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Poplin T, Ironside M, Kuplicki R, Aupperle RL, Guinjoan SM, Khalsa SS, Stewart JL, Victor TA, Paulus MP, Kirlic N. The unique face of comorbid anxiety and depression: Increased frontal, insula and cingulate cortex response during Pavlovian fear-conditioning. J Affect Disord 2024; 366:98-105. [PMID: 39187192 DOI: 10.1016/j.jad.2024.08.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 08/03/2024] [Accepted: 08/23/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Dysregulation of fear processing through altered sensitivity to threat is thought to contribute to the development of anxiety disorders and major depressive disorder (MDD). However, fewer studies have examined fear processing in MDD than in anxiety disorders. The current study used propensity matching to examine the hypothesis that comorbid MDD and anxiety (AnxMDD) shows greater neural correlates of fear processing than MDD, suggesting that the co-occurrence of AnxMDD is exemplified by exaggerated defense related processes. METHODS 195 individuals with MDD (N = 65) or AnxMDD (N = 130) were recruited from the community and completed multi-level assessments, including a Pavlovian fear learning task during functional imaging. Visual images paired with threat (conditioned stimuli: CS+) were compared to stimuli not paired with threat (CS-). RESULTS MDD and AnxMDD showed significantly different patterns of activation for CS+ vs CS- in the dorsal anterior insula/inferior frontal gyrus (partial eta squared; ηp2 = 0.02), dorsolateral prefrontal cortex (ηp2 = 0.01) and dorsal anterior/mid cingulate cortex (ηp2 = 0.01). These differences were driven by greater activation to the CS+ in AnxMDD versus MDD. LIMITATIONS Limitations include the cross-sectional design, a scream US rather than shock and half the number of MDD as AnxMDD participants. CONCLUSIONS AnxMDD showed a pattern of increased activation in regions identified with fear processing. Effects were consistently driven by threat, further suggesting fear signaling as the emergent target process. Differences emerged in regions associated with salience processing, attentional orienting/conflict, self-relevant processing and executive functioning in comorbid anxiety and depression, thereby highlighting potential treatment targets for this prevalent and treatment resistant group.
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Affiliation(s)
- Tate Poplin
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA
| | - Maria Ironside
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA; University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104, USA.
| | - Rayus Kuplicki
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA
| | - Robin L Aupperle
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA; University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104, USA
| | - Salvador M Guinjoan
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA; University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104, USA
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Jennifer L Stewart
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA; University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104, USA
| | - Teresa A Victor
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA
| | - Martin P Paulus
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA; University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104, USA
| | - Namik Kirlic
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, USA
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Lawrence S, Scofield RH. Post traumatic stress disorder associated hypothalamic-pituitary-adrenal axis dysregulation and physical illness. Brain Behav Immun Health 2024; 41:100849. [PMID: 39280087 PMCID: PMC11401111 DOI: 10.1016/j.bbih.2024.100849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 08/11/2024] [Accepted: 08/17/2024] [Indexed: 09/18/2024] Open
Abstract
Conventional human stress responses are mediated by the sympathetic adrenal medullar (SAM) axis and the hypothalamic pituitary adrenal (HPA) axis. The SAM axis mediates the immediate response to stress through norepinephrine and epinephrine while the HPA axis mediates the slow response through corticosteroids, primarily cortisol, to effect systemic changes. Post Traumatic Stress Disorder (PTSD), a psychiatric disorder that develops in a small subset of people exposed to a traumatic event, may dysregulate these systems and result in increased risk of various clinical conditions. These conditions include but are not limited to cardiovascular disease, metabolic conditions, autoimmune diseases, neurocognitive disorders, and women's health complications such as preterm birth, polycystic ovarian syndrome, and endometriosis to name a few. This review focuses on how PTSD dysregulates the HPA axis, and further, how these alterations affect the immune system and physical health outcomes.
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Affiliation(s)
- Stephanie Lawrence
- Department of Veterans Affairs Medical Center, Oklahoma City, OK, 73104, USA
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
- Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA
| | - R Hal Scofield
- Department of Veterans Affairs Medical Center, Oklahoma City, OK, 73104, USA
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
- Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA
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3
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Lukow PB, Lowther M, Pike AC, Yamamori Y, Chavanne AV, Gormley S, Aylward J, McCloud T, Goble T, Rodriguez-Sanchez J, Tuominen EW, Buehler SK, Kirk P, Robinson OJ. Amygdala activity after subchronic escitalopram administration in healthy volunteers: A pharmaco-functional magnetic resonance imaging study. J Psychopharmacol 2024:2698811241286773. [PMID: 39364684 DOI: 10.1177/02698811241286773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
BACKGROUND Selective serotonin reuptake inhibitors (SSRIs) are used for the treatment of several conditions including anxiety disorders, but the basic neurobiology of serotonin function remains unclear. The amygdala and prefrontal cortex are strongly innervated by serotonergic projections and have been suggested to play an important role in anxiety expression. However, serotonergic function in behaviour and SSRI-mediated neurobiological changes remain incompletely understood. AIMS To investigate the neural correlates of subchronic antidepressant administration. METHODS We investigated whether the 2- to 3-week administration of a highly selective SSRI (escitalopram) would alter brain activation on a task robustly shown to recruit the bilateral amygdala and frontal cortices in a large healthy volunteer sample. Participants performed the task during a functional magnetic resonance imaging acquisition before (n = 96) and after subchronic escitalopram (n = 46, days of administration mean (SD) = 15.7 (2.70)) or placebo (n = 40 days of administration mean (SD) = 16.2 (2.90)) self-administration. RESULTS Compared to placebo, we found an elevation in right amygdala activation to the task after escitalopram administration without significant changes in mood. This effect was not seen in the left amygdala, the dorsomedial region of interest, the subgenual anterior cingulate cortex or the right fusiform area. There were no significant changes in connectivity between the dorsomedial cortex and amygdala or the subgenual anterior cingulate cortex after escitalopram administration. CONCLUSIONS To date, this most highly powered study of subchronic SSRI administration indicates that, contrary to effects often seen in patients with anxiety disorders, subchronic SSRI treatment may increase amygdala activation in healthy controls. This finding highlights important gaps in our understanding of the functional role of serotonin.
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Affiliation(s)
- Paulina B Lukow
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Millie Lowther
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Alexandra C Pike
- Institute of Cognitive Neuroscience, University College London, London, UK
- Department of Psychology & York Biomedical Research Institute, University of York, York, UK
| | - Yumeya Yamamori
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Alice V Chavanne
- Institute of Cognitive Neuroscience, University College London, London, UK
- Université Paris-Saclay, Institut National de la Santé et de la Recherche Médicale, INSERM U1299 "Trajectoires Développementales Psychiatrie," Ecole Normale Supérieure Paris-Saclay, CNRS UMR 9010, Centre Borelli, Gif-sur-Yvette, France
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Siobhan Gormley
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Jessica Aylward
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Tayla McCloud
- Institute of Cognitive Neuroscience, University College London, London, UK
- UCL Division of Psychiatry, Maple House, London, UK
| | - Talya Goble
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Julia Rodriguez-Sanchez
- Institute of Cognitive Neuroscience, University College London, London, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
| | - Ella W Tuominen
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Sarah K Buehler
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Peter Kirk
- Institute of Cognitive Neuroscience, University College London, London, UK
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Oliver J Robinson
- Institute of Cognitive Neuroscience, University College London, London, UK
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4
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Langhammer T, Hilbert K, Adolph D, Arolt V, Bischoff S, Böhnlein J, Cwik JC, Dannlowski U, Deckert J, Domschke K, Evens R, Fydrich T, Gathmann B, Hamm AO, Heinig I, Herrmann MJ, Hollandt M, Junghoefer M, Kircher T, Koelkebeck K, Leehr EJ, Lotze M, Margraf J, Mumm JLM, Pittig A, Plag J, Richter J, Roesmann K, Ridderbusch IC, Schneider S, Schwarzmeier H, Seeger F, Siminski N, Straube T, Ströhle A, Szeska C, Wittchen HU, Wroblewski A, Yang Y, Straube B, Lueken U. Resting-state functional connectivity in anxiety disorders: a multicenter fMRI study. Mol Psychiatry 2024:10.1038/s41380-024-02768-2. [PMID: 39367057 DOI: 10.1038/s41380-024-02768-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 08/22/2024] [Accepted: 09/25/2024] [Indexed: 10/06/2024]
Abstract
Anxiety disorders (AD) are associated with altered connectivity in large-scale intrinsic brain networks. It remains uncertain how much these signatures overlap across different phenotypes due to a lack of well-powered cross-disorder comparisons. We used resting-state functional magnetic resonance imaging (rsfMRI) to investigate differences in functional connectivity (FC) in a cross-disorder sample of AD patients and healthy controls (HC). Before treatment, 439 patients from two German multicenter clinical trials at eight different sites fulfilling a primary diagnosis of panic disorder and/or agoraphobia (PD/AG, N = 154), social anxiety disorder (SAD, N = 95), or specific phobia (SP, N = 190) and 105 HC underwent an 8 min rsfMRI assessment. We performed categorical and dimensional regions of interest (ROI)-to-ROI analyses focusing on connectivity between regions of the defensive system and prefrontal regulation areas. AD patients showed increased connectivity between the insula and the thalamus compared to controls. This was mainly driven by PD/AG patients who showed increased (insula/hippocampus/amygdala-thalamus) and decreased (dorsomedial prefrontal cortex/periaqueductal gray-anterior cingulate cortex) positive connectivity between subcortical and cortical areas. In contrast, SAD patients showed decreased negative connectivity exclusively in cortical areas (insula-orbitofrontal cortex), whereas no differences were found in SP patients. State anxiety associated with the scanner environment did not explain the FC between these regions. Only PD/AG patients showed pronounced connectivity changes along a widespread subcortical-cortical network, including the midbrain. Dimensional analyses yielded no significant results. The results highlighting categorical differences between ADs at a systems neuroscience level are discussed within the context of personalized neuroscience-informed treatments. PROTECT-AD's registration at NIMH Protocol Registration System: 01EE1402A and German Register of Clinical Studies: DRKS00008743. SpiderVR's registration at ClinicalTrials.gov: NCT03208400.
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Affiliation(s)
- Till Langhammer
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Kevin Hilbert
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychology, HMU Health and Medical University Erfurt, Erfurt, Germany
| | - Dirk Adolph
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Volker Arolt
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Sophie Bischoff
- Department of Psychiatry and Psychotherapy, Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Joscha Böhnlein
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jan C Cwik
- Department of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Ricarda Evens
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Thomas Fydrich
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Bettina Gathmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Alfons O Hamm
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - Ingmar Heinig
- Institute for Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Maike Hollandt
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
- Department of Clinical Psychology and Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Markus Junghoefer
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany
- Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy and Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Marburg, Germany
| | - Katja Koelkebeck
- LVR-University Hospital Essen, Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, Duisburg, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Martin Lotze
- Functional Imaging Unit, Diagnostic Radiology, University Medicine Greifswald, Greifswald, Germany
| | - Jürgen Margraf
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jennifer L M Mumm
- Department of Psychiatry and Psychotherapy, Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andre Pittig
- Translational Psychotherapy, Institute of Psychology, University of Goettingen, Göttingen, Germany
| | - Jens Plag
- Department of Medicine, Institute for Mental Health and Behavioral Medicine, HMU Health and Medical University, Potsdam, Germany
| | - Jan Richter
- Department of Experimental Psychopathology, University of Hildesheim, Hildesheim, Germany
| | - Kati Roesmann
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany
- Institute for Psychology, Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Osnabrueck, Osnabruck, Germany
| | - Isabelle C Ridderbusch
- Department of Psychiatry and Psychotherapy and Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Marburg, Germany
| | - Silvia Schneider
- Department of Clinical Child and Adolescent Psychology, Ruhr-University Bochum, Bochum, Germany
| | - Hanna Schwarzmeier
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Fabian Seeger
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Niklas Siminski
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
- Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Szeska
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
- Department of Biological Psychology and Affective Science, University of Potsdam, Potsdam, Germany
| | - Hans-Ulrich Wittchen
- Institute for Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University (LMU) Muenchen, Munich, Germany
| | - Adrian Wroblewski
- Department of Psychiatry and Psychotherapy and Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Marburg, Germany
| | - Yunbo Yang
- Department of Psychiatry and Psychotherapy and Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Marburg, Germany
- Department of Experimental Psychopathology, University of Hildesheim, Hildesheim, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy and Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Marburg, Germany
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- German Center for Mental Health (DZPG), partner site Berlin/Potsdam, Berlin, Germany
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Grigorenko EL. The extraordinary "ordinary magic" of resilience. Dev Psychopathol 2024:1-18. [PMID: 39363871 DOI: 10.1017/s0954579424000841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
In this essay, I will briefly sample different instances of the utilization of the concept of resilience, attempting to complement a comprehensive representation of the field in the special issue of Development and Psychopathology inspired by the 42nd Minnesota Symposium on Child Psychology, hosted by the Institute of Child Development at the University of Minnesota and held in October of 2022. Having established the general context of the field, I will zoom in on some of its features, which I consider "low-hanging fruit" and which can be harvested in a systematic way to advance the study of resilience in the context of the future of developmental psychopathology.
