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Watve A, Haugg A, Frei N, Koush Y, Willinger D, Bruehl AB, Stämpfli P, Scharnowski F, Sladky R. Facing emotions: real-time fMRI-based neurofeedback using dynamic emotional faces to modulate amygdala activity. Front Neurosci 2024; 17:1286665. [PMID: 38274498 PMCID: PMC10808718 DOI: 10.3389/fnins.2023.1286665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Maladaptive functioning of the amygdala has been associated with impaired emotion regulation in affective disorders. Recent advances in real-time fMRI neurofeedback have successfully demonstrated the modulation of amygdala activity in healthy and psychiatric populations. In contrast to an abstract feedback representation applied in standard neurofeedback designs, we proposed a novel neurofeedback paradigm using naturalistic stimuli like human emotional faces as the feedback display where change in the facial expression intensity (from neutral to happy or from fearful to neutral) was coupled with the participant's ongoing bilateral amygdala activity. Methods The feasibility of this experimental approach was tested on 64 healthy participants who completed a single training session with four neurofeedback runs. Participants were assigned to one of the four experimental groups (n = 16 per group), i.e., happy-up, happy-down, fear-up, fear-down. Depending on the group assignment, they were either instructed to "try to make the face happier" by upregulating (happy-up) or downregulating (happy-down) the amygdala or to "try to make the face less fearful" by upregulating (fear-up) or downregulating (fear-down) the amygdala feedback signal. Results Linear mixed effect analyses revealed significant amygdala activity changes in the fear condition, specifically in the fear-down group with significant amygdala downregulation in the last two neurofeedback runs as compared to the first run. The happy-up and happy-down groups did not show significant amygdala activity changes over four runs. We did not observe significant improvement in the questionnaire scores and subsequent behavior. Furthermore, task-dependent effective connectivity changes between the amygdala, fusiform face area (FFA), and the medial orbitofrontal cortex (mOFC) were examined using dynamic causal modeling. The effective connectivity between FFA and the amygdala was significantly increased in the happy-up group (facilitatory effect) and decreased in the fear-down group. Notably, the amygdala was downregulated through an inhibitory mechanism mediated by mOFC during the first training run. Discussion In this feasibility study, we intended to address key neurofeedback processes like naturalistic facial stimuli, participant engagement in the task, bidirectional regulation, task congruence, and their influence on learning success. It demonstrated that such a versatile emotional face feedback paradigm can be tailored to target biased emotion processing in affective disorders.
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Affiliation(s)
- Apurva Watve
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zürich, Zürich, Switzerland
| | - Amelie Haugg
- Department of Child and Adolescent Psychiatry, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
| | - Nada Frei
- Department of Child and Adolescent Psychiatry, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
| | - Yury Koush
- Magnetic Resonance Research Center (MRRC), Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, United States
| | - David Willinger
- Department of Child and Adolescent Psychiatry, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
- Division of Psychodynamics, Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Lower Austria, Austria
- Neuroscience Center Zürich, University of Zürich and Swiss Federal Institute of Technology, Zürich, Switzerland
| | - Annette Beatrix Bruehl
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zürich, Zürich, Switzerland
- Center for Affective, Stress and Sleep Disorders, Psychiatric University Hospital Basel, Basel, Switzerland
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zürich, Zürich, Switzerland
| | - Frank Scharnowski
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zürich, Zürich, Switzerland
- Neuroscience Center Zürich, University of Zürich and Swiss Federal Institute of Technology, Zürich, Switzerland
- Zurich Center for Integrative Human Physiology, Faculty of Medicine, University of Zürich, Zürich, Switzerland
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Ronald Sladky
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zürich, Zürich, Switzerland
- Social, Cognitive and Affective Neuroscience Unit, Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
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Ni S, Gao S, Ling C, Jiang J, Wu F, Peng T, Sun J, Zhang N, Xu X. Altered brain regional homogeneity is associated with cognitive dysfunction in first-episode drug-naive major depressive disorder: A resting-state fMRI study. J Affect Disord 2023; 343:102-108. [PMID: 37797751 DOI: 10.1016/j.jad.2023.10.003] [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: 04/05/2023] [Revised: 09/22/2023] [Accepted: 10/02/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Our study aimed to explore the abnormal spontaneous brain activity by regional homogeneity (ReHo) and its association with cognitive function to understand the neuropathology of major depressive disorder (MDD). METHODS ReHo was used to investigate brain activities of 60 patients with first-episode drug-naive MDD and 60 healthy controls (HCs). Partial correlation analysis was conducted on altered ReHo values and the severity of symptoms and cognitive deficits. Moreover, support vector machine analysis was used to evaluate the accuracy of abnormal ReHo values in distinguishing patients with MDD from HCs. RESULTS Compared with HCs, patients with MDD showed significantly increased ReHo values in the right cerebellum crus2 and right thalamus and decreased ReHo values in the right angular gyrus (AG) and right precuneus (PCUN). The ReHo values in right cerebellum crus2 and right AG were positively associated with working memory and visual learning, respectively. Furthermore, the combination of ReHo values in the right cerebellum crus2 and right PCUN discriminated the patients with MDD from HCs with specificity, sensitivity, and accuracy of 0.9688, 0.6250, and 0.90, respectively. LIMITATIONS The design of repeated cross-sectional surveys does not allow analyses of within individual changes. CONCLUSIONS Our study revealed that the pathophysiology mechanism of cognitive deficits in MDD may be related to abnormal spontaneous brain activity. Moreover, the combination of ReHo values in the right cerebellum crus2 and right PCUN can be used to discriminate patients with MDD from HCs effectively.
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Affiliation(s)
- Sulin Ni
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Shuzhan Gao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Chenxi Ling
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Jing Jiang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Fan Wu
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Ting Peng
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Jing Sun
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Ning Zhang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China; Department of Psychiatry, Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China.
| | - Xijia Xu
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China; Department of Psychiatry, Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China.
