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Liu C, Li L, Pan W, Mao P, Ren L, Li B, Ma X. Executive function deficits in patients with the first episode of late-life depression before and after SSRI treatment: A pilot fMRI study. Int J Geriatr Psychiatry 2024; 39:e6095. [PMID: 38687081 DOI: 10.1002/gps.6095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 04/15/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Executive function deficits (EFD) in late-life depression (LLD) has been reported to be associated with antidepressant treatment resistance, increased disability, and poor quality of life. However, the underlying neutral mechanisms of EFD in patients with the first episode of LLD remains unclear. METHODS A total of 27 patients with first-episode, drug-naive LLD and 27 non-depressed controls (NC) were recruited for the present research. Participants underwent the Trail Making Test, the 17-item Hamilton depression rating scale (HAMD-17) test, and task-state functional magnetic resonance imaging scans under the neutral Stroop task. LLD patients' executive functions, depressive symptoms, and brain activity were examined again after 6 months of antidepressant treatment. RESULTS Of the 27 LLD patients, 16 cases completed 6-month follow-ups. Patients in the LLD baseline group spent more time on the Trail Making Test A test than those in the NC group (p < 0.05). In the presence of an incongruency between the word color and meaning, the accuracy rate of the neutral Stroop task in the LLD baseline group was lower, and the reaction time was greater than that in the NC group, with statistically significant difference (p < 0.05). The HAMD-17 score in the LLD follow-up group was significantly lower than that in the LLD baseline group (p < 0.05). More activated brain regions were present in the LLD baseline group than in the NC group when performing the neutral Stroop task. Compared with the LLD baseline group, abnormal activation of relevant brains in the cingulate-prefrontal-parietal network of LLD patients still existed in the LLD follow-up group. CONCLUSIONS LLD patients engaged more brain areas than the NC group while performing the neutral Stroop task. Abnormal activation of the cingulate-prefrontal-parietal network could be a contributing factor to EFD in LLD. TRIAL REGISTRATION ChiCTR, ChiCTR2100042370 (Date of registration: 21/01/2021). LIMITS We didn't enroll enough first-episode, LLD patients, the robustness of the findings need to be confirmed by large sample clinical trials.
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Affiliation(s)
- Chaomeng Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Li Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Weigang Pan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Peixian Mao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Li Ren
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Bing Li
- Hebei Provincial Mental Health Center, Baoding, China
- Hebei Key Laboratory of Major Mental and Behavioral Disorders, Baoding, China
- The Sixth Clinical Medical College of Hebei University, Baoding, China
| | - Xin Ma
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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2
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Liu C, Pan W, Zhu D, Mao P, Ren Y, Ma X. Altered Intrinsic Brain Activity in Patients With Late-Life Depression: A Resting-State Functional MRI Study. Front Psychiatry 2022; 13:894646. [PMID: 35677867 PMCID: PMC9168034 DOI: 10.3389/fpsyt.2022.894646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To investigate the altered intrinsic brain activity (IBA) in patients suffering from late-life depression (LLD) using a percent amplitude of fluctuation (PerAF) method. Methods In total, fifty patients with LLD and 40 non-depressed controls (NCs) were recruited for the present research. Participants underwent the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) test and resting-state functional MRI (rs-fMRI) scans. The RBANS test consists of 12 sub-tests that contribute to a total score and index scores across the following five domains: immediate memory, visuospatial/constructional, language, attention, and delayed memory. The PerAF method was used for data analysis to detect changes in neural activity in the relevant brain regions. A receiver operating characteristic (ROC) curve was conducted to evaluate the ability of the RBANS test and proposed the PerAF method in distinguishing the two groups. The relationships between altered IBA and neuropsychologic deficits were determined by the Pearson correlation analysis. Results A significant difference existed in RBANS total score, immediate memory, visuospatial/constructional, language, attention, and delayed memory between groups (P < 0.05). Compared with the NCs group, the LLD group demonstrated decreased PerAF differences in the bilateral superior frontal gyrus, orbital part (Frontal_Sup_Orb), and bilateral anterior cingulate cortex (ACC). The PerAF method and RBANS test exhibited an excellent discriminatory power with the area under curve (AUC) values in distinguishing the two groups. In addition, the attention score of the RBANS test positively correlated with the PerAF values of the bilateral Frontal_Sup_Orb and bilateral ACC. Conclusion The changes of PerAF in the bilateral Frontal_Sup_Orb and bilateral ACC are related to an increased risk of developing LLD. Moreover, the PerAF method could be used as an underlying sensitivity biomarker to identify the psychiatric disorder.
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Affiliation(s)
- Chaomeng Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Weigang Pan
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Dandi Zhu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Peixian Mao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yanping Ren
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xin Ma
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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3
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Saberi A, Mohammadi E, Zarei M, Eickhoff SB, Tahmasian M. Structural and functional neuroimaging of late-life depression: a coordinate-based meta-analysis. Brain Imaging Behav 2021; 16:518-531. [PMID: 34331655 DOI: 10.1007/s11682-021-00494-9] [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] [Received: 08/31/2020] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
Several neuroimaging studies have investigated localized aberrations in brain structure, function or connectivity in late-life depression, but the ensuing results are equivocal and often conflicting. Here, we provide a quantitative consolidation of neuroimaging in late-life depression using coordinate-based meta-analysis by searching multiple databases up to March 2020. Our search revealed 3252 unique records, among which we identified 32 eligible whole-brain neuroimaging publications comparing 674 patients with 568 controls. The peak coordinates of group comparisons between the patients and the controls were extracted and then analyzed using activation likelihood estimation method. Our sufficiently powered analysis on all the experiments, and more homogenous subsections of the data (patients > controls, controls > patients, and functional imaging experiments) revealed no significant convergent regional abnormality in late-life depression. This inconsistency might be due to clinical and biological heterogeneity of LLD, as well as experimental (e.g., choice of tasks, image modalities) and analytic flexibility (e.g., preprocessing and analytic parameters), and distributed patterns of neural abnormalities. Our findings highlight the importance of clinical/biological heterogeneity of late-life depression, in addition to the need for more reproducible research by using pre-registered and standardized protocols on more homogenous populations to identify potential consistent brain abnormalities in late-life depression.
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Affiliation(s)
- Amin Saberi
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Esmaeil Mohammadi
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany.,Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Masoud Tahmasian
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran.
