and physical abuse scores. Higher right MFG-mid-anterior cingulate cortex (mACC) connectivity was associated with higher IL-1β. Moreover, IL-1β moderated associations between higher right MFG-mACC/insula connectivity and greater depressive symptoms. This study reveals that abnormal functional alterations in the right MFG and right insula were associated with elevated inflammation, childhood adversity, and depressive symptoms in BDII-D. IL-1β may moderate the relationship between MFG-related connectivity and depressive symptoms.
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Affiliation(s)
- Hongqi Xiao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yuan Cao
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena 07743, Germany; Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, China; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Halle-Jena-Magdeburg, Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Leipziger Str. 44, Building 65, 39120 Magdeburg, Germany
| | - Paulo Lizano
- The Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA; Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA; The Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Meng Li
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena 07743, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Halle-Jena-Magdeburg, Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Leipziger Str. 44, Building 65, 39120 Magdeburg, Germany
| | - Huan Sun
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xiaoqin Zhou
- Department of Clinical Research Management, West China Hospital of Sichuan University, Chengdu 610041, PR China
| | - Gaoju Deng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Jiafeng Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Tara Chand
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena 07743, Germany; Department of Clinical Psychology, Friedrich Schiller University Jena, Am Steiger 3-1, 07743 Jena, Germany; Jindal Institute of Behavioural Sciences, O. P. Jindal Global University (Sonipat), Haryana, India
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, China.
| | - Changjian Qiu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China.
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena 07743, Germany; German Center for Mental Health (DZPG), partner site Halle-Jena-Magdeburg, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Halle-Jena-Magdeburg, Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Leipziger Str. 44, Building 65, 39120 Magdeburg, Germany
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Kılıç OHT, Kartı Ö, Kıyat P, Bayram ZN, Kırcı Dallıoğlu Ç. Can retinal nerve fiber layer (RNFL) thickness be a marker for distinguishing bipolar depression from unipolar depression? Nord J Psychiatry 2024:1-6. [PMID: 39046304 DOI: 10.1080/08039488.2024.2381545] [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: 01/04/2024] [Revised: 05/03/2024] [Accepted: 07/13/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE We aimed to compare retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) thickness in bipolar disorder (BD) and major depressive disorder (MDD). METHOD The study included thirty MDD, thirty-two BD participants in depressive episode, and thirty-seven controls matched according to age, gender, body mass index (BMI), and smoking status. Optic coherence tomography (OCT) measurements were performed for both participants and controls. The RNFL and GCC thickness were measured and recorded automatically by a spectral OCT device. Participants were also subjected to Hamilton Depression Rating Scale (HAM-D). RESULTS RNFL superior thickness was significantly lower in BD participants, compared to the MDD participants and controls (p = 0.001). GCC inferior (p = 0.022) and inferonasal (p = 0.005) thickness were detected lower in BD group, compared to the control groups. In the BD group, HAM-D scores were negatively correlated with RNFL-temporal (p = 0.049, r= -0.357), GCC inferotemporal (p = 0.02, r= -0.416) and superotemporal thickness (p = 0.002, r= -0.546). CONCLUSIONS RNFL thickness were lower in BD participants compared to the MDD and controls and, GCC thickness were lower in BD participants compared to the controls. Our findings support the hypothesis that neurodegeneration is part of the pathogenesis of BD. Future research are needed to confirm the lack of RNFL thickness in MDD, which could have immediate therapeutic consequences as well as implications for distinguishing BD from MDD.
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Affiliation(s)
| | - Ömer Kartı
- Buca Seyfi Demirsoy Training and Research Hospital Department of Ophthalmogy, İzmir Democracy University, İzmir, Turkey
| | - Pelin Kıyat
- Buca Seyfi Demirsoy Training and Research Hospital Department of Ophthalmogy, İzmir Democracy University, İzmir, Turkey
| | - Zehra Nur Bayram
- Department of Psychiatry, İzmir Democracy University Institute of Health Sciences, İzmir, Turkey
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Zhang J, Yu Y, Barra V, Ruan X, Chen Y, Cai B. Feasibility study on using house-tree-person drawings for automatic analysis of depression. Comput Methods Biomech Biomed Engin 2024; 27:1129-1140. [PMID: 37417817 DOI: 10.1080/10255842.2023.2231113] [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: 03/10/2023] [Accepted: 06/23/2023] [Indexed: 07/08/2023]
Abstract
Major depression is a severe psychological disorder typically diagnosed using scale tests and through the subjective assessment of medical professionals. Along with the continuous development of machine learning techniques, computer technology has been increasingly employed to identify depression in recent years. Traditional methods of automatic depression recognition rely on using the patient's physiological data, such as facial expressions, voice, electroencephalography (EEG), and magnetic resonance imaging (MRI) as input. However, the acquisition cost of these data is relatively high, making it unsuitable for large-scale depression screening. Thus, we explore the possibility of utilizing a house-tree-person (HTP) drawing to automatically detect major depression without requiring the patient's physiological data. The dataset we used for this study consisted of 309 drawings depicting individuals at risk of major depression and 290 drawings depicting individuals without depression risk. We classified the eight features extracted from HTP sketches using four machine-learning models and used multiple cross-validations to calculate recognition rates. The best classification accuracy rate among these models reached 97.2%. Additionally, we conducted ablation experiments to analyze the association between features and information on depression pathology. The results of Wilcoxon rank-sum tests showed that seven of the eight features significantly differed between the major depression group and the regular group. We demonstrated significant differences in HTP drawings between patients with severe depression and everyday individuals, and using HTP sketches to identify depression automatically is feasible, providing a new approach for automatic identification and large-scale screening of depression.
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Affiliation(s)
- Jie Zhang
- Key Laboratory of Aerospace Information Security and Trusted Computing, Ministry of Education, School of Cyber Science and Engineering, Wuhan University, Wuhan, China
| | - Yaoxiang Yu
- Key Laboratory of Aerospace Information Security and Trusted Computing, Ministry of Education, School of Cyber Science and Engineering, Wuhan University, Wuhan, China
| | - Vincent Barra
- Clermont Auvergne University, CNRS, Mines de Saint-Étienne, Clermont-Auvergne-INP, LIMOS, Clermont-Ferrand, France
| | - Xiaoming Ruan
- Key Laboratory of Aerospace Information Security and Trusted Computing, Ministry of Education, School of Cyber Science and Engineering, Wuhan University, Wuhan, China
| | - Yu Chen
- Key Laboratory of Aerospace Information Security and Trusted Computing, Ministry of Education, School of Cyber Science and Engineering, Wuhan University, Wuhan, China
| | - Bo Cai
- Key Laboratory of Aerospace Information Security and Trusted Computing, Ministry of Education, School of Cyber Science and Engineering, Wuhan University, Wuhan, China
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Jindal M, Chhetri A, Ludhiadch A, Singh P, Peer S, Singh J, Brar RS, Munshi A. Neuroimaging Genomics a Predictor of Major Depressive Disorder (MDD). Mol Neurobiol 2024; 61:3427-3440. [PMID: 37989980 DOI: 10.1007/s12035-023-03775-0] [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: 06/01/2023] [Accepted: 11/05/2023] [Indexed: 11/23/2023]
Abstract
Depression is a complex psychiatric disorder influenced by various genetic and environmental factors. Strong evidence has established the contribution of genetic factors in depression through twin studies and the heritability rate for depression has been reported to be 37%. Genetic studies have identified genetic variations associated with an increased risk of developing depression. Imaging genetics is an integrated approach where imaging measures are combined with genetic information to explore how specific genetic variants contribute to brain abnormalities. Neuroimaging studies allow us to examine both structural and functional abnormalities in individuals with depression. This review has been designed to study the correlation of the significant genetic variants with different regions of neural activity, connectivity, and structural alteration in the brain as detected by imaging techniques to understand the scope of biomarkers in depression. This might help in developing novel therapeutic interventions targeting specific genetic pathways or brain circuits and the underlying pathophysiology of depression based on this integrated approach can be established at length.
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Affiliation(s)
- Manav Jindal
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
| | - Aakash Chhetri
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151401, India
| | - Abhilash Ludhiadch
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151401, India
| | - Paramdeep Singh
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
| | - Sameer Peer
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
| | - Jawahar Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bathinda, India
| | - Rahatdeep Singh Brar
- Department of Diagnostic and Interventional Radiology, Homi Bhabha Cancer Hospital & Research Center, Mohali, India
| | - Anjana Munshi
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151401, India.
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Zhang J, Song Z, Huo Y, Li G, Lu L, Wei C, Zhang S, Gao X, Jiang X, Xu Y. Engeletin alleviates depressive-like behaviours by modulating microglial polarization via the LCN2/CXCL10 signalling pathway. J Cell Mol Med 2024; 28:e18285. [PMID: 38597406 PMCID: PMC11005460 DOI: 10.1111/jcmm.18285] [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: 01/24/2024] [Revised: 03/10/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
Microglial polarization and associated inflammatory activity are the key mediators of depression pathogenesis. The natural Smilax glabra rhizomilax derivative engeletin has been reported to exhibit robust anti-inflammatory activity, but no studies to date have examined the mechanisms through which it can treat depressive symptoms. We showed that treatment for 21 days with engeletin significantly alleviated depressive-like behaviours in chronic stress social defeat stress (CSDS) model mice. T1-weighted imaging (T1WI), T2-weighted imaging (T2WI) imaging revealed no significant differences between groups, but the bilateral prefrontal cortex of CSDS mice exhibited significant increases in apparent diffusion coefficient and T2 values relative to normal control mice, with a corresponding reduction in fractional anisotropy, while engeletin reversed all of these changes. CSDS resulted in higher levels of IL-1β, IL-6, and TNF-a production, enhanced microglial activation, and greater M1 polarization with a concomitant decrease in M2 polarization in the mPFC, whereas engeletin treatment effectively abrogated these CSDS-related pathological changes. Engeletin was further found to suppress the LCN2/C-X-C motif chemokine ligand 10 (CXCL10) signalling axis such that adeno-associated virus-induced LCN2 overexpression ablated the antidepressant effects of engeletin and reversed its beneficial effects on the M1/M2 polarization of microglia. In conclusion, engeletin can alleviate CSDS-induced depressive-like behaviours by regulating the LCN2/CXCL10 pathway and thereby altering the polarization of microglia. These data suggest that the antidepressant effects of engeletin are correlated with the polarization of microglia, highlighting a potential avenue for future design of antidepressant strategies that specifically target the microglia.
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Affiliation(s)
- Jie Zhang
- Department of RadiologyBinzhou Medical University HospitalBinzhouShandongP. R. China
| | - Zheng Song
- Department of PharmacyBinzhou Medical University HospitalBinzhouShandongP. R. China
| | - Yanchao Huo
- Department of PharmacyBinzhou Medical University HospitalBinzhouShandongP. R. China
| | - Guangqiang Li
- Department of PharmacyBinzhou Medical University HospitalBinzhouShandongP. R. China
| | - Liming Lu
- Department of PharmacyBinzhou Medical University HospitalBinzhouShandongP. R. China
| | - Chuanmei Wei
- Department of PharmacyBinzhou Medical University HospitalBinzhouShandongP. R. China
| | - Shuping Zhang
- College of Basic MedicineBinzhou Medical UniversityYantaiShandongP.R. China
| | - Xinfu Gao
- Department of PharmacyBinzhou Medical University HospitalBinzhouShandongP. R. China
| | - Xingyue Jiang
- Department of RadiologyBinzhou Medical University HospitalBinzhouShandongP. R. China
| | - Yangyang Xu
- Department of PharmacyBinzhou Medical University HospitalBinzhouShandongP. R. China
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Cao Y, Sun H, Lizano P, Deng G, Zhou X, Xie H, Mu J, Long X, Xiao H, Liu S, Wu B, Gong Q, Qiu C, Jia Z. Effects of inflammation, childhood adversity, and psychiatric symptoms on brain morphometrical phenotypes in bipolar II depression. Psychol Med 2024; 54:775-784. [PMID: 37671675 DOI: 10.1017/s0033291723002477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
BACKGROUND The neuroanatomical alteration in bipolar II depression (BDII-D) and its associations with inflammation, childhood adversity, and psychiatric symptoms are currently unclear. We hypothesize that neuroanatomical deficits will be related to higher inflammation, greater childhood adversity, and worse psychiatric symptoms in BDII-D. METHODS Voxel- and surface-based morphometry was performed using the CAT toolbox in 150 BDII-D patients and 155 healthy controls (HCs). Partial Pearson correlations followed by multiple comparison correction was used to indicate significant relationships between neuroanatomy and inflammation, childhood adversity, and psychiatric symptoms. RESULTS Compared with HCs, the BDII-D group demonstrated significantly smaller gray matter volumes (GMVs) in frontostriatal and fronto-cerebellar area, insula, rectus, and temporal gyrus, while significantly thinner cortices were found in frontal and temporal areas. In BDII-D, smaller GMV in the right middle frontal gyrus (MFG) was correlated with greater sexual abuse (r = -0.348, q < 0.001) while larger GMV in the right orbital MFG was correlated with greater physical neglect (r = 0.254, q = 0.03). Higher WBC count (r = -0.227, q = 0.015) and IL-6 levels (r = -0.266, q = 0.015) was associated with smaller GMVs in fronto-cerebellar area in BDII-D. Greater positive symptoms was correlated with larger GMVs of the left middle temporal pole (r = 0.245, q = 0.03). CONCLUSIONS Neuroanatomical alterations in frontostriatal and fronto-cerebellar area, insula, rectus, temporal gyrus volumes, and frontal-temporal thickness may reflect a core pathophysiological mechanism of BDII-D, which are related to inflammation, trauma, and psychiatric symptoms in BDII-D.