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Ratsika A, Codagnone MG, Bastiaanssen TFS, Hoffmann Sarda FA, Lynch CMK, Ventura-Silva AP, Rosell-Cardona C, Caputi V, Stanton C, Fülling C, Clarke G, Cryan JF. Maternal high-fat diet-induced microbiota changes are associated with alterations in embryonic brain metabolites and adolescent behaviour. Brain Behav Immun 2024; 121:317-330. [PMID: 39032541 DOI: 10.1016/j.bbi.2024.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 07/09/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024] Open
Abstract
The developing central nervous system is highly sensitive to nutrient changes during the perinatal period, emphasising the potential impact of alterations of maternal diet on offspring brain development and behaviour. A growing body of research implicates the gut microbiota in neurodevelopment and behaviour. Maternal overweight and obesity during the perinatal period has been linked to changes in neurodevelopment, plasticity and affective disorders in the offspring, with implications for microbial signals from the maternal gut. Here we investigate the impact of maternal high-fat diet (mHFD)-induced changes in microbial signals on offspring brain development, and neuroimmune signals, and the enduring effects on behaviour into adolescence. We first demonstrate that maternal caecal microbiota composition at term pregnancy (embryonic day 18: E18) differs significantly in response to maternal diet. Moreover, mHFD resulted in the upregulation of microbial genes in the maternal intestinal tissue linked to alterations in quinolinic acid synthesis and elevated kynurenine levels in the maternal plasma, both neuronal plasticity mediators related to glutamate metabolism. Metabolomics of mHFD embryonic brains at E18 also detected molecules linked to glutamate-glutamine cycle, including glutamic acid, glutathione disulphide, and kynurenine. During adolescence, the mHFD offspring exhibited increased locomotor activity and anxiety-like behaviour in a sex-dependent manner, along with upregulation of glutamate-related genes compared to controls. Overall, our results demonstrate that maternal exposure to high-fat diet results in microbiota changes, behavioural imprinting, altered brain metabolism, and glutamate signalling during critical developmental windows during the perinatal period.
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Affiliation(s)
- Anna Ratsika
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12YT20, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork T12YT20, Ireland
| | - Martin G Codagnone
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12YT20, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork T12YT20, Ireland
| | - Thomaz F S Bastiaanssen
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12YT20, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork T12YT20, Ireland
| | - Fabiana A Hoffmann Sarda
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12YT20, Ireland; Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - Caoimhe M K Lynch
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12YT20, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork T12YT20, Ireland
| | - Ana Paula Ventura-Silva
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12YT20, Ireland
| | - Cristina Rosell-Cardona
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12YT20, Ireland
| | - Valentina Caputi
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12YT20, Ireland
| | | | - Christine Fülling
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12YT20, Ireland
| | - Gerard Clarke
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12YT20, Ireland; Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork T12YT20, Ireland
| | - John F Cryan
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12YT20, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork T12YT20, Ireland.
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7
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Ren X, White EJ, Nacke M, Mayeli A, Touthang J, Al Zoubi O, Kuplicki R, Victor TA, Paulus MP, Aupperle RL, Stewart JL. Blunted stimulus-preceding negativity during reward anticipation in major depressive disorder. J Affect Disord 2024; 362:779-787. [PMID: 39029684 PMCID: PMC11316661 DOI: 10.1016/j.jad.2024.07.060] [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: 10/25/2023] [Revised: 06/24/2024] [Accepted: 07/14/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Reward processing dysfunction is a core characteristic of major depressive disorder (MDD), yet event-related potential (ERP) research in MDD has predominantly focused on reward receipt as opposed to anticipation. The stimulus-preceding negativity (SPN) ERP reflects anticipatory brain processing. This study examines whether individuals with MDD exhibit deficits during reward anticipation as evidenced by altered SPN amplitude. METHODS We assessed prefeedback-SPN amplitudes during a monetary incentive delay (MID) task in individuals with MDD (n = 142, 99 with comorbid anxiety disorders [MDD + ANX]) compared to Controls (n = 37). A mixed analysis of variance was performed on prefeedback-SPN amplitude and behavioral measures, with group (MDD, MDD + ANX, Control) as the between-subjects factor, and feedback (gain, loss) and electrode (F3, F4, Fz, C3, C4, Cz, P3, P4, Pz) as within-subjects factors. RESULTS A group main effect revealed faster reaction times for the Control group than MDD and MDD + ANX groups. A group x feedback interaction indicated that the MDD subgroup had smaller prefeedback-SPN amplitudes than MDD + ANX and Control groups when anticipating gain feedback. Additionally, individuals with current MDD, irrespective of past MDD and comorbid anxiety, exhibited smaller SPN amplitudes than Controls prior to gain feedback. LIMITATIONS The MID paradigm, designed for functional magnetic resonance imaging (fMRI) data acquisition, lacks optimization for ERP analysis. Moreover, the clinical groups included more females than the Control group. CONCLUSIONS Reduced resource allocation to reward anticipation may differentiate MDD from MDD + ANX and Control groups. Further investigation of the neural mechanisms of distinct MDD phenotypes is warranted.
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Affiliation(s)
- Xi Ren
- Laureate Institute for Brain Research, Tulsa, OK, United States.
| | - Evan J White
- Laureate Institute for Brain Research, Tulsa, OK, United States; Oxley College of Health and Natural Sciences, University of Tulsa, Tulsa, OK, United States
| | - Mariah Nacke
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Ahmad Mayeli
- Laureate Institute for Brain Research, Tulsa, OK, United States; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - James Touthang
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Obada Al Zoubi
- Laureate Institute for Brain Research, Tulsa, OK, United States; Department of Psychiatry, Harvard Medical School/McLean Hospital, Boston, MA, United States
| | - Rayus Kuplicki
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Teresa A Victor
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States; Oxley College of Health and Natural Sciences, University of Tulsa, Tulsa, OK, United States
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, United States; Oxley College of Health and Natural Sciences, University of Tulsa, Tulsa, OK, United States
| | - Jennifer L Stewart
- Laureate Institute for Brain Research, Tulsa, OK, United States; Oxley College of Health and Natural Sciences, University of Tulsa, Tulsa, OK, United States
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8
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Xia H, Hou Y, Li Q, Chen A. A meta-analysis of cognitive flexibility in aging: Perspective from functional network and lateralization. Hum Brain Mapp 2024; 45:e70031. [PMID: 39360550 PMCID: PMC11447525 DOI: 10.1002/hbm.70031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 08/21/2024] [Accepted: 09/10/2024] [Indexed: 10/04/2024] Open
Abstract
Cognitive flexibility, the ability to switch between mental processes to generate appropriate behavioral responses, is reduced with typical aging. Previous studies have found that age-related declines in cognitive flexibility are often accompanied by variations in the activation of multiple regions. However, no meta-analyses have examined the relationship between cognitive flexibility in aging and age-related variations in activation within large-scale networks. Here, we conducted a meta-analysis employing multilevel kernel density analysis to identify regions with different activity patterns between age groups, and determined how these regions fall into functional networks. We also employed lateralization analysis to explore the spatial distribution of regions exhibiting group differences in activation. The permutation tests based on Monte Carlo simulation were used to determine the significance of the activation and lateralization results. The results showed that cognitive flexibility in aging was associated with both decreased and increased activation in several functional networks. Compared to young adults, older adults exhibited increased activation in the default mode, dorsal attention, ventral attention, and somatomotor networks, while displayed decreased activation in the visual network. Moreover, we found a global-level left lateralization for regions with decreased activation, but no lateralization for regions with higher activation in older adults. At the network level, the regions with decreased activation were left-lateralized, while the regions with increased activation showed varying lateralization patterns within different networks. To sum up, we found that networks that support various mental functions contribute to age-related variations in cognitive flexibility. Additionally, the aging brain exhibited network-dependent activation and lateralization patterns in response to tasks involving cognitive flexibility. We highlighted that the comprehensive meta-analysis in this study offered new insights into understanding cognitive flexibility in aging from a network perspective.
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Affiliation(s)
- Haishuo Xia
- Faculty of PsychologySouthwest UniversityChongqingChina
| | - Yongqing Hou
- Faculty of PsychologySouthwest UniversityChongqingChina
| | - Qing Li
- Faculty of PsychologySouthwest UniversityChongqingChina
| | - Antao Chen
- School of Psychology, Research Center for Exercise and Brain ScienceShanghai University of SportChina
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9
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Wu H, Lu B, Xiang N, Qiu M, Da H, Xiao Q, Zhang Y, Shi H. Different activation in dorsolateral prefrontal cortex between anxious depression and non-anxious depression during an autobiographical memory task: A fNIRS study. J Affect Disord 2024; 362:585-594. [PMID: 39019227 DOI: 10.1016/j.jad.2024.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 06/06/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVE Using functional near-infrared spectroscopy (fNIRS) previous studies have found that activation differences in the dorsolateral prefrontal cortex (DLPFC) during an autobiographical memory task (AMT) under the condition of different emotional valences may be neurophysiological markers of depression and different depression subtypes. Additionally, compared with non-anxious depression, anxious depression presents abnormal hemodynamic activation in the DLPFC. This study aimed to use fNIRS to investigate hemodynamic activation in the DLPFC of depression patients with and without anxiety during AMT triggered by different emotional valence stimuli. METHODS We recruited 194 patients with depression (91 with non-anxious depression, 103 with anxious depression) and 110 healthy controls from Chinese college students. A 53-channel fNIRS was used to detect cerebral hemodynamic differences in the three groups during AMT. RESULTS The results showed that: (1) the activation of oxy-Hb in the left DLPFC was significantly higher under positive emotional valence than under negative emotional valence for healthy controls and patients with non-anxious depression, while there was no significant difference between positive and negative emotional valence observed in response to anxious depression; and (2) Oxy-Hb activation under negative emotional valence was significantly higher in the anxious depression group than in the non-anxious depression group. CONCLUSIONS This study revealed that the hemodynamic hyperactivation of negative emotional valence in the left DLPFC may be due to the neurophysiological differences between anxious and non-anxious patients with depression.
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Affiliation(s)
- Huifen Wu
- School of Education, Hubei Engineering University, Xiaogan 432000, China
| | - Baoquan Lu
- School of Education, Hubei Engineering University, Xiaogan 432000, China; School of Education, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Nian Xiang
- Department of Neurology, Hospital of Huazhong University of Science and Technology, Wuhan 430074, China
| | - Min Qiu
- Department of Neurology, Hospital of Huazhong University of Science and Technology, Wuhan 430074, China
| | - Hui Da
- School of Education, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Qiang Xiao
- Department of Neurology, Hospital of Huazhong University of Science and Technology, Wuhan 430074, China
| | - Yan Zhang
- School of Education, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Hui Shi
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.
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10
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Rosenberg BM, Moreira JFG, Leal ASM, Saragosa-Harris NM, Gaines E, Meredith WJ, Waizman Y, Ninova E, Silvers JA. Functional connectivity between the nucleus accumbens and amygdala underlies avoidance learning during adolescence: Implications for developmental psychopathology. Dev Psychopathol 2024:1-13. [PMID: 39324228 DOI: 10.1017/s095457942400141x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2024]
Abstract
BACKGROUND Reward and threat processes work together to support adaptive learning during development. Adolescence is associated with increasing approach behavior (e.g., novelty-seeking, risk-taking) but often also coincides with emerging internalizing symptoms, which are characterized by heightened avoidance behavior. Peaking engagement of the nucleus accumbens (NAcc) during adolescence, often studied in reward paradigms, may also relate to threat mechanisms of adolescent psychopathology. METHODS 47 typically developing adolescents (9.9-22.9 years) completed an aversive learning task during functional magnetic resonance imaging, wherein visual cues were paired with an aversive sound or no sound. Task blocks involved an escapable aversively reinforced stimulus (CS+r), the same stimulus without reinforcement (CS+nr), or a stimulus that was never reinforced (CS-). Parent-reported internalizing symptoms were measured using Revised Child Anxiety and Depression Scales. RESULTS Functional connectivity between the NAcc and amygdala differentiated the stimuli, such that connectivity increased for the CS+r (p = .023) but not for the CS+nr and CS-. Adolescents with greater internalizing symptoms demonstrated greater positive functional connectivity for the CS- (p = .041). CONCLUSIONS Adolescents show heightened NAcc-amygdala functional connectivity during escape from threat. Higher anxiety and depression symptoms are associated with elevated NAcc-amygdala connectivity during safety, which may reflect poor safety versus threat discrimination.
