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Wang X, Zhou H, Yan CQ, Shi GX, Zhou P, Huo JW, Yang JW, Zhang YN, Wang L, Cao Y, Liu CZ. Cognitive and Hippocampal Changes in Older Adults With Subjective Cognitive Decline After Acupuncture Intervention. Am J Geriatr Psychiatry 2024; 32:1014-1027. [PMID: 38521736 DOI: 10.1016/j.jagp.2024.03.001] [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: 01/21/2024] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE Converging evidence indicates that subjective cognitive decline (SCD) could be an early indicator of dementia. The hippocampus is the earliest affected region during the progression of cognitive impairment. However, little is known about whether and how acupuncture change the hippocampal structure and function of SCD individuals. METHODS Here, we used multi-modal MRI to reveal the mechanism of acupuncture in treating SCD. Seventy-two older participants were randomized into acupuncture or sham acupuncture group and treated for 12 weeks. RESULTS At the end of the intervention, compared to sham acupuncture, participants with acupuncture treatment showed improvement in composite Z score from multi-domain neuropsychological tests, as well as increased hippocampal volume and functional connectivity. Moreover, the greater white matter integrity of the fornix, which is the major output tract of the hippocampus, was shown in the acupuncture group. CONCLUSION These findings suggest that acupuncture may improve the cognitive function of SCD individuals, and increase hippocampal volume on the regional level and enhance the structural and functional connectivity of hippocampus on the connective level.
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Affiliation(s)
- Xu Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina (XW, HZ, C-QY, G-XS, PZ, J-WY, LW, YC, C-ZL), Beijing University of Chinese Medicine, Beijing, China; School of Life Sciences (XW), Beijing University of Chinese Medicine, Beijing, China
| | - Hang Zhou
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina (XW, HZ, C-QY, G-XS, PZ, J-WY, LW, YC, C-ZL), Beijing University of Chinese Medicine, Beijing, China
| | - Chao-Qun Yan
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina (XW, HZ, C-QY, G-XS, PZ, J-WY, LW, YC, C-ZL), Beijing University of Chinese Medicine, Beijing, China
| | - Guang-Xia Shi
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina (XW, HZ, C-QY, G-XS, PZ, J-WY, LW, YC, C-ZL), Beijing University of Chinese Medicine, Beijing, China
| | - Ping Zhou
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina (XW, HZ, C-QY, G-XS, PZ, J-WY, LW, YC, C-ZL), Beijing University of Chinese Medicine, Beijing, China
| | - Jian-Wei Huo
- Department of Radiology (J-WH, Y-NZ), Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Dongcheng District, Beijing, China
| | - Jing-Wen Yang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina (XW, HZ, C-QY, G-XS, PZ, J-WY, LW, YC, C-ZL), Beijing University of Chinese Medicine, Beijing, China
| | - Ya-Nan Zhang
- Department of Radiology (J-WH, Y-NZ), Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Dongcheng District, Beijing, China
| | - Lu Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina (XW, HZ, C-QY, G-XS, PZ, J-WY, LW, YC, C-ZL), Beijing University of Chinese Medicine, Beijing, China
| | - Yan Cao
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina (XW, HZ, C-QY, G-XS, PZ, J-WY, LW, YC, C-ZL), Beijing University of Chinese Medicine, Beijing, China
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina (XW, HZ, C-QY, G-XS, PZ, J-WY, LW, YC, C-ZL), Beijing University of Chinese Medicine, Beijing, China.
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Ding J, Tang Z, Chen Q, Liu Y, Feng C, Li Y, Ding X. Abnormal degree centrality as a potential imaging biomarker for ischemic stroke: A resting-state functional magnetic resonance imaging study. Neurosci Lett 2024; 831:137790. [PMID: 38670522 DOI: 10.1016/j.neulet.2024.137790] [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: 11/20/2023] [Revised: 03/09/2024] [Accepted: 04/23/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVE To explore degree centrality (DC) abnormalities in ischemic stroke patients and determine whether these abnormalities have potential value in understanding the pathological mechanisms of ischemic stroke patients. METHODS Sixteen ischemic stroke patients and 22 healthy controls (HCs) underwent resting state functional magnetic resonance imaging (rs-fMRI) scanning, and the resulting data were subjected to DC analysis. Then we conducted a correlation analysis between DC values and neuropsychological test scores, including Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). Finally, extracted the abnormal DC values of brain regions and defined them as features for support vector machine (SVM) analysis. RESULTS Compared with HCs, ischemic stroke patients showed increased DC in the bilateral supplementary motor area, and median cingulate and paracingulate gyri and decreased DC in the left postcentral gyrus, right calcarine fissure and surrounding cortex, lingual gyrus, and orbital parts of the right superior frontal gyrus and bilateral cuneus. Correlation analyses revealed that DC values in the right lingual gyrus, calcarine fissure and surrounding cortex, and orbital parts of the right superior frontal gyrus were positively correlated with the MMSE scores. The SVM classification of the DC values achieved an area under the curve (AUC) of 0.93, an accuracy of 89.47%. CONCLUSION Our research results indicate that ischemic stroke patients exhibit abnormalities in the global connectivity mechanisms and patterns of the brain network. These abnormal changes may provide neuroimaging evidence for stroke-related motor, visual, and cognitive impairments, contribute to a deeper comprehension of the underlying pathophysiological mechanisms implicated in ischemic stroke.
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Affiliation(s)
- Jurong Ding
- School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, PR China; Artificial Intelligence Key Laboratory of Sichuan Province, Sichuan University of Science & Engineering, Zigong, PR China.