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Affiliation(s)
- Yuan Cao
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, P.R. China
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena 07743, Germany
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Huan Sun
- Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu 610041, P.R. China
| | - Paulo Lizano
- The Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- The Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Gaoju Deng
- Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu 610041, P.R. China
| | - Xiaoqin Zhou
- Department of Clinical Research Management, West China Hospital of Sichuan University, Chengdu 610041, P.R. China
| | - Hongsheng Xie
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, P.R. China
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Jingshi Mu
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, P.R. China
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Xipeng Long
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, P.R. China
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Hongqi Xiao
- Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu 610041, P.R. China
| | - Shiyu Liu
- Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu 610041, P.R. China
| | - Baolin Wu
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, P.R. 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 610041, P.R. China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen 361021, P.R. China
| | - Changjian Qiu
- Mental Health Center, West China Hospital of Sichuan University, Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu 610041, P.R. China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, P.R. China
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
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Sun H, Yan R, Hua L, Xia Y, Chen Z, Huang Y, Wang X, Xia Q, Yao Z, Lu Q. Abnormal stability of spontaneous neuronal activity as a predictor of diagnosis conversion from major depressive disorder to bipolar disorder. J Psychiatr Res 2024; 171:60-68. [PMID: 38244334 DOI: 10.1016/j.jpsychires.2024.01.028] [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: 11/12/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVE Bipolar disorder (BD) is often misdiagnosed as major depressive disorder (MDD) in the early stage, which may lead to inappropriate treatment. This study aimed to characterize the alterations of spontaneous neuronal activity in patients with depressive episodes whose diagnosis transferred from MDD to BD. METHODS 532 patients with MDD and 132 healthy controls (HCs) were recruited over 10 years. During the follow-up period, 75 participants with MDD transferred to BD (tBD), and 157 participants remained with the diagnosis of unipolar depression (UD). After excluding participants with poor image quality and excessive head movement, 68 participants with the diagnosis of tBD, 150 participants with the diagnosis of UD, and 130 HCs were finally included in the analysis. The dynamic amplitude of low-frequency fluctuations (dALFF) of spontaneous neuronal activity was evaluated in tBD, UD and HC using functional magnetic resonance imaging at study inclusion. Receiver operating characteristic (ROC) analysis was performed to evaluate sensitivity and specificity of the conversion prediction from MDD to BD based on dALFF. RESULTS Compared to HC, tBD exhibited elevated dALFF at left premotor cortex (PMC_L), right lateral temporal cortex (LTC_R) and right early auditory cortex (EAC_R), and UD showed reduced dALFF at PMC_L, left paracentral lobule (PCL_L), bilateral medial prefrontal cortex (mPFC), right orbital frontal cortex (OFC_R), right dorsolateral prefrontal cortex (DLPFC_R), right posterior cingulate cortex (PCC_R) and elevated dALFF at LTC_R. Furthermore, tBD exhibited elevated dALFF at PMC_L, PCL_L, bilateral mPFC, bilateral OFC, DLPFC_R, PCC_R and LTC_R than UD. In addition, ROC analysis based on dALFF in differential areas obtained an area under the curve (AUC) of 72.7%. CONCLUSIONS The study demonstrated the temporal dynamic abnormalities of tBD and UD in the critical regions of the somatomotor network (SMN), default mode network (DMN), and central executive network (CEN). The differential abnormal patterns of temporal dynamics between the two diseases have the potential to predict the diagnosis transition from MDD to BD.
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Affiliation(s)
- Hao Sun
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Rui Yan
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Lingling Hua
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Yi Xia
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Zhilu Chen
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Yinghong Huang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Xiaoqin Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Qiudong Xia
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China
| | - Zhijian Yao
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 249 Guangzhou Road, Nanjing, 210029, China; School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, 210096, China.
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, 210096, China.
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10
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Choi US, Sung YW, Ogawa S. deepPGSegNet: MRI-based pituitary gland segmentation using deep learning. Front Endocrinol (Lausanne) 2024; 15:1338743. [PMID: 38370353 PMCID: PMC10869468 DOI: 10.3389/fendo.2024.1338743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction In clinical research on pituitary disorders, pituitary gland (PG) segmentation plays a pivotal role, which impacts the diagnosis and treatment of conditions such as endocrine dysfunctions and visual impairments. Manual segmentation, which is the traditional method, is tedious and susceptible to inter-observer differences. Thus, this study introduces an automated solution, utilizing deep learning, for PG segmentation from magnetic resonance imaging (MRI). Methods A total of 153 university students were enrolled, and their MRI images were used to build a training dataset and ground truth data through manual segmentation of the PGs. A model was trained employing data augmentation and a three-dimensional U-Net architecture with a five-fold cross-validation. A predefined field of view was applied to highlight the PG region to optimize memory usage. The model's performance was tested on an independent dataset. The model's performance was tested on an independent dataset for evaluating accuracy, precision, recall, and an F1 score. Results and discussion The model achieved a training accuracy, precision, recall, and an F1 score of 92.7%, 0.87, 0.91, and 0.89, respectively. Moreover, the study explored the relationship between PG morphology and age using the model. The results indicated a significant association between PG volume and midsagittal area with age. These findings suggest that a precise volumetric PG analysis through an automated segmentation can greatly enhance diagnostic accuracy and surveillance of pituitary disorders.
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Affiliation(s)
- Uk-Su Choi
- Medical Device Development Center, Daegu-Gyeongbuk Medical Innovation Foundation, Daegu, Republic of Korea
| | - Yul-Wan Sung
- Kansei Fukushi Research Institute, Tohoku Fukushi University, Sendai, Japan
| | - Seiji Ogawa
- Kansei Fukushi Research Institute, Tohoku Fukushi University, Sendai, Japan
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11
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Ravan M, Noroozi A, Sanchez MM, Borden L, Alam N, Flor-Henry P, Colic S, Khodayari-Rostamabad A, Minuzzi L, Hasey G. Diagnostic deep learning algorithms that use resting EEG to distinguish major depressive disorder, bipolar disorder, and schizophrenia from each other and from healthy volunteers. J Affect Disord 2024; 346:285-298. [PMID: 37963517 DOI: 10.1016/j.jad.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Mood disorders and schizophrenia affect millions worldwide. Currently, diagnosis is primarily determined by reported symptomatology. As symptoms may overlap, misdiagnosis is common, potentially leading to ineffective or destabilizing treatment. Diagnostic biomarkers could significantly improve clinical care by reducing dependence on symptomatic presentation. METHODS We used deep learning analysis (DLA) of resting electroencephalograph (EEG) to differentiate healthy control (HC) subjects (N = 239), from those with major depressive disorder (MDD) (N = 105), MDD-atypical (MDD-A) (N = 27), MDD-psychotic (MDD-P) (N = 35), bipolar disorder-depressed episode (BD-DE) (N = 71), BD-manic episode (BD-ME) (N = 49), and schizophrenia (SCZ) (N = 122) and also differentiate subjects with mental disorders on a pair-wise basis. DSM-III-R diagnoses were determined and supplemented by computerized Quick Diagnostic Interview Schedule. After EEG preprocessing, robust exact low-resolution electromagnetic tomography (ReLORETA) computed EEG sources for 82 brain regions. 20 % of all subjects were then set aside for independent testing. Feature selection methods were then used for the remaining subjects to identify brain source regions that are discriminating between diagnostic categories. RESULTS Pair-wise classification accuracies between 90 % and 100 % were obtained using independent test subjects whose data were not used for training purposes. The most frequently selected features across various pairs are in the postcentral, supramarginal, and fusiform gyri, the hypothalamus, and the left cuneus. Brain sites discriminating SCZ from HC were mainly in the left hemisphere while those separating BD-ME from HC were on the right. LIMITATIONS The use of superseded DSM-III-R diagnostic system and relatively small sample size in some disorder categories that may increase the risk of overestimation. CONCLUSIONS DLA of EEG could be trained to autonomously classify psychiatric disorders with over 90 % accuracy compared to an expert clinical team using standardized operational methods.
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Affiliation(s)
- Maryam Ravan
- Department of Electrical and Computer Engineering, New York Institute of Technology, New York, NY, USA.
| | - Amin Noroozi
- Department of Digital, Technologies, and Arts, Staffordshire University, Staffordshire, England, UK
| | - Mary Margarette Sanchez
- Department of Electrical and Computer Engineering, New York Institute of Technology, New York, NY, USA
| | - Lee Borden
- Department of Electrical and Computer Engineering, New York Institute of Technology, New York, NY, USA
| | - Nafia Alam
- Department of Electrical and Computer Engineering, New York Institute of Technology, New York, NY, USA
| | | | - Sinisa Colic
- Department of Electrical Engineering, University of Toronto, Canada
| | | | - Luciano Minuzzi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Gary Hasey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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12
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Wei Y, Gao H, Luo Y, Feng J, Li G, Wang T, Xu H, Yin L, Ma J, Chen J. Systemic inflammation and oxidative stress markers in patients with unipolar and bipolar depression: A large-scale study. J Affect Disord 2024; 346:154-166. [PMID: 37924985 DOI: 10.1016/j.jad.2023.10.156] [Citation(s) in RCA: 1] [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: 04/06/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE Numerous studies have demonstrated that neutrophil/HDL ratio (NHR), lymphocyte/HDL ratio (LHR), monocyte/HDL (MHR) ratio, platelet/HDL ratio (PHR), neutrophil/ALB ratio (NAR) and platelet/ALB ratio (PAR) can serve as systemic inflammation and oxidative stress markers in a variety of diseases. However, few studies have estimated the associations of these markers with unipolar depression (UD) and bipolar depression (BD), as well as psychotic symptoms in UD and BD. METHODS 6297 UD patients, 1828 BD patients and 7630 healthy subjects were recruited. The differences in these indicators among different groups were compared, and the influencing factors for the occurrence of UD or BD and psychotic symptoms were analyzed. RESULTS These ratios displayed unique variation patterns across different diagnostic groups. BD group exhibited higher NHR, LHR, MHR, NAR and lower PAR than UD and HC groups, UD group showed higher MHR than HC group. The psychotic UD group had higher NHR, LHR, MHR and NAR than non-psychotic UD group. Higher LHR, MHR, NAR and lower PAR were risk factors in BD when compared to UD group. CONCLUSIONS Our study demonstrated differences in inflammation and oxidative stress profile between UD and BD patients, as well as between subjects with or without psychotic symptom exist, highlighting the role of inflammation and oxidative stress in the pathophysiology of UD and BD.
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Affiliation(s)
- Yanyan Wei
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China.
| | - Huanqin Gao
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China
| | - Yanhong Luo
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Junhui Feng
- Jining Psychiatric Hospital, Jidai Road 1#, Jining 272000, Shandong, China
| | - Guoguang Li
- The Fourth People's Hospital of Liaocheng, Liaocheng, Shandong 252000, China
| | - Tingting Wang
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Haiting Xu
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China
| | - Lu Yin
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China
| | - Jinbao Ma
- Beijing Tongren Hospital, Dongjiaomin Road 1#, Beijing 100000, China.
| | - Jingxu Chen
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China.
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13
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Wu Y, Zhong Y, Zhang G, Wang C, Zhang N, Chen Q. Distinct functional patterns in child and adolescent bipolar and unipolar depression during emotional processing. Cereb Cortex 2024; 34:bhad461. [PMID: 38044479 DOI: 10.1093/cercor/bhad461] [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: 06/12/2023] [Accepted: 09/28/2023] [Indexed: 12/05/2023] Open
Abstract
Accumulating evidence from functional magnetic resonance imaging studies supported brain dysfunction during emotional processing in bipolar disorder (BD) and major depressive disorder (MDD). However, child and adolescent BD and MDD could display different activation patterns, which have not been fully understood. This study aimed to investigate common and distinct activation patterns of pediatric BD (PBD) and MDD (p-MDD) during emotion processing using meta-analytic approaches. Literature search identified 25 studies, contrasting 252 PBD patients, and 253 healthy controls (HCs) as well as 311 p-MDD patients and 263 HCs. A total of nine meta-analyses were conducted pulling PBD and p-MDD experiments together and separately. The results revealed that PBD and p-MDD showed distinct patterns during negative processing. PBD patients exhibited activity changes in bilateral precuneus, left inferior parietal gyrus, left angular gyrus, and right posterior cingulate cortex while p-MDD patients showed functional disruptions in the left rectus, left triangular part of the inferior frontal gyrus, left orbital frontal cortex, left insula, and left putamen. In conclusion, the activity changes in PBD patients were mainly in regions correlated with emotion perception while the dysfunction among p-MDD patients was in the fronto-limbic circuit and reward-related regions in charge of emotion appraisal and regulation.
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Affiliation(s)
- Yun Wu
- School of Psychology, Nanjing Normal University, 122 Ninghai Road, Gulou District, Nanjing, Jiangsu 210097, China
- Jiangsu Key Laboratory of Mental Health and Cognitive Science, Nanjing Normal University, 122 Ninghai Road, Gulou District, Nanjing 210097, China
- Jiangsu International Collaborative Laboratory of Child and Adolescent Psychological Development and Crisis Intervention, Nanjing Normal University, 122 Ninghai Rd., Gulou District, Nanjing 210097, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, 122 Ninghai Road, Gulou District, Nanjing, Jiangsu 210097, China
- Jiangsu Key Laboratory of Mental Health and Cognitive Science, Nanjing Normal University, 122 Ninghai Road, Gulou District, Nanjing 210097, China
- Jiangsu International Collaborative Laboratory of Child and Adolescent Psychological Development and Crisis Intervention, Nanjing Normal University, 122 Ninghai Rd., Gulou District, Nanjing 210097, China
| | - Gui Zhang
- School of Psychology, Nanjing Normal University, 122 Ninghai Road, Gulou District, Nanjing, Jiangsu 210097, China
- Jiangsu Key Laboratory of Mental Health and Cognitive Science, Nanjing Normal University, 122 Ninghai Road, Gulou District, Nanjing 210097, China
- Jiangsu International Collaborative Laboratory of Child and Adolescent Psychological Development and Crisis Intervention, Nanjing Normal University, 122 Ninghai Rd., Gulou District, Nanjing 210097, China
| | - Chun Wang
- Psychiatry Department, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 264 Guangzhou Road, Gulou District, Nanjing, Jiangsu 210029, China
| | - Ning Zhang
- Psychiatry Department, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 264 Guangzhou Road, Gulou District, Nanjing, Jiangsu 210029, China
| | - Qingrong Chen
- School of Psychology, Nanjing Normal University, 122 Ninghai Road, Gulou District, Nanjing, Jiangsu 210097, China
- Jiangsu Key Laboratory of Mental Health and Cognitive Science, Nanjing Normal University, 122 Ninghai Road, Gulou District, Nanjing 210097, China
- Jiangsu International Collaborative Laboratory of Child and Adolescent Psychological Development and Crisis Intervention, Nanjing Normal University, 122 Ninghai Rd., Gulou District, Nanjing 210097, China
- Jiangsu Collaborative Innovation Center for Language Ability, School of Linguistic Sciences And Arts, Jiangsu Normal University, 57 Heping Road, Yunlong District, Xuzhou, Jiangsu 221009, China
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14
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Wu J, Qi S, Yu W, Gao Y, Ma J. Regional Homogeneity of the Left Posterior Cingulate Gyrus May Be a Potential Imaging Biomarker of Manic Episodes in First-Episode, Drug-Naive Bipolar Disorder. Neuropsychiatr Dis Treat 2023; 19:2775-2785. [PMID: 38106358 PMCID: PMC10725752 DOI: 10.2147/ndt.s441021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Abnormal brain networks with emotional response in bipolar disorder (BD). However, there have been few studies on the local consistency between manic episodes in drug-naive first-episode BD patients and healthy controls (HCs). The purpose of this study is to evaluate the utility of neural activity values analyzed by Regional Homogeneity (ReHo). Methods Thirty-seven manic episodes in first-episode, drug-naive BD patients and 37 HCs participated in resting-state functional magnetic resonance rescanning and scale estimation. Reho and receiver operating characteristic (ROC) curve methods were used to analyze the imaging data. Support vector machine (SVM) method was used to analyze ReHo in different brain regions. Results Compared to HCs, ReHo increased in the left middle temporal gyrus (MTG.L), posterior cingulate gyrus (PCG), inferior parietal gyrus, and bilateral angular gyrus, and decreased in the left dorsolateral superior frontal gyrus in target group. The ROC results showed that the ReHo value of the left PCG could discriminate the target group from the HCs, and the AUC was 0.8766. In addition, the results of the support vector machine show that the increase in ReHo value in the left PCG can effectively discriminate the patients from the controls, with accuracy, sensitivity, and specificity of 86.02%, 86.49%, and 81.08%, respectively. Conclusion The increased activity of the left PCG may contribute new evidence of participation in the pathophysiology of manic episodes in first-episode, drug-naive BD patients. The Reho value of the left posterior cingulate gyrus may be a potential neuroimaging biomarker to discriminate target group from HCs.
