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Tassone VK, Gholamali Nezhad F, Demchenko I, Rueda A, Bhat V. Amygdala biomarkers of treatment response in major depressive disorder: An fMRI systematic review of SSRI antidepressants. Psychiatry Res Neuroimaging 2024; 338:111777. [PMID: 38183847 DOI: 10.1016/j.pscychresns.2023.111777] [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: 09/18/2023] [Revised: 12/04/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024]
Abstract
Functional neuroimaging studies have demonstrated abnormal activity and functional connectivity (FC) of the amygdala among individuals with major depressive disorder (MDD), which may be rectified with selective serotonin reuptake inhibitor (SSRI) treatment. This systematic review aimed to identify changes in the amygdala on functional magnetic resonance imaging (fMRI) scans among individuals with MDD who received SSRIs. A search for fMRI studies examining amygdala correlates of SSRI response via fMRI was conducted through OVID (MEDLINE, PsycINFO, and Embase). The end date was April 4th, 2023. In total, 623 records were screened, and 16 studies were included in this review. While the search pertained to SSRIs broadly, the included studies were escitalopram-, citalopram-, fluoxetine-, sertraline-, and paroxetine-specific. Decreases in event-related amygdala activity were found following 6-to-12-week SSRI treatment, particularly in response to negative stimuli. Eight-week courses of SSRI pharmacotherapy were associated with increased event-related amygdala FC (i.e., with the prefrontal [PFC] and anterior cingulate cortices, insula, thalamus, caudate nucleus, and putamen) and decreased resting-state effective connectivity (i.e., amygdala-PFC). Preliminary evidence suggests that SSRIs may alter amygdala activity and FC in MDD. Additional studies are needed to corroborate findings. Future research should employ long-term follow-ups to determine whether effects persist after treatment termination.
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Affiliation(s)
- Vanessa K Tassone
- Interventional Psychiatry Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario M5B 1M8, Canada; Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, Ontario M5S 1A8, Canada
| | - Fatemeh Gholamali Nezhad
- Interventional Psychiatry Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario M5B 1M8, Canada
| | - Ilya Demchenko
- Interventional Psychiatry Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario M5B 1M8, Canada; Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, Ontario M5S 1A8, Canada
| | - Alice Rueda
- Interventional Psychiatry Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario M5B 1M8, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario M5B 1M8, Canada; Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, Ontario M5S 1A8, Canada; Neuroscience Research Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario M5B 1M8, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada.
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Liu H, Li B, Li Y, Welsh R, Wang Z. ASL MRI Denoising via Multi Channel Collaborative Low-Rank Regularization. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2024; 12926:129261S. [PMID: 38912380 PMCID: PMC11190560 DOI: 10.1117/12.3005223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Arterial spin labeling (ASL) perfusion MRI is the only non-invasive imaging technique for quantifying regional cerebral blood flow (CBF), which is a fundamental physiological variable. ASL MRI has a relatively low signal-to-noise-ratio (SNR). In this study, we proposed a novel ASL denoising method by simultaneously exploiting the inter- and intra-receive channel data correlations. MRI including ASL MRI data have been routinely acquired with multi-channel coils but current denoising methods are designed for denoising the coil-combined data. Indeed, the concurrently acquired multi-channel images differ only by coil sensitivity weighting and random noise, resulting in a strong low-rank structure of the stacked multi-channel data matrix. In our method, this matrix was formed by stacking the vectorized slices from different channels. Matrix rank was then approximately measured through the logarithm-determinant of the covariance matrix. Notably, our filtering technique is applied directly to complex data, avoiding the need to separate magnitude and phase or divide real and imaginary data, thereby ensuring minimal information loss. The degree of low-rank regularization is controlled based on the estimated noise level, striking a balance between noise removal and texture preservation. A noteworthy advantage of our framework is its freedom from parameter tuning, distinguishing it from most existing methods. Experimental results on real-world imaging data demonstrate the effectiveness of our proposed approach in significantly improving ASL perfusion quality. By effectively mitigating noise while preserving important textural information, our method showcases its potential for enhancing the utility and accuracy of ASL perfusion MRI, paving the way for improved neuroimaging studies and clinical diagnoses.
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Affiliation(s)
- Hangfan Liu
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD, USA 21202
| | - Bo Li
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD, USA 21202
| | - Yiran Li
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD, USA 21202
| | - Rebecca Welsh
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD, USA 21202
| | - Ze Wang
- Center for Advanced Imaging Research, University of Maryland School of Medicine, Baltimore, MD, USA 21202
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Chiappelli J, Adhikari BM, Kvarta MD, Bruce HA, Goldwaser EL, Ma Y, Chen S, Ament S, Shuldiner AR, Mitchell BD, Kochunov P, Wang DJJ, Hong LE. Depression, stress and regional cerebral blood flow. J Cereb Blood Flow Metab 2023; 43:791-800. [PMID: 36606600 PMCID: PMC10108192 DOI: 10.1177/0271678x221148979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 01/07/2023]
Abstract
Decreased cerebral blood flow (CBF) may be an important mechanism associated with depression. In this study we aimed to determine if the association of CBF and depression is dependent on current level of depression or the tendency to experience depression over time (trait depression), and if CBF is influenced by depression-related factors such as stressful life experiences and antidepressant medication use. CBF was measured in 254 participants from the Amish Connectome Project (age 18-76, 99 men and 154 women) using arterial spin labeling. All participants underwent assessment of symptoms of depression measured with the Beck Depression Inventory and Maryland Trait and State Depression scales. Individuals diagnosed with a unipolar depressive disorder had significantly lower average gray matter CBF compared to individuals with no history of depression or to individuals with a history of depression that was in remission at time of study. Trait depression was significantly associated with lower CBF, with the associations strongest in cingulate gyrus and frontal white matter. Use of antidepressant medication and more stressful life experiences were also associated with significantly lower CBF. Resting CBF in specific brain regions is associated with trait depression, experience of stressful life events, and current antidepressant use, and may provide a valuable biomarker for further studies.
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Affiliation(s)
- Joshua Chiappelli
- Maryland Psychiatric Research
Center, Department of Psychiatry, University of Maryland School of Medicine,
Baltimore, MD, USA
| | - Bhim M Adhikari
- Maryland Psychiatric Research
Center, Department of Psychiatry, University of Maryland School of Medicine,
Baltimore, MD, USA
| | - Mark D Kvarta
- Maryland Psychiatric Research
Center, Department of Psychiatry, University of Maryland School of Medicine,
Baltimore, MD, USA
| | - Heather A Bruce
- Maryland Psychiatric Research
Center, Department of Psychiatry, University of Maryland School of Medicine,
Baltimore, MD, USA
| | - Eric L Goldwaser
- Maryland Psychiatric Research
Center, Department of Psychiatry, University of Maryland School of Medicine,
Baltimore, MD, USA
| | - Yizhou Ma
- Maryland Psychiatric Research
Center, Department of Psychiatry, University of Maryland School of Medicine,
Baltimore, MD, USA
| | - Shuo Chen
- Maryland Psychiatric Research
Center, Department of Psychiatry, University of Maryland School of Medicine,
Baltimore, MD, USA
| | - Seth Ament
- Maryland Psychiatric Research
Center, Department of Psychiatry, University of Maryland School of Medicine,
Baltimore, MD, USA
| | - Alan R Shuldiner
- Department of Medicine, University
of Maryland School of Medicine, Baltimore, MD, USA
| | - Braxton D Mitchell
- Department of Medicine, University
of Maryland School of Medicine, Baltimore, MD, USA
- Geriatrics Research and Education
Clinical Center, Baltimore Veterans Administration, Baltimore, MD, USA
| | - Peter Kochunov
- Maryland Psychiatric Research
Center, Department of Psychiatry, University of Maryland School of Medicine,
Baltimore, MD, USA
| | - Danny JJ Wang
- Laboratory of Functional MRI
Technology, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck
School of Medicine, University of Southern California, Los Angeles, CA,
USA
| | - L Elliot Hong
- Maryland Psychiatric Research
Center, Department of Psychiatry, University of Maryland School of Medicine,
Baltimore, MD, USA
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Shared and specific characteristics of regional cerebral blood flow and functional connectivity in unmedicated bipolar and major depressive disorders. J Affect Disord 2022; 309:77-84. [PMID: 35452757 DOI: 10.1016/j.jad.2022.04.099] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Identifying brain similarities and differences between bipolar disorder (BD) and major depressive disorder (MDD) can help us better understand their pathophysiological mechanisms and develop more effective treatments. However, the features of whole-brain regional cerebral blood flow (CBF) and intrinsic functional connectivity (FC) underlying BD and MDD have not been directly compared. METHODS Eighty-eight unmedicated BD II depression patients, 95 unmedicated MDD patients, and 96 healthy controls (HCs) underwent three-dimensional arterial spin labeling (3D ASL) and resting-state functional MRI (rs-fMRI). The functional properties of whole brain CBF and seed-based resting-state FC further performed based on those regions with changed CBF were analyzed between the three groups. RESULTS The patients with BD and MDD showed commonly increased CBF in the left posterior lobe of the cerebellum and the left middle temporal gyrus (MTG) compared with HCs. The CBF of the left MTG was positively associated with 24-items Hamilton Depression Rating Scale scores in MDD patients. Decreased FC between the left posterior lobe of the cerebellum and the left inferior frontal gyrus (IFG) was observed only in patients with BD compared with HCs. CONCLUSION Patients with BD and those with MDD shared common features of CBF in the posterior lobe of the cerebellum and the MTG. The altered posterior lobe of the cerebellum-IFG FC can be considered as a potential biomarker for the differentiation of patients with BD from those with MDD.
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Wang YM, Yang ZY. Aberrant pattern of cerebral blood flow in patients with major depressive disorder: A meta-analysis of arterial spin labelling studies. Psychiatry Res Neuroimaging 2022; 321:111458. [PMID: 35152052 DOI: 10.1016/j.pscychresns.2022.111458] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/30/2022] [Accepted: 02/07/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Accumulating evidence has suggested that patients with major depressive disorder (MDD) could exhibit resting-state cerebral blood flow (CBF) abnormalities. However, findings across studies are controversial. METHODS Our study aimed at identifying replicable CBF changes in MDD by conducting a case-control meta-analysis and meta-regression of arterial spin labelling studies using seed-based d mapping software. Fourteen studies encompassing 505 patients with MDD and 443 healthy controls were included. RESULTS We found increased CBF in the inferior parietal lobule, the striatum, and the bilateral thalamus in all patients with MDD relative to healthy controls. While decreased CBF was observed in the inferior frontal gyrus, the insula, the middle occipital gyrus and the bilateral superior temporal gyrus in patients with MDD. Moreover, increased CBF of the bilateral thalamus was associated with more severe depressive symptoms in patients with MDD. The subgroup meta-analysis showed that patients with acute phase had increased CBF in the bilateral thalamus, and decreased CBF in the left middle occipital gyrus and the left middle frontal gyrus. Chronic patients had decreased CBF in the left insula, the right calcarine sulcus, the right inferior frontal gyrus, and the left parahippocampal gyrus. Patients with medication-free had increased CBF in the right anterior cingulate cortex/medial prefrontal cortex, and decreased CBF in the left middle occipital gyrus, the left inferior frontal gyrus, and the left precentral gyrus. CONCLUSIONS These findings suggest an aberrant cerebral blood flow pattern of MDD involving the cortico-striatal-thalamic circuit, which may facilitate understanding of pathophysiology and suggest potential neural biomarkers for clinical assessment, monitoring and interventions of MDD. One important limitation is that eight recruited studies in our meta-analysis have recruited more males than females, which may have a selection bias of patients.
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Affiliation(s)
- Yong-Ming Wang
- School of Biology & Basic Medical Sciences, Medical College of Soochow University, Suzhou 215123, China
| | - Zhuo-Ya Yang
- Department of Basic Psychology, School of Psychology, Army Medical University, Chongqing 400038, China.