| | - Zhiling Tang
- School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, PR China; Artificial Intelligence Key Laboratory of Sichuan Province, Sichuan University of Science & Engineering, Zigong, PR China
| | - Qiang Chen
- School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, PR China; Artificial Intelligence Key Laboratory of Sichuan Province, Sichuan University of Science & Engineering, Zigong, PR China
| | - Yihong Liu
- School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, PR China; Artificial Intelligence Key Laboratory of Sichuan Province, Sichuan University of Science & Engineering, Zigong, PR China
| | - Chenyu Feng
- School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, PR China; Artificial Intelligence Key Laboratory of Sichuan Province, Sichuan University of Science & Engineering, Zigong, PR China
| | - Yuan Li
- School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, PR China; Artificial Intelligence Key Laboratory of Sichuan Province, Sichuan University of Science & Engineering, Zigong, PR China
| | - Xin Ding
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, PR China
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Yan H, Han Y, Shan X, Li H, Liu F, Zhao J, Li P, Guo W. Shared and distinctive dysconnectivity patterns underlying pure generalized anxiety disorder (GAD) and comorbid GAD and depressive symptoms. J Psychiatr Res 2024; 170:225-236. [PMID: 38159347 DOI: 10.1016/j.jpsychires.2023.12.031] [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: 06/27/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
The resting-state connectivity features underlying pure generalized anxiety disorder (GAD, G1) and comorbid GAD and depressive symptoms (G2) have not been directly compared. Furthermore, it is unclear whether these features might serve as potential prognostic biomarkers and change with treatment. Degree centrality (DC) in G1 (40 subjects), G2 (58 subjects), and healthy controls (HCs, 54 subjects) was compared before treatment, and the DC of G1 or G2 at baseline was compared with that after 4 weeks of paroxetine treatment. Using support vector regression (SVR), voxel-wise DC across the entire brain and abnormal DC at baseline were employed to predict treatment response. At baseline, G1 and G2 exhibited lower DC in the left mid-cingulate cortex and vermis IV/V compared to HCs. Additionally, compared to HCs, G1 had lower DC in the left middle temporal gyrus, while G2 showed higher DC in the right inferior temporal/fusiform gyrus. However, there was no significant difference in DC between G1 and G2. The SVR based on abnormal DC at baseline could successfully predict treatment response in responders in G2 or in G1 and G2. Notably, the predictive performance based on abnormal DC at baseline surpassed that based on DC across the entire brain. After treatment, G2 responders showed lower DC in the right medial orbital frontal gyrus, while no change in DC was identified in G1 responders. The G1 and G2 showed common and distinct dysconnectivity patterns and they could potentially serve as prognostic biomarkers. Furthermore, DC in patients with GAD could change with treatment.
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Affiliation(s)
- Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yiding Han
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xiaoxiao Shan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingping Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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Zugman A, Jett L, Antonacci C, Winkler AM, Pine DS. A systematic review and meta-analysis of resting-state fMRI in anxiety disorders: Need for data sharing to move the field forward. J Anxiety Disord 2023; 99:102773. [PMID: 37741177 PMCID: PMC10753861 DOI: 10.1016/j.janxdis.2023.102773] [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: 08/31/2022] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/25/2023]
Abstract
Anxiety disorders are among the most prevalent psychiatric disorders. Neuroimaging findings remain uncertain, and resting state functional magnetic resonance (rs-fMRI) connectivity is of particular interest since it is a scalable functional imaging modality. Given heterogeneous past findings for rs-fMRI in anxious individuals, we characterize patterns across anxiety disorders by conducting a systematic review and meta-analysis. Studies were included if they contained at the time of scanning both a healthy group and a patient group. Due to insufficient study numbers, the quantitative meta-analysis only included seed-based studies. We performed an activation likelihood estimation (ALE) analysis that compared patients and healthy volunteers. All analyses were corrected for family-wise error with a cluster-level threshold of p < .05. Patients exhibited hypo-connectivity between the amygdala and the medial frontal gyrus, anterior cingulate cortex, and cingulate gyrus. This finding, however, was not robust to potential file-drawer effects. Though limited by strict inclusion criteria, our results highlight the heterogeneous nature of reported findings. This underscores the need for data sharing when attempting to detect reliable patterns of disruption in brain activity across anxiety disorders.
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Affiliation(s)
- André Zugman
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States.
| | - Laura Jett
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States; Child Emotion Lab, University of Wisconsin, Madison, Madison, WI, United States.
| | - Chase Antonacci
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States; Department of Psychology, Stanford University, Stanford, CA, United States.
| | - Anderson M Winkler
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States; Division of Human Genetics, School of Medicine, The University of Texas Rio Grande Valley, Brownsville, Texas, United States.
| | - Daniel S Pine
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States.
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Yuan M, Liu B, Yang B, Dang W, Xie H, Lui S, Qiu C, Zhu H, Zhang W. Dysfunction of default mode network characterizes generalized anxiety disorder relative to social anxiety disorder and post-traumatic stress disorder. J Affect Disord 2023; 334:35-42. [PMID: 37127115 DOI: 10.1016/j.jad.2023.04.099] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/04/2023] [Accepted: 04/26/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND The perseverative cognition of generalized anxiety disorder (GAD) is distinctive compared to other anxiety disorders. However, the disease-specific and shared neuropathophysiological mechanisms of GAD remain unclear. METHODS We recruited medication-free patients of GAD (N = 33), social anxiety disorder (SAD; N = 36), post-traumatic stress disorder (PTSD; N = 59), and healthy controls (HC; N = 50). All subjects underwent clinical assessments and resting-state functional magnetic resonance imaging. We compared both the amplitude low-frequency fluctuation (ALFF) and seed-based functional connectivity across the whole brain, using the significantly different regions from the ALFF analyses as seed regions, followed by post-hoc tests. RESULTS We found that ALFF of the left angular gyrus (AG), left inferior parietal lobule (IPL), left precentral gyrus, left middle temporal gyrus, and left cerebellum were higher in GAD compared with SAD, PTSD and HC. This trend was further corroborated by the higher functional connectivity between left AG and bilateral IPL, left inferior temporal gyrus, and left medial prefrontal cortex (mPFC) in GAD. In addition, GAD and SAD both showed abnormally higher left AG-right insula connectivity. Significant correlations were found between anxiety symptom severity and the left AG regional activity and left AG-left mPFC connectivity. LIMITATIONS We did not compare the differences in neuroimaging between GAD and other anxiety disorders, such as panic disorder. CONCLUSIONS The default mode network dysfunction may underlie the distinctive perseverative thoughts of GAD relative to other anxiety disorders, and left AG-right insula connectivity may reflect somatic anxiety of anxiety disorder spectrum.