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Affiliation(s)
- Benjamin M Rosenberg
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - João F Guassi Moreira
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Adriana S Méndez Leal
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | | | - Elizabeth Gaines
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Wesley J Meredith
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Yael Waizman
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Emilia Ninova
- College of Social Work, Florida State University, Tallahassee, FL, USA
| | - Jennifer A Silvers
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
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11
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Davis EP, Leonard BT, Jirsaraie RJ, Keator DB, Small SL, Sandman CA, Risbrough VB, Stern HS, Glynn LM, Yassa MA, Baram TZ, Rasmussen JM. Sex-Specific Effects of Early Life Unpredictability on Hippocampal and Amygdala Responses to Novelty in Adolescents. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.09.20.614130. [PMID: 39345394 PMCID: PMC11429980 DOI: 10.1101/2024.09.20.614130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Background Unpredictable childhood experiences are an understudied form of early life adversity that impacts neurodevelopment in a sex-specific manner. The neurobiological processes by which exposure to early-life unpredictability impacts development and vulnerability to psychopathology remain poorly understood. The present study investigates the sex-specific consequences of early-life unpredictability on the limbic network, focusing on the hippocampus and the amygdala. Methods Participants included 150 youth (54% female). Early life unpredictability was assessed using the Questionnaire of Unpredictability in Childhood (QUIC). Participants engaged in a task-fMRI scan between the ages of 8 and 17 (223 total observations) measuring BOLD responses to novel and familiar scenes. Results Exposure to early-life unpredictability associated with BOLD contrast (novel vs. familiar) in a sex-specific manner. For males, but not females, higher QUIC scores were associated with lower BOLD activation in response to novel vs. familiar stimuli in the hippocampal head and amygdala. Secondary psychophysiological interaction (PPI) analyses revealed complementary sex-specific associations between QUIC and condition-specific functional connectivity between the right and left amygdala, as well as between the right amygdala and hippocampus bilaterally. Conclusion Exposure to unpredictability in early life has persistent implications for the functional operations of limbic circuits. Importantly, consistent with emerging experimental animal and human studies, the consequences of early life unpredictability differ for males and females. Further, impacts of early-life unpredictability were independent of other risk factors including lower household income and negative life events, indicating distinct consequences of early-life unpredictability over and above more commonly studied types of early life adversity.
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Affiliation(s)
- Elysia Poggi Davis
- Department of Psychology, University of Denver, Colorado 80208
- Department of Pediatrics, University of California, Irvine, California 92697
| | - Bianca T. Leonard
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, California 92697
- Department of Neurobiology and Behavior, University of California, Irvine, California 92697
| | - Robert J. Jirsaraie
- Division of Computational and Data Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - David B. Keator
- Department of Psychiatry and Human Behavior, University of California, Irvine, California 92697
- Change Your Brain Change Your Life Foundation, Costa Mesa, California, Amen Clinics, Costa Mesa, CA, USA
| | - Steven L. Small
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Texas 75080
| | - Curt A. Sandman
- Department of Psychiatry and Human Behavior, University of California, Irvine, California 92697
| | - Victoria B Risbrough
- Centre of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Hal S. Stern
- Department of Statistics, University of California, Irvine, Irvine, California
| | - Laura M. Glynn
- Department of Psychology, Chapman University, California 92866
| | - Michael A. Yassa
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, California 92697
- Department of Neurobiology and Behavior, University of California, Irvine, California 92697
- Department of Psychiatry and Human Behavior, University of California, Irvine, California 92697
- Department of Anatomy and Neurobiology, University of California, Irvine, California 92697
| | - Tallie Z. Baram
- Department of Pediatrics, University of California, Irvine, California 92697
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, California 92697
- Department of Anatomy and Neurobiology, University of California, Irvine, California 92697
| | - Jerod M. Rasmussen
- Department of Pediatrics, University of California, Irvine, California 92697
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12
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Leehr EJ, Brede LS, Böhnlein J, Roesmann K, Gathmann B, Herrmann MJ, Junghöfer M, Schwarzmeier H, Seeger FR, Siminski N, Straube T, Klahn AL, Weber H, Schiele MA, Domschke K, Lueken U, Dannlowski U. Impact of NPSR1 gene variation on the neural correlates of phasic and sustained fear in spider phobia-an imaging genetics and independent replication approach. Soc Cogn Affect Neurosci 2024; 19:nsae054. [PMID: 39167471 PMCID: PMC11412251 DOI: 10.1093/scan/nsae054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 05/13/2024] [Accepted: 08/19/2024] [Indexed: 08/23/2024] Open
Abstract
The functional neuropeptide S receptor 1 (NPSR1) gene A/T variant (rs324981) is associated with fear processing. We investigated the impact of NPSR1 genotype on fear processing and on symptom reduction following treatment in individuals with spider phobia. A replication approach was applied [discovery sample: Münster (MS) nMS = 104; replication sample Würzburg (WZ) nWZ = 81]. Participants were genotyped for NPSR1 rs324981 [T-allele carriers (risk) versus AA homozygotes (no-risk)]. A sustained and phasic fear paradigm was applied during functional magnetic resonance imaging. A one-session virtual reality exposure treatment was conducted. Change of symptom severity from pre to post treatment and within session fear reduction were assessed. T-allele carriers in the discovery sample displayed lower anterior cingulate cortex (ACC) activation compared to AA homozygotes independent of condition. For sustained fear, this effect was replicated within a small cluster and medium effect size. No association with symptom reduction was found. Within-session fear reduction was negatively associated with ACC activation in T-allele carriers in the discovery sample. NPSR1 rs324981 genotype might be associated with fear processing in the ACC in spider phobia. Interpretation as potential risk-increasing function of the NPSR1 rs324981 T-allele via impaired top-down control of limbic structures remains speculative. Potential association with symptom reduction warrants further research.
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Affiliation(s)
- Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster 48149, Germany
| | - Leonie S Brede
- Institute for Translational Psychiatry, University of Münster, Münster 48149, Germany
| | - Joscha Böhnlein
- Institute for Translational Psychiatry, University of Münster, Münster 48149, Germany
| | - Kati Roesmann
- Institute for Clinical Psychology, University of Siegen, Siegen 57072, Germany
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster 48149, Germany
- Institute for Psychology, Unit for Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Osnabrück 49076, Germany
| | - Bettina Gathmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster 48149, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Wurzburg 97080, Germany
| | - Markus Junghöfer
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster 48149, Germany
- Otto-Creutzfeld Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster 48149, Germany
| | - Hanna Schwarzmeier
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Wurzburg 97080, Germany
| | - Fabian R Seeger
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Wurzburg 97080, Germany
- Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg 69115, Germany
| | - Niklas Siminski
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Wurzburg 97080, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster 48149, Germany
| | - Anna Luisa Klahn
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg 41345, Sweden
| | - Heike Weber
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Wurzburg 97080, Germany
| | - Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79104, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79104, Germany
| | - Ulrike Lueken
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Wurzburg 97080, Germany
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin 12489, Germany
- German Center for Mental Health (DZPG), partner site Berlin-Potsdam
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster 48149, Germany
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13
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Rheude C, Nikendei C, Stopyra MA, Bendszus M, Krämer B, Gruber O, Friederich HC, Simon JJ. Two sides of the same coin? What neural processing of emotion and rewards can tell us about complex post-traumatic stress disorder and borderline personality disorder. J Affect Disord 2024; 368:711-719. [PMID: 39299592 DOI: 10.1016/j.jad.2024.09.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 09/12/2024] [Accepted: 09/14/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Borderline personality disorder (BPD) and complex posttraumatic stress disorder (cPTSD) share clinical similarities, complicating diagnosis and treatment. Research on the neurobiology of BPD and monotraumatic PTSD has shown that a prefrontal-limbic imbalance in emotional and reward processing is a hallmark of both disorders, but studies examining this network in cPTSD are lacking. Therefore, this study aimed to directly compare neural processing of emotion and reward during decision making in cPTSD and BPD. METHODS Using functional magnetic resonance imaging, we measured neural activity in female patients (27 patients with cPTSD, 21 patients with BPD and 37 healthy controls) during a Desire-Reason Dilemma task featuring distracting fearful facial expressions. RESULTS We found no differences in neural activation when comparing cPTSD and BPD. However, when grouping patients based on symptom severity instead on diagnosis, we found that increased symptoms of cPTSD were associated with increased activation of dorsolateral prefrontal cortex during reward rejection, whereas increased symptoms of BPD were associated with decreased activation in prefrontal and limbic regions during reward rejection with distracting negative emotional stimuli. CONCLUSION This is the first study to investigate and compare emotional processing and reward-based decision making in cPTSD and BPD. Although we found no neural differences between disorders, we identified symptom-related neural patterns. Specifically, we found that elevated cPTSD symptoms were related to greater sensitivity to reward stimuli, whereas heightened BPD symptoms were related to increased susceptibility to emotional stimuli during goal-directed decision making. These findings enhance our understanding of neural pathomechanisms in trauma-related disorders.
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Affiliation(s)
- Christiane Rheude
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany; DZPG (German Centre for Mental Health) - Partner Site Heidelberg/Mannheim/Ulm, Baden-Württemberg, Germany
| | - Marion A Stopyra
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Bernd Krämer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Baden Württemberg, Germany
| | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Baden Württemberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany; DZPG (German Centre for Mental Health) - Partner Site Heidelberg/Mannheim/Ulm, Baden-Württemberg, Germany
| | - Joe J Simon
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany; DZPG (German Centre for Mental Health) - Partner Site Heidelberg/Mannheim/Ulm, Baden-Württemberg, Germany.
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14
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Miedl SF, Franke LK, Danböck SK, Martini M, Hettegger S, Kronbichler M, Flor H, Wilhelm FH. Neural processing of audiovisual and painful analogue trauma and its relationship with subsequent audiovisual and pain intrusions. Eur J Psychotraumatol 2024; 15:2388429. [PMID: 39282770 PMCID: PMC11407396 DOI: 10.1080/20008066.2024.2388429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2024] Open
Abstract
Background: Posttraumatic stress disorder and medically unexplained pain frequently co-occur. While pain is common during traumatic events, the processing of pain during trauma and its relation to audiovisual and pain intrusions is poorly understood.Objective: Here we investigate neural activations during painful analogue trauma, focusing on areas that have been related to threat and pain processing, and how they predict intrusion formation. We also examine the moderating role of cumulative lifetime adversity.Methods: Sixty-five healthy women were assessed using functional magnetic resonance imaging. An analogue trauma was induced by an adaptation of the trauma-film paradigm extended by painful electrical stimulation in a 2 (film: aversive, neutral) x 2 (pain: pain, no-pain) design, followed by 7-day audiovisual and pain intrusion assessment using event-based ecological momentary assessment. Intrusions were fitted with Bayesian multilevel regression and a hurdle lognormal distribution.Results: Conjunction analysis confirmed a wide network including anterior insula (AI) and dorsal anterior cingulate cortex (dACC) being active both, during aversive films and pain. Pain resulted in activation in areas amongst posterior insula and deactivation in a network around ventromedial prefrontal cortex (VMPFC). Higher AI and dACC activity during aversive>neutral film predicted greater audiovisual intrusion probability over time and predicted greater audiovisual intrusion frequency particularly for participants with high lifetime adversity. Lower AI, dACC, hippocampus, and VMPFC activity during pain>no-pain predicted greater pain intrusion probability particularly for participants with high lifetime adversity. Weak regulatory VMPFC activation was associated with both increased audiovisual and pain intrusion frequency.Conclusions: Enhanced AI and dACC processing during aversive films, poor pain vs. no-pain discrimination in AI and dACC, as well as weak regulatory VMPFC processing may be driving factors for intrusion formation, particularly in combination with high lifetime adversity. Results shed light on a potential path for the etiology of PTSD and medically unexplained pain.