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Vanicek T, Reed MB, Seiger R, Godbersen GM, Klöbl M, Unterholzner J, Spurny-Dworak B, Gryglewski G, Handschuh P, Schmidt C, Kraus C, Stimpfl T, Rupprecht R, Kasper S, Lanzenberger R. Increased left dorsolateral prefrontal cortex density following escitalopram intake during relearning: a randomized, placebo-controlled trial in healthy humans. Ther Adv Psychopharmacol 2022; 12:20451253221132085. [PMID: 36420117 PMCID: PMC9677158 DOI: 10.1177/20451253221132085] [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: 12/20/2021] [Accepted: 09/22/2022] [Indexed: 11/18/2022] Open
Abstract
Background Serotonergic agents affect brain plasticity and reverse stress-induced dendritic atrophy in key fronto-limbic brain areas associated with learning and memory. Objectives The aim of this study was to investigate effects of the antidepressant escitalopram on gray matter during relearning in healthy individuals to inform a model for depression and the neurobiological processes of recovery. Design Randomized double blind placebo control, monocenter study. Methods In all, 76 (44 females) healthy individuals performed daily an associative learning task with emotional or non-emotional content over a 3-week period. This was followed by a 3-week relearning period (randomly shuffled association within the content group) with concurrent daily selective serotonin reuptake inhibitor (i.e., 10 mg escitalopram) or placebo intake. Results Via voxel-based morphometry and only in individuals that developed sufficient escitalopram blood levels over the 21-day relearing period, an increased density of the left dorsolateral prefrontal cortex was found. When investigating whether there was an interaction between relearning and drug intervention for all participants, regardless of escitalopram levels, no changes in gray matter were detected with either surfaced-based or voxel-based morphometry analyses. Conclusion The left dorsolateral prefrontal cortex affects executive function and emotional processing, and is a critical mediator of symptoms and treatment outcomes of depression. In line, the findings suggest that escitalopram facilitates neuroplastic processes in this region if blood levels are sufficient. Contrary to our hypothesis, an effect of escitalopram on brain structure that is dependent of relearning content was not detected. However, this may have been a consequence of the intensity and duration of the interventions. Registration ClinicalTrials.gov Identifier: NCT02753738; Trial Name: Enhancement of learning associated neural plasticity by Selective Serotonin Reuptake Inhibitors; URL: https://clinicaltrials.gov/ct2/show/NCT02753738.
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Affiliation(s)
- Thomas Vanicek
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Murray B Reed
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - René Seiger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Godber M Godbersen
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Manfred Klöbl
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Jakob Unterholzner
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Benjamin Spurny-Dworak
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Gregor Gryglewski
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Patricia Handschuh
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Clemens Schmidt
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Christoph Kraus
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Stimpfl
- Clinical Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Siegfried Kasper
- Department of Molecular Neuroscience, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Waehringerstr. 18-20, Vienna 1090, Austria
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Cho SY, Kwon S, Shin HY, Kim HR, Kim JH, Park S, Ryu CW, Park JM, Edden RAE, Jahng GH. Treatment evaluation of Kami Guibi-tang on participants with amnestic mild cognitive impairment using magnetic resonance imaging on brain metabolites, gamma-aminobutyric acid, and cerebral blood flow. J Appl Clin Med Phys 2021; 22:151-164. [PMID: 34633758 PMCID: PMC8598148 DOI: 10.1002/acm2.13443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/09/2021] [Accepted: 09/22/2021] [Indexed: 11/11/2022] Open
Abstract
Purpose To evaluate the effectiveness of Kami Guibi‐tang (KGT) in the treatment of mild cognitive impairment (MCI) using magnetic resonance imaging (MRI) on brain metabolites, neurotransmitter, and cerebral blood flow (CBF). Methods We randomly allocated a total of 30 MCI patients to a KGT (N = 16) or a placebo (N = 14) group and performed MRI scans before and after 24 weeks of treatment. The participants underwent brain magnetic resonance spectroscopy and MRI scans to obtain brain metabolites using Point‐RESolved Spectroscopy (PRESS) single‐voxel spectroscopy, gamma‐aminobutyric acid (GABA) neurotransmitter using Mescher–Garwood PRESS, and CBF using pseudocontinuous arterial spin labeling sequences using a 3.0 Tesla MRI system. We analyzed metabolite and neurotransmitter levels and CBF using repeated‐measure analysis of variance to evaluate between‐subject group effect, within‐subject treatment condition effect, and interaction of group by condition (group x condition). Results The GABA+/creatine (Cr) ratio values were not significantly different between the before and after treatment conditions. The glutamate complex/Cr ratio difference before and after treatment was lower in the KGT group than in the placebo group, but was not statistically significant (p = 0.077). The result of region of interest–based CBF measurement showed that CBF values were significantly lower after treatment at Cluster 2 for the KGT group (p = 0.003) and the placebo group (p = 0.011), at hippocampus for the KGT group (p = 0.004) and the placebo group (p = 0.008), and at the fusiform gyrus for the KGT group (p = 0.002). Furthermore, the absolute CBF difference before and after treatment in the fusiform gyrus was significantly lower in the KGT group than in the placebo group (p = 0.024). Conclusions Although a KGT treatment of 24 weeks showed some significant impact on the level of CBF, the Korean version of the mini‐mental state examination score was not significantly different between before and after treatment conditions, indicating that there was no memory function improvement after treatment in amnestic MCI patients. Therefore, further studies should be performed with a relatively larger population and extending the duration of the KGT treatment.
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Affiliation(s)
- Seung-Yeon Cho
- Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sharonkyuhee Kwon
- Department of Biomedical Engineering, Undergraduate School, College of Electronics and Information, Kyung Hee University, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Hee-Yeon Shin
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Ha-Ri Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Jeong-Hwa Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Soonchan Park
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chang-Woo Ryu
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jung-Mi Park
- Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Richard A E Edden
- Division of Neuroradiology, Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Geon-Ho Jahng
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
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Hou Z, Li T, He X, Zhang Y, Chen H, Jiang W, Yin Y, Yuan Y. Distinct Features of Cerebral Blood Flow and Spontaneous Neural Activity as Integrated Predictors of Early Response to Antidepressants. Front Psychiatry 2021; 12:788398. [PMID: 35115965 PMCID: PMC8804095 DOI: 10.3389/fpsyt.2021.788398] [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: 10/02/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
AIMS The purpose of this study is to explore whether pre-treatment features of brain function can discriminate non-responders to antidepressant medication in the early phase. METHODS Forty-four treatment-responsive depressed (RD) patients, 36 non-responsive depressed (NRD) patients, and 42 healthy controls (HCs) were recruited. Regional cerebral blood flow (CBF) and amplitude of low-frequency fluctuation (ALFF) values were calculated for all subjects. Correlation analyses were used to explore the relationship between symptom improvement and CBF/ALFF. Receiver operating characteristics (ROC) and the 10-fold cross-validation support vector machine (SVM) classifier were applied for the discrimination of treatment response. RESULTS Compared with the HCs, the RD and NRD groups exhibited lower CBF and ALFF in the right posterior lobe of the cerebellum. Compared with the NRD group, the RD group showed distinct CBF patterns in the left frontal striatal regions and right frontal cerebellar regions, as well as distinct ALFF features in the left frontoparietal striatum and right frontotemporal striatal cerebellar regions. The ROC and SVM classifier revealed the optimal power to distinguish the RD and NRD groups based on the combined measures (i.e., CBF and ALFF). CONCLUSION Distinct features of CBF and ALFF in the frontal striatal network may serve as promising neuroimaging predictors for identifying patients with blunted responsiveness, which may facilitate personalized antidepressant treatment.
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Affiliation(s)
- Zhenghua Hou
- Department of Psychosomatics and Psychiatry, Institute of Psychosomatics, School of Medicine, Affiliated Zhongda Hospital, Southeast University, Nanjing, China
| | - Tong Li
- Department of Psychiatry, The New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States.,Department of Information Engineering, Harbin Institute of Technology, Harbin, China
| | - Xiaofu He
- Department of Psychiatry, The New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States
| | - Yuqun Zhang
- Department of Psychosomatics and Psychiatry, Institute of Psychosomatics, School of Medicine, Affiliated Zhongda Hospital, Southeast University, Nanjing, China
| | - Huanxin Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, School of Psychology, Southwest University, Chongqing, China
| | - Wenhao Jiang
- Department of Psychosomatics and Psychiatry, Institute of Psychosomatics, School of Medicine, Affiliated Zhongda Hospital, Southeast University, Nanjing, China
| | - Yingying Yin
- Department of Psychosomatics and Psychiatry, Institute of Psychosomatics, School of Medicine, Affiliated Zhongda Hospital, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Institute of Psychosomatics, School of Medicine, Affiliated Zhongda Hospital, Southeast University, Nanjing, China
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Solleveld MM, Schrantee A, Homberg JR, Lucassen PJ, Reneman L. The influence of age-of-onset of antidepressant use on the acute CBF response to a citalopram challenge; a pharmacological MRI study. Psychiatry Res Neuroimaging 2020; 303:111126. [PMID: 32592855 DOI: 10.1016/j.pscychresns.2020.111126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 06/03/2020] [Accepted: 06/11/2020] [Indexed: 11/21/2022]
Abstract
Preclinical studies have demonstrated that antidepressant treatment in juvenile rodents affect the ontogeny of the serotonin system. However, whether early antidepressant use has similar effects on the development of the serotonin system in humans remains unknown. Therefore, we investigated whether effects of selective serotonin reuptake inhibitor (SSRI) treatment on the serotonin system are modulated by age. With pharmacological Magnetic Resonance Imaging the cerebral blood flow (CBF) response to an acute citalopram challenge was measured, as a proxy for serotonin function. Fifty-one females with major depressive disorder or anxiety disorder were stratified into three groups: 1) those treated with SSRIs <23 years of age, 2) those treated with SSRIs >23 years of age, and 3) those that were never treated with SSRIs. Additionally, a group of 14 healthy controls was included. CBF decreased after a citalopram challenge in the amygdala, hippocampus and orbitofrontal cortex across the whole sample. However, in contrast to preclinical studies, we did not find any age-dependent effect of SSRI exposure on the CBF response. In view of recent concerns on potential adverse effects of SSRIs administered to children, future studies are needed to replicate our negative findings in larger samples sizes and potentially in a prospective design.
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Affiliation(s)
- Michelle M Solleveld
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Swammerdam Institute for Life Sciences, Center for Neurosciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Anouk Schrantee
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Judith R Homberg
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Paul J Lucassen
- Swammerdam Institute for Life Sciences, Center for Neurosciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Liesbeth Reneman
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
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Morgan HE, Ledbetter CR, Ferrier C, Zweig RM, Disbrow EA. Altered Cortico-Limbic Network Connectivity in Parkinsonian Depression: The Effect of Antidepressants. JOURNAL OF PARKINSONS DISEASE 2019; 8:429-440. [PMID: 30124452 DOI: 10.3233/jpd-171204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Depression is a common comorbidity of Parkinson's disease (PD); however, the impact of antidepressant status on cortical function in parkinsonian depression is not fully understood. While studies of resting state functional MRI in major depression have shown that antidepressant treatment affects cortical connectivity, data on connectivity and antidepressant status in PD is sparse. OBJECTIVE We tested the hypothesis that cortico-limbic network (CLN) resting state connectivity is abnormal in antidepressant-treated parkinsonian depression. METHODS Thirteen antidepressant-treated depressed PD and 47 non-depressed PD participants from the Parkinson's Progression Markers Initiative (PPMI) database were included. Data was collected using 3T Siemens TIM Trio MR scanners and analyzed using SPM and CONN functional connectivity toolbox. Volumetric analysis was also performed using BrainSuite. RESULTS We found decreased connectivity in the antidepressant-treated depressed PD group when compared to non-depressed PD between the left frontal operculum and bilateral insula, and also reduced connectivity between right orbitofrontal cortex and left temporal fusiform structures. Increased depression scores were associated with decreased insular-frontal opercular connectivity. No ROI volumetric differences were found between groups. CONCLUSION Given the relationship between depression scores and cortico-limbic connectivity in PD, the abnormal insular-frontal opercular hypoconnectivity in this cohort may be associated with persistent depressive symptoms or antidepressant effects.