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Affiliation(s)
- Minlan Yuan
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Bo Liu
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Biao Yang
- Department of Abdominal Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Wen Dang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Medical Big Data Center, Sichuan University, Chengdu, China
| | - Hua Xie
- Children's National Hospital and Center for Neuroscience, Washington, DC, USA
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Changjian Qiu
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China; Mental Health Center, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu 610041, China.
| | - Hongru Zhu
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu 610041, Sichuan, China; Mental Health Center, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu 610041, China.
| | - Wei Zhang
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China; West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Medical Big Data Center, Sichuan University, Chengdu, China
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Yang X, Kumar P, Wang M, Zhao L, Du Y, Zhang BY, Qi S, Sui J, Li T, Ma X. Antidepressant treatment-related brain activity changes in remitted major depressive disorder. Psychiatry Res Neuroimaging 2023; 330:111601. [PMID: 36724678 DOI: 10.1016/j.pscychresns.2023.111601] [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: 06/29/2022] [Revised: 12/21/2022] [Accepted: 01/24/2023] [Indexed: 01/29/2023]
Abstract
Recent evidence has shown that some brain regions are core hubs and play a key role in the treatment of depression. Twenty-five unmedicated patients with major depressive disorder (MDD) were included, and telephone follow-up was performed at 8, 24, and 48 weeks after enrollment. After reaching clinical remission, they were scheduled for a second magnetic resonance imaging scan and clinical evaluation. Thirty-one healthy controls were also investigated. The intrinsic functional connectivity (degree centrality) of each participant was mapped using a computationally efficient approach. Then, functional connectivity of patients was calculated between the identified regions of interest by degree centrality analysis and every voxel. Later, linear regression analysis was used to identify potential variables predictive of an improvement in disease severity. The prominent hubs identified by degree centrality analysis included the cerebellum, inferior temporal gyrus, lingual gyrus, dorsal medial prefrontal cortex (DMPFC), and dorsal lateral prefrontal cortex. We also found that the increased degree centrality of DMPFC was associated with improvement in depressive symptoms. The brain activity associated with antidepressant effects, especially brain connectivity changes in the left DMPFC, can potentially be used to monitor treatment response and predict treatment outcomes.
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Affiliation(s)
- Xiao Yang
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, 610041, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, 610041, Chengdu, China
| | - Poornima Kumar
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, United States of America; Department of Psychiatry, Harvard Medical School, United States of America
| | - Min Wang
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, 610041, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, 610041, Chengdu, China
| | - Liansheng Zhao
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, 610041, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, 610041, Chengdu, China
| | - Yue Du
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, 610041, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, 610041, Chengdu, China
| | - Belinda Y Zhang
- School of Nursing and Health Professions, University of San Francisco, CA, United States
| | - Shile Qi
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) [Georgia State University, Georgia Institute of Technology, Emory University], 30303, Atlanta, GA, United States
| | - Jing Sui
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China; Chinese Academy of Sciences Center for Excellence in Brain Science, Institute of Automation, 100190, Beijing, China
| | - Tao Li
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, 610041, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, 610041, Chengdu, China
| | - Xiaohong Ma
- Psychiatric Laboratory and Mental Health Center, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, 610041, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, 610041, Chengdu, China.
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Salivary Antioxidant Capacity and Magnesium in Generalized Anxiety Disorder. Metabolites 2023; 13:metabo13010073. [PMID: 36676998 PMCID: PMC9862115 DOI: 10.3390/metabo13010073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/29/2022] [Accepted: 12/29/2022] [Indexed: 01/22/2023] Open
Abstract
Generalized anxiety disorder (GAD) is a prevalent disorder. The search for biomarkers may contribute to new knowledge about molecular pathogenesis and treatment. Since oxidative stress and micronutrient imbalance play a key role in the development of mental disorders, we aimed to study salivary antioxidant capacity and magnesium in patients with GAD in an anxiety model of solving problems with increasing complexity. The study subgroup consisted of 15 patients with GAD, and 17 healthy volunteers of the same age made up the control subgroup. Participants took a test with six levels of difficulty, which included false feedback. In this test, the participants were asked to remember the colors of balloons and react when the color changed. The reaction time, the number of correct answers, as well as biochemical parameters such as the antioxidant capacity of saliva and salivary magnesium, were assessed. There was no difference in the results of the quest between the subgroups; however, anxious participants spent more time at the moment of experimental frustration due to incorrect feedback and additional negative psycho-emotional load. Antioxidant capacity did not differ between the subgroups both before and after the experimental session. Average antioxidant capacity also did not change significantly at the endpoint of the experiment. However, the endpoint antioxidant capacity correlated negatively with the reaction time in anxious patients in the second block (where the false feedback as a frustrating factor appeared). Magnesium was initially significantly higher in the group of anxious participants and decreased at the experiment endpoint; in healthy patients, there were no changes in salivary magnesium at the endpoint. In conclusion, the compensatory potential of oxidative metabolism and magnesium in patients with GAD was spent with additional psycho-emotional stress, in contrast to healthy individuals, but it was sufficient to avoid exhaustion during experimental frustrating exposure.
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Cera N, Monteiro J, Esposito R, Di Francesco G, Cordes D, Caldwell JZK, Cieri F. Neural correlates of psychodynamic and non-psychodynamic therapies in different clinical populations through fMRI: A meta-analysis and systematic review. Front Hum Neurosci 2022; 16:1029256. [PMID: 36644207 PMCID: PMC9832372 DOI: 10.3389/fnhum.2022.1029256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Abstract
Background The COVID-19 pandemic has exacerbated the ongoing crisis in psychiatric and psychological care, contributing to what we have identified as a new psychological and psychiatric pandemic. Psychotherapy is an effective method for easing the psychological suffering experienced also by the various impacts of COVID-19. This treatment can be examined from a neurological perspective, through the application of brain imaging techniques. Specifically, the meta-analysis of imaging studies can aid in expanding researchers' understanding of the many beneficial applications of psychotherapy. Objectives We examined the functional brain changes accompanying different mental disorders with functional Magnetic Resonance Imaging (fMRI), through a meta-analysis, and systematic review in order to better understand the general neural mechanism involved in psychotherapy and the potential neural difference between psychodynamic and non-psychodynamic approaches. Data sources The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were employed for our systematic review and meta-analysis. We conducted a computer-based literature search, following the Population, Intervention, Comparison and Outcomes (PICO) approach, to retrieve all published articles in English regarding the above-described topics from PubMed (MEDLINE), Scopus, and Web of Science. Study eligibility criteria participants and interventions We combined terms related to psychotherapy and fMRI: ("psychotherapy" [All Fields] OR "psychotherapy" [MeSH Terms] OR "psychotherapy" [All Fields] OR "psychotherapies" [All Fields] OR "psychotherapy s" [All Fields]) AND ("magnetic resonance imaging" [MeSH Terms]) OR ("magnetic"[All Fields] AND "resonance"[All Fields] AND "imaging"[All Fields]) OR ("magnetic resonance imaging"[All Fields] OR "fmri"[All Fields]). We considered (1) whole brain fMRI studies; (2) studies in which participants have been involved in a clinical trial with psychotherapy sessions, with pre/post fMRI; (3) fMRI results presented in coordinate-based (x, y, and z) in MNI or Talairach space; (4) presence of neuropsychiatric patients. The exclusion criteria were: (1) systematic review or meta-analysis; (2) behavioral study; (3) single-case MRI or fMRI study; and (4) other imaging techniques (i.e., PET, SPECT) or EEG. Results After duplicates removal and assessment of the content of each published study, we included 38 sources. The map including all studies that assessed longitudinal differences in brain activity showed two homogeneous clusters in the left inferior frontal gyrus, and caudally involving the anterior insular cortex (p < 0.0001, corr.). Similarly, studies that assessed psychotherapy-related longitudinal changes using emotional or cognitive tasks (TASK map) showed a left-sided homogeneity in the anterior insula (p < 0.000) extending to Broca's area of the inferior frontal gyrus (p < 0.0001) and the superior frontal gyrus (p < 0.0001). Studies that applied psychodynamic psychotherapy showed Family-Wise Error (FWE) cluster-corrected (p < 0.05) homogeneity values in the right superior and inferior frontal gyri, with a small cluster in the putamen. No FWE-corrected homogeneity foci were observed for Mindful- based and cognitive behavioral therapy psychotherapy. In both pre- and post-therapy results, studies showed two bilateral clusters in the dorsal anterior insulae (p = 0.00001 and p = 0.00003, respectively) and involvement of the medial superior frontal gyrus (p = 0.0002). Limitations Subjective experiences, such as an individual's response to therapy, are intrinsically challenging to quantify as objective, factual realities. Brain changes observed both pre- and post-therapy could be related to other factors, not necessary to the specific treatment received. Therapeutic modalities and study designs are generally heterogeneous. Differences exist in sample characteristics, such as the specificity of the disorder and number and duration of sessions. Moreover, the sample size is relatively small, particularly due to the paucity of studies in this field and the little contribution of PDT. Conclusions and implications of key findings All psychological interventions seem to influence the brain from a functional point of view, showing their efficacy from a neurological perspective. Frontal, prefrontal regions, insular cortex, superior and inferior frontal gyrus, and putamen seem involved in these neural changes, with the psychodynamic more linked to the latter three regions.