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Affiliation(s)
- Stephan F Miedl
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris-Lodron University Salzburg, Salzburg, Austria
| | - Laila K Franke
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris-Lodron University Salzburg, Salzburg, Austria
| | - Sarah K Danböck
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris-Lodron University Salzburg, Salzburg, Austria
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Michael Martini
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris-Lodron University Salzburg, Salzburg, Austria
| | - Sabrina Hettegger
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris-Lodron University Salzburg, Salzburg, Austria
| | - Martin Kronbichler
- Centre for Cognitive Neuroscience & Department of Psychology, Paris-Lodron University of Salzburg, Salzburg, Austria
- Neuroscience Institute, Christian-Doppler Medical University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Frank H Wilhelm
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris-Lodron University Salzburg, Salzburg, Austria
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15
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Geier TJ, Atkinson SN, Pan AY, Mantz-Wichman M, Jazinski-Chambers K, Hillard CJ, deRoon-Cassini TA. Differences in intestinal bacteria in traumatic injury survivors with and without probable posttraumatic stress disorder. J Affect Disord 2024; 361:528-535. [PMID: 38914163 DOI: 10.1016/j.jad.2024.06.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a common consequence of traumatic injury, yet certain biological factors contributing to PTSD are poorly understood. The gut microbiome may influence mental health outcomes, but its role in heterogeneous PTSD presentations requires elucidation. METHODS Bacterial composition was examined in adults 2-4 years post-trauma with probable PTSD (n = 24) versus trauma-exposed controls without probable PTSD (n = 24). 16S rRNA sequencing and bioinformatic tools assessed microbial diversity and abundance. Relationships between taxa and PTSD symptom clusters were evaluated. RESULTS No differences were found in overall microbial community structure between groups. The probable PTSD group exhibited significantly reduced Actinobacteriota and increased Verrucomicrobiota phylum abundance compared to controls. Specific taxa showed notable inverse associations with negative mood/cognition versus hyperarousal symptoms. Prevotella and Ruminococcaceae were negatively associated with negative mood but positively associated with hyperarousal. CONCLUSIONS Results demonstrate microbial signatures of probable PTSD subtypes, highlighting the microbiome as a potential mediator of heterogeneous trauma psychopathology. Definition of PTSD microbial correlates provides a foundation for personalized psychobiotic interventions targeting predominant symptom profiles.
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Affiliation(s)
- Timothy J Geier
- Department of Surgery, Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI, United States of America.
| | - Samantha N Atkinson
- Department of Microbiology and Immunology, Center for Microbiome Research, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Amy Y Pan
- Department of Pediatrics, Division of Quantitative Health Sciences, Center for Microbiome Research, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Margo Mantz-Wichman
- Department of Surgery, Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Kelley Jazinski-Chambers
- Department of Surgery, Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Cecilia J Hillard
- Department of Pharmacology and Toxicology, Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Terri A deRoon-Cassini
- Department of Surgery, Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI, United States of America; Comprehensive Injury Center, Division of Data Surveillance and Informatics, Medical College of Wisconsin, Milwaukee, WI, United States of America
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16
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Bramlett SN, Foster SL, Weinshenker D, Hepler JR. Endogenous Regulator of G protein Signaling 14 (RGS14) suppresses cocaine-induced emotionally motivated behaviors in female mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.09.12.612719. [PMID: 39314405 PMCID: PMC11419016 DOI: 10.1101/2024.09.12.612719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Addictive drugs hijack the neuronal mechanisms of learning and memory in motivation and emotion processing circuits to reinforce their own use. Regulator of G-protein Signaling 14 (RGS14) is a natural suppressor of post-synaptic plasticity underlying learning and memory in the hippocampus. The present study used immunofluorescence and RGS14 knockout mice to assess the role of RGS14 in behavioral plasticity and reward learning induced by chronic cocaine in emotional-motivational circuits. We report that RGS14 is strongly expressed in discrete regions of the ventral striatum and extended amygdala in wild-type mice, and is co-expressed with D1 and D2 dopamine receptors in neurons of the nucleus accumbens (NAc). Of note, we found that RGS14 is upregulated in the NAc in mice with chronic cocaine history following acute cocaine treatment. We found significantly increased cocaine-induced locomotor sensitization, as well as enhanced conditioned place preference and conditioned locomotor activity in RGS14-deficient mice compared to wild-type littermates. Together, these findings suggest that endogenous RGS14 suppresses cocaine-induced plasticity in emotional-motivational circuits, implicating RGS14 as a protective agent against the maladaptive neuroplastic changes that occur during addiction.
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Affiliation(s)
- Sara N. Bramlett
- Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Stephanie L. Foster
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - David Weinshenker
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - John R. Hepler
- Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta, Georgia, USA
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17
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Lu Q, Lyu Y, Jia N, Dong L, Zhang M, Jin M, Xie M, Li J, Xue F, Li W, Yang Y, Yu Q. Socioeconomic status, individual behaviors and risk of anxiety disorders: A Mendelian randomization study. J Affect Disord 2024; 368:33-40. [PMID: 39265863 DOI: 10.1016/j.jad.2024.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 08/30/2024] [Accepted: 09/08/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND The association between socioeconomic status and individual behaviors (SES/IB) and anxiety disorders has garnered increasing attention, yet the impact of SES/IB on anxiety disorders remains unclear. Therefore, we employed a Mendelian randomization (MR) design to evaluate the causal relationship between SES/IB and anxiety disorders. METHODS We conducted a two-sample MR study to assess the causal effects of SES and IB (smoking behaviors, drinking behaviors, sleeping behaviors, habitual physical activity, leisure sedentary behaviors, and reproductive behaviors) on anxiety disorders. A series of filtering steps were taken to select eligible genetic instruments robustly associated with each of the traits. The inverse variance weighted was used for preliminary analysis, and multiple methods were used for sensitivity testing. RESULTS After Bonferroni correction and rigorous quality control, we found that educational attainment (odds ratio [OR]:0.75; 95 % confidence interval [CI]:0.69-0.81; P = 9.21E-12), alcohol consumption per week (OR: 1.62; 95 % CI: 1.33-1.97; P = 1.80E-06), insomnia (OR: 1.68; 95 % CI: 1.43-1.97; P = 1.45E-10),age at first birth (OR: 0.59; 95 % CI: 0.50-0.68; P = 1.31E-11),and number of sexual partners (OR: 2.19; 95 % CI: 1.71-2.80; P = 6.64E-10) were causally associated with anxiety disorders. LIMITATIONS The subjects included in this study were all of European descent, and whether this finding can be generalized to other populations needs to be further demonstrated. CONCLUSIONS The MR Study provides strong evidence that some factors influence anxiety disorders.
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Affiliation(s)
- Qingxing Lu
- Jilin University, School of Public Health, Department of Epidemiology and Biostatistics, Changchun 130021, China
| | - Yunshu Lyu
- Jilin University, School of Public Health, Department of Epidemiology and Biostatistics, Changchun 130021, China
| | - Ningning Jia
- Jilin University, School of Public Health, Department of Epidemiology and Biostatistics, Changchun 130021, China
| | - Lin Dong
- Jilin University, School of Public Health, Department of Epidemiology and Biostatistics, Changchun 130021, China
| | - Min Zhang
- Jilin University, School of Public Health, Department of Epidemiology and Biostatistics, Changchun 130021, China
| | - Mengdi Jin
- Jilin University, School of Public Health, Department of Epidemiology and Biostatistics, Changchun 130021, China
| | - Mengtong Xie
- Jilin University, School of Public Health, Department of Epidemiology and Biostatistics, Changchun 130021, China
| | - Junnan Li
- Jilin University, School of Public Health, Department of Epidemiology and Biostatistics, Changchun 130021, China
| | - Fengyu Xue
- Jilin University, School of Public Health, Department of Epidemiology and Biostatistics, Changchun 130021, China
| | - Weizhen Li
- Jilin University, School of Public Health, Department of Epidemiology and Biostatistics, Changchun 130021, China
| | - Yuqing Yang
- Jilin University, School of Public Health, Department of Epidemiology and Biostatistics, Changchun 130021, China
| | - Qiong Yu
- Jilin University, School of Public Health, Department of Epidemiology and Biostatistics, Changchun 130021, China..
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18
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Peng Z, Luo Y, Qi R, Cao Z, Ge J, Wu L, Liu J, Zhang L. Influencing factors of posttraumatic stress disorder in Shidu parents who have lost their only child: a cross-sectional survey. BMC Psychiatry 2024; 24:612. [PMID: 39261892 PMCID: PMC11391783 DOI: 10.1186/s12888-024-06059-6] [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: 01/18/2024] [Accepted: 09/04/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND In China, parents who have lost their only child are referred to as Shidu parents (SDPs). This study aimed to investigate the prevalence and risk factors of post-traumatic stress disorder (PTSD) and investigate the influence of depressive and anxiety symptoms on the development of PTSD. METHOD Four hundred and thirty-six SDPs completed assessments of PTSD (Structured Clinical Interview for DSM-IV Disorders, SCID-IV; The Clinician-Administered PTSD Scale-IV, CAPS-IV), depression (Hamilton depression scale), and anxiety (Hamilton Anxiety Scale) via in-person interviews. Logistic regression and hierarchical multiple linear regression analyses were used to explore the association of demographic characteristics, depression, and anxiety symptoms with PTSD. RESULTS The prevalence of PTSD in SDPs was 14.45%. The comorbidity of depression and anxiety symptoms was 87.30% in the SDPs with PTSD. The logistic regression model, which included factors of gender, age, education, depression, and anxiety, which contributed to the development of PTSD, was significant [χ² (11) = 122.47, p < 0.001]. The hierarchical multiple linear regression analysis indicated that female gender and the severity of comorbidities (depression and anxiety) were positively associated with the severity of PTSD. CONCLUSION This study found that the severity of depression and anxiety was closely related to the severity of PTSD, supporting that SDPs are highly prone to the co-occurrence of PTSD, depression, and anxiety after bereavement. Our findings may provide more insights into the development of individualized interventions for parents who have experienced the loss of their only child.
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Affiliation(s)
- Zhuo Peng
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yifeng Luo
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhihong Cao
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Jiyuan Ge
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Wuxi, China
| | - Luoan Wu
- Department of Psychiatry, Yixing Mental Health Center, Wuxi, China
| | - Jin Liu
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Li Zhang
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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19
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Xia M, Wang T, Wang Y, Hu T, Chen D, Wang B. A neural perspective on the treatment of hypertension: the neurological network excitation and inhibition (E/I) imbalance in hypertension. Front Cardiovasc Med 2024; 11:1436059. [PMID: 39323755 PMCID: PMC11422145 DOI: 10.3389/fcvm.2024.1436059] [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: 05/21/2024] [Accepted: 08/29/2024] [Indexed: 09/27/2024] Open
Abstract
Despite the increasing number of anti-hypertensive drugs have been developed and used in the clinical setting, persistent deficiencies persist, including issues such as lifelong dosage, combination therapy. Notwithstanding receiving the treatment under enduring these deficiencies, approximately 4 in 5 patients still fail to achieve reliable blood pressure (BP) control. The application of neuromodulation in the context of hypertension presents a pioneering strategy for addressing this condition, con-currently implying a potential central nervous mechanism underlying hypertension onset. We hypothesize that neurological networks, an essential component of maintaining appropriate neurological function, are involved in hypertension. Drawing on both peer-reviewed research and our laboratory investigations, we endeavor to investigate the underlying neural mechanisms involved in hypertension by identifying a close relationship between its onset of hypertension and an excitation and inhibition (E/I) imbalance. In addition to the involvement of excitatory glutamatergic and GABAergic inhibitory system, the pathogenesis of hypertension is also associated with Voltage-gated sodium channels (VGSCs, Nav)-mediated E/I balance. The overloading of glutamate or enhancement of glutamate receptors may be attributed to the E/I imbalance, ultimately triggering hypertension. GABA loss and GABA receptor dysfunction have also proven to be involved. Furthermore, we have identified that abnormalities in sodium channel expression and function alter neural excitability, thereby disturbing E/I balance and potentially serving as a mechanism underlying hypertension. These insights are expected to furnish potential strategies for the advancement of innovative anti-hypertensive therapies and a meaningful reference for the exploration of central nervous system (CNS) targets of anti-hypertensives.