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Affiliation(s)
| | | | - Christopher Ferrier
- Caddo Parish Magnet High School, Science and Medicine Academic Research Training Program, Shreveport, LA, USA
| | - Richard M Zweig
- Department of Neurology, LSUHSC Shreveport, Shreveport, LA, USA
| | - Elizabeth A Disbrow
- Department of Neurology, LSUHSC Shreveport, Shreveport, LA, USA.,Department of Pharmacology, Toxicology, and Neuroscience, LSUHSC Shreveport, Shreveport, LA, USA
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11
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Schrantee A, Solleveld MM, Schwantje H, Bruin WB, Mutsaerts HJMM, Adriaanse SM, Lucassen P, Booij J, Reneman L. Dose-dependent effects of the selective serotonin reuptake inhibitor citalopram: A combined SPECT and phMRI study. J Psychopharmacol 2019; 33:660-669. [PMID: 30887865 PMCID: PMC6572584 DOI: 10.1177/0269881119836229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Serotonin transporter blockers, like citalopram, dose-dependently bind to the serotonin transporter. Pharmacological magnetic resonance imaging (phMRI) can be used to non-invasively monitor effects of serotonergic medication. Although previous studies showed that phMRI can measure the effect of a single dose of serotoninergic medication, it is currently unclear whether it can also detect dose-dependent effects. AIMS To investigate the dose-dependent phMRI response to citalopram and compared this with serotonin transporter occupancy, measured with single photon emission computed tomography (SPECT). METHODS Forty-five healthy females were randomized to pre-treatment with placebo, a low (4 mg) or clinically standard (16 mg) oral citalopram dose. Prior to citalopram, and 3 h after, subjects underwent SPECT scanning. Subsequently, a phMRI scan with a citalopram challenge (7.5 mg intravenously) was conducted. Change in cerebral blood flow in response to the citalopram challenge was assessed in the thalamus and occipital cortex (control region). RESULTS Citalopram dose-dependently affected serotonin transporter occupancy, as measured with SPECT. In addition, citalopram dose-dependently affected the phMRI response to intravenous citalopram in the thalamus (but not occipital cortex), but phMRI was less sensitive in distinguishing between groups than SPECT. Serotonin transporter occupancy showed a trend-significant correlation to thalamic cerebral blood flow change. CONCLUSION These results suggest that phMRI likely suffers from higher variation than SPECT, but that these techniques probably also assess different functional aspects of the serotonergic synapse; therefore phMRI could complement positron emission tomography/SPECT for measuring effects of serotonergic medication.
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Affiliation(s)
- Anouk Schrantee
- Amsterdam University Medical Centers, Academic Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands,Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands,A Schrantee, Amsterdam University Medical Centers, Academic Medical Center, Department of Radiology and Nuclear Medicine, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
| | - Michelle M Solleveld
- Amsterdam University Medical Centers, Academic Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands,Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Hilde Schwantje
- Amsterdam University Medical Centers, Academic Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
| | - Willem B Bruin
- Amsterdam University Medical Centers, Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands
| | - Henk-Jan MM Mutsaerts
- Amsterdam University Medical Centers, Academic Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
| | - Sofie M Adriaanse
- Amsterdam University Medical Centers, Academic Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
| | - Paul Lucassen
- Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Booij
- Amsterdam University Medical Centers, Academic Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
| | - Liesbeth Reneman
- Amsterdam University Medical Centers, Academic Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
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12
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Cooper CM, Chin Fatt CR, Jha M, Fonzo GA, Grannemann BD, Carmody T, Ali A, Aslan S, Almeida JR, Deckersbach T, Fava M, Kurian BT, McGrath PJ, McInnis M, Parsey RV, Weissman M, Phillips ML, Lu H, Etkin A, Trivedi MH. Cerebral Blood Perfusion Predicts Response to Sertraline versus Placebo for Major Depressive Disorder in the EMBARC Trial. EClinicalMedicine 2019; 10:32-41. [PMID: 31193824 PMCID: PMC6543260 DOI: 10.1016/j.eclinm.2019.04.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Major Depressive Disorder (MDD) has been associated with brain-related changes. However, biomarkers have yet to be defined that could "accurately" identify antidepressant-responsive patterns and reduce the trial-and-error process in treatment selection. Cerebral blood perfusion, as measured by Arterial Spin Labelling (ASL), has been used to understand resting-state brain function, detect abnormalities in MDD, and could serve as a marker for treatment selection. As part of a larger trial to identify predictors of treatment outcome, the current investigation aimed to identify perfusion predictors of treatment response in MDD. METHODS For this secondary analysis, participants include 231 individuals with MDD from the EMBARC study, a randomised, placebo-controlled trial investigating clinical, behavioural, and biological predictors of antidepressant response. Participants received sertraline (n = 114) or placebo (n = 117) and response was monitored for 8 weeks. Pre-treatment neuroimaging was completed, including ASL. A whole-brain, voxel-wise linear mixed-effects model was conducted to identify brain regions in which perfusion levels differentially predict (moderate) treatment response. Clinical effectiveness of perfusion moderators was investigated by composite moderator analysis and remission rates. Composite moderator analysis combined the effect of individual perfusion moderators and identified which contribute to sertraline or placebo as the "preferred" treatment. Remission rates were calculated for participants "accurately" treated based on the composite moderator (lucky) versus "inaccurately" treated (unlucky). FINDINGS Perfusion levels in multiple brain regions differentially predicted improvement with sertraline over placebo. Of these regions, perfusion in the putamen and anterior insula, inferior temporal gyrus, fusiform, parahippocampus, inferior parietal lobule, and orbital frontal gyrus contributed to sertraline response. Remission rates increased from 37% for all those who received sertraline to 53% for those who were lucky to have received it and sertraline was their perfusion-preferred treatment. INTERPRETATION This large study showed that perfusion patterns in brain regions involved with reward, salience, affective, and default mode processing moderate treatment response favouring sertraline over placebo. Accurately matching patients with defined perfusion patterns could significantly increase remission rates. FUNDING National Institute of Mental Health, the Hersh Foundation, and the Center for Depression Research and Clinical Care, Peter O'Donnell Brain Institute at UT Southwestern Medical Center.Trial Registration.Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care for Depression (EMARC) Registration Number: NCT01407094 (https://clinicaltrials.gov/ct2/show/NCT01407094).
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Affiliation(s)
- Crystal M. Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Cherise R. Chin Fatt
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Manish Jha
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Gregory A. Fonzo
- Department of Psychiatry and behavioural Sciences, Stanford University School of Medicine, United States of America
- Stanford Neurosciences Institute, Stanford University, United States of America
- Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, United States of America
| | - Bruce D. Grannemann
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Thomas Carmody
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Aasia Ali
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Sina Aslan
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
- Advance MRI, LLC, United States of America
| | - Jorge R.C. Almeida
- Department of Psychiatry, University of Texas Austin, United States of America
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, United States of America
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, United States of America
| | - Benji T. Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
| | - Patrick J. McGrath
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, United States of America
| | - Melvin McInnis
- Department of Psychiatry, University of Michigan School of Medicine, United States of America
| | - Ramin V. Parsey
- Departments of Psychiatry, Stony Brook University, United States of America
| | - Myrna Weissman
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, United States of America
| | - Mary L. Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America
| | - Hanzhang Lu
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
- Department of Radiology, Johns Hopkins University, United States of America
| | - Amit Etkin
- Department of Psychiatry and behavioural Sciences, Stanford University School of Medicine, United States of America
- Stanford Neurosciences Institute, Stanford University, United States of America
- Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, United States of America
| | - Madhukar H. Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States of America
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13
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He Z, Sheng W, Lu F, Long Z, Han S, Pang Y, Chen Y, Luo W, Yu Y, Nan X, Cui Q, Chen H. Altered resting-state cerebral blood flow and functional connectivity of striatum in bipolar disorder and major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2019; 90:177-185. [PMID: 30500413 DOI: 10.1016/j.pnpbp.2018.11.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 08/26/2018] [Accepted: 11/15/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Clinically distinguishing bipolar disorder (BD) from major depressive disorder (MDD) during depressive states is difficult. Neuroimaging findings suggested that patients with BD and those with MDD differed with respect to the gray matter volumes of their subcortical structures, especially in their striatum. However, whether these disorders have different effects on functionally striatal neuronal activity and connectivity is unclear. METHODS Arterial spin labeling and resting-state functional MRI was performed on 25 currently depressive patients with BD, 25 depressive patients with MDD, and 34 healthy controls (HCs). The functional properties of striatal neuronal activity (cerebral blood flow, CBF) and its functional connectivity (FC) were analyzed, and the results from the three groups were compared. The result of the multiple comparisons was corrected on the basis of the Gaussian Random Field theory. RESULTS The patients with BD and those with MDD both had higher CBF values than the HCs in the right caudate and right putamen. The hyper-metabolism of right striatum in BD patients was associated with increased average duration per depressive episode. The two disorders showed commonly increased FC between the striatum and dorsolateral prefrontal cortex, whereas the altered FC of the striatum with precuneus/cuneus was observed only in patients with BD. CONCLUSIONS Patients with BD and those with MDD had a common deficit in their prefrontal-limbic-striatal circuits. The altered striato-precuneus FC can be considered as a marker for the differentiation of patients with BD from those with MDD.
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Affiliation(s)
- Zongling He
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China; Center for Information in BioMedicine, Key laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Wei Sheng
- Center for Information in BioMedicine, Key laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China; Center for Information in BioMedicine, Key laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Zhiliang Long
- Center for Information in BioMedicine, Key laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Shaoqiang Han
- Center for Information in BioMedicine, Key laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Yajing Pang
- Center for Information in BioMedicine, Key laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Yuyan Chen
- Center for Information in BioMedicine, Key laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Wei Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Yue Yu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaoyu Nan
- Center for Information in BioMedicine, Key laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Qian Cui
- School of Public Administration, University of Electronic Science and Technology of China, Chengdu, China.
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China; Center for Information in BioMedicine, Key laboratory for Neuroinformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China.
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14
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Karthikeyan S, Fiksenbaum L, Grigorian A, Lu H, MacIntosh BJ, Goldstein BI. Normal Cerebral Oxygen Consumption Despite Elevated Cerebral Blood Flow in Adolescents With Bipolar Disorder: Putative Neuroimaging Evidence of Anomalous Energy Metabolism. Front Psychiatry 2019; 10:739. [PMID: 31681045 PMCID: PMC6798187 DOI: 10.3389/fpsyt.2019.00739] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/16/2019] [Indexed: 12/22/2022] Open
Abstract
Background: Regional cerebral blood flow (CBF) is reportedly altered in both adolescents and adults with bipolar disorder (BD). Whether these CBF differences are part of an overall imbalance in cerebral energy homeostasis remains unknown. Therefore, we examined global cerebral metabolic rate of oxygen consumption (CMRO2) as a physiological index of brain metabolism in adolescents with and without BD. Methods: One hundred and fifteen adolescents (mean age 17.3 ± 1.4 years), including 58 BD (type I, II, or not otherwise specified [NOS]) and 57 age-matched healthy controls (HCs) participated in this magnetic resonance imaging (MRI) study. Global estimates for venous blood oxygenation (Yv) and grey matter CBF were measured using T2-relaxation-under-spin-tagging (TRUST) and arterial spin labeling (ASL) MRI, respectively. CMRO2 was calculated using the Fick principle of arteriovenous difference to test for a group difference. We also examined CMRO2 in relation to mood states (i.e. euthymic, depressed, or hypomanic/mixed). Results: Although CBF was significantly higher in BD compared to HCs, there was no group difference in global CMRO2, nor Yv. Meanwhile, Yv significantly decreased with age, and females tended to have greater CBF and CMRO2 in comparison to males. Lastly, there was no significant association between CMRO2 and mood states. Conclusions: Our results indicate a potential mismatch between cerebral blood supply and oxygen metabolism in BD, suggesting inefficiency in energy homeostasis in the brain. Mapping CMRO2 would provide the spatial resolution to investigate regional alterations in metabolism, particularly in the brain regions where CBF is increased.
