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Hird EJ, Slanina-Davies A, Lewis G, Hamer M, Roiser JP. From movement to motivation: a proposed framework to understand the antidepressant effect of exercise. Transl Psychiatry 2024; 14:273. [PMID: 38961071 PMCID: PMC11222551 DOI: 10.1038/s41398-024-02922-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 03/28/2024] [Accepted: 05/10/2024] [Indexed: 07/05/2024] Open
Abstract
Depression is the leading cause of disability worldwide, exerting a profound negative impact on quality of life in those who experience it. Depression is associated with disruptions to several closely related neural and cognitive processes, including dopamine transmission, fronto-striatal brain activity and connectivity, reward processing and motivation. Physical activity, especially aerobic exercise, reduces depressive symptoms, but the mechanisms driving its antidepressant effects are poorly understood. Here we propose a novel hypothesis for understanding the antidepressant effects of exercise, centred on motivation, across different levels of explanation. There is robust evidence that aerobic exercise decreases systemic inflammation. Inflammation is known to reduce dopamine transmission, which in turn is strongly implicated in effort-based decision making for reward. Drawing on a broad range of research in humans and animals, we propose that by reducing inflammation and boosting dopamine transmission, with consequent effects on effort-based decision making for reward, exercise initially specifically improves 'interest-activity' symptoms of depression-namely anhedonia, fatigue and subjective cognitive impairment - by increasing propensity to exert effort. Extending this framework to the topic of cognitive control, we explain how cognitive impairment in depression may also be conceptualised through an effort-based decision-making framework, which may help to explain the impact of exercise on cognitive impairment. Understanding the mechanisms underlying the antidepressant effects of exercise could inform the development of novel intervention strategies, in particular personalised interventions and boost social prescribing.
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Affiliation(s)
- E J Hird
- Institute of Cognitive Neuroscience, University College London, London, UK.
| | - A Slanina-Davies
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - G Lewis
- Division of Psychiatry, University College London, London, UK
| | - M Hamer
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - J P Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
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Leonards CA, Harrison BJ, Jamieson AJ, Agathos J, Steward T, Davey CG. Altered task-related decoupling of the rostral anterior cingulate cortex in depression. Neuroimage Clin 2024; 41:103564. [PMID: 38218081 PMCID: PMC10821626 DOI: 10.1016/j.nicl.2024.103564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/08/2023] [Accepted: 01/07/2024] [Indexed: 01/15/2024]
Abstract
Dysfunctional activity of the rostral anterior cingulate cortex (rACC) - an extensively connected hub region of the default mode network - has been broadly linked to cognitive and affective impairments in depression. However, the nature of aberrant task-related rACC suppression in depression is incompletely understood. In this study, we sought to characterize functional connectivity of rACC activity suppression ('deactivation') - an essential feature of rACC function - during external task engagement in depression. Specifically, we aimed to explore neural patterns of functional decoupling and coupling with the rACC during its task-driven suppression. We enrolled 81 15- to 25-year-old young people with moderate-to-severe major depressive disorder (MDD) before they commenced a 12-week clinical trial that assessed the effectiveness of cognitive behavioral therapy plus either fluoxetine or placebo. Ninety-four matched healthy controls were also recruited. Participants completed a functional magnetic resonance imaging face matching task known to elicit rACC suppression. To identify brain regions associated with the rACC during its task-driven suppression, we employed a seed-based functional connectivity analysis. We found MDD participants, compared to controls, showed significantly reduced 'decoupling' of the rACC with extended task-specific regions during task performance. Specifically, less decoupling was observed in the occipital and fusiform gyrus, dorsal ACC, medial prefrontal cortex, cuneus, amygdala, thalamus, and hippocampus. Notably, impaired decoupling was apparent in participants who did not remit to treatment, but not treatment remitters. Further, we found MDD participants showed significant increased coupling with the anterior insula cortex during task engagement. Our findings indicate that aberrant task-related rACC suppression is associated with disruptions in adaptive neural communication and dynamic switching between internal and external cognitive modes that may underpin maladaptive cognitions and biased emotional processing in depression.
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Affiliation(s)
- Christine A Leonards
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | - Ben J Harrison
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | - Alec J Jamieson
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | - James Agathos
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | - Trevor Steward
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Christopher G Davey
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia.
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Prolonged Longitudinal Transcutaneous Auricular Vagus Nerve Stimulation Effect on Striatal Functional Connectivity in Patients with Major Depressive Disorder. Brain Sci 2022; 12:brainsci12121730. [PMID: 36552189 PMCID: PMC9776392 DOI: 10.3390/brainsci12121730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/11/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Transcutaneous auricular vagus nerve stimulation (taVNS) is effective for treating major depressive disorder (MDD). We aimed to explore the modulating effect of prolonged longitudinal taVNS on the striatal subregions' functional connectivity (FC) in MDD patients. METHODS Sixteen MDD patients were enrolled and treated with taVNS for 8 weeks. Sixteen healthy control subjects (HCs) were recruited without intervention. The resting-state FC (rsFC) based on striatal subregion seed points and the Hamilton Depression Scale (HAMD) were evaluated in the MDD patients and HCs at baseline and after 8 weeks. A two-way ANCOVA test was performed on each rsFC metric to obtain the (group-by-time) interactions. RESULTS The rsFC values between the left ventral caudate (vCa) and right ventral prefrontal cortex (vPFC), and between the right nucleus accumbens (NAc) and right dorsal medial prefrontal cortex (dmPFC) and ventrolateral prefrontal cortex (vlPFC) are lower in the MDD patients compared to the HCs at baseline, and increase following taVNS; the rsFC values between the left vCa and right, superior occipital gyrus (SOG), and between the left dorsal caudate (dCa) and right cuneus are higher in MDD patients and decrease following taVNS. CONCLUSIONS Prolonged longitudinal taVNS can modulate the striatum rsFC with the prefrontal cortex, occipital cortex, temporal cortex, and intra-striatum, and these changes partly underlie any symptomatic improvements. The results indicate that prolonged longitudinal taVNS may produce beneficial treatment effects by modulating the cortical striatum circuitry in patients with MDD.
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Huang H, Wang J, Jiang CQ, Zhu F, Jin YL, Zhu T, Zhang WS, Xu L. Hearing loss and depressive symptoms in older Chinese: whether social isolation plays a role. BMC Geriatr 2022; 22:620. [PMID: 35883170 PMCID: PMC9316428 DOI: 10.1186/s12877-022-03311-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background Existing evidence links hearing loss to depressive symptoms, with the extent of association and underlying mechanisms remaining inconclusive. We conducted a cross-sectional study to examine the association of hearing loss with depressive symptoms and explored whether social isolation mediated the association. Methods Eight thousand nine hundred sixty-two participants from Guangzhou Biobank Cohort Study were included. Data on self-reported hearing status, the 15-item Geriatric Depression Scale (GDS-15), social isolation and potential confounders were collected by face-to-face interview. Results The mean (standard deviation) age of participants was 60.2 (7.8) years. The prevalence of poor and fair hearing was 6.8% and 60.8%, respectively. After adjusting for age, sex, household income, education, occupation, smoking, alcohol use, self-rated health, comorbidities, compared with participants who had normal hearing, those with poor hearing (β = 0.74, 95% confidence interval (CI) 0.54, 0.94) and fair hearing (β = 0.59, 95% CI 0.48, 0.69) had higher scores of GDS-15. After similar adjustment, those with poor hearing (odds ratio (OR) = 2.13, 95% CI 1.65, 2.74) or fair hearing (OR = 1.68, 95% CI 1.43, 1.99) also showed higher odds of depressive symptoms. The association of poor and fair hearing with depressive symptoms attenuated slightly but not substantially after additionally adjusting for social isolation. In the mediation analysis, the adjusted proportion of the association mediated through social isolation was 9% (95% CI: 6%, 22%). Conclusion Poor hearing was associated with a higher risk of depressive symptoms, which was only partly mediated by social isolation. Further investigation of the underlying mechanisms is warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03311-0.
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Affiliation(s)
- Hao Huang
- School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan 2ndRoad, Guangzhou, Guangdong Province, China
| | - Jiao Wang
- School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan 2ndRoad, Guangzhou, Guangdong Province, China
| | | | - Feng Zhu
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Ya Li Jin
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Tong Zhu
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Wei Sen Zhang
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China.
| | - Lin Xu
- School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan 2ndRoad, Guangzhou, Guangdong Province, China. .,School of Public Health, the University of Hong Kong, Hong Kong, China.
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Rosenberg BM, Taschereau-Dumouchel V, Lau H, Young KS, Nusslock R, Zinbarg RE, Craske MG. A Multivoxel Pattern Analysis of Anhedonia During Fear Extinction: Implications for Safety Learning. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 8:417-425. [PMID: 34954395 DOI: 10.1016/j.bpsc.2021.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/01/2021] [Accepted: 12/09/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Pavlovian learning processes are central to the etiology and treatment of anxiety disorders. Anhedonia and related perturbations in reward processes have been implicated in Pavlovian learning. Associations between anhedonia symptoms and neural indices of Pavlovian learning can inform transdiagnostic associations among depressive and anxiety disorders. METHODS Participants ages 18 to 19 years (67% female) completed a fear extinction (n = 254) and recall (n = 249) paradigm during functional magnetic resonance imaging. Symptom dimensions of general distress (common to anxiety and depression), fears (more specific to anxiety), and anhedonia-apprehension (more specific to depression) were evaluated. We trained whole-brain multivoxel pattern decoders for anhedonia-apprehension during extinction and extinction recall and tested the decoders' ability to predict anhedonia-apprehension in an external validation sample. Specificity analyses examined effects covarying for general distress and fears. Decoding was repeated within canonical brain networks to highlight candidate neurocircuitry underlying whole-brain effects. RESULTS Whole-brain decoder training succeeded during both tasks. Prediction of anhedonia-apprehension in the external validation sample was successful for extinction (R2 = 0.047; r = 0.276, p = .002) but not extinction recall (R2 < 0.001, r = -0.063, p = .492). The extinction decoder remained significantly associated with anhedonia-apprehension covarying for fears and general distress (t121 = 3.209, p = .002). Exploratory results highlighted activity in the cognitive control, default mode, limbic, salience, and visual networks related to these effects. CONCLUSIONS Results suggest that patterns of brain activity during extinction, particularly in the cognitive control, default mode, limbic, salience, and visual networks, can be predictive of anhedonia symptoms. Future research should examine associations between anhedonia and extinction, including studies of exposure therapy or positive affect treatments among anhedonic individuals.
