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Yu X, Chen K, Ma Y, Bai T, Zhu S, Cai D, Zhang X, Wang K, Tian Y, Wang J. Molecular basis underlying changes of brain entropy and functional connectivity in major depressive disorders after electroconvulsive therapy. CNS Neurosci Ther 2024; 30:e14690. [PMID: 38529527 PMCID: PMC10964037 DOI: 10.1111/cns.14690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/03/2024] [Accepted: 02/23/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Electroconvulsive therapy (ECT) is widely used for treatment-resistant depression. However, it is unclear whether/how ECT can be targeted to affect brain regions and circuits in the brain to dynamically regulate mood and cognition. METHODS This study used brain entropy (BEN) to measure the irregular levels of brain systems in 46 major depressive disorder (MDD) patients before and after ECT treatment. Functional connectivity (FC) was further adopted to reveal changes of functional couplings. Moreover, transcriptomic and neurotransmitter receptor data were used to reveal genetic and molecular basis of the changes of BEN and functional connectivities. RESULTS Compared to pretreatment, the BEN in the posterior cerebellar lobe (PCL) significantly decreased and FC between the PCL and the right temporal pole (TP) significantly increased in MDD patients after treatment. Moreover, we found that these changes of BEN and FC were closely associated with genes' expression profiles involved in MAPK signaling pathway, GABAergic synapse, and dopaminergic synapse and were significantly correlated with the receptor/transporter density of 5-HT, norepinephrine, glutamate, etc. CONCLUSION: These findings suggest that loops in the cerebellum and TP are crucial for ECT regulation of mood and cognition, which provides new evidence for the antidepressant effects of ECT and the potential molecular mechanism leading to cognitive impairment.
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Affiliation(s)
- Xiaohui Yu
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational MedicineKunming University of Science and TechnologyKunmingChina
- Yunnan Key Laboratory of Primate Biomedical ResearchKunmingChina
| | - Kexuan Chen
- Medical SchoolKunming University of Science and TechnologyKunmingChina
| | - Yingzi Ma
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational MedicineKunming University of Science and TechnologyKunmingChina
- Yunnan Key Laboratory of Primate Biomedical ResearchKunmingChina
| | - Tongjian Bai
- Department of NeurologyThe First Hospital of Anhui Medical UniversityHefeiChina
| | - Shunli Zhu
- School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Defang Cai
- The Second People's Hospital of YuxiThe Affiliated Hospital of Kunming University of Science and TechnologyYuxiChina
| | - Xing Zhang
- The Second People's Hospital of YuxiThe Affiliated Hospital of Kunming University of Science and TechnologyYuxiChina
| | - Kai Wang
- Department of NeurologyThe First Hospital of Anhui Medical UniversityHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
- School of Mental Health and Psychological SciencesAnhui Medical UniversityHefeiChina
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental HealthHefeiChina
- Anhui Province Clinical Research Center for Neurological DiseaseHefeiChina
| | - Yanghua Tian
- Department of NeurologyThe First Hospital of Anhui Medical UniversityHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
- School of Mental Health and Psychological SciencesAnhui Medical UniversityHefeiChina
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental HealthHefeiChina
- Anhui Province Clinical Research Center for Neurological DiseaseHefeiChina
- Institute of Artificial IntelligenceHefei Comprehensive National Science CenterHefeiChina
| | - Jiaojian Wang
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational MedicineKunming University of Science and TechnologyKunmingChina
- Yunnan Key Laboratory of Primate Biomedical ResearchKunmingChina
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Belge JB, van Eijndhoven P, Mulders PCR. Mechanism of Action of ECT in Depression. Curr Top Behav Neurosci 2024; 66:279-295. [PMID: 37962811 DOI: 10.1007/7854_2023_450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Electroconvulsive therapy (ECT) remains the most potent antidepressant treatment available for patients with major depressive disorder (MDD). ECT is highly effective, achieving a response rate of 70-80% and a remission rate of 50-60% even in treatment-resistant patients. The underlying mechanisms of ECT are not fully understood, although several hypotheses have been proposed, including the monoamine hypothesis, anticonvulsive hypothesis, neuroplastic effects, and immunomodulatory properties. In this paper, we provide an overview of magnetic resonance imaging evidence that addresses the neuroplastic changes that occur after ECT at the human systems level and elaborate further on ECTs potent immunomodulatory properties. Despite a growing body of evidence that suggests ECT may normalize many of the structural and functional changes in the brain associated with severe depression, there is a lack of convergence between neurobiological changes and the robust clinical effects observed in depression. This may be due to sample sizes used in ECT studies being generally small and differences in data processing and analysis pipelines. Collaborations that acquire large datasets, such as the GEMRIC consortium, can help translate ECT's clinical efficacy into a better understanding of its mechanisms of action.
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Affiliation(s)
- Jean-Baptiste Belge
- Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Philip van Eijndhoven
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Medical Neuroscience, Nijmegen, The Netherlands
| | - Peter C R Mulders
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Medical Neuroscience, Nijmegen, The Netherlands
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Wang H, Zhang T, Zu M, Fan S, Kai Y, Zhang J, Ji Y, Pang X, Tian Y. Electroconvulsive therapy enhances degree centrality in the orbitofrontal cortex in depressive rumination. Psychiatry Res Neuroimaging 2024; 337:111765. [PMID: 38104485 DOI: 10.1016/j.pscychresns.2023.111765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/13/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
Depressive rumination has been implicated in the onset, duration, and treatment response of refractory depression. Electroconvulsive therapy (ECT) is remarkably effective in treatment of refractory depression by modulating the functional coordination between brain hubs. However, the mechanisms by which ECT regulates depressive rumination remain unsolved. We investigated degree centrality (DC) in 32 pre- and post-ECT depression patients as well as 38 matched healthy controls. An identified brain region was defined as the seed to calculate functional connectivity (FC) in whole brains. Rumination was measured by the Ruminative Response Scale (RRS) and its relationships with identified DC and FC alterations were examined. We found a significant negative correlation between DC of the right orbitofrontal cortex (rOFC) before ECT and brooding level before and after treatment. Moreover, rOFC DC increased after ECT. DC of the left superior temporal gyrus (lSTG) was positively correlated with reflective level before intervention, while lSTG DC decreased after ECT. Patients showed elevated FC in the rOFC with default mode network. No significant association was found between decreased RRS scores and changes in DC and FC. Our findings suggest that functional changes in rOFC and lSTG may be associated with the beneficial effects of ECT on depressive rumination.
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Affiliation(s)
- Hongping Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Ting Zhang
- Department of Psychiatry, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Meidan Zu
- Department of Neurology, Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Siyu Fan
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yiao Kai
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jiahua Zhang
- School of Mental Health and Psychological Science, Anhui Medical University, Hefei, Anhui, China
| | - Yang Ji
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiaonan Pang
- Department of Neurology, Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
| | - Yanghua Tian
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; Department of Neurology, Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
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Kelsall NC, Wang Y, Gameroff MJ, Cha J, Posner J, Talati A, Weissman MM, van Dijk MT. Differences in White Matter Structural Networks in Family Risk of Major Depressive Disorder and Suicidality: A Connectome Analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.07.23295211. [PMID: 37732277 PMCID: PMC10508803 DOI: 10.1101/2023.09.07.23295211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Background Depression and suicide are leading global causes of disability and death and are highly familial. Family and individual history of depression are associated with neurobiological differences including decreased white matter connectivity; however, this has only been shown for individual regions. We use graph theory models to account for the network structure of the brain with high levels of specialization and integration and examine whether they differ by family history of depression or of suicidality within a three-generation longitudinal family study with well-characterized clinical histories. Methods Clinician interviews across three generations were used to classify family risk of depression and suicidality. Then, we created weighted network models using 108 cortical and subcortical regions of interest for 96 individuals using diffusion tensor imaging derived fiber tracts. Global and local summary measures (clustering coefficient, characteristic path length, and global and local efficiencies) and network-based statistics were utilized for group comparison of family history of depression and, separately, of suicidality, adjusted for personal psychopathology. Results Clustering coefficient (connectivity between neighboring regions) was lower in individuals at high family risk of depression and was associated with concurrent clinical symptoms. Network-based statistics showed hypoconnected subnetworks in individuals with high family risk of depression and of suicidality, after controlling for personal psychopathology. These subnetworks highlighted cortical-subcortical connections including between the superior frontal cortex, thalamus, precuneus, and putamen. Conclusions Family history of depression and of suicidality are associated with hypoconnectivity between subcortical and cortical regions, suggesting brain-wide impaired information processing, even in those personally unaffected.
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Guo ZP, Chen L, Tang LR, Gao Y, Chand T, Sen ZD, Li M, Walter M, Wang L, Liu CH. Association between decreased interhemispheric functional connectivity of the insula and duration of illness in recurrent depression. J Affect Disord 2023; 329:88-95. [PMID: 36841304 DOI: 10.1016/j.jad.2023.02.083] [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: 08/09/2022] [Revised: 02/14/2023] [Accepted: 02/19/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVE To investigate the altered interhemispheric functional connectivity in the resting state in patients with recurrent major depressive disorder (MDD). METHODS Voxel-mirrored homotopic connectivity (VMHC), a measure of the functional connectivity between any pair of symmetrical interhemispheric voxels, and pattern classification were examined in 41 recurrent MDD patients (22 during the depressive state and 19 during the remitted state) and 60 age, sex, and education level-matched healthy controls (HC) using resting-state functional magnetic resonance imaging (fMRI). RESULTS Compared with HC, the recurrent MDD patients exhibited decreased VMHC values in the bilateral fusiform, inferior occipital gyrus, posterior insula, precentral gyrus, precuneus, superior temporal gyrus, and thalamus. A significant negative correlation between the VMHC value of the bilateral posterior insula and illness duration in recurrent MDD was identified. Support vector machine (SVM) analysis showed that VMHC in the fusiform and posterior insula could be used to distinguish recurrent MDD patients from HC with a sensitivity and accuracy >0.6. CONCLUSION Our findings revealed a reduction in the resting-state brain activity across several neural networks in patients with recurrent MDD, including within the posterior insula. Lower VMHC values in the posterior insula were associated with longer illness duration, suggesting that impairment in interhemispheric synchronization within the salience network may be due to the accumulated pathology of depression and may contribute to future depression relapse. VMHC changes in the posterior insula may serve as a potential imaging marker to discriminate recurrent MDD patients from HC.
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Affiliation(s)
- Zhi-Peng Guo
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
| | - Lei Chen
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
| | - Li-Rong Tang
- Beijing Hospital of Anding, Capital Medical University, Beijing 100088, China
| | - Yue Gao
- Beijing Hospital of Anding, Capital Medical University, Beijing 100088, China
| | - Tara Chand
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena 07743, Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg 39120, Germany; Department of Clinical Psychology, Friedrich Schiller University, Jena, Germany
| | - Zümrüt Duygu Sen
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena 07743, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Meng Li
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena 07743, Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg 39120, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena 07743, Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg 39120, Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany; German Center for Mental Health (DZPG), Site Halle-Jena-Magdeburg, Germany; Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen 72074, Germany; Department Systems Physiology of Learning, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Lihong Wang
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030, USA.
| | - Chun-Hong Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China.
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White matter changes following electroconvulsive therapy for depression: a multicenter ComBat harmonization approach. Transl Psychiatry 2022; 12:517. [PMID: 36526624 PMCID: PMC9758171 DOI: 10.1038/s41398-022-02284-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/23/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
ECT is proposed to exert a therapeutic effect on WM microstructure, but the limited power of previous studies made it difficult to highlight consistent patterns of change in diffusion metrics. We initiated a multicenter analysis and sought to address whether changes in WM microstructure occur following ECT. Diffusion tensor imaging (DTI) data (n = 58) from 4 different sites were harmonized before pooling them by using ComBat, a batch-effect correction tool that removes inter-site technical variability, preserves inter-site biological variability, and maximizes statistical power. Downstream statistical analyses aimed to quantify changes in Fractional Anisotropy (FA), Mean Diffusivity (MD), Radial Diffusivity (RD) and Axial Diffusivity (AD), by employing whole-brain, tract-based spatial statistics (TBSS). ECT increased FA in the right splenium of the corpus callosum and the left cortico-spinal tract. AD in the left superior longitudinal fasciculus and the right inferior fronto-occipital fasciculus was raised. Increases in MD and RD could be observed in overlapping white matter structures of both hemispheres. At baseline, responders showed significantly smaller FA values in the left forceps major and smaller AD values in the right uncinate fasciculus compared with non-responders. By harmonizing multicenter data, we demonstrate that ECT modulates altered WM microstructure in important brain circuits that are implicated in the pathophysiology of depression. Furthermore, responders appear to present a more decreased WM integrity at baseline which could point toward a specific subtype of patients, characterized by a more altered neuroplasticity, who are especially sensitive to the potent neuroplastic effects of ECT.