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Affiliation(s)
- Sudhir Karthikeyan
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Lisa Fiksenbaum
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Anahit Grigorian
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Bradley J MacIntosh
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.,Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.,Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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15
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Wei W, Karim HT, Lin C, Mizuno A, Andreescu C, Karp JF, Reynolds CF, Aizenstein HJ. Trajectories in Cerebral Blood Flow Following Antidepressant Treatment in Late-Life Depression: Support for the Vascular Depression Hypothesis. J Clin Psychiatry 2018; 79:18m12106. [PMID: 30358242 PMCID: PMC6419103 DOI: 10.4088/jcp.18m12106] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/28/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Studies have identified longitudinally that there exists an association between depression, cerebral blood flow (CBF), and white matter hyperintensities that are thought to be due to vascular pathologies in the brain. However, the changes in CBF, a measure that reflects cerebrovascular integrity, following pharmacotherapy are not well understood. In this study, we investigated the dynamic CBF changes over the course of antidepressant treatment and the association of these changes with depressive symptoms. METHODS We used pseudocontinuous arterial spin labeling to investigate CBF changes in a sample of older patients (≥ 50 years of age; N = 46; 29 female) with a DSM-IV diagnosis of major depressive disorder. Participants had 5 magnetic resonance imaging scans (at baseline, the day after receiving a placebo, the day after receiving a first dose of venlafaxine, a week after starting venlafaxine treatment, and at the end of trial [12 weeks]). Montgomery-Asberg Depression Rating Scale (MADRS) was used to evaluate depression severity and treatment outcome. We investigated the association between changes in depression severity with changes in voxel-wise CBF while adjusting for potential confounding factors. RESULTS Increased CBF in the middle and posterior cingulate between baseline and end of treatment was significantly associated with percent decrease in MADRS score, independent of sex and Mini-Mental State Examination score (5,000 permutations, cluster forming threshold P < .005, family-wise error P < .05). No significant effects were detected between baseline and other scans (ie, placebo, acute [single dose], or subacute [after a week]). CONCLUSIONS Regional CBF increases were associated with decreases in depressive symptoms. This observation is consistent with the vascular depression hypothesis in late-life depression. TRIAL REGISTRATION ClinicalTrials.gov identifiers: NCT00892047 and NCT01124188.
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Affiliation(s)
- Wenjing Wei
- The Third Xiangya Hospital of Central South University, Changsha, Hunan, China,University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Helmet T. Karim
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Chemin Lin
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Akiko Mizuno
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jordan F. Karp
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Charles F. Reynolds
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Howard J. Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America,Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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16
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Carmichael O, Schwarz AJ, Chatham CH, Scott D, Turner JA, Upadhyay J, Coimbra A, Goodman JA, Baumgartner R, English BA, Apolzan JW, Shankapal P, Hawkins KR. The role of fMRI in drug development. Drug Discov Today 2018; 23:333-348. [PMID: 29154758 PMCID: PMC5931333 DOI: 10.1016/j.drudis.2017.11.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/19/2017] [Accepted: 11/13/2017] [Indexed: 12/17/2022]
Abstract
Functional magnetic resonance imaging (fMRI) has been known for over a decade to have the potential to greatly enhance the process of developing novel therapeutic drugs for prevalent health conditions. However, the use of fMRI in drug development continues to be relatively limited because of a variety of technical, biological, and strategic barriers that continue to limit progress. Here, we briefly review the roles that fMRI can have in the drug development process and the requirements it must meet to be useful in this setting. We then provide an update on our current understanding of the strengths and limitations of fMRI as a tool for drug developers and recommend activities to enhance its utility.
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Affiliation(s)
- Owen Carmichael
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.
| | | | - Christopher H Chatham
- Translational Medicine Neuroscience and Biomarkers, Roche Innovation Center, Basel, Switzerland
| | | | - Jessica A Turner
- Psychology Department & Neuroscience Institute, Georgia State University, Atlanta, GA, USA
| | | | | | | | - Richard Baumgartner
- Biostatistics and Research Decision Sciences (BARDS), Merck & Co., Inc., Kenilworth, NJ, USA
| | | | - John W Apolzan
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
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17
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Li Y, Mao D, Li Z, Schär M, Pillai JJ, Pipe JG, Lu H. Cardiac-triggered pseudo-continuous arterial-spin-labeling: A cost-effective scheme to further enhance the reliability of arterial-spin-labeling MRI. Magn Reson Med 2018; 80:969-975. [PMID: 29369422 DOI: 10.1002/mrm.27090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 12/04/2017] [Accepted: 12/27/2017] [Indexed: 01/01/2023]
Affiliation(s)
- Yang Li
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Deng Mao
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Zhiqiang Li
- Imaging Research, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Michael Schär
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jay J Pillai
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - James G Pipe
- Imaging Research, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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18
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Bosch OG, Esposito F, Havranek MM, Dornbierer D, von Rotz R, Staempfli P, Quednow BB, Seifritz E. Gamma-Hydroxybutyrate Increases Resting-State Limbic Perfusion and Body and Emotion Awareness in Humans. Neuropsychopharmacology 2017; 42:2141-2151. [PMID: 28561068 PMCID: PMC5603804 DOI: 10.1038/npp.2017.110] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/04/2017] [Accepted: 05/25/2017] [Indexed: 12/15/2022]
Abstract
Gamma-hydroxybutyrate (GHB) is a GHB-/GABA-B receptor agonist inducing a broad spectrum of subjective effects including euphoria, disinhibition, and enhanced vitality. It is used as treatment for neuropsychiatric disorders including narcolepsy and alcohol withdrawal, but is also a drug of abuse. Non-medical users report enhancement of body and emotion awareness during intoxication. However, the neuronal underpinnings of such awareness alterations under GHB are unknown so far. The assessment of regional cerebral blood flow (rCBF) by pharmacological magnetic resonance imaging (phMRI) enables the elucidation of drug-induced functional brain alterations. Thus, we assessed the effects of GHB (35 mg/kg p.o.) in 17 healthy males on rCBF and subjective drug effects, using a placebo-controlled, double-blind, randomized, cross-over design employing arterial spin labeling phMRI. Compared to placebo, GHB increased subjective ratings for body and emotion awareness, and for dizziness (p<0.01-0.001, Bonferroni-corrected). A whole-brain analysis showed increased rCBF in the bilateral anterior cingulate cortex (ACC) and the right anterior insula under GHB (p<0.05, cluster-corrected). ACC and insula rCBF are correlated with relaxation, and body and emotion awareness (p<0.05-0.001, uncorrected). Interaction analyses revealed that GHB-induced increase of body awareness was accompanied by increased rCBF in ACC, whereas relaxation under GHB was accompanied by elevated rCBF in right anterior insula (p<0.05, uncorrected). In conclusion, enhancement of emotion and body awareness, and increased perfusion of insula and ACC bears implications both for the properties of GHB as a drug of abuse as well as for its putative personalized potential for specific therapeutic indications in affective disorders.
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Affiliation(s)
- Oliver G Bosch
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland,Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, Zurich CH-8032, Switzerland, Tel: +41 44 384 2357, Fax: +41 44 383 4456, E-mail:
| | - Fabrizio Esposito
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Baronissi, Italy
| | - Michael M Havranek
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Dario Dornbierer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland,Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Robin von Rotz
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Philipp Staempfli
- MR-Center of the Department of Psychiatry, Psychotherapy and Psychosomatics and the Department of Child and Adolescent Psychiatry, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland,Neuroscience Center Zurich, Research Group Disorders of the Nervous System, University and ETH Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland,Neuroscience Center Zurich, Research Group Disorders of the Nervous System, University and ETH Zurich, Zurich, Switzerland
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Almeida JRC, Greenberg T, Lu H, Chase HW, Fournier JC, Cooper CM, Deckersbach T, Adams P, Carmody T, Fava M, Kurian B, McGrath PJ, McInnis MG, Oquendo MA, Parsey R, Weissman M, Trivedi M, Phillips ML. Test-retest reliability of cerebral blood flow in healthy individuals using arterial spin labeling: Findings from the EMBARC study. Magn Reson Imaging 2017; 45:26-33. [PMID: 28888770 DOI: 10.1016/j.mri.2017.09.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 03/17/2017] [Accepted: 09/01/2017] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Previous investigations of test-retest reliability of cerebral blood flow (CBF) at rest measured with pseudo-continuous Arterial Spin Labeling (pCASL) demonstrated good reliability, but are limited by the use of similar scanner platforms. In the present study we examined test-retest reliability of CBF in regions implicated in emotion and the default mode network. MATERIAL AND METHODS We measured absolute and relative CBF at rest in thirty-one healthy subjects in two scan sessions, one week apart, at four different sites and three different scan platforms. We derived CBF from pCASL images with an automated algorithm and calculated intra-class correlation coefficients (ICCs) across sessions for regions of interest. In addition, we investigated site effects. RESULTS For both absolute and relative CBF measures, ICCs were good to excellent (i.e. >0.6) in most brain regions, with highest values observed for the subgenual anterior cingulate cortex and ventral striatum. A leave-one-site-out cross validation analysis did not show a significant effect for site on whole brain CBF and there was no proportional bias across sites. However, a significant site effect was present in the repeated measures ANOVA. CONCLUSIONS The high test-retest reliability of CBF measured with pCASL in a range of brain regions implicated in emotion and salience processing, emotion regulation, and the default mode network, which have been previously linked to depression symptomatology supports its use in studies that aim to identify neuroimaging biomarkers of treatment response.
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Affiliation(s)
- Jorge R C Almeida
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; Department of Psychiatry, Brown University School of Medicine, Providence, RI 02906, USA; Departments of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, TX 78712, USA.
| | - Tsafrir Greenberg
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Hanzhang Lu
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Jay C Fournier
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Crystal M Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Phil Adams
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Thomas Carmody
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Benji Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Patrick J McGrath
- Department of Psychiatry, Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, New York, NY 10032, USA
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-3309, USA
| | - Ramin Parsey
- Departments of Psychiatry & Radiology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Myrna Weissman
- Department of Psychiatry, Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, New York, NY 10032, USA
| | - Madhukar Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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20
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Liao W, Wang Z, Zhang X, Shu H, Wang Z, Liu D, Zhang Z. Cerebral blood flow changes in remitted early- and late-onset depression patients. Oncotarget 2017; 8:76214-76222. [PMID: 29100305 PMCID: PMC5652699 DOI: 10.18632/oncotarget.19185] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 06/17/2017] [Indexed: 01/08/2023] Open
Abstract
Abnormal cerebral blood flow (CBF) is reportedly associated with major depressive disorder (MDD). We have investigated CBF changes in early-onset depression (EOD) and late-onset depression (LOD), and their impact on cognitive function. Thirty-two remitted EOD patients, 32 remitted LOD patients, and 43 age-matched healthy controls were recruited, and the pulsed arterial spin labeling data were scanned under 3.0T MRI and processed through voxel-by-voxel statistical analysis. Compared to healthy controls, LOD patients had decreased normalized CBF in the bilateral precuneus, cuneus, right fronto-cingulate-striatal areas, and right temporal, occipital and parietal lobes, but increased normalized CBF in the left frontal and temporal cortices and the cingulate gyrus. EOD patients had decreased normalized CBF in the left cerebellum and right calcarine/lingual/fusiform gyrus, and increased normalized CBF in right angular gyrus. LOD patients displayed hemispheric asymmetry in CBF, and had more regions with abnormal CBF than EOD patients. A significant correlation between abnormal CBF and impaired cognitive function was detected in LOD patients, but not EOD patients. These results demonstrate greater CBF abnormalities in LOD patients than EOD patients, and suggest these CBF changes may be associated with progressive degradation of cognitive function in LOD patients.