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Affiliation(s)
- Jiajia Wu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
| | - Shuangyu Qi
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
| | - Wei Yu
- Department of Psychiatry, Xianning Bode Mental Hospital, Xianning, People’s Republic of China
| | - Yujun Gao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Jun Ma
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, People’s Republic of China
- Wuhan Hospital for Psychotherapy, Wuhan, People’s Republic of China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
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15
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Li Q, Dong F, Gai Q, Che K, Ma H, Zhao F, Chu T, Mao N, Wang P. Diagnosis of Major Depressive Disorder Using Machine Learning Based on Multisequence MRI Neuroimaging Features. J Magn Reson Imaging 2023; 58:1420-1430. [PMID: 36797655 DOI: 10.1002/jmri.28650] [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: 11/26/2022] [Revised: 02/03/2023] [Accepted: 02/04/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Previous studies have found qualitative structural and functional brain changes in major depressive disorder (MDD) patients. However, most studies ignored the complementarity of multisequence MRI neuroimaging features and cannot determine accurate biomarkers. PURPOSE To evaluate machine-learning models combined with multisequence MRI neuroimaging features to diagnose patients with MDD. STUDY TYPE Prospective. SUBJECTS A training cohort including 111 patients and 90 healthy controls (HCs) and a test cohort including 28 patients and 22 HCs. FIELD STRENGTH/SEQUENCE A 3.0 T/T1-weighted imaging, resting-state functional MRI with echo-planar sequence, and single-shot echo-planar diffusion tensor imaging. ASSESSMENT Recruitment and integration were used to reflect the dynamic changes of functional networks, while gray matter volume and fractional anisotropy were used to reflect the changes in the morphological and anatomical network. We then fused features with significant differences in functional, morphological, and anatomical networks to evaluate a random forest (RF) classifier to diagnose patients with MDD. Furthermore, a support vector machine (SVM) classifier was used to verify the stability of neuroimaging features. Linear regression analyses were conducted to investigate the relationships among multisequence neuroimaging features and the suicide risk of patients. STATISTICAL TESTS The comparison of functional network attributes between patients and controls by two-sample t-test. Network-based statistical analysis was used to identify structural and anatomical connectivity changes between MDD and HCs. The performance of the model was evaluated by receiver operating characteristic (ROC) curves. RESULTS The performance of the RF model integrating multisequence neuroimaging features in the diagnosis of depression was significantly improved, with an AUC of 93.6%. In addition, we found that multisequence neuroimaging features could accurately predict suicide risk in patients with MDD (r = 0.691). DATA CONCLUSION The RF model fusing functional, morphological, and anatomical network features performed well in diagnosing patients with MDD and provided important insights into the pathological mechanisms of MDD. EVIDENCE LEVEL 1. TECHNICAL EFFICACY Stage 2.
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Affiliation(s)
- Qinghe Li
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, People's Republic of China
- School of Medical Imaging, Binzhou Medical University, Yantai, Shandong, People's Republic of China
| | - Fanghui Dong
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, People's Republic of China
| | - Qun Gai
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, People's Republic of China
| | - Kaili Che
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, People's Republic of China
| | - Heng Ma
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, People's Republic of China
| | - Feng Zhao
- School of Compute Science and Technology, Shandong Technology and Business University, Yantai, Shandong, People's Republic of China
| | - Tongpeng Chu
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, People's Republic of China
| | - Ning Mao
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, People's Republic of China
| | - Peiyuan Wang
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong, People's Republic of China
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Bartoli F, Nasti C, Palpella D, Piacenti S, Di Lella ME, Mauro S, Prestifilippo L, Crocamo C, Carrà G. Characterizing the clinical profile of mania without major depressive episodes: a systematic review and meta-analysis of factors associated with unipolar mania. Psychol Med 2023; 53:7277-7286. [PMID: 37016793 PMCID: PMC10719688 DOI: 10.1017/s0033291723000831] [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: 09/09/2022] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND The diagnostic concept of unipolar mania (UM), i.e. the lifetime occurrence of mania without major depressive episodes, remains a topic of debate despite the evidence accumulated in the last few years. We carried out a systematic review and meta-analysis of observational studies testing factors associated with UM as compared to bipolar disorder with a manic-depressive course (md-BD). METHODS Studies indexed up to July 2022 in main electronic databases were searched. Random-effects meta-analyses of the association between UM and relevant correlates yielded odds ratio (OR) or standardized mean difference (SMD), with 95% confidence intervals (CIs). RESULTS Based on data from 21 studies, factors positively or negatively associated with UM, as compared to md-BD, were: male gender (OR 1.47; 95% CI 1.11-1.94); age at onset (SMD -0.25; 95% CI -0.46 to -0.04); number of hospitalizations (SMD 0.53; 95% CI 0.21-0.84); family history of depression (OR 0.55; 95% CI 0.36-0.85); suicide attempts (OR 0.25; 95% CI 0.19-0.34); comorbid anxiety disorders (OR 0.35; 95% CI 0.26-0.49); psychotic features (OR 2.16; 95% CI 1.55-3.00); hyperthymic temperament (OR 1.99; 95% CI 1.17-3.40). The quality of evidence for the association with previous suicide attempts was high, moderate for anxiety disorders and psychotic features, and low or very low for other correlates. CONCLUSIONS Despite the heterogeneous quality of evidence, this work supports the hypothesis that UM might represent a distinctive diagnostic construct, with peculiar clinical correlates. Additional research is needed to better differentiate UM in the context of affective disorders, favouring personalized care approaches.
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Affiliation(s)
- Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Christian Nasti
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Dario Palpella
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Susanna Piacenti
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Maria Elisa Di Lella
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Stefano Mauro
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Luca Prestifilippo
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
- Division of Psychiatry, University College London, Maple House 149, London W1T 7BN, UK
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Wang TW, Gong J, Wang Y, Liang Z, Pang KL, Wang JS, Zhang ZG, Zhang CY, Zhou Y, Li JC, Wang YN, Zhou YJ. Differences in Non-suicidal Self-injury Behaviors between Unipolar Depression and Bipolar Depression in Adolescent Outpatients. Curr Med Sci 2023; 43:998-1004. [PMID: 37558867 DOI: 10.1007/s11596-023-2772-z] [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: 04/26/2022] [Accepted: 05/24/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) has a higher prevalence in adolescents with depressive disorders than in community adolescents. This study examined the differences in NSSI behaviors between adolescents with unipolar depression (UD) and those with bipolar depression (BD). METHODS Adolescents with UD or BD were recruited from 20 general or psychiatric hospitals across China. The methods, frequency, and function of NSSI were assessed by Functional Assessment of Self-Mutilation. The Beck Suicide Ideation Scale was used to evaluate adolescents' suicidal ideation, and the 10-item Kessler Psychological Distress Scale to estimate the anxiety and depression symptoms. RESULTS The UD group had higher levels of depression (19.16 vs.17.37, F=15.23, P<0.001) and anxiety symptoms (17.73 vs.16.70, F=5.00, P=0.026) than the BD group. Adolescents with BD had a longer course of NSSI than those with UD (2.00 vs.1.00 year, Z=-3.39, P=0.001). There were no statistical differences in the frequency and the number of methods of NSSI between the UD and BD groups. Depression (r=0.408, P<0.01) and anxiety (r=0.391, P<0.01) were significantly and positively related to NSSI frequency. CONCLUSION Adolescents with BD had a longer course of NSSI than those with UD. More importantly, NSSI frequency were positively and strongly correlated with depression and anxiety symptoms, indicating the importance of adequate treatment of depression and anxiety in preventing and intervening adolescents' NSSI behaviors.
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Affiliation(s)
- Ting-Wei Wang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, 518000, China
| | - Jian Gong
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Yang Wang
- College of Management, Shenzhen University, Shenzhen, 518000, China
| | - Zhen Liang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, 518000, China
| | - Ke-Liang Pang
- School of Pharmaceutical Sciences, IDG/McGovern Institute for Brain Research, Tsinghua University-Peking University Joint Center for Life Sciences, Tsinghua University, Beijing, 100000, China
| | - Jie-Si Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100000, China
| | - Zhi-Guo Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, 518000, China
| | - Chun-Yan Zhang
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, 518000, China
| | - Yue Zhou
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Jun-Chang Li
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, 518000, China
| | - Yan-Ni Wang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China.
| | - Yong-Jie Zhou
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, 518000, China.
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18
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Yu H, Ni P, Tian Y, Zhao L, Li M, Li X, Wei W, Wei J, Du X, Wang Q, Guo W, Deng W, Ma X, Coid J, Li T. Association of the plasma complement system with brain volume deficits in bipolar and major depressive disorders. Psychol Med 2023; 53:6102-6112. [PMID: 36285542 DOI: 10.1017/s0033291722003282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Inflammation plays a crucial role in the pathogenesis of major depressive disorder (MDD) and bipolar disorder (BD). This study aimed to examine whether the dysregulation of complement components contributes to brain structural defects in patients with mood disorders. METHODS A total of 52 BD patients, 35 MDD patients, and 53 controls were recruited. The human complement immunology assay was used to measure the levels of complement factors. Whole brain-based analysis was performed to investigate differences in gray matter volume (GMV) and cortical thickness (CT) among the BD, MDD, and control groups, and relationships were explored between neuroanatomical differences and levels of complement components. RESULTS GMV in the medial orbital frontal cortex (mOFC) and middle cingulum was lower in both patient groups than in controls, while the CT of the left precentral gyrus and left superior frontal gyrus were affected differently in the two disorders. Concentrations of C1q, C4, factor B, factor H, and properdin were higher in both patient groups than in controls, while concentrations of C3, C4 and factor H were significantly higher in BD than in MDD. Concentrations of C1q, factor H, and properdin showed a significant negative correlation with GMV in the mOFC at the voxel-wise level. CONCLUSIONS BD and MDD are associated with shared and different alterations in levels of complement factors and structural impairment in the brain. Structural defects in mOFC may be associated with elevated levels of certain complement factors, providing insight into the shared neuro-inflammatory pathogenesis of mood disorders.
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Affiliation(s)
- Hua Yu
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Peiyan Ni
- The Psychiatric Laboratory and Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P R China
| | - Yang Tian
- The Psychiatric Laboratory and Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P R China
| | - Liansheng Zhao
- The Psychiatric Laboratory and Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P R China
| | - Mingli Li
- The Psychiatric Laboratory and Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P R China
| | - Xiaojing Li
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wei Wei
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jinxue Wei
- The Psychiatric Laboratory and Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P R China
| | - Xiangdong Du
- Suzhou Psychiatry Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu, China
| | - Qiang Wang
- The Psychiatric Laboratory and Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P R China
| | - Wanjun Guo
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wei Deng
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaohong Ma
- The Psychiatric Laboratory and Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P R China
| | - Jeremy Coid
- The Psychiatric Laboratory and Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P R China
| | - Tao Li
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Science and Brain-machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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19
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Thiel K, Meinert S, Winter A, Lemke H, Waltemate L, Breuer F, Gruber M, Leenings R, Wüste L, Rüb K, Pfarr JK, Stein F, Brosch K, Meller T, Ringwald KG, Nenadić I, Krug A, Repple J, Opel N, Koch K, Leehr EJ, Bauer J, Grotegerd D, Hahn T, Kircher T, Dannlowski U. Reduced fractional anisotropy in bipolar disorder v. major depressive disorder independent of current symptoms. Psychol Med 2023; 53:4592-4602. [PMID: 35833369 PMCID: PMC10388324 DOI: 10.1017/s0033291722001490] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Patients with bipolar disorder (BD) show reduced fractional anisotropy (FA) compared to patients with major depressive disorder (MDD). Little is known about whether these differences are mood state-independent or influenced by acute symptom severity. Therefore, the aim of this study was (1) to replicate abnormalities in white matter microstructure in BD v. MDD and (2) to investigate whether these vary across depressed, euthymic, and manic mood. METHODS In this cross-sectional diffusion tensor imaging study, n = 136 patients with BD were compared to age- and sex-matched MDD patients and healthy controls (HC) (n = 136 each). Differences in FA were investigated using tract-based spatial statistics. Using interaction models, the influence of acute symptom severity and mood state on the differences between patient groups were tested. RESULTS Analyses revealed a main effect of diagnosis on FA across all three groups (ptfce-FWE = 0.003). BD patients showed reduced FA compared to both MDD (ptfce-FWE = 0.005) and HC (ptfce-FWE < 0.001) in large bilateral clusters. These consisted of several white matter tracts previously described in the literature, including commissural, association, and projection tracts. There were no significant interaction effects between diagnosis and symptom severity or mood state (all ptfce-FWE > 0.704). CONCLUSIONS Results indicated that the difference between BD and MDD was independent of depressive and manic symptom severity and mood state. Disruptions in white matter microstructure in BD might be a trait effect of the disorder. The potential of FA values to be used as a biomarker to differentiate BD from MDD should be further addressed in future studies using longitudinal designs.