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Electroconvulsive therapy changes temporal dynamics of intrinsic brain activity in depressed patients. Psychiatry Res 2022; 316:114732. [PMID: 35926361 DOI: 10.1016/j.psychres.2022.114732] [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: 01/19/2021] [Revised: 07/14/2022] [Accepted: 07/16/2022] [Indexed: 11/24/2022]
Abstract
Electroconvulsive therapy (ECT) has been demonstrated to be effective in treating depressed patients. Previous neuroimaging studies have focused mainly on alterations in static brain activity and connectivity to study the effects of ECT in depressed patients. However, it remains unclear whether the temporal dynamics of brain activity are associated with mechanisms of ECT in depressed patients. We measured the dynamics of spontaneous brain activity using dynamic amplitude of low-frequency fluctuation (dALFF) in healthy controls (n = 40) and patients diagnosed with unipolar depression (UD, n = 36) or bipolar disorder (BD, n = 9) before and after ECT. Furthermore, the temporal variability of intrinsic brain activity (iBA) was quantified as the variance of dALFF across sliding window. In addition, correlation analysis was performed to investigate the relationships among dALFF, depressive symptoms, and cognitive function in depressed patients. We lack second resting-state functional magnetic resonance imaging (rs-fMRI) data for healthy controls. After ECT, patients showed decreased brain dynamics (less temporal variability) in the right dorsal anterior cingulate cortex (dACC) and the right precuneus, whereas they showed increased brain dynamics in the bilateral superior medial frontal cortex (mSFC). No significant correlation was found between the dALFF and clinical variables in depressed patients. Our findings suggest that right dACC, right precuneus, and bilateral mSFC play an important role in response to ECT depressed patients from the perspective of dynamic local brain activity, indicating that the dALFF variability may be useful in further understanding the mechanisms of ECT's antidepressant effects.
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Li Y, Yu X, Ma Y, Su J, Li Y, Zhu S, Bai T, Wei Q, Becker B, Ding Z, Wang K, Tian Y, Wang J. Neural signatures of default mode network in major depression disorder after electroconvulsive therapy. Cereb Cortex 2022; 33:3840-3852. [PMID: 36089839 DOI: 10.1093/cercor/bhac311] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 06/17/2022] [Accepted: 07/08/2022] [Indexed: 11/12/2022] Open
Abstract
Functional abnormalities of default mode network (DMN) have been well documented in major depressive disorder (MDD). However, the association of DMN functional reorganization with antidepressant treatment and gene expression is unclear. Moreover, whether the functional interactions of DMN could predict treatment efficacy is also unknown. Here, we investigated the link of treatment response with functional alterations of DMN and gene expression with a comparably large sample including 46 individuals with MDD before and after electroconvulsive therapy (ECT) and 46 age- and sex-matched healthy controls. Static and dynamic functional connectivity (dFC) analyses showed increased intrinsic/static but decreased dynamic functional couplings of inter- and intra-subsystems and between nodes of DMN. The changes of static functional connections of DMN were spatially correlated with brain gene expression profiles. Moreover, static and dFC of the DMN before treatment as features could predict depressive symptom improvement following ECT. Taken together, these results shed light on the underlying neural and genetic basis of antidepressant effect of ECT and the intrinsic functional connectivity of DMN have the potential to serve as prognostic biomarkers to guide accurate personalized treatment.
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Affiliation(s)
- Yuanyuan Li
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China.,School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China
| | - Xiaohui Yu
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China
| | - Yingzi Ma
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China
| | - Jing Su
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China
| | - Yue Li
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China
| | - Shunli Zhu
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China
| | - Tongjian Bai
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China
| | - Qiang Wei
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China
| | - Benjamin Becker
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China
| | - Zhiyong Ding
- Medical Imaging Department, Maternal and Child Health-care Hospital of Qujing, Qujing 655000, China
| | - Kai Wang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China.,Anhui Medical University, School of Mental Health and Psychological Sciences, Hefei 230022, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China.,Anhui Province Clinical Research Center for Neurological Disease, Hefei 230022, China
| | - Yanghua Tian
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230088, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China.,Anhui Medical University, School of Mental Health and Psychological Sciences, Hefei 230022, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China.,Anhui Province Clinical Research Center for Neurological Disease, Hefei 230022, China.,Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
| | - Jiaojian Wang
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China.,Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan 650500, China
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Deng K, Yue JH, Xu J, Ma PP, Chen X, Li L, Bai TJ, Bo QJ, Cao J, Chen GM, Chen NX, Chen W, Cheng C, Cui XL, Duan J, Fang YR, Gong QY, Guo WB, Hou ZH, Hu L, Kuang L, Li F, Li T, Liu YS, Liu ZN, Long YC, Luo QH, Meng HQ, Peng DH, Qiu HT, Qiu J, Shi YS, Si TM, Tang YQ, Wang F, Wang K, Wang L, Wang X, Wang Y, Wu XP, Wu XR, Xie CM, Xie GR, Xie HY, Xie P, Yang H, Yang J, Yao JS, Yao SQ, Yin YY, Yuan YG, Zhang AX, Zhang H, Zhang KR, Zhang L, Zhang ZJ, Zhou RB, Zhou YT, Zhu JJ, Zou CJ, Zhou C, Zuo XN, Yan CG, Xu XF, Cheng YQ, Cheng YQ. Impaired robust interhemispheric function integration of depressive brain from REST-meta-MDD database in China. Bipolar Disord 2022; 24:400-411. [PMID: 34606159 DOI: 10.1111/bdi.13139] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/22/2021] [Accepted: 09/25/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Recently, functional homotopy (FH) architecture, defined as robust functional connectivity (FC) between homotopic regions, has been frequently reported to be altered in MDD patients (MDDs) but with divergent locations. METHODS In this study, we obtained resting-state functional magnetic resonance imaging (R-fMRI) data from 1004 MDDs (mean age, 33.88 years; age range, 18-60 years) and 898 matched healthy controls (HCs) from an aggregated dataset from 20 centers in China. We focused on interhemispheric function integration in MDDs and its correlation with clinical characteristics using voxel-mirrored homotopic connectivity (VMHC) devised to inquire about FH patterns. RESULTS As compared with HCs, MDDs showed decreased VMHC in visual, motor, somatosensory, limbic, angular gyrus, and cerebellum, particularly in posterior cingulate gyrus/precuneus (PCC/PCu) (false discovery rate [FDR] q < 0.002, z = -7.07). Further analysis observed that the reduction in SMG and insula was more prominent with age, of which SMG reflected such age-related change in males instead of females. Besides, the reduction in MTG was found to be a male-special abnormal pattern in MDDs. VMHC alterations were markedly related to episode type and illness severity. The higher Hamilton Depression Rating Scale score, the more apparent VMHC reduction in the primary visual cortex. First-episode MDDs revealed stronger VMHC reduction in PCu relative to recurrent MDDs. CONCLUSIONS We confirmed a significant VMHC reduction in MDDs in broad areas, especially in PCC/PCu. This reduction was affected by gender, age, episode type, and illness severity. These findings suggest that the depressive brain tends to disconnect information exchange across hemispheres.
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Affiliation(s)
- Ke Deng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.,Department of Psychiatry, The First Hospital of Jiaxing or The First Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China
| | - Ji-Hui Yue
- Department of Psychiatry, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China.,Research Center of Molecular Imaging, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Jian Xu
- Department of Rheumatology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Ping-Ping Ma
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.,Fifth People's Hospital of Zigong City, Zigong, Sichuan, China
| | - Xiao Chen
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Le Li
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | | | - Qi-Jing Bo
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jun Cao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guan-Mao Chen
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Ning-Xuan Chen
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Wei Chen
- Department of Psychiatry, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chang Cheng
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xi-Long Cui
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Jia Duan
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Yi-Ru Fang
- Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi-Yong Gong
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Psychoradiology Research Unit of Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wen-Bin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zheng-Hua Hou
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Lan Hu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Feng Li
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Tao Li
- Mental Health Center, West China Hospital, Sichuan University Chengdu, Sichuan, China
| | - Yan-Song Liu
- Department of Clinical Psychology, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Zhe-Ning Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yi-Cheng Long
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qing-Hua Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hua-Qing Meng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dai-Hui Peng
- Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hai-Tang Qiu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiang Qiu
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Yu-Shu Shi
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Tian-Mei Si
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Yan-Qin Tang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Fei Wang
- Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Kai Wang
- Anhui Medical University, Hefei, Anhui, China
| | - Li Wang
- National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Xiang Wang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ying Wang
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | | | - Xin-Ran Wu
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Chun-Ming Xie
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, Jiangsu, China
| | - Guang-Rong Xie
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hai-Yan Xie
- Department of Psychiatry, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Peng Xie
- Institute of Neuroscience, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Neurobiology, Chongqing, China.,Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hong Yang
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jian Yang
- The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China
| | - Jia-Shu Yao
- Department of Psychiatry, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shu-Qiao Yao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ying-Ying Yin
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Yong-Gui Yuan
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Ai-Xia Zhang
- The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China
| | - Hong Zhang
- Xi'an Central Hospital, Xi'an, Shaanxi, China
| | - Ke-Rang Zhang
- First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Lei Zhang
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Zhi-Jun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, Jiangsu, China
| | - Ru-Bai Zhou
- Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi-Ting Zhou
- Mental Health Center, West China Hospital, Sichuan University Chengdu, Sichuan, China
| | - Jun-Juan Zhu
- Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao-Jie Zou
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Cong Zhou
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xi-Nian Zuo
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Chao-Gan Yan
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Xiu-Feng Xu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yu-Qi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yu-Qi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, China
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10
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Spagna A, Wang J, Rosario IE, Zhang L, Zu M, Wang K, Tian Y. Cognitive Considerations in Major Depression: Evaluating the Effects of Pharmacotherapy and ECT on Mood and Executive Control Deficits. Brain Sci 2022; 12:brainsci12030350. [PMID: 35326307 PMCID: PMC8946784 DOI: 10.3390/brainsci12030350] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/20/2022] [Accepted: 03/01/2022] [Indexed: 02/04/2023] Open
Abstract
Deficits in the executive control of attention greatly impact the quality of life of patients diagnosed with major depressive disorder (MDD). However, attentional deficits are often underemphasized in clinical contexts compared with mood-based symptoms, and a comprehensive approach for specifically evaluating and treating them has yet to be developed. The present study evaluates the efficacy of bifrontal electroconvulsive therapy (ECT) combined with drug therapy (DT) in alleviating mood-related symptomatology and executive control deficits in drug-refractory MDD patients and compares these effects with those observed in MDD patients undergoing DT only. The Hamilton Rating Scale for Depression and the Lateralized Attentional Network Test-Revised were administered across two test sessions to assess treatment-related changes in mood-based symptoms and conflict processing, respectively, in patients undergoing ECT + DT (n = 23), patients undergoing DT (n = 33), and healthy controls (n = 40). Although both groups showed an improvement in mood-based symptoms following treatment and a deficit in conflict processing estimated on error rate, a post-treatment reduction of an executive control deficit estimated on RT was solely observed in the ECT + DT patient group. Furthermore, Bayesian correlational analyses confirmed the dissociation of mood-related symptoms and of executive control measures, supporting existing literature proposing that attentional deficits and mood symptoms are independent aspects of MDD. The cognitive profile of MDD includes executive control deficits, and while both treatments improved mood-based symptoms, only ECT + DT exerted an effect on both measures of the executive control deficit. Our findings highlight the importance of considering the improvement in both mood and cognitive deficits when determining the efficacy of therapeutic approaches for MDD.
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Affiliation(s)
- Alfredo Spagna
- Department of Psychology, Columbia University in the City of New York, New York, NY 10027, USA; (J.W.); (I.E.R.)
- Institute for Brain and Spinal Cord, Sorbonne University, 75013 Paris, France
- Correspondence: (A.S.); (K.W.); (Y.T.)
| | - Jason Wang
- Department of Psychology, Columbia University in the City of New York, New York, NY 10027, USA; (J.W.); (I.E.R.)
| | - Isabella Elaine Rosario
- Department of Psychology, Columbia University in the City of New York, New York, NY 10027, USA; (J.W.); (I.E.R.)
| | - Li Zhang
- Anhui Mental Health Center, Hefei 230022, China;
| | - Meidan Zu
- Department of Psychology and Sleep Medicine, The Second Hospital of Anhui Medical University, Hefei 230601, China;
| | - Kai Wang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230031, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
- Anhui Province Clinical Research Center for Neurological Disease, Hefei 230032, China
- Correspondence: (A.S.); (K.W.); (Y.T.)
| | - Yanghua Tian
- Department of Psychology and Sleep Medicine, The Second Hospital of Anhui Medical University, Hefei 230601, China;
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230031, China
- Department of Neurology, The Second Hospital of Anhui Medical University, Hefei 230601, China
- Correspondence: (A.S.); (K.W.); (Y.T.)