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Affiliation(s)
- Wenxiang Liao
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu 210009, China
| | - Ze Wang
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang 311121, China
| | - Xiangrong Zhang
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu 210009, China.,Department of Geriatric Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Hao Shu
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu 210009, China
| | - Zan Wang
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu 210009, China
| | - Duan Liu
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu 210009, China
| | - Zhijun Zhang
- Neurologic Department of Affiliated ZhongDa Hospital, Neuropsychiatric Institute and Medical School of Southeast University, Nanjing, Jiangsu 210009, China
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21
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Frontocingulate cerebral blood flow and cerebrovascular reactivity associated with antidepressant response in late-life depression. J Affect Disord 2017; 215:103-110. [PMID: 28324779 PMCID: PMC5472992 DOI: 10.1016/j.jad.2017.03.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 03/08/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Vascular pathology is common in late-life depression (LLD) and may contribute to alterations in cerebral blood flow (CBF) and cerebrovascular reactivity (CVR). In turn, such hemodynamic deficits may adversely affect brain function and clinical course. The goal of this study was to examine whether altered cerebral hemodynamics in depressed elders predicted antidepressant response. METHODS 21 depressed elders completed cranial 3T MRI, including a pseudo-continuous Arterial Spin Labeling (pcASL) acquisition on both room air and during a hypercapnia challenge. Participants then completed 12 weeks of open-label sertraline. Statistical analyses examined the relationship between regional normalized CBF and CVR values and change in Montgomery-Asberg Depression Rating Scale (MADRS) and tested for differences based on remission status. RESULTS 10 participants remitted and 11 did not. After controlling for age and baseline MADRS, greater change in MADRS with treatment was associated with lower pre-treatment normalized CBF in the caudal anterior cingulate cortex (cACC) and lateral orbitofrontal cortex (OFC), as well as lower CVR with hypercapnia in the caudal medial frontal gyrus (cMFG). After controlling for age and baseline MADRS score, remitters exhibited lower CBF in the cACC and lower CVR in the cMFG. LIMITATIONS Our sample was small, did not include a placebo arm, and we examined only specific regions of interest. CONCLUSIONS Our findings suggest that increased perfusion of the OFC and the ACC is associated with a poor antidepressant response. They do not support that vascular pathology as measured by CBF and CVR negatively affects acute treatment outcomes.
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22
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Thomann PA, Wolf RC, Nolte HM, Hirjak D, Hofer S, Seidl U, Depping MS, Stieltjes B, Maier-Hein K, Sambataro F, Wüstenberg T. Neuromodulation in response to electroconvulsive therapy in schizophrenia and major depression. Brain Stimul 2017; 10:637-644. [DOI: 10.1016/j.brs.2017.01.578] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 01/10/2017] [Accepted: 01/13/2017] [Indexed: 01/18/2023] Open
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23
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EEG marker of inhibitory brain activity correlates with resting-state cerebral blood flow in the reward system in major depression. Eur Arch Psychiatry Clin Neurosci 2016; 266:755-764. [PMID: 26590845 DOI: 10.1007/s00406-015-0652-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/09/2015] [Indexed: 01/08/2023]
Abstract
Frontal alpha band asymmetry (FAA) is a marker of altered reward processing in major depressive disorder (MDD), associated with reduced approach behavior and withdrawal. However, its association with brain metabolism remains unclear. The aim of this study was to investigate FAA and its correlation with resting-state cerebral blood flow (rCBF). We hypothesized an association of FAA with regional rCBF in brain regions relevant to reward processing and motivated behavior, such as the striatum. We enrolled 20 patients and 19 healthy subjects. FAA scores and rCBF were quantified with the use of EEG and arterial spin labeling. Correlations of the two were evaluated, as well as the association with FAA and psychometric assessments of motivated behavior and anhedonia. Patients showed a left-lateralized pattern of frontal alpha activity and a correlation of FAA lateralization with subscores of Hamilton Depression Rating Scale linked to motivated behavior. An association of rCBF and FAA scores was found in clusters in the dorsolateral prefrontal cortex bilaterally (patients), in the left medial frontal gyrus, in the right caudate head and in the right inferior parietal lobule (whole group). No correlations were found in healthy controls. Higher inhibitory right-lateralized alpha power was associated with lower rCBF values in prefrontal and striatal regions, predominantly in the right hemisphere, which are involved in the processing of motivated behavior and reward. Inhibitory brain activity in the reward system may contribute to some of the motivational problems observed in MDD.
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24
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Cantisani A, Stegmayer K, Bracht T, Federspiel A, Wiest R, Horn H, Müller TJ, Schneider C, Höfle O, Strik W, Walther S. Distinct resting-state perfusion patterns underlie psychomotor retardation in unipolar vs. bipolar depression. Acta Psychiatr Scand 2016; 134:329-38. [PMID: 27497085 DOI: 10.1111/acps.12625] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Psychomotor abnormalities characterize both unipolar (UP) depression and bipolar (BP) depression. We aimed to assess their neurobiological correlates in terms of motor activity (AL) and resting-state cerebral blood flow (rCBF) and investigate their association in BP, UP, and healthy controls (HC). METHOD We enrolled 42 depressed patients (22 BP, 20 UP) and 19 HC matched for age, gender, education, income. AL and rCBF were objectively assessed with the use of wrist actigraphy and arterial spin labeling. Group differences and the association of AL and rCBF were computed. RESULTS Activity level was significantly reduced in patients, but no difference was found between BP and UP. Increased perfusion was found in BP compared with UP and HC, in multiple brain areas. We found positive correlations of rCBF and AL in BP and UP, in different parts of the insula and frontal regions. Only BP showed a cluster in the left precentral gyrus. In HC, only inverse correlations of AL and rCBF were found. CONCLUSION The differences in rCBF and in the localization of the clusters of positive AL/rCBF correlations between BP and UP suggest that different neural impairments may underlie motor symptoms in the two disorders, but finally converge in phenotypically similar manifestations.
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Affiliation(s)
- A Cantisani
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland. , .,NeuroFarBa Department, University of Florence, Florence, Italy. ,
| | - K Stegmayer
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - T Bracht
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - A Federspiel
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - R Wiest
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - H Horn
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - T J Müller
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - C Schneider
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - O Höfle
- Department of Neurology, University Hospital Bern, Bern, Switzerland
| | - W Strik
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - S Walther
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
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25
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Paloyelis Y, Doyle OM, Zelaya FO, Maltezos S, Williams SC, Fotopoulou A, Howard MA. A Spatiotemporal Profile of In Vivo Cerebral Blood Flow Changes Following Intranasal Oxytocin in Humans. Biol Psychiatry 2016; 79:693-705. [PMID: 25499958 DOI: 10.1016/j.biopsych.2014.10.005] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 08/21/2014] [Accepted: 10/07/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Animal and human studies highlight the role of oxytocin in social cognition and behavior and the potential of intranasal oxytocin (IN-OT) to treat social impairment in individuals with neuropsychiatric disorders such as autism. However, extensive efforts to evaluate the central actions and therapeutic efficacy of IN-OT may be marred by the absence of data regarding its temporal dynamics and sites of action in the living human brain. METHODS In a placebo-controlled study, we used arterial spin labeling to measure IN-OT-induced changes in resting regional cerebral blood flow (rCBF) in 32 healthy men. Volunteers were blinded regarding the nature of the compound they received. The rCBF data were acquired 15 min before and up to 78 min after onset of treatment onset (40 IU of IN-OT or placebo). The data were analyzed using mass univariate and multivariate pattern recognition techniques. RESULTS We obtained robust evidence delineating an oxytocinergic network comprising regions expected to express oxytocin receptors, based on histologic evidence, and including core regions of the brain circuitry underpinning social cognition and emotion processing. Pattern recognition on rCBF maps indicated that IN-OT-induced changes were sustained over the entire posttreatment observation interval (25-78 min) and consistent with a pharmacodynamic profile showing a peak response at 39-51 min. CONCLUSIONS Our study provides the first visualization and quantification of IN-OT-induced changes in rCBF in the living human brain unaffected by cognitive, affective, or social manipulations. Our findings can inform theoretical and mechanistic models regarding IN-OT effects on typical and atypical social behavior and guide future experiments (e.g., regarding the timing of experimental manipulations).
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Affiliation(s)
- Yannis Paloyelis
- Departments of Neuroimaging, Institute of Psychiatry, King's College London, London.
| | - Orla M Doyle
- Departments of Neuroimaging, Institute of Psychiatry, King's College London, London
| | - Fernando O Zelaya
- Departments of Neuroimaging, Institute of Psychiatry, King's College London, London
| | - Stefanos Maltezos
- Departments of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King's College London, London
| | - Steven C Williams
- Departments of Neuroimaging, Institute of Psychiatry, King's College London, London
| | - Aikaterini Fotopoulou
- Research Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
| | - Matthew A Howard
- Departments of Neuroimaging, Institute of Psychiatry, King's College London, London
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26
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Changes in the regional cerebral blood flow detected by arterial spin labeling after 6-week escitalopram treatment for major depressive disorder. J Affect Disord 2016; 194:135-43. [PMID: 26826533 DOI: 10.1016/j.jad.2015.12.062] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 12/25/2015] [Accepted: 12/26/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND A few studies have used pseudo-continuous arterial spin labeling (pCASL) to assess the regional cerebral blood flow (rCBF) in patients with major depressive disorder (MDD). However, rCBF changes during treatment with escitalopram have not been studied in detail. We used pCASL to investigate the effect of 6-week escitalopram treatment on the rCBF in MDD patients. METHODS We subjected 53 MDD patients and 36 controls to pCASL (T1, baseline). The patients then received treatment with escitalopram for 6 weeks and 27 were scanned again (T2). We used selected regions of interest that exhibited differences between the controls and patients at T1 and compared the T2 rCBF in the patients with the T1 rCBF of the controls. We also compared the T1 and T2 rCBF in the patients to assess their response to escitalopram. RESULTS After 6-week treatment with escitalopram, the rCBF in the patients' left inferior temporal gyri, the middle- and inferior frontal gyri, and the subgenual anterior cingulate, which had been higher at T1 than in the controls, was decreased. Their rCBF in the right lingual gyrus remained significantly lower at T2. LIMITATION We did not have a placebo-control group and the number of patients available at T2 was small. CONCLUSION In MDD patients, 6-week escitalopram treatment elicited significant rCBF changes toward normalization in most of the areas that had shown significant differences between the patients and the controls at T1. The persistence of rCBF anomalies in the right lingual gyrus may be a trait marker of MDD.
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27
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Chen Y, Pressman P, Simuni T, Parrish TB, Gitelman DR. Effects of acute levodopa challenge on resting cerebral blood flow in Parkinson's Disease patients assessed using pseudo-continuous arterial spin labeling. PeerJ 2015; 3:e1381. [PMID: 26734502 PMCID: PMC4699782 DOI: 10.7717/peerj.1381] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 10/14/2015] [Indexed: 01/20/2023] Open
Abstract
Introduction. Levodopa is the gold-standard for treatment of Parkinson’s disease (PD) related motor symptoms. In this study, we used pseudo-continuous arterial spin labeling (pCASL) to quantify changes in cerebral blood flow (CBF) after acute oral administration of levodopa in PD patients. Materials and Methods. Thirteen patients (3 females, age 66.2 ± 8.7 years) with moderately advanced PD (Hoehn and Yahr stage >2 (median 2.5), disease duration >3 years) were scanned on a 3T Siemens MR scanner before and after oral levodopa administration. Statistical parametric mapping was used to detect drug-induced changes in CBF and its correlation to clinical severity scales. Images were normalized and flipped in order to examine effects on the more affected (left) and less affected (right) cerebral hemispheres across the cohort. Results. Levodopa did not change global CBF but increased regional CBF in dorsal midbrain, precuneus/cuneus, more affected inferior frontal pars opercularis and triangularis, bilateral pre- and postcentral gyri, more affected inferior parietal areas, as well as less affected putamen/globus pallidus by 27–74% (p < 0.05, FWE corrected for multiple comparisons). CBF change was negatively correlated with improvement in bradykinesia UPDRS-III subscore in the more affected precentral gyrus, and total predrug UPDRS-III score in the mid-cingulate region. Drug-induced CBF change in a widespread network of regions including parietal and postcentral areas was also negatively correlated with the predrug rigidity UPDRS-III subscore. Conclusion. These findings are in line with prior reports of abnormal activity in the nigrostriatal pathway of PD patients and demonstrate the feasibility of pCASL as a neuroimaging tool for investigating in vivo physiological effects of acute drug administration in PD.