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Affiliation(s)
- Nicoletta Cera
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- CIBIT-Coimbra Institute for Biomedical Imaging and Translational Research, Coimbra, Portugal
| | - Jessica Monteiro
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Roberto Esposito
- Department of Radiology, Area Vasta 1/ASUR Marche, Pesaro, Italy
| | | | - Dietmar Cordes
- Department of Neurology, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
- Department of Brain Health, University of Nevada, Las Vegas, NV, United States
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, United States
| | - Jessica Z. K. Caldwell
- Department of Neurology, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
| | - Filippo Cieri
- Department of Neurology, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
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Zhang Q, Li B, Jin S, Liu W, Liu J, Xie S, Zhang L, Kang Y, Ding Y, Zhang X, Cheng W, Yang Z. Comparing the Effectiveness of Brain Structural Imaging, Resting-state fMRI, and Naturalistic fMRI in Recognizing Social Anxiety Disorder in Children and Adolescents. Psychiatry Res Neuroimaging 2022; 323:111485. [PMID: 35567906 DOI: 10.1016/j.pscychresns.2022.111485] [Citation(s) in RCA: 6] [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: 10/05/2021] [Revised: 04/07/2022] [Accepted: 04/16/2022] [Indexed: 01/11/2023]
Abstract
Social anxiety disorder (SAD) is a common anxiety disorder in childhood and adolescence. Studies on SAD in adults have reported both structural and functional aberrancies of the brain at the group level. However, evidence has shown differences in anxiety-related brain abnormalities between adolescents and adults. Since children and adolescents can afford limited scan time, optimizing the scan tasks is essential for SAD research in children and adolescents. Thus, we need to address whether brain structure, resting-state fMRI, and naturalistic imaging enable individualized identification of SAD in children and adolescents, which measurement is more effective, and whether pooling multi-modal features can improve the identification of SAD. We comprehensively addressed these questions by building machine learning models based on parcel-wise brain features. We found that naturalistic fMRI yielded higher classification accuracy (69.17%) than the other modalities and the classification performance showed dependence on the contents of the movie. The classification models also identified contributing brain regions, some of which exhibited correlations with the symptoms scores of SAD. However, pooling brain features from the three modalities did not help enhance the classification accuracy. These results support the application of carefully designed naturalistic imaging in recognizing children and adolescents at risk of SAD.
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Affiliation(s)
- Qinjian Zhang
- School of Computer Science and Technology, University of Chinese Academy of Sciences, Beijing, China
| | - Baobin Li
- School of Computer Science and Technology, University of Chinese Academy of Sciences, Beijing, China
| | - Shuyu Jin
- Laboratory of Psychological Health and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjing Liu
- Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingjing Liu
- Laboratory of Psychological Health and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuqi Xie
- Laboratory of Psychological Health and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Zhang
- Laboratory of Psychological Health and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yinzhi Kang
- Laboratory of Psychological Health and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yue Ding
- Laboratory of Psychological Health and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaochen Zhang
- Laboratory of Psychological Health and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenhong Cheng
- Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Zhi Yang
- Laboratory of Psychological Health and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China.
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10
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Chang W, Liu J, Nie L, Pang X, Lv Z, Zheng J. The Degree Centrality and Functional Connectivity in Patients With Temporal Lobe Epilepsy Presenting as Ictal Panic: A Resting State fMRI Study. Front Neurol 2022; 13:822253. [PMID: 35837228 PMCID: PMC9274169 DOI: 10.3389/fneur.2022.822253] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesIctal panic (IP) can be observed occasionally in patients with temporal lobe epilepsy (TLE). Such descriptions can be found in previous studies, but the mechanism is still not clear and often confused with panic attacks in patients with panic disorder (PD). We try to use imaging methods (resting-state functional magnetic resonance imaging, rs-fMRI) to study the mechanism of this psychiatric comorbidity in patients with TLE.MethodsForty right-onset TLE patients were observed, including 28 patients with TLE but without IP and 12 patients with TLEIP along with 30 gender-age matched healthy controls were included. We collected clinical/physiological/neuropsychological and rs-fMRI data. Degree centrality (DC) and functional connectivity (FC) were calculated. For the DC and FC values, analysis of covariance (ANCOVA) was used to find different areas and t-tests were used to compare differences between the TLEIP, TLE without IP, and healthy control(HC)groups. The relationship between brain abnormalities and patient characteristics was explored by correlation analyses.ResultsNo significant differences in gender and age were found among the three groups, and no significant differences in education level, Montreal Cognitive Assessment (MOCA), Hamilton Depressive Scale (HAMD), Hamilton Anxiety Scale (HAMA), and epilepsy duration (years) between the TLEIP and TLE without IP groups. In addition to fear, other symptoms were observed, including nausea, palpitations, rising epigastric sensation, and dyspnea. There was no correlation between the duration of IP and HAMA. Moreover, all IP durations were <2 min. Compared to the HCs and TLE without IP group, the DC value of the TLEIP group in the left middle temporal gyrus (LMTG) was significantly increased. Compared to the HCs, FC could be found between the LMTG and left inferior temporal gyrus (LITG) in the TLEIP group. In addition, there was FC between the LMTG and cerebellum in the TLEIP group. The difference in the magnitude of FC between the TLEIP vs. HC group was greater than the difference between the TLE vs. HC group.ConclusionsThis study describes brain abnormalities in patients with TLEIP. These results will help to preliminarily understand the mechanism of ictal panic and abnormal functional connection in patients with TLE, and further explore the neuroimaging mechanism of ictal panic in patients with TLE.