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Wang Y, Zhang A, Yang C, Li G, Sun N, Liu P, Wang Y, Zhang K. Enhanced Functional Connectivity Within Executive Function Network in Remitted or Partially Remitted MDD Patients. Front Psychiatry 2020; 11:538333. [PMID: 33584355 PMCID: PMC7875881 DOI: 10.3389/fpsyt.2020.538333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 12/18/2020] [Indexed: 12/30/2022] Open
Abstract
Background: Impaired executive function (EF) is associated with a range of typical clinical characteristics and psychosocial dysfunction in major depressive disorder (MDD). However, because of the lack of objective cognitive tests, inconsistencies in research results, and improvement in patients' subjective experience, few clinicians are concerned with the persistent impairment of EF in euthymia. The study makes a further investigation for EF in remitted and partially remitted MDD patients via multiple EF tests and fMRI, so as to explore the executive function of patients in euthymia. Methods: We recruited 19 MDD patients and 17 age-, gender-, and education-matched healthy controls (HCs). All participants completed EF tests and fMRI scanning. Bilateral dorsolateral prefrontal cortex (dlPFC) regions were selected as the region of interests (ROIs) to conduct seed-based functional connectivity (FC). We conducted fractional amplitude of low-frequency fluctuations (fALFF) analysis for all ROIs and whole brain. Results: All MDD patients were in remission or partial remission, and they were comparable with HCs on all the EF tests. MDD group showed increased positive FC between left dlPFC and cerebellar Crus I, right dlPFC and supramarginal gyrus after 8-weeks treatment, even taking residual depressive symptoms into account. We did not find group difference of fALFF value. Conclusion: MDD patients persisted with EF impairment despite the remission or partially remission of depressive symptoms. Clinicians should focus on residual cognitive symptoms, which may contribute to maximize the efficacy of routine therapy.
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Affiliation(s)
- Yuchen Wang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China.,Department of Medical Psychology, College of Humanities and Social Science, Shanxi Medical University, Taiyuan, China
| | - Aixia Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Chunxia Yang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Gaizhi Li
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Ning Sun
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China.,College of Nursing, Shanxi Medical University, Taiyuan, China
| | - Penghong Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yanfang Wang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
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5
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Vega JN, Taylor WD, Gandelman JA, Boyd BD, Newhouse PA, Shokouhi S, Albert KM. Persistent Intrinsic Functional Network Connectivity Alterations in Middle-Aged and Older Women With Remitted Depression. Front Psychiatry 2020; 11:62. [PMID: 32153440 PMCID: PMC7047962 DOI: 10.3389/fpsyt.2020.00062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 01/24/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In younger adults, residual alterations in functional neural networks persist during remitted depression. However, there are fewer data for midlife and older adults at risk of recurrence. Such residual network alterations may contribute to vulnerability to recurrence. This study examined intrinsic network functional connectivity in midlife and older women with remitted depression. METHODS A total of 69 women (24 with a history of depression, 45 with no psychiatric history) over 50 years of age completed 3T fMRI with resting-state acquisition. Participants with remitted depression met DSM-IV-TR criteria for an episode in the last 10 years but not the prior year. Whole-brain seed-to-voxel resting-state functional connectivity analyses examined the default mode network (DMN), executive control network (ECN), and salience network (SN), plus bilateral hippocampal seeds. All analyses were adjusted for age and used cluster-level correction for multiple comparisons with FDR < 0.05 and a height threshold of p < 0.001, uncorrected. RESULTS Women with a history of depression exhibited decreased functional connectivity between the SN (right insula seed) and ECN regions, specifically the left superior frontal gyrus. They also exhibited increased functional connectivity between the left hippocampus and the left postcentral gyrus. We did not observe any group differences in functional connectivity for DMN or ECN seeds. CONCLUSIONS Remitted depression in women is associated with connectivity differences between the SN and ECN and between the hippocampus and the postcentral gyrus, a region involved in interoception. Further work is needed to determine whether these findings are related to functional alterations or are predictive of recurrence.
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Affiliation(s)
- Jennifer N Vega
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Warren D Taylor
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System, Nashville, TN, United States
| | - Jason A Gandelman
- Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Brian D Boyd
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Paul A Newhouse
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System, Nashville, TN, United States
| | - Sepideh Shokouhi
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Kimberly M Albert
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
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Andreescu C, Ajilore O, Aizenstein HJ, Albert K, Butters MA, Landman BA, Karim HT, Krafty R, Taylor WD. Disruption of Neural Homeostasis as a Model of Relapse and Recurrence in Late-Life Depression. Am J Geriatr Psychiatry 2019; 27:1316-1330. [PMID: 31477459 PMCID: PMC6842700 DOI: 10.1016/j.jagp.2019.07.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/26/2019] [Accepted: 07/29/2019] [Indexed: 12/29/2022]
Abstract
The significant public health burden associated with late-life depression (LLD) is magnified by the high rates of recurrence. In this manuscript, we review what is known about recurrence risk factors, conceptualize recurrence within a model of homeostatic disequilibrium, and discuss the potential significance and challenges of new research into LLD recurrence. The proposed model is anchored in the allostatic load theory of stress. We review the allostatic response characterized by neural changes in network function and connectivity and physiologic changes in the hypothalamic-pituitary-adrenal axis, autonomic nervous system, immune system, and circadian rhythm. We discuss the role of neural networks' instability following treatment response as a source of downstream disequilibrium, triggering and/or amplifying abnormal stress response, cognitive dysfunction and behavioral changes, ultimately precipitating a full-blown recurrent episode of depression. We propose strategies to identify and capture early change points that signal recurrence risk through mobile technology to collect ecologically measured symptoms, accompanied by automated algorithms that monitor for state shifts (persistent worsening) and variance shifts (increased variability) relative to a patient's baseline. Identifying such change points in relevant sensor data could potentially provide an automated tool that could alert clinicians to at-risk individuals or relevant symptom changes even in a large practice.
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Affiliation(s)
| | | | - Howard J. Aizenstein
- Department of Psychiatry, University of Pittsburgh,Department of Bioengineering, University of Pittsburgh
| | - Kimberly Albert
- The Center for Cognitive Medicine, the Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center
| | | | - Bennett A. Landman
- Departments of Computer Science, Electrical Engineering, and Biomedical Engineering, Vanderbilt University; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center
| | | | - Robert Krafty
- Department of Biostatistics, University of Pittsburgh
| | - Warren D. Taylor
- The Center for Cognitive Medicine, the Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center,Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System
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7
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Dong D, Li C, Ming Q, Zhong X, Zhang X, Sun X, Jiang Y, Gao Y, Wang X, Yao S. Topologically state-independent and dependent functional connectivity patterns in current and remitted depression. J Affect Disord 2019; 250:178-185. [PMID: 30856495 DOI: 10.1016/j.jad.2019.03.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/23/2019] [Accepted: 03/04/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Identification of state-independent and -dependent neural biomarkers may provide insight into the pathophysiology and effective treatment of major depressive disorder (MDD), therefore we aimed to investigate the state-independent and -dependent topological alterations of MDD. METHOD Brain resting-state functional magnetic resonance imaging (fMRI) data were acquired from 59 patients with unmedicated first episode current MDD (cMDD), 48 patients with remitted MDD (rMDD) and 60 demographically matched healthy controls (HCs). Using graph theory, we systematically studied the topological organization of their whole-brain functional networks at the global and nodal level. RESULTS At a global level, both patient groups showed decreased normalized clustering coefficient in relative to HCs. On a nodal level, both patient groups showed decreased nodal centrality, predominantly in cortex-mood-regulation brain regions including the dorsolateral prefrontal cortex, posterior parietal cortex and posterior cingulate cortex. By comparison to cMDD patients, rMDD group had a higher nodal centrality in right parahippocampal gyrus. LIMITATIONS The present study, an exploratory analysis, may require further confirmation with task-based and experimental studies. CONCLUSIONS Deficits in the topological organization of the whole brain and cortex-mood-regulation brain regions in both rMDD and cMDD represent state-independent biomarkers.