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Affiliation(s)
- Benjamin M Rosenberg
- Department of Psychology, College of Life Sciences, University of California, Los Angeles, Los Angeles, California.
| | - Vincent Taschereau-Dumouchel
- Department of Psychiatry and Addictology, University of Montréal, Montreal, Quebec, Canada; Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada
| | - Hakwan Lau
- RIKEN Center for Brain Science, Saitama, Japan
| | - Katherine S Young
- Social, Genetic and Development Psychiatry Centre, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom; National Institute for Health Research Maudsley Biomedical Research Centre, King's College London, London, United Kingdom
| | - Robin Nusslock
- Department of Psychology, Northwestern University, Evanston, Illinois; Institute for Policy Research, Northwestern University, Evanston, Illinois
| | - Richard E Zinbarg
- Department of Psychology, Northwestern University, Evanston, Illinois; Family Institute at Northwestern University, Northwestern University, Evanston, Illinois
| | - Michelle G Craske
- Department of Psychology, College of Life Sciences, University of California, Los Angeles, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
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Wang X, Liu W, Wang X, Mu Z, Xu J, Chang Y, Zhang Q, Wu J, Cong F. Shared and Unshared Feature Extraction in Major Depression During Music Listening Using Constrained Tensor Factorization. Front Hum Neurosci 2021; 15:799288. [PMID: 34975439 PMCID: PMC8714749 DOI: 10.3389/fnhum.2021.799288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Ongoing electroencephalography (EEG) signals are recorded as a mixture of stimulus-elicited EEG, spontaneous EEG and noises, which poses a huge challenge to current data analyzing techniques, especially when different groups of participants are expected to have common or highly correlated brain activities and some individual dynamics. In this study, we proposed a data-driven shared and unshared feature extraction framework based on nonnegative and coupled tensor factorization, which aims to conduct group-level analysis for the EEG signals from major depression disorder (MDD) patients and healthy controls (HC) when freely listening to music. Constrained tensor factorization not only preserves the multilinear structure of the data, but also considers the common and individual components between the data. The proposed framework, combined with music information retrieval, correlation analysis, and hierarchical clustering, facilitated the simultaneous extraction of shared and unshared spatio-temporal-spectral feature patterns between/in MDD and HC groups. Finally, we obtained two shared feature patterns between MDD and HC groups, and obtained totally three individual feature patterns from HC and MDD groups. The results showed that the MDD and HC groups triggered similar brain dynamics when listening to music, but at the same time, MDD patients also brought some changes in brain oscillatory network characteristics along with music perception. These changes may provide some basis for the clinical diagnosis and the treatment of MDD patients.
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Affiliation(s)
- Xiulin Wang
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
- School of Biomedical Engineering, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian, China
| | - Wenya Liu
- School of Biomedical Engineering, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian, China
- Faculty of Information Technology, University of Jyväskylä, Jyvaskyla, Finland
| | - Xiaoyu Wang
- School of Biomedical Engineering, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian, China
| | - Zhen Mu
- Department of Psychology, College of Humanities and Social Sciences, Dalian Medical University, Dalian, China
| | - Jing Xu
- Department of Neurology and Psychiatry, First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Yi Chang
- Department of Neurology and Psychiatry, First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Qing Zhang
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Jianlin Wu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Fengyu Cong
- School of Biomedical Engineering, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian, China
- Faculty of Information Technology, University of Jyväskylä, Jyvaskyla, Finland
- School of Artificial Intelligence, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian, China
- Key Laboratory of Integrated Circuit and Biomedical Electronic System, Dalian University of Technology, Dalian, China
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7
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Miller JG, Ho TC, Kirshenbaum JS, Chahal R, Gifuni AJ, Gotlib IH. Testing a Developmental Model of Positive Parenting, Amygdala–Subgenual Anterior Cingulate Cortex Connectivity, and Depressive Symptoms in Adolescents Before and During the COVID-19 Pandemic. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:291-299. [PMID: 36325504 PMCID: PMC9616303 DOI: 10.1016/j.bpsgos.2021.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 12/17/2022] Open
Abstract
Background Neurobiological measures may inform our understanding of individual differences in adolescents’ general risk for and resilience to depressive symptoms, including during the COVID-19 pandemic. We tested a developmental model linking variation in amygdala–subgenual anterior cingulate cortex (sgACC) resting-state connectivity to perceived parenting experiences earlier in adolescence, to concurrent depressive symptoms before the pandemic, and to subsequent depressive symptoms during the pandemic. Methods We used data from a longitudinal study that included three waves (N = 214 adolescents; ages 9–15 years at time 1 [T1], 11–17 years at T2, and 12–19 years during the pandemic at T3). We assessed positive parenting (warm and supportive) (T1), depressive symptoms (T1 to T3), and functional connectivity between the sgACC and basolateral (BLA) and centromedial amygdala (T1 and T2). We modeled associations among earlier positive parenting, amygdala–sgACC connectivity, and depressive symptoms before and during the pandemic. Results Less positive parenting at T1 was associated prospectively with stronger BLA–sgACC connectivity at T2 (β = −0.22) over and above the effect of BLA–sgACC connectivity at T1. Stronger BLA–sgACC connectivity, in turn, was associated with heightened depressive symptoms, both before the pandemic (r = 0.21) and during the pandemic (β = 0.19; independent of the effect of pre-pandemic symptoms). Conclusions Adolescents who experience less positive parenting may develop a pattern of BLA–sgACC connectivity that increases their risk for mental health problems. BLA–sgACC connectivity may be associated with depressive symptoms in general, including during periods of heightened risk for adolescents, such as the pandemic.
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Affiliation(s)
- Jonas G. Miller
- Department of Psychology, Stanford University, Stanford, California
- Address correspondence to Jonas G. Miller, Ph.D.
| | - Tiffany C. Ho
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | | | - Rajpreet Chahal
- Department of Psychology, Stanford University, Stanford, California
| | - Anthony J. Gifuni
- Department of Psychology, Stanford University, Stanford, California
- Psychiatry Department, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Ian H. Gotlib
- Department of Psychology, Stanford University, Stanford, California
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Lee ES, Youn H, Hyung WSW, Suh S, Han CE, Eo JS, Jeong HG. The effects of cerebral amyloidopathy on regional glucose metabolism in older adults with depression and mild cognitive impairment while performing memory tasks. Eur J Neurosci 2021; 54:6663-6672. [PMID: 34528336 DOI: 10.1111/ejn.15461] [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: 06/22/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022]
Abstract
Co-occurring depression and mild cognitive impairment (MCI) in older adults are important because they have a high risk of conversion to dementia. In the present study, task-related F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) was used to analyse older adults with concomitant depression and MCI. We recruited 20 older adults with simultaneous depression and MCI and 10 older adults with normal cognition (NC). The Verbal Paired Associates test and digit span test were used for the task-related FDG-PET. The 20 older adults with depression and MCI were classified into two groups based on the F-18 florbetaben PET results: depressed MCI patients with (LLD-MCI-A[+]; n = 11) and without amyloid accumulation (LLD-MCI-A[-]; n = 9). Reduced regional cerebral glucose metabolism (rCMglc) in the left superior frontal region was observed in the LLD-MCI-A(-) group compared with the NC group. Analyses of the NC and LLD-MCI-A(+) groups showed significantly decreased rCMglc in the right inferior parietal and left middle frontal regions in the LLD-MCI-A(+) group. rCMglc in the left precuneus was lower in the LLD-MCI-A(+) group than in the LLD-MCI-A(-) group. Significant correlations between the rCMglc in the right inferior parietal/left precuneus regions and memory task scores were observed based on correlation analyses of NC and LLD-MCI-A(+) groups. The findings in the present study indicate the presence of amyloid accumulation influences glucose metabolism in depressed elderly subjects with MCI while performing cognitive tasks. Task-related FDG-PET examinations may help differentiate MCI associated with depression from comorbid depression in patients with prodromal Alzheimer's disease.
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Affiliation(s)
- Eun Seong Lee
- Department of Nuclear Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - HyunChul Youn
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | | | - Sangil Suh
- Department of Radiology, Korea University Guro Hospital, Seoul, South Korea
| | - Cheol E Han
- Department of Electronics and Information Engineering, Korea University, Sejong, South Korea
| | - Jae Seon Eo
- Department of Nuclear Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Seoul, South Korea.,Korea University Research Institute of Mental Health, Seoul, South Korea
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LeMoult J. From Stress to Depression: Bringing Together Cognitive and Biological Science. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2020; 29:592-598. [PMID: 33343103 PMCID: PMC7727022 DOI: 10.1177/0963721420964039] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
One of the most consistent findings in the depression literature is that stressful life events predict the onset and course of depressive episodes. Cognitive and biological responses to life stressors have both been identified, albeit largely independently, as central to understanding the association between stress and depression. I maintain that the largest advances in the understanding of depression will come from examining the ways that cognitive and biological responses to stressors reciprocally influence one another and, in doing so, contribute to the onset and maintenance of depression. I summarize the cognitive and biological stress responses implicated in depression and then describe the reciprocal ways that they are associated with each other. Finally, I discuss the broader implications of taking this integrated approach and suggest directions and considerations for future research.
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Affiliation(s)
- Joelle LeMoult
- Department of Psychology, University of British Columbia
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10
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Chen Y, Chen T, Cai X. Light-sensitive circuits related to emotional processing underlie the antidepressant neural targets of light therapy. Behav Brain Res 2020; 396:112862. [PMID: 32827569 DOI: 10.1016/j.bbr.2020.112862] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/13/2020] [Accepted: 08/11/2020] [Indexed: 02/05/2023]
Abstract
Since Aaron Beck proposed his cognitive model of depression, biased attention, biased processing, and biased rumination (different phases of biased cognition) have been considered as the key elements consistently linked with depression. Increasing evidence suggests that the functional failures in the "emotional processing system (EPS)" underlie the neurological foundation of the biased cognition of depression. Light therapy, a non-intrusive approach, exerts powerful effects on emotion and cognition and affects the activity, functional connectivity, and plasticity of multiple brain structures. Although numerous studies have reported its effectiveness in treating depression, the findings have not been integrated with Beck's cognitive model and EPS, and the neurobiological mechanisms of antidepressant light therapy remain largely unknown. In this review, integrated with the classical theories of Beck's cognitive model of depression and EPS, we identified the key neural circuits and abnormalities involved in the cognitive bias of depression and, accordingly, identified and depicted several light-sensitive circuits (LSCs, neural circuits in the EPS that are responsive to light stimulation) that may underlie the antidepressant neural targets of light therapy, as listed below: In summary, the LSCs above narrow down the research scope of identifying the neural targets of antidepressant light therapy and help elucidate the neuropsychological mechanism of antidepressant light therapy.
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Affiliation(s)
- Yaodong Chen
- School of Architecture and Design, Southwest JiaoTong University, Chengdu, China.
| | - Taolin Chen
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xueli Cai
- School of Architecture and Design, Southwest JiaoTong University, Chengdu, China
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11
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Scharnowski F, Nicholson AA, Pichon S, Rosa MJ, Rey G, Eickhoff SB, Van De Ville D, Vuilleumier P, Koush Y. The role of the subgenual anterior cingulate cortex in dorsomedial prefrontal-amygdala neural circuitry during positive-social emotion regulation. Hum Brain Mapp 2020; 41:3100-3118. [PMID: 32309893 PMCID: PMC7336138 DOI: 10.1002/hbm.25001] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 01/10/2023] Open
Abstract
Positive-social emotions mediate one's cognitive performance, mood, well-being, and social bonds, and represent a critical variable within therapeutic settings. It has been shown that the upregulation of positive emotions in social situations is associated with increased top-down signals that stem from the prefrontal cortices (PFC) which modulate bottom-up emotional responses in the amygdala. However, it remains unclear if positive-social emotion upregulation of the amygdala occurs directly through the dorsomedial PFC (dmPFC) or indirectly linking the bilateral amygdala with the dmPFC via the subgenual anterior cingulate cortex (sgACC), an area which typically serves as a gatekeeper between cognitive and emotion networks. We performed functional MRI (fMRI) experiments with and without effortful positive-social emotion upregulation to demonstrate the functional architecture of a network involving the amygdala, the dmPFC, and the sgACC. We found that effortful positive-social emotion upregulation was associated with an increase in top-down connectivity from the dmPFC on the amygdala via both direct and indirect connections with the sgACC. Conversely, we found that emotion processes without effortful regulation increased network modulation by the sgACC and amygdala. We also found that more anxious individuals with a greater tendency to suppress emotions and intrusive thoughts, were likely to display decreased amygdala, dmPFC, and sgACC activity and stronger connectivity strength from the sgACC onto the left amygdala during effortful emotion upregulation. Analyzed brain network suggests a more general role of the sgACC in cognitive control and sheds light on neurobiological informed treatment interventions.