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Xue C, Zhang X, Cao P, Yuan Q, Liang X, Zhang D, Qi W, Hu J, Xiao C. Evidence of functional abnormalities in the default mode network in bipolar depression: A coordinate-based activation likelihood estimation meta-analysis. J Affect Disord 2023; 326:96-104. [PMID: 36717032 DOI: 10.1016/j.jad.2023.01.088] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 01/15/2023] [Accepted: 01/25/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND The default mode network (DMN) is thought to be involved in the pathophysiology of bipolar depression (BD). However, the findings of prior studies on DMN alterations in BD are inconsistent. Thus, this study aimed to systematically investigate functional abnormalities of the DMN in BD patients. METHODS We systematically searched PubMed, Ovid, and Web of Science for functional neuroimaging studies on regional homogeneity, amplitude of low frequency fluctuations (ALFF), and functional connectivity of the DMN in BD patients published before March 18, 2022. The stereotactic coordinates of the reported altered brain regions were extracted and incorporated into a brain map using the coordinate-based activation likelihood estimation approach. RESULTS A total of 43 original research studies were included in the meta-analysis. BD patients showed specific changes in the DMN including decreased ALFF/fractional ALFF in the left cingulate gyrus (CG) and bilateral precuneus (PCUN); increased functional connectivity (FC) in the left CG, left posterior CG, left PCUN, bilateral medial frontal gyrus, and bilateral superior frontal gyrus; and decreased FC in the left CG, left PCUN, left inferior parietal lobule, and left postcentral gyrus. LIMITATIONS Conclusions are limited by the small number of studies, additional meta-analyses are needed to obtain more data in BD subgroup. CONCLUSION This meta-analysis supports specific changes in DMN activity and FC in BD patients, which may be powerful biomarkers for the diagnosis of BD. The CG and PCUN were the most affected regions and are thus potential targets for clinical interventions to delay BD progression.
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Affiliation(s)
- Chen Xue
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Xulian Zhang
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Ping Cao
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Qianqian Yuan
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Xuhong Liang
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Da Zhang
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Wenzhang Qi
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Jun Hu
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
| | - Chaoyong Xiao
- Department of Radiology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
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Shao J, Zhang Y, Xue L, Wang X, Wang H, Zhu R, Yao Z, Lu Q. Shared and disease-sensitive dysfunction across bipolar and unipolar disorder during depressive episodes: a transdiagnostic study. Neuropsychopharmacology 2022; 47:1922-1930. [PMID: 35177806 PMCID: PMC9485137 DOI: 10.1038/s41386-022-01290-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/21/2022] [Accepted: 01/28/2022] [Indexed: 02/05/2023]
Abstract
Patients with depressive episodes (PDE), such as unipolar disorder (UD) and bipolar disorder (BD), are often defined as distinct diagnostic categories, but increasing converging evidence indicated shared etiologies and pathophysiological characteristics across different clinical diagnoses. We explored whether these transdiagnostic deficits are caused by the common neural substrates across diseases or disease-sensitive mechanisms, or a combination of both. In this study, we utilized a Bayesian model to decompose the resting-state brain activity into multiple hyper- and hypo-activity patterns (refer to as "factors"), so as to explore the shared and disease-sensitive alteration patterns in PDE. The model was constructed over a total of 259 patients (131 UD and 128 BD) with 100 healthy controls as the reference. The other 32 initial depressive episode BD (IDE-BD) patients who had symptoms of mania or hypomania during follow-up were taken as an independent set to estimate the factor composition using the established model for further analysis. We revealed three transdiagnostic alteration factors in PDE. Based on the distribution of factors and the tendency of factor composition at the group level, these factors were defined as BD sensitive factor, UD sensitive factor and shared basic alteration factor. We further found that the factor composition and the ROIs-based alteration degree (mainly involving in orbitofrontal gyrus and part of parietal lobe) were associated with the bipolar index in IDE-BD patients. Our findings contributed to understanding the core transdiagnostic shared and disease-sensitive alterations in PDE and to predicting the risk of emotional state transition in IDE-BD patients.
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Affiliation(s)
- Junneng Shao
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China
| | - Yujie Zhang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China
| | - Li Xue
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China
| | - Xinyi Wang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China
| | - Huan Wang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China
| | - Rongxin Zhu
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
- Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, 210093, China.
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China.
- Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing, China.
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Tassone VK, Demchenko I, Salvo J, Mahmood R, Di Passa AM, Kuburi S, Rueda A, Bhat V. Contrasting the amygdala activity and functional connectivity profile between antidepressant-free participants with major depressive disorder and healthy controls: A systematic review of comparative fMRI studies. Psychiatry Res Neuroimaging 2022; 325:111517. [PMID: 35944425 DOI: 10.1016/j.pscychresns.2022.111517] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 07/11/2022] [Accepted: 07/19/2022] [Indexed: 11/23/2022]
Abstract
Functional neuroimaging research suggests that the amygdala is implicated in the pathophysiology of major depressive disorder (MDD). This systematic review aimed to identify consistently reported amygdala activity and functional connectivity (FC) abnormalities in antidepressant-free participants with MDD as compared to healthy controls at baseline (i.e., before treatment initiation or experimental manipulation). A search for relevant published studies and registered clinical trials was conducted through OVID (MEDLINE, PsycINFO, and Embase) and ClinicalTrials.gov with an end date of March 7th, 2022. Fifty published studies and two registered clinical trials were included in this review. Participants with MDD frequently exhibited amygdala hyperactivity in response to negative stimuli, abnormal event-related amygdala-anterior cingulate cortex (ACC) FC, and abnormal resting-state amygdala FC with the insula and the prefrontal, temporal, and parietal cortices. Decreased resting-state FC was consistently found between the amygdala and the orbitofrontal cortex, striatum, cerebellum, and middle/inferior frontal gyri. Due to the limited number of studies examining resting-state amygdala activity and FC with specific subregions of interest, including those within the ACC, further investigation is warranted.
