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Zhang F, Liu W, Guo Q, Hu Y, Hu H, Zheng Y, Chen H, Liu C, Tang X, Wei Y, Wang J, Li G, Zhang T, Liu X. Attenuated frontotemporal brain activation during cognitive tasks is associated with lower succinate dehydrogenase protein levels in patients with major depressive disorder. J Affect Disord 2024; 363:563-571. [PMID: 39067530 DOI: 10.1016/j.jad.2024.07.024] [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: 03/13/2024] [Revised: 06/05/2024] [Accepted: 07/12/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Previous studies have shown a lower hemodynamic response in patients with major depressive disorder (MDD) during cognitive tasks. However, the mechanism underlying impaired hemodynamic and neural responses to cognitive tasks in MDD patients remains unclear. Succinate dehydrogenase (SDH) is a key biomarker of mitochondrial energy generation, and it can affect the hemodynamic response via the neurovascular coupling effect. In the current study, cerebral hemodynamic responses were detected during verbal fluency tasks (VFTs) via functional near-infrared spectroscopy (fNIRS) and SDH protein levels were examined in serum from MDD patients to quickly identify whether these hemodynamic alterations were related to mitochondrial energy metabolism. METHODS Fifty patients with first-episode drug-naïve MDD and 42 healthy controls (HCs) were recruited according to inclusion and exclusion criteria. The 17-item Hamilton Depression Rating Scale (17-HDRS), Hamilton Anxiety Rating Scale (HAMA) and Inventory of Depressive Symptomatology-Self Report (IDS-SR) were used to assess the clinical symptoms of the patients. All participants underwent fNIRS measurements to evaluate cerebral hemodynamic responses in the frontal and temporal cortex during VFTs; moreover, SDH protein levels were measured using an enzyme-linked immunosorbent assay. RESULTS Activation in the frontal-temporal brain region during the VFTs was lower in patients with MDD than in HCs. The SDH level in the serum of MDD patients was also significantly lower than that in HCs (p = 0.003), which significantly affected right lateral frontal (p = 0.025) and right temporal (p = 0.022) lobe activation. Both attenuated frontal-temporal activation during the VFTs (OR = 1.531) and lower SDH levels (OR = 1.038) were risk factors for MDD. CONCLUSIONS MDD patients had lower cerebral hemodynamic responses to VFTs; this was associated with mitochondrial dysfunction, as indicated by SDH protein levels. Furthermore, attenuated hemodynamic responses in frontotemporal regions and lower SDH levels increased the risk for MDD. LIMITATIONS The sample size is relatively small. SDH protein levels in peripheral blood may not necessarily reflect mitochondrial energy generation in the central nervous system.
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Affiliation(s)
- Fuxu Zhang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Wanying Liu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Qian Guo
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yao Hu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Hao Hu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yanqun Zheng
- Huashan Hospital, Fudan University, 200040, China
| | - Haiying Chen
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Caiping Liu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Xiaochen Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yanyan Wei
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Guanjun Li
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Xiaohua Liu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
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Wu H, Lu B, Zhang Y, Li T. Differences in prefrontal cortex activation in Chinese college students with different severities of depressive symptoms: A large sample of functional near-infrared spectroscopy (fNIRS) findings. J Affect Disord 2024; 350:521-530. [PMID: 38237870 DOI: 10.1016/j.jad.2024.01.044] [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: 03/26/2023] [Revised: 11/23/2023] [Accepted: 01/03/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Previous studies proposed that functional near-infrared spectroscopy (fNIRS) can be used to distinguish between not only different severities of depressive symptoms but also different subgroups of depression, such as anxious and non-anxious depression, bipolar and unipolar depression, and melancholia and non-melancholia depression. However, the differences in brain haemodynamic activation between depression subgroups (such as confirmed depression [CD] and suspected depression [SD]) with different symptom severities and the possible correlation between symptom severity and haemodynamic activation in specific brain regions using fNIRS have yet to be clarified. METHODS The severity of depression symptoms was classified using the Hospital Anxiety and Depression scale (HADS) and the Mini International Neuropsychiatric Interview by psychiatrists. We recruited 654 patients with depression who had varying severities of depressive symptoms, including 276 with SD and 378 with CD, and 317 with HCs from among Chinese college students. The 53-channel fNIRS was used to detect the cerebral hemodynamic difference of the three groups during the VFT (verbal fluency task). RESULTS Compared with the HC, region-specific fNIRS leads indicate CD patients had significant lower haemodynamic activation in three particular prefrontal regions: 1) right dorsolateral prefrontal cortex (DLPFC), 2) bilateral frontopolar cortex (FPC), and 3) right Broca's area (BA). SD vs. HC comparisons revealed only significant lower haemodynamic activation in the right FPC area. Compared to SD patients, CD patients exhibited decreased hemodynamic activation changes in the right DLPFC and the right BA. Correlation analysis established a significant negative correlation between the hemodynamic changes in the bilateral FPC and the severity of depressive symptoms. CONCLUSIONS The right DLPFC and right BA are expected to be physiological mechanisms to distinguish depression subgroups (CD, SD) with different symptom severities. The haemodynamic changes in the bilateral FPC was nagatively associated with the symptom severity of depression.
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Affiliation(s)
- Huifen Wu
- School of Education and psychology, Hubei Engineering University, Xiaogan, China
| | - Baoquan Lu
- School of Education and psychology, Hubei Engineering University, Xiaogan, China.
| | - Yan Zhang
- School of Education, Huazhong University of Science and Technology, Wuhan, China.
| | - Taiping Li
- School of Education and psychology, Hubei Engineering University, Xiaogan, China.
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Shin JE, Lee YS, Park SY, Jeong MY, Choi JK, Cha JH, Lee YJ. The Relationship between Depression Severity and Prefrontal Hemodynamic Changes in Adolescents with Major Depression Disorder: A Functional Near-infrared Spectroscopy Study. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2024; 22:118-128. [PMID: 38247418 PMCID: PMC10811388 DOI: 10.9758/cpn.23.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/17/2023] [Accepted: 06/17/2023] [Indexed: 01/23/2024]
Abstract
Objective : Numerous studies have identified hemodynamic changes in adults with major depressive disorder (MDD) by using functional near-infrared spectroscopy (fNIRS). However, studies on adolescents with MDD are limited. As adolescence is a stage of rapid brain development, differences may occur depending on age. This study used fNIRS as an objective tool to investigate hemodynamic changes in the frontal lobe according to depression severity and age in adolescents with MDD. Methods : Thirty adolescents (12 aged 12-15 years and 18 aged 16-18 years) were retrospectively investigated. The Children's Depression Inventory was used as a psychiatric evaluation scale, fNIRS was used as an objective brain function evaluation tool, and the Verbal Fluency Test was performed. Results : During the Verbal Fluency Test, in the younger MDD group, oxygenated-hemoglobin concentration increased in the right dorsolateral prefrontal cortex region as the severity of depression increased. In the older MDD group, the oxygenated-hemoglobin concentration decreased in the right dorsolateral prefrontal cortex region as the severity of depression increased. Conclusion : These results suggest that fNIRS may be an objective tool for identifying age differences among adolescents with MDD. To generalize the results and verify fNIRS as a potential biomarker tool, follow-up studies with a larger sample group should be conducted.
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Affiliation(s)
- Jeong Eun Shin
- Department of Medical Sciences, Graduate School of Soonchunhyang University, Asan, Korea
| | - Yun Sung Lee
- Sejong Special Self-Governing City Mental Health Welfare Center, Sejong, Korea
| | - Seo Young Park
- Sejong Special Self-Governing City Mental Health Welfare Center, Sejong, Korea
| | - Mi Young Jeong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | | | - Yeon Jung Lee
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Kim S, Yoon H, Shin J, Yang CM. Classification of fNIRS signals from adolescents with MDD in suicide high- and low-risk groups using machine learning. J Affect Disord 2023; 340:379-386. [PMID: 37536425 DOI: 10.1016/j.jad.2023.07.118] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023]
Abstract
Prefrontal cortex activation is attenuated during cognitive tasks in patients with suicidal ideation or major depressive disorder (MDD). However, the apparent relationship between patients with MDD, especially suicide high-risk (SHR) adolescents, and the characteristics of their hemodynamic responses has not yet been elucidated. To investigate this relationship, we recruited 30 patients with MDD aged 13-19. Functional near-infrared spectroscopy (fNIRS) data were collected for all patients during a Stroop test. Through a ten-time iterative leave-one-out cross-validation via 1000 iterative random search-based feature selections, we achieved a generalized classification accuracy of 70.3±5.0 % (from min. 63.3 % to max. 76.7 %). From the results of random search-based feature selection, Ch08oxy and Ch09deoxy were identified as the two most relevant fNIRS channels. This finding implies that these fNIRS channels can be used as neurological biomarkers to distinguish SHR adolescents with MDD from suicide low-risk (SLR) adolescents. In addition, we determined the oxy-Hb channels of the SHR group, except for Ch01oxy, Ch02oxy, Ch11oxy, and Ch14oxy, were hyperactivated compared to the SLR group.
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Affiliation(s)
- Seonghyeon Kim
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan 54538, Republic of Korea
| | - Haram Yoon
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan 54538, Republic of Korea
| | - Jaeyoung Shin
- Department of Electronic Engineering, Wonkwang University, Iksan 54538, Republic of Korea.
| | - Chan-Mo Yang
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan 54538, Republic of Korea.