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Affiliation(s)
- Frank Scharnowski
- Department of Cognition, Emotion and Methods in Psychology, Faculty of PsychologyUniversity of ViennaViennaAustria
- Department of Psychiatry, Psychotherapy and PsychosomaticsPsychiatric Hospital, University of ZürichZürichSwitzerland
- Neuroscience Center ZürichUniversity of Zürich and Swiss Federal Institute of TechnologyZürichSwitzerland
- Zürich Center for Integrative Human Physiology (ZIHP)University of ZürichZürichSwitzerland
| | - Andrew A. Nicholson
- Department of Cognition, Emotion and Methods in Psychology, Faculty of PsychologyUniversity of ViennaViennaAustria
| | - Swann Pichon
- Geneva Neuroscience Center, Department of NeuroscienceUniversity of GenevaGenevaSwitzerland
- NCCR Affective SciencesUniversity of GenevaGenevaSwitzerland
- Faculty of Psychology and Educational ScienceUniversity of GenevaGenevaSwitzerland
| | - Maria J. Rosa
- Department of Computer ScienceCentre for Computational Statistics and Machine Learning, University College LondonLondonUK
| | - Gwladys Rey
- Geneva Neuroscience Center, Department of NeuroscienceUniversity of GenevaGenevaSwitzerland
- Institute of BioengineeringEcole Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
| | - Simon B. Eickhoff
- Institute of Neuroscience and MedicineBrain & Behaviour (INM‐7), Research Center JülichJülichGermany
- Institute of Systems Neuroscience, Medical FacultyHeinrich Heine University DüsseldorfDüsseldorfGermany
| | - Dimitri Van De Ville
- Department of Radiology and Medical InformaticsUniversity of GenevaGenevaSwitzerland
- Institute of BioengineeringEcole Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
| | - Patrik Vuilleumier
- Geneva Neuroscience Center, Department of NeuroscienceUniversity of GenevaGenevaSwitzerland
- NCCR Affective SciencesUniversity of GenevaGenevaSwitzerland
| | - Yury Koush
- Department of Radiology and Biomedical ImagingYale UniversityNew HavenConnecticutUSA
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12
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Reis JC, Travado L, Antoni MH, Oliveira FPM, Almeida SD, Almeida P, Heller AS, Sousa B, Costa DC. Negative affect and stress-related brain metabolism in patients with metastatic breast cancer. Cancer 2020; 126:3122-3131. [PMID: 32286691 DOI: 10.1002/cncr.32902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/25/2020] [Accepted: 03/20/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cancer and its treatment represent major stressors requiring that patients make multiple adaptations. Despite evidence that poor adaptation to stressors is associated with more distress and negative affect (NA), neuroimmune dysregulation and poorer health outcomes, current understanding is very limited of how NA covaries with central nervous system changes to account for these associations. METHODS NA was correlated with brain metabolic activity using 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) in several regions of interest in 61 women with metastatic breast cancer. Patients underwent 18 F-FDG PET/CT and completed an assessment of NA using the Brief Symptom Inventory. RESULTS Regression analyses revealed that NA was significantly negatively correlated with the standardized uptake value ratio of the insula, thalamus, hypothalamus, ventromedial prefrontal cortex, and lateral prefrontal cortex. Voxel-wise correlation analyses within these 5 regions of interest demonstrated high left-right symmetry and the highest NA correlations with the anterior insula, thalamus (medial and ventral portion), lateral prefrontal cortex (right Brodmann area 9 [BA9], left BA45, and right and left BA10 and BA8), and ventromedial prefrontal cortex (bilateral BA11). CONCLUSIONS The regions of interest most strongly negatively associated with NA represent key areas for successful adaptation to stressors and may be particularly relevant in patients with metastatic breast cancer who are dealing with multiple challenges of cancer and its treatment.
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Affiliation(s)
- Joaquim C Reis
- Institute of Biophysics and Biomedical Engineering, Faculty of Science, University of Lisbon, Lisbon, Portugal
| | - Luzia Travado
- Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
| | - Michael H Antoni
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Department of Psychology and Cancer Control Program, Miami, Florida
| | - Francisco P M Oliveira
- Nuclear Medicine-Radiopharmacology, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
| | - Silvia D Almeida
- Institute of Biophysics and Biomedical Engineering, Faculty of Science, University of Lisbon, Lisbon, Portugal
| | - Pedro Almeida
- Institute of Biophysics and Biomedical Engineering, Faculty of Science, University of Lisbon, Lisbon, Portugal
| | - Aaron S Heller
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Department of Psychology and Cancer Control Program, Miami, Florida
| | - Berta Sousa
- Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
| | - Durval C Costa
- Nuclear Medicine-Radiopharmacology, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
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13
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Zhu Y, Jayagopal JK, Mehta RK, Erraguntla M, Nuamah J, McDonald AD, Taylor H, Chang SH. Classifying Major Depressive Disorder Using fNIRS During Motor Rehabilitation. IEEE Trans Neural Syst Rehabil Eng 2020; 28:961-969. [DOI: 10.1109/tnsre.2020.2972270] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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14
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Emotional distress, brain functioning, and biobehavioral processes in cancer patients: a neuroimaging review and future directions. CNS Spectr 2020; 25:79-100. [PMID: 31010446 DOI: 10.1017/s1092852918001621] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Despite emerging evidence that distress and adversity can contribute to negative health outcomes in cancer, little is known about the brain networks, regions, or circuits that can contribute to individual differences in affect/distress states and health outcomes in treated cancer patients. To understand the state-of-the-science in this regard, we reviewed neuroimaging studies with cancer patients that examined the associations between negative affect (distress) and changes in the metabolism or structure of brain regions. Cancer patients showed changes in function and/or structure of key brain regions such as the prefrontal cortex, thalamus, amygdala, hippocampus, cingulate cortex (mainly subgenual area), hypothalamus, basal ganglia (striatum and caudate), and insula, which are associated with greater anxiety, depression, posttraumatic stress disorder (PTSD) symptoms, and distress. These results provide insights for understanding the effects of these psychological and emotional factors on peripheral stress-related biobehavioral pathways known to contribute to cancer progression and long-term health outcomes. This line of work provides leads for understanding the brain-mediated mechanisms that may explain the health effects of psychosocial interventions in cancer patients and survivors. A multilevel and integrated model for distress management intervention effects on psychological adaptation, biobehavioral processes, cancer pathogenesis, and clinical outcomes is proposed for future research.
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15
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Youn H, Lee S, Han C, Kim SH, Jeong HG. Association between brain amyloid accumulation and neuropsychological characteristics in elders with depression and mild cognitive impairment. Int J Geriatr Psychiatry 2019; 34:1907-1915. [PMID: 31489705 DOI: 10.1002/gps.5209] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 08/31/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To investigate the presence of cerebral amyloidopathy and its associations with performances on neurocognitive tests and clinical features in depressed elders with mild cognitive impairment (MCI). METHODS/DESIGN In total, 94 older adults with concomitant MCI and some depressive symptoms were included in this study. Cerebral amyloidopathy was evaluated using 18 F-florbetaben-positron emission tomography. A standardized neurocognitive test battery and brain magnetic resonance imaging (MRI) were administered to all subjects. We examined the Apolipoprotein E genotype using a polymerase chain reaction-based method. RESULTS Among the 94 initial participants, seven participants were excluded because of failure to undergo MRI or complete the neuropsychological battery. Among 87 subjects, 45 elders (51.7%) had cerebral amyloidopathy and were classified as the concomitant depression and MCI with cerebral amyloid-accumulation-positive (CDAP) group; others were classified as the concomitant depression and MCI with cerebral amyloid-accumulation-negative (CDAN) group. Poorer performances on word list recall and constructional recall were observed in the CDAP group than in the CDAN group. CONCLUSIONS The results indicate that around half of older adults with concomitant MCI and some depressive symptoms might be prone to have Alzheimer dementia. Results of neurocognitive tests possibly aid in discerning the presence of cerebral amyloidopathy.
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Affiliation(s)
- HyunChul Youn
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Suji Lee
- Department of Biomedical Sciences, Korea University Graduate School, Seoul, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Seung-Hyun Kim
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.,Korea University Research Institute of Mental Health, Republic of Korea
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16
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Xiong G, Dong D, Cheng C, Jiang Y, Sun X, He J, Li C, Gao Y, Zhong X, Zhao H, Wang X, Yao S. State-independent and -dependent structural alterations in limbic-cortical regions in patients with current and remitted depression. J Affect Disord 2019; 258:1-10. [PMID: 31382099 DOI: 10.1016/j.jad.2019.07.065] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 07/24/2019] [Accepted: 07/29/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND The high recurrence of major depressive disorder (MDD) may derive from underlying state-independent structural alterations. METHODS First-episode drug-naïve currently depressed (cMDD) patients (N = 97), remitted depressed (RD) patients (N = 72), and healthy controls (HCs, N = 100) underwent structural magnetic resonance imaging (MRI). Group differences in cortical thickness (CT), surface area (SA), and local gyrification index (lGI) were analyzed in FreeSurfer. RESULTS Both groups of depressed patients had significantly decreased CT, relative to HCs, in the left precentral gyrus and significantly increased lGI values in the left superior frontal gyrus (SFG) indicative of state-independent alterations. Relative to HCs, the cMDD group had decreased CT of the SFG, caudal middle frontal gyrus (MFG), posterior cingulate cortex (PCC), and lateral occipital regions as well as increased SA or lGI of the superior temporal gyrus, precuneus, and pericalcarine, whereas the RD group had increased SA or lGI of the SFG, caudal MFG, and supramarginal gyrus; these alterations appeared to be state-dependent. SA or lGI values of the fusiform gyrus, inferior temporal gyrus, and superior parietal lobule differed between the cMDD and RD groups, consistent with state-dependent alterations. Beck depression inventory scores correlated with CT or lGI values of the caudal MFG, lateral occipital cortex in depressed patients. LIMITATIONS The structural features of several subcortical limbic regions were not analyzed. CONCLUSIONS Left precentral gyrus CT and left SFG gyrification alterations may represent state-independent alterations in MDD.
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Affiliation(s)
- Ge Xiong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China
| | - Daifeng Dong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China
| | - Chang Cheng
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China
| | - Yali Jiang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China
| | - Xiaoqiang Sun
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China
| | - Jiayue He
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China
| | - Chuting Li
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China; China National Clinical Research Center on Mental disorders (Xiangya), Changsha, Hunan 410011, China
| | - Yidian Gao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China
| | - Xue Zhong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China
| | - Haofei Zhao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China; China National Clinical Research Center on Mental disorders (Xiangya), Changsha, Hunan 410011, China
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China; China National Clinical Research Center on Mental disorders (Xiangya), Changsha, Hunan 410011, China.