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Affiliation(s)
- Vanessa K Tassone
- Interventional Psychiatry Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario, M5B 1M8, Canada
| | - Ilya Demchenko
- Interventional Psychiatry Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario, M5B 1M8, Canada
| | - Joseph Salvo
- Interventional Psychiatry Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario, M5B 1M8, Canada
| | - Raesham Mahmood
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, Ontario, M5S 1A8, Canada
| | - Anne-Marie Di Passa
- Interventional Psychiatry Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario, M5B 1M8, Canada
| | - Sarah Kuburi
- Interventional Psychiatry Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario, M5B 1M8, Canada
| | - Alice Rueda
- Interventional Psychiatry Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario, M5B 1M8, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, St. Michael's Hospital, 193 Yonge Street 6-013, Toronto, Ontario, M5B 1M8, Canada; Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, Ontario, M5S 1A8, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, M5B 1T8, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada.
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Siegel-Ramsay JE, Bertocci MA, Wu B, Phillips ML, Strakowski SM, Almeida JRC. Distinguishing between depression in bipolar disorder and unipolar depression using magnetic resonance imaging: a systematic review. Bipolar Disord 2022; 24:474-498. [PMID: 35060259 DOI: 10.1111/bdi.13176] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Magnetic resonance imaging (MRI) studies comparing bipolar and unipolar depression characterize pathophysiological differences between these conditions. However, it is difficult to interpret the current literature due to differences in MRI modalities, analysis methods, and study designs. METHODS We conducted a systematic review of publications using MRI to compare individuals with bipolar and unipolar depression. We grouped studies according to MRI modality and task design. Within the discussion, we critically evaluated and summarized the functional MRI research and then further complemented these findings by reviewing the structural MRI literature. RESULTS We identified 88 MRI publications comparing participants with bipolar depression and unipolar depressive disorder. Compared to individuals with unipolar depression, participants with bipolar disorder exhibited heightened function, increased within network connectivity, and reduced grey matter volume in salience and central executive network brain regions. Group differences in default mode network function were less consistent but more closely associated with depressive symptoms in participants with unipolar depression but distractibility in bipolar depression. CONCLUSIONS When comparing mood disorder groups, the neuroimaging evidence suggests that individuals with bipolar disorder are more influenced by emotional and sensory processing when responding to their environment. In contrast, depressive symptoms and neurofunctional response to emotional stimuli were more closely associated with reduced central executive function and less adaptive cognitive control of emotionally oriented brain regions in unipolar depression. Researchers now need to replicate and refine network-level trends in these heterogeneous mood disorders and further characterize MRI markers associated with early disease onset, progression, and recovery.
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Affiliation(s)
- Jennifer E Siegel-Ramsay
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Michele A Bertocci
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Bryan Wu
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Stephen M Strakowski
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
| | - Jorge R C Almeida
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, Texas, USA
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Xiang J, Tan Y, Niu Y, Sun J, Zhang N, Li D, Wang B. Analysis of functional MRI signal complexity based on permutation fuzzy entropy in bipolar disorder. Neuroreport 2021; 32:465-471. [PMID: 33657075 DOI: 10.1097/wnr.0000000000001617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Bipolar disorder is a manifestation of an emotional disease and is associated with emotional and cognitive dysfunction. The entropy-based method has been widely used to study the complexity of resting-state functional MRI (rs-fMRI) signals in mental diseases; however, alterations in the brain rs-fMRI signal complexities in bipolar disorder patients remain unclear, and previously used entropy methods are sensitive to noise. Here, we performed a work using permutation fuzzy entropy (PFEN), which has better performance than previously used methods, to analyze the brain complexity of bipolar disorder patients. Based on PFEN research, we obtained brain entropy maps of 49 bipolar disorder patients and 49 normal control, extracted the regions of interest to analyze the complexity of abnormal brain regions and further analyzed the correlation between the PFEN values of abnormal brain regions and the clinical measurement scores. Compared with the values in the normal control group, we found that significantly increased PFEN values mainly appeared in the middle temporal gyrus, angular gyrus, superior occipital gyrus and medial superior frontal gyrus, and the decreased PFEN values were found in the inferior temporal gyrus in bipolar disorder patients. In addition, the PFEN values of the angular gyrus was significantly negatively correlated with clinical scores. These findings improve our understanding of the pathophysiology of bipolar disorder patients.
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Affiliation(s)
- Jie Xiang
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, Shanxi, China
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da Silva RDA, Tancini MB, Lage R, Nascimento RL, Santana CMT, Landeira-Fernandez J, Nardi AE, Cheniaux E, Mograbi DC. Autobiographical Memory and Episodic Specificity Across Different Affective States in Bipolar Disorder. Front Psychiatry 2021; 12:641221. [PMID: 34025473 PMCID: PMC8138163 DOI: 10.3389/fpsyt.2021.641221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 04/08/2021] [Indexed: 11/13/2022] Open
Abstract
Autobiographical memory is essential to ground a sense of self-identity, contributing to social functioning and the development of future plans, and being an essential source for the psychiatric interview. Previous studies have suggested loss of autobiographical episodic specificity in unipolar depression, but relatively fewer investigations have been conducted in bipolar disorder (BD) patients, particularly across different mood states. Similarly, there is a scarcity of systematic investigations about mood-congruent and mood-dependent memory in relation to autobiographical memory in BD. Considering this, a total of 74 patients with BD (24 in euthymia, 26 in mania, and 24 in depression) responded with autobiographical memories to cue words belonging to four categories: mania, depression, BD, and neutral. Episodic specificity was scored according to the Autobiographical Interview, with high intra- and inter-rater reliability. Results indicated that patients in mania generally re-experience more episodic details than those in depression. Depressed bipolar patients reported fewer details of perception and less time integration of memories than those in euthymia or mania. Words linked to depression and BD induced greater episodic re-experiencing than neutral words, just as words about BD provided greater episodic re-experiencing and more details of emotion/thoughts than words about mania. Words linked to depression provoked more time details about the recalled episodes than words on BD or neutral themes. No mood-congruent or mood-dependent effects were observed. Current findings may improve the ability of clinicians to conduct psychiatric interviews and the diagnosis of BD, with special attention to how memory details are generated across different mood states of the condition. Additionally, interventions to foster autobiographical recollection in BD may be developed, similar to what has already been done in the context of schizophrenia.