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Xu H, Wang Y, Wang YM, Cao Y, Li P, Hu Y, Xia G. Insomniacs show greater prefrontal activation during verbal fluency task compared to non-insomniacs: a functional near-infrared spectroscopy investigation of depression in patients. BMC Psychiatry 2023; 23:217. [PMID: 36997897 PMCID: PMC10064712 DOI: 10.1186/s12888-023-04694-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/17/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Previous studies have shown that insomnia affects human prefrontal function and that there are specific patterns of brain activation to counteract sleep and improve cognition. However, the effects of insomnia on the prefrontal cortex of MDD (major depressive disorder) patients and the patterns of activation to counteract sleep in MDD patients remain unclear. The aim of this study is to examine this using fNIRS (functional near-infrared spectroscopy). METHODS Eighty depressed patients and 44 healthy controls were recruited for this study. fNIRS was used to assess changes in the concentration of oxygenated hemoglobin ([oxy-Hb]) in the prefrontal cortex of all participants during the VFT (verbal fluency test) and to record the number of words created to assess cognitive ability. The Pittsburgh Sleep Quality Index was used to assess sleep quality, and the Hamilton Rating Scale for Depression (24-item) and Hamilton Rating Scale for Anxiety (14-item) were used to assess the severity of depression and anxiety. RESULTS When comparing patients, the healthy control group had significantly higher [oxy-Hb] values in the bilateral prefrontal cortex during VFT than the MDD group. In the MDD group, the [oxy-Hb] values in all brain regions except the right DLPFC were significantly higher in the group with insomnia than in the group without insomnia, but their VFT performance was significantly lower than in the group without insomnia and the healthy group. PSQI scores were positively correlated with [oxy-Hb] values in some left-brain regions, whereas HAMD and HAMA scores were not correlated with [oxy-Hb] values. CONCLUSION The PFC was significantly less active during VFT in those with MDD than in healthy controls. All brain regions, except the right DLPFC, were significantly more active in MDD patients with insomnia than in those without insomnia, suggesting that sleep quality needs to be an important indicator in fNIRS screening. In addition, there was a positive correlation between the severity of insomnia in the left VLPFC and the level of activation, suggesting a role for the left brain region in the neurophysiology of overcoming sleepiness in MDD patients. these findings may provide new ideas for the treatment of MDD patients in the future. TRIAL REGISTRATION Our experiment was registered in the China Clinical Trial Registry (registration number ChiCTR2200065622) on November 10.( The first patient was recruited in 10/11/2022.).
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Affiliation(s)
- HuaSen Xu
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - YuXing Wang
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - Yi Ming Wang
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China.
| | - YaQi Cao
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - PeiFan Li
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - YongXue Hu
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
| | - GuangYuan Xia
- Department of psychiatry, Affliated Hospital to Guizhou Medical University, Guizhou, China
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Song Z, Zhou Y, Zheng Y, Huang W, Meng Z, Li H, Jiang R, Teng Y, Tao M. Factors influencing functional near-infrared spectroscopy in postpartum depression: A cross-sectional study. Int J Gynaecol Obstet 2023; 161:1046-1052. [PMID: 36609765 DOI: 10.1002/ijgo.14663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/09/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To explore whether functional near-infrared spectroscopy (fNIRS) can aid in the early detection and diagnosis of postpartum depression. METHODS The study was a cross-sectional survey that invited all women who sought postpartum health examination 42 days after childbirth between August 2020 and January 2021. Personal information, Edinburgh Postnatal Depression Scale (EPDS), and well as fNIRS results were collected. RESULTS In all, 109 individuals agreed to participate and completed the examination in its entirety. The variance in integral and centroid values was not statistically significant across different subgroups of depression (P > 0.05). The difference in diagnosis of postpartum major depression between EPDS and fNIRS was statistically significant (P < 0.001). fNIRS results in postpartum depression diagnosis were substantially associated with gestational diabetes mellitus (P = 0.027), the number of pregnancies (P = 0.001), and postpartum body mass index (P = 0.035). CONCLUSION fNIRS can provide an objective method for early detection and diagnosis of postpartum depression. Certain clinical conditions can have an effect on brain activity, which may result in postpartum depression. Additional high-quality study is required to establish strong evidence on the subject.
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Affiliation(s)
- Zicheng Song
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yang Zhou
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yuanyi Zheng
- Department of Ultrasound, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Wenjun Huang
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Zheying Meng
- Department of Ultrasound, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Huiying Li
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Rongzhen Jiang
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yincheng Teng
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Minfang Tao
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Ma X, Liu P, Law S, Ravindran N, Xu B, Fan T, Feng K. Characteristics of psychomotor retardation distinguishes patients with depression using multichannel near-infrared spectroscopy and finger tapping task. J Affect Disord 2022; 318:255-262. [PMID: 36087791 DOI: 10.1016/j.jad.2022.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/26/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Psychomotor retardation (PMR) is frequently noted as a characteristic feature of major depressive disorder (MDD). In patients with depression, it is characterized by retardation of speech, emotion, thinking, and cognition. This study explored the activation pattern of the prefrontal cortex (PFC) during the finger-tapping task (FTT) in subjects with MDD, aiming to provide additional understanding on the connection between PMR and PFC activation pattern in depression through the use of near-Infrared Spectroscopy (NIRS). We hypothesized that, through use of NIRS during the FTT, motor retardation in depression would generate a distinct PFC activation pattern, allowing for differentiation between patients with MDD and healthy controls (HCs). METHODS Thirty-five patients with MDD and thirty-nine HCs underwent NIRS evaluation during performance of the FTT. The FTT included both left-finger tapping and right-finger tapping performed by a computer screen. Each participant was assessed using a 45-channel NIRS and various clinical scales. FINDINGS During the left-FTT, the left orbitofrontal cortex (OFC) showed higher oxy-hemoglobin (Oxy-Hb) activation in the MDD group when compared to the HCs. During the right-FTT, the right dorsolateral prefrontal cortex (DLPFC) demonstrated lower Oxy-Hb activation, and the dorsomedial prefrontal cortex (DMPFC) showed higher Oxy-Hb activation in the MDD group versus the HC group. CONCLUSION Our results demonstrated different activation patterns of the PFC between the MDD and HC groups, using FTT as a motor performance task. In particular, the OFC, the DLPFC and the DMPFC areas hold promise as new useful sites for such differentiation in future investigations.
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Affiliation(s)
- Xiangyun Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Pozi Liu
- YuQuan Hospital, Tsinghua University, Beijing 10000, China
| | - Samuel Law
- Department of Psychiatry, University of Toronto, Canada
| | | | - Bo Xu
- YuQuan Hospital, Tsinghua University, Beijing 10000, China
| | - Tengteng Fan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
| | - Kun Feng
- YuQuan Hospital, Tsinghua University, Beijing 10000, China.
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Kamishikiryo T, Okada G, Itai E, Masuda Y, Yokoyama S, Takamura M, Fuchikami M, Yoshino A, Mawatari K, Numata S, Takahashi A, Ohmori T, Okamoto Y. Left DLPFC activity is associated with plasma kynurenine levels and can predict treatment response to escitalopram in major depressive disorder. Psychiatry Clin Neurosci 2022; 76:367-376. [PMID: 35543406 PMCID: PMC9544423 DOI: 10.1111/pcn.13373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/16/2022] [Accepted: 04/24/2022] [Indexed: 11/27/2022]
Abstract
AIM To establish treatment response biomarkers that reflect the pathophysiology of depression, it is important to use an integrated set of features. This study aimed to determine the relationship between regional brain activity at rest and blood metabolites related to treatment response to escitalopram to identify the characteristics of depression that respond to treatment. METHODS Blood metabolite levels and resting-state brain activity were measured in patients with moderate to severe depression (n = 65) before and after 6-8 weeks of treatment with escitalopram, and these were compared between Responders and Nonresponders to treatment. We then examined the relationship between blood metabolites and brain activity related to treatment responsiveness in patients and healthy controls (n = 36). RESULTS Thirty-two patients (49.2%) showed a clinical response (>50% reduction in the Hamilton Rating Scale for Depression score) and were classified as Responders, and the remaining 33 patients were classified as Nonresponders. The pretreatment fractional amplitude of low-frequency fluctuation (fALFF) value of the left dorsolateral prefrontal cortex (DLPFC) and plasma kynurenine levels were lower in Responders, and the rate of increase of both after treatment was correlated with an improvement in symptoms. Moreover, the fALFF value of the left DLPFC was significantly correlated with plasma kynurenine levels in pretreatment patients with depression and healthy controls. CONCLUSION Decreased resting-state regional activity of the left DLPFC and decreased plasma kynurenine levels may predict treatment response to escitalopram, suggesting that it may be involved in the pathophysiology of major depressive disorder in response to escitalopram treatment.
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Affiliation(s)
- Toshiharu Kamishikiryo
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Go Okada
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Eri Itai
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Yoshikazu Masuda
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Satoshi Yokoyama
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Masahiro Takamura
- Department of Neurology, Faculty of MedicineShimane UniversityIzumo‐shiJapan
| | - Manabu Fuchikami
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Atsuo Yoshino
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
| | - Kazuaki Mawatari
- Department of Preventive Environment and Nutrition, Institute of Biomedical SciencesTokushima UniversityTokushimaJapan
| | - Shusuke Numata
- Department of Psychiatry, Institute of Biomedical ScienceTokushima University Graduate SchoolTokushimaJapan
| | - Akira Takahashi
- Department of Preventive Environment and Nutrition, Institute of Biomedical SciencesTokushima UniversityTokushimaJapan
| | - Tetsuro Ohmori
- Department of Psychiatry, Institute of Biomedical ScienceTokushima University Graduate SchoolTokushimaJapan
| | - Yasumasa Okamoto
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
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Erdoğan SB, Yükselen G. Four-Class Classification of Neuropsychiatric Disorders by Use of Functional Near-Infrared Spectroscopy Derived Biomarkers. SENSORS (BASEL, SWITZERLAND) 2022; 22:5407. [PMID: 35891088 PMCID: PMC9322944 DOI: 10.3390/s22145407] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
Diagnosis of most neuropsychiatric disorders relies on subjective measures, which makes the reliability of final clinical decisions questionable. The aim of this study was to propose a machine learning-based classification approach for objective diagnosis of three disorders of neuropsychiatric or neurological origin with functional near-infrared spectroscopy (fNIRS) derived biomarkers. Thirteen healthy adolescents and sixty-seven patients who were clinically diagnosed with migraine, obsessive compulsive disorder, or schizophrenia performed a Stroop task, while prefrontal cortex hemodynamics were monitored with fNIRS. Hemodynamic and cognitive features were extracted for training three supervised learning algorithms (naïve bayes (NB), linear discriminant analysis (LDA), and support vector machines (SVM)). The performance of each algorithm in correctly predicting the class of each participant across the four classes was tested with ten runs of a ten-fold cross-validation procedure. All algorithms achieved four-class classification performances with accuracies above 81% and specificities above 94%. SVM had the highest performance in terms of accuracy (85.1 ± 1.77%), sensitivity (84 ± 1.7%), specificity (95 ± 0.5%), precision (86 ± 1.6%), and F1-score (85 ± 1.7%). fNIRS-derived features have no subjective report bias when used for automated classification purposes. The presented methodology might have significant potential for assisting in the objective diagnosis of neuropsychiatric disorders associated with frontal lobe dysfunction.