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Affiliation(s)
- Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute of Translational Neuroscience, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lena Waltemate
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Fabian Breuer
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ramona Leenings
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lucia Wüste
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Kathrin Rüb
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | | | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Kai Gustav Ringwald
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Koch
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Elisabeth J. Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jochen Bauer
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
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20
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Bandeira ID, Leal GC, Correia-Melo FS, Souza-Marques B, Silva SS, Lins-Silva DH, Mello RP, Vieira F, Dorea-Bandeira I, Faria-Guimarães D, Carneiro B, Caliman-Fontes AT, Kapczinski F, Miranda-Scippa Â, Lacerda ALT, Quarantini LC. Arketamine for bipolar depression: Open-label, dose-escalation, pilot study. J Psychiatr Res 2023; 164:229-234. [PMID: 37385001 DOI: 10.1016/j.jpsychires.2023.06.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/29/2023] [Accepted: 06/21/2023] [Indexed: 07/01/2023]
Abstract
There are significantly fewer options for the treatment of bipolar depression than major depressive disorder, with an urgent need for alternative therapies. In this pilot study, we treated six subjects with bipolar disorder types I and II (according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria) who had been in a current depressive episode for at least four weeks. Four subjects were female (66.66%), and the mean age was 45.33 (±12.32). Subjects received adjunct treatment with two arketamine intravenous infusions one week apart-0.5 mg/kg first and then 1 mg/kg. The mean baseline Montgomery-Åsberg Depression Rating Scale (MADRS) total score was 36.66, which decreased to 27.83 24h after the first infusion of 0.5 mg/kg of arketamine (p = 0.036). In respect of the 1 mg/kg dose, the mean MADRS total score before the second infusion was 32.0, which dropped to 17.66 after 24h (p < 0.001). Arketamine appears to have rapid-acting antidepressant properties, consistent with previous animal studies on major depression. All individuals tolerated both doses, exhibiting nearly absent dissociation, and no manic symptoms. To the best of our knowledge, this pilot trial is the first to test the feasibility and safety of the (R)-enantiomer of ketamine (arketamine) for bipolar depression.
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Affiliation(s)
- Igor D Bandeira
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, United States
| | - Gustavo C Leal
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Fernanda S Correia-Melo
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Breno Souza-Marques
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Samantha S Silva
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Daniel H Lins-Silva
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Rodrigo P Mello
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Flávia Vieira
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Ingrid Dorea-Bandeira
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Daniela Faria-Guimarães
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Beatriz Carneiro
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Ana Teresa Caliman-Fontes
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Flávio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Ângela Miranda-Scippa
- Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Acioly L T Lacerda
- Laboratório Interdisciplinar de Neurociências Clínicas, Universidade Federal de São Paulo, São Paulo, Brazil; Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil; Instituto Sinapse de Neurociências Clínicas, Campinas, Brazil
| | - Lucas C Quarantini
- Laboratório de Neuropsicofarmacologia, Serviço de Psiquiatria do Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil; Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.
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21
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Wu X, Tu M, Chen N, Yang J, Jin J, Qu S, Xiong S, Cao Z, Xu M, Pei S, Hu H, Ge Y, Fang J, Shao X. The efficacy and cerebral mechanism of intradermal acupuncture for major depressive disorder: a study protocol for a randomized controlled trial. Front Psychiatry 2023; 14:1181947. [PMID: 37255689 PMCID: PMC10226652 DOI: 10.3389/fpsyt.2023.1181947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/27/2023] [Indexed: 06/01/2023] Open
Abstract
Background Major depressive disorder (MDD) has emerged as the fifth leading cause of years lived with disability, with a high prevalent, affecting nearly 4% of the global population. While available evidence suggests that intradermal acupuncture may enhance the effectiveness of antidepressants, whether its efficacy is a specific therapeutic effect or a placebo effect has not been reported. Moreover, the cerebral mechanism of intradermal acupuncture as a superficial acupuncture (usually subcutaneous needling to a depth of 1-2 mm) for MDD remains unclear. Methods A total of 120 participants with MDD will be enrolled and randomized to the waiting list group, sham intradermal acupuncture group and active intradermal acupuncture group. All 3 groups will receive a 6-week intervention and a 4-week follow-up. The primary outcome will be measured by the Hamilton Depression Rating Scale-17 and the secondary outcome measures will be the Self-Rating depression scale and Pittsburgh sleep quality index. Assessments will be conducted at baseline, 3 weeks, 6 weeks, and during the follow-up period. In addition, 20 eligible participants in each group will be randomly selected to undergo head magnetic resonance imaging before and after the intervention to explore the effects of intradermal acupuncture on brain activity in MDD patients. Discussion If the intradermal acupuncture is beneficial, it is promising to be included in the routine treatment of MDD. Clinical Trial Registration Clinicaltrials.gov, NCT05720637.
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Affiliation(s)
- Xiaoting Wu
- Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Clinical Medical College, Zhejiang Chinese Medical University,, Hangzhou, China
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Mingqi Tu
- Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Clinical Medical College, Zhejiang Chinese Medical University,, Hangzhou, China
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Nisang Chen
- Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Clinical Medical College, Zhejiang Chinese Medical University,, Hangzhou, China
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiajia Yang
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Junyan Jin
- Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Clinical Medical College, Zhejiang Chinese Medical University,, Hangzhou, China
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Siying Qu
- Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Clinical Medical College, Zhejiang Chinese Medical University,, Hangzhou, China
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Sangsang Xiong
- Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Clinical Medical College, Zhejiang Chinese Medical University,, Hangzhou, China
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhijian Cao
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Maosheng Xu
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Shuangyi Pei
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Hantong Hu
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yinyan Ge
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Jianqiao Fang
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaomei Shao
- Key Laboratory for Research of Acupuncture Treatment and Transformation of Emotional Diseases, The Third Clinical Medical College, Zhejiang Chinese Medical University,, Hangzhou, China
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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22
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Gao K, Ayati M, Kaye NM, Koyuturk M, Calabrese JR, Ganocy SJ, Lazarus HM, Christian E, Kaplan D. Differences in intracellular protein levels in monocytes and CD4 + lymphocytes between bipolar depressed patients and healthy controls: A pilot study with tyramine-based signal-amplified flow cytometry. J Affect Disord 2023; 328:116-127. [PMID: 36806598 DOI: 10.1016/j.jad.2023.02.058] [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: 07/25/2022] [Revised: 01/30/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Molecular biomarkers for bipolar disorder (BD) that distinguish it from other manifestations of depressive symptoms remain unknown. The aim of this study was to determine if a very sensitive tyramine-based signal-amplification technology for flow cytometry (CellPrint™) could facilitate the identification of cell-specific analyte expression profiles of peripheral blood cells for bipolar depression (BPD) versus healthy controls (HCs). METHODS The diagnosis of psychiatric disorders was ascertained with Mini International Neuropsychiatric Interview for DSM-5. Expression levels for eighteen protein analytes previously shown to be related to bipolar disorder were assessed with CellPrint™ in CD4+ T cells and monocytes of bipolar patients and HCs. Implementation of protein-protein interaction (PPI) network and pathway analysis was subsequently used to identify new analytes and pathways for subsequent interrogations. RESULTS Fourteen drug-naïve or -free patients with bipolar I or II depression and 17 healthy controls (HCs) were enrolled. The most distinguishable changes in analyte expression based on t-tests included GSK3β, HMGB1, IRS2, phospho-GSK3αβ, phospho-RELA, and TSPO in CD4+ T cells and calmodulin, GSK3β, IRS2, and phospho-HS1 in monocytes. Subsequent PPI and pathway analysis indicated that prolactin, leptin, BDNF, and interleukin-3 signal pathways were significantly different between bipolar patients and HCs. LIMITATION The sample size of the study was small and 2 patients were on medications. CONCLUSION In this pilot study, CellPrint™ was able to detect differences in cell-specific protein levels between BPD patients and HCs. A subsequent study including samples from patients with BPD, major depressive disorder, and HCs is warranted.
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Affiliation(s)
- Keming Gao
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, United States of America; Case Western Reserve University School of Medicine, Cleveland, OH, United States of America.
| | - Marzieh Ayati
- Department of Computer Science, University of Texas Rio Grande Valley, Edinburg, TX, United States of America
| | - Nicholas M Kaye
- CellPrint Biotechnology, Cleveland, OH, United States of America
| | - Mehmet Koyuturk
- Department of Computer and Data Sciences, Center for Proteomics and Bioinformatics, Case Western Reserve University, Cleveland, OH, United States of America
| | - Joseph R Calabrese
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, United States of America; Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - Stephen J Ganocy
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, United States of America; Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - Hillard M Lazarus
- Case Western Reserve University School of Medicine, Cleveland, OH, United States of America; CellPrint Biotechnology, Cleveland, OH, United States of America; Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States of America
| | - Eric Christian
- CellPrint Biotechnology, Cleveland, OH, United States of America
| | - David Kaplan
- CellPrint Biotechnology, Cleveland, OH, United States of America
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23
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Zeng J, Zhang Y, Xiang Y, Liang S, Xue C, Zhang J, Ran Y, Cao M, Huang F, Huang S, Deng W, Li T. Optimizing multi-domain hematologic biomarkers and clinical features for the differential diagnosis of unipolar depression and bipolar depression. NPJ MENTAL HEALTH RESEARCH 2023; 2:4. [PMID: 38609642 PMCID: PMC10955811 DOI: 10.1038/s44184-023-00024-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/01/2023] [Indexed: 04/14/2024]
Abstract
There is a lack of objective features for the differential diagnosis of unipolar and bipolar depression, especially those that are readily available in practical settings. We investigated whether clinical features of disease course, biomarkers from complete blood count, and blood biochemical markers could accurately classify unipolar and bipolar depression using machine learning methods. This retrospective study included 1160 eligible patients (918 with unipolar depression and 242 with bipolar depression). Patient data were randomly split into training (85%) and open test (15%) sets 1000 times, and the average performance was reported. XGBoost achieved the optimal open-test performance using selected biomarkers and clinical features-AUC 0.889, sensitivity 0.831, specificity 0.839, and accuracy 0.863. The importance of features for differential diagnosis was measured using SHapley Additive exPlanations (SHAP) values. The most informative features include (1) clinical features of disease duration and age of onset, (2) biochemical markers of albumin, low density lipoprotein (LDL), and potassium, and (3) complete blood count-derived biomarkers of white blood cell count (WBC), platelet-to-lymphocyte ratio (PLR), and monocytes (MONO). Overall, onset features and hematologic biomarkers appear to be reliable information that can be readily obtained in clinical settings to facilitate the differential diagnosis of unipolar and bipolar depression.
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Affiliation(s)
- Jinkun Zeng
- Hangzhou Seventh People's Hospital, Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yaoyun Zhang
- Alibaba Damo Academy, 969 West Wen Yi Road, Yu Hang District, Hangzhou, Zhejiang, China
| | - Yutao Xiang
- Center for Cognition and Brain Sciences, Unit of Psychiatry, Institute of Translational Medicine, University of Macau, Macao, China
| | - Sugai Liang
- Hangzhou Seventh People's Hospital, Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chuang Xue
- Hangzhou Seventh People's Hospital, Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Junhang Zhang
- Hangzhou Seventh People's Hospital, Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ya Ran
- West China Hospital, Sichuan University, Sichuan, China
| | - Minne Cao
- Hangzhou Seventh People's Hospital, Affiliated Mental Health Center, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Fei Huang
- Alibaba Damo Academy, 969 West Wen Yi Road, Yu Hang District, Hangzhou, Zhejiang, China
| | - Songfang Huang
- Alibaba Damo Academy, 969 West Wen Yi Road, Yu Hang District, Hangzhou, Zhejiang, China
| | - Wei Deng
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, 1369 West Wenyi Road, 311121, Hangzhou, China.
| | - Tao Li
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, 1369 West Wenyi Road, 311121, Hangzhou, China.
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, 310058, Hangzhou, China.
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Li G, Zhang B, Long M, Ma J. Abnormal degree centrality can be a potential imaging biomarker in first-episode, drug-naive bipolar mania. Neuroreport 2023; 34:323-331. [PMID: 37010493 PMCID: PMC10065818 DOI: 10.1097/wnr.0000000000001896] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 02/14/2023] [Indexed: 04/04/2023]
Abstract
Brain network abnormalities in emotional response exist in bipolar mania. However, few studies have been published on network degree centrality of first-episode, drug-naive bipolar mania, and healthy controls. This study aimed to assess the utility of neural activity values analyzed via degree centrality methods. Sixty-six first-episode, drug-naive patients with bipolar mania and 60 healthy controls participated in resting-state functional magnetic resonance rescanning and scale estimating. The degree centrality and receiver operating characteristic (ROC) curve methods were used for an analysis of the imaging data. Relative to healthy controls, first-episode bipolar mania patients displayed increased degree centrality values in the left middle occipital gyrus, precentral gyrus, supplementary motor area, Precuneus, and decreased degree centrality values in the left parahippocampal gyrus, right insula and superior frontal gyrus, medial. ROC results exhibited degree centrality values in the left parahippocampal gyrus that could distinguish first-episode bipolar mania patients from healthy controls with 0.8404 for AUC. Support vector machine results showed that reductions in degree centrality values in the left parahippocampal gyrus can be used to effectively differentiate between bipolar disorder patients and healthy controls with respective accuracy, sensitivity, and specificity values of 83.33%, 85.51%, and 88.41%. Increased activity in the left parahippocampal gyrus may be a distinctive neurobiological feature of first-episode, drug-naive bipolar mania. Degree centrality values in the left parahippocampal gyrus might be served as a potential neuroimaging biomarker to discriminate first-episode, drug-naive bipolar mania patients from healthy controls.
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Affiliation(s)
- Guangyu Li
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan
- Yunnan Psychiatric Hospital, Kunming
| | - Baoli Zhang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan
| | - Meixin Long
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin
| | - Jun Ma
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan
- Department of Psychiatry, Wuhan Mental Health Center
- Wuhan Hospital for Psychotherapy, Wuhan, China
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25
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Maralakunte M, Gupta V, Grover S, Ahuja CK, Sahoo S, Kishore K, Vyas S, Garg G, Singh P, Govind V. Cross-sectional analysis of whole-brain microstructural changes in adult patients with bipolar and unipolar depression by diffusion kurtosis imaging. Neuroradiol J 2023; 36:176-181. [PMID: 35817080 PMCID: PMC10034704 DOI: 10.1177/19714009221114446] [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: 11/16/2022] Open
Abstract
RATIONALE AND OBJECTIVES More than half of the bipolar depression (BD) subjects are misdiagnosed as unipolar depression (UD) due to lack of objective diagnostic criteria. We aimed to identify microstructural neuronal changes differentiating BD from UD groups using diffusion kurtosis imaging (DKI). The objective of the study is to identify an objective neuro-imaging marker to differentiate BD from UD. MATERIALS AND METHODS A prospective, cross-sectional study included total of 62 subjects with diagnosis of bipolar depression (n = 21), unipolar depression (n = 21), and healthy controls (n = 20). All subjects underwent diffusion-weighted imaging (b = 0,1000,2000) of the whole brain on 3-Tesla MR scanner. DKI data was analyzed using 189 region whole-brain atlas. Eight diffusion and kurtosis metrics including mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), fractional anisotropy (FA), mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), and kurtosis fractional anisotropy (FKA) were measured against these 189 regions. Principle component analysis (PCA) was utilized to identify the most significant regions of the brain. ANOVA with post hoc tests was used for analyzing these regions. RESULTS BD group showed increased MD, RD, decreased AK at the left amygdala and decreased MK and RK at the right hemi-cerebellum. UD group showed increased MK and RK at the right external capsule; and increased AK, MK, and RK at the right amygdala. CONCLUSION The right and left amygdala, right external capsule, and right hemi-cerebellum showed microstructural abnormalities capable of differentiating BD and UD groups. Diffusion imaging especially DKI can aid in management of depression patients.