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17
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Park C, Rosenblat JD, Lee Y, Pan Z, Cao B, Iacobucci M, McIntyre RS. The neural systems of emotion regulation and abnormalities in major depressive disorder. Behav Brain Res 2019; 367:181-188. [DOI: 10.1016/j.bbr.2019.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/06/2019] [Accepted: 04/01/2019] [Indexed: 12/13/2022]
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18
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Davis AD, Hassel S, Arnott SR, Harris J, Lam RW, Milev R, Rotzinger S, Zamyadi M, Frey BN, Minuzzi L, Strother SC, MacQueen GM, Kennedy SH, Hall GB. White Matter Indices of Medication Response in Major Depression: A Diffusion Tensor Imaging Study. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:913-924. [PMID: 31471185 DOI: 10.1016/j.bpsc.2019.05.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 05/28/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND While response to antidepressants in major depressive disorder is difficult to predict, characterizing the organization and integrity of white matter in the brain with diffusion tensor imaging (DTI) may provide the means to distinguish between antidepressant responders and nonresponders. METHODS DTI data were collected at 6 sites (Canadian Biomarker Integration Network in Depression-1 [CAN-BIND-1 study]) from 200 (127 women) depressed and 112 (71 women) healthy participants at 3 time points: at baseline, 2 weeks, and 8 weeks following initiation of selective serotonin reuptake inhibitor treatment. Therapeutic response was established by a 50% reduction of symptoms at 8 weeks. Analysis on responders, nonresponders, and control subjects yielded 4 scalar metrics: fractional anisotropy and mean, axial, and radial diffusivity. Region-of-interest analysis was carried out on 40 white matter regions using a skeletonization approach. Mixed-effects regression was incorporated to test temporal trends. RESULTS The data acquired at baseline showed that axial diffusivity in the external capsule, which overlaps the superior longitudinal fasciculus, was significantly associated with medication response. Regression analysis revealed further baseline differences of responders compared with nonresponders in the cingulum regions, sagittal stratum, and corona radiata. Additional group differences relative to control subjects were seen in the internal capsule, posterior thalamic radiation, and uncinate fasciculus. Most effect sizes were moderate (near 0.5), with a maximum of 0.76 in the cingulum-hippocampus region. No temporal changes in DTI metrics were observed over the 8-week study period. CONCLUSIONS Several DTI measures of altered white matter specifically distinguished medication responders and nonresponders at baseline and show promise for predicting treatment response in depression.
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Affiliation(s)
- Andrew D Davis
- Department of Psychology, Neuroscience & Behavior, McMaster University, Hamilton, Ontario, Canada; Imaging Research Center, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Stefanie Hassel
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Stephen R Arnott
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
| | - Jacqueline Harris
- Department of Computer Science, University of Alberta, Edmonton, Alberta, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Roumen Milev
- Department of Psychology, Queen's University, Kingston, Ontario, Canada; Department of Psychiatry, Queen's University and Providence Care Hospital, Kingston, Ontario, Canada
| | - Susan Rotzinger
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Psychiatry, Krembil Research Centre, University Health Network, Toronto, Ontario, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Mojdeh Zamyadi
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Luciano Minuzzi
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Stephen C Strother
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Glenda M MacQueen
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Psychiatry, Krembil Research Centre, University Health Network, Toronto, Ontario, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Geoffrey B Hall
- Department of Psychology, Neuroscience & Behavior, McMaster University, Hamilton, Ontario, Canada; Imaging Research Center, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
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19
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Motivation and cognitive control in depression. Neurosci Biobehav Rev 2019; 102:371-381. [PMID: 31047891 DOI: 10.1016/j.neubiorev.2019.04.011] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/25/2019] [Accepted: 04/17/2019] [Indexed: 12/15/2022]
Abstract
Depression is linked to deficits in cognitive control and a host of other cognitive impairments arise as a consequence of these deficits. Despite of their important role in depression, there are no mechanistic models of cognitive control deficits in depression. In this paper we propose how these deficits can emerge from the interaction between motivational and cognitive processes. We review depression-related impairments in key components of motivation along with new cognitive neuroscience models that focus on the role of motivation in the decision-making about cognitive control allocation. Based on this review we propose a unifying framework which connects motivational and cognitive control deficits in depression. This framework is rooted in computational models of cognitive control and offers a mechanistic understanding of cognitive control deficits in depression.
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20
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Hirshfeld-Becker DR, Gabrieli JDE, Shapero BG, Biederman J, Whitfield-Gabrieli S, Chai XJ. Intrinsic Functional Brain Connectivity Predicts Onset of Major Depression Disorder in Adolescence: A Pilot Study. Brain Connect 2019; 9:388-398. [PMID: 30848160 DOI: 10.1089/brain.2018.0646] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Children with familial risk for major depressive disorder (MDD) have elevated risk for developing depression as adolescents. Here, we investigated longitudinally whether resting-state functional connectivity (RSFC) could predict the onset of MDD. In this pilot study, we followed a group of never-depressed children with familial risk for MDD and a group of age-matched controls without familial risk who had undergone an MRI study at 8-14 years of age. Participants were reassessed 3-4 years later with diagnostic interviews. We first investigated group differences in RSFC from regions in the emotion regulation, cognitive control, and default mode networks in the children who later developed MDD (converted), the children who did not develop MDD (nonconverted), and the control group. We then built a prediction model based on baseline RSFC that was independent of the group differences to classify the individuals who later developed MDD. Compared with the nonconverted group, the converted group exhibited hypoconnectivity between subgenual anterior cingulate cortex (sgACC) and inferior parietal lobule (IPL) and between left and right dorsolateral prefrontal cortices. The nonconverted group exhibited higher sgACC-IPL connectivity than did both the converted and control groups, suggesting a possible resilience factor to MDD. Classification between converted and nonconverted individuals based on baseline RSFC yielded high predictive accuracy with high sensitivity and specificity that was superior to classification based on baseline clinical rating scales. Intrinsic brain connectivity measured in healthy children with familial risk for depression has the potential to predict MDD onset, and it can be a useful neuromarker in early identification of children for preventive treatment.
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Affiliation(s)
- Dina R Hirshfeld-Becker
- 1 Child Cognitive Behavioral Therapy Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,2 Harvard Medical School, Boston, Massachusetts
| | - John D E Gabrieli
- 3 Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts.,4 McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Benjamin G Shapero
- 1 Child Cognitive Behavioral Therapy Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.,2 Harvard Medical School, Boston, Massachusetts
| | - Joseph Biederman
- 2 Harvard Medical School, Boston, Massachusetts.,5 Pediatric Psychopharmacology Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Susan Whitfield-Gabrieli
- 3 Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts.,4 McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Xiaoqian J Chai
- 6 Division of Cognitive Neurology/Neuropsychology, Department of Neurology, Johns Hopkins University, Baltimore, Maryland
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21
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Shapero BG, Chai XJ, Vangel M, Biederman J, Hoover CS, Whitfield-Gabrieli S, Gabrieli JDE, Hirshfeld-Becker DR. Neural markers of depression risk predict the onset of depression. Psychiatry Res Neuroimaging 2019; 285:31-39. [PMID: 30716688 PMCID: PMC6426125 DOI: 10.1016/j.pscychresns.2019.01.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 01/23/2019] [Accepted: 01/24/2019] [Indexed: 12/22/2022]
Abstract
Although research highlights neural correlates of Major Depressive Disorder (MDD), it is unclear whether these correlates reflect the state of depression or a pre-existing risk factor. The current study examined whether baseline differences in brain activations, resting-state connectivity, and brain structural differences between non-symptomatic children at high- and low-risk for MDD based on familial depression prospectively predict the onset of a depressive episode or increases in depressive symptomatology. We re-assessed 44 participants (28 high-risk; 16 low-risk) who had undergone neuroimaging in a previous study 3-4 years earlier (Mean age at follow-up = 14.3 years, SD = 1.9 years; 45% females; 70% Caucasian). We investigated whether baseline brain imaging data (including an emotional face match task fMRI, resting-state fMRI and structural MRI) that differentiated the risk groups also predicted the onset of depression. Resting-state functional connectivity abnormalities in the default mode and cognitive control network that differentiated high-risk from low-risk youth at baseline predicted the onset of MDD during adolescence, after taking risk status into account. Increased functional activation to both happy and fearful faces was associated with greater decreases in self-reported depression symptoms at follow-up. This preliminary evidence could be used to identify youth at-risk for depression and inform early intervention strategies.
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Affiliation(s)
- Benjamin G Shapero
- Child Cognitive Behavioral Therapy Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA; Harvard Medical School, Boston, MA 02215, USA.
| | - Xiaoqian J Chai
- Division of Cognitive Neurology / Neuropsychology, Department of Neurology, Johns Hopkins University, Baltimore, MD 21231, USA
| | - Mark Vangel
- Harvard Medical School, Boston, MA 02215, USA; Biostatistics Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Joseph Biederman
- Harvard Medical School, Boston, MA 02215, USA; Pediatric Psychopharmacology Program, Department of Psychiatry, Massachusetts General Hospital, Boston MA 02114, USA
| | - Christian S Hoover
- Child Cognitive Behavioral Therapy Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Susan Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - John D E Gabrieli
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Dina R Hirshfeld-Becker
- Child Cognitive Behavioral Therapy Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA; Harvard Medical School, Boston, MA 02215, USA
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White matter abnormalities in depression: A categorical and phenotypic diffusion MRI study. NEUROIMAGE-CLINICAL 2019; 22:101710. [PMID: 30849644 PMCID: PMC6406626 DOI: 10.1016/j.nicl.2019.101710] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/25/2019] [Accepted: 02/03/2019] [Indexed: 01/10/2023]
Abstract
Mood depressive disorder is one of the most disabling chronic diseases with a high rate of everyday life disability that affects 350 million people around the world. Recent advances in neuroimaging have reported widespread structural abnormalities, suggesting a dysfunctional frontal-limbic circuit involved in the pathophysiological mechanisms of depression. However, a variety of different white matter regions has been implicated and is sought to suffer from lack of reproducibility of such categorical-based biomarkers. These inconsistent results might be attributed to various factors: actual categorical definition of depression as well as clinical phenotype variability. In this study, we 1/ examined WM changes in a large cohort (114 patients) compared to a healthy control group and 2/ sought to identify specific WM alterations in relation to specific depressive phenotypes such as anhedonia (i.e. lack of pleasure), anxiety and psychomotor retardation –three core symptoms involved in depression. Consistent with previous studies, reduced white matter was observed in the genu of the corpus callosum extending to the inferior fasciculus and posterior thalamic radiation, confirming a frontal-limbic circuit abnormality. Our analysis also reported other patterns of increased fractional anisotropy and axial diffusivity as well as decreased apparent diffusion coefficient and radial diffusivity in the splenium of the corpus callosum and posterior limb of the internal capsule. Moreover, a positive correlation between FA and anhedonia was found in the superior longitudinal fasciculus as well as a negative correlation in the cingulum. Then, the analysis of the anxiety and diffusion metric revealed that increased anxiety was associated with greater FA values in genu and splenium of corpus callosum, anterior corona radiata and posterior thalamic radiation. Finally, the motor retardation analysis showed a correlation between increased Widlöcher depressive retardation scale scores and reduced FA in the body and genu of the corpus callosum, fornix, and superior striatum. Through this twofold approach (categorical and phenotypic), this study has underlined the need to move forward to a symptom-based research area of biomarkers, which help to understand the pathophysiology of mood depressive disorders and to stratify precise phenotypes of depression with targeted therapeutic strategies. Mood depressive disorder is one of the most disabling chronic disease. Past studies of diffusion analysis had found inconsistent results. We analyzed white matter integrity in a large cohort of depressed patients. We conducted both categorical and dimensional approaches. In the future, these biomarkers could help to develop new therapeutic strategies.
