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Wang H, Zhang T, Zu M, Fan S, Kai Y, Zhang J, Ji Y, Pang X, Tian Y. Electroconvulsive therapy enhances degree centrality in the orbitofrontal cortex in depressive rumination. Psychiatry Res Neuroimaging 2024; 337:111765. [PMID: 38104485 DOI: 10.1016/j.pscychresns.2023.111765] [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: 09/30/2023] [Revised: 11/13/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
Depressive rumination has been implicated in the onset, duration, and treatment response of refractory depression. Electroconvulsive therapy (ECT) is remarkably effective in treatment of refractory depression by modulating the functional coordination between brain hubs. However, the mechanisms by which ECT regulates depressive rumination remain unsolved. We investigated degree centrality (DC) in 32 pre- and post-ECT depression patients as well as 38 matched healthy controls. An identified brain region was defined as the seed to calculate functional connectivity (FC) in whole brains. Rumination was measured by the Ruminative Response Scale (RRS) and its relationships with identified DC and FC alterations were examined. We found a significant negative correlation between DC of the right orbitofrontal cortex (rOFC) before ECT and brooding level before and after treatment. Moreover, rOFC DC increased after ECT. DC of the left superior temporal gyrus (lSTG) was positively correlated with reflective level before intervention, while lSTG DC decreased after ECT. Patients showed elevated FC in the rOFC with default mode network. No significant association was found between decreased RRS scores and changes in DC and FC. Our findings suggest that functional changes in rOFC and lSTG may be associated with the beneficial effects of ECT on depressive rumination.
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Affiliation(s)
- Hongping Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Ting Zhang
- Department of Psychiatry, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Meidan Zu
- Department of Neurology, Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Siyu Fan
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yiao Kai
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jiahua Zhang
- School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Yang Ji
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiaonan Pang
- Department of Neurology, Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
| | - Yanghua Tian
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; Department of Neurology, Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
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2
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Granger SJ, Adams JG, Kark SM, Sathishkumar MT, Chen IY, Benca RM, McMillan L, Janecek JT, Yassa MA. Latent anxiety in clinical depression is associated with worse recognition of emotional stimuli. J Affect Disord 2022; 301:368-377. [PMID: 34999127 DOI: 10.1016/j.jad.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 12/17/2021] [Accepted: 01/02/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Major Depressive Disorder, characterized by cognitive affective biases, is a considerable public health challenge. Past work has shown that higher depressive symptoms are associated with augmented memory of negative stimuli. In contrast, anxiety symptoms have been associated with overgeneralization of emotional memories. Given the high comorbidity of depression and anxiety, it is critical to understand how cognitive affective biases are differentially associated with clinical symptoms. METHOD We used continuous measures of depression (Beck Depression Inventory [BDI-II]) and anxiety (Beck Anxiety Inventory [BAI]) to evaluate an adult sample (N = 79; 18-41 years old, 58 female). Emotional memory discrimination and recognition memory were tested using an emotional discrimination task. We applied exploratory factor analysis to questions from the BAI and BDI-II to uncover latent constructs consisting of negative affect, anhedonia, somatic anxiety, and cognitive anxiety. RESULTS We report evidence that anxious symptoms were associated with impaired recognition of negative items after accounting for age and sex. Our exploratory factor analysis revealed that impaired negative item recognition is largely associated with somatic and cognitive anxiety factors. LIMITATIONS Interpretations in a mixed pathology sample, especially given collinearity among factors, may be difficult. CONCLUSIONS We provide evidence that somatic and cognitive anxiety are related to impaired recognition memory for negative stimuli. Future clinical investigations should uncover the neurobiological basis supporting the link between recognition of negative stimuli and somatic/cognitive symptoms of anxiety.