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Affiliation(s)
- Yufen Chen
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL , USA
| | - Peter Pressman
- Department of Neurology, Memory and Aging Center, University of California , San Francisco, CA , USA
| | - Tanya Simuni
- Department of Neurology, Feinberg School of Medicine, Northwestern University , Chicago, IL , USA
| | - Todd B Parrish
- Department of Radiology, Feinberg School of Medicine, Northwestern University , Chicago, IL , USA
| | - Darren R Gitelman
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Medicine, Advocate Lutheran General Hospital, Park Ridge, IL, USA; Department of Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
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28
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Vasic N, Wolf ND, Grön G, Sosic-Vasic Z, Connemann BJ, Sambataro F, von Strombeck A, Lang D, Otte S, Dudek M, Wolf RC. Baseline brain perfusion and brain structure in patients with major depression: a multimodal magnetic resonance imaging study. J Psychiatry Neurosci 2015; 40:412-21. [PMID: 26125119 PMCID: PMC4622640 DOI: 10.1503/jpn.140246] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Abnormal regional cerebral blood flow (rCBF) and grey matter volume have been frequently reported in patients with major depressive disorder (MDD). However, it is unclear to what extent structural and functional change co-occurs in patients with MDD and whether markers of neural activity, such as rCBF, can be predicted by structural change. METHODS Using MRI, we investigated resting-state rCBF and brain structure in patients with MDD and healthy controls between July 2008 and January 2013. We acquired perfusion images obtained with continuous arterial spin labelling, used voxel-based morphometry to assess grey matter volume and integrated biological parametric mapping analyses to investigate the impact of brain atrophy on rCBF. RESULTS We included 43 patients and 29 controls in our study. Frontotemporal grey matter volume was reduced in patients compared with controls. In patients, rCBF was reduced in the anterior cingulate and bilateral parahippocampal areas and increased in frontoparietal and striatal regions. These abnormalities were confirmed by analyses with brain volume as a covariate. In patients with MDD there were significant negative correlations between the extent of depressive symptoms and bilateral parahippocampal rCBF. We found a positive correlation between depressive symptoms and rCBF for right middle frontal cortical blood flow. LIMITATIONS Medication use in patients has to be considered as a limitation of our study. CONCLUSION Our data suggest that while changes of cerebral blood flow and brain volume co-occur in patients with MDD, structural change is not sufficient to explain altered neural activity in patients at rest. Abnormal brain structure and function in patients with MDD appear to reflect distinct levels of neuropathology.
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Affiliation(s)
- Nenad Vasic
- Correspondence to: N. Vasic, Department of Forensic Psychiatry and Psychotherapy, University of Ulm, District Hospital Guenzburg, Ludwig-Heilmeyer-Str. 2, 89312 Guenzburg, Germany;
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29
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Rosa MJ, Mehta MA, Pich EM, Risterucci C, Zelaya F, Reinders AATS, Williams SCR, Dazzan P, Doyle OM, Marquand AF. Estimating multivariate similarity between neuroimaging datasets with sparse canonical correlation analysis: an application to perfusion imaging. Front Neurosci 2015; 9:366. [PMID: 26528117 PMCID: PMC4603249 DOI: 10.3389/fnins.2015.00366] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/23/2015] [Indexed: 01/16/2023] Open
Abstract
An increasing number of neuroimaging studies are based on either combining more than one data modality (inter-modal) or combining more than one measurement from the same modality (intra-modal). To date, most intra-modal studies using multivariate statistics have focused on differences between datasets, for instance relying on classifiers to differentiate between effects in the data. However, to fully characterize these effects, multivariate methods able to measure similarities between datasets are needed. One classical technique for estimating the relationship between two datasets is canonical correlation analysis (CCA). However, in the context of high-dimensional data the application of CCA is extremely challenging. A recent extension of CCA, sparse CCA (SCCA), overcomes this limitation, by regularizing the model parameters while yielding a sparse solution. In this work, we modify SCCA with the aim of facilitating its application to high-dimensional neuroimaging data and finding meaningful multivariate image-to-image correspondences in intra-modal studies. In particular, we show how the optimal subset of variables can be estimated independently and we look at the information encoded in more than one set of SCCA transformations. We illustrate our framework using Arterial Spin Labeling data to investigate multivariate similarities between the effects of two antipsychotic drugs on cerebral blood flow.
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Affiliation(s)
- Maria J. Rosa
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | - Mitul A. Mehta
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | | | | | - Fernando Zelaya
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | - Antje A. T. S. Reinders
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | - Steve C. R. Williams
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
- National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, King's College LondonLondon, UK
| | - Orla M. Doyle
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | - Andre F. Marquand
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Radboud UniversityNijmegen, Netherlands
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“Domain gauges”: A reference system for multivariate profiling of brain fMRI activation patterns induced by psychoactive drugs in rats. Neuroimage 2015. [DOI: 10.1016/j.neuroimage.2015.02.032 [doi]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Bruns A, Mueggler T, Künnecke B, Risterucci C, Prinssen EP, Wettstein JG, von Kienlin M. “Domain gauges”: A reference system for multivariate profiling of brain fMRI activation patterns induced by psychoactive drugs in rats. Neuroimage 2015. [DOI: 10.1016/j.neuroimage.2015.02.032 [doi].] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Bruns A, Mueggler T, Künnecke B, Risterucci C, Prinssen EP, Wettstein JG, von Kienlin M. "Domain gauges": A reference system for multivariate profiling of brain fMRI activation patterns induced by psychoactive drugs in rats. Neuroimage 2015; 112:70-85. [PMID: 25724758 DOI: 10.1016/j.neuroimage.2015.02.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 02/06/2015] [Accepted: 02/16/2015] [Indexed: 01/01/2023] Open
Abstract
Pharmacological magnetic resonance imaging (phMRI) of the brain has become a widely used tool in both preclinical and clinical drug research. One of its challenges is to condense the observed complex drug-induced brain-activation patterns into semantically meaningful metrics that can then serve as a basis for informed decision making. To aid interpretation of spatially distributed activation patterns, we propose here a set of multivariate metrics termed "domain gauges", which have been calibrated based on different classes of marketed or validated reference drugs. Each class represents a particular "domain" of interest, i.e., a specific therapeutic indication or mode of action. The drug class is empirically characterized by the unique activation pattern it evokes in the brain-the "domain profile". A domain gauge provides, for any tested intervention, a "classifier" as a measure of response strength with respect to the domain in question, and a "differentiator" as a measure of deviation from the domain profile, both along with error ranges. Capitalizing on our in-house database with an unprecedented wealth of standardized perfusion-based phMRI data obtained from rats subjected to various validated treatments, we exemplarily focused on 3 domains based on therapeutic indications: an antipsychotic, an antidepressant and an anxiolytic domain. The domain profiles identified as part of the gauge definition process, as well as the outputs of the gauges when applied to both reference and validation data, were evaluated for their reconcilability with prior biological knowledge and for their performance in drug characterization. The domain profiles provided quantitative activation patterns with high biological plausibility. The antipsychotic profile, for instance, comprised key areas (e.g., cingulate cortex, nucleus accumbens, ventral tegmental area, substantia nigra) which are believed to be strongly involved in mediating an antipsychotic effect, and which are in line with network-level dysfunctions observed in schizophrenia. The domain gauges plausibly positioned the vast majority of the pharmacological and even non-pharmacological treatments. The results also suggest the segregation of sub-domains based on, e.g., the mode of action. Upon judicious selection of domains and careful calibration of the gauges, our approach represents a valuable analytical tool for biological interpretation and decision making in drug discovery.
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Affiliation(s)
- Andreas Bruns
- Roche Pharmaceutical Research & Early Development, Neuroscience Discovery, Roche Innovation Center Basel, Switzerland.
| | - Thomas Mueggler
- Roche Pharmaceutical Research & Early Development, Neuroscience Discovery, Roche Innovation Center Basel, Switzerland
| | - Basil Künnecke
- Roche Pharmaceutical Research & Early Development, Neuroscience Discovery, Roche Innovation Center Basel, Switzerland
| | - Céline Risterucci
- Roche Pharmaceutical Research & Early Development, Neuroscience Discovery, Roche Innovation Center Basel, Switzerland
| | - Eric P Prinssen
- Roche Pharmaceutical Research & Early Development, Neuroscience Discovery, Roche Innovation Center Basel, Switzerland
| | - Joseph G Wettstein
- Roche Pharmaceutical Research & Early Development, Neuroscience Discovery, Roche Innovation Center Basel, Switzerland
| | - Markus von Kienlin
- Roche Pharmaceutical Research & Early Development, Neuroscience Discovery, Roche Innovation Center Basel, Switzerland
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Phillips ML, Chase HW, Sheline YI, Etkin A, Almeida JR, Deckersbach T, Trivedi MH. Identifying predictors, moderators, and mediators of antidepressant response in major depressive disorder: neuroimaging approaches. Am J Psychiatry 2015; 172:124-38. [PMID: 25640931 PMCID: PMC4464814 DOI: 10.1176/appi.ajp.2014.14010076] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Despite significant advances in neuroscience and treatment development, no widely accepted biomarkers are available to inform diagnostics or identify preferred treatments for individuals with major depressive disorder. METHOD In this critical review, the authors examine the extent to which multimodal neuroimaging techniques can identify biomarkers reflecting key pathophysiologic processes in depression and whether such biomarkers may act as predictors, moderators, and mediators of treatment response that might facilitate development of personalized treatments based on a better understanding of these processes. RESULTS The authors first highlight the most consistent findings from neuroimaging studies using different techniques in depression, including structural and functional abnormalities in two parallel neural circuits: serotonergically modulated implicit emotion regulation circuitry, centered on the amygdala and different regions in the medial prefrontal cortex; and dopaminergically modulated reward neural circuitry, centered on the ventral striatum and medial prefrontal cortex. They then describe key findings from the relatively small number of studies indicating that specific measures of regional function and, to a lesser extent, structure in these neural circuits predict treatment response in depression. CONCLUSIONS Limitations of existing studies include small sample sizes, use of only one neuroimaging modality, and a focus on identifying predictors rather than moderators and mediators of differential treatment response. By addressing these limitations and, most importantly, capitalizing on the benefits of multimodal neuroimaging, future studies can yield moderators and mediators of treatment response in depression to facilitate significant improvements in shorter- and longer-term clinical and functional outcomes.
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Reproducibility of pharmacological ASL using sequences from different vendors: implications for multicenter drug studies. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2015; 28:427-36. [PMID: 25588906 DOI: 10.1007/s10334-014-0480-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 11/30/2014] [Accepted: 12/24/2014] [Indexed: 01/08/2023]
Abstract
OBJECT The current study assesses the multicenter feasibility of pharmacological arterial spin labeling (ASL) by comparing a caffeine-induced relative cerebral blood flow decrease (%CBF↓) measured with two pseudo-continuous ASL sequences as provided by two major vendors. MATERIALS AND METHODS Twenty-two healthy volunteers were scanned twice with both a 3D spiral (GE) and a 2D EPI (Philips) sequence. The inter-session reproducibility was evaluated by comparisons of the mean and within-subject coefficient of variability (wsCV) of the %CBF↓, both for the total cerebral gray matter and on a voxel level. RESULTS The %CBF↓ was larger when measured with the 3D spiral sequence (23.9 ± 5.9 %) than when measured with the 2D EPI sequence (19.2 ± 5.6 %) on a total gray matter level (p = 0.02), and on a voxel level in the posterior watershed area (p < 0.001). There was no difference between the gray matter wsCV of the 3D spiral (57.3 %) and 2D EPI sequence (66.7 %, p = 0.3), whereas on a voxel level, the wsCV was visibly different between the sequences. CONCLUSION The observed differences between ASL sequences of both vendors can be explained by differences in the employed readout modules. These differences may seriously hamper multicenter pharmacological ASL, which strongly encourages standardization of ASL implementations.
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Stewart SB, Koller JM, Campbell MC, Black KJ. Arterial spin labeling versus BOLD in direct challenge and drug-task interaction pharmacological fMRI. PeerJ 2014; 2:e687. [PMID: 25538867 PMCID: PMC4266850 DOI: 10.7717/peerj.687] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 11/16/2014] [Indexed: 11/30/2022] Open
Abstract
A carefully controlled study allowed us to compare the sensitivity of ASL (arterial spin labeling) and BOLD (blood oxygen level dependent) fMRI for detecting the effects of the adenosine A2a antagonist tozadenant in Parkinson disease. The study compared the effect of drug directly or the interaction of the drug with a cognitive task. Only ASL detected the direct effect of tozadenant. BOLD was more sensitive to the cognitive task, which (unlike most drugs) allows on–off comparisons over short periods of time. Neither ASL nor BOLD could detect a cognitive-pharmacological interaction. These results are consistent with the known relative advantages of each fMRI method, and suggest that for drug development, directly imaging pharmacodynamic effects with ASL may have advantages over cognitive-pharmacological interaction BOLD, which has hitherto been the more common approach to pharmacological fMRI.