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Affiliation(s)
- Daifeng Dong
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Chuting Li
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Qingsen Ming
- Department of Psychiatry, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, PR China
| | - Xue Zhong
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiaocui Zhang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiaoqiang Sun
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Yali Jiang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Yidian Gao
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China.
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8
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Dong D, Ming Q, Zhong X, Pu W, Zhang X, Jiang Y, Gao Y, Sun X, Wang X, Yao S. State-independent alterations of intrinsic brain network in current and remitted depression. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:475-480. [PMID: 30193990 DOI: 10.1016/j.pnpbp.2018.08.031] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/15/2018] [Accepted: 08/29/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND It has been proposed that state-independent, or trait, neurobiological alterations across illness phases may contribute to the high recurrence of major depressive disorder (MDD). Although intrinsic brain network abnormalities have been implicated consistently in MDD neuropathology, MDD state-independent and -dependent resting-state network alterations have not been clearly studied. METHODS Resting-state functional magnetic resonance imaging (fMRI) data were collected from 57 medication-naive first-episode current MDD patients, 35 remitted MDD patients, and 66 healthy controls (HCs). Independent component analysis (ICA) was used to extract subnetworks of the default mode network (DMN), central executive network (CEN), and salience network (SN). RESULTS Relative to HCs, the current MDD and remitted MDD groups had decreased intra-intrinsic functional connectivity (iFC) in the dorsal lateral prefrontal cortex (dlPFC) of the left CEN, increased inter-FC between the SN and right CEN (rCEN), and decreased inter-FC between the anterior DMN (aDMN) and rCEN. The altered intra-iFC in the left CEN were correlated negatively with the depressive level in the remitted MDD. CONCLUSIONS Hypoactivity of the dlPFC in the left CEN, increased inter-FC between the SN and rCEN, and decreased inter-FC between the aDMN and rCEN may reflect state-independent biomarkers of MDD.
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Affiliation(s)
- Daifeng Dong
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Qingsen Ming
- Dpartment of Psychiatry, The First Affiliated Hospital of Sochoow University, Suzhou, Jiangsu, PR China
| | - Xue Zhong
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Weidan Pu
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiaocui Zhang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Yali Jiang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Yidian Gao
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiaoqiang Sun
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China.
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9
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Cheng C, Dong D, Jiang Y, Ming Q, Zhong X, Sun X, Xiong G, Gao Y, Yao S. State-Related Alterations of Spontaneous Neural Activity in Current and Remitted Depression Revealed by Resting-State fMRI. Front Psychol 2019; 10:245. [PMID: 30804860 PMCID: PMC6378291 DOI: 10.3389/fpsyg.2019.00245] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/24/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose: Although efforts have been made to identify neurobiological characteristic of major depressive disorder (MDD) in recent years, trait- and state-related biological characteristics of MDD still remains unclear. Using functional magnetic resonance imaging (fMRI), the aim of this study was to explore whether altered spontaneous neural activities in MDD are trait- or state- related. Materials and Methods: Resting-state fMRI data were analyzed for 72 current MDD (cMDD) patients (first-episode, medication-naïve), 49 remitted MDD (rMDD) patients, and 78 age- and sex- matched healthy control (HC) subjects. The values of amplitude of low-frequency fluctuation (ALFF) were compared between groups. Results: Compared with the cMDD group, the rMDD group had increased ALFF values in the left middle occipital gyrus, left middle temporal gyrus and right cerebellum anterior lobe. Besides, compared with the HC group, the cMDD group had decreased ALFF values in the left middle occipital gyrus. Further analysis explored that the mean ALFF values in the left middle occipital gyrus, left middle temporal gyrus and right cerebellum anterior lobe were correlated positively with BDI scores in rMDD patients. Conclusion: Abnormal activity in the left middle occipital gyrus, left middle temporal gyrus and right cerebellum anterior lobe may be state-specific in current (first-episode, medication-naïve) and remitted (medication-naïve) depression patients. Furthermore, the state-related compensatory effect was found in these brain areas.
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Affiliation(s)
- Chang Cheng
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China.,Preschool Education Department, Changsha Normal University, Changsha, China
| | - Daifeng Dong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yali Jiang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qingsen Ming
- Department of Psychiatry, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, China
| | - Xue Zhong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoqiang Sun
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ge Xiong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yidian Gao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
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10
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Takamura M, Okamoto Y, Okada G, Toki S, Yamamoto T, Yamamoto O, Jitsuiki H, Yokota N, Tamura T, Kurata A, Kaichi Y, Akiyama Y, Awai K, Yamawaki S. Disrupted Brain Activation and Deactivation Pattern during Semantic Verbal Fluency Task in Patients with Major Depression. Neuropsychobiology 2017; 74:69-77. [PMID: 28052303 DOI: 10.1159/000453399] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 11/13/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Patients with major depressive disorder (MDD) exhibit cognitive impairment, and evidence suggests that the semantic version of the verbal fluency task is a reliable cognitive marker of the disorder. Here, using functional magnetic resonance imaging (fMRI), we investigated the dysfunction of neural processing in acute depression and examined the effects of a 6-week pharmacological intervention. METHODS Sixteen patients with MDD participated in 2 fMRI sessions, and 16 healthy control (HC) subjects participated in 1 fMRI session. During each fMRI session, the participants performed a semantic verbal fluency task. Brain activity during the task was compared between groups (MDD 1st fMRI vs. HC) and times (MDD 1st fMRI vs. 2nd fMRI). RESULTS Significant brain hypoactivation was observed in MDD patients at the prefrontal, lateral parietal, and limbic regions compared to HC, and MDD patients exhibited hyperactivation at the left precuneus compared to HC. Hypoactivity of the left dorsolateral prefrontal cortex (DLPFC) and hyperactivity of the precuneus were normalized with treatment. CONCLUSIONS Hypoactivation of the left DLPFC and hyperactivation of the precuneus should be considered as dysregulation of anticorrelated brain networks during a cognitive demanding task. This failure of network regulation may be an important factor in the pathophysiology of MDD.