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11
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Xin Y, Bai T, Zhang T, Chen Y, Wang K, Yu S, Liu N, Tian Y. Electroconvulsive therapy modulates critical brain dynamics in major depressive disorder patients. Brain Stimul 2022; 15:214-225. [DOI: 10.1016/j.brs.2021.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/03/2021] [Accepted: 12/20/2021] [Indexed: 01/04/2023] Open
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12
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Dai B, Wu X, Yan F, Chen Y, Xu Y, Xia Q, Zhang X, Xie X. Effects of Modified Electroconvulsive Therapy on Serum Cortisol, Nesfatin-1, and Pro-inflammatory Cytokine Levels in Elderly Patients With Treatment-Resistant Depression. Front Endocrinol (Lausanne) 2022; 13:904005. [PMID: 35784549 PMCID: PMC9243445 DOI: 10.3389/fendo.2022.904005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
AIM Modified electroconvulsive therapy (MECT) is an effective strategy for treatment-resistant depression (TRD); however, the mechanism underlying effects of MECT remains unclear. Accumulating evidence suggests that TRD is closely associated with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, anorexigenic peptides, and pro-inflammatory cytokines. However, MECT effects on the HPA axis, anorexigenic peptides, and pro-inflammatory cytokines in elderly patients with TRD remain unclear. In this study, we investigated whether the HPA axis (cortisol), anorexigenic peptides (nesfatin-1), and pro-inflammatory cytokines (C-reactive protein, tumor necrosis factor-α, and interleukin-6, and interleukin-1β) are involved in the mechanism underlying MECT effects in elderly patients with TRD. METHODS Elderly patients with TRD were enrolled in this study between December 2019 and October 2021; all patients underwent MECT after physical examination. Serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels were measured before and after the first, third, and sixth MECT sessions. The Hamilton Depression Rating Scale-24 (HAMD-24) and the Mini-Mental State Examination (MMSE) were used to evaluate depression and cognitive impairment, respectively. We compared pre- and post-MECT serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels to confirm the short-term effects of MECT on these serum indices. We compared these serum indices across three time points (before the first, third, and sixth MECT sessions) to determine the long-term effects of MECT on serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels. RESULTS We observed no statistically significant changes in the pre- and post-MECT serum cortisol, nesfatin-1, or pro-inflammatory cytokine levels. No significant changes in serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels were observed across the aforementioned time points. Moreover, there were no statistically significant sex-based differences in the aforementioned serum indices. Furthermore, the serum cortisol level was negatively correlated with the serum IL-6 level before and after the first MECT session in patients with high cortisol levels (> the 50th percentile value of all samples). Additionally, the post-MECT HAMD-24 and MMSE scores were significantly lower. CONCLUSIONS MECT reduced depressive symptoms despite an adverse effect on cognition and had no significant effect on the serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels in elderly patients with TRD.
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Affiliation(s)
- Biao Dai
- Department of Basic and Clinical Pharmacology, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Pharmacy, Hefei Fourth People’s Hospital, Hefei, China
- Department of Medical Education and Research, Anhui Mental Health Center, Hefei, China
| | - Xiaoping Wu
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Medical Education and Research, Anhui Mental Health Center, Hefei, China
- Department of Geriatric Psychology, Hefei Fourth People’s Hospital, Hefei, China
| | - Fanfan Yan
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Medical Education and Research, Anhui Mental Health Center, Hefei, China
- Department of Geriatric Psychology, Hefei Fourth People’s Hospital, Hefei, China
| | - Yang Chen
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Medical Education and Research, Anhui Mental Health Center, Hefei, China
- Modified Electroconvulsive Therapy Room, Hefei Fourth People’s Hospital, Hefei, China
| | - Yayun Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Qingrong Xia
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Medical Education and Research, Anhui Mental Health Center, Hefei, China
- Department of Science and Education, Hefei Fourth People’s Hospital, Hefei, China
| | - Xulai Zhang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Medical Education and Research, Anhui Mental Health Center, Hefei, China
- Department of Geriatric Psychology, Hefei Fourth People’s Hospital, Hefei, China
- Anhui Provincial Clinical Research Center for Mental and Mental Diseases, Hefei, China
| | - Xuefeng Xie
- Department of Basic and Clinical Pharmacology, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China
- *Correspondence: Xuefeng Xie,
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13
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Wang H, Zhou H, Guo Y, Gao L, Xu H. Voxel-Wise Analysis of Structural and Functional MRI for Lateralization of Handedness in College Students. Front Hum Neurosci 2021; 15:687965. [PMID: 34483863 PMCID: PMC8414999 DOI: 10.3389/fnhum.2021.687965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/12/2021] [Indexed: 11/26/2022] Open
Abstract
The brain structural and functional basis of lateralization in handedness is largely unclear. This study aimed to explore this issue by using voxel-mirrored homotopic connectivity (VMHC) measured by resting-state functional MRI (R-fMRI) and gray matter asymmetry index (AI) by high-resolution anatomical images. A total of 50 healthy subjects were included, among them were 13 left-handers, 24 right-handers, and 13 mixed-handers. Structural and R-fMRI data of all subjects were collected. There were significant differences in VMHC among the three groups in lateral temporal-occipital, orbitofrontal, and primary hand motor regions. Meanwhile, there were significant differences in AI that existed in medial prefrontal, superior frontal, and superior temporal regions. Besides, the correlation analysis showed that the closer the handedness score to the extreme of the left-handedness (LH), the stronger the interhemispheric functional connectivity, as well as more leftward gray matter. In general, left/mixed-handedness (MH) showed stronger functional homotopy in the transmodal association regions that depend on the integrity of the corpus callosum, but more variable in primary sensorimotor cortices. Furthermore, the group differences in VMHC largely align with that in AI. We located the specific regions for LH/MH from the perspective of structural specification and functional integration, suggesting the plasticity of hand movement and different patterns of emotional processing.
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Affiliation(s)
- Haha Wang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hong Zhou
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yihao Guo
- Siemens MR Collaboration, Siemens Healthcare, Guangzhou, China
| | - Lei Gao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
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14
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Porta-Casteràs D, Cano M, Camprodon JA, Loo C, Palao D, Soriano-Mas C, Cardoner N. A multimetric systematic review of fMRI findings in patients with MDD receiving ECT. Prog Neuropsychopharmacol Biol Psychiatry 2021; 108:110178. [PMID: 33197507 DOI: 10.1016/j.pnpbp.2020.110178] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/21/2020] [Accepted: 11/11/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is considered the most effective treatment for major depressive disorder (MDD). In recent years, the pursuit of the neurobiological mechanisms of ECT action has generated a significant amount of functional magnetic resonance imaging (fMRI) research. OBJECTIVE In this systematic review, we integrated all fMRI research in patients with MDD receiving ECT and, importantly, evaluated the level of convergence and replicability across multiple fMRI metrics. RESULTS While according to most studies changes in patients with MDD after ECT appear to be widely distributed across the brain, our multimetric review revealed specific changes involving functional connectivity increases in the superior and middle frontal gyri as the most replicated and across-modality convergent findings. Although this modulation of prefrontal connectivity was associated to ECT outcome, we also identified fMRI measurements of the subgenual anterior cingulate cortex as the fMRI signals most significantly linked to clinical response. CONCLUSION We identified specific prefrontal and cingulate territories which activity and connectivity with other brain regions is modulated by ECT, critically accounting for its mechanism of action.
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Affiliation(s)
- Daniel Porta-Casteràs
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Marta Cano
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Joan A Camprodon
- Laboratory for Neuropsychiatry and Neuromodulation, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Colleen Loo
- School of Psychiatry, University of New South Wales, Sydney, Australia; The Black Dog Institute, Sydney, Australia; St George Hospital, Sydney, Australia
| | - Diego Palao
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Carles Soriano-Mas
- Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, CIBERSAM, Carlos III Health Institute, Barcelona, Spain
| | - Narcís Cardoner
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
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15
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Wang L, Wei Q, Wang C, Xu J, Wang K, Tian Y, Wang J. Altered functional connectivity patterns of insular subregions in major depressive disorder after electroconvulsive therapy. Brain Imaging Behav 2021; 14:753-761. [PMID: 30610527 DOI: 10.1007/s11682-018-0013-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Although electroconvulsive therapy (ECT) is an efficient treatment for major depressive disorder (MDD), however, it also brings memory impairment. The insula is a critical brain structure for coordinating affective, cognitive memory, saliency processing, and attention switching suggesting functional activity of insula maybe an important indicator to delineate the treatment and side effects of ECT. Here, Resting-state functional connectivity analyses of insular subregions were performed to reveal the changes of connectivity in 23 MDD patients before and after ECT and 25 healthy control (HC) and identified significantly increased functional connectivity of the right ventral anterior insular subregion with bilateral caudate, angular gyrus, and dorsolateral prefrontal cortex after ECT. Granger causality analyses identified significantly increased effective connectivity from dorsolateral prefrontal cortex to right angular gyrus in MDD patients after ECT. Furthermore, increased effective connectivity from dorsolateral prefrontal cortex to right angular gyrus exhibited significantly positive correlation with changed Hamilton Rating Scale for Depression scores. These results showed that ECT can normalize abnormal functional connectivity and effective connectivity in MDD. Our findings also indicated that the right ventral anterior insula and effective connectivity from dorsolateral prefrontal cortex to right angular gyrus are biomarkers of antidepressant effects during ECT of MDD.
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Affiliation(s)
- Lijie Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 625014, China.,School of life Science and technology, University of Electronic Science and Technology of China, Chengdu, 625014, China
| | - Qiang Wei
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China
| | - Chao Wang
- College of Psychology and Sociology, Shenzhen University, Shenzhen, 518060, China
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Kai Wang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China.,Department of Medical Psychology, Anhui Medical University, Hefei, 230022, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China.,Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China
| | - Yanghua Tian
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China.
| | - Jiaojian Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 625014, China. .,School of life Science and technology, University of Electronic Science and Technology of China, Chengdu, 625014, China.
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16
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Wei Q, Ji Y, Bai T, Zu M, Guo Y, Mo Y, Ji G, Wang K, Tian Y. Enhanced cerebro-cerebellar functional connectivity reverses cognitive impairment following electroconvulsive therapy in major depressive disorder. Brain Imaging Behav 2021; 15:798-806. [PMID: 32361944 DOI: 10.1007/s11682-020-00290-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Electroconvulsive therapy (ECT), a rapidly acting and effective treatment for major depressive disorder (MDD), is frequently accompanied by cognitive impairment. Recent studies have documented that ECT reorganizes dysregulated inter/intra- connected cerebral networks, including the affective network, the cognitive control network(CCN) and default mode network (DMN).Moreover, cerebellum is thought to play an important role in emotion regulation and cognitive processing. However, little is known about the relationship between cerebro-cerebellar connectivity alterations following ECT and antidepressant effects or cognitive impairment. We performed seed-based resting-state functional connectivity (RSFC) analyses in 28 MDD patients receiving ECT and 20 healthy controls to identify cerebro-cerebellar connectivity differences related to MDD and changes induced by ECT. Six seed regions (three per hemisphere) in the cerebrum were selected for RSFC, corresponding to the affective network, CCN and DMN, to establish cerebro-cerebellar functional connectivity with cerebellum. MDD patients showed increased RSFC between left sgACC and left cerebellar lobule VI after ECT. Ggranger causality analyses (GCA) identified the causal interaction is from left cerebellar lobule VI to left sgACC. Furthermore, increased effective connectivity from left cerebellar lobule VI to left sgACC exhibited positively correlated with the change in verbal fluency test (VFT) score following ECT (r = 0.433, p = 0.039). Our findings indicate that the enhanced cerebro-cerebellar functional connectivity from left lobule VI to left sgACC may ameliorate cognitive impairment induced by ECT. This study identifies a potential neural pathway for mitigation of cognitive impairment following ECT.
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Affiliation(s)
- Qiang Wei
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 230022, Hefei, Anhui Province, China.,Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Yang Ji
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 230022, Hefei, Anhui Province, China
| | - Tongjian Bai
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 230022, Hefei, Anhui Province, China.,Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Meidan Zu
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 230022, Hefei, Anhui Province, China
| | - Yuanyuan Guo
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 230022, Hefei, Anhui Province, China
| | - Yuting Mo
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 230022, Hefei, Anhui Province, China
| | - Gongjun Ji
- Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Kai Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 230022, Hefei, Anhui Province, China. .,Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Hefei, China. .,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, 230022, Hefei, China. .,Department of Medical Psychology, Anhui Medical University, 230022, Hefei, China.
| | - Yanghua Tian
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 230022, Hefei, Anhui Province, China. .,Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Hefei, China.