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Affiliation(s)
- Rafael de Assis da Silva
- Department of Psychology, Pontifícia Universidade Católica-Rio, Rio de Janeiro, Brazil.,School of Medicine and Surgery, Federal University of the State of Rio de Janeiro (Unirio), Rio de Janeiro, Brazil
| | - Marcelo Baggi Tancini
- Department of Psychology, Pontifícia Universidade Católica-Rio, Rio de Janeiro, Brazil
| | - Renata Lage
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rodrigo L Nascimento
- Department of Psychology, Pontifícia Universidade Católica-Rio, Rio de Janeiro, Brazil
| | - Cristina M T Santana
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - J Landeira-Fernandez
- Department of Psychology, Pontifícia Universidade Católica-Rio, Rio de Janeiro, Brazil
| | - Antonio Egidio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elie Cheniaux
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Faculdade de Ciências Médicas, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Daniel C Mograbi
- Department of Psychology, Pontifícia Universidade Católica-Rio, Rio de Janeiro, Brazil.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Enhanced functional connectivity between insular subregions correlates with the efficacy of music and instruction-guided relaxation in depression. Neuroreport 2020; 31:1215-1224. [PMID: 33105441 DOI: 10.1097/wnr.0000000000001534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Music and instruction-guided relaxation (MIGR) is a complementary therapeutic tool used in the treatment of the major depressive disorder (MDD). However, the neural mechanism that underlies the effect of MIGR on MDD patients is not known. Twenty-three right-handed MDD patients and 23 age-, sex-, handedness-, and educational level-matched healthy controls were enrolled. Resting-state functional MRI data were acquired from patients before and after MIGR and from healthy controls. The relationships between insular subregion-based functional connectivity and Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale (HAM-A), Automatic Thoughts Questionnaire, and Ruminative Responses Scale scores were examined. One-way analysis of variance exhibited significant differences among the three groups in functional connectivity between the left dorsal anterior insula (dAI) and left superior medial frontal gyrus (SMFG), left dAI and left precuneus, left posterior insula and left gyrus rectus, right ventral anterior insula (vAI) and left posterior cingulate cortex (PCC), right vAI and right inferior frontal gyrus (R-IFG). Further comparisons in regions of interest showed that MDD patients before MIGR showed decreased functional connectivity between the left dAI and left SMFG, left dAI and left precuneus, left posterior insula, and left gyrus rectus, right vAI and left PCC, right vAI and R-IFG relative to those in healthy controls. The strength of functional connectivity between the right dAI and left putamen also exhibited a negative correlation with the HAM-A score in MDD cases before MIGR. MIGR may result in enhanced functional connectivity in insular subregions, thereby potentially increasing the regulatory influence of cognitive reappraisal.
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Docteur A, Mirabel-Sarron C, Kaya Lefèvre H, Sala L, Husky M, Swendsen J, Gorwood P. Role of autobiographical memory in the impact of MBCT on dysfunctional attitudes, depressive symptoms and anxiety in bipolar I patients. J Affect Disord 2020; 276:907-913. [PMID: 32739709 DOI: 10.1016/j.jad.2020.07.072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/22/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The literature suggests that cognitive reactivity in bipolar patients can increase relapse vulnerability, is enhanced by depressive mood and dysfunctional attitudes, and could be improved with MBCT. Autobiographical memory (AM) could be involved in cognitive reactivity, and improved with MBCT training. This study aims to investigate the effect of MBCT for bipolar patients on depressive and anxious symptoms, dysfunctional attitudes and AM, and the predictive versus mediating role of AM in the impact of MBCT on clinical symptoms. METHODS Sixty-two outpatients diagnosed with bipolar I disorder were assigned to MBCT and were compared to 37 bipolar patients on a waiting list. Affective symptoms and dysfunctional attitudes were explored using self-report inventories (BDI, BAI, DAS) and AM was assessed using the Autobiographical Memory Test. RESULTS Patients receiving MBCT demonstrated significantly decreased depressive symptoms, dysfunctional attitudes, overgeneral memories and omissions, and increased specific memories. General AM and omissions at baseline respectively predicted lower anxiety and dysfunctional attitudes improvement following therapy, but the improvement of AM did not explain the impact of MBCT on depression and dysfunctional attitudes improvement. LIMITS Further studies should consider patients' therapeutic adherence and mechanisms involved in MBCT in order to better apprehend how MBCT may reduce dysfunctional attitudes and improve AM in bipolar patients. CONCLUSION Results are consistent with the hypothesis that MBCT reduces cognitive reactivity and AM impairment in bipolar disorders. Findings suggest that AM training prior to MBCT may influence MBCT efficacy, but that MBCT efficacy on AM and clinical symptoms are non-related phenomena.