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Affiliation(s)
- Masahiro Takamura
- Department of Psychiatry and Neurosciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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11
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Elvevåg B, Cohen AS, Wolters MK, Whalley HC, Gountouna V, Kuznetsova KA, Watson AR, Nicodemus KK. An examination of the language construct in NIMH's research domain criteria: Time for reconceptualization! Am J Med Genet B Neuropsychiatr Genet 2016; 171:904-19. [PMID: 26968151 PMCID: PMC5025728 DOI: 10.1002/ajmg.b.32438] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 02/11/2016] [Indexed: 12/25/2022]
Abstract
The National Institute of Mental Health's Research Domain Criteria (RDoC) Initiative "calls for the development of new ways of classifying psychopathology based on dimensions of observable behavior." As a result of this ambitious initiative, language has been identified as an independent construct in the RDoC matrix. In this article, we frame language within an evolutionary and neuropsychological context and discuss some of the limitations to the current measurements of language. Findings from genomics and the neuroimaging of performance during language tasks are discussed in relation to serious mental illness and within the context of caveats regarding measuring language. Indeed, the data collection and analysis methods employed to assay language have been both aided and constrained by the available technologies, methodologies, and conceptual definitions. Consequently, different fields of language research show inconsistent definitions of language that have become increasingly broad over time. Individually, they have also shown significant improvements in conceptual resolution, as well as in experimental and analytic techniques. More recently, language research has embraced collaborations across disciplines, notably neuroscience, cognitive science, and computational linguistics and has ultimately re-defined classical ideas of language. As we move forward, the new models of language with their remarkably multifaceted constructs force a re-examination of the NIMH RDoC conceptualization of language and thus the neuroscience and genetics underlying this concept. © 2016 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Brita Elvevåg
- Department of Clinical MedicineUniversity of Tromsø−The Arctic University of NorwayTromsøNorway
- Norwegian Centre for eHealth ResearchUniversity Hospital of North NorwayTromsøNorway
| | - Alex S. Cohen
- Department of PsychologyLouisiana State UniversityBaton RougeLouisiana
| | - Maria K. Wolters
- School of InformaticsUniversity of EdinburghEdinburghUnited Kingdom
| | | | - Viktoria‐Eleni Gountouna
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghUnited Kingdom
| | - Ksenia A. Kuznetsova
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghUnited Kingdom
| | - Andrew R. Watson
- Division of PsychiatryUniversity of EdinburghEdinburghUnited Kingdom
| | - Kristin K. Nicodemus
- Centre for Genomic and Experimental MedicineInstitute of Genetics and Molecular MedicineUniversity of EdinburghEdinburghUnited Kingdom
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12
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Hammar Å, Neto E, Clemo L, Hjetland GJ, Hugdahl K, Elliott R. Striatal hypoactivation and cognitive slowing in patients with partially remitted and remitted major depression. Psych J 2016; 5:191-205. [DOI: 10.1002/pchj.134] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 02/26/2016] [Accepted: 04/04/2016] [Indexed: 01/24/2023]
Affiliation(s)
- Åsa Hammar
- Department of Biological and Medical Psychology; University of Bergen; Bergen Norway
- Division of Psychiatry; Haukeland University Hospital; Bergen Norway
- Moodnet Research Group; Haukeland University Hospital; Bergen Norway
| | - Emanuel Neto
- Department of Biological and Medical Psychology; University of Bergen; Bergen Norway
| | - Leila Clemo
- Neuroscience and Psychiatry Department; University of Manchester; Manchester UK
| | - Gunnhild J. Hjetland
- Department of Biological and Medical Psychology; University of Bergen; Bergen Norway
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology; University of Bergen; Bergen Norway
- Division of Psychiatry; Haukeland University Hospital; Bergen Norway
- Department of Radiology; Haukeland University Hospital; Bergen Norway
| | - Rebecca Elliott
- Neuroscience and Psychiatry Department; University of Manchester; Manchester UK
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13
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Yıldız M, Alim S, Batmaz S, Demir S, Songur E, Ortak H, Demirci K. Duration of the depressive episode is correlated with ganglion cell inner plexifrom layer and nasal retinal fiber layer thicknesses: Optical coherence tomography findings in major depression. Psychiatry Res Neuroimaging 2016; 251:60-66. [PMID: 27124425 DOI: 10.1016/j.pscychresns.2016.04.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 04/17/2016] [Indexed: 01/20/2023]
Abstract
Optical coherence tomography (OCT) is a relatively new, noninvasive imaging technique that has been used increasingly to diagnose and manage a variety of retinal diseases. Since the axons in retinal nerve fiber layer (RNFL) are nonmyelinated within the retina, OCT has been used in various neurodegenerative diseases to visualize the process of neurodegeneration. Decreases in RNFL and ganglion cell inner plexiform layer (GCIPL) thicknesses were observed in patients with schizophrenia. To date, there is no clinical research investigating OCT parameters in patients with MD. We compared the RNFL thickness, GCIPL thickness in 58 MD patients and 57 healthy controls, and investigated their correlation with clinical variables of depression. Depressed patients were not different from the healthy controls with regard to OCT parameters. GCIPL and nasal RNFL were correlated with the duration of the latest depressive episode. Some measures of OCT were negatively associated with clinical variables like a family history of psychiatric diagnosis and the duration of the latest episode. Larger studies including depressed patients of different severity, including structured interviews and controlling for the effect of antidepressant treatment will provide better results.
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Affiliation(s)
- Mesut Yıldız
- Department of Psychiatry, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey.