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Huang J, Zhang J, Zhang T, Wang P, Zheng Z. Increased Prefrontal Activation During Verbal Fluency Task After Repetitive Transcranial Magnetic Stimulation Treatment in Depression: A Functional Near-Infrared Spectroscopy Study. Front Psychiatry 2022; 13:876136. [PMID: 35444573 PMCID: PMC9013767 DOI: 10.3389/fpsyt.2022.876136] [Citation(s) in RCA: 1] [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: 02/15/2022] [Accepted: 03/09/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Previous studies have shown the clinical effect of 2 Hz repetitive transcranial magnetic stimulation (rTMS) for depression; however, its underlying neural mechanisms are poorly understood. The aim of this study was to examine the effects of rTMS on the activity of the prefrontal cortex in patients with depression, using functional near-infrared spectroscopy (fNIRS). METHODS Forty patients with major depressive disorder (MDD) and 40 healthy controls were enrolled in this study. Patients underwent 4 weeks of 2 Hz TMS delivered to the right dorsolateral prefrontal cortex (DLPFC). fNIRS was used to measure the changes in the concentration of oxygenated hemoglobin ([oxy-Hb]) in the prefrontal cortex during a verbal fluency task (VFT) in depressed patients before and after rTMS treatment. The severity of depression was assessed using the Hamilton Rating Scale for Depression-24 item (HAMD-24). RESULTS Prior to rTMS, depressed patients exhibited significantly smaller [oxy-Hb] values in the bilateral prefrontal cortex during the VFT compared with the healthy controls. After 4 weeks of 2 Hz right DLPFC rTMS treatment, increased [oxy-Hb] values in the bilateral frontopolar prefrontal cortex (FPPFC), ventrolateral prefrontal cortex (VLPFC) and left DLPFC during the VFT were observed in depressed patients. The increased [oxy-Hb] values from baseline to post-treatment in the right VLPFC in depressed patients were positively related to the reduction of HAMD score following rTMS. CONCLUSION These findings suggest that the function of the prefrontal cortex in depressed patients was impaired and could be recovered by 2 Hz rTMS. The fNIRS-measured prefrontal activation during a cognitive task is a potential biomarker for monitoring depressed patients' treatment response to rTMS.
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Affiliation(s)
- Jiaxi Huang
- Mental Health Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Jiaqi Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Tingyu Zhang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Pu Wang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.,Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, Guangzhou, China
| | - Zhong Zheng
- Mental Health Center, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
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11
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Hu S, Li XJ, Law S, Shen CY, Yao GQ, Zhang XQ, Li J, Chen GF, Xu B, Liu XM, Ma XY, Feng K, Liu PZ. Prefrontal cortex alterations in major depressive disorder, generalized anxiety disorder and their comorbidity during a verbal fluency task assessed by multi-channel near-infrared spectroscopy. Psychiatry Res 2021; 306:114229. [PMID: 34749225 DOI: 10.1016/j.psychres.2021.114229] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/17/2021] [Accepted: 09/26/2021] [Indexed: 01/04/2023]
Abstract
Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are frequently comorbid with each other, and both associated with substantial cognitive impairments; however, it is still unclear whether their impairments are neurobiologically similar or distinct. This study aims to investigate the cognitive functions of the prefrontal cortex (PFC) in patients with MDD and GAD during the verbal fluency task (VFT) using functional near-infrared spectroscopy (fNIRS). Fifty-two patients with MDD, fifty-one patients with GAD, fifty-two patients with the comorbidity of MDD and GAD (CMG), and forty-seven healthy controls (HC) participated in the study. Significant hypoactivation in the left ventrolateral and the left dorsolateral PFC was common in all patient groups when compared to HCs, suggesting a shared etiology. Furthermore, MDD patients showed significant hypoactivation at the right frontal pole cortex (FPoC) when compared to HCs and significant hypoactivation at the middle FPoC when compared to the CMG patients. Our work is the first fNIRS study to reveal the shared and unique neurobiological profiles of MDD, GAD and their comorbidity under the same standard experimentation condition, suggesting fNIRS holds promise as an adjutant to assist clinical diagnosis.
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Affiliation(s)
- Shuang Hu
- School of Medicine, Tsinghua University, Beijing, China
| | - Xiao-Jun Li
- School of Medicine, Tsinghua University, Beijing, China
| | - Samuel Law
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Canada
| | - Chen-Yu Shen
- Department of Psychiatry, Beijing Yuquan Hospital, Tsinghua University, Beijing, China
| | - Guan-Qun Yao
- School of Medicine, Tsinghua University, Beijing, China
| | - Xiao-Qian Zhang
- Department of Psychiatry, Beijing Yuquan Hospital, Tsinghua University, Beijing, China
| | - Juan Li
- School of Medicine, Tsinghua University, Beijing, China; Department of Psychiatry, Beijing Yuquan Hospital, Tsinghua University, Beijing, China
| | - Gui-Fang Chen
- School of Medicine, Tsinghua University, Beijing, China; Department of Psychiatry, Beijing Yuquan Hospital, Tsinghua University, Beijing, China
| | - Bo Xu
- Department of Psychiatry, Beijing Yuquan Hospital, Tsinghua University, Beijing, China
| | - Xiao-Min Liu
- Department of Neurology and Psychiatry, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Xiang-Yun Ma
- Beijing Sixth Hospital, Peking University, Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health, National Clinical Research Center for Mental Disorders, Beijing, China
| | - Kun Feng
- Department of Psychiatry, Beijing Yuquan Hospital, Tsinghua University, Beijing, China.
| | - Po-Zi Liu
- School of Medicine, Tsinghua University, Beijing, China; Department of Psychiatry, Beijing Yuquan Hospital, Tsinghua University, Beijing, China.
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12
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Ong SK, Husain SF, Wee HN, Ching J, Kovalik JP, Cheng MS, Schwarz H, Tang TB, Ho CS. Integration of the Cortical Haemodynamic Response Measured by Functional Near-Infrared Spectroscopy and Amino Acid Analysis to Aid in the Diagnosis of Major Depressive Disorder. Diagnostics (Basel) 2021; 11:diagnostics11111978. [PMID: 34829325 PMCID: PMC8617819 DOI: 10.3390/diagnostics11111978] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Major depressive disorder (MDD) is a debilitating condition with a high disease burden and medical comorbidities. There are currently few to no validated biomarkers to guide the diagnosis and treatment of MDD. In the present study, we evaluated the differences between MDD patients and healthy controls (HCs) in terms of cortical haemodynamic responses during a verbal fluency test (VFT) using functional near-infrared spectroscopy (fNIRS) and serum amino acid profiles, and ascertained if these parameters were correlated with clinical characteristics. Methods: Twenty-five (25) patients with MDD and 25 age-, gender-, and ethnicity-matched HCs were recruited for the study. Real-time monitoring of the haemodynamic response during completion of a VFT was quantified using a 52-channel NIRS system. Serum samples were analysed and quantified by liquid chromatography-mass spectrometry for amino acid profiling. Receiver-operating characteristic (ROC) curves were used to classify potential candidate biomarkers. Results: The MDD patients had lower prefrontal and temporal activation during completion of the VFT than HCs. The MDD patients had lower mean concentrations of oxy-Hb in the left orbitofrontal cortex (OFC), and lower serum histidine levels. When the oxy-haemoglobin response was combined with the histidine concentration, the sensitivity and specificity of results improved significantly from 66.7% to 73.3% and from 65.0% to 90.0% respectively, as compared to results based only on the NIRS response. Conclusions: These findings demonstrate the use of combination biomarkers to aid in the diagnosis of MDD. This technique could be a useful approach to detect MDD with greater precision, but additional studies are required to validate the methodology.
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Affiliation(s)
- Samantha K. Ong
- Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore;
| | - Syeda F. Husain
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119276, Singapore;
| | - Hai Ning Wee
- Cardiovascular and Metabolic Disorders Programme, Duke-NUS Graduate Medical School, Singapore 169609, Singapore; (H.N.W.); (J.C.); (J.-P.K.)
| | - Jianhong Ching
- Cardiovascular and Metabolic Disorders Programme, Duke-NUS Graduate Medical School, Singapore 169609, Singapore; (H.N.W.); (J.C.); (J.-P.K.)
| | - Jean-Paul Kovalik
- Cardiovascular and Metabolic Disorders Programme, Duke-NUS Graduate Medical School, Singapore 169609, Singapore; (H.N.W.); (J.C.); (J.-P.K.)
| | - Man Si Cheng
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore; (M.S.C.); (H.S.)
| | - Herbert Schwarz
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore; (M.S.C.); (H.S.)
| | - Tong Boon Tang
- Centre for Intelligent Signal and Imaging Research (CISIR), University Teknologi PETRONAS, Bandar Seri Iskandar 32610, Perak, Malaysia;
| | - Cyrus S. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Correspondence: ; Tel.: +65-67795555
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13
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Lee YJ, Kim M, Kim JS, Lee YS, Shin JE. Clinical Applications of Functional Near-Infrared Spectroscopy in Children and Adolescents with Psychiatric Disorders. Soa Chongsonyon Chongsin Uihak 2021; 32:99-103. [PMID: 34285634 PMCID: PMC8262974 DOI: 10.5765/jkacap.210011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/12/2021] [Accepted: 05/21/2021] [Indexed: 11/24/2022] Open
Abstract
The purpose of this review is to examine the clinical use of functional near-infrared spectroscopy (fNIRS) in children and adolescents with psychiatric disorders. Many studies have been conducted using objective evaluation tools for psychiatric evaluation, such as predicting psychiatric symptoms and treatment responses. Compared to other tools, fNIRS has the advantage of being a noninvasive, inexpensive, and portable method and can be used with patients in the awake state. This study mainly focused on its use in patients with attention-deficit/hyperactivity disorder and autism spectrum disorder. We hope that research involving fNIRS will be actively conducted in various diseases in the future.