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23
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Dooley LN, Kuhlman KR, Robles TF, Eisenberger NI, Craske MG, Bower JE. The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. Neurosci Biobehav Rev 2018; 94:219-237. [PMID: 30201219 PMCID: PMC6192535 DOI: 10.1016/j.neubiorev.2018.09.006] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/28/2018] [Accepted: 09/06/2018] [Indexed: 12/25/2022]
Abstract
A wealth of evidence has implicated inflammation in the development of depression. Yet, the heterogeneous nature of depression has impeded efforts to understand, prevent, and treat the disease. The purpose of this integrative review is to summarize the connections between inflammation and established core features of depression that exhibit more homogeneity than the syndrome itself: exaggerated reactivity to negative information, altered reward processing, decreased cognitive control, and somatic syndrome. For each core feature, we first provide a brief overview of its relevance to depression and neurobiological underpinnings, and then review evidence investigating a potential role of inflammation. We focus primarily on findings from experimental paradigms of exogenously-induced inflammation. We conclude that inflammation likely plays a role in exaggerated reactivity to negative information, altered reward reactivity, and somatic symptoms. There is less evidence supporting an effect of inflammation on cognitive control as assessed by standard neuropsychological measures. Finally, we discuss implications for future research and recommendationsfor how to test the role of inflammation in the pathogenesis of heterogeneous psychiatric disorders.
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Affiliation(s)
| | - Kate R Kuhlman
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA; Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA.
| | - Theodore F Robles
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Naomi I Eisenberger
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Michelle G Craske
- Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Julienne E Bower
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA 90095, USA; Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
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Youn H, Lee ES, Lee S, Suh S, Jeong HG, Eo JS. Regional glucose metabolism due to the presence of cerebral amyloidopathy in older adults with depression and mild cognitive impairment. J Affect Disord 2018; 239:30-36. [PMID: 29991443 DOI: 10.1016/j.jad.2018.06.029] [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: 04/24/2018] [Revised: 06/08/2018] [Accepted: 06/12/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Depression is a risk factor for mild cognitive impairment (MCI) and for the conversion from MCI to Alzheimer's disease (AD). This study investigated regional cerebral glucose metabolism (rCMglc) in older adults with depression and MCI, either with or without amyloidopathy. METHODS We recruited 31 older adults diagnosed with depression and MCI, and 21 older adults with normal cognition (NC). All participants completed demographic questionnaires and were examined with a standardized neuropsychological battery, F-18 fluorodeoxyglucose positron emission tomography (PET), and F-18 florbetaben PET. We classified subjects with depression and MCI into amyloid-β-positive (CDAP; n = 16) and amyloid-β-negative (CDAN; n = 15) groups. Pairwise rCMglc analyses were conducted between all three groups (CDAP vs. NC, CDAN vs. NC, and CDAP vs. CDAN). RESULTS In comparison with the NC group, the CDAP group showed reduced rCMglc predominantly in temporoparietal regions, whereas the CDAN group showed lower rCMglc in regions of the frontal lobe, in addition to the temporoparietal regions. The CDAN group also showed lower rCMglc in right anterior cingulate and left inferior orbitofrontal regions, in a comparison between the CDAP and CDAN groups. LIMITATIONS The generalizability of the findings is limited because this study has a relatively small number of participants. In addition, this study used cross-sectional design rather than longitudinal design. CONCLUSIONS Our findings may provide a reference to assess the risk of future cognitive deterioration. Consequently, this study is expected to contribute to prevention and early identification of dementia associated with AD.
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Affiliation(s)
- HyunChul Youn
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Republic of Korea
| | - Eun Seong Lee
- Department of Nuclear Medicine, Korea University College of Medicine, Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul, Republic of Korea; Department of Molecular Medicine and Biopharmaceutical Sciences, WCU Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Suji Lee
- Department of Biomedical Sciences, Korea University, Seoul, Republic of Korea
| | - Sangil Suh
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Republic of Korea; Korea University Research Institute of Mental Health, Republic of Korea.
| | - Jae Seon Eo
- Department of Nuclear Medicine, Korea University College of Medicine, Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul, Republic of Korea.
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25
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Sin ELL, Shao R, Geng X, Cho V, Lee TMC. The Neuroanatomical Basis of Two Subcomponents of Rumination: A VBM Study. Front Hum Neurosci 2018; 12:324. [PMID: 30154706 PMCID: PMC6102317 DOI: 10.3389/fnhum.2018.00324] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 07/25/2018] [Indexed: 01/11/2023] Open
Abstract
Rumination is a trait that includes two subcomponents, namely brooding and reflective pondering, respectively construed as maladaptive and adaptive response styles to negative experiences. Existing evidence indicates that rumination in general is associated with structural and functional differences in the anterior cingulate cortex (ACC) and the dorsal lateral prefrontal cortex (DLPFC). However, conclusive evidence on the specific neural structural basis of each of the two subcomponents is lacking. In this voxel-based morphometry study, we investigated the independent and specific neural structural basis of brooding and reflective pondering in 30 healthy young adults, who belonged to high or low brooding or reflective pondering groups. Consistent with past research, modest but significant positive correlation was found between brooding and reflective pondering. When controlling for reflective pondering, high-brooding group showed increased gray matter volumes in the left DLPFC and ACC. Further analysis on extracted gray matter values showed that gray matter of the same DLPFC and ACC regions also showed significant negative effects of reflective pondering. Taken together, our findings indicate that the two subcomponents of rumination might share some common processes yet also have distinct neural basis. In view of the significant roles of the left DLPFC and ACC in attention and self-related emotional processing/regulation, our findings provide insight into how the potentially shared and distinct cognitive, affective and neural processes of brooding and reflective pondering can be extended to clinical populations to further elucidate the neurobehavioral relationships between rumination and prefrontal abnormality.
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Affiliation(s)
- Emily L L Sin
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong.,Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong
| | - R Shao
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong.,Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Xiujuan Geng
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong.,Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Valda Cho
- Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tatia M C Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong.,Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong.,Institute of Clinical Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong
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A mind full of self: Self-referential processing as a mechanism underlying the therapeutic effects of mindfulness training on internalizing disorders. Neurosci Biobehav Rev 2018; 92:172-186. [PMID: 29886175 DOI: 10.1016/j.neubiorev.2018.06.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 05/03/2018] [Accepted: 06/06/2018] [Indexed: 01/06/2023]
Abstract
The aim of the current review is to advance the hypothesis that change in self-referential processing is a key but under-examined mechanism through which mindfulness training confers its therapeutic benefits for individuals with internalizing disorders. Consequently, we integrated neuroscientific studies on aberrant self-referential processing in internalizing disorders with contemplative science scholarship examining the effects of mindfulness training on the self-referential system. Reviewing these literatures yielded four major conclusions: (1) internalizing disorders can be characterized by excessive self-referential processing and emotion dysregulation; (2) mindfulness training has moderate effects on reducing internalizing symptoms; (3) mindfulness training promotes the shifting from narrative self-focus to present-centered experiential awareness; (4) such mindfulness-induced changes in self-reference is accompanied by reduced activation in overactive self-referential brain regions that have been implicated in internalizing disorders. Clinical and research implications related to delineating the role of self-referential processing in producing the therapeutic effects of mindfulness training are discussed.
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27
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Smith R, Alkozei A, Killgore WDS, Lane RD. Nested positive feedback loops in the maintenance of major depression: An integration and extension of previous models. Brain Behav Immun 2018; 67:374-397. [PMID: 28943294 DOI: 10.1016/j.bbi.2017.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/18/2017] [Accepted: 09/19/2017] [Indexed: 12/15/2022] Open
Abstract
Several theories of Major Depressive Disorder (MDD) have previously been proposed, focusing largely on either a psychological (i.e., cognitive/affective), biological, or neural/computational level of description. These theories appeal to somewhat distinct bodies of work that have each highlighted separate factors as being of considerable potential importance to the maintenance of MDD. Such factors include a range of cognitive/attentional information-processing biases, a range of structural and functional brain abnormalities, and also dysregulation within the autonomic, endocrine, and immune systems. However, to date there have been limited efforts to integrate these complimentary perspectives into a single multi-level framework. Here we review previous work in each of these MDD research domains and illustrate how they can be synthesized into a more comprehensive model of how a depressive episode is maintained. In particular, we emphasize how plausible (but insufficiently studied) interactions between the various MDD-related factors listed above can lead to a series of nested positive feedback loops, which are each capable of maintaining an individual in a depressive episode. We also describe how these different feedback loops could be active to different degrees in different individual cases, potentially accounting for heterogeneity in both depressive symptoms and treatment response. We conclude by discussing how this integrative model might extend understanding of current treatment mechanisms, and also potentially guide the search for markers to inform treatment selection in individual cases.
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Affiliation(s)
- Ryan Smith
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA.
| | - Anna Alkozei
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | | | - Richard D Lane
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
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Neural substrates of trait impulsivity, anhedonia, and irritability: Mechanisms of heterotypic comorbidity between externalizing disorders and unipolar depression. Dev Psychopathol 2017; 28:1177-1208. [PMID: 27739396 DOI: 10.1017/s0954579416000754] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Trait impulsivity, which is often defined as a strong preference for immediate over delayed rewards and results in behaviors that are socially inappropriate, maladaptive, and short-sighted, is a predisposing vulnerability to all externalizing spectrum disorders. In contrast, anhedonia is characterized by chronically low motivation and reduced capacity to experience pleasure, and is common to depressive disorders. Although externalizing and depressive disorders have virtually nonoverlapping diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, heterotypic comorbidity between them is common. Here, we review common neural substrates of trait impulsivity, anhedonia, and irritability, which include both low tonic mesolimbic dopamine activity and low phasic mesolimbic dopamine responding to incentives during reward anticipation and associative learning. We also consider how other neural networks, including bottom-up emotion generation systems and top-down emotion regulation systems, interact with mesolimbic dysfunction to result in alternative manifestations of psychiatric illness. Finally, we present a model that emphasizes a translational, transdiagnostic approach to understanding externalizing/depression comorbidity. This model should refine ways in which internalizing and externalizing disorders are studied, classified, and treated.
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Mediation by anxiety of the relationship between amygdala activity during emotion processing and poor quality of life in young adults. Transl Psychiatry 2017; 7:e1178. [PMID: 28742077 PMCID: PMC5538112 DOI: 10.1038/tp.2017.127] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 04/20/2017] [Indexed: 01/15/2023] Open
Abstract
Young adults often experience psychological distress and poor quality of life (QoL). Yet, there are no objective neural markers to accurately guide interventions to help improve these measures. We thus aimed to identify directional relationships between frontoamygdala emotional regulation circuitry activity during emotion processing, personality traits, and symptoms associated with psychological distress, and QoL. One hundred twenty 18-25-year olds, n=51 psychologically distressed and n=69 healthy individuals, completed a face emotion-processing task during functional magnetic resonance imaging, clinical and behavioral measures, and QoL assessment. Penalized regression, accounting for large numbers of independent variables, showed that increased state and trait anxiety, cohort and measures of general and anhedonic depression severity predicted poorer QoL (all exponents>0.87). Only state and trait anxiety predicted emotion processing-related frontoamygdala activity (all exponents=1.00). State and trait anxiety fully mediated the relationship between amygdala activity and QoL (P-value increased from 0.001 to 0.29: left amygdala, and from 0.003 to 0.94: right amygdala). State anxiety fully mediated the relationship between left ventrolateral prefrontal cortical (vlPFC) activity and QoL (P-value increased from 0.01 to 0.18). Testing an alternative mediational pathway showed that the relationship between state and trait anxiety and QoL was not mediated by amygdala or left vlPFC activity. We thereby identify specific, directional relationships linking amygdala and left vlPFC activity, state and trait anxiety, and poor QoL across different diagnoses. Our findings highlight roles of amygdala and left vlPFC activity as neural predictors of anxiety and poor QoL, and as potentially important targets for novel interventions to reduce anxiety and, in turn, improve QoL in young adults.