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Affiliation(s)
| | - Vivek Gupta
- Interventional Neuroradiology, Fortis Hospital, India
| | | | | | | | | | - Sameer Vyas
- Department of Radiodiagnosis and
Imaging, PGIMER, India
| | - Gaurav Garg
- Department of Radiodiagnosis and
Imaging, PGIMER, India
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26
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Ai YW, Du Y, Chen L, Liu SH, Liu QS, Cheng Y. Brain Inflammatory Marker Abnormalities in Major Psychiatric Diseases: a Systematic Review of Postmortem Brain Studies. Mol Neurobiol 2023; 60:2116-2134. [PMID: 36600081 DOI: 10.1007/s12035-022-03199-2] [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: 10/15/2022] [Accepted: 12/23/2022] [Indexed: 01/06/2023]
Abstract
Schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD) are common neuropsychiatric disorders that lead to neuroinflammation in the pathogenesis. It is possible to further explore the connection between inflammation in the brain and SCZ, BD, and MDD. Therefore, we systematically reviewed PubMed and Web of Science on brain inflammatory markers measured in SCZ, BD, and MDD postmortem brains. Out of 2166 studies yielded by the search, 46 studies met the inclusion criteria in SCZ, BD, and MDD postmortem brains. The results were variable across inflammatory markers. For example, 26 studies were included to measure the differential expression between SCZ and control subjects. Similarly, seven of the included studies measured the differential expression of inflammatory markers in patients with BD. The heterogeneity from the included studies is not clear at present, which may be caused by several factors, including the measured brain region, disease stage, brain source, medication, and other factors.
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Affiliation(s)
- Yang-Wen Ai
- School of Pharmacy, Center on Translational Neuroscience, Minzu University of China, Haidian District, 27 Zhongguancun South St, 100081, Beijing, China
| | - Yang Du
- School of Pharmacy, Center on Translational Neuroscience, Minzu University of China, Haidian District, 27 Zhongguancun South St, 100081, Beijing, China
| | - Lei Chen
- School of Pharmacy, Center on Translational Neuroscience, Minzu University of China, Haidian District, 27 Zhongguancun South St, 100081, Beijing, China
| | - Shu-Han Liu
- School of Pharmacy, Center on Translational Neuroscience, Minzu University of China, Haidian District, 27 Zhongguancun South St, 100081, Beijing, China
| | - Qing-Shan Liu
- School of Pharmacy, Center on Translational Neuroscience, Minzu University of China, Haidian District, 27 Zhongguancun South St, 100081, Beijing, China.
| | - Yong Cheng
- School of Pharmacy, Center on Translational Neuroscience, Minzu University of China, Haidian District, 27 Zhongguancun South St, 100081, Beijing, China. .,Institute of National Security, Minzu University of China, Haidian District, 27 Zhongguancun South St, 100081, Beijing, China.
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27
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Kondo F, Whitehead JC, Corbalán F, Beaulieu S, Armony JL. Emotion regulation in bipolar disorder type-I: multivariate analysis of fMRI data. Int J Bipolar Disord 2023; 11:12. [PMID: 36964848 PMCID: PMC10039967 DOI: 10.1186/s40345-023-00292-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/13/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Bipolar disorder type-I (BD-I) patients are known to show emotion regulation abnormalities. In a previous fMRI study using an explicit emotion regulation paradigm, we compared responses from 19 BD-I patients and 17 matched healthy controls (HC). A standard general linear model-based univariate analysis revealed that BD patients showed increased activations in inferior frontal gyrus when instructed to decrease their emotional response as elicited by neutral images. We implemented multivariate pattern recognition analyses on the same data to examine if we could classify conditions within-group as well as HC versus BD. METHODS We reanalyzed explicit emotion regulation data using a multivariate pattern recognition approach, as implemented in PRONTO software. The original experimental paradigm consisted of a full 2 × 2 factorial design, with valence (Negative/Neutral) and instruction (Look/Decrease) as within subject factors. RESULTS The multivariate models were able to accurately classify different task conditions when HC and BD were analyzed separately (63.24%-75.00%, p = 0.001-0.012). In addition, the models were able to correctly classify HC versus BD with significant accuracy in conditions where subjects were instructed to downregulate their felt emotion (59.60%-60.84%, p = 0.014-0.018). The results for HC versus BD classification demonstrated contributions from the salience network, several occipital and frontal regions, inferior parietal lobes, as well as other cortical regions, to achieve above-chance classifications. CONCLUSIONS Our multivariate analysis successfully reproduced some of the main results obtained in the previous univariate analysis, confirming that these findings are not dependent on the analysis approach. In particular, both types of analyses suggest that there is a significant difference of neural patterns between conditions within each subject group. The multivariate approach also revealed that reappraisal conditions provide the most informative activity for differentiating HC versus BD, irrespective of emotional valence (negative or neutral). The current results illustrate the importance of investigating the cognitive control of emotion in BD. We also propose a set of candidate regions for further study of emotional control in BD.
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Affiliation(s)
- Fumika Kondo
- Douglas Mental Health University Institute, Verdun, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Jocelyne C Whitehead
- Douglas Mental Health University Institute, Verdun, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | | | - Serge Beaulieu
- Douglas Mental Health University Institute, Verdun, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Jorge L Armony
- Douglas Mental Health University Institute, Verdun, QC, Canada.
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada.
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
- Department of Psychology, Université de Montréal, Montreal, QC, Canada.
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28
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Saccaro LF, Crokaert J, Perroud N, Piguet C. Structural and functional MRI correlates of inflammation in bipolar disorder: A systematic review. J Affect Disord 2023; 325:83-92. [PMID: 36621677 DOI: 10.1016/j.jad.2022.12.162] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/15/2022] [Accepted: 12/31/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Bipolar disorder (BD) is a common affective disorder characterized by recurrent oscillations between mood states and associated with inflammatory diseases and chronic inflammation. However, data on MRI abnormalities in BD and their relationship with inflammation are heterogeneous and no review has recapitulated them. METHODS In this pre-registered (PROSPERO: CRD42022308461) systematic review we searched Web of Science Core Collection and PubMed for articles correlating functional or structural MRI measures with immune-related markers in BD. RESULTS We included 23 studies (6 on functional, 16 on structural MRI findings, 1 on both, including 1'233 BD patients). Overall, the quality of the studies included was fair, with a low risk of bias. LIMITATIONS Heterogeneity in the methods and results of the studies and small sample sizes limit the generalizability of the conclusions. CONCLUSIONS A qualitative synthesis suggests that the links between immune traits and functional or structural MRI alterations point toward brain areas involved in affective and somatomotor processing, with a trend toward a negative correlation between peripheral inflammatory markers and brain regions volume. We discuss how disentangling the complex relationship between the immune system and MRI alterations in BD may unveil mechanisms underlying symptoms pathophysiology, potentially with quickly translatable diagnostic, prognostic, and therapeutic implications.
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Affiliation(s)
- Luigi F Saccaro
- Psychiatry Department, Faculty of Medicine, University of Geneva, Switzerland; Psychiatry Department, Geneva University Hospital, Switzerland.
| | - Jasper Crokaert
- Psychiatry Department, Faculty of Medicine, University of Geneva, Switzerland; Child and Adolescence Psychiatry Division, Geneva University Hospital, Switzerland
| | - Nader Perroud
- Psychiatry Department, Faculty of Medicine, University of Geneva, Switzerland; Psychiatry Department, Geneva University Hospital, Switzerland
| | - Camille Piguet
- Psychiatry Department, Faculty of Medicine, University of Geneva, Switzerland; Psychiatry Department, Geneva University Hospital, Switzerland; Child and Adolescence Psychiatry Division, Geneva University Hospital, Switzerland
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29
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Yasin S, Othmani A, Raza I, Hussain SA. Machine learning based approaches for clinical and non-clinical depression recognition and depression relapse prediction using audiovisual and EEG modalities: A comprehensive review. Comput Biol Med 2023; 159:106741. [PMID: 37105109 DOI: 10.1016/j.compbiomed.2023.106741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 02/25/2023] [Accepted: 03/02/2023] [Indexed: 03/07/2023]
Abstract
Mental disorders are rapidly increasing each year and have become a major challenge affecting the social and financial well-being of individuals. There is a need for phenotypic characterization of psychiatric disorders with biomarkers to provide a rich signature for Major Depressive Disorder, improving the understanding of the pathophysiological mechanisms underlying these mental disorders. This comprehensive review focuses on depression and relapse detection modalities such as self-questionnaires, audiovisuals, and EEG, highlighting noteworthy publications in the last ten years. The article concentrates on the literature that adopts machine learning by audiovisual and EEG signals. It also outlines preprocessing, feature extraction, and public datasets for depression detection. The review concludes with recommendations that will help improve the reliability of developed models and the determinism of computational intelligence-based systems in psychiatry. To the best of our knowledge, this survey is the first comprehensive review on depression and relapse prediction by self-questionnaires, audiovisual, and EEG-based approaches. The findings of this review will serve as a useful and structured starting point for researchers studying clinical and non-clinical depression recognition and relapse through machine learning-based approaches.
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Affiliation(s)
- Sana Yasin
- Department of Computer Science, COMSATS University Islamabad, Lahore Campus Lahore, Pakistan; Department of Computer Science, University of Okara, Okara, Pakistan.
| | - Alice Othmani
- Université Paris-Est Créteil (UPEC), LISSI, Vitry sur Seine, 94400, France.
| | - Imran Raza
- Department of Computer Science, COMSATS University Islamabad, Lahore Campus Lahore, Pakistan.
| | - Syed Asad Hussain
- Department of Computer Science, COMSATS University Islamabad, Lahore Campus Lahore, Pakistan.
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30
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McIntyre RS, Bloudek L, Timmons JY, Gillard P, Harrington A. Total healthcare cost savings through improved bipolar I disorder identification using the Rapid Mood Screener in patients diagnosed with major depressive disorder. Curr Med Res Opin 2023; 39:605-611. [PMID: 36776128 DOI: 10.1080/03007995.2023.2177413] [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: 02/14/2023]
Abstract
INTRODUCTION Misdiagnosis of bipolar I disorder (BP-I) as major depressive disorder (MDD) leads to increased healthcare resource utilization and costs. The cost-effectiveness of the Rapid Mood Screener (RMS), a tool to identify BP-I in patients with depressive symptoms, was assessed in patients diagnosed with MDD presenting with depressive episodes. METHODS A decision-tree model of a hypothetical cohort of 1000 patients in a US health plan was used to estimate the number of correct diagnoses and overall total, direct healthcare costs over a 3-year timeframe for RMS-screened versus unscreened patients. Model inputs included the prevalence of BP-I in patients diagnosed with MDD, RMS sensitivity/specificity, and the cost of misdiagnosing BP-I as MDD. RESULTS Screening with the RMS resulted in 171, 159, and 143 additional correct BP-I or MDD diagnoses at Years 1, 2, and 3, respectively. Total healthcare plan cost savings were $1279 per patient in Year 1. Cumulative cost savings per patient for RMS screening versus no RMS screening were $2307 over 2 years and $3011 over 3 years. Scenario analyses showed that the RMS would remain cost-saving assuming a lower prevalence of BP-I (20% or 10%) versus the base case (24.3%). CONCLUSION The RMS is a cost-effective tool to identify BP-I in patients who would otherwise be misdiagnosed with MDD. Screening with the RMS resulted in cost-savings over 3 years, with model results remaining robust even with lower prevalence of BP-I and reduced RMS sensitivity assumptions.
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Affiliation(s)
- Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, Canada
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31
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Zhang L, Li Q, Du Y, Gao Y, Bai T, Ji GJ, Tian Y, Wang K. Effect of high-definition transcranial direct current stimulation on improving depression and modulating functional activity in emotion-related cortical-subcortical regions in bipolar depression. J Affect Disord 2023; 323:570-580. [PMID: 36503046 DOI: 10.1016/j.jad.2022.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/09/2022] [Accepted: 12/03/2022] [Indexed: 12/13/2022]
Abstract
Preliminary studies have suggested that transcranial direct current stimulation (tDCS) is effective for bipolar depression, However, brain correlates of the depression alleviating are unclear. To determine the efficacy and safety of tDCS as an add-on treatment for patients with bipolar depression and further to identify the effect of tDCS on the resting-state brain activities, we recruited fifty patients with bipolar depression to complete the double-blind, sham-controlled and randomized clinical trial. Fourteen sessions of tDCS were performed once a day for 14 days. The anode was placed over F3 with return electrodes placed at FP1, FZ, C3 and F7. Regional homogeneity (ReHo) was examined on 50 patients with bipolar depression before and after 14-day active or sham tDCS. Patients in the active group showed significantly superior alleviating the depression symptoms compared with those receiving sham. The active group after 14-day active tDCS showed increased ReHo values in the orbitofrontal cortex and middle frontal gyrus and decreased ReHo values in subcortical structures including hippocampus, parahippocampa gyrus, amygdala, putamen and lentiform nucleus. The reduction of depression severity showed positive correlation of increased ReHo values in the orbitofrontal cortex and middle frontal gyrus and negative correlation of altered ReHo values in the putamen and lentiform. TDCS was an effective and safe add-on intervention for this small bipolar depression sample. The reduction of depression induced by tDCS is associated with a modulation of neural synchronization in the cortical and subcortical structures (ReHo values) within an emotion-related brain network.
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Affiliation(s)
- Li Zhang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, Anhui Province, China; Anhui Mental Health Center, Hefei, Anhui Province, China; Brain Disorders and Neuromodulation Research Centre, Anhui Mental Health Center, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China
| | - Qun Li
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, Anhui Province, China; Anhui Mental Health Center, Hefei, Anhui Province, China; Brain Disorders and Neuromodulation Research Centre, Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Yuan Du
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, Anhui Province, China; Anhui Mental Health Center, Hefei, Anhui Province, China; Brain Disorders and Neuromodulation Research Centre, Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Yue Gao
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, Anhui Province, China; Anhui Mental Health Center, Hefei, Anhui Province, China; Brain Disorders and Neuromodulation Research Centre, Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Tongjian Bai
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China
| | - Gong-Jun Ji
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China; Department of Medical Psychology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Yanghua Tian
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China; Department of Neurology, First Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui Province, China.
| | - Kai Wang
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China; Department of Medical Psychology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Department of Neurology, First Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui Province, China.