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Affiliation(s)
- Min Xia
- Department of Anesthesiology, General Hospital of The Yangtze River Shipping, Wuhan Brain Hospital, Wuhan, China
- Liaoning Provincial Key Laboratory of Cerebral Diseases, Department of Physiology, College of Basic Medical Sciences, National-Local Joint Engineering Research Center for Drug Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
| | - Tianyu Wang
- Liaoning Provincial Key Laboratory of Cerebral Diseases, Department of Physiology, College of Basic Medical Sciences, National-Local Joint Engineering Research Center for Drug Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
| | - Yizhu Wang
- Liaoning Provincial Key Laboratory of Cerebral Diseases, Department of Physiology, College of Basic Medical Sciences, National-Local Joint Engineering Research Center for Drug Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Tingting Hu
- Department of Anesthesiology, General Hospital of The Yangtze River Shipping, Wuhan Brain Hospital, Wuhan, China
| | - Defang Chen
- Liaoning Provincial Key Laboratory of Cerebral Diseases, Department of Physiology, College of Basic Medical Sciences, National-Local Joint Engineering Research Center for Drug Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
- Emergency Intensive Care Unit, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Bin Wang
- Liaoning Provincial Key Laboratory of Cerebral Diseases, Department of Physiology, College of Basic Medical Sciences, National-Local Joint Engineering Research Center for Drug Research and Development (R&D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, China
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20
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Azriel O, Arad G, Tik N, Weiser M, Bloch M, Garber E, Lazarov A, Pine DS, Tavor I, Bar-Haim Y. Neural activation changes following attention bias modification treatment or a selective serotonin reuptake inhibitor for social anxiety disorder. Psychol Med 2024:1-13. [PMID: 39252484 DOI: 10.1017/s0033291724001521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
BACKGROUND Delineation of changes in neural function associated with novel and established treatments for social anxiety disorder (SAD) can advance treatment development. We examined such changes following selective serotonin reuptake inhibitor (SSRI) and attention bias modification (ABM) variant - gaze-contingent music reward therapy (GC-MRT), a first-line and an emerging treatments for SAD. METHODS Eighty-one patients with SAD were allocated to 12-week treatments of either SSRI or GC-MRT, or waitlist (ns = 22, 29, and 30, respectively). Baseline and post-treatment functional magnetic resonance imaging (fMRI) data were collected during a social-threat processing task, in which attention was directed toward and away from threat/neutral faces. RESULTS Patients who received GC-MRT or SSRI showed greater clinical improvement relative to patients in waitlist. Compared to waitlist patients, treated patients showed greater activation increase in the right inferior frontal gyrus and anterior cingulate cortex when instructed to attend toward social threats and away from neutral stimuli. An additional anterior cingulate cortex cluster differentiated between the two active groups. Activation in this region increased in ABM and decreased in SSRI. In the ABM group, symptom change was positively correlated with neural activation change in the dorsolateral prefrontal cortex. CONCLUSIONS Brain function measures show both shared and treatment-specific changes following ABM and SSRI treatments for SAD, highlighting the multiple pathways through which the two treatments might work. Treatment-specific neural responses suggest that patients with SAD who do not fully benefit from SSRI or ABM may potentially benefit from the alternative treatment, or from a combination of the two. TRIAL REGISTRATION ClinicalTrials.gov, Identifier: NCT03346239. https://clinicaltrials.gov/ct2/show/NCT03346239.
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Affiliation(s)
- Omer Azriel
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Gal Arad
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Niv Tik
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Mark Weiser
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Psychiatry, Sheba Medical Center, Tel Aviv, Israel
| | - Miki Bloch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eddie Garber
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Daniel S Pine
- Section on Developmental Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Ido Tavor
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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21
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Li L, Jiang J, Zhong S, Lin J, Yao Y, Kemp GJ, Chen Y, Gong Q. Transdiagnostic depression severity and its relationship to global and prefrontal-amygdala structural properties in people with major depression and post-traumatic stress disorder. Cereb Cortex 2024; 34:bhae381. [PMID: 39315647 PMCID: PMC11420672 DOI: 10.1093/cercor/bhae381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 08/27/2024] [Accepted: 09/12/2024] [Indexed: 09/25/2024] Open
Abstract
While some studies have used a transdiagnostic approach to relate depression to metabolic or functional brain alterations, the structural substrate of depression across clinical diagnostic categories is underexplored. In a cross-sectional study of 52 patients with major depressive disorder and 51 with post-traumatic stress disorder, drug-naïve, and spanning mild to severe depression severity, we examined transdiagnostic depressive correlates with regional gray matter volume and the topological properties of gray matter-based networks. Locally, transdiagnostic depression severity correlated positively with gray matter volume in the right middle frontal gyrus and negatively with nodal topological properties of gray matter-based networks in the right amygdala. Globally, transdiagnostic depression severity correlated positively with normalized characteristic path length, a measure implying brain integration ability. Compared with 62 healthy control participants, both major depressive disorder and post-traumatic stress disorder patients showed altered nodal properties in regions of the fronto-limbic-striatal circuit, and global topological organization in major depressive disorder in particular was characterized by decreased integration and segregation. These findings provide evidence for a gray matter-based structural substrate underpinning depression, with the prefrontal-amygdala circuit a potential predictive marker for depressive symptoms across clinical diagnostic categories.
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Affiliation(s)
- Lei Li
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Guoxuexiang 37#, Wuhou, Chengdu, 640041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Guoxuexiang 37#, Wuhou, Chengdu, 640041, China
| | - Jing Jiang
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Guoxuexiang 37#, Wuhou, Chengdu, 640041, China
- The Third People’s Hospital, Yangshijie 19#, Qingyang, Chengdu, 610031, China
| | - Shitong Zhong
- West China School of Medicine, Sichuan University, Renminnanlu 16#, Wuhou, Chengdu, 640041, China
| | - Jinping Lin
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Guoxuexiang 37#, Wuhou, Chengdu, 640041, China
| | - Yuhao Yao
- West China School of Medicine, Sichuan University, Renminnanlu 16#, Wuhou, Chengdu, 640041, China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre and Institute of Life Course and Medical Sciences, University of Liverpool, Foundation Building, Brownlow Hill, Liverpool, L69 7ZX, United Kingdom
| | - Ying Chen
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Guoxuexiang 37#, Wuhou, Chengdu, 640041, China
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Guoxuexiang 37#, Wuhou, Chengdu, 640041, China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Jinyuanxilu 699#, Jimei, Xiamen, 361022, China
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22
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Roberts AC, Mulvihill KG. Multiple faces of anxiety: a frontal lobe perspective. Trends Neurosci 2024; 47:708-721. [PMID: 39127569 DOI: 10.1016/j.tins.2024.07.001] [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: 03/27/2024] [Revised: 06/20/2024] [Accepted: 07/11/2024] [Indexed: 08/12/2024]
Abstract
Marked dysregulation of the human prefrontal cortex (PFC) and anterior cingulate cortex (ACC) characterises a variety of anxiety disorders, and its amelioration is a key feature of treatment success. Overall treatment response, however, is highly variable, and about a third of patients are resistant to treatment. In this review we hypothesise that a major contributor to this variation in treatment response are the multiple faces of anxiety induced by distinct forms of frontal cortex dysregulation. Comparison of findings from humans and non-human primates reveals marked similarity in the functional organisation of threat regulation across the frontal lobes. This organisation is discussed in relation to the 'predatory imminence continuum' model of threat and the differential engagement of executive functions at the core of both emotion generation and regulation strategies.
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Affiliation(s)
- Angela C Roberts
- Department of Physiology, Development, and Neuroscience, University of Cambridge, Cambridge, UK.
| | - Kevin G Mulvihill
- Department of Physiology, Development, and Neuroscience, University of Cambridge, Cambridge, UK.
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23
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Chaki S. Melanin-concentrating hormone receptor: A therapeutic target for novel anxiolytics. Pharmacol Biochem Behav 2024; 242:173818. [PMID: 38971471 DOI: 10.1016/j.pbb.2024.173818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/26/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024]
Abstract
Anxiety disorders are chronic, disabling psychiatric disorders, and there is a growing medical need for the development of novel pharmacotherapeutic agents showing improved efficacy and an improved side effect profile as compared with the currently prescribed anxiolytic drugs. In the course of the search for next-generation anxiolytics, neuropeptide receptors have garnered interest as potential therapeutic targets, underscored by pivotal roles in modulating stress responses and findings from animal studies using pharmacological tools. Among these neuropeptide receptors, the type 1 receptor for melanin-concentrating hormone (MCH1), which has been demonstrated to be involved in an array of physiological processes, including the regulation of stress responses and affective states, has gained attraction as a therapeutic target for drugs used in the treatment of psychiatric disorders, including anxiety disorders. To date, a plethora of MCH1 antagonists have been synthesized, and studies using MCH1 antagonists and genetically manipulated mice lacking MCH1 have revealed that the blockade of MCH1 produces anxiolytic-like effects across diverse rodent paradigms. In addition, MCH1 antagonists have been demonstrated to show a rapid onset of antidepressant-like effects; therefore, they may be effective for conditions commonly encountered in patients with anxiety disorders, which is an advantage for anxiolytic drugs. Notably, MCH1 antagonists have not manifested the undesirable side effects observed with the currently prescribed anxiolytics. All these preclinical findings testify to the potential of MCH1 antagonists as novel anxiolytics. Although there are still issues that need to be resolved prior to the initiation of clinical trials, such as elucidating the precise neuronal mechanisms underlying their anxiolytic effects and exploring pertinent biomarkers that can be used in clinical trials, MCH1 blockade appears to be an attractive way to tackle anxiety disorders.
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Affiliation(s)
- Shigeyuki Chaki
- Research Headquarters, Taisho Pharmaceutical Co., Ltd., Saitama, Saitama 331-9530, Japan; Chiba University Center for Forensic Mental Health, Chiba, Chiba 260-8670, Japan.
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24
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Sütçübaşı B, Bayram A, Metin B, Demiralp T. Neural correlates of approach-avoidance behavior in healthy subjects: Effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) over the right dorsolateral prefrontal cortex. Int J Psychophysiol 2024; 203:112392. [PMID: 39002638 DOI: 10.1016/j.ijpsycho.2024.112392] [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: 12/05/2023] [Revised: 07/01/2024] [Accepted: 07/10/2024] [Indexed: 07/15/2024]
Abstract
The dorsolateral prefrontal cortex (dlPFC) is implicated in top-down regulation of emotion, but the detailed network mechanisms require further elucidation. To investigate network-level functions of the dlPFC in emotion regulation, this study measured changes in task-based activation, resting-state and task-based functional connectivity (FC) patterns following suppression of dlPFC excitability by 1-Hz repetitive transcranial magnetic stimulation (rTMS). In a sham-controlled within-subject design, 1-Hz active or sham rTMS was applied to the right dlPFC of 19 healthy volunteers during two separate counterbalanced sessions. Following active and sham rTMS, functional magnetic resonance imaging (fMRI) was conducted in the resting state (rs-fMRI) and during approach-avoidance task responses to pictures with positive and negative emotional content (task-based fMRI). Activation and generalized psychophysiological interaction analyses were performed on task-based fMRI, and seed-based FC analysis was applied to rs-fMRI data. Task-based fMRI revealed greater and more lateralized activation in the right hemisphere during negative picture responses compared to positive picture responses. After active rTMS, greater activation was observed in the left middle prefrontal cortex compared to sham rTMS. Further, rTMS reduced response times and error rates in approach to positive pictures compared to negative pictures. Significant FC changes due to rTMS were observed predominantly in the frontoparietal network (FPN) and visual network (VN) during the task, and in the default mode network (DMN) and VN at rest. Suppression of right dlPFC activity by 1-Hz rTMS alters large-scale neural networks and modulates emotion, supporting potential applications for the treatment of mood disorders.
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Affiliation(s)
- Bernis Sütçübaşı
- Acibadem University, Faculty of Humanities and Social Sciences, Department of Psychology, Istanbul, Turkey
| | - Ali Bayram
- Istanbul University, Aziz Sancar Institute of Experimental Medicine, Department of Neuroscience, Istanbul, Turkey.
| | - Barış Metin
- Uskudar University, Faculty of Medicine, Department of Neurology, Istanbul, Turkey.
| | - Tamer Demiralp
- Istanbul University, Istanbul Faculty of Medicine, Department of Physiology, Istanbul, Turkey.
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25
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Choi TY, Jeong S, Koo JW. Mesocorticolimbic circuit mechanisms of social dominance behavior. Exp Mol Med 2024; 56:1889-1899. [PMID: 39218974 PMCID: PMC11447232 DOI: 10.1038/s12276-024-01299-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/10/2024] [Accepted: 05/23/2024] [Indexed: 09/04/2024] Open
Abstract
Social animals, including rodents, primates, and humans, partake in competition for finite resources, thereby establishing social hierarchies wherein an individual's social standing influences diverse behaviors. Understanding the neurobiological underpinnings of social dominance is imperative, given its ramifications for health, survival, and reproduction. Social dominance behavior comprises several facets, including social recognition, social decision-making, and actions, indicating the concerted involvement of multiple brain regions in orchestrating this behavior. While extensive research has been dedicated to elucidating the neurobiology of social interaction, recent studies have increasingly delved into adverse social behaviors such as social competition and hierarchy. This review focuses on the latest advancements in comprehending the mechanisms of the mesocorticolimbic circuit governing social dominance, with a specific focus on rodent studies, elucidating the intricate dynamics of social hierarchies and their implications for individual well-being and adaptation.
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Affiliation(s)
- Tae-Yong Choi
- Emotion, Cognition and Behavior Research Group, Korea Brain Research Institute, Daegu, Republic of Korea.
| | - Sejin Jeong
- Emotion, Cognition and Behavior Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
- Department of Life Sciences, Yeungnam University, Gyeongsan, Republic of Korea
| | - Ja Wook Koo
- Emotion, Cognition and Behavior Research Group, Korea Brain Research Institute, Daegu, Republic of Korea.
- Department of Brain Sciences, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea.