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Affiliation(s)
- Stephanie B Stewart
- Department of Psychiatry, Washington University School of Medicine , St Louis, MO , USA ; Department of Neurology, Washington University School of Medicine , St Louis, MO , USA
| | - Jonathan M Koller
- Department of Psychiatry, Washington University School of Medicine , St Louis, MO , USA
| | - Meghan C Campbell
- Department of Neurology, Washington University School of Medicine , St Louis, MO , USA ; Department of Radiology, Washington University School of Medicine , St Louis, MO , USA
| | - Kevin J Black
- Department of Psychiatry, Washington University School of Medicine , St Louis, MO , USA ; Department of Neurology, Washington University School of Medicine , St Louis, MO , USA ; Department of Radiology, Washington University School of Medicine , St Louis, MO , USA ; Department of Anatomy and Neurobiology, Washington University School of Medicine , St Louis, MO , USA ; Division of Biology and Biomedical Sciences, Washington University School of Medicine , St Louis, MO , USA
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Early brain changes associated with psychotherapy in major depressive disorder revealed by resting-state fMRI: Evidence for the top-down regulation theory. Int J Psychophysiol 2014; 94:437-44. [DOI: 10.1016/j.ijpsycho.2014.10.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 10/20/2014] [Accepted: 10/21/2014] [Indexed: 01/17/2023]
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Jann K, Gee DG, Kilroy E, Schwab S, Smith RX, Cannon TD, Wang DJJ. Functional connectivity in BOLD and CBF data: similarity and reliability of resting brain networks. Neuroimage 2014; 106:111-22. [PMID: 25463468 DOI: 10.1016/j.neuroimage.2014.11.028] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 11/03/2014] [Accepted: 11/14/2014] [Indexed: 11/25/2022] Open
Abstract
Resting-state functional connectivity (FC) fMRI (rs-fcMRI) offers an appealing approach to mapping the brain's intrinsic functional organization. Blood oxygen level dependent (BOLD) and arterial spin labeling (ASL) are the two main rs-fcMRI approaches to assess alterations in brain networks associated with individual differences, behavior and psychopathology. While the BOLD signal is stronger with a higher temporal resolution, ASL provides quantitative, direct measures of the physiology and metabolism of specific networks. This study systematically investigated the similarity and reliability of resting brain networks (RBNs) in BOLD and ASL. A 2 × 2 × 2 factorial design was employed where each subject underwent repeated BOLD and ASL rs-fcMRI scans on two occasions on two MRI scanners respectively. Both independent and joint FC analyses revealed common RBNs in ASL and BOLD rs-fcMRI with a moderate to high level of spatial overlap, verified by Dice Similarity Coefficients. Test-retest analyses indicated more reliable spatial network patterns in BOLD (average modal Intraclass Correlation Coefficients: 0.905 ± 0.033 between-sessions; 0.885 ± 0.052 between-scanners) than ASL (0.545 ± 0.048; 0.575 ± 0.059). Nevertheless, ASL provided highly reproducible (0.955 ± 0.021; 0.970 ± 0.011) network-specific CBF measurements. Moreover, we observed positive correlations between regional CBF and FC in core areas of all RBNs indicating a relationship between network connectivity and its baseline metabolism. Taken together, the combination of ASL and BOLD rs-fcMRI provides a powerful tool for characterizing the spatiotemporal and quantitative properties of RBNs. These findings pave the way for future BOLD and ASL rs-fcMRI studies in clinical populations that are carried out across time and scanners.
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Affiliation(s)
- Kay Jann
- Department of Neurology, UCLA, 90025 Los Angeles, USA.
| | - Dylan G Gee
- Department of Psychology, UCLA, 90025 Los Angeles, USA
| | - Emily Kilroy
- Department of Neurology, UCLA, 90025 Los Angeles, USA
| | - Simon Schwab
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University Bern, 3000 Bern 60, Switzerland
| | | | - Tyrone D Cannon
- Department of Psychology, Yale University, 06520 New Haven, USA
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Gardner A, Åstrand D, Öberg J, Jacobsson H, Jonsson C, Larsson S, Pagani M. Towards mapping the brain connectome in depression: functional connectivity by perfusion SPECT. Psychiatry Res 2014; 223:171-7. [PMID: 24931481 DOI: 10.1016/j.pscychresns.2014.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 05/08/2014] [Accepted: 05/14/2014] [Indexed: 12/29/2022]
Abstract
Several studies have demonstrated altered brain functional connectivity in the resting state in depression. However, no study has investigated interregional networking in patients with persistent depressive disorder (PDD). The aim of this study was to assess differences in brain perfusion distribution and connectivity between large groups of patients and healthy controls. Participants comprised 91 patients with PDD and 65 age- and sex-matched healthy controls. Resting state perfusion was investigated by single photon emission computed tomography, and group differences were assessed by Statistical Parametric Mapping. Brain connectivity was explored through a voxel-wise interregional correlation analysis using as covariate of interest the normalized values of clusters of voxels in which perfusion differences were found in group analysis. Significantly increased regional brain perfusion distribution covering a large part of the cerebellum was observed in patients as compared with controls. Patients showed a significant negative functional connectivity between the cerebellar cluster and caudate, bilaterally. This study demonstrated inverse relative perfusion between the cerebellum and the caudate in PDD. Functional uncoupling may be associated with a dysregulation between the role of the cerebellum in action control and of the caudate in action selection, initiation and decision making in the patients. The potential impact of the resting state condition and the possibility of mitochondrial impairment are discussed.
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Affiliation(s)
- Ann Gardner
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Järva Psychiatric Out-patient Clinic, Stockholm, Sweden
| | - Disa Åstrand
- Section of Imaging Physics, Solna Nuclear Medicine, Department of Medical Physics, Karolinska University Hospital, Stockholm, Sweden
| | - Johanna Öberg
- Section of Imaging Physics, Department of Hospital Physics, Karolinska University Hospital, Stockholm, Sweden
| | - Hans Jacobsson
- Department of Nuclear Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Cathrine Jonsson
- Section of Imaging Physics, Solna Nuclear Medicine, Department of Medical Physics, Karolinska University Hospital, Stockholm, Sweden
| | - Stig Larsson
- Department of Nuclear Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Marco Pagani
- Department of Nuclear Medicine, Karolinska Hospital, Stockholm, Sweden; Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy.
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Viviani R, Lehmann ML, Stingl JC. Use of magnetic resonance imaging in pharmacogenomics. Br J Clin Pharmacol 2014; 77:684-94. [PMID: 23802603 PMCID: PMC3971984 DOI: 10.1111/bcp.12197] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 06/18/2013] [Indexed: 01/11/2023] Open
Abstract
Because of the large variation in the response to psychoactive medication, many studies have attempted to uncover genetic factors that determine response. While considerable knowledge exists on the large effects of genetic polymorphisms on pharmacokinetics and plasma concentrations of drugs, effects of the concentration at the target site and pharmacodynamic effects on brain functions in disease are much less known. This article reviews the role of magnetic resonance imaging (MRI) to visualize response to medication in brain behaviour circuits in vivo in humans and assess the influence of pharmacogenetic factors. Two types of studies have been used to characterize effects of medication and genetic variation. In task-related activation studies the focus is on changes in the activity of a neural circuit associated with a specific psychological process. The second type of study investigates resting state perfusion. These studies provide an assessment of vascular changes associated with bioavailability of drugs in the brain, but may also assess changes in neural activity after binding of centrally active agents. Task-related pharmacogenetic studies of cognitive function have characterized the effects in the prefrontal cortex of genetic polymorphisms of dopamine receptors (DRD2), metabolic enzymes (COMT) and in the post-synaptic signalling cascade under the administration of dopamine agonists and antagonists. In contrast, pharmacogenetic imaging with resting state perfusion is still in its infancy. However, the quantitative nature of perfusion imaging, its non-invasive character and its repeatability might be crucial assets in visualizing the effects of medication in vivo in man during therapy.
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Affiliation(s)
- Roberto Viviani
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany; Institute of Psychology, University of Innsbruck, Innsbruck, Austria
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Di Simplicio M, Norbury R, Reinecke A, Harmer CJ. Paradoxical effects of short-term antidepressant treatment in fMRI emotional processing models in volunteers with high neuroticism. Psychol Med 2014; 44:241-252. [PMID: 23597109 DOI: 10.1017/s0033291713000731] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Short-term antidepressant administration has been reported to decrease amygdala response to threat in healthy volunteers and depressed patients. Neuroticism (N) is a risk factor for depression but has also been associated with slow or incomplete remission with antidepressant drug treatment. Our aim was to investigate early selective serotonin reuptake inhibitor (SSRI) administration neural effects on implicit processing of fearful facial expressions in volunteers with high levels of N. METHOD Highly neurotic subjects received 20 mg/day citalopram versus placebo for 7 days in a double-blind, between-groups design. On the last day haemoperfusion and functional magnetic resonance imaging (fMRI) data during a gender discrimination task with fearful and happy faces were acquired. A control group of non-neurotic volunteers was also tested. RESULTS High-N volunteers had reduced responses to threatening facial expressions across key neural circuits compared to low-N volunteers. SSRI treatment was found to elevate resting perfusion in the right amygdala, increase bilateral amygdalae activation to positive and negative facial expressions and increase activation to fearful versus happy facial expressions in occipital, parietal, temporal and prefrontal cortical areas. CONCLUSIONS These results suggest that 7 days of SSRI administration can increase neural markers of fear reactivity in subjects at the high end of the N dimension and may be related to early increases in anxiety and agitation seen early in treatment. Such processes may be involved in the later therapeutic effects through decreased avoidance and increased learning about social 'threat' cues.
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Affiliation(s)
| | - R Norbury
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - A Reinecke
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - C J Harmer
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
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Wolf DH, Pinkham AE, Satterthwaite TD, Ruparel K, Elliott MA, Valdez J, Smith MA, Detre JA, Gur RC, Gur RE. Oral alprazolam acutely increases nucleus accumbens perfusion. Mol Psychiatry 2013; 18:960-1. [PMID: 23070072 PMCID: PMC3957329 DOI: 10.1038/mp.2012.139] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Benzodiazepines treat anxiety, but can also produce euphoric effects, contributing to abuse. Using perfusion magnetic resonance imaging, we provide the first direct evidence in humans that alprazolam (Xanax) acutely increases perfusion in the nucleus accumbens, a key reward-processing region linked to addiction.
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Affiliation(s)
- Daniel H. Wolf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104
| | - Amy E. Pinkham
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104
| | - Theodore D. Satterthwaite
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104
| | - Kosha Ruparel
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104
| | - Mark A. Elliott
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104
| | - Jeffrey Valdez
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104
| | | | - John A. Detre
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104,Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104
| | - Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104,Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104,Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104,Philadelphia Veterans Administration Medical Center, Philadelphia PA 19104
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104,Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104,Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia PA 19104
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Effects of amisulpride on human resting cerebral perfusion. Psychopharmacology (Berl) 2013; 229:95-103. [PMID: 23584671 DOI: 10.1007/s00213-013-3091-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 03/22/2013] [Indexed: 12/12/2022]
Abstract
RATIONALE Quantitative neuroimaging studies show that different neuroleptics have similar effects on resting metabolism/perfusion in the basal ganglia, but vary in their effect on the cortex, especially in the prefrontal and temporal lobes. These differences may represent signatures of the action of medication on distinctive receptor combinations. OBJECTIVES This study seeks to determine the effect on cerebral perfusion at rest of low-dose amisulpride, a neuroleptic with a receptor profile relatively selective to dopaminergic D2-receptors and both antidepressant and antipsychotic efficacy. METHODS Continuous arterial spin labelling in a placebo-controlled, double blind, crossover study at steady state of N = 20 healthy male adults. RESULTS Relative to placebo, amisulpride was associated with extensive and significant cortical decrements in resting perfusion levels, particularly in the prefrontal lobes (p = 0.01, corrected). Decrements spared the basal ganglia, where perfusion was slightly increased. CONCLUSIONS In contrast to earlier reports on other neuroleptics, amisulpride was associated with intense cortical perfusion decrements at rest. These results are consistent with an existing model in which dopaminergic blockade is associated not only with metabolism/perfusion increases in the basal ganglia, but also with decreases in the cerebral cortex that in most neuroleptics are compensated by action on other receptor systems. The selective receptor profile of amisulpride may explain the extensive cortical decrements.