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17
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Sinha P, Joshi H, Ithal D. Resting State Functional Connectivity of Brain With Electroconvulsive Therapy in Depression: Meta-Analysis to Understand Its Mechanisms. Front Hum Neurosci 2021; 14:616054. [PMID: 33551779 PMCID: PMC7859100 DOI: 10.3389/fnhum.2020.616054] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/15/2020] [Indexed: 12/25/2022] Open
Abstract
Introduction: Electroconvulsive therapy (ECT) is a commonly used brain stimulation treatment for treatment-resistant or severe depression. This study was planned to find the effects of ECT on brain connectivity by conducting a systematic review and coordinate-based meta-analysis of the studies performing resting state fMRI (rsfMRI) in patients with depression receiving ECT. Methods: We systematically searched the databases published up to July 31, 2020, for studies in patients having depression that compared resting-state functional connectivity (rsFC) before and after a course of pulse wave ECT. Meta-analysis was performed using the activation likelihood estimation method after extracting details about coordinates, voxel size, and method for correction of multiple comparisons corresponding to the significant clusters and the respective rsFC analysis measure with its method of extraction. Results: Among 41 articles selected for full-text review, 31 articles were included in the systematic review. Among them, 13 articles were included in the meta-analysis, and a total of 73 foci of 21 experiments were examined using activation likelihood estimation in 10 sets. Using the cluster-level interference method, one voxel-wise analysis with the measure of amplitude of low frequency fluctuations and one seed-voxel analysis with the right hippocampus showed a significant reduction (p < 0.0001) in the left cingulate gyrus (dorsal anterior cingulate cortex) and a significant increase (p < 0.0001) in the right hippocampus with the right parahippocampal gyrus, respectively. Another analysis with the studies implementing network-wise (posterior default mode network: dorsomedial prefrontal cortex) resting state functional connectivity showed a significant increase (p < 0.001) in bilateral posterior cingulate cortex. There was considerable variability as well as a few key deficits in the preprocessing and analysis of the neuroimages and the reporting of results in the included studies. Due to lesser studies, we could not do further analysis to address the neuroimaging variability and subject-related differences. Conclusion: The brain regions noted in this meta-analysis are reasonably specific and distinguished, and they had significant changes in resting state functional connectivity after a course of ECT for depression. More studies with better neuroimaging standards should be conducted in the future to confirm these results in different subgroups of depression and with varied aspects of ECT.
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Affiliation(s)
- Preeti Sinha
- ECT Services, Noninvasive Brain Stimulation (NIBS) Team, Department of Psychiatry, Bengaluru, India.,Geriatric Clinic and Services, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Himanshu Joshi
- Geriatric Clinic and Services, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India.,Multimodal Brain Image Analysis Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Dhruva Ithal
- ECT Services, Noninvasive Brain Stimulation (NIBS) Team, Department of Psychiatry, Bengaluru, India.,Accelerated Program for Discovery in Brain Disorders, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
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18
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Bifrontal electroconvulsive therapy changed regional homogeneity and functional connectivity of left angular gyrus in major depressive disorder. Psychiatry Res 2020; 294:113461. [PMID: 33038791 DOI: 10.1016/j.psychres.2020.113461] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022]
Abstract
Electroconvulsive therapy (ECT) is a rapid and effective treatment for MDD. However, the mechanism of ECT for MDD has not been clarified. In this study, we used resting-state functional magnetic resonance imaging (rs-fMRI) to explore the mechanism of ECT. Two groups of subjects were recruited: healthy controls (HCs) and MDD patients who received bifrontal ECT. MDD patients and HCs underwent rs-fMRI scans and clinical assessments (Hamilton Depression Rating Scale, Rey-Auditory Verbal Learning Test (RAVLT), and the verbal fluency test). Regional homogeneity (ReHo) and functional connectivity were evaluated for the analysis of rs-fMRI data. The results showed that ReHo values in the left angular gyrus (LAG) significantly increased in MDD patients after ECT, and the functional connectivity of the LAG with bilateral inferior temporal gyrus, bilateral middle frontal gyrus, left superior frontal gyrus, left middle temporal gyrus, left precuneus, left posterior cingulate gyrus, and right angular gyrus was found to be strengthened after ECT. The scores of delayed recall trial in the RAVLT of MDD patients were related to the functional connectivity of the LAG with the left inferior temporal gyrus and the left posterior cingulate gyrus. It indicated LAG palyed an important role in the mechanism of ECT in MDD.
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19
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Tao L, Wang L, Chen X, Liu F, Ruan F, Zhang J, Shen L, Yu Y. Modulation of Interhemispheric Functional Coordination in Breast Cancer Patients Receiving Chemotherapy. Front Psychol 2020; 11:1689. [PMID: 32849022 PMCID: PMC7403228 DOI: 10.3389/fpsyg.2020.01689] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/22/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives Chemotherapy induces cognitive impairments including memory impairment attention deficit and executive dysfunction in patients with breast cancer (BC) during or after chemotherapy. Previous studies identified brain structural and functional changes in BC patients receiving chemotherapy; however, there are no studies assessing functional connectivity (FC) between homotopic brain regions in BC patients using a voxel-mirrored homotopic connectivity (VMHC) method. In the present study, we explored cognitive function and whole brain homotopic FC in BC patients receiving chemotherapy compared with healthy controls using the VMHC method. Methods The present cross-sectional study included 35 premenopausal women with breast cancer who received chemotherapy, as well as 32 age- and sex-matched healthy controls (HC). All subjects underwent resting-state functional magnetic resonance imaging, which measured homotopic brain FC, and cognitive neuropsychological assessments evaluating attention, memory, and executive function domains. Results The BC group had lower VMHC than the HC group in the cingulated posterior, insular and postcentral regions. No region exhibited higher VMHC in the BC group than in HC group. Correlation analysis in the BC group indicated that VMHC values in the cingulated posterior were significantly correlated with executive function tests, and that the VMHC values in the insular were significantly correlated with memory tests. Conclusion The present study showed that VMHC decreased in different brain regions including cingulated posterior, insular and postcentral regions. A significant correlation was observed between the VMHC values in the brain regions and neuropsychological tests. These results suggested that changes in VMHC values in different brain regions may underlie cognitive changes in BC patients receiving chemotherapy.
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Affiliation(s)
- Longxiang Tao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lu Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Xingui Chen
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Fujun Liu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Feiyan Ruan
- Department of Breast Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jingjie Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Li Shen
- Department of Radiotherapy, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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20
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Xu J, Wei Q, Bai T, Wang L, Li X, He Z, Wu J, Hu Q, Yang X, Wang C, Tian Y, Wang J, Wang K. Electroconvulsive therapy modulates functional interactions between submodules of the emotion regulation network in major depressive disorder. Transl Psychiatry 2020; 10:271. [PMID: 32759936 PMCID: PMC7406501 DOI: 10.1038/s41398-020-00961-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/17/2020] [Accepted: 07/27/2020] [Indexed: 12/14/2022] Open
Abstract
An increasing number of neuroimaging studies have consistently revealed that disrupted functional interactions within the cognitive emotion regulation network (ERN) contribute to the onset of major depressive disorders (MDD). To disentangle the functional reorganization of ERN after electroconvulsive therapy (ECT) in MDD is curial for understanding its neuropathology. Resting-state functional magnetic resonance imaging data was collected from 23 MDD patients before and after ECT, as well as 25 healthy controls. Network modularity analysis was used to identify the submodules and functional connectivity (FC) was used to investigate the functional reorganization of ERN in the MDD patients after ECT. Four submodules of ERN were identified, including emotion response module (ERM), emotion integration module (EIM), emotion generation module (EGM), and emotion execution module (EEM). The increased intra-modular FC of EEM and inter-modular FCs of EEM with EIM\ERM were found in MDD patients after ECT. Modular transition analysis revealed that left ventrolateral prefrontal cortex, supplementary motor area, posterior cingulate cortex, right angular gyrus, and right precentral gyrus were transferred across different submodules across the three groups. Further analyses showed correlations between changed FC and clinical symptoms in the MDD patients after ECT. Finally, we also identified 11 increased connections between nodes belonging to different submodules of ERN in MDD patients after ECT. These results showed that ECT could induce functional reorganization of intra- and inter-modules within the ERN, and the functional changes were related to therapeutic efficacy or memory impairments of ECT in MDD patients.
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Affiliation(s)
- Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Qiang Wei
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China
| | - Tongjian Bai
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China
| | - Lijie Wang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 625014, China
| | - Xuemei Li
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 625014, China
| | - Zhengyu He
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 625014, China
| | - Jianhuang Wu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Qingmao Hu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Xun Yang
- School of Public Affairs, Chongqing University, Chongqing, 400044, China
| | - Chao Wang
- College of Psychology and Sociology, Shenzhen University, Shenzhen, 518055, China
| | - Yanghua Tian
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China.
- Department of Neurology, Shannan People's Hospital, Shannan, 856000, China.
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230022, China.
| | - Jiaojian Wang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 625014, China.
- Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, 518057, China.
| | - Kai Wang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China
- Department of Medical Psychology, Anhui Medical University, Hefei, 230022, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China
- Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China
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21
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Wang J, Ji Y, Li X, He Z, Wei Q, Bai T, Tian Y, Wang K. Improved and residual functional abnormalities in major depressive disorder after electroconvulsive therapy. Prog Neuropsychopharmacol Biol Psychiatry 2020; 100:109888. [PMID: 32061788 DOI: 10.1016/j.pnpbp.2020.109888] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/03/2020] [Accepted: 02/11/2020] [Indexed: 02/07/2023]
Abstract
Electroconvulsive therapy (ECT) can induce fast remission of depression but still retain the residual functional impairments in major depressive disorder (MDD) patients. To delineate the different functional circuits of effective antidepressant treatment and residual functional impairments is able to better guide clinical therapy for depression. Herein, voxel-level whole brain functional connectivity homogeneity (FcHo), functional connectivity, multivariate pattern classification approaches were applied to reveal the specific circuits for treatment response and residual impairments in MDD patients after ECT. Increased FcHo values in right dorsomedial prefrontal cortex (dmPFC) and left angular gyrus (AG) and their corresponding functional connectivities between dmPFC and right AG, dorsolateral prefrontal cortex (dlPFC), superior frontal gyrus, precuneus (Pcu) and between left AG with dlPFC, bilateral AG, and left ventrolateral prefrontal cortex in MDD patients after ECT. Moreover, we found decreased FcHo values in left middle occipital gyrus (MOG) and lingual gyrus (LG) and decreased functional connectivities between MOG and dorsal postcentral gyrus (PCG) and between LG and middle PCG/anterior superior parietal lobule in MDD patients before and after ECT compared to healthy controls (HCs). The increased or normalized FcHo and functional connections may be related to effective antidepressant therapy, and the decreased FcHo and functional connectivities may account for the residual functional impairments in MDD patients after ECT. The different change patterns in MDD after ECT indicated a specific brain circuit supporting fast remission of depression, which was supported by the following multivariate pattern classification analyses. Finally, we found that the changed FcHo in dmPFC was correlated with changed depression scores. These results revealed a specific functional circuit supporting antidepressant effects of ECT and neuroanatomical basis for residual functional impairments. Our findings also highlighted the key role of dmPFC in antidepressant and will provide an important reference for depression treatment.