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Affiliation(s)
- Yeon Jung Lee
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Minjae Kim
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Ji-Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Yun Sung Lee
- Department of Medical Sciences, Graduate School of Soonchunhyang University, Asan, Korea
| | - Jeong Eun Shin
- Department of Medical Sciences, Graduate School of Soonchunhyang University, Asan, Korea
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14
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Lee YJ, Park SY, Sung LY, Kim JH, Choi J, Oh K, Hahn SW. Reduced left ventrolateral prefrontal cortex activation during verbal fluency tasks is associated with suicidal ideation severity in medication-naïve young adults with major depressive disorder: A functional near-infrared spectroscopy study. Psychiatry Res Neuroimaging 2021; 312:111288. [PMID: 33872934 DOI: 10.1016/j.pscychresns.2021.111288] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/16/2021] [Accepted: 04/08/2021] [Indexed: 12/01/2022]
Abstract
The reduction in the oxygenation dynamics in the prefrontal cortex (PFC) during cognitive tasks is a well-known occurrence in major depressive disorders (MDD). Studies focusing on oxygenation changes in the PFC in individuals with suicidal ideation are limited. Therefore, this study investigated and confirmed the presence of prefrontal dysfunction depending on the intensity of suicidal ideation among 77 young adults (45 patients with MDD and 32 healthy controls) using near-infrared spectroscopy (NIRS). All participants underwent assessment with the Beck Depression Inventory-II, Beck Anxiety Inventory, and Beck Scale for Suicidal ideation. NIRS revealed relative hypofunction in the left dorsolateral PFC, left ventrolateral PFC (LVLPFC), and both orbitofrontal cortices in young adults with MDD compared to that in the healthy controls during verbal fluency tasks. Furthermore, the oxyhaemoglobin changes in the LVLPFC mediated the indirect effect of depression severity on suicidal ideation intensity. Our results confirmed that functional NIRS is a useful auxiliary tool for objectively assessing the risk of suicidal ideation.
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Affiliation(s)
- Yeon Jung Lee
- Department of Psychiatry, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Republic of Korea.
| | - Seo Young Park
- Department of Medical Sciences, Graduate School of Soonchunhyang University, Asan, Republic of Korea
| | - Lee Yun Sung
- Department of Medical Sciences, Graduate School of Soonchunhyang University, Asan, Republic of Korea
| | - Jung Ho Kim
- Department of Nursing, Masan University, Masan, Gyeongnam, Republic of Korea
| | | | | | - Sang-Woo Hahn
- Department of Psychiatry, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Republic of Korea
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15
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Dong SY, Choi J, Park Y, Baik SY, Jung M, Kim Y, Lee SH. Prefrontal Functional Connectivity During the Verbal Fluency Task in Patients With Major Depressive Disorder: A Functional Near-Infrared Spectroscopy Study. Front Psychiatry 2021; 12:659814. [PMID: 34093276 PMCID: PMC8175962 DOI: 10.3389/fpsyt.2021.659814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
Deviations in activation patterns and functional connectivity have been observed in patients with major depressive disorder (MDD) with prefrontal hemodynamics of patients compared with healthy individuals. The graph-theoretical approach provides useful network metrics for evaluating functional connectivity. The evaluation of functional connectivity during a cognitive task can be used to explain the neurocognitive mechanism underlying the cognitive impairments caused by depression. Overall, 31 patients with MDD and 43 healthy individuals completed a verbal fluency task (VFT) while wearing a head-mounted functional near-infrared spectroscopy (fNIRS) devices. Hemodynamics and functional connectivity across eight prefrontal subregions in the two groups were analyzed and compared. We observed a reduction in prefrontal activation and weaker overall and interhemispheric subregion-wise correlations in the patient group compared with corresponding values in the control group. Moreover, efficiency, the network measure related to the effectiveness of information transfer, showed a significant between-group difference [t (71.64) = 3.66, corrected p < 0.001] along with a strong negative correlation with depression severity (rho = -0.30, p = 0.009). The patterns of prefrontal functional connectivity differed significantly between the patient and control groups during the VFT. Network measures can quantitatively characterize the reduction in functional connectivity caused by depression. The efficiency of the functional network may play an important role in the understanding of depressive symptoms.
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Affiliation(s)
- Suh-Yeon Dong
- Department of Information Technology Engineering, Sookmyung Women's University, Seoul, South Korea
| | | | - Yeonsoo Park
- Department of Psychology, University of Notre Dame, Dame, RI, United States
| | - Seung Yeon Baik
- Department of Psychology, Penn State University, State College, PA, United States
| | - Minjee Jung
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea
| | - Yourim Kim
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, South Korea.,Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, South Korea
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16
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Functional connectivity of the prefrontal cortex and amygdala is related to depression status in major depressive disorder. J Affect Disord 2020; 274:897-902. [PMID: 32664030 DOI: 10.1016/j.jad.2020.05.053] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/27/2020] [Accepted: 05/10/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND We used resting-state functional magnetic resonance imaging to examine possible amygdala-prefrontal cortex functional connectivity abnormalities and to clarify the correlation of the abnormal connectivity with response to antidepressant medications. METHODS We recruited 40 drug-naïve patients with first-episode depression, had a 17-item Hamilton Rating Scale for Depression (HRSD17) score>17 for participation in a magnetic resonance imaging scan. Remission was defined as an HRSD17 score <7 following 8 weeks of fluoxetine antidepressant treatment. Gender- and age-matched healthy subjects (n = 26) also underwent MRI scanning. Finally, the association between the change in HRSD17 scores and a change in connectivity between the amygdala and prefrontal cortex from pre to post-treatment was evaluated in major depressive disorder (MDD). RESULTS After controlling for age, gender and years of education, a statistically significant increase in functional connectivity to the right prefrontal cortex from the amygdala was observed in the MDD group compared with the healthy control group (p<0.05, corrected). After 8 weeks of antidepressant treatment and remission in the MDD group, a significant decrease in functional connectivity to the right prefrontal cortex and the left prefrontal cortex from the amygdala was observed, compared with the level of connectivity in the drug-naïve MDD group(p<0.05,corrected). There were no significant associations between the difference in HRSD17 scores rMDD and fMDD with the change in connectivity. LIMITATIONS The design of this study lack resistance to treatment for the depressed group. CONCLUSIONS Increased functional connectivity of PFC-AMY is a promise to be a biomarker of MDD, however weather it could be a biomarker of fluoxetine treatment needs future studying.
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17
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Ho CSH, Lim LJH, Lim AQ, Chan NHC, Tan RS, Lee SH, Ho RCM. Diagnostic and Predictive Applications of Functional Near-Infrared Spectroscopy for Major Depressive Disorder: A Systematic Review. Front Psychiatry 2020; 11:378. [PMID: 32477179 PMCID: PMC7232562 DOI: 10.3389/fpsyt.2020.00378] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/15/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Major depressive disorder (MDD) is a global psychiatric disorder with no established biomarker. There is growing evidence that functional near-infrared spectroscopy (fNIRS) has the ability to aid in the diagnosis and prediction of the treatment response of MDD. The aim of this review was to systematically review, and gather the evidence from existing studies that used fNIRS signals in the diagnosis of MDD, correlations with depression symptomatology, and the monitoring of treatment response. METHODS PubMed, EMBASE, ScienceDirect, and Cochrane Library databases were searched for published English articles from 1980 to June 2019 that focused on the application of fNIRS for (i) differentiating depressed versus nondepressed individuals, (ii) correlating with depression symptomatology, and in turn (iii) monitoring treatment responses in depression. Studies were included if they utilized fNIRS to evaluate cerebral hemodynamic variations in patients with MDD of any age group. The quality of the evidence was assessed using the Newcastle-Ottawa quality assessment scale. RESULTS A total of 64 studies were included in this review, with 12 studies being longitudinal, while the rest were cross-sectional. More than two-thirds of the studies (n = 49) had acceptable quality. fNIRS consistently demonstrated attenuated cerebral hemodynamic changes in depressed compared to healthy individuals. fNIRS signals have also shown promise in correlating with individual symptoms of depression and monitoring various treatment responses. CONCLUSIONS This review provides comprehensive updated evidence of the diagnostic and predictive applications of fNIRS in patients with MDD. Future studies involving larger sample sizes, standardized methodology, examination of more brain regions in an integrative approach, and longitudinal follow-ups are needed.
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Affiliation(s)
- Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lucas J H Lim
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - A Q Lim
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - Nicole H C Chan
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - R S Tan
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - S H Lee
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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18
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Baik SY, Kim JY, Choi J, Baek JY, Park Y, Kim Y, Jung M, Lee SH. Prefrontal Asymmetry during Cognitive Tasks and its Relationship with Suicide Ideation in Major Depressive Disorder: An fNIRS Study. Diagnostics (Basel) 2019; 9:E193. [PMID: 31731795 PMCID: PMC6963177 DOI: 10.3390/diagnostics9040193] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/08/2019] [Accepted: 11/13/2019] [Indexed: 01/25/2023] Open
Abstract
Reduced oxygenation changes in the prefrontal cortex during cognitive tasks have been reported in major depressive disorder (MDD). However, prefrontal asymmetry during cognitive tasks and its relation to suicide ideations have been less frequently examined in patients with MDD. This study investigated prefrontal asymmetry and its moderating effect on the relationship between depression severity and suicidal ideation in MDD patients during cognitive tasks. Forty-two patients with MDD and 64 healthy controls (HCs) were assessed for changes in oxygenated and deoxygenated hemoglobin (Hb) in the prefrontal cortex using functional near-infrared spectroscopy (fNIRS) during the verbal fluency task (VFT), Stroop task, and two-back task. Depression, anxiety, and suicide ideation were measured through self-report questionnaires. Relatively smaller left oxy-Hb changes during VFT, but not during the Stroop or two-back tasks, were found in MDD patients compared with HCs. Furthermore, prefrontal asymmetry during VFT moderated the effect of depression severity on suicide ideation, and was significantly and positively correlated with suicide ideation in patients with MDD. Specifically, relatively greater left oxy-Hb changes were associated with greater suicide ideation. These findings suggest fNIRS-measured prefrontal asymmetry as a potential biomarker for MDD and for the assessment of suicidal risk in patients with MDD.