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Gómez-Carrillo A, Paquin V, Dumas G, Kirmayer LJ. Restoring the missing person to personalized medicine and precision psychiatry. Front Neurosci 2023; 17:1041433. [PMID: 36845417 PMCID: PMC9947537 DOI: 10.3389/fnins.2023.1041433] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/09/2023] [Indexed: 02/11/2023] Open
Abstract
Precision psychiatry has emerged as part of the shift to personalized medicine and builds on frameworks such as the U.S. National Institute of Mental Health Research Domain Criteria (RDoC), multilevel biological "omics" data and, most recently, computational psychiatry. The shift is prompted by the realization that a one-size-fits all approach is inadequate to guide clinical care because people differ in ways that are not captured by broad diagnostic categories. One of the first steps in developing this personalized approach to treatment was the use of genetic markers to guide pharmacotherapeutics based on predictions of pharmacological response or non-response, and the potential risk of adverse drug reactions. Advances in technology have made a greater degree of specificity or precision potentially more attainable. To date, however, the search for precision has largely focused on biological parameters. Psychiatric disorders involve multi-level dynamics that require measures of phenomenological, psychological, behavioral, social structural, and cultural dimensions. This points to the need to develop more fine-grained analyses of experience, self-construal, illness narratives, interpersonal interactional dynamics, and social contexts and determinants of health. In this paper, we review the limitations of precision psychiatry arguing that it cannot reach its goal if it does not include core elements of the processes that give rise to psychopathological states, which include the agency and experience of the person. Drawing from contemporary systems biology, social epidemiology, developmental psychology, and cognitive science, we propose a cultural-ecosocial approach to integrating precision psychiatry with person-centered care.
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Affiliation(s)
- Ana Gómez-Carrillo
- Culture, Mind, and Brain Program, Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, QC, Canada
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Vincent Paquin
- Culture, Mind, and Brain Program, Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Guillaume Dumas
- Culture, Mind, and Brain Program, Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, QC, Canada
- Precision Psychiatry and Social Physiology Laboratory at the CHU Sainte-Justine Research Center, Université de Montréal, Montreal, QC, Canada
- Mila–Quebec Artificial Intelligence Institute, Montreal, QC, Canada
| | - Laurence J. Kirmayer
- Culture, Mind, and Brain Program, Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, QC, Canada
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
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Discriminating between bipolar and major depressive disorder using a machine learning approach and resting-state EEG data. Clin Neurophysiol 2023; 146:30-39. [PMID: 36525893 DOI: 10.1016/j.clinph.2022.11.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/28/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Distinguishing major depressive disorder (MDD) from bipolar disorder (BD) is a crucial clinical challenge as effective treatment is quite different for each condition. In this study electroencephalography (EEG) was explored as an objective biomarker for distinguishing MDD from BD using an efficient machine learning algorithm (MLA) trained by a relatively large and balanced dataset. METHODS A 3 step MLA was applied: (1) a multi-step preprocessing method was used to improve the quality of the EEG signal, (2) symbolic transfer entropy (STE), an effective connectivity measure, was applied to the resultant EEG and (3) the MLA used the extracted STE features to distinguish MDD (N = 71) from BD (N = 71) subjects. RESULTS 14 connectivity features were selected by the proposed algorithm. Most of the selected features were related to the frontal, parietal, and temporal lobe electrodes. The major involved regions were the Broca region in the frontal lobe and the somatosensory association cortex in the parietal lobe. These regions are near electrodes FC5 and CPz and are involved in processing language and sensory information, respectively. The resulting classifier delivered an evaluation accuracy of 88.5% and a test accuracy of 89.3%, using 80% of the data for training and evaluation and the remaining 20% for testing, respectively. CONCLUSIONS The high evaluation and test accuracies of our algorithm, derived from a large balanced training sample suggests that this method may hold significant promise as a clinical tool. SIGNIFICANCE The proposed MLA may provide an inexpensive and readily available tool that clinicians may use to enhance diagnostic accuracy and shorten time to effective treatment.
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Gamma band VMPFC-PreCG.L connection variation after the onset of negative emotional stimuli can predict mania in depressive patients. J Psychiatr Res 2023; 158:165-171. [PMID: 36586215 DOI: 10.1016/j.jpsychires.2022.12.026] [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: 03/27/2022] [Revised: 11/27/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Because of the similar clinical symptoms, it is difficult to distinguish unipolar disorder (UD) from bipolar disorder (BD) in the depressive episode using the available clinical features, especially for those who meet the diagnostic criteria of UD, however, experience the manic episode during the follow-up (tBD). METHODS Magnetoencephalography recordings during a sad expression recognition task were obtained from 81 patients (27 BD, 24 tBD, 30 UD) and 26 healthy controls (HCs). Source analysis was applied to localize 64 regions of interest in the low gamma band (30-50 Hz). Regional functional connections (FCs) were constructed respectively within three time periods (early: 0-200 ms, middle: 200-400 ms, and post: 400-600 ms). The network-based statistic method was used to explore the abnormal connection patterns in tBD compared to UD and HC. BD was applied to explore whether such abnormality is still significant between every two groups of BD, tBD, UD, and HC. RESULTS The VMPFC-PreCG.L connection was found to be a significantly different connection between tBD and UD in the early time period and between tBD and BD in the middle time period. Furthermore, the middle/early time period ratio of FC value of VMPFC-PreCG.L connection was negatively correlated with the bipolarity index in tBD. CONCLUSIONS The VMPFC-PreCG.L connection in different time periods after the onset of sad facial stimuli may be a potential biomarker to distinguish the different states of BD. The FC ratio of VMPFC-PreCG.L connection may predict whether patients with depressive episodes subsequently develop mania.
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Liu Z, Yuan X, Li Y, Shangguan Z, Zhou L, Hu B. PRA-Net: Part-and-Relation Attention Network for depression recognition from facial expression. Comput Biol Med 2023; 157:106589. [PMID: 36934531 DOI: 10.1016/j.compbiomed.2023.106589] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/04/2023] [Accepted: 01/22/2023] [Indexed: 01/25/2023]
Abstract
Artificial intelligence methods are widely applied to depression recognition and provide an objective solution. Many effective automated methods for detecting depression use facial expressions, which are strong indicators to reflect psychiatric disorders. However, these methods suffer from insufficient representations of depression. To this end, we propose a novel Part-and-Relation Attention Network (PRA-Net), which can enhance depression representations by accurately focusing on features that are highly correlated with depression. Specifically, we first perform partition on the feature map instead of the original image, in order to obtain part features rich in semantic information. Afterwards, self-attention is used to calculate the weight of each part feature. Following, the relationship between the part feature and the global content representation is explored by relation attention to refine the weight. Finally, all features are aggregated into a more compact and depression-informative representation via both weights for depression score prediction. Extensive experiments demonstrate the superiority of our method. Compared to other end-to-end methods, our method achieves state-of-the-art performance on AVEC2013 and AVEC2014.
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Affiliation(s)
- Zhenyu Liu
- Gansu Provincial Key Laboratory of Wearable Computing School of Information Science and Engineering Lanzhou University, Lanzhou, China.
| | - Xiaoyan Yuan
- Gansu Provincial Key Laboratory of Wearable Computing School of Information Science and Engineering Lanzhou University, Lanzhou, China.
| | - Yutong Li
- Gansu Provincial Key Laboratory of Wearable Computing School of Information Science and Engineering Lanzhou University, Lanzhou, China.
| | - Zixuan Shangguan
- Gansu Provincial Key Laboratory of Wearable Computing School of Information Science and Engineering Lanzhou University, Lanzhou, China.
| | - Li Zhou
- Gansu Provincial Key Laboratory of Wearable Computing School of Information Science and Engineering Lanzhou University, Lanzhou, China.
| | - Bin Hu
- Gansu Provincial Key Laboratory of Wearable Computing School of Information Science and Engineering Lanzhou University, Lanzhou, China.
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Kong L, Li H, Lin F, Zheng W, Zhang H, Wu R. Neurochemical and microstructural alterations in bipolar and depressive disorders: A multimodal magnetic resonance imaging study. Front Neurol 2023; 14:1089067. [PMID: 36937532 PMCID: PMC10014904 DOI: 10.3389/fneur.2023.1089067] [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: 11/07/2022] [Accepted: 02/09/2023] [Indexed: 03/05/2023] Open
Abstract
AIMS Depression in bipolar disorder (BD) is often misdiagnosed as unipolar depression (UD), leading to mistreatments and poor clinical outcomes in many bipolar patients. Herein, we report direct comparisons between medication-free patients with BD and those with UD in terms of the microstructure and neurometabolites in eight brain regions. METHODS A total of 20 patients with BD, 30 with UD patients, and 20 matched healthy controls (HCs) underwent 3.0T magnetic resonance imaging with chemical exchange saturation transfer (CEST) for glutamate (Glu; GluCEST) imaging, multivoxel magnetic resonance spectroscopy, and diffusion kurtosis imaging. RESULTS Compared with HCs, patients with UD showed significantly lower levels of multiple metabolites, GluCEST% values, and diffusional kurtosis [mean kurtosis (MK)] values in most brain regions. In contrast, patients with BD presented significantly higher levels of Glu in their bilateral ventral prefrontal white matter (VPFWM), higher choline (Cho)-containing compounds in their left VPFWM and anterior cingulate cortex (ACC), and higher GluCEST% values in their bilateral VPFWM and ACC; moreover, reduced MK in these patients was more prominent in the left VPFWM and left thalamus. CONCLUSION The findings demonstrated that both patients with UD and BD have abnormal microstructure and metabolic alterations, and the changes are not completely consistent in the prefrontal lobe region. Elevated Glu, Cho, and GluCEST% in the ACC and VPFWM of patients with UD and BD may help in differentiating between these two disorders. Our findings support the significance for the microstructural integrity and brain metabolic changes of the prefrontal lobe region in BD and UD.
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Affiliation(s)
- Lingmei Kong
- Department of Medical Imaging, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Hui Li
- Department of Psychiatry, Shantou University Mental Health Center, Shantou, China
| | - Fengfeng Lin
- Department of Medical Imaging, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Wenbin Zheng
- Department of Medical Imaging, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Haidu Zhang
- Department of Medical Imaging, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Renhua Wu
- Department of Medical Imaging, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
- *Correspondence: Renhua Wu
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Supti KF, Asaduzzaman M, Suhee FI, Shahriar M, Islam SMA, Bhuiyan MA, Qusar MMAS, Islam MR. Elevated Serum Macrophage Migration Inhibitory Factor Levels are Associated With Major Depressive Disorder. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2023; 16:2632010X231220841. [PMID: 38144435 PMCID: PMC10748934 DOI: 10.1177/2632010x231220841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/27/2023] [Indexed: 12/26/2023]
Abstract
Background Previous studies have suggested the involvement of an activated inflammatory process in major depressive disorder (MDD), as altered expression of inflammatory cytokines is observed in depression. This alteration can be the cause or a consequence of MDD. However, acknowledging inflammatory cytokines as prospective biomarkers would aid in diagnosing or guiding better therapeutic options. Therefore, we designed this study to assess the macrophage migration inhibitory factor (MIF) in depression. Method We collected blood samples from 115 MDD patients and 113 healthy controls (HCs) matched by age and sex. MDD patients were diagnosed by a qualified psychiatrist based on the symptoms mentioned in the diagnostic and statistical manual of mental disorders (DSM-5). We applied the Hamilton depression (Ham-D) rating scale to assess the severity of depression. We assessed serum levels of MIF using ELISA kit (Boster Bio, USA). Result We detected increased serum MIF levels in MDD patients compared to HCs (6.15 ± 0.23 ng/mL vs 3.95 ± 0.21 ng/mL, P < 0.001). Moreover, this increase is more among female patients than female controls. Also, we noticed a positive correlation between altered MIF levels and the Ham-D scores (r = 0.233; P = 0.012), where we found that patients who scored higher on the Ham-D scale had higher MIF levels in serum. Moreover, the area under the curve (AUC) of receiver operating characteristic (ROC) curve represented the good diagnostic performance of altered serum MIF. Conclusion Our study findings indicate the association of pro-inflammatory cytokine MIF in the pathophysiology of depression as we identified elevated serum MIF levels in depressive patients compared to HCs. However, more researches are required to confirm whether this alteration of cytokine is the causative factor or a consequence of depression. We recommend conducting further studies to understand the pattern of this alteration of MIF levels in MDD patients.
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Affiliation(s)
| | - Md. Asaduzzaman
- Department of Pharmacy, University of Asia Pacific, Dhaka, Bangladesh
| | | | - Mohammad Shahriar
- Department of Pharmacy, University of Asia Pacific, Dhaka, Bangladesh
| | | | | | - MMA Shalahuddin Qusar
- Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Ramna, Dhaka, Bangladesh
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Xiong Y, Ye C, Sun R, Chen Y, Zhong X, Zhang J, Zhong Z, Chen H, Huang M. Disrupted Balance of Gray Matter Volume and Directed Functional Connectivity in Mild Cognitive Impairment and Alzheimer's Disease. Curr Alzheimer Res 2023; 20:161-174. [PMID: 37278043 PMCID: PMC10514512 DOI: 10.2174/1567205020666230602144659] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/11/2023] [Accepted: 04/04/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Alterations in functional connectivity have been demonstrated in Alzheimer's disease (AD), an age-progressive neurodegenerative disorder that affects cognitive function; however, directional information flow has never been analyzed. OBJECTIVE This study aimed to determine changes in resting-state directional functional connectivity measured using a novel approach, granger causality density (GCD), in patients with AD, and mild cognitive impairment (MCI) and explore novel neuroimaging biomarkers for cognitive decline detection. METHODS In this study, structural MRI, resting-state functional magnetic resonance imaging, and neuropsychological data of 48 Alzheimer's Disease Neuroimaging Initiative participants were analyzed, comprising 16 patients with AD, 16 with MCI, and 16 normal controls. Volume-based morphometry (VBM) and GCD were used to calculate the voxel-based gray matter (GM) volumes and directed functional connectivity of the brain. We made full use of voxel-based between-group comparisons of VBM and GCD values to identify specific regions with significant alterations. In addition, Pearson's correlation analysis was conducted between directed functional connectivity and several clinical variables. Furthermore, receiver operating characteristic (ROC) analysis related to classification was performed in combination with VBM and GCD. RESULTS In patients with cognitive decline, abnormal VBM and GCD (involving inflow and outflow of GCD) were noted in default mode network (DMN)-related areas and the cerebellum. GCD in the DMN midline core system, hippocampus, and cerebellum was closely correlated with the Mini- Mental State Examination and Functional Activities Questionnaire scores. In the ROC analysis combining VBM with GCD, the neuroimaging biomarker in the cerebellum was optimal for the early detection of MCI, whereas the precuneus was the best in predicting cognitive decline progression and AD diagnosis. CONCLUSION Changes in GM volume and directed functional connectivity may reflect the mechanism of cognitive decline. This discovery could improve our understanding of the pathology of AD and MCI and provide available neuroimaging markers for the early detection, progression, and diagnosis of AD and MCI.