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Affiliation(s)
- Steven J Granger
- Center for the Neurobiology of Learning and Memory, University of California, Irvine 92697, USA; Department of Neurobiology and Behavior, University of California, Irvine 92697, USA
| | - Joren G Adams
- Center for the Neurobiology of Learning and Memory, University of California, Irvine 92697, USA; Department of Neurobiology and Behavior, University of California, Irvine 92697, USA
| | - Sarah M Kark
- Center for the Neurobiology of Learning and Memory, University of California, Irvine 92697, USA; Department of Neurobiology and Behavior, University of California, Irvine 92697, USA
| | - Mithra T Sathishkumar
- Center for the Neurobiology of Learning and Memory, University of California, Irvine 92697, USA; Department of Neurobiology and Behavior, University of California, Irvine 92697, USA
| | - Ivy Y Chen
- Department of Psychiatry and Human Behavior, University of California, 1418 Biological Sciences 3, Irvine, CA 92697, USA
| | - Ruth M Benca
- Center for the Neurobiology of Learning and Memory, University of California, Irvine 92697, USA; Department of Neurobiology and Behavior, University of California, Irvine 92697, USA; Department of Psychiatry and Human Behavior, University of California, 1418 Biological Sciences 3, Irvine, CA 92697, USA
| | - Liv McMillan
- Center for the Neurobiology of Learning and Memory, University of California, Irvine 92697, USA; Department of Neurobiology and Behavior, University of California, Irvine 92697, USA
| | - John T Janecek
- Center for the Neurobiology of Learning and Memory, University of California, Irvine 92697, USA; Department of Neurobiology and Behavior, University of California, Irvine 92697, USA
| | - Michael A Yassa
- Center for the Neurobiology of Learning and Memory, University of California, Irvine 92697, USA; Department of Neurobiology and Behavior, University of California, Irvine 92697, USA; Department of Psychiatry and Human Behavior, University of California, 1418 Biological Sciences 3, Irvine, CA 92697, USA.
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3
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Isato A, Yokokawa K, Higuchi M, Suhara T, Yamada M. Resting-state functional connectivity relates to interindividual variations in positive memory. Behav Brain Res 2022; 419:113663. [PMID: 34780857 DOI: 10.1016/j.bbr.2021.113663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/29/2021] [Accepted: 11/07/2021] [Indexed: 11/28/2022]
Abstract
Individual differences in positive memory recollection are of interest in mental health, as positive memories can help protect people against stress and depression. However, it is unclear how individual differences in positive memory recollection are reflected in brain activity in the resting state. Here, we investigate the resting-state functional connectivity (FC) associated with interindividual variations in positive memory by employing cluster-level inferences based on randomization/permutation region of interest (ROI)-to-ROI analyses. We identified a cluster of FCs that was positively associated with positive memory performance, including the frontal operculum, central operculum, parietal operculum, Heschl's gyrus, and planum temporale. The current results suggest that positive memory is innervated by frontotemporal network connectivity, which may have implications for future investigations of vulnerability to stress and depression.
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Affiliation(s)
- Ayako Isato
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan; Faculty of Humanities, Saitama Gakuen University, Saitama 333-0831, Japan
| | - Keita Yokokawa
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Makoto Higuchi
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Tetsuya Suhara
- Institute for Quantum Life Science, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Makiko Yamada
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan; Institute for Quantum Life Science, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan.
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4
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Kaltenboeck A, Ruzickova T, Breunhölder V, Zghoul T, Cowen PJ, Harmer CJ. No antidepressant-like acute effects of bright light on emotional information processing in healthy volunteers. Psychopharmacology (Berl) 2022; 239:277-286. [PMID: 34743231 PMCID: PMC8770384 DOI: 10.1007/s00213-021-06003-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/12/2021] [Indexed: 01/10/2023]
Abstract
RATIONALE Bright light treatment (BLT) is an efficacious antidepressant intervention, but its mechanism of action is not well understood. Antidepressant drugs acutely affect how emotional information is processed, pushing the brain to prioritise positive relative to negative input. Whether BLT could have a similar effect is not known to date. OBJECTIVE To test whether BLT acutely influences emotional information processing similar to antidepressant drugs, using an established healthy volunteer assay. METHODS Following a double-blind, parallel-group design, 49 healthy volunteers (18-65 years, 26 females) were randomly allocated to 60-min BLT (≥ 10,000 lux) or sham-placebo treatment early in the morning in autumn/winter. Immediately after treatment, emotional information processing was assessed using the Oxford Emotional Test Battery, a validated set of behavioural tasks tapping into emotional information processing in different cognitive domains. Participants also completed questionnaires before and after treatment to assess changes in subjective state. RESULTS The BLT group did not show significantly more positively biased emotional information processing compared to the placebo group (p > 0.05 for all measures). After adjustment for pre-treatment scores, there were also no significant post-treatment differences between groups in subjective state (p > 0.05 for all measures). CONCLUSIONS BLT did not show immediate effects on emotional information processing in an established healthy volunteer assay. Thus, BLT might exert its clinical effects through a different (cognitive) mechanism than other antidepressant interventions. Future studies should corroborate this finding including clinical populations and more intensive treatment regimes, and control for potential chronobiological effects.