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30
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Altered Intrinsic Functional Brain Architecture in Children at Familial Risk of Major Depression. Biol Psychiatry 2016; 80:849-858. [PMID: 26826874 PMCID: PMC4956583 DOI: 10.1016/j.biopsych.2015.12.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 12/02/2015] [Accepted: 12/02/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Neuroimaging studies of patients with major depression have revealed abnormal intrinsic functional connectivity measured during the resting state in multiple distributed networks. However, it is unclear whether these findings reflect the state of major depression or reflect trait neurobiological underpinnings of risk for major depression. METHODS We compared resting-state functional connectivity, measured with functional magnetic resonance imaging, between unaffected children of parents who had documented histories of major depression (at-risk, n = 27; 8-14 years of age) and age-matched children of parents with no lifetime history of depression (control subjects, n = 16). RESULTS At-risk children exhibited hyperconnectivity between the default mode network and subgenual anterior cingulate cortex/orbital frontal cortex, and the magnitude of connectivity positively correlated with individual symptom scores. At-risk children also exhibited 1) hypoconnectivity within the cognitive control network, which also lacked the typical anticorrelation with the default mode network; 2) hypoconnectivity between left dorsolateral prefrontal cortex and subgenual anterior cingulate cortex; and 3) hyperconnectivity between the right amygdala and right inferior frontal gyrus, a key region for top-down modulation of emotion. Classification between at-risk children and control subjects based on resting-state connectivity yielded high accuracy with high sensitivity and specificity that was superior to clinical rating scales. CONCLUSIONS Children at familial risk for depression exhibited atypical functional connectivity in the default mode, cognitive control, and affective networks. Such task-independent functional brain measures of risk for depression in children could be used to promote early intervention to reduce the likelihood of developing depression.
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Grierson AB, Hickie IB, Naismith SL, Scott J. The role of rumination in illness trajectories in youth: linking trans-diagnostic processes with clinical staging models. Psychol Med 2016; 46:2467-2484. [PMID: 27352637 PMCID: PMC4988274 DOI: 10.1017/s0033291716001392] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 05/04/2016] [Accepted: 05/12/2016] [Indexed: 01/04/2023]
Abstract
Research in developmental psychopathology and clinical staging models has increasingly sought to identify trans-diagnostic biomarkers or neurocognitive deficits that may play a role in the onset and trajectory of mental disorders and could represent modifiable treatment targets. Less attention has been directed at the potential role of cognitive-emotional regulation processes such as ruminative response style. Maladaptive rumination (toxic brooding) is a known mediator of the association between gender and internalizing disorders in adolescents and is increased in individuals with a history of early adversity. Furthermore, rumination shows moderate levels of genetic heritability and is linked to abnormalities in neural networks associated with emotional regulation and executive functioning. This review explores the potential role of rumination in exacerbating the symptoms of alcohol and substance misuse, and bipolar and psychotic disorders during the peak age range for illness onset. Evidence shows that rumination not only amplifies levels of distress and suicidal ideation, but also extends physiological responses to stress, which may partly explain the high prevalence of physical and mental co-morbidity in youth presenting to mental health services. In summary, the normative developmental trajectory of rumination and its role in the evolution of mental disorders and physical illness demonstrates that rumination presents a detectable, modifiable trans-diagnostic risk factor in youth.
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Affiliation(s)
- A. B. Grierson
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - I. B. Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - S. L. Naismith
- Charles Perkins Centre & Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - J. Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
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Foland-Ross LC, Behzadian N, LeMoult J, Gotlib IH. Concordant Patterns of Brain Structure in Mothers with Recurrent Depression and Their Never-Depressed Daughters. Dev Neurosci 2016; 38:115-123. [PMID: 27198667 PMCID: PMC4927380 DOI: 10.1159/000444448] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 02/04/2016] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND A growing body of research has demonstrated that having a mother with a history of major depressive disorder (MDD) is one of the strongest predictors of depression in adolescent offspring. Few studies, however, have assessed neural markers of this increased risk for depression, or examined whether risk-related anomalies in adolescents at maternal risk for depression are related to neural abnormalities in their depressed mothers. We addressed these questions by examining concordance in brain structure in two groups of participants: mothers with a history of depression and their never-depressed daughters, and never-depressed mothers and their never-depressed daughters. METHOD We scanned mothers with (remitted; RMD) and without (control; CTL) a history of recurrent episodes of depression and their never-depressed daughters, computed cortical gray matter thickness, and tested whether mothers' thickness predicted daughters' thickness. RESULTS Both RMD mothers and their high-risk daughters exhibited focal areas of thinner cortical gray matter compared with their CTL/low-risk counterparts. Importantly, the extent of thickness anomalies in RMD mothers predicted analogous abnormalities in their daughters; this pattern was not present in CTL/low-risk dyads. CONCLUSIONS We identified neuroanatomical risk factors that may underlie the intergenerational transmission of risk for MDD. Our findings suggest that there is concordance in brain structure in dyads that is affected by maternal depression, and that the location, direction, and extent of neural anomalies in high-risk offspring mirror those of their recurrent depressed mothers.
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Gradin VB, Pérez A, Macfarlane JA, Cavin I, Waiter G, Tone EB, Dritschel B, Maiche A, Steele JD. Neural correlates of social exchanges during the Prisoner's Dilemma game in depression. Psychol Med 2016; 46:1289-1300. [PMID: 26763141 DOI: 10.1017/s0033291715002834] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Depression is a disabling disorder that significantly impacts on the interpersonal functioning of individuals. However, little is known about the neural substrates of such difficulties. In the last few years neuroeconomics, which combines imaging with multiplayer behavioural economic paradigms, has been used to study the neural substrates of normal and abnormal interpersonal interactions. METHOD This study used functional magnetic resonance imaging to investigate neural activity in unmedicated depressed participants (n = 25) and matched healthy controls (n = 25). During scanning, participants played a behavioural economic game, the Prisoner's Dilemma. In this game, the participant and a co-player independently choose either to cooperate or not cooperate with each other. RESULTS Depressed participants reported higher levels of negative feelings (betrayal, guilt) during the game than did controls. Neural activation was compared between 'imbalanced' events [when one of the players cooperated and the other defected ('CD' and 'DC')] and 'draw' events [when both players either cooperated or defected ('CC' and 'DD')]. Participants preferentially activated the anterior insula and the dorsolateral prefrontal cortex (DLPFC), a region implicated in cognitive control and regulation of emotions. Importantly, compared to controls depressed participants showed reduced activation in the left DLPFC, with the extent of signal reduction correlating with increased self-report feelings of guilt associated with DC outcomes. CONCLUSIONS Our findings suggest that depression is associated with reduced activation of the DLPFC during social events that involve unreciprocated cooperation. This abnormality may underlie anomalies in cognitive control and top-down regulation of emotions during challenging social exchanges.
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Affiliation(s)
- V B Gradin
- Faculty of Psychology,CIBPsi, Universidad de la República,Montevideo,Uruguay
| | - A Pérez
- Faculty of Psychology,CIBPsi, Universidad de la República,Montevideo,Uruguay
| | - J A Macfarlane
- Medical Physics,NHS Tayside,University of Dundee,Dundee,UK
| | - I Cavin
- Medical Physics,NHS Tayside,University of Dundee,Dundee,UK
| | - G Waiter
- Aberdeen Biomedical Imaging Centre,University of Aberdeen,Aberdeen,UK
| | - E B Tone
- Department of Psychology,Georgia State University,Atlanta, GA,USA
| | - B Dritschel
- Department of Psychology,University of St Andrews,Fife,UK
| | - A Maiche
- Faculty of Psychology,CIBPsi, Universidad de la República,Montevideo,Uruguay
| | - J D Steele
- School of Medicine (Neuroscience),University of Dundee,Ninewells Hospital and Medical School,Dundee,UK
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Vasavada MM, Leaver AM, Espinoza RT, Joshi SH, Njau SN, Woods RP, Narr KL. Structural connectivity and response to ketamine therapy in major depression: A preliminary study. J Affect Disord 2016; 190:836-841. [PMID: 26630613 PMCID: PMC4685004 DOI: 10.1016/j.jad.2015.11.018] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 10/30/2015] [Accepted: 11/15/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Ketamine elicits an acute antidepressant effect in patients with major depressive disorder (MDD). Here, we used diffusion imaging to explore whether regional differences in white matter microstructure prior to treatment may predict clinical response 24h following ketamine infusion in 10 MDD patients. METHODS FSL's Tract-Based Spatial Statistics (TBSS) established voxel-level differences in fractional anisotropy (FA) between responders (patients showing >50% improvement in symptoms 24h post-infusion) and non-responders in major white matter pathways. Follow-up regions-of-interest (ROI) analyses examined differences in FA and radial (RD), axial (AD) and mean diffusivity (MD) between responders and non-responders and 15 age- and sex-matched controls, with groups compared pairwise. RESULTS Whole brain TBSS (p<0.05, corrected) and confirmatory tract-based regions-of-interest analyses showed larger FA values in the cingulum and forceps minor in responders compared to non-responders; complementary decreases in RD occurred in the cingulum (p<0.05). Only non-responders differed from controls showing decreased FA in the forceps minor, increased RD in the cingulum and forceps minor, and increased MD in the forceps minor (p<0.05). LIMITATIONS Non-responders showed an earlier age of onset and longer current depressive episode than responders. Though these factors did not interact with diffusion metrics, results may be impacted by the limited sample size. CONCLUSIONS Though findings are considered preliminary, significant differences in FA, RD and MD shown in non-responders compared to responders and controls in fronto-limbic and ventral striatal pathways suggest that the structural architecture of specific functional networks mediating emotion may predict ketamine response in MDD.
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Affiliation(s)
- Megha M Vasavada
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Amber M Leaver
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Randall T Espinoza
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Stephanie N Njau
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Roger P Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA,Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA; Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, CA, USA.
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Chi KF, Korgaonkar M, Grieve SM. Imaging predictors of remission to anti-depressant medications in major depressive disorder. J Affect Disord 2015; 186:134-44. [PMID: 26233324 DOI: 10.1016/j.jad.2015.07.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 06/17/2015] [Accepted: 07/03/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND We review what is currently known about neuroimaging predictors of remission in major depressive disorder (MDD) after antidepressant medication (ADM) treatment. METHODS A systematic literature search found a total of twenty-seven studies comparing baseline neuroimaging findings in depressed patients who achieved remission with non-remitters following treatment with ADMs. RESULTS Eighteen of these studies utilised structural magnetic resonance imaging (MRI). These studies associated larger hippocampal (four studies) and cingulate volume (two studies) with remission. Two diffusion MRI studies identified a positive relationship between the fractional anisotropy of the cingulum bundle and remission. White matter signal hyperintensities were quantified in two papers - both observing decreased remission rates with increasing lesion burden. Nine studies on functional imaging met inclusion criteria - three using functional MRI, one with single photon emission computed tomography (SPECT), and five which evaluated patients with positron emission tomography (PET). These findings were not convergent, with different regions of interest interrogated. LIMITATIONS The studies were generally underpowered. Overall these data were heterogeneous with only a small number identifying concordant findings. CONCLUSIONS At present, the data remains inconsistent. The more promising biomarker of remission to ADMs appears to be hippocampal size, although this marker also has conflicting reports. Given remission should be the primary end-point of treatment, and that ADMs are the front-line treatment type for MDD, more focussed research is required to focus specifically on the imaging correlates of remission to ADMs.