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Affiliation(s)
- Weiwei Chang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinping Liu
- Department of Neurology, The Guilin People's Hospital, Guilin, China
| | - Liluo Nie
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaomin Pang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zongxia Lv
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- *Correspondence: Jinou Zheng
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11
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Hartong V, van Emmerik A. Psychedelic Microdosing, Mindfulness, and Anxiety: A Cross-Sectional Mediation Study. J Psychoactive Drugs 2022:1-11. [PMID: 35694791 DOI: 10.1080/02791072.2022.2080616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
While anecdotal reports claim that psychedelic microdosing reduces anxiety and mood symptoms, evidence supporting these claims is scarce. This cross-sectional study investigated the association between microdosing and trait anxiety. Furthermore, it was investigated if trait mindfulness mediated this association. Participants completed anonymous online questionnaires and were divided into three groups: current microdosers (n = 186), former microdosers (n = 77) and microdosing-naïve controls (n = 234). Trait anxiety and trait mindfulness were measured using the State-Trait Anxiety Inventory - Trait subscale (STAI-T) and the 15-item Five-Facet Mindfulness Questionnaire (FFMQ-15) respectively. Current and former microdosers reported lower STAI-T scores compared to microdosing-naïve controls. Furthermore, associations of current and former microdosing with trait anxiety were mediated by trait mindfulness, with small effects of FFMQ-15 Total, Non-judging and Non-reactivity scores. However, in an exploratory analysis, all associations between microdosing and STAI-T scores became non-significant when participants with previous macrodose experience (n = 386) were excluded. Our findings suggest that RCT<apos;>s are warranted to test causal hypotheses concerning the effects of microdosing and the role of trait mindfulness in the effects of microdosing, while controlling for previous macrodose experience.
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Affiliation(s)
- Vincent Hartong
- Department of Psychology, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Arnold van Emmerik
- Department of Psychology, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, Netherlands
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12
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Kim MK, Eom H, Kwon JH, Kyeong S, Kim JJ. Neural effects of a short-term virtual reality self-training program to reduce social anxiety. Psychol Med 2022; 52:1296-1305. [PMID: 32880252 DOI: 10.1017/s0033291720003098] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Social anxiety disorder (SAD) is characterized by anxiety regarding social situations, avoidance of external social stimuli, and negative self-beliefs. Virtual reality self-training (VRS) at home may be a good interim modality for reducing social fears before formal treatment. This study aimed to find neurobiological evidence for the therapeutic effect of VRS. METHODS Fifty-two patients with SAD were randomly assigned to a VRS or waiting list (WL) group. The VRS group received an eight-session VRS program for 2 weeks, whereas the WL group received no intervention. Clinical assessments and functional magnetic resonance imaging scanning with the distress and speech evaluation tasks were repeatedly performed at baseline and after 3 weeks. RESULTS The post-VRS assessment showed significantly decreased anxiety and avoidance scores, distress index, and negative evaluation index for 'self', but no change in the negative evaluation index for 'other'. Patients showed significant responses to the distress task in various regions, including both sides of the prefrontal regions, occipital regions, insula, and thalamus, and to the speech evaluation task in the bilateral anterior cingulate cortex. Among these, significant neuronal changes after VRS were observed only in the right lingual gyrus and left thalamus. CONCLUSIONS VRS-induced improvements in the ability to pay attention to social stimuli without avoidance and even positively modulate emotional cues are based on functional changes in the visual cortices and thalamus. Based on these short-term neuronal changes, VRS can be a first intervention option for individuals with SAD who avoid society or are reluctant to receive formal treatment.
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Affiliation(s)
- Min-Kyeong Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyojung Eom
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Hee Kwon
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sunghyon Kyeong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Jin Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
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13
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Li JY, Wu H, Yuan S, Wang C, Wang Q, Zhong Y, Zhang N, Heffner K, Fox PT. A meta-analysis on neural changes of cognitive training for mental disorders in executive function tasks: increase or decrease brain activation? BMC Psychiatry 2022; 22:155. [PMID: 35232404 PMCID: PMC8886766 DOI: 10.1186/s12888-022-03796-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 02/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cognitive impairment is often found in patients with psychiatric disorders, and cognitive training (CT) has been shown to help these patients. To better understand the mechanisms of CT, many neuroimaging studies have investigated the neural changes associated with it. However, the results of those studies have been inconsistent, making it difficult to draw conclusions from the literature. Therefore, the objective of this meta-analysis was to identify consistent patterns in the literature of neural changes associated with CT for psychiatric disorders. METHODS We searched for cognitive training imaging studies in PubMed, Cochrane library, Scopus, and ProQuest electronic databases. We conducted an activation likelihood estimation (ALE) for coordinate-based meta-analysis of neuroimaging studies, conduct behavioral analysis of brain regions identified by ALE analysis, conduct behavioral analysis of brain regions identified by ALE analysis, and then created a functional meta-analytic connectivity model (fMACM) of the resulting regions. RESULTS Results showed that CT studies consistently reported increased activation in the left inferior frontal gyrus (IFG) and decreased activation in the left precuneus and cuneus from pre- to post- CT. CONCLUSION CT improves cognitive function by supporting language and memory function, and reducing neuronal resources associated with basic visual processing.