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Affiliation(s)
- Seung Yeon Baik
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 411-706, Korea; (S.Y.B.)
| | - Jeong-Youn Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 411-706, Korea; (S.Y.B.)
| | | | | | - Yeonsoo Park
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 411-706, Korea; (S.Y.B.)
| | - Yourim Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 411-706, Korea; (S.Y.B.)
| | - Minjee Jung
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 411-706, Korea; (S.Y.B.)
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 411-706, Korea; (S.Y.B.)
- Department of Psychiatry, Inje University, Ilsan Paik Hospital, Goyang 411-706, Korea
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19
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Yamagata B, Yamanaka K, Takei Y, Hotta S, Hirano J, Tabuchi H, Mimura M. Brain functional alterations observed 4-weekly in major depressive disorder following antidepressant treatment. J Affect Disord 2019; 252:25-31. [PMID: 30959413 DOI: 10.1016/j.jad.2019.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/29/2019] [Accepted: 04/02/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a heterogeneous condition. Identifying the brain responses to antidepressant treatment is of particular interest as these may represent potential neural networks related to treatment response, forming one aspect of the biological markers of MDD. Near-infrared spectroscopy (NIRS) is suitable for repeated measurements with short intervals because of its noninvasiveness, and can provide detailed time courses of functional alterations in prefrontal regions. METHODS We conducted a 12-week longitudinal study to explore prefrontal hemodynamic changes at 4-week intervals following sertraline treatment in 11 medication-naïve participants with MDD using 52-channel NIRS. RESULTS While all participants achieved remission after treatment, intra-class correlation coefficient of oxygenated hemoglobin [oxy-Hb] values throughout the 12-week observation was moderate at the spatially and temporally contiguous cluster located in the left inferior frontal and temporal gyri. There was a significant negative correlation between mean [oxy-Hb] values in the significant cluster at 4 weeks and changes in Hamilton Rating Scale for Depression total score from 4 to 8 weeks (r = -0.73, P = 0.011) and from 4 to 12 weeks (r = -0.63, P = 0.039). LIMITATIONS Without healthy controls for comparison, we were unable to fully evaluate whether improvement of [oxy-Hb] activations after treatment in MDD reached normal levels or not. CONCLUSION Our NIRS findings of detailed prefrontal hemodynamic alterations over short interval observations such as 4 weeks may have revealed potential trait marker for MDD and biological maker for predicting clinical response to sertraline treatment in MDD.
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Affiliation(s)
- Bun Yamagata
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo 160-8582, Japan.
| | - Kaori Yamanaka
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo 160-8582, Japan
| | - Yuichi Takei
- Department of Psychiatry and Neuroscience, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Shogo Hotta
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo 160-8582, Japan
| | - Jinichi Hirano
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo 160-8582, Japan
| | - Hajime Tabuchi
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo 160-8582, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo 160-8582, Japan
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20
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Kondo A, Shoji Y, Morita K, Sato M, Ishii Y, Yanagimoto H, Nakano S, Uchimura N. Characteristics of oxygenated hemoglobin concentration change during pleasant and unpleasant image-recall tasks in patients with depression: Comparison with healthy subjects. Psychiatry Clin Neurosci 2018; 72:611-622. [PMID: 29808572 DOI: 10.1111/pcn.12684] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 04/09/2018] [Accepted: 05/13/2018] [Indexed: 11/29/2022]
Abstract
AIM Patients with major depressive disorder (MDD) have been reported to show cognitive impairment in attention, cognition control, and motivation. The prefrontal cortex plays an important role in the pathophysiology of depression. Neurophysiological abnormalities have been examined in MDD patients by several neuroimaging studies. However, the underlying neural mechanism is still unclear. We evaluated brain function during pleasant and unpleasant image-recall tasks using multichannel near-infrared spectroscopy (NIRS) in MDD patients. METHODS The subjects were 25 MDD patients and 25 age- and sex-matched healthy controls. Patients were classified according to DSM-IV-TR criteria. We measured the oxygenated hemoglobin concentration change (δoxyHb) in the forehead and temporal lobe during image-recall task with pleasant (e.g., puppy) and unpleasant (e.g., snake) images using NIRS. To check whether all subjects understood the task, they were asked to draw pictures of both image tasks after NIRS measurement. RESULTS The δoxyHb in the healthy group was significantly higher than that in the MDD group in the bilateral frontal region during the unpleasant condition. A significant negative correlation between the Hamilton Rating Scale for Depression score and δoxyHb was observed in the left frontal region during the unpleasant condition. CONCLUSION We suggest that image-recall tasks related to emotion measured by NIRS might be a visually useful psychophysiological marker to understand the decrease in the frontal lobe function in MDD patients. In particular, we suggest that the decrease in δoxyHb in the left frontal lobe is related to the severity of depression.
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Affiliation(s)
- Akihiko Kondo
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume, Japan
| | - Yoshihisa Shoji
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Kiichiro Morita
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Mamoru Sato
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Youhei Ishii
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume, Japan
| | - Hiroko Yanagimoto
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Shinya Nakano
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume, Japan
| | - Naohisa Uchimura
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
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21
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Hypofunction of left dorsolateral prefrontal cortex in depression during verbal fluency task: A multi-channel near-infrared spectroscopy study. J Affect Disord 2018; 231:83-90. [PMID: 29455100 DOI: 10.1016/j.jad.2018.01.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 12/13/2017] [Accepted: 01/22/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Previous functional neuroimaging studies of depression have demonstrated frontotemporal dysfunction, including the dorsolateral prefrontal cortex, while patients perform working memory and language comprehension tasks. Recent near-infrared spectroscopy (NIRS) studies have shown frontotemporal hypofunction in depression by verbal fluency task, but the regions of impairment affecting respective depressive symptoms still remain unclear. We investigated frontotemporal function during word production task in depression with multi-channel NIRS. Further, we aimed to clarify whether any depressive symptoms affect frontotemporal dysfunction. METHODS One hundred seventy-seven major depressive patients and 50 healthy control volunteers participated in this study. Their cerebral activations were compared during verbal fluency task. RESULTS Although performance was not significantly different, hypoactivation in the bilateral frontotemporal regions was significantly observed in depressed patients, compared with controls. Left lateral frontotemporal activation was significantly reduced in the group with mandatory symptom, which is depressed mood, or loss of interest or pleasure, compared with the group that still has residual depressive symptoms in spite MDD having been remitted. LIMITATION the MDD group had significantly higher age and education level than the controls. Conclusions Our findings indicate hypofunction of the bilateral frontotemporal regions in depression during verbal fluency task. Further, hypofunction of these regions in the left hemisphere by this task could reflect whether the subjects recovered from depressed mood, or loss of interest or pleasure.
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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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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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Bartova L, Meyer BM, Diers K, Rabl U, Scharinger C, Popovic A, Pail G, Kalcher K, Boubela RN, Huemer J, Mandorfer D, Windischberger C, Sitte HH, Kasper S, Praschak-Rieder N, Moser E, Brocke B, Pezawas L. Reduced default mode network suppression during a working memory task in remitted major depression. J Psychiatr Res 2015; 64:9-18. [PMID: 25801734 PMCID: PMC4415908 DOI: 10.1016/j.jpsychires.2015.02.025] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 01/14/2015] [Accepted: 02/26/2015] [Indexed: 01/06/2023]
Abstract
Insufficient default mode network (DMN) suppression was linked to increased rumination in symptomatic Major Depressive Disorder (MDD). Since rumination is known to predict relapse and a more severe course of MDD, we hypothesized that similar DMN alterations might also exist during full remission of MDD (rMDD), a condition known to be associated with increased relapse rates specifically in patients with adolescent onset. Within a cross-sectional functional magnetic resonance imaging study activation and functional connectivity (FC) were investigated in 120 adults comprising 78 drug-free rMDD patients with adolescent- (n = 42) and adult-onset (n = 36) as well as 42 healthy controls (HC), while performing the n-back task. Compared to HC, rMDD patients showed diminished DMN deactivation with strongest differences in the anterior-medial prefrontal cortex (amPFC), which was further linked to increased rumination response style. On a brain systems level, rMDD patients showed an increased FC between the amPFC and the dorsolateral prefrontal cortex, which constitutes a key region of the antagonistic working-memory network. Both whole-brain analyses revealed significant differences between adolescent-onset rMDD patients and HC, while adult-onset rMDD patients showed no significant effects. Results of this study demonstrate that reduced DMN suppression exists even after full recovery of depressive symptoms, which appears to be specifically pronounced in adolescent-onset MDD patients. Our results encourage the investigation of DMN suppression as a putative predictor of relapse in clinical trials, which might eventually lead to important implications for antidepressant maintenance treatment.