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Affiliation(s)
- Alexander Kaltenboeck
- Department of Psychiatry, University of Oxford, Oxford, UK. .,Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
| | - Tereza Ruzickova
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
| | - Veronika Breunhölder
- grid.4305.20000 0004 1936 7988School of Mathematics and Maxwell Institute for Mathematical Sciences, University of Edinburgh, Edinburgh, UK
| | - Tarek Zghoul
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK ,grid.416938.10000 0004 0641 5119Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Philip J. Cowen
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK ,grid.416938.10000 0004 0641 5119Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Catherine J. Harmer
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK ,grid.416938.10000 0004 0641 5119Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
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5
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Zhang T, Hou Q, Bai T, Ji G, Lv H, Xie W, Jin S, Yang J, Qiu B, Tian Y, Wang K. Functional and structural alterations in the pain-related circuit in major depressive disorder induced by electroconvulsive therapy. J Neurosci Res 2021; 100:477-489. [PMID: 34825381 DOI: 10.1002/jnr.24979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/08/2021] [Accepted: 09/25/2021] [Indexed: 12/12/2022]
Abstract
Approximately two-thirds of major depressive disorder (MDD) patients have pain, which exacerbates the severity of depression. Electroconvulsive therapy (ECT) is an efficacious treatment that can alleviate depressive symptoms; however, treatment for pain and the underlying neural substrate is elusive. We enrolled 34 patients with MDD and 33 matched healthy controls to complete clinical assessments and neuroimaging scans. MDD patients underwent second assessments and scans after ECT. We defined a pain-related network with a published meta-analysis and calculated topological patterns to reveal topologic alterations induced by ECT. Using the amplitude of low-frequency fluctuations (ALFFs), we probed local function aberrations of pain-related circuits in MDD patients. Subsequently, we applied gray matter volume (GMV) to reveal structural alterations of ECT relieving pain. The relationships between functional and structural aberrations and pain were determined. ECT significantly alleviated pain. The neural mechanism based on pain-related circuits indicated that ECT weakened the circuit function (ALFF: left amygdala and right supplementary motor area), while augmenting the structure (GMV: bilateral amygdala/insula/hippocampus and anterior cingulate cortex). The topologic patterns became less efficient after ECT. Correlation analysis between the change in pain and GMV had negative results in bilateral amygdala/insula/hippocampus. Similarity, there was a positive correlation between a change in ALFF in the left amygdala and improved clinical symptoms. ECT improved pain by decreasing brain local function and global network patterns, while increasing structure in pain-related circuits. Functional and structural alterations were associated with improvement in pain.