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Watts JM, Whitlow CT, Maldjian JA. Clinical applications of arterial spin labeling. NMR IN BIOMEDICINE 2013; 26:892-900. [PMID: 23378178 DOI: 10.1002/nbm.2904] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 10/23/2012] [Accepted: 11/12/2012] [Indexed: 06/01/2023]
Abstract
MR arterial spin labeling is primarily applied as a neuroimaging method to measure cerebral blood flow. As this technique becomes more widely available, a basic understanding of the clinical applications is necessary for optimal utilization in the setting of patient care. This review focuses on the use of arterial spin labeling imaging for the evaluation of cerebrovascular disease, brain tumors and neuropsychiatric illness.
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Affiliation(s)
- Jonathan M Watts
- Wake Forest School of Medicine, Department of Radiology, Winston Salem, NC, USA
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Becerra L, Upadhyay J, Chang PC, Bishop J, Anderson J, Baumgartner R, Schwarz AJ, Coimbra A, Wallin D, Nutile L, George E, Maier G, Sunkaraneni S, Iyengar S, Evelhoch JL, Bleakman D, Hargreaves R, Borsook D. Parallel buprenorphine phMRI responses in conscious rodents and healthy human subjects. J Pharmacol Exp Ther 2013; 345:41-51. [PMID: 23370795 DOI: 10.1124/jpet.112.201145] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Pharmacological magnetic resonance imaging (phMRI) is one method by which a drug's pharmacodynamic effects in the brain can be assessed. Although phMRI has been frequently used in preclinical and clinical settings, the extent to which a phMRI signature for a compound translates between rodents and humans has not been systematically examined. In the current investigation, we aimed to build on recent clinical work in which the functional response to 0.1 and 0.2 mg/70 kg i.v. buprenorphine (partial µ-opioid receptor agonist) was measured in healthy humans. Here, we measured the phMRI response to 0.04 and 0.1 mg/kg i.v. buprenorphine in conscious, naive rats to establish the parallelism of the phMRI signature of buprenorphine across species. PhMRI of 0.04 and 0.1 mg/kg i.v. buprenorphine yielded dose-dependent activation in a brain network composed of the somatosensory cortex, cingulate, insula, striatum, thalamus, periaqueductal gray, and cerebellum. Similar dose-dependent phMRI activation was observed in the human phMRI studies. These observations indicate an overall preservation of pharmacodynamic responses to buprenorphine between conscious, naive rodents and healthy human subjects, particularly in brain regions implicated in pain and analgesia. This investigation further demonstrates the usefulness of phMRI as a translational tool in neuroscience research that can provide mechanistic insight and guide dose selection in drug development.
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Affiliation(s)
- Lino Becerra
- Imaging Consortium for Drug Development, P.A.I.N. Group, Harvard Medical School, Children’s Hospital of Boston, Waltham, Massachusetts 02453, USA.
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Licata SC, Nickerson LD, Lowen SB, Trksak GH, Maclean RR, Lukas SE. The hypnotic zolpidem increases the synchrony of BOLD signal fluctuations in widespread brain networks during a resting paradigm. Neuroimage 2013; 70:211-22. [PMID: 23296183 DOI: 10.1016/j.neuroimage.2012.12.055] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 12/21/2012] [Accepted: 12/22/2012] [Indexed: 12/17/2022] Open
Abstract
Networks of brain regions having synchronized fluctuations of the blood oxygen level-dependent functional magnetic resonance imaging (BOLD fMRI) time-series at rest, or "resting state networks" (RSNs), are emerging as a basis for understanding intrinsic brain activity. RSNs are topographically consistent with activity-related networks subserving sensory, motor, and cognitive processes, and studying their spontaneous fluctuations following acute drug challenge may provide a way to understand better the neuroanatomical substrates of drug action. The present within-subject double-blind study used BOLD fMRI at 3T to investigate the functional networks influenced by the non-benzodiazepine hypnotic zolpidem (Ambien). Zolpidem is a positive modulator of γ-aminobutyric acid(A) (GABA(A)) receptors, and engenders sedative effects that may be explained in part by how it modulates intrinsic brain activity. Healthy participants (n=12) underwent fMRI scanning 45 min after acute oral administration of zolpidem (0, 5, 10, or 20mg), and changes in BOLD signal were measured while participants gazed at a static fixation point (i.e., at rest). Data were analyzed using group independent component analysis (ICA) with dual regression and results indicated that compared to placebo, the highest dose of zolpidem increased functional connectivity within a number of sensory, motor, and limbic networks. These results are consistent with previous studies showing an increase in functional connectivity at rest following administration of the positive GABA(A) receptor modulators midazolam and alcohol, and suggest that investigating how zolpidem modulates intrinsic brain activity may have implications for understanding the etiology of its powerful sedative effects.
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Affiliation(s)
- Stephanie C Licata
- Behavioral Psychopharmacology Research Laboratory, McLean Hospital/Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA.
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Cortical responses to amphetamine exposure studied by pCASL MRI and pharmacokinetic/pharmacodynamic dose modeling. Neuroimage 2012; 68:75-82. [PMID: 23246855 DOI: 10.1016/j.neuroimage.2012.11.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 10/17/2012] [Accepted: 11/19/2012] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Perfusion measurement by arterial spin labeling (ASL) techniques is well suited for pharmaceutical magnetic resonance imaging (phMRI) studies to investigate how drugs change the cerebral perfusion status and further, neuronal activity. MATERIALS AND METHOD Twelve healthy normal male volunteers participated in the study which was based on a double blinded design. Six subjects were randomly selected to receive a single oral dose of 20mg d-amphetamine and six were given placebo. Perfusion measurements by pseudo-continuous ASL (pCASL) technique were repeatedly performed at 10 different time points with a 3T clinical MRI scanner during a 10 hour period after dose together with physiologic data and blood sample collections. The dynamic changes in cerebral perfusion in response to the plasma concentration variations of d-amphetamine were analyzed at voxel-level and for regions of interest. RESULTS Compared to the placebo group a 20% reduction in cerebral blood flow (CBF) was observed in gray matter for the subjects that received d-amphetamine. The most significant reduction of regional CBF (rCBF) was detected in the basal ganglia, frontal region and insular cortex using voxel based analysis. A relation between d-amphetamine exposure and CBF response was found using PK/PD modeling, which predicted on average a 15% decrease of the CBF in gray matter at a plasma concentration of 30 ng/ml. CONCLUSION In this study we have demonstrated that repeated perfusion measurements by pCASL technique was sufficiently robust to differentiate the neurological response between the groups that received d-amphetamine and placebo. Quantitative and repetitive CBF measurements can be used for PK/PD modeling of CNS drug responses in humans.
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Orosz A, Jann K, Federspiel A, Horn H, Höfle O, Dierks T, Wiest R, Strik W, Müller T, Walther S. Reduced Cerebral Blood Flow Within the Default-Mode Network and Within Total Gray Matter in Major Depression. Brain Connect 2012; 2:303-10. [DOI: 10.1089/brain.2012.0101] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Ariane Orosz
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, Bern, Switzerland
| | - Kay Jann
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, Bern, Switzerland
| | - Andrea Federspiel
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, Bern, Switzerland
| | - Helge Horn
- University Hospital of Psychiatry, Bern, Switzerland
| | - Oliver Höfle
- University Hospital of Psychiatry, Bern, Switzerland
| | - Thomas Dierks
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, Bern, Switzerland
| | - Roland Wiest
- Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland
| | - Werner Strik
- University Hospital of Psychiatry, Bern, Switzerland
| | - Thomas Müller
- University Hospital of Psychiatry, Bern, Switzerland
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Arterial spin labeling MRI: an emerging biomarker for Alzheimer's disease and other neurodegenerative conditions. Curr Opin Neurol 2012; 25:421-8. [PMID: 22610458 DOI: 10.1097/wco.0b013e328354ff0a] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The search for biomarkers that detect and track disease progression in early Alzheimer's disease has been a major pursuit for two decades. Functional measures reflecting alterations of synaptic activity associated with neuronal dysfunction have displayed promise for following disease course in early stages. Although fluorodeoxyglucose positron emission tomography (FDG PET) and blood oxygen level-dependent functional MRI (BOLD fMRI) have been studied extensively for this purpose, this review will discuss the emergence and potential role of arterial spin labeling (ASL) MRI, which measures cerebral blood flow (CBF), in neurodegeneration. RECENT FINDINGS Several recent studies have explored ASL MRI in early and prodromal Alzheimer's disease and have reported areas of hypoperfusion that overlap considerably with hypometabolism frequently reported with FDG PET. However, some studies have also noted increased regional CBF of patients with prodromal and early stage clinical Alzheimer's disease, which may have implications for pathophysiology and the role of compensatory responses to neurodegeneration. Additionally, a few recent studies have begun to use this modality to explore the role of cerebrovascular factors in cognitive decline and the relationship to Alzheimer's disease. SUMMARY ASL MRI is just beginning to be applied more widely to various neurodegenerative conditions. Initial data suggest that this methodology may provide similar information to FDG PET, but with several advantages in the ease of acquisition and expense. Additional applications of this modality, including task-related studies and testing of pharmacological effects, are underexplored, but are potentially of significant value in understanding disease-related functional changes and treatment effects.
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Feasibility of ASL-based phMRI with a single dose of oral citalopram for repeated assessment of serotonin function. Neuroimage 2012; 63:1695-700. [DOI: 10.1016/j.neuroimage.2012.07.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 06/18/2012] [Accepted: 07/18/2012] [Indexed: 11/22/2022] Open
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Schouw MLJ, Gevers S, Caan MWA, Majoie CBLM, Booij J, Nederveen AJ, Reneman L. Mapping serotonergic dysfunction in MDMA (ecstasy) users using pharmacological MRI. Eur Neuropsychopharmacol 2012; 22:537-45. [PMID: 22209360 DOI: 10.1016/j.euroneuro.2011.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 10/12/2011] [Accepted: 12/02/2011] [Indexed: 11/30/2022]
Abstract
3,4-Methylenedioxymethamphetamine (MDMA or ecstasy) is a popular recreational drug that has been shown to induce loss of brain serotonin (5-HT) neurons. The purpose of this study was to determine the usefulness of pharmacological magnetic resonance imaging (phMRI) in assessing 5-HT dysfunction by examining the hemodynamic response evoked by infusion with the selective 5-HT reuptake inhibitor citalopram. We studied the effects of MDMA on brain hemodynamics using arterial spin labeling (ASL) based phMRI following a citalopram challenge (7.5mg/kg, i.v.), combined with [¹²³I]β-CIT SPECT imaging in ten male MDMA users and seven healthy non-users. Single photon emission computed tomography (SPECT) imaging was used to assess the availability of 5-HT transporters (SERT). Imaging results were compared with the results of behavioral measures and mood changes following drug administration, in both groups (using the Beck Depression Inventory, Barratt Impulsiveness Scale and a visual analog scale). Reductions in SERT binding were observed in the occipital cortex of MDMA users. In line with this, citalopram induced decreases in cerebral blood flow (CBF) in the occipital cortex of MDMA users. ASL based phMRI also detected a CBF decrease in the thalamus of MDMA users. In concordance with imaging findings, behavioral measures differed significantly between MDMA users and controls. MDMA users had higher impulsivity scores and felt more uncomfortable after citalopram infusion, compared with control subjects. Our findings indicate that phMRI is very well suited for in-vivo assessment of 5-HT dysfunction.
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Affiliation(s)
- M L J Schouw
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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