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Affiliation(s)
- Lucie Bartova
- Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bernhard M. Meyer
- Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Kersten Diers
- Department of Psychology, Dresden University of Technology, Dresden, Germany
| | - Ulrich Rabl
- Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Christian Scharinger
- Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Ana Popovic
- Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Gerald Pail
- Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Klaudius Kalcher
- MR Centre of Excellence, Medical University of Vienna, Vienna, Austria,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Roland N. Boubela
- MR Centre of Excellence, Medical University of Vienna, Vienna, Austria,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Julia Huemer
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Dominik Mandorfer
- Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Christian Windischberger
- MR Centre of Excellence, Medical University of Vienna, Vienna, Austria,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Harald H. Sitte
- Center of Physiology and Pharmacology, Institute of Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Siegfried Kasper
- Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Nicole Praschak-Rieder
- Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Ewald Moser
- MR Centre of Excellence, Medical University of Vienna, Vienna, Austria,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Burkhard Brocke
- Department of Psychology, Dresden University of Technology, Dresden, Germany
| | - Lukas Pezawas
- Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
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Tomioka H, Yamagata B, Kawasaki S, Pu S, Iwanami A, Hirano J, Nakagome K, Mimura M. A longitudinal functional neuroimaging study in medication-naïve depression after antidepressant treatment. PLoS One 2015; 10:e0120828. [PMID: 25786240 PMCID: PMC4364958 DOI: 10.1371/journal.pone.0120828] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/27/2015] [Indexed: 01/15/2023] Open
Abstract
Recent studies have indicated the potential clinical use of near infrared spectroscopy (NIRS) as a tool in assisting the diagnosis of major depressive disorder (MDD); however, it is still unclear whether NIRS signal changes during cognitive task are state- or trait-dependent, and whether NIRS could be a neural predictor of treatment response. Therefore, we conducted a longitudinal study to explore frontal haemodynamic changes following antidepressant treatment in medication-naïve MDD using 52-channel NIRS. This study included 25 medication-naïve individuals with MDD and 62 healthy controls (HC). We performed NIRS scans before and after antidepressant treatment and measured changes of [oxy-Hb] activation during a verbal fluency task (VFT) following treatment. Individuals with MDD showed significantly decreased [oxy-Hb] values during a VFT compared with HC in the bilateral frontal and temporal cortices at baseline. There were no [oxy-Hb] changes between pre- and post-antidepressant treatment time points in the MDD cohort despite significant improvement in depressive symptoms. There was a significant association between mean [oxy-Hb] values during a VFT at baseline and improvement in depressive symptoms following treatment in the bilateral inferior frontal and middle temporal gyri in MDD. These findings suggest that hypofrontality response to a VFT may represent a potential trait marker for depression rather than a state marker. Moreover, the correlation analysis indicates that the NIRS signals before the initiation of treatment may be a biological marker to predict patient’s clinical response to antidepressant treatment. The present study provides further evidence to support a potential application of NIRS for the diagnosis and treatment of depression.
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Affiliation(s)
- Hiroi Tomioka
- Department of Psychiatry, Showa University School of Medicine, Tokyo 157-8577, Japan
| | - Bun Yamagata
- Department of Psychiatry, Showa University School of Medicine, Tokyo 157-8577, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Shingo Kawasaki
- Hitachi Medical Corporation, Application Development Office, Chiba 277-0804, Japan
| | - Shenghong Pu
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Tottori 683-8504, Japan
| | - Akira Iwanami
- Department of Psychiatry, Showa University School of Medicine, Tokyo 157-8577, Japan
| | - Jinichi Hirano
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kazuyuki Nakagome
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Tottori 683-8504, Japan; National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan
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Pu S, Nakagome K, Yamada T, Yokoyama K, Matsumura H, Nagata I, Kaneko K. Prefrontal activation predicts social functioning improvement after initial treatment in late-onset depression. J Psychiatr Res 2015; 62:62-70. [PMID: 25659188 DOI: 10.1016/j.jpsychires.2015.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 01/15/2015] [Accepted: 01/16/2015] [Indexed: 10/24/2022]
Abstract
The activation of oxygenated hemoglobin (oxy-Hb) has been shown to be lacking in the prefrontal cortex (PFC) of patients with late-onset depression (LOD), in verbal fluency task (VFT)-related near-infrared spectroscopy (NIRS). In our previous studies, we have emphasized the connection between the lack of activation in the frontopolar cortex and social functioning disorder in patients with LOD. In this study, we investigated whether the responsiveness to medical treatment of untreated patients with LOD, particularly social functioning improvements, could be predicted by NIRS findings at the initial examination. The subjects were 29 patients with LOD who were diagnosed with major depression at 65 years or older at the initial examination (mean age ± standard deviation, 72.4 ± 5.71 years). We measured the changes in hemoglobin concentration in the prefrontal and temporal cortex regions during a VFT by using 52-channel NIRS. In addition, depression status and social functioning were evaluated with the Hamilton Depression Rating Scale and the Social Adaptation Self-evaluation Scale, respectively, at the initial examination and 8 weeks after the treatment. A negative correlation was found between the NIRS activation in the right ventrolateral PFC region before treatment and the improvement in social functioning. These results suggested that the social functioning improvements were greater in LOD with initially lower NIRS activation in the right ventrolateral PFC region. NIRS is a simple technique that can be used before treatment to evaluate the social functioning levels of patients with LOD, and predict social functioning improvement after treatment.
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Affiliation(s)
- Shenghong Pu
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan.
| | - Kazuyuki Nakagome
- National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8551, Japan
| | - Takeshi Yamada
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Katsutoshi Yokoyama
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Hiroshi Matsumura
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Izumi Nagata
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
| | - Koichi Kaneko
- Division of Neuropsychiatry, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan
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27
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Smoski MJ, Keng SL, Ji JL, Moore T, Minkel J, Dichter GS. Neural indicators of emotion regulation via acceptance vs reappraisal in remitted major depressive disorder. Soc Cogn Affect Neurosci 2015; 10:1187-94. [PMID: 25617820 DOI: 10.1093/scan/nsv003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 01/13/2015] [Indexed: 11/13/2022] Open
Abstract
Mood disorders are characterized by impaired emotion regulation abilities, reflected in alterations in frontolimbic brain functioning during regulation. However, little is known about differences in brain function when comparing regulatory strategies. Reappraisal and emotional acceptance are effective in downregulating negative affect, and are components of effective depression psychotherapies. Investigating neural mechanisms of reappraisal vs emotional acceptance in remitted major depressive disorder (rMDD) may yield novel mechanistic insights into depression risk and prevention. Thirty-seven individuals (18 rMDD, 19 controls) were assessed during a functional magnetic resonance imaging task requiring reappraisal, emotional acceptance or no explicit regulation while viewing sad images. Lower negative affect was reported following reappraisal than acceptance, and was lower following acceptance than no explicit regulation. In controls, the acceptance > reappraisal contrast revealed greater activation in left insular cortex and right prefrontal gyrus, and less activation in several other prefrontal regions. Compared with controls, the rMDD group had greater paracingulate and right midfrontal gyrus (BA 8) activation during reappraisal relative to acceptance. Compared with reappraisal, acceptance is associated with activation in regions linked to somatic and emotion awareness, although this activation is associated with less reduction in negative affect. Additionally, a history of MDD moderated these effects.
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Affiliation(s)
- Moria J Smoski
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA,
| | - Shian-Ling Keng
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore 117570, Singapore
| | - Jie Lisa Ji
- Duke Institute for Brain Sciences, Duke University, Durham, NC 27708, USA
| | - Tyler Moore
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Jared Minkel
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA, Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA, and
| | - Gabriel S Dichter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA, Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA, and Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC 27710, USA
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28
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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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29
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Backes H, Dietsche B, Nagels A, Konrad C, Witt SH, Rietschel M, Kircher T, Krug A. Genetic variation in CACNA1C affects neural processing in major depression. J Psychiatr Res 2014; 53:38-46. [PMID: 24612926 DOI: 10.1016/j.jpsychires.2014.02.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 02/06/2014] [Accepted: 02/06/2014] [Indexed: 11/28/2022]
Abstract
Genetic studies found the A allele of the single nucleotide polymorphism rs1006737 in the CACNA1C gene, which encodes for the alpha 1C subunit of the voltage-dependent, L-type calcium ion channel Cav1.2, to be overrepresented in patients with major depressive disorder (MDD). Altered prefrontal brain functioning and impaired semantic verbal fluency (SVF) are robust findings in these patients. A recent functional magnetic resonance imaging (fMRI) study found the A allele to be associated with poorer performance and increased left inferior frontal gyrus (IFG) activation during SVF tasks in healthy subjects. In the present study, we investigated the effects of rs1006737 on neural processing during SVF in MDD. In response to semantic category cues, 40 patients with MDD and 40 matched controls overtly generated words while brain activity was measured with fMRI. As revealed by whole brain analyses, genotype significantly affected brain activity in patients. Compared to patients with GG genotype, patients with A allele demonstrated increased task-related activation in the left middle/inferior frontal gyrus and the bilateral cerebellum. Patients with A allele also showed enhanced functional coupling between left middle/inferior and right superior/middle frontal gyri. No differential effects of genotype on SVF performance or brain activation were found between diagnostic groups. The current data provide further evidence for an impact of rs1006737 on the left IFG and demonstrate that genetic variation in CACNA1C modulates neural responses in patients with MDD. The observed functional alterations in prefrontal and cerebellar areas might represent a mechanism by which rs1006737 influences susceptibility to MDD.
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Affiliation(s)
- Heidelore Backes
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany.
| | - Bruno Dietsche
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Arne Nagels
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J 5, 68159 Mannheim, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J 5, 68159 Mannheim, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
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Influence of subjective happiness on the prefrontal brain activity: an fNIRS study. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 812:287-293. [PMID: 24729245 DOI: 10.1007/978-1-4939-0620-8_38] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Focusing on the relationship between subjective happiness (SH) and emotional changes, we examined influences of SH on emotion-related prefrontal activity using multichannel NIRS. The International Affective Picture System (IAPS) was used to evoke emotional changes. Subjects were a total of 18 right-handed healthy students. Frequency of picture-induced increases in oxygenated haemoglobin (oxy-Hb) was evaluated. Subjects with a high SH score had a higher frequency of increased oxy-Hb in the left prefrontal cortex (PFC) while viewing pleasant pictures, whereas they showed a lower frequency in the right PFC while viewing unpleasant pictures. It is well known that the left PFC and right PFC are engaged in different ways in the emotional processes. Although further investigations are required, the present results indicate that the SH level influences the right-left differences in emotion-related prefrontal activity.