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Affiliation(s)
- Ting Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Qiangqiang Hou
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Tongjian Bai
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Gongjun Ji
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Huaming Lv
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Wen Xie
- Anhui Mental Health Center, Hefei, China
| | | | - Jinying Yang
- Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
| | - Bensheng Qiu
- Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
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6
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Altered neural activity in the reward-related circuit and executive control network associated with amelioration of anhedonia in major depressive disorder by electroconvulsive therapy. Prog Neuropsychopharmacol Biol Psychiatry 2021; 109:110193. [PMID: 33285263 DOI: 10.1016/j.pnpbp.2020.110193] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 02/03/2023]
Abstract
Anhedonia is a core characteristic of depression, the amelioration of which accounts for depressive symptom improvement. Electroconvulsive therapy (ECT) has been shown remarkable antidepressive effect, however, less is known about the effect of ECT on anhedonia and its underlying neural mechanism. Herein, we investigated local and global intrinsic brain functional alterations during the resting state in 46 patients with pre- and post-ECT major depressive disorder using the amplitude of low-frequency fluctuations (ALFF) and degree centrality (DC) approach. Functional connectivity (FC) was also calculated between nodes with significant local and global intrinsic brain functional alterations. The severity of anhedonia and depression was assessed with the Temporal Experience of Pleasure Scale and Hamilton Depression Rating Scale, respectively. The relationship between the change in anhedonia and depressive symptoms and brain functional alterations was determined. Increased ALFF and DC were observed in the bilateral dorsal medial prefrontal cortex (dmPFC), right dorsal lateral prefrontal cortex (dlPFC), left orbitofrontal cortex, and right orbitofrontal cortex (ROFC) after ECT. Correlational analysis between the change in anhedonia and ALFF had positive results in the dmPFC. Similarly, there was a positive correlation between the change in anhedonia and change in DC in the dmPFC, right dlPFC, ROFC, and middle frontal gyrus. Furthermore, there was a significant relationship between the change in anhedonia and altered dmPFC-dlPFC FC. These results revealed that amelioration of anhedonia may be associated with intrinsic neural activity alteration in the reward-related circuit and executive control network following ECT.
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7
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Daming M, Xin L, Shuwen H, Pengfei G, Shuai L, Feng G, Xiaomei C, Binbin C, Hui Z. Somatization Symptoms Regulate Emotional Memory Bias in Adolescents With Major Depressive Disorder. Front Psychiatry 2021; 12:656198. [PMID: 34512408 PMCID: PMC8428275 DOI: 10.3389/fpsyt.2021.656198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/02/2021] [Indexed: 11/21/2022] Open
Abstract
Objective: Somatization symptoms are commonly comorbid with depression. Furthermore, people with depression and somatization have a negative memory bias. We investigated the differences in emotional memory among adolescent patients with depressive disorders, with and without functional somatization symptoms (FSS). Methods: We recruited 30 adolescents with depression and FSS, 38 adolescents with depression but without FSS, and 38 healthy participants. Emotional memory tasks were conducted to evaluate the emotional memory of the participants in the three groups. The clinical symptoms were evaluated using the Hamilton Depression Rating Scale (HDRS) and the Children's Somatization Inventory (CSI). Results: The valence ratings and recognition accuracy rates for positive and neutral images of adolescent patients were significantly lower than those of the control group (F = 12.208, P < 0.001; F = 6.801, P < 0.05; F = 14.536, P < 0.001; F = 6.306, P < 0.05, respectively); however, the recognition accuracy rate for negative images of adolescent patients of depression without FSS was significantly lower than that of patients with FSS and control group participants (F = 10.316, P < 0.001). These differences persisted after controlling for HDRS scores. The within-group analysis revealed that patients of depression with FSS showed significantly higher recognition accuracy rates for negative images than the other types (F = 5.446, P < 0.05). The recognition accuracy rate for negative images was positively correlated with CSI scores (r = 0.352, P < 0.05). Conclusion: Therefore, emotional memory impairment exists in adolescent patients of depression and FSS are associated with negative emotional memory retention.