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26
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Sgobbi RF, Incrocci RM, Paliarin F, Nobre MJ. The modulatory role of serotonin-1A receptors of the basolateral amygdala and dorsal periaqueductal gray on the impact of hormonal variation on the conditioned fear response. Neuroscience 2024; 554:118-127. [PMID: 39019393 DOI: 10.1016/j.neuroscience.2024.07.017] [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: 02/23/2024] [Revised: 06/07/2024] [Accepted: 07/10/2024] [Indexed: 07/19/2024]
Abstract
Despite significant advances in the study of fear and fear memory formation, little is known about fear learning and expression in females. This omission has been proven surprising, as normal and pathological behaviors are highly influenced by ovarian hormones, particularly estradiol and progesterone. In the current study, we investigated the joint influence of serotonin (5-HT) neurotransmission and estrous cycle phases (low or high levels of estradiol and progesterone) on the expression of conditioned fear in a group of female rats that were previously divided according to their response to stressful stimuli into low or high anxiety-like subjects. The baseline amplitude of the unconditioned acoustic startle responses was high in high-anxiety female rats, with no effect on the estrous cycle observed. Data collected during the proestrus-estrus phase revealed that low-anxiety rats had startle amplitudes similar to those of high-anxiety rats. It is supposed that high-anxiety female rats benefit from increased estradiol and progesterone levels to achieve comparable potentiated startle amplitudes. In contrast, female rats experienced a significant decrease in hormone levels during the Diestrus phase. This decrease is believed to play a role in preventing them from displaying a heightened startle response when faced with strongly aversive stimuli. Data collected after 5-HT and 8-OH-DPAT were administered into the basolateral nuclei and dorsal periaqueductal gray suggest that 5-HT neurotransmission works with progesterone and estrogen to reduce startle potentiation, most likely by activating the serotonin-1A receptor subtype.
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Affiliation(s)
- R F Sgobbi
- Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo (USP), 14040-901 Ribeirão Preto, SP, Brasil
| | - R M Incrocci
- Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo (USP), 14040-901 Ribeirão Preto, SP, Brasil
| | - F Paliarin
- Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo (USP), 14040-901 Ribeirão Preto, SP, Brasil
| | - M J Nobre
- Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo (USP), 14040-901 Ribeirão Preto, SP, Brasil; Departamento de Psicologia, Uni-FACEF, 14401-135, Franca, SP, Brasil.
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Herzog S, Schneck N, Galfalvy H, Hwei-Choo T, Schmidt M, Michel CA, Sublette ME, Burke A, Ochsner K, Mann JJ, Oquendo MA, Stanley BH. A Neural Signature for Reappraisal as an Emotion Regulation Strategy: Relationship to Stress-Related Suicidal Ideation and Negative Affect in Major Depression. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00246-5. [PMID: 39197491 DOI: 10.1016/j.bpsc.2024.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 07/16/2024] [Accepted: 08/06/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND Impaired emotion regulation (ER) contributes to major depression, and suicidal ideation (SI) and behavior. ER is typically studied by explicitly directing participants to regulate, but this may not capture depressed individuals' spontaneous tendencies to engage ER in daily life. METHODS In N=82 participants with major depressive disorder (MDD), we examined the relationship of spontaneous engagement of ER to real-world responses to stress. We used a machine learning-derived neural signature reflecting neural systems underlying cognitive reappraisal (an ER strategy) to identify reappraisal-related activity while participants recalled negative autobiographical memories under the following conditions: 1) unstructured recall; 2) distanced recall, a form of reappraisal; and 3) immersed recall (comparison condition). Participants also completed a week of ecological momentary assessment (EMA) measuring daily stressors, suicidal ideation (SI), and negative affect. RESULTS Higher reappraisal signature output for the unstructured period, a proxy for the spontaneous tendency to engage ER, was associated with greater increases in SI following stressors (b=0.083, p=0.041). Higher signature output for distanced recall, a proxy for the capacity to engage ER when directed, was associated with lower negative affect following stressors (b=-0.085, p=0.029). Output for the immerse period was not associated with EMA outcomes. CONCLUSIONS Findings suggest that, in MDD, the spontaneous tendency to react to negative memories with attempts to reappraise may indicate greater reactivity to negative cues; while intact capacity to use reappraisal when directed may be associated with more adaptive responses to stress. These data have implications for understanding stress-related increases in suicide risk in depression.
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Varkevisser T, Geuze E, van Honk J. Amygdala fMRI-A Critical Appraisal of the Extant Literature. Neurosci Insights 2024; 19:26331055241270591. [PMID: 39148643 PMCID: PMC11325331 DOI: 10.1177/26331055241270591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 07/08/2024] [Indexed: 08/17/2024] Open
Abstract
Even before the advent of fMRI, the amygdala occupied a central space in the affective neurosciences. Yet this amygdala-centred view on emotion processing gained even wider acceptance after the inception of fMRI in the early 1990s, a landmark that triggered a goldrush of fMRI studies targeting the amygdala in vivo. Initially, this amygdala fMRI research was mostly confined to task-activation studies measuring the magnitude of the amygdala's response to emotional stimuli. Later, interest began to shift more towards the study of the amygdala's resting-state functional connectivity and task-based psychophysiological interactions. Later still, the test-retest reliability of amygdala fMRI came under closer scrutiny, while at the same time, amygdala-based real-time fMRI neurofeedback gained widespread popularity. Each of these major subdomains of amygdala fMRI research has left its marks on the field of affective neuroscience at large. The purpose of this review is to provide a critical assessment of this literature. By integrating the insights garnered by these research branches, we aim to answer the question: What part (if any) can amygdala fMRI still play within the current landscape of affective neuroscience? Our findings show that serious questions can be raised with regard to both the reliability and validity of amygdala fMRI. These conclusions force us to cast doubt on the continued viability of amygdala fMRI as a core pilar of the affective neurosciences.
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Affiliation(s)
- Tim Varkevisser
- University Medical Center, Utrecht, The Netherlands
- Brain Research and Innovation Center, Ministry of Defence, Utrecht, The Netherlands
- Utrecht University, Utrecht, The Netherlands
| | - Elbert Geuze
- University Medical Center, Utrecht, The Netherlands
- Brain Research and Innovation Center, Ministry of Defence, Utrecht, The Netherlands
| | - Jack van Honk
- Utrecht University, Utrecht, The Netherlands
- University of Cape Town, Cape Town, South Africa
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Siegel P, Peterson BS. Advancing the treatment of anxiety disorders in transition-age youth: a review of the therapeutic effects of unconscious exposure. J Child Psychol Psychiatry 2024. [PMID: 39128857 DOI: 10.1111/jcpp.14037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND The real-world effectiveness of exposure-based therapies for youth depends on the willingness and ability of young people to tolerate confronting their fears, which can be experienced as highly aversive and create problems with treatment engagement and acceptance. Recently, neuroscientific research on the nonconscious basis of fear has been translated into novel exposure interventions that bypass conscious processing of feared stimuli and that thus do not cause phobic youth to experience distress. We present a review of these unconscious exposure interventions. METHODS A PRISMA-based search yielded 20 controlled experiments based on three paradigms that tested if fear-related responses could be reduced without conscious awareness in highly phobic, transition-age youth: 14 randomized controlled trials (RCTs), 5 fMRI studies (1 was also an RCT), 4 psychophysiological studies (3 were also RCTs), and 1 ERP study. We conducted meta-analyses of outcomes where feasible. RESULTS Unconscious exposure interventions significantly (1) reduced avoidance behavior (range of Cohen's d = 0.51-0.95) and self-reported fear (d = 0.45-1.25) during in vivo exposure to the feared situation; (2) reduced neurobiological indicators of fear (d = 0.54-0.62) and concomitant physiological arousal (d = 0.55-0.64); (3) activated neural systems supporting fear regulation more strongly than visible exposure to the same stimuli (d = 1.2-1.5); (4) activated regions supporting fear regulation that mediated the reduction of avoidance behavior (d = 0.70); (5) evoked ERPs suggesting encoding of extinction memories (d = 2.13); and (6) had these effects without inducing autonomic arousal or subjective fear. CONCLUSIONS Unconscious exposure interventions significantly reduce a variety of symptomatic behaviors with mostly moderate effect sizes in transition-age youth with specific phobias. fMRI and physiological findings establish a neurophysiological basis for this efficacy, and suggest it occurs through extinction learning. Unconscious exposure was well tolerated, entirely unassociated with drop out, and is highly scalable for clinical practice. However, a number of limitations must be addressed to assess potential clinical impacts, including combining unconscious exposure with exposure therapy to boost treatment acceptance and efficacy.
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Affiliation(s)
- Paul Siegel
- Department of Psychology, Purchase College, State University of New York, Purchase, NY, USA
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Bradley S Peterson
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Psychiatry, Children's Hospital Los Angeles, Institute for the Developing Mind, Los Angeles, CA, USA
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30
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Aukema RJ, Petrie GN, Matarasso AK, Baglot SL, Molina LA, Füzesi T, Kadhim S, Nastase AS, Rodriguez Reyes I, Bains JS, Morena M, Bruchas MR, Hill MN. Identification of a stress-responsive subregion of the basolateral amygdala in male rats. Neuropsychopharmacology 2024:10.1038/s41386-024-01927-x. [PMID: 39117904 DOI: 10.1038/s41386-024-01927-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/14/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024]
Abstract
The basolateral amygdala (BLA) is reliably activated by psychological stress and hyperactive in conditions of pathological stress or trauma; however, subsets of BLA neurons are also readily activated by rewarding stimuli and can suppress fear and avoidance behaviours. The BLA is highly heterogeneous anatomically, exhibiting continuous molecular and connectivity gradients throughout the entire structure. A critical gap remains in understanding the anatomical specificity of amygdala subregions, circuits, and cell types explicitly activated by acute stress and how they are dynamically activated throughout stimulus exposure. Using a combination of topographical mapping for the activity-responsive protein FOS and fiber photometry to measure calcium transients in real-time, we sought to characterize the spatial and temporal patterns of BLA activation in response to a range of novel stressors (shock, swim, restraint, predator odour) and non-aversive, but novel stimuli (crackers, citral odour). We report four main findings: (1) the BLA exhibits clear spatial activation gradients in response to novel stimuli throughout the medial-lateral and dorsal-ventral axes, with aversive stimuli strongly biasing activation towards medial aspects of the BLA; (2) novel stimuli elicit distinct temporal activation patterns, with stressful stimuli exhibiting particularly enhanced or prolonged temporal activation patterns; (3) changes in BLA activity are associated with changes in behavioural state; and (4) norepinephrine enhances stress-induced activation of BLA neurons via the ß-noradrenergic receptor. Moving forward, it will be imperative to combine our understanding of activation gradients with molecular and circuit-specificity.
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Affiliation(s)
- Robert J Aukema
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Mathison Centre for Mental Health, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Gavin N Petrie
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Mathison Centre for Mental Health, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Avi K Matarasso
- Bioengineering, University of Washington, Seattle, WA, 98195, USA
- Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, 98195, USA
- UW Center for the Neurobiology of Addiction, Pain, and Emotion (NAPE), University of Washington, Seattle, WA, 98195, USA
| | - Samantha L Baglot
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Mathison Centre for Mental Health, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Leonardo A Molina
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Tamás Füzesi
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Sandra Kadhim
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Mathison Centre for Mental Health, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Andrei S Nastase
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Mathison Centre for Mental Health, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Itzel Rodriguez Reyes
- Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, 98195, USA
- UW Center for the Neurobiology of Addiction, Pain, and Emotion (NAPE), University of Washington, Seattle, WA, 98195, USA
| | - Jaideep S Bains
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Maria Morena
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Mathison Centre for Mental Health, University of Calgary, Calgary, AB, T2N 4N1, Canada
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, 00185, Italy
- Neuropsychopharmacology Unit, European Center for Brain Research, Santa Lucia Foundation, Rome, 00143, Italy
| | - Michael R Bruchas
- Bioengineering, University of Washington, Seattle, WA, 98195, USA
- Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, 98195, USA
- UW Center for the Neurobiology of Addiction, Pain, and Emotion (NAPE), University of Washington, Seattle, WA, 98195, USA
| | - Matthew N Hill
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 4N1, Canada.
- Mathison Centre for Mental Health, University of Calgary, Calgary, AB, T2N 4N1, Canada.
- Department of Cell Biology and Anatomy, University of Calgary, Calgary, AB, T2N 4N1, Canada.
- Department of Psychiatry, University of Calgary, Calgary, AB, T2N 4N1, Canada.