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Affiliation(s)
- Aurélie Docteur
- GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, F-75014 Paris, France
| | | | - Héline Kaya Lefèvre
- GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, F-75014 Paris, France; Université de Paris, LPPS, F-92100 Boulogne-Billancourt, France.
| | - Loretta Sala
- GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, F-75014 Paris, France
| | - Mathilde Husky
- Laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | - Joel Swendsen
- INCIA, UMR 5287, CNRS/Université de Bordeaux, Bordeaux, France
| | - Philip Gorwood
- GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, F-75014 Paris, France; Université de Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, F-75014 Paris, France
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11
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Han S, Cui Q, Wang X, Li L, Li D, He Z, Guo X, Fan Y, Guo J, Sheng W, Lu F, Chen H. Resting state functional network switching rate is differently altered in bipolar disorder and major depressive disorder. Hum Brain Mapp 2020; 41:3295-3304. [PMID: 32400932 PMCID: PMC7375077 DOI: 10.1002/hbm.25017] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/20/2020] [Accepted: 04/11/2020] [Indexed: 12/24/2022] Open
Abstract
The clinical misdiagnosis ratio of bipolar disorder (BD) patients to major depressive disorder (MDD) patients is high. Recent findings hypothesize that the ability to flexibly recruit functional neural networks is differently altered in BD and MDD patients. This study aimed to explore distinct aberrance of network flexibility during dynamic networks configuration in BD and MDD patients. Resting state functional magnetic resonance imaging of 40 BD patients, 61 MDD patients, and 61 matched healthy controls were recruited. Dynamic functional connectivity matrices for each subject were constructed with a sliding window method. Then, network switching rate of each node was calculated and compared among the three groups. BD and MDD patients shared decreased network switching rate of regions including left precuneus, bilateral parahippocampal gyrus, and bilateral dorsal medial prefrontal cortex. Apart from these regions, MDD patients presented specially decreased network switching rate in the bilateral anterior insula, left amygdala, and left striatum. Taken together, BD and MDD patients shared decreased network switching rate of key hubs in default mode network and MDD patients presented specially decreased switching rate in salience network and striatum. We found shared and distinct aberrance of network flexibility which revealed altered adaptive functions during dynamic networks configuration of BD and MDD.
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Affiliation(s)
- Shaoqiang Han
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina
| | - Qian Cui
- MOE Key Lab for NeuroinformationHigh‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of ChinaChengduChina
- School of Public Affairs and Administration, University of Electronic Science and Technology of ChinaChengduChina
| | - Xiao Wang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina
| | - Liang Li
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina
| | - Di Li
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina
| | - Zongling He
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina
| | - Xiaonan Guo
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina
| | - Yun‐Shuang Fan
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina
| | - Jing Guo
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina
| | - Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengduChina
- MOE Key Lab for NeuroinformationHigh‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of ChinaChengduChina
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12
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Vellante F, Ferri F, Baroni G, Croce P, Migliorati D, Pettoruso M, De Berardis D, Martinotti G, Zappasodi F, Giannantonio MD. Euthymic bipolar disorder patients and EEG microstates: a neural signature of their abnormal self experience? J Affect Disord 2020; 272:326-334. [PMID: 32553374 DOI: 10.1016/j.jad.2020.03.175] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/27/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND A growing number of neuroimaging studies have revealed spatial abnormalities of resting-state functional brain network activity in bipolar disorder (BD). Conversely, abnormalities of resting state temporal dynamics have been scarcely investigated so far. The aim of this study was to characterize the EEG microstates activity in BD patients with a history of manic predominant polarity. Patients were euthymic and pharmacologically stabilized. METHODS Nineteen BD patients (mean age 34.4 ± 11.0, 7 female) and 19 healthy controls (HC; mean age 38.2 ± 9.9, 7 female) were recruited. The psychometric evaluation included the Hamilton Depression Scale (HAMD), the Young Mania Rating Scale (YMRS), the Dissociative Experience Scale (DES), and the State-Trait Anxiety Inventory (STAI). Two runs of 2 minutes of EEG activity by a 128-channel system were acquired at rest and analyzed through microstate analysis. RESULTS We found a reduced presence of microstate B in BD patients compared to HC, since BD patients have a tendency to transit from the microstate B to the microstates C and D significantly more than HC. Furthermore, microstate B features were correlated with DES, state STAI and trait STAI scores. CONCLUSION The reduced presence of microstate B might be associated with episodic autobiographic memory deficit, exaggerated self-focusing and states of dissociations characteristic of BD. Strong correlations of microstate B metrics and dynamics with symptoms of dissociation and anxiety across the two groups supported this interpretation.
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Affiliation(s)
- Federica Vellante
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy.
| | - Francesca Ferri
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Gaia Baroni
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Pierpaolo Croce
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Daniele Migliorati
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Mauro Pettoruso
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Domenico De Berardis
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy; Hospital "Giuseppe Mazzini", Teramo, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Filippo Zappasodi
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy; Institute for Advanced Biomedical Technologies, "G. d'Annunzio" University of Chieti-Pescara, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Italy; Institute for Advanced Biomedical Technologies, "G. d'Annunzio" University of Chieti-Pescara, Italy
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Liu P, Li Q, Zhang A, Liu Z, Sun N, Yang C, Wang Y, Zhang K. Similar and Different Regional Homogeneity Changes Between Bipolar Disorder and Unipolar Depression: A Resting-State fMRI Study. Neuropsychiatr Dis Treat 2020; 16:1087-1093. [PMID: 32425537 PMCID: PMC7196208 DOI: 10.2147/ndt.s249489] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/09/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the regional homogeneity (ReHo) between unipolar depression (UD) and bipolar disorder (BD), and to search for brain imaging markers for distinguishing UD and BD. METHODS A total of 58 patients who met the diagnosis criteria of UD in DSM-Ⅳ, 40 patients who met the diagnosis criteria of BD in DSM-Ⅳ and 54 healthy controls (HC) completed the resting-state functional magnetic resonance (rs-fMRI) scans. The ReHo of the three groups was compared and Pearson correlation analysis was performed between the ReHo values and the clinical symptoms. RESULTS (1) Significant differences were found in the right hippocampus, right parahippocampal gyrus, right Inferior orbitofrontal gyrus, right superior temporal gyrus, right inferior temporal gyrus, and right middle occipital gyrus across the three groups. (2) Compared to HC, the ReHo in the right parahippocampal gyrus in UD significantly increased. (3) When compared to HC, the ReHo in the right hippocampus in BD significantly increased. The ReHo in the right middle occipital gyrus decreased. (4) Compared to UD, BD exhibited significantly decreased ReHo in the right inferior temporal gyrus. No correlations were observed between the scores of 24-item Hamilton Depression Rating Scale (HDMD-24), Hamilton Anxiety Scale (HAMA), Young Mania Rating Scale (YMRS), and the ReHo values of altered brain regions between BD and UD. CONCLUSION The results suggest that there was a considerable difference in the ReHo of brain among UD, BD, and HCs. ReHo in the right inferior temporal gyrus showed significant differences between BD and UD that might serve as neuroimaging markers to identify BD and UD.