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Affiliation(s)
- Yu Xiong
- Department of Neurology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518107, China
| | - Chenghui Ye
- Department of Neurology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518107, China
| | - Ruxin Sun
- Department of Neurology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518107, China
| | - Ying Chen
- Department of Neurology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518107, China
| | - Xiaochun Zhong
- Department of Neurology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518107, China
| | - Jiaqi Zhang
- Department of Neurology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518107, China
| | - Zhanhua Zhong
- Department of Neurology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518107, China
| | - Hongda Chen
- Department of Traditional Chinese Medicine, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518107, China
| | - Min Huang
- Department of Neurology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518107, China
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Goldman DA, Sankar A, Rich A, Kim JA, Pittman B, Constable RT, Scheinost D, Blumberg HP. A graph theory neuroimaging approach to distinguish the depression of bipolar disorder from major depressive disorder in adolescents and young adults. J Affect Disord 2022; 319:15-26. [PMID: 36103935 PMCID: PMC9669784 DOI: 10.1016/j.jad.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/03/2022] [Accepted: 09/09/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Markers to differentiate depressions of bipolar disorder (BD-Dep) from depressions of major depressive disorder (MDD-Dep), and for more targeted treatments, are critically needed to decrease current high rates of misdiagnosis that can lead to ineffective or potentially deleterious treatments. Distinguishing, and specifically treating the depressions, during the adolescent/young adult epoch is especially important to decrease illness progression and improve prognosis, and suicide, as it is the epoch when suicide thoughts and behaviors often emerge. With differences in functional connectivity patterns reported when BD-Dep and MDD-Dep have been studied separately, this study used a graph theory approach aimed to identify functional connectivity differences in their direct comparison. METHODS Functional magnetic resonance imaging whole-brain functional connectivity (Intrinsic Connectivity Distribution, ICD) measures were compared across adolescents/young adults with BD-Dep (n = 28), MDD-Dep (n = 20) and HC (n = 111). Follow-up seed-based connectivity was conducted on regions of significant ICD differences. Relationships with demographic and clinical measures were assessed. RESULTS Compared to the HC group, both the BD-Dep and MDD-Dep groups exhibited left-sided frontal, insular, and medial temporal ICD increases. The BD-Dep group had additional right-sided ICD increases in frontal, basal ganglia, and fusiform areas. In seed-based analyses, the BD-Dep group exhibited increased interhemispheric functional connectivity between frontal areas not seen in the MDD-Dep group. LIMITATIONS Modest sample size; medications not studied systematically. CONCLUSIONS This study supports bilateral and interhemispheric functional dysconnectivity as features of BD-Dep that may differentiate it from MDD-Dep in adolescents/young adults and serve as a target for early diagnosis and treatment strategies.
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Affiliation(s)
- Danielle A Goldman
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06511, United States of America; Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - Anjali Sankar
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, United States of America; Department of Neurology and Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Alexandra Rich
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - Jihoon A Kim
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - R Todd Constable
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06511, United States of America
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, United States of America; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06511, United States of America; Child Study Center, Yale School of Medicine, New Haven, CT 06511, United States of America.
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Zhou J, Jiang X, Zhou Y, Zhu Y, Jia L, Sun T, Liu L, Sun Q, Ren L, Guo Y, Wu F, Kong L, Tang Y. Distinguishing major depressive disorder from bipolar disorder in remission: A brain structural network analysis. J Affect Disord 2022; 319:8-14. [PMID: 36058360 DOI: 10.1016/j.jad.2022.08.102] [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: 12/18/2021] [Revised: 05/18/2022] [Accepted: 08/26/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND It is challenging to differentiate major depressive disorder (MDD) from bipolar disorder (BD) in depression and remission. To exclude the potential influence of depressive episodes, we compared the white matter (WM) network between MDD and BD patients in remission to find disease-specific alterations in MDD and BD, and then distinguish these two affective disorders. METHODS We recruited 33 patients with remitted MDD (rMDD), 54 patients with remitted BD (rBD), and 60 healthy controls (HCs). Diffusion tensor imaging and high-resolution 3D T1-weighted image were acquired. Global and nodal topological parameters were used to depict the alterations of the whole-brain WM network. RESULTS We found that rMDD displayed increased global network efficiency (Eglob) and local network efficiency (Eloc) compared with HCs, whereas we found no significance between rBD and HCs. Compared with rBD and HCs, patients in the rMDD group showed increased nodal degree and nodal efficiency, and decreased nodal shortest path length in the four cerebral regions, including the right calcarine fissure (CAL.R), right cuneus (CUN.R), left lingual gyrus (LING.L), and left middle occipital gyrus (MOG.L). We did not find any rBD specific changes of nodal topological metrics. LIMITATIONS The main limitation is the possible effects of medication and BD subtypes on the results. CONCLUSIONS Our findings indicate that rMDD exhibited elevated global properties compared with HCs group, and increased nodal properties in the CAL.R, CUN.R, LING.L, and MOG.L specifically compared with rBD and HCs, which may underlie the distinction of the two affective disorders in remission.
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Affiliation(s)
- Jian Zhou
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China; Brain Function Research Section, The First Hospital of China Medical University, Shenyang, China
| | - Xiaowei Jiang
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China; Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Yifang Zhou
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China; Brain Function Research Section, The First Hospital of China Medical University, Shenyang, China
| | - Yue Zhu
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China; Brain Function Research Section, The First Hospital of China Medical University, Shenyang, China
| | - Linna Jia
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China; Brain Function Research Section, The First Hospital of China Medical University, Shenyang, China
| | - Ting Sun
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China; Brain Function Research Section, The First Hospital of China Medical University, Shenyang, China
| | - Linzi Liu
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China; Brain Function Research Section, The First Hospital of China Medical University, Shenyang, China
| | - Qikun Sun
- Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, China
| | - Luyu Ren
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China; Brain Function Research Section, The First Hospital of China Medical University, Shenyang, China
| | - Yanan Guo
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China; Brain Function Research Section, The First Hospital of China Medical University, Shenyang, China
| | - Feng Wu
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China; Brain Function Research Section, The First Hospital of China Medical University, Shenyang, China
| | - Lingtao Kong
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China; Brain Function Research Section, The First Hospital of China Medical University, Shenyang, China
| | - Yanqing Tang
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China; Department of Geriatric Medicine, The First Hospital of China Medical University, Shenyang, China.
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Zou W, Song P, Lu W, Shao R, Zhang R, Yau SY, Yuan TF, Wang Y, Lin K. Global hippocampus functional connectivity as a predictive neural marker for conversion to future mood disorder in unaffected offspring of bipolar disorder parents. Asian J Psychiatr 2022; 78:103307. [PMID: 36332319 DOI: 10.1016/j.ajp.2022.103307] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 09/06/2022] [Accepted: 09/17/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Hippocampus-related functional alteration in genetically at-risk individuals may reflect an endophenotype of a mood disorder. Herein, we performed a prospective study to investigate whether baseline hippocampus functional connectivity (FC) in offspring of patients with bipolar disorder (BD) would predict subsequent conversion to mood disorder. METHODS Eighty bipolar offspring and 40 matched normal controls (NC) underwent resting state functional MRI (rsfMRI) scanning on a 3.0 Tesla MR scanner. The offspring were subdivided into asymptomatic offspring (AO) (n = 41) and symptomatic offspring (SO) (n = 39) according to whether they manifested subthreshold mood symptoms. After identifying the different hippocampus FCs between the AO and SO, a logistic regression analysis was conducted to investigate whether the baseline hippocampus FCs predicted a future mood disorder during a 6-year follow-up. RESULTS We identified seven baseline para/hippocampus FCs that showed differences between AO and SO, which were entered as predictive features in the logistic regressive model. Of the 80 bipolar offspring entering the analysis, the FCs between left hippocampus and left precuneus, and between right hippocampus and left posterior cingulate, showed a discriminative capacity for predicting future mood disorder (area-under-curve, or AUC=75.76 % and 75.00 % respectively), and for predicting BD onset (AUC=77.46 % and 81.63 %, respectively). CONCLUSIONS The present findings revealed high predictive utility of the hippocampus resting state FCs for future mood disorder and BD onset in individuals at familial risk. These neural markers can potentially improve early detection of individuals carrying particularly high risk for future mood disorder.
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Affiliation(s)
- Wenjin Zou
- Department of Radiology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Peilun Song
- School of Information Engineering, Zhengzhou University, Zhengzhou, China
| | - Weicong Lu
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Robin Shao
- Laboratory of Neuropsychology and Laboratory of Social Cognitive Affective, Neuroscience, Department of Psychology, University of Hong Kong, Hong Kong
| | - Ruoxi Zhang
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Suk-Yu Yau
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China.
| | - Yaping Wang
- School of Information Engineering, Zhengzhou University, Zhengzhou, China.
| | - Kangguang Lin
- Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; School of Health and Life Sciences, University of Health and Rehabilitation Sciences, No. 17, Shandong Road, Shinan district, Qingdao City, Shandong Province, China.
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Delvecchio G, Gritti D, Squarcina L, Brambilla P. Neurovascular alterations in bipolar disorder: A review of perfusion weighted magnetic resonance imaging studies. J Affect Disord 2022; 316:254-272. [PMID: 35940377 DOI: 10.1016/j.jad.2022.07.059] [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: 09/13/2021] [Revised: 07/08/2022] [Accepted: 07/22/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Bipolar Disorder (BD) is a severe chronic psychiatric disorder whose aetiology is still largely unknown. However, increasing literature reported the involvement of neurovascular factors in the pathophysiology of BD, suggesting that a measure of Cerebral Blood Flow (CBF) could be an important biomarker of the illness. Therefore, since, to date, Magnetic Resonance Perfusion Weighted Imaging (PWI) techniques, such as Dynamic Susceptibility Contrast (DSC) and Arterial Spin Labelling (ASL), are the most common approaches that allow non-invasive in-vivo perfusion measurements,this review aims to summarize the results from all PWI studies that evaluated the CBF in BD. METHODS A bibliographic search in PubMed up until May 2021 was performed. 16 PWI studies that used DSC or ASL sequences met our inclusion criteria. RESULTS Overall, the results supported the presence of hyper-perfusion in the cingulate cortex and fronto-temporal regions, as well as the presence of hypo-perfusion in the cerebellum in BD, compared with both healthy controls and patients with unipolar depression. CBF changes after cognitive and aerobic training, as well as in relation with other physiological, clinical, and neurocognitive variables were also reported. LIMITATIONS The heterogeneity across the studies, in terms of experimental designs, sample selection, and methodological approach employed, limited the studies' comparison. CONCLUSIONS These findings showed CBF alterations in the cingulate cortex, fronto-temporal regions, and cerebellum in BD, suggesting that CBF may be an important pathophysiological marker of BD that merits further investigation to clarify the extent of neurovascular alterations.
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Affiliation(s)
- Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Davide Gritti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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FATOUROU E, TRUONG A, HOPPENSTEADT D, FAREED J, HAİN D, SİNACORE J, HALARİS A. Elevated Matrix Metalloproteinase 9 in Treatment Resistant Bipolar Depression. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.1123325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: Matrix metalloproteinase is a family of proteases with different pathophysiological roles. Matrix metalloproteinase 9 (MMP9) plays an enzymatic role in the restructuring of the extracellular matrix and adhesion molecules. MMP9 is upregulated in pro-inflammatory states and leads to breakdown of tight junctions thereby increasing blood-brain barrier (BBB) permeability. MMP9 may contribute to the pathophysiology of bipolar disorder (BD) via proteolysis of the BBB thus allowing entry of cytokines and neurotoxic agents into CNS. Polymorphisms of the MMP9 gene may pose increased risk for BD and schizophrenia. In this study we sought to determine MMP9 levels in treatment resistant bipolar depressed patients before and after treatment. Methods: Treatment resistant bipolar depressed patients were treated with escitalopram, in combination with the COX-2 inhibitor, celecoxib. It was hypothesized that combination treatment would reverse resistance and augmented treatment responses. This was a 10-week, randomized, double-blind, two-arm, placebo-controlled study. Results: MMP9 levels were higher in bipolar depressed patients compared to healthy controls at baseline, however, the difference did not reach significance. Levels decreased after treatment reaching significance in the escitalopram plus placebo group. Female patients had significantly lower MMP9 levels at end of treatment. MMP9 was higher in carriers the MMP9 SNP, rs3918242, than in noncarriers, but the difference did not reach statistical significance. Conclusion: MMP9 decreased in bipolar depressed patients with treatment. Age, sex and the rs3918242 polymorphism play a role in MMP9 levels. Future studies should confirm the role of MMP9 in the pathogenesis and pathophysiology of bipolar disorder, as a potential diagnostic biomarker.
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Affiliation(s)
- Evangelia FATOUROU
- Mount Sinai University, Icahn School of Medicine, Department of Psychiatry,
| | - Alexander TRUONG
- University of California, Public Health Sciences, Riverside School of Medicine
| | - Debra HOPPENSTEADT
- Loyola University, Chicago Stritch School of Medicine, Department of Pathology
| | - Jawed FAREED
- Loyola University, Chicago Stritch School of Medicine, Department of Pathology
| | | | - James SİNACORE
- University of California, Public Health Sciences, Riverside School of Medicine
| | - Angelos HALARİS
- Loyola University, Chicago Stritch School of Medicine, Department of Psychiatry, Chicago
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Working memory updating in individuals with bipolar and unipolar depression: fMRI study. Transl Psychiatry 2022; 12:441. [PMID: 36220840 PMCID: PMC9553934 DOI: 10.1038/s41398-022-02211-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 01/10/2023] Open
Abstract
Understanding neurobiological characteristics of cognitive dysfunction in distinct psychiatric disorders remains challenging. In this secondary data analysis, we examined neurobiological differences in brain response during working memory updating among individuals with bipolar disorder (BD), those with unipolar depression (UD), and healthy controls (HC). Individuals between 18-45 years of age with BD (n = 100), UD (n = 109), and HC (n = 172) were scanned using fMRI while performing 0-back (easy) and 2-back (difficult) tasks with letters as the stimuli and happy, fearful, or neutral faces as distractors. The 2(n-back) × 3(groups) × 3(distractors) ANCOVA examined reaction time (RT), accuracy, and brain activation during the task. HC showed more accurate and faster responses than individuals with BD and UD. Difficulty-related activation in the prefrontal, posterior parietal, paracingulate cortices, striatal, lateral occipital, precuneus, and thalamic regions differed among groups. Individuals with BD showed significantly lower difficulty-related activation differences in the left lateral occipital and the right paracingulate cortices than those with UD. In individuals with BD, greater difficulty-related worsening in accuracy was associated with smaller activity changes in the right precuneus, while greater difficulty-related slowing in RT was associated with smaller activity changes in the prefrontal, frontal opercular, paracingulate, posterior parietal, and lateral occipital cortices. Measures of current depression and mania did not correlate with the difficulty-related brain activation differences in either group. Our findings suggest that the alterations in the working memory circuitry may be a trait characteristic of reduced working memory capacity in mood disorders. Aberrant patterns of activation in the left lateral occipital and paracingulate cortices may be specific to BD.