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España JC, Yasoda-Mohan A, Vanneste S. The Locus Coeruleus in Chronic Pain. Int J Mol Sci 2024; 25:8636. [PMID: 39201323 PMCID: PMC11354431 DOI: 10.3390/ijms25168636] [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: 06/25/2024] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 09/02/2024] Open
Abstract
Pain perception is the consequence of a complex interplay between activation and inhibition. Noradrenergic pain modulation inhibits nociceptive transmission and pain perception. The main source of norepinephrine (NE) in the central nervous system is the Locus Coeruleus (LC), a small but complex cluster of cells in the pons. The aim of this study is to review the literature on the LC-NE inhibitory system, its influence on chronic pain pathways and its frequent comorbidities. The literature research showed that pain perception is the consequence of nociceptive and environmental processing and is modulated by the LC-NE system. If perpetuated in time, nociceptive inputs can generate neuroplastic changes in the central nervous system that reduce the inhibitory effects of the LC-NE complex and facilitate the development of chronic pain and frequent comorbidities, such as anxiety, depression or sleeping disturbances. The exact mechanisms involved in the LC functional shift remain unknown, but there is some evidence that they occur through plastic changes in the medial and lateral pathways and their brain projections. Additionally, there are other influencing factors, like developmental issues, neuroinflammatory glial changes, NE receptor affinity and changes in LC neuronal firing rates.
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Affiliation(s)
- Jorge Castejón España
- Lab for Clinical and Integrative Neuroscience, Trinity College Institute for Neuroscience, School of Psychology, Trinity College Dublin, D02 PN40 Dublin, Ireland; (J.C.E.); (A.Y.-M.)
- Compass Physio, A83 YW96 Enfield, Ireland
| | - Anusha Yasoda-Mohan
- Lab for Clinical and Integrative Neuroscience, Trinity College Institute for Neuroscience, School of Psychology, Trinity College Dublin, D02 PN40 Dublin, Ireland; (J.C.E.); (A.Y.-M.)
- Global Brain Health Institute, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, Trinity College Institute for Neuroscience, School of Psychology, Trinity College Dublin, D02 PN40 Dublin, Ireland; (J.C.E.); (A.Y.-M.)
- Global Brain Health Institute, Trinity College Dublin, D02 PN40 Dublin, Ireland
- Brain Research Centre for Advanced, International, Innovative and Interdisciplinary Neuromodulation, 9000 Ghent, Belgium
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Munguia A, Ostrosky F, Lozano A, Castañeda D, Lujan A, Diaz K, Perez M, Lara R, Sacristan E. The relationship between changes in functional networks and cognitive changes and PTSD symptoms in maltreated children before and after TF-CBT. Behav Brain Res 2024; 471:115091. [PMID: 38838966 DOI: 10.1016/j.bbr.2024.115091] [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: 12/06/2023] [Revised: 05/27/2024] [Accepted: 06/02/2024] [Indexed: 06/07/2024]
Abstract
Several studies have found that maltreated children show neuropsychological deficits in various cognitive domains such as memory and attention, language, visuospatial skills, emotional regulation, social cognition, and executive functioning. In terms of functional connectivity, abused children show an increased connectivity in the salience network (SN) as opposed to a decreased connectivity within the default (DMN) and executive networks (CEN). Children who suffer maltreatment may develop post-traumatic stress disorder (PTSD), which in turn, can increase psychological and cognitive sequelae. The present study examined the relation between resting state functional connectivity (RSFC), PTSD symptoms and neuropsychological profiles in abused children before and after following a psychological therapy named Trauma Focused Cognitive Behavioral therapy (TF-CBT). Resting state functional magnetic resonance imaging, neuropsychological (attention, memory and executive functions) and clinical evaluations were performed in 13 abused children with PTSD (mean age=8.77 years old, S.D.=1.83) recruited from a non-governmental shelter in Mexico and in a control group of 10 children from the general population (mean age = 9.57 years old, S.D. = 1.91). Both groups were matched according to age and gender. Changes in PTSD symptoms correlated with changes in the left insula node. Additionally, significant correlations were identified between changes in the average connectivity of the DMN, intra-nodal connectivity of lateral parietal and medial prefrontal regions, and performance in attention and memory tasks.
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Affiliation(s)
- Ana Munguia
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - Feggy Ostrosky
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico.
| | - Asucena Lozano
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - Dianela Castañeda
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - Angélica Lujan
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - Karla Diaz
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - Martha Perez
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - Rafael Lara
- Centro Nacional de Investigación en Imagenología e Instrumentación Médica, Universidad Autónoma Metropolitana, Ciudad de México 09340, Mexico
| | - Emilio Sacristan
- Centro Nacional de Investigación en Imagenología e Instrumentación Médica, Universidad Autónoma Metropolitana, Ciudad de México 09340, Mexico
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Shalev A, Cho D, Marmar CR. Neurobiology and Treatment of Posttraumatic Stress Disorder. Am J Psychiatry 2024; 181:705-719. [PMID: 39086292 DOI: 10.1176/appi.ajp.20240536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
The recent worldwide surge of warfare and hostilities exposes increasingly large numbers of individuals to traumatic events, placing them at risk of developing posttraumatic stress disorder (PTSD) and challenging both clinicians and service delivery systems. This overview summarizes and updates the core knowledge of the genetic, molecular, and neural circuit features of the neurobiology of PTSD and advances in evidence-based psychotherapy, pharmacotherapy, neuromodulation, and digital treatments. While the complexity of the neurobiology and the biological and clinical heterogeneity of PTSD have challenged clinicians and researchers, there is an emerging consensus concerning the underlying mechanisms and approaches to diagnosis, treatment, and prevention of PTSD. This update addresses PTSD diagnosis, prevalence, course, risk factors, neurobiological mechanisms, current standard of care, and innovations in next-generation treatment and prevention strategies. It provides a comprehensive summary and concludes with areas of research for integrating advances in the neurobiology of the disorder with novel treatment and prevention targets.
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Affiliation(s)
- Arieh Shalev
- Department of Psychiatry, NYU Grossman School of Medicine, New York
| | - Dayeon Cho
- Department of Psychiatry, NYU Grossman School of Medicine, New York
| | - Charles R Marmar
- Department of Psychiatry, NYU Grossman School of Medicine, New York
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34
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Ma LH, Li S, Jiao XH, Li ZY, Zhou Y, Zhou CR, Zhou CH, Zheng H, Wu YQ. BLA-involved circuits in neuropsychiatric disorders. Ageing Res Rev 2024; 99:102363. [PMID: 38838785 DOI: 10.1016/j.arr.2024.102363] [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: 11/04/2023] [Revised: 05/04/2024] [Accepted: 05/30/2024] [Indexed: 06/07/2024]
Abstract
The basolateral amygdala (BLA) is the subregion of the amygdala located in the medial of the temporal lobe, which is connected with a wide range of brain regions to achieve diverse functions. Recently, an increasing number of studies have focused on the participation of the BLA in many neuropsychiatric disorders from the neural circuit perspective, aided by the rapid development of viral tracing methods and increasingly specific neural modulation technologies. However, how to translate this circuit-level preclinical intervention into clinical treatment using noninvasive or minor invasive manipulations to benefit patients struggling with neuropsychiatric disorders is still an inevitable question to be considered. In this review, we summarized the role of BLA-involved circuits in neuropsychiatric disorders including Alzheimer's disease, perioperative neurocognitive disorders, schizophrenia, anxiety disorders, depressive disorders, posttraumatic stress disorders, autism spectrum disorders, and pain-associative affective states and cognitive dysfunctions. Additionally, we provide insights into future directions and challenges for clinical translation.
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Affiliation(s)
- Lin-Hui Ma
- Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Shuai Li
- Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xin-Hao Jiao
- Jiangsu Province Key Laboratory of Anesthesiology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Zi-Yi Li
- Jiangsu Province Key Laboratory of Anesthesiology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Yue Zhou
- Jiangsu Province Key Laboratory of Anesthesiology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Chen-Rui Zhou
- Jiangsu Province Key Laboratory of Anesthesiology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Cheng-Hua Zhou
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou 221004, China.
| | - Hui Zheng
- Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
| | - Yu-Qing Wu
- Jiangsu Province Key Laboratory of Anesthesiology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China.
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35
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Zhang X, Wu B, Yang X, Kemp GJ, Wang S, Gong Q. Abnormal large-scale brain functional network dynamics in social anxiety disorder. CNS Neurosci Ther 2024; 30:e14904. [PMID: 39107947 PMCID: PMC11303268 DOI: 10.1111/cns.14904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 07/02/2024] [Accepted: 07/25/2024] [Indexed: 08/10/2024] Open
Abstract
AIMS Although static abnormalities of functional brain networks have been observed in patients with social anxiety disorder (SAD), the brain connectome dynamics at the macroscale network level remain obscure. We therefore used a multivariate data-driven method to search for dynamic functional network connectivity (dFNC) alterations in SAD. METHODS We conducted spatial independent component analysis, and used a sliding-window approach with a k-means clustering algorithm, to characterize the recurring states of brain resting-state networks; then state transition metrics and FNC strength in the different states were compared between SAD patients and healthy controls (HC), and the relationship to SAD clinical characteristics was explored. RESULTS Four distinct recurring states were identified. Compared with HC, SAD patients demonstrated higher fractional windows and mean dwelling time in the highest-frequency State 3, representing "widely weaker" FNC, but lower in States 2 and 4, representing "locally stronger" and "widely stronger" FNC, respectively. In State 1, representing "widely moderate" FNC, SAD patients showed decreased FNC mainly between the default mode network and the attention and perceptual networks. Some aberrant dFNC signatures correlated with illness duration. CONCLUSION These aberrant patterns of brain functional synchronization dynamics among large-scale resting-state networks may provide new insights into the neuro-functional underpinnings of SAD.
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Affiliation(s)
- Xun Zhang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China HospitalSichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
| | - Baolin Wu
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China HospitalSichuan UniversityChengduChina
| | - Xun Yang
- School of Public AffairsChongqing UniversityChongqingChina
| | - Graham J. Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Life Course and Medical SciencesUniversity of LiverpoolLiverpoolUK
| | - Song Wang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China HospitalSichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
| | - Qiyong Gong
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China HospitalSichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Department of RadiologyWest China Xiamen Hospital of Sichuan UniversityXiamenChina
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36
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Simoncini Malucelli G, Mercante A, Pizza F, Brunetti V, Biscarini F, Vandi S, Mazzoni A, Franceschini C, Della Marca G, Vollono C, Chieffo DPR, Plazzi G. Exploring the emotional and behavioural profile in paediatric narcolepsy type 1: A case-control study. J Sleep Res 2024; 33:e14064. [PMID: 37872846 DOI: 10.1111/jsr.14064] [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: 06/23/2023] [Revised: 09/14/2023] [Accepted: 09/22/2023] [Indexed: 10/25/2023]
Abstract
Narcolepsy type 1 (NT1) is a central disorder of hypersomnolence often arising in childhood and adolescence. NT1 has a significant, but poorly defined, psychological impact. We aimed to investigate the psycho-social functioning of children and adolescents with NT1. We performed a cross-sectional, child and parent-reported questionnaire survey in 37 children and adolescents (6-17 years) with NT1, compared with age- and sex-matched controls. Questionnaires (SSHS, ESS-CHAD, CDI, MASC, CBCL, CRS-R, and SNAP-IV) evaluated various aspects of behavioural and emotional profiles, sleep habits, and daytime sleepiness. Subsequently, NT1 intra-group analysis was performed to investigate the effect of sex (males vs females) and pharmacological treatment (treated vs non-treated) on psychological features. The NT1 questionnaires total scores were then correlated with the clinical characteristics (age, body mass index [BMI], ESS-CHAD score, cerebrospinal hypocretin-1 [Hcrt-1] levels, and diagnostic delay). Patients with NT1 showed a higher tendency to depressive symptoms, anxiety, somatisation, inattention, hyperactivity, oppositional/defiant problems, and other maladaptive behaviours compared with controls. Among NT1 patients, females showed a higher propensity to anxiety, and non-treated patients displayed higher depressive symptoms. Psychological symptoms increased with age, BMI, and daytime sleepiness in patients with NT1, while a younger age was associated with more frequent somatisation symptoms. Lower cerebrospinal Hcrt-1 levels correlated with poorer social competencies, daily activities, and inattention. Diagnostic delay was associated with a higher impact of depressive symptoms and behavioural problems. NT1 in children and adolescents is associated with poorer functioning in multiple psychological domains calling for a multidisciplinary approach and monitoring to reduce disease burden and to prevent psychiatric consequences.