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Affiliation(s)
- Jin Yang Li
- grid.89957.3a0000 0000 9255 8984Nan jing Brain Hospital affiliated to Nanjing Medical University, Nanjing, 210029 Jiangsu China ,grid.89957.3a0000 0000 9255 8984Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, 210029 Jiangsu China
| | - Huiqin Wu
- grid.89957.3a0000 0000 9255 8984Nan jing Brain Hospital affiliated to Nanjing Medical University, Nanjing, 210029 Jiangsu China
| | - Shiting Yuan
- grid.89957.3a0000 0000 9255 8984Nan jing Brain Hospital affiliated to Nanjing Medical University, Nanjing, 210029 Jiangsu China
| | - Chun Wang
- Nan jing Brain Hospital affiliated to Nanjing Medical University, Nanjing, 210029, Jiangsu, China. .,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
| | - Qian Wang
- grid.24696.3f0000 0004 0369 153XBeiJing TianTan Hospital, Capital Medical University, Beijing, 100050 China
| | - Yuan Zhong
- grid.260474.30000 0001 0089 5711School of Psychology, Nanjing Normal University, Nanjing, 210029 Jiangsu China
| | - Ning Zhang
- grid.89957.3a0000 0000 9255 8984Nan jing Brain Hospital affiliated to Nanjing Medical University, Nanjing, 210029 Jiangsu China ,grid.89957.3a0000 0000 9255 8984Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, 210029 Jiangsu China
| | - Kathi Heffner
- grid.412750.50000 0004 1936 9166Department of Psychiatry, University of Rochester School of Nursing, Rochester, New York 14622 USA
| | - Peter T. Fox
- grid.89957.3a0000 0000 9255 8984Nan jing Brain Hospital affiliated to Nanjing Medical University, Nanjing, 210029 Jiangsu China ,grid.89957.3a0000 0000 9255 8984Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, 210029 Jiangsu China ,grid.267309.90000 0001 0629 5880South Texas Veterans Healthcare System, University of Texas Health San Antonio, San Antonio, USA ,grid.267309.90000 0001 0629 5880Research Imaging Institute, University of Texas Health San Antonio, San Antonio, USA
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14
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Resting-state neuroimaging in social anxiety disorder: a systematic review. Mol Psychiatry 2022; 27:164-179. [PMID: 34035474 DOI: 10.1038/s41380-021-01154-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/21/2021] [Accepted: 04/30/2021] [Indexed: 02/04/2023]
Abstract
There has been a growing interest in resting-state brain alterations in people with social anxiety disorder. However, the evidence has been mixed and contested and further understanding of the neurobiology of this disorder may aid in informing methods to increase diagnostic accuracy and treatment targets. With this systematic review, we aimed to synthesize the findings of the neuroimaging literature on resting-state functional activity and connectivity in social anxiety disorder, and to summarize associations between brain and social anxiety symptoms to further characterize the neurobiology of the disorder. We systematically searched seven databases for empirical research studies. Thirty-five studies met the inclusion criteria, with a total of 1611 participants (795 people with social anxiety disorder and 816 controls). Studies involving resting-state seed-based functional connectivity analyses were the most common. Individuals with social anxiety disorder (vs. controls) displayed both higher and lower connectivity between frontal-amygdala and frontal-parietal regions. Frontal regions were the most consistently implicated across other analysis methods, and most associated with social anxiety symptoms. Small sample sizes and variation in the types of analyses used across studies may have contributed to the inconsistencies in the findings of this review. This review provides novel insights into established neurobiological models of social anxiety disorder and provides an update on what is known about the neurobiology of this disorder in the absence of any overt tasks (i.e., resting state). The knowledge gained from this body of research enabled us to also provide recommendations for a more standardized imaging pre-processing approach to examine resting-state brain activity and connectivity that could help advance knowledge in this field. We believe this is warranted to take the next step toward clinical translation in social anxiety disorder that may lead to better treatment outcomes by informing the identification of neurobiological targets for treatment.
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15
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Wang Q, Wang C, Deng Q, Zhan L, Tang Y, Li H, Antwi CO, Xiang A, Lv Y, Jia X, Ren J. Alterations of regional spontaneous brain activities in anxiety disorders: A meta-analysis. J Affect Disord 2022; 296:233-240. [PMID: 34619449 DOI: 10.1016/j.jad.2021.09.062] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/03/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Recent resting-state functional magnetic resonance imaging studies have provided strong evidence of abnormal regional spontaneous brain activities among anxiety-disordered patients. However, the evidence has been divergent and inconclusive. Therefore, it is necessary to perform a meta-analysis identifying a common pattern of altered regional spontaneous brain activity for anxiety disorders. METHOD Corresponding research of anxiety disorders, namely, whole-brain rs-fMRI studies that measured differences in regional homogeneity, amplitude of low-frequency fluctuations, or fractional amplitude of low-frequency fluctuations, were analyzed in this study. Overall, seven studies with 235 anxiety-disordered patients and 241 healthy controls were ultimately included in the meta-analysis. The meta-analysis was processed by seed-based d mapping. RESULTS Compared with healthy controls, patients with anxiety disorders showed significantly decreased regional spontaneous brain activities in the right putamen, the right orbital inferior frontal gyrus, and the right temporal pole. No increases in regional spontaneous brain activities were detected in patients relative to the controls. LIMITATION Limited number of available studies, only Asian samples, and insufficient information of sample characteristics. CONCLUSION The present study suggests that anxiety disorders are associated with aberrant regional brain activity in areas connected with emotion processing, which extends our understanding of anxiety disorders' pathophysiology.
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Affiliation(s)
- Qianqian Wang
- School of Teacher Education, Zhejiang Normal University, Jinhua, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Chunjie Wang
- Institute of Brain Science and Department of Psychology, School of Education, Hangzhou Normal University, Hangzhou, China
| | - Qiuyue Deng
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Linlin Zhan
- School of Western Language, Heilongjiang University, Heilongjiang, China
| | - Yingying Tang
- School of Teacher Education, Zhejiang Normal University, Jinhua, China
| | - Huayun Li
- School of Teacher Education, Zhejiang Normal University, Jinhua, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Collins Opoku Antwi
- School of Teacher Education, Zhejiang Normal University, Jinhua, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Anfeng Xiang
- The First Rehabilitation Hospital of Shanghai, Tongji University School of Medicine, Shanghai, China
| | - Yating Lv
- Institute of Brain Science and Department of Psychology, School of Education, Hangzhou Normal University, Hangzhou, China; Center for Cognition and Brain Disorders, the Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
| | - Xize Jia
- School of Teacher Education, Zhejiang Normal University, Jinhua, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China.
| | - Jun Ren
- School of Teacher Education, Zhejiang Normal University, Jinhua, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China.