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Affiliation(s)
- Jiaojian Wang
- Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen 518057, China.
| | - Yang Ji
- Department of Neurology, the First Hospital of Anhui Medical University, Hefei 230022, China
| | - Xuemei Li
- Key Laboratory for Neurolnformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Zhengyu He
- Key Laboratory for Neurolnformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Qiang Wei
- Department of Neurology, the First Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China
| | - Tongjian Bai
- Department of Neurology, the First Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China.
| | - Yanghua Tian
- Department of Neurology, the First Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China.
| | - Kai Wang
- Department of Neurology, the First Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China; Department of Medical Psychology, Anhui Medical University, Hefei 230022, China
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22
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Wei Q, Bai T, Brown EC, Xie W, Chen Y, Ji G, Ramasubbu R, Tian Y, Wang K. Thalamocortical connectivity in electroconvulsive therapy for major depressive disorder. J Affect Disord 2020; 264:163-171. [PMID: 32056746 DOI: 10.1016/j.jad.2019.11.120] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 09/28/2019] [Accepted: 11/28/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) can lead to rapid and effective responses in major depressive disorder (MDD). However, the precise neural mechanisms of ECT for MDD are still unclear. Previous work has confirmed that thalamocortical circuits play an important role in emotion and cognition. However, the relationship between mechanisms of ECT for MDD and thalamocortical connectivity has not yet been investigated. METHOD Thalamocortical functional connectivity analysis was performed on resting-state functional magnetic resonance imaging (fMRI) data collected from 28 MDD patients both pre- and post-ECT treatment, as well as 20 healthy controls. The cortex was parceled into six regions of interest (ROIs), which were used as seeds to assess the functional connectivity between the cortex and each voxel in the thalamus. Then, functional connectivity between the identified thalamic subregions and the rest of the brain was quantified to better localize thalamocortical connectivity related to ECT. Structural connectivity among the functionally abnormal regions was also determined using probabilistic tractography from diffusion tensor imaging (DTI) data. RESULTS There was decreased parietal cortex-left pulvinar and left pulvinar-bilateral precuneus functional connectivity in post-ECT MDD patients, compared to pre-ECT MDD patients. Furthermore, functional connectivity strength of parietal cortex-left pulvinar and left pulvinar-bilateral precuneus was negative correlation with verbal fluency test scores in post-ECT MDD patients. No significant change was found in structural connectivity analysis. LIMITATIONS The sample size of our study was not large. CONCLUSION Our findings implicate that the specific abnormalities in thalamocortical circuit may be associated with cognitive impairment induced by ECT.
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Affiliation(s)
- Qiang Wei
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Tongjian Bai
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Elliot C Brown
- Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Neuroscience Research Center, Berlin Institute of Health, Berlin, Germany; Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada; Department of Psychiatry, University of Calgary, Calgary, AB, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Wen Xie
- Anhui Mental Health Center, Hefei, China
| | - Yang Chen
- Anhui Mental Health Center, Hefei, China
| | - Gongjun Ji
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Rajamannar Ramasubbu
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada; Department of Psychiatry, University of Calgary, Calgary, AB, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Yanghua Tian
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.
| | - Kai Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.
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23
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Ji G, Chen X, Bai T, Wang L, Wei Q, Gao Y, Tao L, He K, Li D, Dong Y, Hu P, Yu F, Zhu C, Tian Y, Yu Y, Wang K. Classification of schizophrenia by intersubject correlation in functional connectome. Hum Brain Mapp 2019; 40:2347-2357. [PMID: 30663853 PMCID: PMC6865403 DOI: 10.1002/hbm.24527] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/07/2018] [Accepted: 01/08/2019] [Indexed: 01/16/2023] Open
Abstract
Functional connectomes have been suggested as fingerprinting for individual identification. Accordingly, we hypothesized that subjects in the same phenotypic group have similar functional connectome features, which could help to discriminate schizophrenia (SCH) patients from healthy controls (HCs) and from depression patients. To this end, we included resting-state functional magnetic resonance imaging data of SCH, depression patients, and HCs from three centers. We first investigated the characteristics of connectome similarity between individuals, and found higher similarity between subjects belonging to the same group (i.e., SCH-SCH) than different groups (i.e., HC-SCH). These findings suggest that the average connectome within group (termed as group-specific functional connectome [GFC]) may help in individual classification. Consistently, significant accuracy (75-77%) and area under curve (81-86%) were found in discriminating SCH from HC or depression patients by GFC-based leave-one-out cross-validation. Cross-center classification further suggests a good generalizability of the GFC classification. We additionally included normal aging data (255 young and 242 old subjects with different scanning sequences) to show factors could be improved for better classification performance, and the findings emphasized the importance of increasing sample size but not temporal resolution during scanning. In conclusion, our findings suggest that the average functional connectome across subjects contained group-specific biological features and may be helpful in clinical diagnosis for schizophrenia.
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Affiliation(s)
- Gong‐Jun Ji
- Department of Medical PsychologyChaohu Clinical Medical College, Anhui Medical UniversityHefeiChina
- Laboratory of Cognitive NeuropsychologyCollaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Xingui Chen
- Laboratory of Cognitive NeuropsychologyCollaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Tongjian Bai
- Laboratory of Cognitive NeuropsychologyCollaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Lu Wang
- Laboratory of Cognitive NeuropsychologyCollaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Qiang Wei
- Laboratory of Cognitive NeuropsychologyCollaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Yaxiang Gao
- Laboratory of Cognitive NeuropsychologyCollaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Longxiang Tao
- Department of RadiologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Kongliang He
- Anhui Mental Health CenterHefeiChina
- The Fourth People's Hospital of HefeiHefeiChina
| | - Dandan Li
- Laboratory of Cognitive NeuropsychologyCollaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Yi Dong
- Anhui Mental Health CenterHefeiChina
- The Second Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Panpan Hu
- Laboratory of Cognitive NeuropsychologyCollaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Fengqiong Yu
- Department of Medical PsychologyChaohu Clinical Medical College, Anhui Medical UniversityHefeiChina
- Laboratory of Cognitive NeuropsychologyCollaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Chunyan Zhu
- Department of Medical PsychologyChaohu Clinical Medical College, Anhui Medical UniversityHefeiChina
- Laboratory of Cognitive NeuropsychologyCollaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Yanghua Tian
- Laboratory of Cognitive NeuropsychologyCollaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Yongqiang Yu
- Department of RadiologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Kai Wang
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
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24
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Sinha P, Reddy RV, Srivastava P, Mehta UM, Bharath RD. Network neurobiology of electroconvulsive therapy in patients with depression. Psychiatry Res Neuroimaging 2019; 287:31-40. [PMID: 30952030 DOI: 10.1016/j.pscychresns.2019.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 03/16/2019] [Accepted: 03/19/2019] [Indexed: 12/22/2022]
Abstract
Graph theory, a popular analytic tool for resting state fMRI (rsfMRI) has provided important insights in the neurobiology of depression. We aimed to analyze the changes in the network measures of segregation and integration associated with the administration of ECT in patients with depression and to correlate with both clinical response and cognitive deficits. Changes in normalised clustering coefficient (γ), path length (λ) and small-world (σ) index were explored in 17 patients with depressive episode before 1st and after 6th brief-pulse bifrontal ECT (BFECT) sessions. Significant brain regions were then correlated with differences in clinical and cognitive scales. There was significantly increased γ and σ despite significant increase in λ in several brain regions after ECT in patients with depression. The brain areas revealing significant differences in γ before and after ECT were medial left superior frontal gyrus, left paracentral lobule, right pallidum and left inferior frontal operculum; correlating with changes in verbal fluency, HAM-D scores and delayed verbal memory (last two regions) respectively. BFECT reorganized the brain network topology in patients with depression and made it more segregated and less integrated; these correlated with clinical improvement and associated cognitive deficits.
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Affiliation(s)
- Preeti Sinha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - R Venkateswara Reddy
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India; Cognitive Neuroscience Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - Prerna Srivastava
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - Urvakhsh M Mehta
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India; Cognitive Neuroscience Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India.
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25
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Xu J, Wang J, Bai T, Zhang X, Li T, Hu Q, Li H, Zhang L, Wei Q, Tian Y, Wang K. Electroconvulsive Therapy Induces Cortical Morphological Alterations in Major Depressive Disorder Revealed with Surface-Based Morphometry Analysis. Int J Neural Syst 2019; 29:1950005. [PMID: 31387489 DOI: 10.1142/s0129065719500059] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although electroconvulsive therapy (ECT) is one of the most effective treatments for major depressive disorder (MDD), the mechanism underlying the therapeutic efficacy and side effects of ECT remains poorly understood. Here, we investigated alterations in the cortical morphological measurements including cortical thickness (CT), surface area (SA), and local gyrification index (LGI) in 23 MDD patients before and after ECT. Furthermore, multivariate pattern analysis using linear support vector machine (SVM) was applied to investigate whether the changed morphological measurements can be effective indicators for therapeutic efficacy of ECT. Surface-based morphometry (SBM) analysis found significantly increased vertex-wise and regional cortical thickness (CT) and surface area (SA) in widespread regions, mainly located in the left insula (INS) and left fusiform gyrus, as well as hypergyrification in the left middle temporal gyrus (MTG) in MDD patients after ECT. Partial correlational analyses identified associations between the morphological properties and depressive symptom scores and impaired memory scores. Moreover, SVM result showed that the changed morphological measurements were effective to classify the MDD patients before and after ECT. Our findings suggested that ECT may enhance cortical neuroplasticity to facilitate neurogenesis to remit depressive symptoms and to impair delayed memory. These findings indicated that the cortical morphometry is a good index for therapeutic efficacy of ECT.
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Affiliation(s)
- Jinping Xu
- 1Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, P. R. China.,2University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Jiaojian Wang
- 3The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 625014, P. R. China
| | - Tongjian Bai
- 4Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, P. R. China
| | - Xiaodong Zhang
- 1Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, P. R. China
| | - Tian Li
- 1Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, P. R. China
| | - Qingmao Hu
- 1Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, P. R. China.,5CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, P. R. China
| | - Hongming Li
- 6Center for Biomedical Image Computing and Analytics, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Li Zhang
- 7Anhui Mental Health Center, Hefei 230022, P. R. China
| | - Qiang Wei
- 4Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, P. R. China
| | - Yanghua Tian
- 4Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, P. R. China.,8Department of Neurology, Shannan People's Hospital, Shannan, 856000, P. R. China
| | - Kai Wang
- 4Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, P. R. China.,9Department of Medical Psychology, Anhui Medical University, Hefei 230022, P. R. China.,10Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, P. R. China.,11Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Hefei 230022, P. R. China
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Qiu H, Li X, Luo Q, Li Y, Zhou X, Cao H, Zhong Y, Sun M. Alterations in patients with major depressive disorder before and after electroconvulsive therapy measured by fractional amplitude of low-frequency fluctuations (fALFF). J Affect Disord 2019; 244:92-99. [PMID: 30326347 PMCID: PMC6239214 DOI: 10.1016/j.jad.2018.10.099] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 09/08/2018] [Accepted: 10/08/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is an important treatment option for patients with major depressive disorder (MDD). However, the mechanisms of ECT in MDD are still unclear. METHODS Twenty-four patients with severe MDD and 14 healthy controls were enrolled in this study. Eight ECT sessions were conducted for MDD patients using brief-pulse square-wave signal at bitemporal locations. To investigate the regional cerebral blood flow in MDD patients before and after ECT treatments by resting-state functional magnetic resonance imaging (rs-fMRI), the patients were scanned twice (before the first ECT and after the eighth ECT) for data acquisition. Afterward, we adopted fractional amplitude of low-frequency fluctuations (fALFF) to assess the alterations of regional brain activity. RESULTS Compared with healthy controls, the fALFF in the cerebellum lobe, parahippocampal gyrus, fusiform gyrus, anterior cingulate gyrus, and thalamus in MDD patients before ECT (pre-ECT) was significantly increased. In another comparison, the fALFF in the cerebellum anterior lobe, fusiform gyrus, insula, parahippocampal gyrus, middle frontal gyrus, and inferior frontal gyrus in pre-ECT patients was significantly greater than the post-ECT fALFF. LIMITATIONS Only two rs-fMRI scans were conducted at predefined times: before the first and after the eighth ECT treatment. More scans during the ECT sessions would yield more information. In addition, the sample size in this study was limited. The number of control subjects was relatively small. A larger number of subjects would produce more robust findings. CONCLUSIONS The fALFF of both healthy controls and post-ECT patients in cerebellum anterior lobe, fusiform gyrus, and parahippocampal gyrus is significantly lower than the fALFF of pre-ECT patients. This finding demonstrates that ECT treatment is effective on these brain areas in MDD patients.
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Affiliation(s)
- Haitang Qiu
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Xinke Li
- College of Communication Engineering, Chongqing University, Chongqing 400044, PR China; Collaborative innovation center for brain science, Chongqing University, Chongqing 400044, PR China; Department of Neurosurgery, University of Pittsburgh, Pittsburgh 15213, PA, USA.
| | - Qinghua Luo
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, PR China
| | - Yongming Li
- College of Communication Engineering, Chongqing University, Chongqing 400044, PR China; Collaborative innovation center for brain science, Chongqing University, Chongqing 400044, PR China
| | - Xichuan Zhou
- College of Communication Engineering, Chongqing University, Chongqing 400044, PR China
| | - Hailin Cao
- College of Communication Engineering, Chongqing University, Chongqing 400044, PR China
| | - Yuanhong Zhong
- College of Communication Engineering, Chongqing University, Chongqing 400044, PR China
| | - Mingui Sun
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh 15213, PA, USA
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Interhemispheric connectivity and hemispheric specialization in schizophrenia patients and their unaffected siblings. NEUROIMAGE-CLINICAL 2019; 21:101656. [PMID: 30660663 PMCID: PMC6412072 DOI: 10.1016/j.nicl.2019.101656] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/13/2018] [Accepted: 01/03/2019] [Indexed: 11/20/2022]
Abstract
Hemispheric integration and specialization are two prominent organizational principles for macroscopic brain function. Impairments of interhemispheric cooperation have been reported in schizophrenia patients, but whether such abnormalities should be attributed to effects of illness or familial risk remains inconclusive. Moreover, it is unclear how abnormalities in interhemispheric connectivity impact hemispheric specialization. To address these questions, we performed magnetic resonance imaging (MRI) in a large cohort of 253 participants, including 84 schizophrenia patients, 106 of their unaffected siblings and 63 healthy controls. Interhemispheric connectivity and hemispheric specialization were calculated from resting-state functional connectivity, and compared across groups. Results showed that schizophrenia patients exhibit lower interhemispheric connectivity as compared to controls and siblings. In addition, patients showed higher levels of hemispheric specialization as compared to siblings. Level of interhemispheric connectivity and hemispheric specialization correlated with duration of illness in patients. No significant alterations were identified in siblings relative to controls on both measurements. Furthermore, alterations in interhemispheric connectivity correlated with changes in hemispheric specialization in patients relative to controls and siblings. Taken together, these results suggest that lower interhemispheric connectivity and associated abnormalities in hemispheric specialization are features of established illness, rather than an expression of preexistent familial risk for schizophrenia.