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Affiliation(s)
- Mo Daming
- Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Anhui Mental Health Center, Hefei, China.,Hefei Fourth People's Hospital, Hefei, China
| | - Li Xin
- Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Anhui Mental Health Center, Hefei, China.,Hefei Fourth People's Hospital, Hefei, China
| | - Hu Shuwen
- Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Anhui Mental Health Center, Hefei, China.,Hefei Fourth People's Hospital, Hefei, China
| | - Guo Pengfei
- Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Anhui Mental Health Center, Hefei, China.,Hefei Fourth People's Hospital, Hefei, China
| | - Liu Shuai
- Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Anhui Mental Health Center, Hefei, China.,Hefei Fourth People's Hospital, Hefei, China
| | - Geng Feng
- Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Anhui Mental Health Center, Hefei, China.,Hefei Fourth People's Hospital, Hefei, China
| | - Cao Xiaomei
- Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Anhui Mental Health Center, Hefei, China.,Hefei Fourth People's Hospital, Hefei, China
| | - Chen Binbin
- Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Anhui Mental Health Center, Hefei, China.,Hefei Fourth People's Hospital, Hefei, China
| | - Zhong Hui
- Department of Psychiatry, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Anhui Mental Health Center, Hefei, China.,Hefei Fourth People's Hospital, Hefei, China
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8
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Zhang T, Bai T, Xie W, Wei Q, Lv H, Wang A, Guan J, Tian Y, Wang K. Abnormal connectivity of anterior-insular subdivisions and relationship with somatic symptom in depressive patients. Brain Imaging Behav 2020; 15:1760-1768. [PMID: 32748317 DOI: 10.1007/s11682-020-00371-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Depressive patients frequently present with somatic complaints such as pain and fatigue. The anterior insula (AI) is a crucial region for somatic processing, but reported contributions of AI dysfunction to somatic symptoms have varied across studies. We speculated that functional heterogeneity among AI subdivisions may contribute to this inconsistency. To reveal the correlation between each subdivision and somatic symptoms, we investigated resting-state functional connectivity (RSFC) based on seeds within distinct AI subdivisions in 45 depressive patients and 35 matched healthy controls (HCs). Depressive and somatic symptoms were assessed using the Hamilton Depression Rating Scale (HDRS) and the 15-item somatic symptom severity scale of the Patient Health Questionnaire (PHQ-15), respectively. The contributions of AI subregion-specific pathways to depression were further validated by examining changes in symptom severity and RSFC following electroconvulsive therapy (ECT). At baseline, depressive patients exhibited weaker RSFC between ventral AI (vAI) and right orbitofrontal cortex (rOFC) than HCs. Moreover, vAI-rOFC RSFC strength was negatively correlated with PHQ-15 and HDRS scores, indicating that weaker RSFC predicted greater symptom severity. ECT reduced depressive and somatic symptoms, and symptom mitigation was correlated with enhanced vAI-rOFC RSFC. The findings suggest that reduced vAI-rOFC RSFC underlies the somatic symptoms of depression and that enhancing vAI-rOFC RSFC can contribute to amelioration of somatic symptoms.
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Affiliation(s)
- Ting Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China
| | - Tongjian Bai
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China
| | - Wen Xie
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Qiang Wei
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China
| | - Huaming Lv
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China
| | - Anzhen Wang
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Jianjun Guan
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, Hefei, China. .,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China. .,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China. .,National Clinical Research Center for Mental Disorders, Hefei, China. .,Department of Medical Psychology, Anhui Medical University, Anhui Province, Hefei, China.
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Province, Hefei, China. .,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China. .,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China. .,Department of Medical Psychology, Anhui Medical University, Anhui Province, Hefei, China.