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Affiliation(s)
- Penghong Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China.,Department of Psychiatry, Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Qi Li
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China.,Department of Psychiatry, Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Aixia Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Zhifen Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Ning Sun
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Chunxia Yang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Yanfang Wang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China
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14
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Qiu M, Liu G, Zhang H, Huang Y, Ying S, Wang J, Shen T, Peng D. The Insular Subregions Topological Characteristics of Patients With Bipolar Depressive Disorder. Front Psychiatry 2020; 11:253. [PMID: 32351411 PMCID: PMC7175992 DOI: 10.3389/fpsyt.2020.00253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/16/2020] [Indexed: 12/12/2022] Open
Abstract
The insular cortex appears to have a crucial role in emotional processing and cognitive control in bipolar disorder (BD). However, most previous studies focused on the entire insular region of BD, neglecting the topological profile of its subregions. Our study aimed to investigate its subregion topological characteristics using the resting-state functional connectivity (rsFC) in patients with BD on depression episode. The magnetic resonance imaging (MRI) data of 28 depressed BD patients and 28 age- and gender-matched healthy controls (HCs) were acquired. We observed that compared to HCs, depressed patients with BD exhibited significantly decreased rsFC between the right ventral anterior insula (vAI) and the left middle temporal gyrus/the right angular, the right dorsal anterior insula (dAI) and the left precuneus, as well as the right posterior insula and the right lingual gyrus. Furthermore, hyperconnectivity was observed between the left dAI and the left medial frontal gyrus, as well as right dAI and left superior temporal gyrus in BD depression. However, no significant group effect was observed between aberrant FC patterns and clinical variables. These findings revealed the functional connectivity patterns of insular subregions for the depressed BD patients, suggesting the potential neural substrate of insular subregions involved in depressive episode of BD. Hence, these results may provide a neural substrate for the potential treatment target of BD on depression episode.
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Affiliation(s)
- Meihui Qiu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Geya Liu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Huifeng Zhang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yueqi Huang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shihui Ying
- Institute of Biomedical Engineering, School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Jinhong Wang
- Department of Medical Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Shen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daihui Peng
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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15
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Martens K, Takano K, Barry TJ, Holmes EA, Wyckaert S, Raes F. Remediating reduced memory specificity in bipolar disorder: A case study using a Computerized Memory Specificity Training. Brain Behav 2019; 9:e01468. [PMID: 31747124 PMCID: PMC6908894 DOI: 10.1002/brb3.1468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/08/2019] [Accepted: 10/13/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Reduced autobiographical memory specificity (rAMS) is a vulnerability factor found across unipolar depression (UD), posttraumatic stress disorder (PTSD), eating disorder, schizophrenia, and bipolar disorder (BD). A group delivered psychological therapy training called Memory Specificity Training (MeST) remediates rAMS in UD and PTSD, with additional downstream effects on related psychological processes and symptoms. Its impact in BD is unknown. In this case study, we examined the impact of a computerized version of MeST (c-MeST) on improving AMS and related symptoms and processes in participant with rapid cycling type I BD. METHOD An experimental case study with an ABA design was used. During baseline (14 days, Phase A), the training phase (nine sessions across 17 days, Phase B), and a 1-month follow-up (Phase A), memory specificity, depressive symptoms, and related processes and symptoms were repeatedly measured. RESULTS Memory specificity increased significantly after the participant completed c-MeST. Session-to-session scores indicated that AMS improved most from the in-person baseline assessment to the first online session. All other measures of processes and symptoms deteriorated during the training phase but regressed to baseline during follow-up. CONCLUSION Memory specificity was improved as indicated by increased AMS from pre-intervention measurement to 1-month follow-up. Other improvements in symptoms were not observed. Rather, some related maladaptive psychological processes and symptoms worsened during the training phase and regressed to baseline during follow-up.