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Shao J, Zhang Y, Xue L, Wang X, Wang H, Zhu R, Yao Z, Lu Q. Shared and disease-sensitive dysfunction across bipolar and unipolar disorder during depressive episodes: a transdiagnostic study. Neuropsychopharmacology 2022; 47:1922-1930. [PMID: 35177806 PMCID: PMC9485137 DOI: 10.1038/s41386-022-01290-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/21/2022] [Accepted: 01/28/2022] [Indexed: 02/05/2023]
Abstract
Patients with depressive episodes (PDE), such as unipolar disorder (UD) and bipolar disorder (BD), are often defined as distinct diagnostic categories, but increasing converging evidence indicated shared etiologies and pathophysiological characteristics across different clinical diagnoses. We explored whether these transdiagnostic deficits are caused by the common neural substrates across diseases or disease-sensitive mechanisms, or a combination of both. In this study, we utilized a Bayesian model to decompose the resting-state brain activity into multiple hyper- and hypo-activity patterns (refer to as "factors"), so as to explore the shared and disease-sensitive alteration patterns in PDE. The model was constructed over a total of 259 patients (131 UD and 128 BD) with 100 healthy controls as the reference. The other 32 initial depressive episode BD (IDE-BD) patients who had symptoms of mania or hypomania during follow-up were taken as an independent set to estimate the factor composition using the established model for further analysis. We revealed three transdiagnostic alteration factors in PDE. Based on the distribution of factors and the tendency of factor composition at the group level, these factors were defined as BD sensitive factor, UD sensitive factor and shared basic alteration factor. We further found that the factor composition and the ROIs-based alteration degree (mainly involving in orbitofrontal gyrus and part of parietal lobe) were associated with the bipolar index in IDE-BD patients. Our findings contributed to understanding the core transdiagnostic shared and disease-sensitive alterations in PDE and to predicting the risk of emotional state transition in IDE-BD patients.
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Affiliation(s)
- Junneng Shao
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China
| | - Yujie Zhang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China
| | - Li Xue
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China
| | - Xinyi Wang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China
| | - Huan Wang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China
| | - Rongxin Zhu
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, China.
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China.
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China.
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Brain structure and synaptic protein expression alterations after antidepressant treatment in a Wistar-Kyoto rat model of depression. J Affect Disord 2022; 314:293-302. [PMID: 35878834 DOI: 10.1016/j.jad.2022.07.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/20/2022] [Accepted: 07/17/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Structural MRI has demonstrated brain alterations in depression pathology and antidepressants treatment. While synaptic plasticity has been previously proposed as the potential underlying mechanism of MRI findings at a cellular and molecular scale, there is still insufficient evidence to link the MRI findings and synaptic plasticity mechanisms in depression pathology. METHODS In this study, a Wistar-Kyoto (WKY) depression rat model was treated with antidepressants (citalopram or Jie-Yu Pills) and tested in a series of behavioral tests and a 7.0 MRI scanner. We then measured dendritic spine density within altered brain regions. We also examined expression of synaptic marker proteins (PSD-95 and SYP). RESULTS WKY rats exhibited depression-like behaviors in the sucrose preference test (SPT) and forced swim test (FST), and anxiety-like behaviors in the open field test (OFT). Both antidepressants reversed behavioral changes in SPT and OFT but not in FST. We found a correlation between SPT performance and brain volumes as detected by MRI. All structural changes were consistent with alterations of the corpus callosum (white matter), dendritic spine density, as well as PSD95 and SYP expression at different levels. Two antidepressants similarly reversed these macro- and micro-changes. LIMITATIONS The single dose of antidepressants was the major limitation of this study. Further studies should focus on the white matter microstructure changes and myelin-related protein alterations, in addition to comparing the effects of ketamine. CONCLUSION Translational evidence links structural MRI changes and synaptic plasticity alterations, which promote our understanding of SPT mechanisms and antidepressant response in WKY rats.
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Zhou Y, Tang J, Sun Y, Yang WFZ, Ma Y, Wu Q, Chen S, Wang Q, Hao Y, Wang Y, Li M, Liu T, Liao Y. A brainnetome atlas-based methamphetamine dependence identification using neighborhood component analysis and machine learning on functional MRI data. Front Cell Neurosci 2022; 16:958437. [PMID: 36238830 PMCID: PMC9550874 DOI: 10.3389/fncel.2022.958437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Addiction to methamphetamine (MA) is a major public health concern. Developing a predictive model that can classify and characterize the brain-based biomarkers predicting MA addicts may directly lead to improved treatment outcomes. In the current study, we applied the support vector machine (SVM)-based classification method to resting-state functional magnetic resonance imaging (rs-fMRI) data obtained from individuals with methamphetamine use disorder (MUD) and healthy controls (HCs) to identify brain-based features predictive of MUD. Brain connectivity analyses were conducted for 36 individuals with MUD as well as 37 HCs based on the brainnetome atlas, and the neighborhood component analysis was applied for feature selection. Eighteen most relevant features were screened out and fed into the SVM to classify the data. The classifier was able to differentiate individuals with MUD from HCs with a high prediction accuracy, sensitivity, specificity, and AUC of 88.00, 86.84, 89.19, and 0.94, respectively. The top six discriminative features associated with changes in the functional activity of key nodes in the default mode network (DMN), all the remaining discriminative features are related to the thalamic connections within the cortico-striato-thalamo-cortical (CSTC) loop. In addition, the functional connectivity (FC) between the bilateral inferior parietal lobule (IPL) and right cingulate gyrus (CG) was significantly correlated with the duration of methamphetamine use. The results of this study not only indicated that MUD-related FC alterations were predictive of group membership, but also suggested that machine learning techniques could be used for the identification of MUD-related imaging biomarkers.
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Affiliation(s)
- Yanan Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Psychiatry, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province), Changsha, China
| | - Jingsong Tang
- Department of Psychiatry, School of Medicine, Sir Run-Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Yunkai Sun
- Department of Psychiatry, School of Medicine, Sir Run-Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Winson Fu Zun Yang
- Department of Psychological Sciences, College of Arts and Sciences, Texas Tech University, Lubbock, TX, United States
| | - Yuejiao Ma
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qiuxia Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shubao Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qianjin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yuzhu Hao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yunfei Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Manyun Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tieqiao Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Tieqiao Liu
| | - Yanhui Liao
- Department of Psychiatry, School of Medicine, Sir Run-Run Shaw Hospital, Zhejiang University, Hangzhou, China
- Yanhui Liao
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Yamaoka K, Uotsu N, Hoshino E. Relationship between psychosocial stress-induced prefrontal cortex activity and gut microbiota in healthy Participants-A functional near-infrared spectroscopy study. Neurobiol Stress 2022; 20:100479. [PMID: 36039149 PMCID: PMC9418982 DOI: 10.1016/j.ynstr.2022.100479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/14/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022] Open
Abstract
Brain and gut microbes communicate in a bidirectional manner with each affecting a person's response to psychosocial stress. Although human studies demonstrated that the intake of probiotics can alter stress-related behavior in both patients and healthy participants, the association between stress-related brain functions and the gut microbiota has mostly been investigated in patients with depression. However, the response to psychosocial stress differs, even among healthy individuals, and elucidating the natural state of the gut microbiota would broaden the understanding of responses to psychosocial stress. We investigated the relationship between psychosocial stress response in the prefrontal cortex and the abundance of gut microbes in healthy male participants. The participants were exposed to psychosocial stress during a task while brain activation data were recorded using functional near-infrared spectroscopy. The heart rate and subjective stress were recorded, and fecal samples were collected. The stressful condition was accompanied by high subjective stress, high heart rate, and higher prefrontal activation in the right pre-motor cortex/supplementary motor area, right dorsolateral prefrontal cortex, right frontal pole, and right inferior prefrontal gyrus. The psychosocial stress response in the prefrontal cortex was also associated with changes in the gut microbiota abundance. The abundance of Alistipes, Clostridium IV, Clostridium XI, Faecalibacterium, and Blautia in healthy participants who had high psychosocial stress resembled that noted in patients with depression. These results suggest that the gut microbiota differs, among healthy participants, depending on the psychosocial stress response. We believe that this study is the first to report a direct relationship between brain function and the gut microbiota in healthy participants, and our findings would shed a new light on this field in the near future. Brain and gut microbe communication affects the response to psychosocial stress. Gut microbiota related to psychosocial stress in healthy individuals is unknown. Stress-induced brain activation was observed in the right prefrontal cortex. Brain activity was associated with gut microbiota related to depression. Gut microbiota differs depending on the response to psychosocial stress.
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Key Words
- ANOVA, Analysis of variance
- BD, Bipolar disorder
- BMI, Body mass index
- CH, Channel
- CRH, Corticotropin-releasing hormone
- DNA, Deoxynucleic acid
- Depression
- FP, Frontal pole
- Functional near-infrared spectroscopy
- GABA, Gamma Amino Butyric Acid
- Gut microbiome
- HPA-axis, Hypothalamic-pituitary-adrenal axis
- IFG, Inferior prefrontal gyrus
- MDD, Major depressive disorder
- MIST, Montreal Imaging Stress Task
- PANAS, Positive and Negative Affect Schedule
- PET, Positron emission tomography
- PFC, Prefrontal cortex
- PMC/SMA, Pre-motor cortex/supplementary motor area
- POMS2, Profile of Mood States 2 short version
- Prefrontal cortex
- Psychosocial stress
- SSES, State Self-Esteem Scale
- STAI, State-Trait Anxiety Inventory
- VAS, Visual analog scale
- bpm, Beat per minute
- deoxy-Hb, Deoxygenated hemoglobin
- dlPFC, Dorsolateral prefrontal cortex
- fMRI, Functional magnetic resonance imaging
- fNIRS, Functional near-infrared spectroscopy
- oxy-Hb, Oxygenated hemoglobin
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Affiliation(s)
- Kao Yamaoka
- FANCL Corporation Research Institute, 12-13 Kamishinano, Totsuka-ku, Yokohama, Kanagawa, 244-0806, Japan
| | - Nobuo Uotsu
- FANCL Corporation Research Institute, 12-13 Kamishinano, Totsuka-ku, Yokohama, Kanagawa, 244-0806, Japan
| | - Eiichi Hoshino
- Keio University Global Research Institute (KGRI), 2-15-45 Mita, Minato-ku, Tokyo, 108-8345, Japan
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Fischer AS, Holt-Gosselin B, Hagan KE, Fleming SL, Nimarko AF, Gotlib IH, Singh MK. Intrinsic Connectivity and Family Dynamics: Striatolimbic Markers of Risk and Resilience in Youth at Familial Risk for Mood Disorders. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:855-866. [PMID: 35272095 PMCID: PMC9452604 DOI: 10.1016/j.bpsc.2022.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 02/04/2022] [Accepted: 02/22/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Few studies to date have characterized functional connectivity (FC) within emotion and reward networks in relation to family dynamics in youth at high familial risk for bipolar disorder (HR-BD) and major depressive disorder (HR-MDD) relative to low-risk youth (LR). Such characterization may advance our understanding of the neural underpinnings of mood disorders and lead to more effective interventions. METHODS A total of 139 youth (43 HR-BD, 46 HR-MDD, and 50 LR) aged 12.9 ± 2.7 years were longitudinally followed for 4.5 ± 2.4 years. We characterized differences in striatolimbic FC that distinguished between HR-BD, HR-MDD, and LR and between resilience and conversion to psychopathology. We then examined whether risk status moderated FC-family dynamic associations. Finally, we examined whether baseline between-group FC differences predicted resilence versus conversion to psychopathology. RESULTS HR-BD had greater amygdala-middle frontal gyrus and dorsal striatum-middle frontal gyrus FC relative to HR-MDD and LR, and HR-MDD had lower amygdala-fusiform gyrus and dorsal striatum-precentral gyrus FC relative to HR-BD and LR (voxel-level p < .001, cluster-level false discovery rate-corrected p < .05). Resilient youth had greater amygdala-orbitofrontal cortex and ventral striatum-dorsal anterior cingulate cortex FC relative to youth with conversion to psychopathology (voxel-level p < .001, cluster-level false discovery rate-corrected p < .05). Greater family rigidity was inversely associated with amygdala-fusiform gyrus FC across all groups (false discovery rate-corrected p = .017), with a moderating effect of bipolar risk status (HR-BD vs. HR-MDD p < .001; HR-BD vs. LR p = .005). Baseline FC differences did not predict resilence versus conversion to psychopathology. CONCLUSIONS Findings represent neural signatures of risk and resilience in emotion and reward processing networks in youth at familial risk for mood disorders that may be targets for novel interventions tailored to the family context.
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Affiliation(s)
- Adina S Fischer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
| | | | - Kelsey E Hagan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Scott L Fleming
- Department of Biomedical Data Science, Stanford University, Stanford, California
| | - Akua F Nimarko
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, California
| | - Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
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50
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Siegel-Ramsay JE, Bertocci MA, Wu B, Phillips ML, Strakowski SM, Almeida JRC. Distinguishing between depression in bipolar disorder and unipolar depression using magnetic resonance imaging: a systematic review. Bipolar Disord 2022; 24:474-498. [PMID: 35060259 DOI: 10.1111/bdi.13176] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Magnetic resonance imaging (MRI) studies comparing bipolar and unipolar depression characterize pathophysiological differences between these conditions. However, it is difficult to interpret the current literature due to differences in MRI modalities, analysis methods, and study designs. METHODS We conducted a systematic review of publications using MRI to compare individuals with bipolar and unipolar depression. We grouped studies according to MRI modality and task design. Within the discussion, we critically evaluated and summarized the functional MRI research and then further complemented these findings by reviewing the structural MRI literature. RESULTS We identified 88 MRI publications comparing participants with bipolar depression and unipolar depressive disorder. Compared to individuals with unipolar depression, participants with bipolar disorder exhibited heightened function, increased within network connectivity, and reduced grey matter volume in salience and central executive network brain regions. Group differences in default mode network function were less consistent but more closely associated with depressive symptoms in participants with unipolar depression but distractibility in bipolar depression. CONCLUSIONS When comparing mood disorder groups, the neuroimaging evidence suggests that individuals with bipolar disorder are more influenced by emotional and sensory processing when responding to their environment. In contrast, depressive symptoms and neurofunctional response to emotional stimuli were more closely associated with reduced central executive function and less adaptive cognitive control of emotionally oriented brain regions in unipolar depression. Researchers now need to replicate and refine network-level trends in these heterogeneous mood disorders and further characterize MRI markers associated with early disease onset, progression, and recovery.
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Affiliation(s)
- Jennifer E Siegel-Ramsay
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Michele A Bertocci
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Bryan Wu
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Stephen M Strakowski
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Jorge R C Almeida
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
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