| | - Sait Alim
- Department of Ophthalmology, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey
| | - Sedat Batmaz
- Department of Psychiatry, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey
| | - Selim Demir
- Department of Ophthalmology, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey
| | - Emrah Songur
- Department of Psychiatry, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey
| | - Hüseyin Ortak
- Department of Ophthalmology, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey
| | - Kadir Demirci
- Department of Psychiatry, Süleyman Demirel University, Faculty of Medicine, Isparta, Turkey
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14
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Pantzar A, Atti AR, Bäckman L, Laukka EJ. Effects of psychiatric history on cognitive performance in old-age depression. Front Psychol 2015; 6:865. [PMID: 26175699 PMCID: PMC4483519 DOI: 10.3389/fpsyg.2015.00865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 06/12/2015] [Indexed: 11/13/2022] Open
Abstract
Cognitive deficits in old-age depression vary as a function of multiple factors; one rarely examined factor is long-term psychiatric history. We investigated effects of psychiatric history on cognitive performance in old-age depression and in remitted persons. In the population-based Swedish National Study on Aging and Care in Kungsholmen study, older persons (≥60 years) without dementia were tested with a cognitive battery and matched to the Swedish National Inpatient Register (starting 1969). Participants were grouped according to current depression status and psychiatric history and compared to healthy controls (n = 96). Group differences were observed for processing speed, attention, executive functions, and verbal fluency. Persons with depression and psychiatric inpatient history (n = 20) and late-onset depression (n = 49) performed at the lowest levels, whereas cognitive performance in persons with self-reported recurrent unipolar depression (n = 52) was intermediate. Remitted persons with inpatient history of unipolar depression (n = 38) exhibited no cognitive deficits. Heart disease burden, physical inactivity, and cumulative inpatient days modulated the observed group differences in cognitive performance. Among currently depressed persons, those with inpatient history, and late onset performed at the lowest levels. Importantly, remitted persons showed no cognitive deficits, possibly reflecting the extended time since the last admission (m = 15.6 years). Thus, the present data suggest that cognitive deficits in unipolar depression may be more state- than trait-related. Information on profiles of cognitive performance, psychiatric history, and health behaviors may be useful in tailoring individualized treatment.
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Affiliation(s)
- Alexandra Pantzar
- Aging Research Center, Karolinska Institutet and Stockholm University Stockholm, Sweden
| | | | - Lars Bäckman
- Aging Research Center, Karolinska Institutet and Stockholm University Stockholm, Sweden ; Stockholm Gerontology Research Center Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center, Karolinska Institutet and Stockholm University Stockholm, Sweden
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15
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Gałecki P, Talarowska M, Anderson G, Berk M, Maes M. Mechanisms underlying neurocognitive dysfunctions in recurrent major depression. Med Sci Monit 2015; 21:1535-47. [PMID: 26017336 PMCID: PMC4459569 DOI: 10.12659/msm.893176] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Recent work shows that depression is intimately associated with changes in cognitive functioning, including memory, attention, verbal fluency, and other aspects of higher-order cognitive processing. Changes in cognitive functioning are more likely to occur when depressive episodes are recurrent and to abate to some degree during periods of remission. However, with accumulating frequency and duration of depressive episodes, cognitive deficits can become enduring, being evident even when mood improves. Such changes in cognitive functioning give depression links to mild cognitive impairment and thereby with neurodegenerative conditions, including Alzheimer’s disease, Parkinson’s disease, schizophrenia, and multiple sclerosis. Depression may then be conceptualized on a dimension of depression – mild cognitive impairment – dementia. The biological underpinnings of depression have substantial overlaps with those of neurodegenerative conditions, including reduced neurogenesis, increased apoptosis, reactive oxygen species, tryptophan catabolites, autoimmunity, and immune-inflammatory processes, as well as decreased antioxidant defenses. These evolving changes over the course of depressive episodes drive the association of depression with neurodegenerative conditions. As such, the changes in cognitive functioning in depression have important consequences for the treatment of depression and in reconceptualizing the role of depression in wider neuroprogressive conditions. Here we review the data on changes in cognitive functioning in recurrent major depression and their association with other central conditions.
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Affiliation(s)
- Piotr Gałecki
- Department of Adult Psychiatry, Medical University of Łódź, Łódź, Poland
| | - Monika Talarowska
- Department of Adult Psychiatry, Medical University of Łódź, Łódź, Poland
| | | | - Michael Berk
- Orygen Research Centre, Parkville, VIC, Australia
| | - Michael Maes
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia
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16
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Increased neural activity during overt and continuous semantic verbal fluency in major depression: mainly a failure to deactivate. Eur Arch Psychiatry Clin Neurosci 2014; 264:631-45. [PMID: 24557502 DOI: 10.1007/s00406-014-0491-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 02/07/2014] [Indexed: 12/15/2022]
Abstract
Major depression is associated with impairments in semantic verbal fluency (VF). However, the neural correlates underlying dysfunctional cognitive processing in depressed subjects during the production of semantic category members still remain unclear. In the current study, an overt and continuous semantic VF paradigm was used to examine these mechanisms in a representative sample of 33 patients diagnosed with a current episode of unipolar depression and 33 statistically matched healthy controls. Subjects articulated words in response to semantic category cues while brain activity was measured with functional magnetic resonance imaging (fMRI). Compared to controls, patients showed poorer task performance. On the neural level, a group by condition interaction analysis, corrected for task performance, revealed a reduced task-related deactivation in patients in the right parahippocampal gyrus, the right fusiform gyrus, and the right supplementary motor area. An additional and an increased task-related activation in patients were observed in the right precentral gyrus and the left cerebellum, respectively. These results indicate that a failure to suppress potentially interfering activity from inferior temporal regions involved in default-mode network functions and visual imagery, accompanied by an enhanced recruitment of areas implicated in speech initiation and higher-order language processes, may underlie dysfunctional cognitive processing during semantic VF in depression. The finding that patients with depression demonstrated both decreased performance and aberrant brain activation during the current semantic VF task demonstrates that this paradigm is a sensitive tool for assessing brain dysfunctions in clinical populations.
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17
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Laurent HK, Ablow JC. A face a mother could love: depression-related maternal neural responses to infant emotion faces. Soc Neurosci 2013; 8:228-39. [PMID: 23330663 DOI: 10.1080/17470919.2012.762039] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Depressed mothers show negatively biased responses to their infants' emotional bids, perhaps due to faulty processing of infant cues. This study is the first to examine depression-related differences in mothers' neural response to their own infant's emotion faces, considering both effects of perinatal depression history and current depressive symptoms. Primiparous mothers (n = 22), half of whom had a history of major depressive episodes (with one episode occurring during pregnancy and/or postpartum), were exposed to images of their own and unfamiliar infants' joy and distress faces during functional neuroimaging. Group differences (depression vs. no-depression) and continuous effects of current depressive symptoms were tested in relation to neural response to own infant emotion faces. Compared to mothers with no psychiatric diagnoses, those with depression showed blunted responses to their own infant's distress faces in the dorsal anterior cingulate cortex. Mothers with higher levels of current symptomatology showed reduced responses to their own infant's joy faces in the orbitofrontal cortex and insula. Current symptomatology also predicted lower responses to own infant joy-distress in left-sided prefrontal and insula/striatal regions. These deficits in self-regulatory and motivational response circuits may help explain parenting difficulties in depressed mothers.