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Affiliation(s)
- Kris Martens
- Faculty of Psychology and Educational SciencesKU LeuvenLeuvenBelgium
| | | | - Tom J. Barry
- Department of PsychologyThe University of Hong KongHong KongHong Kong
- Department of PsychologyThe Institute of PsychiatryKing's College LondonLondonUK
| | | | - Sabine Wyckaert
- University Psychiatric Center KU Leuven, Campus KortenbergKortenbergBelgium
| | - Filip Raes
- Faculty of Psychology and Educational SciencesKU LeuvenLeuvenBelgium
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16
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Differentiating between bipolar and unipolar depression in functional and structural MRI studies. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91:20-27. [PMID: 29601896 DOI: 10.1016/j.pnpbp.2018.03.022] [Citation(s) in RCA: 133] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/25/2018] [Accepted: 03/25/2018] [Indexed: 01/10/2023]
Abstract
Distinguishing depression in bipolar disorder (BD) from unipolar depression (UD) solely based on clinical clues is difficult, which has led to the exploration of promising neural markers in neuroimaging measures for discriminating between BD depression and UD. In this article, we review structural and functional magnetic resonance imaging (MRI) studies that directly compare UD and BD depression based on neuroimaging modalities including functional MRI studies on regional brain activation or functional connectivity, structural MRI on gray or white matter morphology, and pattern classification analyses using a machine learning approach. Numerous studies have reported distinct functional and structural alterations in emotion- or reward-processing neural circuits between BD depression and UD. Different activation patterns in neural networks including the amygdala, anterior cingulate cortex (ACC), prefrontal cortex (PFC), and striatum during emotion-, reward-, or cognition-related tasks have been reported between BD and UD. A stronger functional connectivity pattern in BD was pronounced in default mode and in frontoparietal networks and brain regions including the PFC, ACC, parietal and temporal regions, and thalamus compared to UD. Gray matter volume differences in the ACC, hippocampus, amygdala, and dorsolateral prefrontal cortex (DLPFC) have been reported between BD and UD, along with a thinner DLPFC in BD compared to UD. BD showed reduced integrity in the anterior part of the corpus callosum and posterior cingulum compared to UD. Several studies performed pattern classification analysis using structural and functional MRI data to distinguish between UD and BD depression using a supervised machine learning approach, which yielded a moderate level of accuracy in classification.
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17
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Thomas SA, Christensen RE, Schettini E, Saletin JM, Ruggieri AL, MacPherson HA, Kim KL, Dickstein DP. Preliminary analysis of resting state functional connectivity in young adults with subtypes of bipolar disorder. J Affect Disord 2019; 246:716-726. [PMID: 30616161 PMCID: PMC8805680 DOI: 10.1016/j.jad.2018.12.068] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 11/25/2018] [Accepted: 12/23/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND A precision medicine approach to bipolar disorder (BD) requires greater knowledge of neural mechanisms, especially within the BD phenotype. The present study evaluated differences in resting state functional connectivity (RSFC) between young adults followed longitudinally since childhood with full-threshold type I BD (BD-I)-characterized by distinct manic episodes-or a more sub-syndromal presentation of BD (BD Not Otherwise Specified [BD-NOS]), compared to one another and to healthy controls (HC). Independent Components Analysis (ICA), a multivariate data-driven method, and dual regression were used to explore whether connectivity within resting state networks (RSNs) differentiated the groups, especially for characteristic fronto-limbic alterations in BD. METHODS Young adults (ages 18-30) with BD-I (n = 28), BD-NOS (n = 14), and HCs (n = 52) underwent structural and RSFC neuroimaging. ICA derived 30 components from RSFC data; a subset of these components, representing well-characterized RSNs, was used for between-group analyses. RESULTS Participants with BD-I had significantly greater connectivity strength between the executive control network and right caudate vs. HCs. Participants with BD-NOS had significantly greater connectivity strength between the sensorimotor network and left precentral gyrus vs. HCs, which was significantly related to psychiatric symptoms. LIMITATIONS Limitations included small BD-NOS sample size and variation in BD mood state and medication status. CONCLUSIONS Results for BD-I participants support prior findings of fronto-limbic alterations characterizing BD. Alterations in the sensorimotor network for adults with BD-NOS aligns with the small but growing body of evidence that sensorimotor network alterations may represent a marker for vulnerability to BD. Further study is required to evaluate specificity.
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Affiliation(s)
- Sarah A. Thomas
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA,Division of Child Psychiatry, Department of Psychiatry and
Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI,
USA,Corresponding Author: Sarah A. Thomas, Bradley
Hospital PediMIND Program, 1011 Veterans Memorial Parkway, East Providence, RI
02915, Phone: (401) 432-1618, Fax: (401) 432-1607,
| | - Rachel E. Christensen
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Elana Schettini
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Jared M. Saletin
- Division of Child Psychiatry, Department of Psychiatry and
Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI,
USA,Emma Pendleton Bradley Hospital Sleep Research Laboratory,
Providence, RI, USA
| | - Amanda L. Ruggieri
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA
| | - Heather A. MacPherson
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA,Division of Child Psychiatry, Department of Psychiatry and
Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI,
USA
| | - Kerri L. Kim
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA,Division of Child Psychiatry, Department of Psychiatry and
Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI,
USA
| | - Daniel P. Dickstein
- Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND)
Program, Emma Pendleton Bradley Hospital, East Providence, RI, USA,Division of Child Psychiatry, Department of Psychiatry and
Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI,
USA
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18
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Abnormal intrinsic cerebro-cerebellar functional connectivity in un-medicated patients with bipolar disorder and major depressive disorder. Psychopharmacology (Berl) 2018; 235:3187-3200. [PMID: 30206663 DOI: 10.1007/s00213-018-5021-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 08/29/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The cerebellum plays an important role in depression. Cerebro-cerebellar circuits have been found to show aberrance in bipolar disorder (BD) and major depressive disorder (MDD). However, whether the cerebro-cerebellar connectivity contributes equally to the pathologic mechanisms of BD and MDD remains unknown. METHODS We recruited 33 patients with MDD, 32 patients with BD, and 43 healthy controls (HC). We selected six seed regions (three per hemisphere) in the cerebrum, corresponding to the affective, cognitive control, and default mode networks, to establish cerebro-cerebellar functional connectivity maps. RESULTS Relative to the HC, both the BD and MDD patients exhibited weaker negative connectivity between the right subgenual anterior cingulate cortex and the cerebellar vermis IV_V (pBD = 0.03, pMDD = 0.001) and weaker positive connectivity between the left precuneus and the left cerebellar lobule IX (pBD = 0.043, pMDD = 0.000). Moreover, the MDD patients showed weaker positive connectivity in the left precuneus-left cerebellar lobule IX circuit than the BD patients (p = 0.049). In addition, the BD patients showed weaker positive connectivity in the right dorsolateral prefrontal cortex-left cerebellar lobule Crus Ι circuit compared to the HC (p = 0.002) or the MDD patients (p = 0.013). Receiver operating characteristic curves analyses showed that the altered cerebro-cerebellar connectivities could be used to distinguish the patients from the HC with relatively high accuracy. CONCLUSIONS Our findings suggested that differences in connectivity of cerebro-cerebellar circuits, which are involved in affective or cognitive functioning, significantly contributed to BD and MDD.