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31
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Ikeda E, Shiozaki K, Ikeda H, Suzuki M, Hirayasu Y. Prefrontal dysfunction in remitted depression at work reinstatement using near-infrared spectroscopy. Psychiatry Res 2013; 214:254-9. [PMID: 24139959 DOI: 10.1016/j.pscychresns.2013.07.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Revised: 07/14/2013] [Accepted: 07/25/2013] [Indexed: 01/27/2023]
Abstract
A long-term and/or recurrent sickness absence from work due to depression has been an important health problem in industrial countries. In addition, previous sick leave is a risk factor of recurrence. However, many characteristics, especially biological aspects, have not been investigated in remitted depressive patients who were ready to return to work from sickness absence. Therefore, the purpose of this study is to clarify the pathophysiological characteristics of patients who were at risk for recurrence of sickness absence. We recruited 21 patients and 16 healthy control subjects. All patients were ready to return to work within one month from long-term sickness absence. All subjects were examined for prefrontal function represented by oxyHb changes during the verbal fluency task (VFT) and the Stroop task using near-infrared spectroscopy. Suppressed prefrontal reaction during the VFT and increased prefrontal reaction during the Stroop task were observed in the patient group compared with the control group. Significantly lengthened reaction time was observed in the incongruent condition in the patient group during the Stroop task. Depressive patients showed impaired executive function measured by the Stroop task and had prefrontal dysfunction despite clinical remission. Residual prefrontal dysfunction may be one biological reason for repetitive sickness absence.
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Affiliation(s)
- Eiji Ikeda
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan; Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
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32
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Kong L, Chen K, Tang Y, Wu F, Driesen N, Womer F, Fan G, Ren L, Jiang W, Cao Y, Blumberg HP, Xu K, Wang F. Functional connectivity between the amygdala and prefrontal cortex in medication-naive individuals with major depressive disorder. J Psychiatry Neurosci 2013; 38:417-22. [PMID: 24148846 PMCID: PMC3819156 DOI: 10.1503/jpn.120117] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Convergent evidence suggests dysfunction within the prefrontal cortex (PFC) and amygdala, important components of a neural system that subserves emotional processing, in individuals with major depressive disorder (MDD). Abnormalities in this system in the left hemisphere and during processing of negative emotional stimuli are especially implicated. In this study, we used functional magnetic resonance imaging (fMRI) to investigate amygdala-PFC functional connectivity during emotional face processing in medication-naive individuals with MDD. METHODS Individuals with MDD and healthy controls underwent fMRI scanning while processing 3 types of emotional face stimuli. We compared the strength of functional connectivity from the amygdala between the MDD and control groups. RESULTS Our study included 28 individuals with MDD and 30 controls. Decreased amygdala-left rostral PFC (rPFC) functional connectivity was observed in the MDD group compared with controls for the fear condition (p < 0.05, corrected). No significant differences were found in amygdala connectivity to any cerebral regions between the MDD and control groups for the happy or neutral conditions. LIMITATIONS All participants with MDD were experiencing acute episodes, therefore the findings could not be generalized to the entire MDD population. CONCLUSION Medication-naive individuals with MDD showed decreased amygdala-left rPFC functional connectivity in response to negative emotional stimuli, suggesting that abnormalities in amygdala-left rPFC neural circuitry responses to negative emotional stimuli might play an important role in the pathophysiology of MDD.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Ke Xu
- Correspondence to: K. Xu, Department of Radiology, The First Affiliated Hospital, China Medical University, 155 Nanjing North St., Shenyang 110001, Liaoning, China; or F. Wang, Department of Radiology, The first Affiliated hospital, China Medical University, 155 Nanjing North St., Shenyang 110001, Liaoning, China and Department of Psychiatry, Yale University School of Medicine, New Haven CT 06511, USA;
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Neural mechanisms of cognitive reappraisal in remitted major depressive disorder. J Affect Disord 2013; 151:171-7. [PMID: 23796796 PMCID: PMC3769423 DOI: 10.1016/j.jad.2013.05.073] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 05/24/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Down-regulation of negative emotions by cognitive strategies relies on prefrontal cortical modulation of limbic brain regions, and impaired frontolimbic functioning during cognitive reappraisal has been observed in affective disorders. However, no study to date has examined cognitive reappraisal in unmedicated euthymic individuals with a history of major depressive disorder relative to symptom-matched controls. Given that a history of depression is a critical risk factor for future depressive episodes, investigating the neural mechanisms of emotion regulation in remitted major depressive disorder (rMDD) may yield novel insights into depression risk. METHOD We assessed 37 individuals (18 rMDD, 19 controls) with functional magnetic resonance imaging (fMRI) during a task requiring cognitive reappraisal of sad images. RESULTS Both groups demonstrated decreased self-reported negative affect after cognitive reappraisal and no group differences in the effects of cognitive reappraisal on mood were evident. Functional MRI results indicated greater paracingulate gyrus (rostral anterior cingulate cortex, Brodmann area 32) activation and decreased right midfrontal gyrus (Brodmann area 6) activation during the reappraisal of sad images. LIMITATIONS Trial-by-trial ratings of pre-regulation affect were not collected, limiting the interpretation of post-regulation negative affect scores. CONCLUSIONS Results suggest that activation of rostral anterior cingulate cortex, a region linked to the prediction of antidepressant treatment response, and of the right midfrontal gyrus, a region involved in cognitive control in the context of cognitive reappraisal, may represent endophenotypic markers of future depression risk. Future prospective studies will be needed to validate the predictive utility of these neural markers.
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Holsen LM, Lancaster K, Klibanski A, Whitfield-Gabrieli S, Cherkerzian S, Buka S, Goldstein JM. HPA-axis hormone modulation of stress response circuitry activity in women with remitted major depression. Neuroscience 2013; 250:733-42. [PMID: 23891965 DOI: 10.1016/j.neuroscience.2013.07.042] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 07/01/2013] [Accepted: 07/17/2013] [Indexed: 11/27/2022]
Abstract
Decades of clinical and basic research indicate significant links between altered hypothalamic-pituitary-adrenal (HPA)-axis hormone dynamics and major depressive disorder (MDD). Recent neuroimaging studies of MDD highlight abnormalities in stress response circuitry regions which play a role in the regulation of the HPA-axes. However, there is a dearth of research examining these systems in parallel, especially as related to potential trait characteristics. The current study addresses this gap by investigating neural responses to a mild visual stress challenge with real-time assessment of adrenal hormones in women with MDD in remission and controls. Fifteen women with recurrent MDD in remission (rMDD) and 15 healthy control women were scanned on a 3T Siemens MR scanner while viewing neutral and negative (stress-evoking) stimuli. Blood samples were obtained before, during, and after scanning for the measurement of HPA-axis hormone levels. Compared to controls, rMDD women demonstrated higher anxiety ratings, increased cortisol levels, and hyperactivation in the amygdala and hippocampus, p<0.05, family-wise error (FWE)-corrected in response to the stress challenge. Among rMDD women, amygdala activation was negatively related to cortisol changes and positively associated with the duration of remission. Findings presented here provide evidence for differential effects of altered HPA-axis hormone dynamics on hyperactivity in stress response circuitry regions elicited by a well-validated stress paradigm in women with recurrent MDD in remission.
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Affiliation(s)
- L M Holsen
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
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Hernández-Ribas R, Deus J, Pujol J, Segalàs C, Vallejo J, Menchón JM, Cardoner N, Soriano-Mas C. Identifying brain imaging correlates of clinical response to repetitive transcranial magnetic stimulation (rTMS) in major depression. Brain Stimul 2013; 6:54-61. [DOI: 10.1016/j.brs.2012.01.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 10/28/2011] [Accepted: 01/03/2012] [Indexed: 12/29/2022] Open
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Stern ER, Welsh RC, Gonzalez R, Fitzgerald KD, Abelson JL, Taylor SF. Subjective uncertainty and limbic hyperactivation in obsessive-compulsive disorder. Hum Brain Mapp 2012; 34:1956-70. [PMID: 22461182 DOI: 10.1002/hbm.22038] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 12/13/2011] [Accepted: 12/20/2011] [Indexed: 11/07/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is often associated with pathological uncertainty regarding whether an action has been performed correctly or whether a bad outcome will occur, leading to compulsive "evidence gathering" behaviors aimed at reducing uncertainty. The current study used event-related functional magnetic resonance imaging to investigate neural functioning in OCD patients and controls as subjective certainty was rated in response to sequential pieces of evidence for a decision. Uncertainty was experimentally manipulated so that some decisions were associated with no "objective" uncertainty (all observed evidence pointed to one correct choice), whereas other decisions contained calculable but varying levels of objective uncertainty based on displayed probabilities. Results indicated that OCD patients differed from controls on decisions that contained no objective uncertainty, such that patients rated themselves as more uncertain. Patients also showed greater activation in a network of brain regions previously associated with internally-focused thought and valuation including ventromedial prefrontal cortex, parahippocampus, middle temporal cortex, as well as amygdala and orbitofrontal cortex/ventral anterior insula. In the patient group, a significantly greater number of positive intersubject correlations were found among several of these brain regions, suggesting that this network is more interconnected in patients. OCD patients did not differ from controls on decisions where task parameters led to uncertainty. These results indicate that OCD is associated with hyperactivation in a network of limbic/paralimbic brain regions when making decisions, which may contribute to the greater subjective experience of doubt that characterizes the disorder.
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Affiliation(s)
- Emily R Stern
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
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Dichter GS, Kozink RV, McClernon FJ, Smoski MJ. Remitted major depression is characterized by reward network hyperactivation during reward anticipation and hypoactivation during reward outcomes. J Affect Disord 2012; 136:1126-34. [PMID: 22036801 PMCID: PMC3272083 DOI: 10.1016/j.jad.2011.09.048] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 09/30/2011] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although functional brain imaging has established that individuals with unipolar major depressive disorder (MDD) are characterized by frontostriatal dysfunction during reward processing, no research to date has examined the chronometry of neural responses to rewards in euthymic individuals with a history of MDD. METHOD A monetary incentive delay task was used during fMRI scanning to assess neural responses in frontostriatal reward regions during reward anticipation and outcomes in 19 participants with remitted major depressive disorder (rMDD) and in 19 matched control participants. RESULTS During the anticipation phase of the task, the rMDD group was characterized by relatively greater activation in bilateral anterior cingulate gyrus, in right midfrontal gyrus, and in the right cerebellum. During the outcome phase of the task, the rMDD group was characterized by relatively decreased activation in bilateral orbital frontal cortex, right frontal pole, left insular cortex, and left thalamus. Exploratory analyses indicated that activation within a right frontal pole cluster that differentiated groups during reward anticipation predicted the number of lifetime depressive episodes within the rMDD group. LIMITATIONS Replication with larger samples is needed. CONCLUSIONS Results suggest a double dissociation between reward network reactivity and temporal phase of the reward response in rMDD, such that rMDD is generally characterized by reward network hyperactivation during reward anticipation and reward network hypoactivation during reward outcomes. More broadly, these data suggest that aberrant frontostriatal response to rewards may potentially represent a trait marker for MDD, though future research is needed to evaluate the prospective utility of this functional neural endophenotype as a marker of MDD risk.