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18
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Snyder HR. Major depressive disorder is associated with broad impairments on neuropsychological measures of executive function: a meta-analysis and review. Psychol Bull 2013; 139:81-132. [PMID: 22642228 PMCID: PMC3436964 DOI: 10.1037/a0028727] [Citation(s) in RCA: 1003] [Impact Index Per Article: 91.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cognitive impairments are now widely acknowledged as an important aspect of major depressive disorder (MDD), and it has been proposed that executive function (EF) may be particularly impaired in patients with MDD. However, the existence and nature of EF impairments associated with depression remain strongly debated. Although many studies have found significant deficits associated with MDD on neuropsychological measures of EF, others have not, potentially due to low statistical power, task impurity, and diverse patient samples, and there have been no recent, comprehensive, meta-analyses investigating EF in patients with MDD. The current meta-analysis uses random-effects models to synthesize 113 previous research studies that compared participants with MDD to healthy control participants on at least one neuropsychological measure of EF. Results of the meta-analysis demonstrate that MDD is reliably associated with impaired performance on neuropsychological measures of EF, with effect sizes ranging from 0.32 to 0.97. Although patients with MDD also have slower processing speed, motor slowing alone cannot account for these results. In addition, some evidence suggests that deficits on neuropsychological measures of EF are greater in patients with more severe current depression symptoms, and those taking psychotropic medications, whereas evidence for effects of age was weaker. The results are consistent with the theory that MDD is associated with broad impairment in multiple aspects of EF. Implications for treatment of MDD and theories of EF are discussed. Future research is needed to establish the specificity and causal link between MDD and EF impairments.
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Affiliation(s)
- Hannah R Snyder
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO 80309, USA.
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19
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Liu F, Hu M, Wang S, Guo W, Zhao J, Li J, Xun G, Long Z, Zhang J, Wang Y, Zeng L, Gao Q, Wooderson SC, Chen J, Chen H. Abnormal regional spontaneous neural activity in first-episode, treatment-naive patients with late-life depression: a resting-state fMRI study. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39:326-31. [PMID: 22796277 DOI: 10.1016/j.pnpbp.2012.07.004] [Citation(s) in RCA: 136] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 06/29/2012] [Accepted: 07/03/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND The previous resting perfusion or task-based studies have provided evidence of functional changes in the brains of patients with late-life depression (LLD). Little is known, so far, about the changes in the spontaneous brain activity in LLD during the resting state. The aim of this study was to investigate the spontaneous neural activity in first-episode, treatment-naive patients with LLD by using resting-state functional magnetic resonance imaging (fMRI). METHODS A novel analytical method, coherence-based regional homogeneity (Cohe-ReHo), was used to assess regional spontaneous neural activity during the resting state in 15 first-episode, treatment-naive patients with LLD and 15 age- and gender-matched healthy controls. RESULTS Compared to the healthy controls, the LLD group showed significantly decreased Cohe-ReHo in left caudate nucleus, right anterior cingulate gyrus, left dorsolateral prefrontal cortex, right angular gyrus, bilateral medial prefrontal cortex, and right precuneus, while significantly increased Cohe-ReHo in left cerebellum posterior lobe, left superior temporal gyrus, bilateral supplementary motor area, and right postcentral gyrus (p<0.005, corrected for multiple comparisons). CONCLUSIONS These findings indicated abnormal spontaneous neural activity was distributed extensively in first-episode, treatment-naive patients with LLD during the resting state. Our results might supply a novel way to look into the underlying pathophysiology mechanisms of patients with LLD.
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Affiliation(s)
- Feng Liu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
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20
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Imaging correlates of apathy and depression in Parkinson's disease. J Neurol Sci 2011; 310:58-60. [DOI: 10.1016/j.jns.2011.07.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 06/30/2011] [Accepted: 07/05/2011] [Indexed: 11/22/2022]
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Abstract
The risk of recurrence in depression is high. It increases with the number of previous episodes while the triggering role of stressful life events progressively decreases. According to the scar hypothesis each episode leaves a long-lasting mark that increases the vulnerability for future episodes. Studies examining scars in depression have explored different domains (psychological, social, neurobiological) but they remain largely inconclusive. We were here interested in studies, still scarce, examining this issue at a neurocognitive level, particularly in those using structural and functional brain imaging techniques. Since depression is essentially a disease of emotion, the neural circuits involved in treating and regulating emotional information are of particular interest. Results indicate the persistence of structural and functional neural abnormalities even in remitted untreated subjects. They also suggest that abnormalities may increase with the number of episodes. However a causal link is difficult to establish and abnormalities may precede the first episode. Longitudinal studies are needed. At a cognitive level, neural abnormalities underlie abnormalities in the way subjects treat and regulate emotional information that may increase their vulnerability to develop new episodes. At a neurobiological level, disturbances in neuroplasticity appear as a possible mechanism. Depression should be considered as a continuous rather than an episodic process, and present data offer interesting perspectives concerning the prevention and the treatment of depressive episodes and their recurrence.
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Affiliation(s)
- P Vidailhet
- INSERM U666, Pôle de Psychiatrie et de Santé Mentale, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
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22
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Abstract
Abnormalities in specific cerebral networks likely confer vulnerability that increases the susceptibility for development of geriatric depression and affect the course of symptoms. Functional neuroimaging enables the in vivo identification of alterations in cerebral function that characterize disease vulnerability and contribute to variability in depressive symptoms and antidepressant response. Judicious use of functional neuroimaging tools can advance pathophysiologic models of geriatric depression. Furthermore, geriatric depression provides a logical context within which to study the role of specific functional abnormalities in both antidepressant response and key behavioral and cognitive abnormalities of mood disorders.
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Affiliation(s)
- Faith M. Gunning
- Institute of Geriatric Psychiatry, Weill Cornell Medical College, 21 Bloomingdale Road; White Plains, N.Y. 10605; Tel. (914) 997-8643; Fax Number (914) 682-6979
| | - Gwenn S. Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview Medical Center, Alpha Commons Bldg. 4th floor, 5300 Alpha Commons Drive, Baltimore, MD 21224, USA. Phone Number: 410-550-8696, Fax Number: 410-550-0564
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23
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Gunning-Dixon FM, Walton M, Cheng J, Acuna J, Klimstra S, Zimmerman ME, Brickman AM, Hoptman MJ, Young RC, Alexopoulos GS. MRI signal hyperintensities and treatment remission of geriatric depression. J Affect Disord 2010; 126:395-401. [PMID: 20452031 PMCID: PMC2946967 DOI: 10.1016/j.jad.2010.04.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Revised: 02/25/2010] [Accepted: 04/09/2010] [Indexed: 12/21/2022]
Abstract
BACKGROUND White matter abnormalities may interfere with limbic-cortical balance and contribute to chronic depressive syndromes in the elderly. This study sought to clarify the relationship of SH to treatment response. We hypothesized that patients who failed to remit during a 12-week controlled treatment trial of escitalopram would exhibit greater SH burden than patients who remitted. METHODS The participants were 42 non-demented individuals with non-psychotic major depression and 25 elderly comparison subjects. After a 2-week single blind placebo period, subjects who still had a Hamilton Depression Rating Scale (HDRS) of 18 or greater received escitalopram 10mg daily for 12 weeks. Remission was defined as a HDRS score of 7 or below for 2 consecutive weeks. FLAIR sequences were acquired on a 1.5 T scanner and total SH were quantified using a semi-automated thresholding method. RESULTS The patient sample consisted of 22 depressed patients who achieved remission during the study and 20 depressed patients who remained symptomatic. ANCOVA, with age and gender as covariates, revealed that depressed subjects had greater total SH burden relative to non-depressed controls. Furthermore, patients who failed to remit following escitalopram treatment had significantly greater SH burden than both patients who remitted and elderly comparison subjects, whereas SH burden did not differ between depressed patients who remitted and elderly comparison subjects. LIMITATIONS Patients were treated with a fixed dose of antidepressants and the index of SH is an overall measure that does not permit examination of the relationship of regional SH to treatment remission. DISCUSSION SH may contribute to a "disconnection state" both conferring vulnerability to and perpetuating late-life depression.