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19
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Barry TJ, Chiu CP, Raes F, Ricarte J, Lau H. The Neurobiology of Reduced Autobiographical Memory Specificity. Trends Cogn Sci 2018; 22:1038-1049. [DOI: 10.1016/j.tics.2018.09.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/28/2018] [Accepted: 09/04/2018] [Indexed: 12/22/2022]
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20
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Amen DG, Krishnamani P, Meysami S, Newberg A, Raji CA. Classification of Depression, Cognitive Disorders, and Co-Morbid Depression and Cognitive Disorders with Perfusion SPECT Neuroimaging. J Alzheimers Dis 2018; 57:253-266. [PMID: 28211813 DOI: 10.3233/jad-161232] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Depression and cognitive disorders (CDs) are two common co-morbid afflictions that commonly present with overlapping symptoms. OBJECTIVE To evaluate if perfusion neuroimaging with brain SPECT can distinguish persons with depression from those with CDs or both conditions. METHODS Inclusion criteria were DSM-IV defined depression or CDs (Alzheimer's disease, vascular dementia, dementia not otherwise specified, and amnestic disorders not otherwise specified) including persons with both (total n = 4,541; 847 CDs, 3,269 depression, 425 with both). Perfusion differences between the groups were calculated using two-sampled t-tests corrected for multiple comparisons. Diagnostic separation was determined with discriminant analysis. Feature selection revealed predictive regions in delineating depression from CDs and comorbid cases. RESULTS Persons with CDs had lower cerebral perfusion compared to depression. In co-morbid persons, cerebral hypoperfusion was additive, with regions showing lower regional cerebral blood flow compared to either diagnosis alone. Both baseline and concentration SPECT regions yielded correct classification of 86% and leave one out cross-validation of 83%. AUC analysis for SPECT regions showed 86% accuracy, 80% sensitivity and 75% specificity. Discriminant analysis separated depression and CDs from comorbid cases with correct classification of 90.8% and cross validated accuracy of 88.6%. Area under the curve was 83% with sensitivity of 80% and specificity of 70%. Feature selection identified the most predictive regions in left hippocampus, right insula, cerebellar, and frontal lobe regions. CONCLUSION Quantitative perfusion SPECT neuroimaging distinguishes depression from dementia and those with both co-morbidities. Perfusion brain SPECT can be utilized clinically to delineate between these two disorders.
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Affiliation(s)
| | | | | | - Andrew Newberg
- Thomas Jefferson University School of Medicine, Philadelphia, PA, USA
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Parlar M, Densmore M, Hall GB, Lanius R, McKinnon MC. Neural and behavioural correlates of autobiographical memory retrieval in patients with major depressive disorder and a history of trauma exposure. Neuropsychologia 2018; 110:148-158. [DOI: 10.1016/j.neuropsychologia.2017.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/07/2017] [Accepted: 07/06/2017] [Indexed: 12/27/2022]
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Qiu M, Zhang H, Mellor D, Shi J, Wu C, Huang Y, Zhang J, Shen T, Peng D. Aberrant Neural Activity in Patients With Bipolar Depressive Disorder Distinguishing to the Unipolar Depressive Disorder: A Resting-State Functional Magnetic Resonance Imaging Study. Front Psychiatry 2018; 9:238. [PMID: 29922189 PMCID: PMC5996277 DOI: 10.3389/fpsyt.2018.00238] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/15/2018] [Indexed: 01/21/2023] Open
Abstract
This study aims to explore the intrinsic patterns of spontaneous activity of bipolar depression (BD) patients by analyzing the fractional amplitude of low frequency fluctuation (fALFF) that help differentiate BD from unipolar depressive disorder(UD). Twenty eight patients with BD, 47 patients with UD and 29 healthy controls were enrolled to receive the resting-state functional magnetic resonance imaging (rs-fMRI) scans. The group differences of fALFF values were calculated among three groups. In addition, the correlations between the clinical variables and mfALFF values were estimated. The brain regions with activation discrepancies among three groups are located in precuneus, the left middle temporal gyrus (MTG) and left inferior parietal lobe (IPL) and lingual gyrus. Compared with HC group, BD group shows decreased fALFF in precuneus, the left IPL and increased fALFF in lingual gyrus remarkably; UD group shows significantly decreased fALFF in precuneus, the left MTG and the left IPL. On the contrast of patients with UD, patients with BD have significantly increased fALFF value in the left precuneus, the left MGT and lingual gyrus. Furthermore, a negative correlation is found between the mfALFF values in precuneus and the scores of cognitive impairment factor in the UD group. The similar pattern of intrinsic activity in PCC suggests depressive state-dependent change. The aberrant patterns of intrinsic activity in precuneus, the IPL and lingual gyrus might be provide quantitative nodes that help to conduct further study for better distinguishing between BD and UD.
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Affiliation(s)
- Meihui Qiu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huifeng Zhang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - David Mellor
- School of Psychology, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - Jun Shi
- Institute of Biomedical Engineering, School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Chuangxin Wu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yueqi Huang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianye Zhang
- Department of Medical Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Shen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daihui Peng
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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