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16
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Wang S, Zhao Y, Wang X, Yang X, Cheng B, Pan N, Suo X, Gong Q. Emotional intelligence mediates the association between middle temporal gyrus gray matter volume and social anxiety in late adolescence. Eur Child Adolesc Psychiatry 2021; 30:1857-1869. [PMID: 33011842 DOI: 10.1007/s00787-020-01651-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 09/18/2020] [Indexed: 12/17/2022]
Abstract
As a common mental health problem, social anxiety refers to the fear and avoidance of interacting in social or performance situations, which plays a crucial role in many health and social problems. Although a growing body of studies has explored the neuroanatomical alterations related to social anxiety in clinical patients, far fewer have examined the association between social anxiety and brain morphology in the general population, which may help us understand the neural underpinnings of social anxiety more comprehensively. Here, utilizing a voxel-based morphometry approach via structural magnetic resonance imaging, we investigated brain gray matter correlates of social anxiety in 231 recent graduates of the same high school grade. We found that social anxiety was positively associated with gray matter volume in the right middle temporal gyrus (MTG), which is a core brain area for cognitive processing of emotions and feelings. Critically, emotional intelligence mediated the impact of right MTG volume on social anxiety. Notably, our results persisted even when controlling for the effects of general anxiety and depression. Altogether, our research reveals right MTG gray matter volume as a neurostructural correlate of social anxiety in a general sample of adolescents and suggests a potential indirect effect of emotional intelligence on the association between gray matter volume and social anxiety.
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Affiliation(s)
- Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yajun Zhao
- School of Education and Psychology, Southwest Minzu University, Chengdu, China
| | - Xiuli Wang
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xun Yang
- School of Public Affairs, Chongqing University, Chongqing, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China. .,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China. .,Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
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17
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Bas-Hoogendam JM, van Steenbergen H, Cohen Kadosh K, Westenberg PM, van der Wee NJA. Intrinsic functional connectivity in families genetically enriched for social anxiety disorder - an endophenotype study. EBioMedicine 2021; 69:103445. [PMID: 34161885 PMCID: PMC8237289 DOI: 10.1016/j.ebiom.2021.103445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/18/2021] [Accepted: 06/04/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Social anxiety disorder (SAD) is a serious psychiatric condition with a high prevalence, and a typical onset during childhood/adolescence. The condition runs in families, but it is largely unknown which neurobiological characteristics transfer this genetic vulnerability ('endophenotypes'). Using data from the Leiden Family Lab study on SAD, including two generations of families genetically enriched for SAD, we investigated whether social anxiety (SA) co-segregated with changes in intrinsic functional connectivity (iFC), and examined heritability. METHODS Functional MRI data were acquired during resting-state in 109 individuals (56 males; mean age: 31·5, range 9·2-61·5 years). FSL's tool MELODIC was used to perform independent component analysis. Six networks of interest (default mode, dorsal attention, executive control, frontoparietal, limbic and salience) were identified at the group-level and used to generate subject-specific spatial maps. Voxel-wise regression models, with SA-level as predictor and voxel-wise iFC as candidate endophenotypes, were performed to investigate the association with SA, within masks of the networks of interest. Subsequently, heritability was estimated. FINDINGS SA co-segregated with iFC within the dorsal attention network (positive association in left middle frontal gyrus and right postcentral gyrus) and frontoparietal network (positive association within left middle temporal gyrus) (cluster-forming-threshold z>2·3, cluster-corrected extent-threshold p<0·05). Furthermore, iFC of multiple voxels within these clusters was at least moderately heritable. INTERPRETATION These findings provide initial evidence for increased iFC as candidate endophenotype of SAD, particularly within networks involved in attention. These changes might underlie attentional biases commonly present in SAD. FUNDING Leiden University Research Profile 'Health, Prevention and the Human Lifecycle'.
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Affiliation(s)
- Janna Marie Bas-Hoogendam
- Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333, AK, Leiden, the Netherlands; Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands.
| | - Henk van Steenbergen
- Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333, AK, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands.
| | | | - P Michiel Westenberg
- Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333, AK, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands.
| | - Nic J A van der Wee
- Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands.
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18
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Different Degree Centrality Changes in the Brain after Acupuncture on Contralateral or Ipsilateral Acupoint in Patients with Chronic Shoulder Pain: A Resting-State fMRI Study. Neural Plast 2020; 2020:5701042. [PMID: 32377180 PMCID: PMC7197008 DOI: 10.1155/2020/5701042] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 11/07/2019] [Accepted: 11/19/2019] [Indexed: 12/14/2022] Open
Abstract
Chronic shoulder pain (CSP) is the third most common musculoskeletal problem. For maximum treatment effectiveness, most acupuncturists usually choose acupoint in the nonpainful side, to alleviate pain or improve shoulder function. This method is named opposite needling, which means acupuncture points on the right side are selected for diseases on the left side and vice versa. However, the underlying neural mechanisms related to treatment are currently unclear. The purpose of this study was to determine whether different mechanisms were observed with contralateral and ipsilateral acupuncture at Tiaokou (ST 38) in patients with unilateral CSP. Twenty-four patients were randomized to the contralateral acupuncture group (contra-group) and the ipsilateral acupuncture group (ipsi-group). The patients received one acupuncture treatment session at ST 38 on the nonpainful or painful sides, respectively. Before and after acupuncture treatment, they underwent functional magnetic resonance scanning. The treatment-related changes in degree centrality (DC) maps were compared between the two groups. We found alleviated pain and improved shoulder function in both groups, but better shoulder functional improvement was observed in the contra-group. Increased DC in the anterior/paracingulate cortex and decreased DC in bilateral postcentral gyri were found in the contra-group, while decreased DC in the bilateral cerebellum and right thalamus was observed in the ipsi-group. Furthermore, the DC value in the bilateral anterior/paracingulate cortex was positively correlated with the treatment-related change in the Constant–Murley score. The current study reveals different changes of DC patterns after acupuncture at contralateral or ipsilateral ST 38 in patients with CSP. Our findings support the hypothesis of acupoint specificity and provide the evidence for acupuncturists to select acupoints for CSP.
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Bas-Hoogendam JM, Westenberg PM. Imaging the socially-anxious brain: recent advances and future prospects. F1000Res 2020; 9:F1000 Faculty Rev-230. [PMID: 32269760 PMCID: PMC7122428 DOI: 10.12688/f1000research.21214.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2020] [Indexed: 12/20/2022] Open
Abstract
Social anxiety disorder (SAD) is serious psychiatric condition with a genetic background. Insight into the neurobiological alterations underlying the disorder is essential to develop effective interventions that could relieve SAD-related suffering. In this expert review, we consider recent neuroimaging work on SAD. First, we focus on new results from magnetic resonance imaging studies dedicated to outlining biomarkers of SAD, including encouraging findings with respect to structural and functional brain alterations associated with the disorder. Furthermore, we highlight innovative studies in the field of neuroprediction and studies that established the effects of treatment on brain characteristics. Next, we describe novel work aimed to delineate endophenotypes of SAD, providing insight into the genetic susceptibility to develop the disorder. Finally, we outline outstanding questions and point out directions for future research.