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Affiliation(s)
- Faith M. Gunning-Dixon
- Weill Medical College of Cornell University, Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY
| | - Michael Walton
- Weill Medical College of Cornell University, Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY
| | - Janice Cheng
- Weill Medical College of Cornell University, Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY
| | - Jessica Acuna
- Weill Medical College of Cornell University, Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY
| | - Sibel Klimstra
- Weill Medical College of Cornell University, Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY
| | - Molly E. Zimmerman
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY
| | - Adam M. Brickman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Matthew J. Hoptman
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, Department of Psychiatry, New York University School of Medicine, New York, NY
| | - Robert C. Young
- Weill Medical College of Cornell University, Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY
| | - George S. Alexopoulos
- Weill Medical College of Cornell University, Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY
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Suda M, Uehara T, Fukuda M, Sato T, Kameyama M, Mikuni M. Dieting tendency and eating behavior problems in eating disorder correlate with right frontotemporal and left orbitofrontal cortex: a near-infrared spectroscopy study. J Psychiatr Res 2010; 44:547-55. [PMID: 19962158 DOI: 10.1016/j.jpsychires.2009.11.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Revised: 10/30/2009] [Accepted: 11/05/2009] [Indexed: 11/19/2022]
Abstract
Frontal lobe dysfunctions have been implicated as one of the pathophysiological bases in eating disorder (ED). Neural substrates of ED have been examined in neuroimaging studies employing symptom-related stimuli, such as food and body-image distortion, but with inconsistent results because of differences in study design, task, and stimulus used. In order to elucidate frontal lobe dysfunction correlates of clinical symptoms in ED, we examined the frontal lobe function during a cognitive task, not a symptom-related task, using near-infrared spectroscopy (NIRS), which is suitable for the functional neuroimaging study of ED because of its complete noninvasiveness and natural measurement setting. Regional hemodynamic changes were monitored during a verbal fluency task (letter version) using a 52-channel NIRS apparatus in 27 female ED patients and 27 matched healthy controls, and their correlations with clinical symptoms assessed using the Eating Attitude Scale (EAT-26) were examined. Regional hemodynamic changes were significantly smaller in the ED group than in the control group in the bilateral orbitofrontal and right frontotemporal regions, and negatively correlated with dieting tendency scores in EAT-26 in the right frontotemporal regions and with the eating restriction and binge eating scores in the left orbitofrontal regions. The clinical symptoms of ED are considered to consist of two components: dieting tendency that correlates with the right frontotemporal cortex and eating behavior problems that correlate with left the orbitofrontal cortex.
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Affiliation(s)
- Masashi Suda
- Department of Psychiatry and Neuroscience, Gunma University of Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan
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Thomas EJ, Elliott R. Brain imaging correlates of cognitive impairment in depression. Front Hum Neurosci 2009; 3:30. [PMID: 19844612 PMCID: PMC2763880 DOI: 10.3389/neuro.09.030.2009] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Accepted: 09/24/2009] [Indexed: 11/13/2022] Open
Abstract
This review briefly summarises recent research on the neural basis of cognition in depression. Two broad areas are covered: emotional and non-emotional processing. We consider how research findings support models of depression based on disrupted cortico-limbic circuitry, and how modern connectivity analysis techniques can be used to test such models explicitly. Finally we discuss clinical implications of cognitive imaging in depression, and specifically the possible role for these techniques in diagnosis and treatment planning.
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Affiliation(s)
- Emma J Thomas
- Neuroscience and Psychiatry Unit, University of Manchester Manchester, UK
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Gunning FM, Cheng J, Murphy CF, Kanellopoulos D, Acuna J, Hoptman MJ, Klimstra S, Morimoto S, Weinberg J, Alexopoulos GS. Anterior cingulate cortical volumes and treatment remission of geriatric depression. Int J Geriatr Psychiatry 2009; 24:829-36. [PMID: 19551696 PMCID: PMC2828674 DOI: 10.1002/gps.2290] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Structural abnormalities of the anterior cingulate cortex (ACC) may interfere with the interaction of cortical and limbic networks involved in emotional regulation and contribute to chronic depressive syndromes in the elderly. This study examined the relationship of regional anterior cingulate cortical volumes with treatment remission of elderly depressed patients. We hypothesized that patients who failed to remit during a 12-week controlled treatment trial of escitalopram would exhibit smaller anterior cingulate gray matter volumes than patients who remitted. METHODS The participants were 41 non-demented individuals with non-psychotic major depression. After a 2-week single-blind placebo period, subjects who still had a Hamilton Depression Rating Scale (HDRS) of 18 or greater received escitalopram 10 mg daily for 12 weeks. Remission was defined as a HDRS score of 7 or below for at least 2 consecutive weeks. The patient sample consisted of 22 depressed patients who achieved remission during the study and 19 depressed patients who remained symptomatic. High-resolution magnetization-prepared rapidly acquired gradient echo (MPRAGE) sequences were acquired on a 1.5 T scanner and regional ACC volumes were manually outlined (dorsal, rostral, anterior subgenual, and posterior subgenual). RESULTS Repeated measure analyses revealed that patients who failed to remit following escitalopram treatment had smaller dorsal and rostral anterior cingulate gray matter volumes than patients who remitted, whereas subgenual cortical volumes did not differ between the groups. CONCLUSIONS Structural abnormalities of the dorsal and rostral anterior cingulate may perpetuate late-life depression.
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Affiliation(s)
- Faith M Gunning
- Weill Cornell Medical College, Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY, USA.