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Affiliation(s)
- Kee F Chi
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2006, Australia; Sydney Translational Imaging Laboratory, Charles Perkins Centre and Sydney Medical School, University of Sydney, NSW 2006, Australia
| | - Mayuresh Korgaonkar
- The Brain Dynamics Centre, Westmead Millennium Institute and Sydney Medical School, Sydney, NSW, Australia; Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Westmead Hospital, Sydney, NSW, Australia
| | - Stuart M Grieve
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2006, Australia; Sydney Translational Imaging Laboratory, Charles Perkins Centre and Sydney Medical School, University of Sydney, NSW 2006, Australia; The Brain Dynamics Centre, Westmead Millennium Institute and Sydney Medical School, Sydney, NSW, Australia.
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Changes of Functional Brain Networks in Major Depressive Disorder: A Graph Theoretical Analysis of Resting-State fMRI. PLoS One 2015; 10:e0133775. [PMID: 26327292 PMCID: PMC4556670 DOI: 10.1371/journal.pone.0133775] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 07/01/2015] [Indexed: 01/24/2023] Open
Abstract
Recent developments in graph theory have heightened the need for investigating the disruptions in the topological structure of functional brain network in major depressive disorder (MDD). In this study, we employed resting-state functional magnetic resonance imaging (fMRI) and graph theory to examine the whole-brain functional networks among 42 MDD patients and 42 healthy controls. Our results showed that compared with healthy controls, MDD patients showed higher local efficiency and modularity. Furthermore, MDD patients showed altered nodal centralities of many brain regions, including hippocampus, temporal cortex, anterior cingulate gyrus and dorsolateral prefrontal gyrus, mainly located in default mode network and cognitive control network. Together, our results suggested that MDD was associated with disruptions in the topological structure of functional brain networks, and provided new insights concerning the pathophysiological mechanisms of MDD.
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Gelman PL, Flores-Ramos M, López-Martínez M, Fuentes CC, Grajeda JPR. Hypothalamic-pituitary-adrenal axis function during perinatal depression. Neurosci Bull 2015; 31:338-50. [PMID: 25732527 DOI: 10.1007/s12264-014-1508-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 09/24/2014] [Indexed: 12/01/2022] Open
Abstract
Abnormal function of the hypothalamic-pituitary-adrenal (HPA) axis is an important pathological finding in pregnant women exhibiting major depressive disorder. They show high levels of cortisol pro-inflammatory cytokines, hypothalamic-pituitary peptide hormones and catecholamines, along with low dehydroepiandrosterone levels in plasma. During pregnancy, the TH2 balance together with the immune system and placental factors play crucial roles in the development of the fetal allograft to full term. These factors, when altered, may generate a persistent dysfunction of the HPA axis that may lead to an overt transfer of cortisol and toxicity to the fetus at the expense of reduced activity of placental 11β-hydroxysteroid dehydrogenase type 2. Epigenetic modifications also may contribute to the dysregulation of the HPA axis. Affective disorders in pregnant women should be taken seriously, and therapies focused on preventing the deleterious effects of stressors should be implemented to promote the welfare of both mother and baby.
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Frontal EEG Asymmetry as a Promising Marker of Depression Vulnerability: Summary and Methodological Considerations. Curr Opin Psychol 2015; 4:93-97. [PMID: 26462291 DOI: 10.1016/j.copsyc.2014.12.017] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Frontal EEG asymmetry is a promising neurophysiological marker of depression risk. It predicts emotional response and negative affect hours to years later. Yet, inconsistencies in the literature may be due to differing methodological approaches between research groups. Within the past two years, a number of studies have shown this line of research may be strengthened by augmenting resting assessments with emotionally evocative tasks, utilizing optimal recording montages, and taking an integrative neuroscience approach that links frontal asymmetry to other indices of neural function. This review will focus on recent work in frontal asymmetry and depression with a particular focus on promising future directions and methodological considerations that may increase consistency between research groups.
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Young JJ, Bruno D, Pomara N. A review of the relationship between proinflammatory cytokines and major depressive disorder. J Affect Disord 2014; 169:15-20. [PMID: 25128861 DOI: 10.1016/j.jad.2014.07.032] [Citation(s) in RCA: 279] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 07/10/2014] [Accepted: 07/22/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Determining etiological factors and reviewing advances in diagnostic modalities sensitive and specific to Major Depressive Disorder (MDD) is of importance in its evaluation and treatment. The inflammatory hypothesis is one of the most prevalent topics concerning MDD and may provide insight into the pathogenesis of depression, development of biomarkers, and ultimately production of more effective depression therapies. METHOD We reviewed several studies to evaluate contemporary concepts concerning proinflammatory cytokines and their relationship to various depressive disorders, the use of anti-inflammatory therapies in MDD treatment, and the application of neuroimaging in conjunction with cytokine profiles from both plasma and CSF as possible diagnostic tools. RESULTS Proinflammatory cytokines in both plasma and CSF have been found to influence the progression and severity of depressive disorders in different populations. Studies have shown elevated serum levels of IL-1, IL-6, TNF-α, CRP, and MCP-1 in depressed patients, but have presented mixed results with IL-8 serum levels, and with IL-6 and MCP-1 CSF levels. Anti-inflammatory treatment of MDD may have adjuvant properties with current depression medications. MRI and NIRS neuroimaging confirm neurological abnormalities in the presence of elevated proinflammatory cytokines in depressed or stressed patients. LIMITATIONS Heterogeneity of MDD and limited CSF cytokine research complicate the study of MDD pathogenesis. CONCLUSION There is significant evidence that inflammatory processes influence the development and progression of MDD. Future studies with larger arrays of cytokine profiles aided by neuroimaging may provide more sensitive and specific modes of diagnostics in determining MDD etiology and provide guidance in individual therapies.
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Affiliation(s)
- Juan Joseph Young
- Geriatric Psychiatry Division, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Davide Bruno
- Department of Psychology, Liverpool Hope University, Liverpool, UK
| | - Nunzio Pomara
- Geriatric Psychiatry Division, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Langone Medical Center, New York University, New York, NY, USA.
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Iacoviello BM, Charney DS. Developing cognitive-emotional training exercises as interventions for mood and anxiety disorders. Eur Psychiatry 2014; 30:75-81. [PMID: 25451246 DOI: 10.1016/j.eurpsy.2014.09.415] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 09/29/2014] [Accepted: 09/29/2014] [Indexed: 12/28/2022] Open
Abstract
There is an urgent need for more effective treatments for mood and anxiety disorders. As our understanding of the cognitive and affective neuroscience underlying psychiatric disorders expands, so do opportunities to develop novel interventions that capitalize on the capacity for brain plasticity. Cognitive training is one such strategy. This paper provides the background and rationale for developing cognitive-emotional training exercises as an intervention strategy, and proposes guidelines for the development and evaluation of cognitive training interventions with a specific focus on major depressive disorder as an example.
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Affiliation(s)
- B M Iacoviello
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA.
| | - D S Charney
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
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Hall LM, Klimes-Dougan B, Hunt RH, Thomas KM, Houri A, BA EN, Mueller BA, Lim KO, Cullen KR. An fMRI study of emotional face processing in adolescent major depression. J Affect Disord 2014; 168:44-50. [PMID: 25036008 PMCID: PMC4171128 DOI: 10.1016/j.jad.2014.06.037] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 06/24/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) often begins during adolescence when the brain is still maturing. To better understand the neurobiological underpinnings of MDD early in development, this study examined brain function in response to emotional faces in adolescents with MDD and healthy (HC) adolescents using functional magnetic resonance imaging (fMRI). METHOD Thirty-two unmedicated adolescents with MDD and 23 healthy age- and gender-matched controls completed an fMRI task viewing happy and fearful faces. Fronto-limbic regions of interest (ROI; bilateral amygdala, insula, subgenual and rostral anterior cingulate cortices) and whole-brain analyses were conducted to examine between-group differences in brain function. RESULTS ROI analyses revealed that patients had greater bilateral amygdala activity than HC in response to viewing fearful versus happy faces, which remained significant when controlling for comorbid anxiety. Whole-brain analyses revealed that adolescents with MDD had lower activation compared to HC in a right hemisphere cluster comprised of the insula, superior/middle temporal gyrus, and Heschl׳s gyrus when viewing fearful faces. Brain activity in the subgenual anterior cingulate cortex was inversely correlated with depression severity. LIMITATIONS Limitations include a cross-sectional design with a modest sample size and use of a limited range of emotional stimuli. CONCLUSIONS Results replicate previous studies that suggest emotion processing in adolescent MDD is associated with abnormalities within fronto-limbic brain regions. Findings implicate elevated amygdalar arousal to negative stimuli in adolescents with depression and provide new evidence for a deficit in functioning of the saliency network, which may be a future target for early intervention and MDD treatment.
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Affiliation(s)
- Leah M.J. Hall
- Department of Psychology, University of Minnesota, Twin Cities
| | | | - Ruskin H. Hunt
- Institute of Child Development, University of Minnesota, Twin Cities
| | | | - Alaa Houri
- Department of Psychiatry, University of Minnesota, Twin Cities
| | - Emily Noack BA
- Department of Psychology, University of Minnesota, Twin Cities
| | | | - Kelvin O. Lim
- Department of Psychiatry, University of Minnesota, Twin Cities,Center for Magnetic Resonance Research, University of Minnesota, Twin Cities
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Korgaonkar MS, Fornito A, Williams LM, Grieve SM. Abnormal structural networks characterize major depressive disorder: a connectome analysis. Biol Psychiatry 2014; 76:567-74. [PMID: 24690111 DOI: 10.1016/j.biopsych.2014.02.018] [Citation(s) in RCA: 248] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 02/12/2014] [Accepted: 02/13/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) has been shown to be associated with a disrupted topological organization of functional brain networks. However, little is known regarding whether these changes have a structural basis. Diffusion tensor imaging (DTI) enables comprehensive whole-brain mapping of the white matter tracts that link regions distributed throughout the entire brain, the so-called human connectome. METHODS We examined whole-brain structural networks in a cohort of 95 MDD outpatients and 102 matched control subjects. Structural networks were represented by an 84 × 84 connectivity matrix representing probabilistic white matter connections between 84 parcellated cortical and subcortical regions using DTI tractography. Network-based statistics were used to assess differences in the interregional connectivity matrix between the two groups, and graph theory was used to examine overall topological organization. RESULTS Our network-based statistics analysis demonstrates lowered structural connectivity within two distinct brain networks that are present in depression: the first primarily involves the regions of the default mode network and the second comprises the frontal cortex, thalamus, and caudate regions that are central in emotional and cognitive processing. These two altered networks were observed in the context of an overall preservation of topology as reflected as no significant group differences for the graph-theory measures. CONCLUSIONS This is the first report to use DTI to show the structural connectomic alterations present in MDD. Our findings highlight that altered structural connectivity between nodes of the default mode network and the frontal-thalamo-caudate regions are core neurobiological features associated with MDD.
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Affiliation(s)
- Mayuresh S Korgaonkar
- The Brain Dynamics Centre, Sydney Medical School-Westmead and Westmead Millennium Institute for Medical Research, Sydney; Discipline of Psychiatry, University of Sydney Medical School: Western, Westmead Hospital, Sydney
| | - Alex Fornito
- Monash Clinical and Imaging Neuroscience, School of Psychology and Psychiatry & Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Leanne M Williams
- The Brain Dynamics Centre, Sydney Medical School-Westmead and Westmead Millennium Institute for Medical Research, Sydney; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Stuart M Grieve
- The Brain Dynamics Centre, Sydney Medical School-Westmead and Westmead Millennium Institute for Medical Research, Sydney; Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Australia; Department of Radiology, Royal Prince Alfred Hospital, Australia; Charles Perkins Centre, University of Sydney, Camperdown, Australia.