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Affiliation(s)
- Gabriel S. Dichter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC 27710,Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599,Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599,Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27710
| | - Rachel V. Kozink
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC 27710
| | - F. Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC 27710,Duke-UNC Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27710,Durham Veterans Affairs Medical Center, and VISN 6 Mental Illness Research, Education, and Clinical Center, Durham, NC
| | - Moria J. Smoski
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC 27710,Address correspondence: , or Dr. Gabriel S. Dichter, Department of Psychiatry, University of North Carolina School of Medicine, CB# 3366, 101 Manning Drive, Chapel Hill, NC 27599-3366
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Arnold JF, Fitzgerald DA, Fernández G, Rijpkema M, Rinck M, Eling PATM, Becker ES, Speckens A, Tendolkar I. Rose or black-coloured glasses? Altered neural processing of positive events during memory formation is a trait marker of depression. J Affect Disord 2011; 131:214-23. [PMID: 21256599 DOI: 10.1016/j.jad.2010.12.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Revised: 12/14/2010] [Accepted: 12/14/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Valence-specific memory enhancement is one of the core cognitive functions that causes and maintains Major Depressive Disorder (MDD). While previous neuroimaging studies have elucidated the neural underpinnings of this emotional enhancement effect in depressed patients, this study aimed at detecting processing biases that are maintained throughout remission while patients were euthymic. METHODS Fourteen medication-free women remitted from unipolar MDD and 14 matched controls were scanned while learning negative, positive, and neutral words, which were subsequently tested with free recall. RESULTS The two groups did not differ in memory performance and showed no neural differences during successful encoding of neutral or negative words. However, during successful encoding of positive words, patients exhibited a larger recruitment of a set of areas, comprising cingulate gyrus, right inferior- and left medial-frontal gyrus as well as the right anterior hippocampus/amygdala. LIMITATIONS Restriction to female participants may limit the generalization of the findings. CONCLUSION Female MDD patients in clinical remission exert greater neural recruitment of memory-related brain regions when successfully encoding positive words, suggesting that neural biases related to memory formation of positive information do not entirely normalize. Further research is needed to establish whether this processing bias during successful memory formation of positive information is predictive for future relapse thereby offering the possibility to develop more focused therapeutic interventions to specifically target these processes.
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Affiliation(s)
- Jennifer F Arnold
- Radboud University Nijmegen Medical Centre, Department of Psychiatry, The Netherlands.
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Holsen LM, Spaeth SB, Lee JH, Ogden LA, Klibanski A, Whitfield-Gabrieli S, Goldstein JM. Stress response circuitry hypoactivation related to hormonal dysfunction in women with major depression. J Affect Disord 2011; 131:379-87. [PMID: 21183223 PMCID: PMC3073153 DOI: 10.1016/j.jad.2010.11.024] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Revised: 11/01/2010] [Accepted: 11/24/2010] [Indexed: 02/05/2023]
Abstract
BACKGROUND Women have approximately twice the risk of major depressive disorder (MDD) than men, yet this difference remains largely unexplained. Previous MDD research suggests high rates of endocrine dysfunction, which may be related to deficits in brain activity in stress response circuitry [hypothalamus, amygdala, hippocampus, anterior cingulate cortex (ACC), orbitofrontal cortex (OFC)]. This functional magnetic resonance imaging (fMRI) study investigated the relationship between hypothalamic-pituitary-gonadal (HPG)-axis hormones and stress response circuitry dysfunction in MDD in women. METHODS During the late follicular/midcycle phase of the menstrual cycle, female participants (10 with extensive histories of MDD, in remission, 10 healthy controls) were scanned while viewing negative and neutral arousal pictures. Group differences in blood oxygen-level dependent (BOLD) signal changes were analyzed using SPM2. Baseline gonadal hormones included estradiol, progesterone, and testosterone. RESULTS fMRI results showed greater BOLD signal intensity changes in controls versus MDD in hypothalamus, amygdala, hippocampus, OFC, ACC, and subgenual ACC, findings unrelated to medication status. MDD women had a lower serum estradiol and higher serum progesterone compared to controls. Hypoactivations in hypothalamus, subgenual ACC, amygdala and OFC in MDD were associated with low estradiol and high progesterone. LIMITATIONS Generalizability of our findings is limited by small sample size and restriction to females, although this did not affect the internal validity of the results. CONCLUSIONS Hypoactivation of the stress response circuitry in MDD women is associated with dysregulation of the HPG-axis. Associations between brain activity deficits and hormonal disruption in MDD may ultimately contribute to understanding sex differences in MDD.
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Affiliation(s)
- Laura M. Holsen
- Harvard Medical School, Departments of Psychiatry and Medicine, Brigham and Women's Hospital, Connors Center for Women's Health and Gender Biology,Massachusetts General Hospital & Massachusetts Institute of Technology, Athinoula Martinos Center for Biomedical Imaging
| | - Sarah B. Spaeth
- Harvard Medical School, Departments of Psychiatry and Medicine, Brigham and Women's Hospital, Connors Center for Women's Health and Gender Biology,Massachusetts General Hospital & Massachusetts Institute of Technology, Athinoula Martinos Center for Biomedical Imaging
| | - Jong-Hwan Lee
- Harvard Medical School, Department of Radiology, Brigham and Women's Hospital
| | - Lauren A. Ogden
- Harvard Medical School, Departments of Psychiatry and Medicine, Brigham and Women's Hospital, Connors Center for Women's Health and Gender Biology,Massachusetts General Hospital & Massachusetts Institute of Technology, Athinoula Martinos Center for Biomedical Imaging
| | - Anne Klibanski
- Harvard Medical School, Department of Medicine, Massachusetts General Hospital
| | - Susan Whitfield-Gabrieli
- Massachusetts General Hospital & Massachusetts Institute of Technology, Athinoula Martinos Center for Biomedical Imaging,Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
| | - Jill M. Goldstein
- Harvard Medical School, Departments of Psychiatry and Medicine, Brigham and Women's Hospital, Connors Center for Women's Health and Gender Biology,Massachusetts General Hospital & Massachusetts Institute of Technology, Athinoula Martinos Center for Biomedical Imaging,Corresponding author: Jill M. Goldstein, Ph.D.; Brigham and Women’s Hospital, Division of Women’s Health; One Brigham Circle; 1620 Tremont St., Boston, MA 02120; Phone: 617-525-7517; Fax: 617-525-7746;
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Senhorini MCT, Cerqueira CT, Schaufelberger MS, Almeida JC, Amaro E, Sato JR, Barreiros MAM, Ayres AM, Castro CC, Scazufca M, Menezes PR, Busatto GF. Brain activity patterns during phonological verbal fluency performance with varying levels of difficulty: A functional magnetic resonance imaging study in Portuguese-speaking healthy individuals. J Clin Exp Neuropsychol 2011; 33:864-73. [DOI: 10.1080/13803395.2011.561299] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | | | - Jorge C. Almeida
- a Department of Psychiatry , University of São Paulo , São Paulo, Brazil
| | - Edson Amaro
- b Institute of Radiology, University of São Paulo , São Paulo, Brazil
| | - João R. Sato
- b Institute of Radiology, University of São Paulo , São Paulo, Brazil
| | | | - Adriana M. Ayres
- a Department of Psychiatry , University of São Paulo , São Paulo, Brazil
| | - Cláudio C. Castro
- c Section of Magnetic Resonance, Heart Institute, University of São Paulo , São Paulo, Brazil
| | - Márcia Scazufca
- a Department of Psychiatry , University of São Paulo , São Paulo, Brazil
| | - Paulo R. Menezes
- d Department of Preventive Medicine , University of São Paulo , São Paulo, Brazil
| | - Geraldo F. Busatto
- a Department of Psychiatry , University of São Paulo , São Paulo, Brazil
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Gruber O, Zilles D, Kennel J, Gruber E, Falkai P. A systematic experimental neuropsychological investigation of the functional integrity of working memory circuits in major depression. Eur Arch Psychiatry Clin Neurosci 2011; 261:179-84. [PMID: 21063718 PMCID: PMC3071944 DOI: 10.1007/s00406-010-0165-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Accepted: 10/25/2010] [Indexed: 01/21/2023]
Abstract
Verbal and visuospatial working memory (WM) impairment is a well-documented finding in psychiatric patients suffering from major psychoses such as schizophrenia or bipolar affective disorder. However, in major depression (MDD) the literature on the presence and the extent of WM deficits is inconsistent. The use of a multitude of different WM tasks most of which lack process-specificity may have contributed to these inconsistencies. Eighteen MDD patients and 18 healthy controls matched with regard to age, gender and education were tested using process- and circuit-specific WM tasks for which clear brain-behaviour relationships had been established in prior functional neuroimaging studies. Patients suffering from acute MDD showed a selective impairment in articulatory rehearsal of verbal information in working memory. By contrast, visuospatial WM was unimpaired in this sample. There were no significant correlations between symptom severity and WM performance. These data indicate a dysfunction of a specific verbal WM system in acutely ill patients with MDD. As the observed functional deficit did not correlate with different symptom scores, further, longitudinal studies are required to clarify whether and how this deficit is related to illness acuity and clinical state of MDD patients.
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Affiliation(s)
- Oliver Gruber
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry, University Medical Centre, Georg August University, Goettingen, Germany.
| | - David Zilles
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry, University Medical Centre, Georg August University, Goettingen, Germany
| | - Jennifer Kennel
- Department of Psychiatry and Psychotherapy, Saarland University Hospital, Homburg, Germany
| | - Eva Gruber
- Department of Psychiatry and Psychotherapy, Saarland University Hospital, Homburg, Germany
| | - Peter Falkai
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry, University Medical Centre, Georg August University, Goettingen, Germany
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