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Wang J, Wei Q, Bai T, Zhou X, Sun H, Becker B, Tian Y, Wang K, Kendrick K. Electroconvulsive therapy selectively enhanced feedforward connectivity from fusiform face area to amygdala in major depressive disorder. Soc Cogn Affect Neurosci 2018; 12:1983-1992. [PMID: 28981882 PMCID: PMC5716231 DOI: 10.1093/scan/nsx100] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 08/17/2017] [Indexed: 12/30/2022] Open
Abstract
Electroconvulsive therapy (ECT) has been widely used to treat the major depressive disorder (MDD), especially for treatment-resistant depression. However, the neuroanatomical basis of ECT remains an open problem. In our study, we combined the voxel-based morphology (VBM), resting-state functional connectivity (RSFC) and granger causality analysis (GCA) to identify the longitudinal changes of structure and function in 23 MDD patients before and after ECT. In addition, multivariate pattern analysis using linear support vector machine (SVM) was applied to classify 23 depressed patients from 25 gender, age and education matched healthy controls. VBM analysis revealed the increased gray matter volume of left superficial amygdala after ECT. The following RSFC and GCA analyses further identified the enhanced functional connectivity between left amygdala and left fusiform face area (FFA) and effective connectivity from FFA to amygdala after ECT, respectively. Moreover, SVM-based classification achieved an accuracy of 83.33%, a sensitivity of 82.61% and a specificity of 84% by leave-one-out cross-validation. Our findings indicated that ECT may facilitate the neurogenesis of amygdala and selectively enhance the feedforward cortical-subcortical connectivity from FFA to amygdala. This study may shed new light on the pathological mechanism of MDD and may provide the neuroanatomical basis for ECT.
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Affiliation(s)
- Jiaojian Wang
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China
| | - Qiang Wei
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China
| | - Tongjian Bai
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China
| | | | - Hui Sun
- Beijing Key Laboratory of Learning and Cognition, School of Education, Capital Normal University, Beijing 100048, China
| | - Benjamin Becker
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China
| | - Yanghua Tian
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China
| | - Kai Wang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China
| | - Keith Kendrick
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China
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How Does Repetitive Transcranial Magnetic Stimulation Influence the Brain in Depressive Disorders?: A Review of Neuroimaging Magnetic Resonance Imaging Studies. J ECT 2018; 34:79-86. [PMID: 29324522 DOI: 10.1097/yct.0000000000000477] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Repetitive transcranial magnetic stimulation (rTMS) is a nonpharmacological technique used to stimulate the brain. It is a safe and proven alternative tool to treat resistant major depressive disorders (MDDs). Neuroimaging studies suggest a wide corticolimbic network is involved in MDDs. We researched observable changes in magnetic resonance imaging induced by rTMS to clarify the operational mechanism. METHODS A systematic search of the international literature was performed using PubMed and Embase, using papers published up to January 1, 2017. The following MESH terms were used: (depression or major depressive disorder) and (neuroimaging or MRI) and (rTMS or repetitive transcranial magnetic stimulation). We searched the databases using a previously defined strategy to identify potentially eligible studies. RESULTS Both structural and functional changes were observed on magnetic resonance imagings performed before and after rTMS. Various areas of the brain were impacted when rTMS was used. Although the results were very heterogeneous, a pattern that involved the anterior cingulate cortex and the prefrontal cortex emerged. These are known to be regions of interest in MDDs. However, the various parameters used in rTMS make any generalization difficult. CONCLUSIONS Repetitive transcranial magnetic stimulation helps to treat MDDs with good efficacy. Its effect on the brain, as observed in several neuroimaging studies, seems to impact on the structural and functional features of several networks and structures involved in major depressive disorders.
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Structural-functional brain changes in depressed patients during and after electroconvulsive therapy. Acta Neuropsychiatr 2018; 30:17-28. [PMID: 27876102 DOI: 10.1017/neu.2016.62] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Electroconvulsive therapy (ECT) is a non-pharmacological treatment that is effective in treating severe and treatment-resistant depression. Although the efficacy of ECT has been demonstrated to treat major depressive disorder (MDD), the brain mechanisms underlying this process remain unclear. Structural-functional changes occur with the use of ECT as a treatment for depression based on magnetic resonance imaging (MRI). For this reason, we have tried to identify the changes that were identified by MRI to try to clarify some operating mechanisms of ECT. We focus to brain changes on MRI [structural MRI (sMRI), functional MRI (fMRI) and diffusion tensor imging (DTI)] after ECT. METHODS A systematic search of the international literature was performed using the bibliographic search engines PubMed and Embase. The research focused on papers published up to 30 September 2015. The following Medical Subject Headings (MESH) terms were used: electroconvulsive therapy AND (MRI OR fMRI OR DTI). Papers published in English were included. Four authors searched the database using a predefined strategy to identify potentially eligible studies. RESULTS There were structural changes according to the sMRI performed before and after ECT treatment. These changes do not seem to be entirely due to oedema. This investigation assessed the functional network connectivity associated with the ECT response in MDD. ECT response reverses the relationship from negative to positive between the two pairs of networks. CONCLUSION We found structural-functional changes in MRI post-ECT. Because of the currently limited MRI data on ECT in the literature, it is necessary to conduct further investigations using other MRI technology.
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Zhu J, Lin X, Lin C, Zhuo C, Yu Y. Selective functional dysconnectivity of the dorsal-anterior subregion of the precuneus in drug-naive major depressive disorder. J Affect Disord 2018; 225:676-683. [PMID: 28917194 DOI: 10.1016/j.jad.2017.08.084] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 07/13/2017] [Accepted: 08/27/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Patients with major depressive disorder (MDD) have shown altered resting-state functional connectivity (rsFC) of the precuneus; however, it is unknown whether rsFC of the precuneus subregions is differentially affected in this disorder. METHODS In this study, we aimed to clarify this issue by comparing rsFC of each precuneus subregion between patients with MDD and healthy controls. Forty-seven drug-naive patients with MDD and 47 sex-, age- and education-matched healthy controls underwent resting-state functional magnetic resonance imaging (fMRI). The precuneus was divided into PCun-1 (dorsal-central portion; medial area 7), PCun-2 (dorsal-anterior portion; medial area 5), PCun-3 (dorsal-posterior portion; dorsomedial parietooccipital sulcus) and PCun-4 (ventral portion; area 31). The rsFC of each precuneus subregion was compared between the two groups. RESULTS Compared with healthy controls, patients with MDD exhibited increased rsFC between the left PCun-2 and the right fusiform gyrus, lateral prefrontal cortex, sensorimotor cortex and supramarginal gyrus. No significant inter-group difference was observed in the rsFC of other precuneus subregions. In addition, there was no difference in gray matter volume of all the precuneus subregions between patients with MDD and healthy controls. LIMITATIONS Some of the patients had chronic MDD and relevant neuropsychological data were not collected. CONCLUSIONS These findings suggest a selective functional dysconnectivity of the precuneus subregions in drug-naive MDD, characterized by the hyperconnnectivity between the dorsal-anterior subregion and regions involved in visual, executive control, sensorimotor and bottom-up attention functions.
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Affiliation(s)
- Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Chongguang Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Chuanjun Zhuo
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China; Department of Psychiatry, Tianjin Mental Health Center, Tianjin, China.
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
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Wang J, Wei Q, Yuan X, Jiang X, Xu J, Zhou X, Tian Y, Wang K. Local functional connectivity density is closely associated with the response of electroconvulsive therapy in major depressive disorder. J Affect Disord 2018; 225:658-664. [PMID: 28910748 DOI: 10.1016/j.jad.2017.09.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/13/2017] [Accepted: 09/02/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) has been demonstrated to be an effective treatment of major depressive disorder (MDD). However, the neuroanatomical basis of response to ECT is still largely unknown. METHODS In present study, we used functional connectivity density (FCD) and resting-state functional connectivity (RSFC) to identify the relationship between the changes of resting-state activities and ECT responses in 23 MDD patients before and after ECT. In addition, the identified neural indices as classification characteristics were entered into multivariate pattern analysis using linear support vector machine (SVM) to classify 23 MDD patients before ECT from 25 gender, age and years of education matched healthy controls. RESULTS We found that the changes of local FCD (lFCD), not long-range FCD, of the left pre-/postcentral gyrus (Pre-/postCG), left superior temporal gyrus (STG), and right STG were significantly correlated with the changes of Hamilton Rating Scale for Depression (HRSD) scores in MDD patients before and after ECT. The subsequent functional connectivity analysis revealed significantly decreased functional connectivity between right STG and right intraparietal sulcus (IPS) in MDD after ECT in spite of no correlation with HRSD scores. Finally, SVM-based classification achieved an accuracy of 72.92% with a sensitivity of 73.91% and a specificity of 72% by leave-one-out cross-validation. CONCLUSIONS Our findings indicated that Pre-/postCG and bilateral STG play an important role in response of ECT in MDD patients, and the lFCD in these areas may serve as a biomarker for predicting ECT response.
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Affiliation(s)
- Jiaojian Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 625014, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu 625014, China.
| | - Qiang Wei
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xinru Yuan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 625014, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu 625014, China
| | - Xiaoyan Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 625014, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu 625014, China
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | | | - Yanghua Tian
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Department of Neurology, Shannan People's Hospital, Shannan 856000, China.
| | - Kai Wang
- Department of Medical Psychology, Anhui Medical University, Hefei, China; Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Hefei, China.
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Wang J, Wei Q, Wang L, Zhang H, Bai T, Cheng L, Tian Y, Wang K. Functional reorganization of intra- and internetwork connectivity in major depressive disorder after electroconvulsive therapy. Hum Brain Mapp 2017; 39:1403-1411. [PMID: 29266749 DOI: 10.1002/hbm.23928] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/17/2017] [Accepted: 12/11/2017] [Indexed: 02/02/2023] Open
Abstract
Electroconvulsive therapy (ECT) is an effective and rapid treatment for major depressive disorder (MDD). However, the neurobiological underpinnings of ECT are still largely unknown. Recent studies have identified dysregulated brain networks in MDD. Therefore, we hypothesized that ECT may improve MDD symptoms through reorganizing these networks. To test this hypothesis, we used resting-state functional connectivity to investigate changes to the intra- and internetwork architecture of five reproducible resting-state networks: the default mode network (DMN), dorsal attention network (DAN), executive control network (CON), salience network (SAL), and sensory-motor network. Twenty-three MDD patients were assessed before and after ECT, along with 25 sex-, age-, and education-matched healthy controls. At the network level, enhanced intranetwork connectivities were found in the CON in MDD patients after ECT. Furthermore, enhanced internetwork connectivities between the DMN and SAL, and between the CON and DMN, DAN, and SAL were also identified. At the nodal level, the posterior cingulate cortex had increased connections with the left posterior cerebellum, right posterior intraparietal sulcus (rpIPS), and right anterior prefrontal cortex. The rpIPS had increased connections with the medial PFC (mPFC) and left anterior cingulate cortex. The left lateral parietal had increased connections with the dorsal mPFC (dmPFC), left anterior prefrontal cortex, and right anterior cingulate cortex. The dmPFC had increased connection with the left anterolateral prefrontal cortex. Our findings indicate that enhanced interactions in intra- and internetworks may contribute to the ECT response in MDD patients. These findings provide novel and important insights into the neurobiological mechanisms underlying ECT.