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Iacoviello BM, Wu G, Alvarez E, Huryk K, Collins KA, Murrough JW, Iosifescu DV, Charney DS. Cognitive-emotional training as an intervention for major depressive disorder. Depress Anxiety 2014; 31:699-706. [PMID: 24753225 DOI: 10.1002/da.22266] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 02/26/2014] [Accepted: 03/01/2014] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND There is an urgent need for more effective treatments for major depressive disorder (MDD). As understanding of the cognitive and affective neuroscience underlying psychiatric disorders expands, so do opportunities to develop interventions that capitalize on the capacity for brain plasticity. Cognitive training is one such strategy. In this article, we report a proof-of-concept study of a novel cognitive-emotional training exercise designed to enhance cognitive control for emotional information processing and targeting components of the neural networks that have been implicated in MDD. METHODS Twenty-one participants with MDD in a current episode were randomly assigned to one of the two treatment conditions: 11 participating in a cognitive-emotional training paradigm (emotional faces memory task (EFMT)) involving eight sessions over 4 weeks, and 10 participating in an active control condition (control training, CT). Assessments of MDD symptoms, negative affective bias in cognitive processing, and neurocognition (attention and working memory) were administered at baseline and after 4 weeks. RESULTS Participants in the EFMT group exhibited a greater reduction in MDD symptoms compared to the CT group, and 6 of the 11 EFMT participants achieved clinical response (≥ 50% reduction in symptoms). EFMT participants also exhibited changes in negative affective bias in the hypothesized direction whereas the CT participants did not. Both groups exhibited similar, small improvements in attention and working memory. CONCLUSIONS Cognitive-emotional training may represent a feasible and effective intervention strategy for MDD. This proof-of-concept study highlights the need for future studies to fully understand the effectiveness, and mechanisms of effect, of these training strategies.
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Quah-Smith I. Laser Ear Acupuncture: How Much is Enough? A Prospective Observational Study on Laser Dosages Required in the Healing Patient During Posturology and During the Treatment of Mental Distress. Med Acupunct 2014. [DOI: 10.1089/acu.2014.1027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Im Quah-Smith
- Centre for Healthy Brain Aging, UNSW Medicine, University of New South Wales (UNSW), Randwick, and Roseville Wellness Group, Roseville, both in New South Wales Australia
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Brühl A, Rufer M, Kaffenberger T, Baur V, Herwig U. Neural circuits associated with positive and negative self-appraisal. Neuroscience 2014; 265:48-59. [DOI: 10.1016/j.neuroscience.2014.01.053] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 01/08/2014] [Accepted: 01/27/2014] [Indexed: 11/15/2022]
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Abstract
While antidepressants are supposed to exert similar effects on mood and drive via various mechanisms of action, diverging effects are observed regarding side-effects and accordingly on neural correlates of motivation, emotion, reward and salient stimuli processing as a function of the drugs impact on neurotransmission. In the context of erotic stimulation, a unidirectional modulation of attentional functioning despite opposite effects on sexual arousal has been suggested for the selective serotonin reuptake-inhibitor (SSRI) paroxetine and the selective dopamine and noradrenaline reuptake-inhibitor (SDNRI) bupropion. To further elucidate the effects of antidepressant-related alterations of neural attention networks, we investigated 18 healthy males under subchronic administration (7 d) of paroxetine (20 mg), bupropion (150 mg) and placebo within a randomized placebo-controlled cross-over double-blind functional magnetic resonance imaging (fMRI) design during an established preceding attention task. Neuropsychological effects beyond the fMRI-paradigm were assessed by measuring alertness and divided attention. Comparing preceding attention periods of salient vs. neutral pictures, we revealed congruent effects of both drugs vs. placebo within the anterior midcingulate cortex, dorsolateral prefrontal cortex, anterior prefrontal cortex, superior temporal gyrus, anterior insula and the thalamus. Relatively decreased activation in this network was paralleled by slower reaction times in the divided attention task in both verum conditions compared to placebo. Our results suggest similar effects of antidepressant treatments on behavioural and neural attentional functioning by diverging neurochemical pathways. Concurrent alterations of brain regions within a fronto-parietal and cingulo-opercular attention network for top-down control could point to basic neural mechanisms of antidepressant action irrespective of receptor profiles.
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Quah-Smith I, Suo C, Williams MA, Sachdev PS. The Antidepressant Effect of Laser Acupuncture: A Comparison of the Resting Brain's Default Mode Network in Healthy and Depressed Subjects During Functional Magnetic Resonance Imaging. Med Acupunct 2013; 25:124-133. [PMID: 24761169 DOI: 10.1089/acu.2012.0901] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It has been suggested that the antidepressant effect of laser acupuncture involves modulation of the default mode network (DMN) or resting state network (RSN). In this study, the authors investigated changes in the DMN during laser acupuncture in depressed and nondepressed participants. OBJECTIVE To aim of this study was to determine if the modulation of the DMN effects by laser acupuncture in depressed participants are different from those of nondepressed participants. DESIGN Randomized stimulation was performed with laser acupuncture on four putative antidepressant acupoints (LR 14, LR 8, CV 14, and HT 7) in a block on-off design, while the blood oxygenation level-dependent (BOLD) fMRI response was recorded from each subject's whole brain on a 3T scanner. DMN patterns of the participants were identified, using an independent component analysis. The identified DMN components from both the nondepressed group and the depressed group were then analytically compared using SPM5. SETTING This study took place at a research institute. SUBJECTS Ten nondepressed participants and 10 depressed participants (DS) as confirmed by the Hamilton Depression Rating Scale (HAM-D) participated in this study. INTERVENTION Low Intensity Laser Acupuncture. MAIN OUTCOME MEASURES Significant DMN patterns in one group were greater than those in the other group. RESULTS The nondepressed participants had significant modulation of DMN in the frontal region at the medial frontal gyrus (verum laser>rest, p<0.001) for three acupoints (LR 14, LR 8, and CV 14). For the depressive participants, the DMN modulation occurred at the inferior parietal cortex and the cerebellum (verum laser>rest, p<0.001). CONCLUSIONS Laser acupuncture on LR 8, LR 14, and CV 14 stimulated both the anterior and posterior DMN in both the nondepressed and depressed participants. However, in the nondepressed participants, there was consistently outstanding modulation of the anterior DMN at the medial frontal gyrus across all three acupoints. In the depressed participants, there was wider posterior DMN modulation at the parieto-temporal-limbic cortices. This is part of the antidepressant effect of laser acupuncture.
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Affiliation(s)
- Im Quah-Smith
- School of Psychiatry, Faculty of Medicine, University of New South Wales (UNSW) , Australia . ; Neuropsychiatric Institute (NPI) , Prince of Wales Hospital, Randwick, Australia
| | - Chao Suo
- Brain and Ageing Research Program, Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales , New South Wales, Australia
| | - Mark A Williams
- Macquarie Centre for Cognitive Sciences, Macquarie University , Sydney, Australia
| | - Perminder S Sachdev
- School of Psychiatry, Faculty of Medicine, University of New South Wales (UNSW) , Australia . ; Neuropsychiatric Institute (NPI) , Prince of Wales Hospital, Randwick, Australia . ; Centre for Healthy Brain Ageing, NPI, Euroa Centre, Prince of Wales Hospital , New South Wales, Australia
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Vance DE, Dodson JE, Watkins J, Kennedy BH, Keltner NL. Neurological and psychiatric diseases and their unique cognitive profiles: implications for nursing practice and research. J Neurosci Nurs 2013; 45:77-87. [PMID: 23422693 PMCID: PMC3589568 DOI: 10.1097/jnn.0b013e3182829038] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
To successfully negotiate and interact with one's environment, optimal cognitive functioning is needed. Unfortunately, many neurological and psychiatric diseases impede certain cognitive abilities such as executive functioning or speed of processing; this can produce a poor fit between the patient and the cognitive demands of his or her environment. Such nondementia diseases include bipolar disorder, schizophrenia, post-traumatic stress syndrome, depression, and anxiety disorders, just to name a few. Each of these diseases negatively affects particular areas of the brain, resulting in distinct cognitive profiles (e.g., deficits in executive functioning but normal speed of processing as seen in schizophrenia). In fact, it is from these cognitive deficits in which such behavioral and emotional symptoms may manifest (e.g., delusions, paranoia). This article highlights the distinct cognitive profiles of such common neurological and psychiatric diseases. An understanding of such disease-specific cognitive profiles can assist nurses in providing care to patients by knowing what cognitive deficits are associated with each disease and how these cognitive deficits impact everyday functioning and social interactions. Implications for nursing practice and research are posited within the framework of cognitive reserve and neuroplasticity.
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Affiliation(s)
- David E. Vance
- School of Nursing, NB 456, 1701 University Boulevard, University of Alabama at Birmingham (UAB), Birmingham, AL 35294-1210, Office: 205-934-7589, Fax: 205-996-7183
| | - Joan E. Dodson
- Department of Psychology & Center for Translational Research in Aging and Mobility, Holly Mears Building, Room 130, 924 19th Street South, University of Alabama at Birmingham (UAB), Birmingham, AL 35294, Office: 205-934-2551, Fax: 2059756110
| | - Jason Watkins
- School of Nursing, NB 456, 1701 University Boulevard, University of Alabama at Birmingham (UAB), Birmingham, AL 35294-1210, Office: 205-306-0646, Fax: 205-996-7183
| | - Bridgett H. Kennedy
- Department of Psychology, CH 415, 1300 University Boulevard, University of Alabama at Birmingham (UAB), Birmingham, AL 35294-1170, Office: 205-934-7517, Fax: 205-975-2295
| | - Norman L. Keltner
- 1701 University Boulevard, University of Alabama at Birmingham, Birmingham, AL 35294-1210; Office: 205-934-6790; Fax: 205-996-7183
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Kanske P, Kotz SA. Reprint of “Effortful control, depression, and anxiety correlate with the influence of emotion on executive attentional control”. Biol Psychol 2013; 92:456-63. [DOI: 10.1016/j.biopsycho.2013.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 04/26/2012] [Indexed: 11/30/2022]
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Towards automated detection of depression from brain structural magnetic resonance images. Neuroradiology 2013; 55:567-84. [PMID: 23338839 DOI: 10.1007/s00234-013-1139-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 01/07/2013] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Depression is a major issue worldwide and is seen as a significant health problem. Stigma and patient denial, clinical experience, time limitations, and reliability of psychometrics are barriers to the clinical diagnoses of depression. Thus, the establishment of an automated system that could detect such abnormalities would assist medical experts in their decision-making process. This paper reviews existing methods for the automated detection of depression from brain structural magnetic resonance images (sMRI). METHODS Relevant sources were identified from various databases and online sites using a combination of keywords and terms including depression, major depressive disorder, detection, classification, and MRI databases. Reference lists of chosen articles were further reviewed for associated publications. RESULTS The paper introduces a generic structure for representing and describing the methods developed for the detection of depression from sMRI of the brain. It consists of a number of components including acquisition and preprocessing, feature extraction, feature selection, and classification. CONCLUSION Automated sMRI-based detection methods have the potential to provide an objective measure of depression, hence improving the confidence level in the diagnosis and prognosis of depression.
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