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9
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Bai T, Wei Q, Xie W, Wang A, Wang J, JI GJ, Wang K, Tian Y. Hippocampal-subregion functional alterations associated with antidepressant effects and cognitive impairments of electroconvulsive therapy. Psychol Med 2019; 49:1357-1364. [PMID: 30229715 PMCID: PMC6518386 DOI: 10.1017/s0033291718002684] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 08/22/2018] [Accepted: 08/22/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Electroconvulsive therapy (ECT), an effective antidepressive treatment, is frequently accompanied by cognitive impairment (predominantly memory), usually transient and self-limited. The hippocampus is a key region involved in memory and emotion processing, and in particular, the anterior-posterior hippocampal subregions has been shown to be associated with emotion and memory. However, less is known about the relationship between hippocampal-subregion alterations following ECT and antidepressant effects or cognitive impairments. METHODS Resting-state functional connectivity (RSFC) based on the seeds of hippocampal subregions were investigated in 45 pre- and post-ECT depressed patients. Structural connectivity between hippocampal subregions and corresponding functionally abnormal regions was also conducted using probabilistic tractography. Antidepressant effects and cognitive impairments were measured by the Hamilton Depressive Rating Scale (HDRS) and the Category Verbal Fluency Test (CVFT), respectively. Their relationships with hippocampal-subregions alterations were examined. RESULTS After ECT, patients showed increased RSFC in the hippocampal emotional subregion (HIPe) with the left middle occipital gyrus (LMOG) and right medial temporal gyrus (RMTG). Decreased HDRS was associated with increased HIPe-RMTG RSFC (r = -0.316, p = 0.035) significantly and increased HIPe-LMOG RSFC at trend level (r = -0.283, p = 0.060). In contrast, the hippocampal cognitive subregion showed decreased RSFC with the bilateral angular gyrus, and was correlated with decreased CVFT (r = 0.418, p = 0.015 for left; r = 0.356, p = 0.042 for right). No significant changes were found in structural connectivity. CONCLUSION The hippocampal-subregions functional alterations may be specially associated with the antidepressant and cognitive effects of ECT.
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Affiliation(s)
- Tongjian Bai
- 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
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China
| | - Qiang Wei
- 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
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China
| | - Wen Xie
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Anzhen Wang
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Jiaojian Wang
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China
| | - Gong-Jun JI
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China
| | - Kai Wang
- 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
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China
| | - Yanghua Tian
- 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
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China
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Bai T, Wei Q, Zu M, Xie W, Wang J, Gong‐Jun J, Yu F, Tian Y, Wang K. Functional plasticity of the dorsomedial prefrontal cortex in depression reorganized by electroconvulsive therapy: Validation in two independent samples. Hum Brain Mapp 2019; 40:465-473. [PMID: 30240504 PMCID: PMC6865625 DOI: 10.1002/hbm.24387] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 08/29/2018] [Indexed: 12/28/2022] Open
Abstract
Previous studies have implied a key role for the prefrontal cortex in the antidepressive effect of electroconvulsive therapy (ECT). However, there is still ubiquitous inconsistency across these studies, partly due to several confounding effects induced by the use of different samples. Studies with independent samples are necessary for validations to minimize confounding effects. In the current study, resting-state magnetic resonance imaging of 84 participants was collected using two scanners and two types of scanning parameters. One sample consisted of 28 patients and 23 healthy controls, and the other sample consisted of 33 patients. The local activity (indexed by the amplitude of low-frequency fluctuations) and functional connectivity were used to examine functional plasticity in the two independent samples before and after ECT. Both samples showed increased local activity of the dorsomedial prefrontal cortex (DMPFC) and enhanced connectivity of the DMPFC with the posterior cingulate cortex (PCC) following ECT. The enhanced connectivity between the DMPFC and PCC was positively associated with clinical improvement for both samples. These findings provide relatively strong evidence to support the functional plasticity of the dorsomedial prefrontal cortex and reorganization by ECT. The functional plasticity of the DMPFC-PCC may underlie the antidepressive effect of ECT.
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Affiliation(s)
- Tongjian Bai
- Department of Neurologythe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Qiang Wei
- Department of Neurologythe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Meidan Zu
- Department of Neurologythe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Wen Xie
- Department of affective disorderFourth People's Hospital of HefeiAnhui ShengChina
| | - Jiaojian Wang
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Ji Gong‐Jun
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefei230022China
- Department of Medical Psychologythe First Affiliated Hospital of Anhui Medical UniversityHefei230022China
| | - Fengqiong Yu
- Department of Neurologythe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Yanghua Tian
- Department of Neurologythe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefei230022China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental HealthHefei230022China
| | - Kai Wang
- Department of Neurologythe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefei230022China
- Department of Medical Psychologythe First Affiliated Hospital of Anhui Medical UniversityHefei230022China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental HealthHefei230022China
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