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Affiliation(s)
- Jiaojian Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 625014, China.,School of life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 625014, China
| | - Qiang Wei
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China
| | - Lijie Wang
- School of life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, 625014, China
| | - Hongyu Zhang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China
| | - Tongjian Bai
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China
| | - Li Cheng
- Anhui Mental Health Center, Hefei, 230022, China
| | - Yanghua Tian
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China.,Department of Neurology, Shannan People's Hospital, Shannan, 856000, China
| | - Kai Wang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China.,Department of Medical Psychology, Anhui Medical University, Hefei, 230022, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China.,Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China
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Electroconvulsive therapy regulates emotional memory bias of depressed patients. Psychiatry Res 2017; 257:296-302. [PMID: 28787655 DOI: 10.1016/j.psychres.2017.07.069] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 06/20/2017] [Accepted: 07/29/2017] [Indexed: 12/17/2022]
Abstract
Emotional memory bias is considered to be an important base of the etiology of depression and can be reversed by antidepressants via enhancing the memory for positive stimuli. Another antidepressant treatment, electroconvulsive therapy (ECT), has rapid antidepressant effect and frequently causes short-term memory impairment. However, it is unclear about the short-term effect of ECT on memory bias. In this study, the incidental memory task with emotional pictures were applied to evaluate the emotional memory of twenty depressed patients at pre- and post-ECT (three days after ECT) compared to twenty healthy controls. The depressive symptoms were evaluated using the Hamilton rating scale of depression (HRSD). Before ECT, patients showed decreased recognition memory for positive pictures compared to controls and remembered negative pictures more easily than positive pictures in the recognition task. In patients, the main effect of session (pre-ECT and post-ECT) was significant for both recognition and recall memory with reduced memory performance. The interaction between valence (positive, neutral and negative) and session was significant for recognition memory, indicating that negative memory was impaired more severely than positive memory. Our study indicates that ECT relieves depressive symptoms and regulates emotional memory through more severe impairment on memory for negative stimuli.
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Kong XM, Xu SX, Sun Y, Wang KY, Wang C, Zhang J, Xia JX, Zhang L, Tan BJ, Xie XH. Electroconvulsive therapy changes the regional resting state function measured by regional homogeneity (ReHo) and amplitude of low frequency fluctuations (ALFF) in elderly major depressive disorder patients: An exploratory study. Psychiatry Res Neuroimaging 2017; 264:13-21. [PMID: 28412557 DOI: 10.1016/j.pscychresns.2017.04.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 04/06/2017] [Accepted: 04/06/2017] [Indexed: 02/07/2023]
Abstract
Electroconvulsive therapy (ECT) is the most effective and rapid treatment for severe major depressive disorder (MDD) in elderly patients. The mechanism of ECT is unclear, and studies on ECT in elderly MDD patients by resting-state functional magnetic resonance imaging are rare. Thirteen elderly MDD patients were scanned before and after ECT using a 3.0T MRI scanner. Regional homogeneity (ReHo) and amplitude of low-frequency fluctuations (ALFF) were processed to compare resting-state function before and after treatment. Depression and anxiety symptoms of all patients abated after ECT. Decreased ReHo values in the bilateral superior frontal gyrus (SFG) were observed after ECT, and the values of right SFG significantly correlated with an altered Hamilton depression rating scale score. Increased ALFF values in the left middle frontal gyrus, right middle frontal gyrus, orbital part, and decreased ALFF values in the left midcingulate area, left precentral gyrus, right SFG/middle frontal gyrus after ECT were also observed. These results support the hypothesis that ECT may affect the regional resting state brain function in geriatric MDD patients.
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Affiliation(s)
- Xiao-Ming Kong
- Department of psychiatry, Anhui Mental Health Center, Hefei, China
| | - Shu-Xian Xu
- Department of psychiatry, Huizhou 2nd Municipal Hospital, Huizhou, China; Department of psychiatry, Anhui Medical University, Hefei, China
| | - Yan Sun
- Department of endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ke-Yong Wang
- Department of psychiatry, Anhui Mental Health Center, Hefei, China.
| | - Chen Wang
- Department of psychiatry, Anhui Mental Health Center, Hefei, China; Department of psychiatry, Anhui Medical University, Hefei, China
| | - Ji Zhang
- Department of magnetic resonance imaging, Hefei 2nd Municipal Hospital, Hefei, China
| | - Jin-Xiang Xia
- Department of magnetic resonance imaging, Hefei 2nd Municipal Hospital, Hefei, China
| | - Li Zhang
- Department of psychiatry, Anhui Mental Health Center, Hefei, China
| | - Bo-Jian Tan
- Department of psychiatry, Huizhou 2nd Municipal Hospital, Huizhou, China
| | - Xin-Hui Xie
- Department of psychiatry, Anhui Mental Health Center, Hefei, China; Department of psychiatry, Huizhou 2nd Municipal Hospital, Huizhou, China; Department of psychiatry, Anhui Medical University, Hefei, China.
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Jiang J, Wang J, Li C. Potential Mechanisms Underlying the Therapeutic Effects of Electroconvulsive Therapy. Neurosci Bull 2017; 33:339-347. [PMID: 28032314 PMCID: PMC5567510 DOI: 10.1007/s12264-016-0094-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/23/2016] [Indexed: 01/01/2023] Open
Abstract
In spite of the extensive application of electroconvulsive therapy (ECT), how it works remains unclear. So far, researchers have made great efforts in figuring out the mechanisms underlying the effect of ECT treatment via determining the levels of neurotransmitters and cytokines and using genetic and epigenetic tools, as well as structural and functional neuroimaging. To help address this question and provide implications for future research, relevant clinical trials and animal experiments are reviewed.
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Affiliation(s)
- Jiangling Jiang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, 200030, China
- Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China.
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, 200030, China.
- Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, 200030, China.
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Chen GD, Ji F, Li GY, Lyu BX, Hu W, Zhuo CJ. Antidepressant Effects of Electroconvulsive Therapy Unrelated to the Brain's Functional Network Connectivity alterations at an Individual Level. Chin Med J (Engl) 2017; 130:414-419. [PMID: 28218214 PMCID: PMC5324377 DOI: 10.4103/0366-6999.199845] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Electroconvulsive therapy (ECT) can alleviate the symptoms of treatment-resistant depression (TRD). Functional network connectivity (FNC) is a newly developed method to investigate the brain's functional connectivity patterns. The first aim of this study was to investigate FNC alterations between TRD patients and healthy controls. The second aim was to explore the relationship between the ECT treatment response and pre-ECT treatment FNC alterations in individual TRD patients. METHODS This study included 82 TRD patients and 41 controls. Patients were screened at baseline and after 2 weeks of treatment with a combination of ECT and antidepressants. Group information guided-independent component analysis (GIG-ICA) was used to compute subject-specific functional networks (FNs). Grassmann manifold and step-wise forward component selection using support vector machines were adopted to perform the FNC measure and extract the functional networks' connectivity patterns (FCP). Pearson's correlation analysis was used to calculate the correlations between the FCP and ECT response. RESULTS A total of 82 TRD patients in the ECT group were successfully treated. On an average, 8.50 ± 2.00 ECT sessions were conducted. After ECT treatment, only 42 TRD patients had an improved response to ECT (the Hamilton scores reduction rate was more than 50%), response rate 51%. 8 FNs (anterior and posterior default mode network, bilateral frontoparietal network, audio network, visual network, dorsal attention network, and sensorimotor network) were obtained using GIG-ICA. We did not found that FCPs were significantly different between TRD patients and healthy controls. Moreover, the baseline FCP was unrelated to the ECT treatment response. CONCLUSIONS The FNC was not significantly different between the TRD patients and healthy controls, and the baseline FCP was unrelated to the ECT treatment response. These findings will necessitate that we modify the experimental scheme to explore the mechanisms underlying ECT's effects on depression and explore the specific predictors of the effects of ECT based on the pre-ECT treatment magnetic resonance imaging.
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Affiliation(s)
- Guang-Dong Chen
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang 325000, China
| | - Feng Ji
- Department of Mental Health, Jining Medical University, Jining, Shandong 272076, China
| | - Gong-Ying Li
- Department of Mental Health, Jining Medical University, Jining, Shandong 272076, China
| | - Bo-Xuan Lyu
- Department of Genetic Laboratory, Beijing Jiashibosi Technology Co., Ltd., Beijing 100000, China
| | - Wei Hu
- Department of Information, China Potevio Information Industry Company Limited, Beijing 100080, China
| | - Chuan-Jun Zhuo
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
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Li X, Steffens DC, Potter GG, Guo H, Song S, Wang L. Decreased between-hemisphere connectivity strength and network efficiency in geriatric depression. Hum Brain Mapp 2017; 38:53-67. [PMID: 27503772 PMCID: PMC5899899 DOI: 10.1002/hbm.23343] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/29/2016] [Indexed: 12/25/2022] Open
Abstract
White matter (WM) lesions have been recognized as a key etiological factor in geriatric depression. However, little is known about the topological pattern changes of WM in geriatric depression in the remitted state (RGD) and its relationship to depressive episodes. To address these questions, we acquired diffusion tensor images in 24 RGD and 24 healthy participants. Among them, 10 patients and 19 healthy controls completed a 1-year follow up. Between-hemisphere connectivity and graph theoretical methods were used to analyze the data. We found significantly reduced WM connectivity between the left and right hemisphere in the RGD group compared with the control group. Those with multiple depression episodes had greater reduction in between-hemisphere connectivity strength than those with fewer episodes. In addition, the RGD group had a reduced global clustering coefficient, global efficiency, and network strength, and an increased shortest path length compared with the controls. A lower clustering coefficient was correlated with poorer memory function. The reduction of nodal clustering coefficient, global efficiency, and network strength in several regions were associated with slower information processing speed. At 1-year follow up, the network properties in the RGD subjects were significantly changed suggesting instability of WM network properties of depressed patients. Together, our study provides direct evidence of reduced between-hemisphere WM connectivity with greater depressive episodes, and of alterations of network properties with cognitive dysfunction in geriatric depression. Hum Brain Mapp 38:53-67, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Xuesong Li
- Department of Biomedical EngineeringSchool of Medicine, Tsinghua UniversityBeijingChina
| | - David C. Steffens
- Department of PsychiatryUniversity of Connecticut School of MedicineFarmingtonConnecticut
| | - Guy G. Potter
- Department of Psychiatry and Behavioral ScienceDuke UniversityDurhamNorth Carolina
| | - Hua Guo
- Department of Biomedical EngineeringSchool of Medicine, Tsinghua UniversityBeijingChina
| | - Sen Song
- Department of Biomedical EngineeringSchool of Medicine, Tsinghua UniversityBeijingChina
| | - Lihong Wang
- Department of PsychiatryUniversity of Connecticut School of MedicineFarmingtonConnecticut
- Department of Psychiatry and Behavioral ScienceDuke UniversityDurhamNorth Carolina
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Hou Z, Song X, Jiang W, Yue Y, Yin Y, Zhang Y, Liu Y, Yuan Y. Prognostic value of imbalanced interhemispheric functional coordination in early therapeutic efficacy in major depressive disorder. Psychiatry Res Neuroimaging 2016; 255:1-8. [PMID: 27497214 DOI: 10.1016/j.pscychresns.2016.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/06/2016] [Accepted: 07/27/2016] [Indexed: 12/11/2022]
Abstract
This study aims to explore the early response of antidepressant therapy by measuring the voxel-mirrored homotopic connectivity (VMHC) in major depressive disorder (MDD). Eighty-two MDD patients [n=42 treatment-responsive depression (RD) and n=40 non-responding depression (NRD)] and n=50 normal controls (NC) underwent clinical measures and a magnetic resonance imaging scan, and the VMHC values were calculated. Receiver operating characteristic (ROC) curve analysis was applied to determine the capability of altered VMHC to distinguish NRD. The NRD showed significantly decreased VMHC in bilateral precuneus (PCU) and inferior temporal gyrus (ITG), and increased VMHC in middle frontal gyrus (MFG) and caudate nucleus as compared to RD. When compared with NC, the NRD exhibited reduced VMHC in bilateral cerebellum anterior lobe, thalamus and postcentral gyrus. Moreover, VHMC in medial frontal gyrus, postcentral gyrus and precentral gyrus were significantly decreased in RD. Correlation analysis showed that reduced VMHC in PCU was negatively correlated with the baseline HAMD score of the NRD group. The ROC curve indicated that the combined changes of the three regional VMHC (PCU, ITG and MFG) could effectively identify NRD. The current study suggests that interhemispheric asynchrony may represents a novel neural trait underlying the prediction of early therapeutic outcome in MDD.
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Affiliation(s)
- Zhenghua Hou
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Xiaopeng Song
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Wenhao Jiang
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Yingying Yue
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Yingying Yin
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Yuqun Zhang
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Yijun Liu
- Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality, Southwest University, Chongqing 400715, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China.