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Okada G, Okamoto Y, Yamashita H, Ueda K, Takami H, Yamawaki S. Attenuated prefrontal activation during a verbal fluency task in remitted major depression. Psychiatry Clin Neurosci 2009; 63:423-5. [PMID: 19566776 DOI: 10.1111/j.1440-1819.2009.01952.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of the present study was to investigate whether a functional abnormality in the left prefrontal cortex observed in patients with major depression performing a verbal fluency task is present after remission of depression. Functional magnetic resonance imaging was used to study changes in cerebral blood oxygenation in eight remitted patients with major depression and 10 healthy control subjects during a verbal fluency task. Compared to the control subjects, the patients had a reduced response in the left prefrontal cortex (middle frontal gyrus, Brodmann area 10). These findings suggest the presence of dysfunction in the left prefrontal cortex during remission in major depression.
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Affiliation(s)
- Go Okada
- Department of Psychiatry and Neurosciences, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
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Modulation of a human memory circuit by subsyndromal depression in late life: a functional magnetic resonance imaging study. Am J Geriatr Psychiatry 2009; 17:24-9. [PMID: 18790875 PMCID: PMC2614878 DOI: 10.1097/jgp.0b013e318180056a] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Functional deactivation of the posteromedial cortex (PMC) seems to be a physiologic process underlying normal memory. The authors examined whether older subjects with subsyndromal depressive symptoms show impaired PMC deactivation. DESIGN Subjects underwent 4T functional magnetic resonance imaging scan while performing a novel and familiar face-name associative encoding task. The Beck-II Depression Inventory (BDI) was used to self-rate depression symptoms. A novel-minus-familiar encoding contrast was built into a simple regression model showing brain activation magnitudes that covaried with BDI score. A region-of-interest mask was applied to isolate the PMC and other midline structures of the default-mode network. SETTING The study was conducted at a university-based medical center. PARTICIPANTS Participants included 62 nondemented subjects aged 55-85, with and without mild memory deficits. BDI scores ranged from 0 to 17. RESULTS Analysis revealed a distinct PMC cluster confined to the dorsal posterior cingulate cortex (BA 31) whose activity correlated significantly with BDI score. A multiple regression model further showed that BDI score, as well as a history of depression and current use of antidepressants, had a significant effect on cluster variance, while age, education, gender, and mini-mental state exam scores did not. CONCLUSIONS Our findings raise the hypothesis that subsyndromal depressive symptoms in late life may impair physiological PMC deactivation in the dorsal posterior cingulate cortex. A prospective study of a full spectrum of depressed patients may be warranted.
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Current world literature. Curr Opin Psychiatry 2008; 21:651-9. [PMID: 18852576 DOI: 10.1097/yco.0b013e3283130fb7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Paradiso S, Vaidya JG, McCormick LM, Jones A, Robinson RG. Aging and alexithymia: association with reduced right rostral cingulate volume. Am J Geriatr Psychiatry 2008; 16:760-9. [PMID: 18697882 PMCID: PMC2925448 DOI: 10.1097/jgp.0b013e31817e73b0] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Previous studies have linked alexithymia to an inability to process emotions appropriately. Older persons show changes in emotion processing and have higher alexithymia scores. Because the anterior cingulate cortex (ACC) is one of the regions showing earlier decline in late-life, and alexithymia seems to be related to a dysfunction in right hemisphere regions including the ACC subserving affective processes, the present study sought to test the hypothesis that reduced ACC volume accounts for the association between older age and alexithymia. DESIGN Correlation analyses between functionally distinct ACC subregions, age and alexithymia features. SETTING University of Iowa. PARTICIPANTS Twenty-four healthy volunteers aged between 24 and 79 years. MEASUREMENTS Psychiatric and neuropsychological assessment and assessment of alexithymia using the 20-item Toronto Alexithymia Scale. High-resolution magnetic resonance imaging, and in-house developed methods for ACC parcellation. RESULTS Older age directly correlated with higher overall alexithymia and reduced bilateral rostral and right dorsal ACC gray matter volume. Furthermore, higher alexithymia scores correlated with reduced right rostral ACC volume. This correlation seems to be influenced primarily by Factor 3 of the alexithymia scale measuring diversion of attention to external details in place of internal feelings. CONCLUSIONS These results suggest that alexithymia in older age may be a result of structural changes in the right rostral ACC.
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Affiliation(s)
- Sergio Paradiso
- Department of Psychiatry, University of Iowa, Iowa City, IA 52242, USA.
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Hoppenbrouwers SS, Schutter DJLG, Fitzgerald PB, Chen R, Daskalakis ZJ. The role of the cerebellum in the pathophysiology and treatment of neuropsychiatric disorders: a review. ACTA ACUST UNITED AC 2008; 59:185-200. [PMID: 18687358 DOI: 10.1016/j.brainresrev.2008.07.005] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2008] [Revised: 07/11/2008] [Accepted: 07/19/2008] [Indexed: 12/29/2022]
Abstract
The cerebellum has traditionally been looked upon as a brain area primarily involved in motor behaviour. The last decade has however heralded the cerebellum as a brain region of renewed interest for neuropsychiatric disorders. This renewed interest is fuelled by new insights obtained from neuroanatomical research, modern functional neuroimaging and transcranial magnetic stimulation studies. In this review, evidence in support of cerebellar involvement in neuropsychiatric disorders will be presented. In addition, transcranial magnetic stimulation will be introduced as a novel way to study cerebellar contributions to the pathophysiology of psychiatric disorders. In conclusion, a new functional concept of the cerebellum as more than simply a brain area regulating motor control appears mandatory and the involvement of the cerebellum should be considered when studying the neurological basis of neuropsychiatric disorders.
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Abstract
OBJECTIVE This study used neuropsychological measures of executive skills to examine the functioning of frontostriatal networks in elderly bipolar patients. DESIGN The authors hypothesized that elders with bipolar mania would exhibit poor executive functions relative to both elderly comparison subjects and depressed patients. SETTING The study was conducted in the geriatric psychiatry services of a university hospital. PARTICIPANTS Nondemented elders: 14 with bipolar disorder I, manic (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), 14 with unipolar major depression (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), and 14 nonpsychiatric comparison (NC) subjects. MEASUREMENTS Executive functions were assessed with the initiation/perseveration subscale of the Dementia Rating Scale and the manual Go/No-Go tasks from the extended initiation/perseveration scale. RESULTS Manic elders demonstrated poor performance on tasks of initiation/perseveration and response inhibition, and performed significantly worse than both depressed patients and NC subjects. In this sample, there was no evidence for a relationship between severity of manic symptoms and executive performance. CONCLUSION These findings extend the observation that elderly bipolar manic patients have deficits in executive functioning compared with NC samples and provide evidence that the executive deficits demonstrated by bipolar manic elders can be more severe than those in unipolar depressed elders. As executive functions require frontostriatal integrity, these observations support investigation of specific frontostriatal network abnormalities in late-life bipolar disorder.
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