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Affiliation(s)
- Janna Marie Bas-Hoogendam
- Developmental and Educational Psychology, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, c/o LUMC, postzone C2-S, P.O.Box 9600, 2300 RC Leiden, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - P. Michiel Westenberg
- Developmental and Educational Psychology, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, c/o LUMC, postzone C2-S, P.O.Box 9600, 2300 RC Leiden, The Netherlands
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Santos VA, Carvalho DD, Van Ameringen M, Nardi AE, Freire RC. Neuroimaging findings as predictors of treatment outcome of psychotherapy in anxiety disorders. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91:60-71. [PMID: 29627509 DOI: 10.1016/j.pnpbp.2018.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 03/27/2018] [Accepted: 04/02/2018] [Indexed: 12/11/2022]
Abstract
Anxiety disorders are the largest group of mental disorders and a leading cause of impairment, implicating in high costs for health systems and society. Effective pharmacological and psychological treatments are available, but a significant fraction of these patients does not respond adequately to these treatments. The objective of this study is to identify neuroimaging findings that could predict response to psychotherapy in anxiety disorders. METHODS The authors reviewed psychotherapy clinical trials with neuroimaging conducted with patients with anxiety disorders. A systematic review was performed in MEDLINE database through PubMed, the Cochrane Collaboration's Clinical Trials Register (CENTRAL), PsycINFO and Thomson Reuters's Web of Science. RESULTS From the studies included in this review, 24 investigated anxiety disorder patients, and findings in the amygdala, dorsolateral prefrontal cortex (dlPFC), anterior cingulate cortex (ACC) and insula predicted response to psychotherapy in social anxiety disorder. Findings in ACC, hippocampus, insula, dlPFC, amygdala and inferior frontal gyrus (iFG) predicted response to psychotherapy in panic disorder and generalized anxiety disorder. LIMITATIONS There was great heterogeneity between the included studies regarding neuroimaging techniques and the tasks performed during functional neuroimaging. CONCLUSION Neuroimaging studies suggest that abnormalities in hippocampus, amygdala, iFG, uncus and areas linked with emotional regulation (dlPFC and ACC), predict a good outcome to psychotherapy in anxiety disorders.
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Affiliation(s)
- Veruska Andrea Santos
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Dessana David Carvalho
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michael Van Ameringen
- MacAnxiety Research Centre, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Antonio Egidio Nardi
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Christophe Freire
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Cerebral resting state markers of biased perception in social anxiety. Brain Struct Funct 2018; 224:759-777. [PMID: 30506458 DOI: 10.1007/s00429-018-1803-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 11/24/2018] [Indexed: 01/29/2023]
Abstract
Social anxiety (SA) comprises a multitude of persistent fears around the central element of dreaded negative evaluation and exclusion. This very common anxiety is spectrally distributed among the general population and associated with social perception biases deemed causal in its maintenance. Here, we investigated cerebral resting state markers linking SA and biased social perception. To this end, resting state functional connectivity (RSFC) was assessed as the neurobiological marker in a study population with greatly varying SA using fMRI in the first step of the experiment. One month later the impact of unattended laughter-exemplifying social threat-on a face rating task was evaluated as a measure of biased social perception. Applying a dimensional approach, SA-related cognitive biases tied to the valence, dominance and arousal of the threat signal and their underlying RSFC patterns among central nodes of the cerebral emotion, voice and face processing networks were identified. In particular, the connectivity patterns between the amygdalae and the right temporal voice area met all criteria for a cerebral mediation of the association between SA and the laughter valence-related interpretation bias. Thus, beyond this identification of non-state-dependent cerebral markers of biased perception in SA, this study highlights both a starting point and targets for future research on the causal relationships between cerebral connectivity patterns, SA and biased perception, potentially via neurofeedback methods.
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Wang X, Cheng B, Luo Q, Qiu L, Wang S. Gray Matter Structural Alterations in Social Anxiety Disorder: A Voxel-Based Meta-Analysis. Front Psychiatry 2018; 9:449. [PMID: 30298028 PMCID: PMC6160565 DOI: 10.3389/fpsyt.2018.00449] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 08/30/2018] [Indexed: 02/05/2023] Open
Abstract
The current insight into the neurobiological pathogenesis underlying social anxiety disorder (SAD) is still rather limited. We implemented a meta-analysis to explore the neuroanatomical basis of SAD. We undertook a systematic search of studies comparing gray matter volume (GMV) differences between SAD patients and healthy controls (HC) using a whole-brain voxel-based morphometry (VBM) approach. The anisotropic effect size version of seed-based d mapping (AES-SDM) meta-analysis was conducted to explore the GMV differences of SAD patients compared with HC. We included eleven studies with 470 SAD patients and 522 HC in the current meta-analysis. In the main meta-analysis, relative to HC, SAD patients showed larger GMVs in the left precuneus, right middle occipital gyrus (MOG) and supplementary motor area (SMA), as well as smaller GMV in the left putamen. In the subgroup analyses, compared with controls, adult patients (age ≥ 18 years) with SAD exhibited larger GMVs in the left precuneus, right superior frontal gyrus (SFG), angular gyrus, middle temporal gyrus (MTG), MOG and SMA, as well as a smaller GMV in the left thalamus; SAD patients without comorbid depressive disorder exhibited larger GMVs in the left superior parietal gyrus and precuneus, right inferior temporal gyrus, fusiform gyrus, MTG and superior temporal gyrus (STG), as well as a smaller GMV in the bilateral thalami; and currently drug-free patients with SAD exhibited a smaller GMV in the left thalamus compared with HC while no larger GMVs were found. For SAD patients with different clinical features, our study revealed directionally consistent larger cortical GMVs and smaller subcortical GMVs, including locationally consistent larger precuneus and thalamic deficits in the left brain. Age, comorbid depressive disorder and concomitant medication use of the patients might be potential confounders of SAD at the neuroanatomical level.
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Affiliation(s)
- Xiuli Wang
- Department of Clinical Psychology, the Fourth People's Hospital of Chengdu, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Qiang Luo
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Lihua Qiu
- Department of Radiology, the Second People's Hospital of Yibin, Yibin, China
| | - Song Wang
- Department of Clinical Psychology, the Fourth People's Hospital of Chengdu, Chengdu, China.,Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China
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