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Hou Z, Sui Y, Song X, Yuan Y. Disrupted Interhemispheric Synchrony in Default Mode Network Underlying the Impairment of Cognitive Flexibility in Late-Onset Depression. Front Aging Neurosci 2016; 8:230. [PMID: 27729858 PMCID: PMC5037230 DOI: 10.3389/fnagi.2016.00230] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/16/2016] [Indexed: 12/16/2022] Open
Abstract
The intuitive association between cognitive impairment and aberrant functional activity in the brain network has prompted interest in exploring the role of functional connectivity in late-onset depression (LOD). The relationship of altered voxel-mirrored homotopic connectivity (VMHC) and cognitive dysfunction in LOD is not yet well understood. This study was designed to examine the implicit relationship between the disruption of interhemispheric functional coordination and cognitive impairment in LOD. LOD patients (N = 31) and matched healthy controls (HCs; N = 37) underwent neuropsychological tests and functional magnetic resonance imaging (fMRI) in this study. The intergroup difference of interhemispheric coordination was determined by calculating VMHC value in the whole brain. The neuro-behavioral relevancy approach was applied to explore the association between disrupted VMHC and cognitive measures. Receiver operating characteristic (ROC) curve analysis was used to determine the capability of disrupted regional VMHC to distinguish LOD. Compared to the HC group, significantly attenuated VMHC in the superior frontal gyrus (SFG), superior temporal gyrus (STG), posterior cerebellar lobe (CePL) and post- and precentral gyri were observed in the bilateral brain of LOD patients. The interhemispheric asynchrony in bilateral CePLs was positively correlated with the performance of trail making test B (TMT-B) in LOD patients (r = 0.367, P = 0.040). ROC analysis revealed that regions with abnormal VMHC could efficiently distinguish LOD from HCs (Area Under Curve [AUC] = 0.90, P < 0.001). Altered linkage patterns of intrinsic homotopic connectivity and impaired cognitive flexibility was first investigated in LOD, and it would provide a novel clue for revealing the neural substrates underlying cognitive impairment in LOD.
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Affiliation(s)
- Zhenghua Hou
- Department of Psychosomatics and Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University Nanjing, China
| | - Yuxiu Sui
- Department of Psychiatry, Affiliated Nanjing Brain Hospital of Nanjing Medical University Nanjing, China
| | - Xiaopeng Song
- Department of Biomedical Engineering, College of Engineering, Peking University Beijing, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University Nanjing, China
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The Clinical Applicability of Functional Connectivity in Depression: Pathways Toward More Targeted Intervention. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:262-270. [PMID: 29560882 DOI: 10.1016/j.bpsc.2016.02.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 02/23/2016] [Accepted: 02/24/2016] [Indexed: 12/29/2022]
Abstract
Resting-state functional magnetic resonance imaging provides a noninvasive method to rapidly map large-scale brain networks affected in depression and other psychiatric disorders. Dysfunctional connectivity in large-scale brain networks has been consistently implicated in major depressive disorder (MDD). Although advances have been made in identifying neural circuitry implicated in MDD, this information has yet to be translated into improved diagnostic or treatment interventions. In the first section of this review, we discuss dysfunctional connectivity in affective salience, cognitive control, and default mode networks observed in MDD in association with characteristic symptoms of the disorder. In the second section, we address neurostimulation focusing on transcranial magnetic stimulation and evidence that this approach may directly modulate circuit abnormalities. Finally, we discuss possible avenues of future research to develop more precise diagnoses and targeted interventions within the heterogeneous diagnostic category of MDD as well as the methodological limitations to clinical implementation. We conclude by proposing, with cautious optimism, the future incorporation of neuroimaging into clinical practice as a tool to aid in more targeted diagnosis and treatment guided by circuit-level connectivity dysfunction in patients with depression.
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Modulation of intrinsic brain activity by electroconvulsive therapy in major depression. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:77-86. [PMID: 26878070 DOI: 10.1016/j.bpsc.2015.09.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION One of the most effective interventions for intractable major depressive episodes is electroconvulsive therapy (ECT). Because ECT is also relatively fast-acting, longitudinal study of its neurobiological effects offers critical insight into the mechanisms underlying depression and antidepressant response. Here we assessed modulation of intrinsic brain activity in corticolimbic networks associated with ECT and clinical response. METHODS We measured resting-state functional connectivity (RSFC) in patients with treatment-resistant depression (n=30), using functional magnetic resonance imaging (fMRI) acquired before and after completing a treatment series with right-unilateral ECT. Using independent component analysis, we assessed changes in RSFC with 1) symptom improvement and 2) ECT regardless of treatment outcome in patients, with reference to healthy controls (n=33, also scanned twice). RESULTS After ECT, consistent changes in RSFC within targeted depression-relevant functional networks were observed in the dorsal anterior cingulate (ACC), mediodorsal thalamus (mdTh), hippocampus, and right anterior temporal, medial parietal, and posterior cingulate cortex in all patients. In a separate analysis, changes in depressive symptoms were associated with RSFC changes in the dorsal ACC, mdTh, putamen, medial prefrontal, and lateral parietal cortex. RSFC of these regions did not change in healthy controls. CONCLUSIONS Neuroplasticity underlying clinical change was in part separable from changes associated with the effects of ECT observed in all patients. However, both ECT and clinical change were associated with RSFC modulation in dorsal ACC, mdTh and hippocampus, which may indicate that these regions underlie the mechanisms of clinical outcome in ECT and may be effective targets for future neurostimulation therapies.
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Hermesdorf M, Sundermann B, Feder S, Schwindt W, Minnerup J, Arolt V, Berger K, Pfleiderer B, Wersching H. Major depressive disorder: Findings of reduced homotopic connectivity and investigation of underlying structural mechanisms. Hum Brain Mapp 2015; 37:1209-17. [PMID: 26704348 DOI: 10.1002/hbm.23097] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/14/2015] [Accepted: 12/11/2015] [Indexed: 12/12/2022] Open
Abstract
Depression has been associated with various alterations in magnetic resonance imaging (MRI) derived resting-state functional connectivity. Recently, homotopic connectivity, defined as functional connectivity between homotopic regions across hemispheres, has been reported to be reduced in patients with major depressive disorder (MDD). However, little is known about structural factors underlying alterations of homotopic connectivity, which would contribute to the understanding of the altered neurophysiological architecture in patients with MDD. We compared 368 patients with MDD and 461 never-depressed controls regarding voxel-mirrored homotopic connectivity (VMHC) and potential underlying mechanisms such as the structural connectivity of the corpus callosum, measured by DTI-derived fractional anisotropy (FA), and left-right symmetries in homotopic gray matter volumes. Compared to controls, patients with MDD exhibited reduced VMHC in the cuneus, putamen, superior temporal gyrus, insula, and precuneus. Within these regions, no differences in left-right symmetries in homotopic gray matter volumes were evident across cohorts. FA of the corpus callosum correlated with VMHC in the entire sample. However, patients with MDD and controls did not differ with regard to callosal FA. The findings indicate that MDD is associated with a loss of interhemispheric synchrony in regions known to be implicated in self-referential and reward processing. They also suggest that additional mechanisms are implicated in altered homotopic connectivity of patients with MDD, other than direct callosal fiber pathways or asymmetries in homotopic gray matter volumes.
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Affiliation(s)
- Marco Hermesdorf
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Benedikt Sundermann
- Department of Clinical Radiology, University Hospital Münster, Münster, Germany
| | - Stephan Feder
- Department of Clinical Radiology, University Hospital Münster, Münster, Germany
| | - Wolfram Schwindt
- Department of Clinical Radiology, University Hospital Münster, Münster, Germany
| | - Jens Minnerup
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - Volker Arolt
- Department of Psychiatry, University Hospital Münster, Münster, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Bettina Pfleiderer
- Department of Clinical Radiology, University Hospital Münster, Münster, Germany
| | - Heike Wersching
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
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Gudayol-Ferré E, Peró-Cebollero M, González-Garrido AA, Guàrdia-Olmos J. Changes in brain connectivity related to the treatment of depression measured through fMRI: a systematic review. Front Hum Neurosci 2015; 9:582. [PMID: 26578927 PMCID: PMC4630287 DOI: 10.3389/fnhum.2015.00582] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 10/06/2015] [Indexed: 01/18/2023] Open
Abstract
Depression is a mental illness that presents alterations in brain connectivity in the Default Mode Network (DMN), the Affective Network (AN) and other cortical-limbic networks, and the Cognitive Control Network (CCN), among others. In recent years the interest in the possible effect of the different antidepressant treatments on functional connectivity has increased substantially. The goal of this paper is to conduct a systematic review of the studies on the relationship between the treatment of depression and brain connectivity. Nineteen studies were found in a systematic review on this topic. In all of them, there was improvement of the clinical symptoms after antidepressant treatment. In 18 out of the 19 studies, clinical improvement was associated to changes in brain connectivity. It seems that both DMN and the connectivity between cortical and limbic structures consistently changes after antidepressant treatment. However, the current evidence does not allow us to assure that the treatment of depression leads to changes in the CCN. In this regard, some papers report a positive correlation between changes in brain connectivity and improvement of depressive symptomatology, particularly when they measure cortical-limbic connectivity, whereas the changes in DMN do not significantly correlate with clinical improvement. Finally, some papers suggest that changes in connectivity after antidepressant treatment might be partly related to the mechanisms of action of the treatment administered. This effect has been observed in two studies with stimulation treatment (one with rTMS and one with ECT), and in two papers that administered three different pharmacological treatments. Our review allows us to make a series of recommendations that might guide future researchers exploring the effect of anti-depression treatments on brain connectivity.
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Affiliation(s)
- Esteve Gudayol-Ferré
- Facultad de Psicología, Universidad Michoacana de San Nicolás de Hidalgo Morelia, Mexico
| | - Maribel Peró-Cebollero
- Departament de Metodologia de les Ciències del Comportament, Facultat de Psicologia, Institut de Recerca en Cervell, Cognició i Conducta IR3C, Universitat de Barcelona Barcelona, Spain
| | | | - Joan Guàrdia-Olmos
- Departament de Metodologia de les Ciències del Comportament, Facultat de Psicologia, Institut de Recerca en Cervell, Cognició i Conducta IR3C, Universitat de Barcelona Barcelona, Spain
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Liu Y, Du L, Li Y, Liu H, Zhao W, Liu D, Zeng J, Li X, Fu Y, Qiu H, Li X, Qiu T, Hu H, Meng H, Luo Q. Antidepressant Effects of Electroconvulsive Therapy Correlate With Subgenual Anterior Cingulate Activity and Connectivity in Depression. Medicine (Baltimore) 2015; 94:e2033. [PMID: 26559309 PMCID: PMC4912303 DOI: 10.1097/md.0000000000002033] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The mechanisms underlying the effects of electroconvulsive therapy (ECT) in major depressive disorder (MDD) are not fully understood. Resting-state functional magnetic resonance imaging (rs-fMRI) is a new tool to study the effects of brain stimulation interventions, particularly ECT. The authors aim to investigate the mechanisms of ECT in MDD by rs-fMRI.They used rs-fMRI to measure functional changes in the brain of first-episode, treatment-naive MDD patients (n = 23) immediately before and then following 8 ECT sessions (brief-pulse square-wave apparatus, bitemporal). They also computed voxel-wise amplitude of low-frequency fluctuation (ALFF) as a measure of regional brain activity and selected the left subgenual anterior cingulate cortex (sgACC) to evaluate functional connectivity between the sgACC and other brain regions.Increased regional brain activity measured by ALFF mainly in the left sgACC following ECT. Functional connectivity of the left sgACC increased in the ipsilateral parahippocampal gyrus, pregenual ACC, contralateral middle temporal pole, and orbitofrontal cortex. Importantly, reduction in depressive symptoms were negatively correlated with increased ALFF in the left sgACC and left hippocampus, and with distant functional connectivity between the left sgACC and contralateral middle temporal pole. That is, across subjects, as depression improved, regional brain activity in sgACC and its functional connectivity increased in the brain.Eight ECT sessions in MDD patients modulated activity in the sgACC and its networks. The antidepressant effects of ECT were negatively correlated with sgACC brain activity and connectivity. These findings suggest that sgACC-associated prefrontal-limbic structures are associated with the therapeutic effects of ECT in MDD.
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Affiliation(s)
- Yi Liu
- From the Department of Radiology (YL, YL); Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China (LD, WZ, DL, JZ, YF, HQ, XL, TQ, HH, HM, QL); Department of Psychiatry Brain Stimulation Laboratory, Medical University of South Carolina, Charleston, SC (LD, XL); and Medical Psychology Department, the Third Military Medical University third hospital, Chongqing, P.R. China (HL)
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