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Affiliation(s)
| | - Anna Mercante
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Fabio Pizza
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Valerio Brunetti
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Neurologia - Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesco Biscarini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Stefano Vandi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Alice Mazzoni
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Giacomo Della Marca
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Neurologia - Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Catello Vollono
- Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Neurofisiopatologia - Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- Clinical Psychology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department Women Children and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Tomasi J, Lisoway AJ, Zai CC, Zai G, Richter MA, Sanches M, Herbert D, Mohiuddin AG, Tiwari AK, Kennedy JL. Genetic and polygenic investigation of heart rate variability to identify biomarkers associated with Anxiety disorders. Psychiatry Res 2024; 338:115982. [PMID: 38850888 DOI: 10.1016/j.psychres.2024.115982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/11/2024] [Accepted: 05/26/2024] [Indexed: 06/10/2024]
Abstract
Given that anxiety disorders (AD) are associated with reduced vagally-mediated heart rate variability (HRV), genetic variants related to HRV may provide insight into anxiety etiology. This study used polygenic risk scores (PRS) to explore the genetic overlap between AD and HRV, and investigated whether HRV-related polymorphisms influence anxiety risk. Resting vagally-mediated HRV was measured using a wearable device in 188 European individuals (AD=101, healthy controls=87). AD PRS was tested for association with resting HRV, and HRV PRS for association with AD. We also investigated 15 significant hits from an HRV genome-wide association study (GWAS) for association with resting HRV and AD and if this association is mediated through resting HRV. The AD PRS and HRV PRS showed nominally significant associations with resting HRV and anxiety disorders, respectively. HRV GWAS variants associated with resting HRV were rs12980262 (NDUFA11), rs2680344 (HCN4), rs4262 and rs180238 (GNG11), and rs10842383 (LINC00477). Mediation analyses revealed that NDUFA11 rs12980262 A-carriers and GNG11 rs180238 and rs4262 C-carriers had higher anxiety risk through lower HRV. This study supports an anxiety-HRV genetic relationship, with HRV-related genetic variants translating to AD. This study encourages exploration of HRV genetics to understand mechanisms and identify novel treatment targets for anxiety.
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Affiliation(s)
- Julia Tomasi
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada.
| | - Amanda J Lisoway
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Clement C Zai
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Gwyneth Zai
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; General Adult Psychiatry and Health Systems Division, CAMH, Toronto, ON, Canada
| | - Margaret A Richter
- Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Frederick W. Thompson Anxiety Disorders Centre, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Marcos Sanches
- Biostatistics Core, Centre for Addiction and Mental Health, Toronto, Canada
| | - Deanna Herbert
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Ayeshah G Mohiuddin
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Arun K Tiwari
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
| | - James L Kennedy
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
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Alnemr L, Salama AH, Abdelrazek S, Alfakeer H, Ali Alkhateeb M, Torun P. Prevalence of social anxiety disorder and its associated factors among foreign-born undergraduate students in Türkiye: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003184. [PMID: 39078858 PMCID: PMC11288422 DOI: 10.1371/journal.pgph.0003184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/09/2024] [Indexed: 08/02/2024]
Abstract
Social anxiety disorder (SAD) is prevalent among university students, yet data on its severity among foreign-born international undergraduate students in Türkiye remains limited. This study aims to determine the prevalence of SAD and its associated factors within this population. A cross-sectional study was conducted using a Google Form survey distributed across various universities from September 17, 2023, to February 1, 2024. The survey comprised two sections: sociodemographic information and 17 items of the Social Phobia Inventory (SPIN), which measures the frequency and intensity of social anxiety symptoms. Data analysis included descriptive statistics and inferential analysis, multiple regression, and binomial logistic regression. Out of 506 participants, 455 were included in the study. Results revealed that 39.1% exhibited no or very mild symptoms of SAD, while 23.7% experienced mild symptoms, 21.3% faced moderate symptoms, and 11.6% and 4.2% presented with severe to very severe symptoms, respectively. Factors such as gender (p < 0.0001), previous academic failures (p = 0.013), family history of mental health issues (p = 0.009), exercise frequency (p < 0.0001), and perceptions of relationships with classmates (p < 0.0001) were significantly associated with SAD. Females showed a higher probability of SAD compared to males (OR = 1.976). Individuals engaging in over 90 minutes of exercise per week were less likely to have SAD (OR = 0.383), and occasional smokers had a lower risk of SAD compared to non-smokers (OR = 0.422). Our study uncovered a notably elevated prevalence of Social Anxiety Disorder (SAD) among foreign-born undergraduate students in Türkiye. Factors such as being female, having a family history of mental illnesses, studying in a stressful environment, experiencing academic failure, and engaging in less frequent exercise were associated with noticeable symptoms of SAD. These findings emphasize the urgent need for heightened efforts in recognizing and addressing SAD within this population.
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Affiliation(s)
- Lujain Alnemr
- Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Türkiye
| | - Abdelaziz H. Salama
- Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Türkiye
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Salma Abdelrazek
- Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Türkiye
| | - Hussein Alfakeer
- Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Türkiye
| | - Mohamed Ali Alkhateeb
- Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Türkiye
| | - Perihan Torun
- Department of Public Health, Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Türkiye
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Li JS, Tun SM, Ficek-Tani B, Xu W, Wang S, Horien CL, Toyonaga T, Nuli SS, Zeiss CJ, Powers AR, Zhao Y, Mormino EC, Fredericks CA. Medial Amygdalar Tau Is Associated With Mood Symptoms in Preclinical Alzheimer's Disease. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00200-3. [PMID: 39059466 DOI: 10.1016/j.bpsc.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/01/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND While the amygdala receives early tau deposition in Alzheimer's disease (AD) and is involved in social and emotional processing, the relationship between amygdalar tau and early neuropsychiatric symptoms in AD is unknown. We sought to determine whether focal tau binding in the amygdala and abnormal amygdalar connectivity were detectable in a preclinical AD cohort and identify relationships between these and self-reported mood symptoms. METHODS We examined 598 individuals (347 amyloid positive [58% female], 251 amyloid negative [62% female] subset in tau positron emission tomography and functional magnetic resonance imaging cohorts) from the A4 (Anti-Amyloid Treatment in Asymptomatic AD) Study. In the tau positron emission tomography cohort, we used amygdalar segmentations to examine representative nuclei from 3 functional divisions of the amygdala. We analyzed between-group differences in division-specific tau binding in the amygdala in preclinical AD. We conducted seed-based functional connectivity analyses from each division in the functional magnetic resonance imaging cohort. Finally, we conducted exploratory post hoc correlation analyses between neuroimaging biomarkers of interest and anxiety and depression scores. RESULTS Amyloid-positive individuals demonstrated increased tau binding in the medial and lateral amygdala, and tau binding in these regions was associated with mood symptoms. Across amygdalar divisions, amyloid-positive individuals had relatively higher regional connectivity from the amygdala to other temporal regions, the insula, and the orbitofrontal cortex, but medial amygdala to retrosplenial cortex connectivity was lower. Medial amygdala to retrosplenial connectivity was negatively associated with anxiety symptoms, as was retrosplenial tau. CONCLUSIONS Our findings suggest that preclinical tau deposition in the amygdala and associated changes in functional connectivity may be related to early mood symptoms in AD.
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Affiliation(s)
- Joyce S Li
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | - Samantha M Tun
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut
| | | | - Wanwan Xu
- Department of Biostatistics, Yale School of Medicine, New Haven, Connecticut
| | - Selena Wang
- Department of Biostatistics, Yale School of Medicine, New Haven, Connecticut
| | | | - Takuya Toyonaga
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | | | - Caroline J Zeiss
- Department of Comparative Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Albert R Powers
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Yize Zhao
- Department of Biostatistics, Yale School of Medicine, New Haven, Connecticut
| | - Elizabeth C Mormino
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
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Spagnolo PA, Parker JA, Hallett M, Horovitz S. Functional Movement Disorder Is Associated with Abnormal Interoceptive Brain Activity: A Task-based Functional MRI Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.23.24310881. [PMID: 39108511 PMCID: PMC11302712 DOI: 10.1101/2024.07.23.24310881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
Background Aberrant interoceptive processing has been hypothesized to contribute to the pathophysiology of functional neurological disorder, although findings have been inconsistent. Here, we utilized functional magnetic resonance imaging (fMRI) to examine neural correlates of interoceptive attention - the conscious focus and awareness of bodily sensations - in functional movement disorder (FMD). Methods We used voxelwise analyses to compare blood oxygenation level-dependent responses between 13 adults with hyperkinetic FMD and 13 healthy controls (HCs) during a task requiring attention to different bodily sensations and to an exteroceptive stimulus. Additionally, we examined between-group differences in self-reported measures of interoception and evaluated their relationship with neural activity. Results Interoceptive conditions (heartbeat, stomach and 'body', indicating sensations from the body part or limb affected in FMD participants) activated a network involving the precuneus, the posterior cingulate cortex (PCC) and caudate nucleus (CN) bilaterally, and the right anterior insula (aINS) (p <0.05, corrected). Group differences in brain activity were mainly driven by processing of disease-related interoceptive signals, which in the FMD group was associated with a broader neural activation than monitoring gastric interoception, while no group differences were detected during cardiac interoception. Differences based on interoceptive focus (body vs heartbeat and stomach) between FMD subjects and HCs were found in PCC, CN, angular gyrus, thalamus, and in the mid-insula (p <0.05, corrected). Conclusions This is, to our knowledge, the first study showing that FMD is associated with abnormal interoceptive processing in regions involved in monitoring body state, attentional focus, and homeostatic inference.
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Affiliation(s)
- Primavera A Spagnolo
- Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jacob A Parker
- Neuroscience Graduate Group; University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Hallett
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Building 10, Room 7D37, 10 Center Drive, Bethesda, MD 20892-1428, USA
| | - Silvina Horovitz
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
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41
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Hong Y, Hu J, Zhang S, Liu J, Yan F, Yang H, Hu H. Integrative analysis identifies region- and sex-specific gene networks and Mef2c as a mediator of anxiety-like behavior. Cell Rep 2024; 43:114455. [PMID: 38990717 DOI: 10.1016/j.celrep.2024.114455] [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: 12/20/2023] [Revised: 05/20/2024] [Accepted: 06/21/2024] [Indexed: 07/13/2024] Open
Abstract
The molecular mechanisms underlying multi-brain region origins and sexual dimorphism of anxiety remain unclear. Here, we leverage large-scale transcriptomics from seven brain regions in mouse models of anxiety and extensive experiments to dissect brain-region- and sex-specific gene networks. We identify 4,840 genes with sex-specific expression alterations across seven brain regions, organized into ten network modules with sex-biased expression patterns. Modular analysis prioritizes 86 sex-specific mediators of anxiety susceptibility, including myocyte-specific enhancer factor 2c (Mef2c) in the CA3 region of male mice. Mef2c expression is decreased in the pyramidal neurons (PyNs) of susceptible male mice. Up-regulating Mef2c in CA3 PyNs significantly alleviates anxiety-like behavior, whereas down-regulating Mef2c induces anxiety-like behavior in male mice. The anxiolytic effect of Mef2c up-regulation is associated with enhanced neuronal excitability and synaptic transmission. In summary, this study uncovers brain-region- and sex-specific networks and identifies Mef2c in CA3 PyNs as a critical mediator of anxiety in male mice.
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Affiliation(s)
- Yizhou Hong
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China; State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China
| | - Jiameng Hu
- School of Life Science and Technology, Chongqing Innovation Institute of China Pharmaceutical University, China Pharmaceutical University, Nanjing, China
| | - Shiya Zhang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China; College of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jiaxin Liu
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China; College of Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Fangrong Yan
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Hua Yang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China.
| | - Haiyang Hu
- School of Life Science and Technology, Chongqing Innovation Institute of China Pharmaceutical University, China Pharmaceutical University, Nanjing, China; Central Laboratory, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
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Hilbert K, Böhnlein J, Meinke C, Chavanne AV, Langhammer T, Stumpe L, Winter N, Leenings R, Adolph D, Arolt V, Bischoff S, Cwik JC, Deckert J, Domschke K, Fydrich T, Gathmann B, Hamm AO, Heinig I, Herrmann MJ, Hollandt M, Hoyer J, Junghöfer M, Kircher T, Koelkebeck K, Lotze M, Margraf J, Mumm JLM, Neudeck P, Pauli P, Pittig A, Plag J, Richter J, Ridderbusch IC, Rief W, Schneider S, Schwarzmeier H, Seeger FR, Siminski N, Straube B, Straube T, Ströhle A, Wittchen HU, Wroblewski A, Yang Y, Roesmann K, Leehr EJ, Dannlowski U, Lueken U. Lack of evidence for predictive utility from resting state fMRI data for individual exposure-based cognitive behavioral therapy outcomes: A machine learning study in two large multi-site samples in anxiety disorders. Neuroimage 2024; 295:120639. [PMID: 38796977 DOI: 10.1016/j.neuroimage.2024.120639] [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: 03/08/2024] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024] Open
Abstract
Data-based predictions of individual Cognitive Behavioral Therapy (CBT) treatment response are a fundamental step towards precision medicine. Past studies demonstrated only moderate prediction accuracy (i.e. ability to discriminate between responders and non-responders of a given treatment) when using clinical routine data such as demographic and questionnaire data, while neuroimaging data achieved superior prediction accuracy. However, these studies may be considerably biased due to very limited sample sizes and bias-prone methodology. Adequately powered and cross-validated samples are a prerequisite to evaluate predictive performance and to identify the most promising predictors. We therefore analyzed resting state functional magnet resonance imaging (rs-fMRI) data from two large clinical trials to test whether functional neuroimaging data continues to provide good prediction accuracy in much larger samples. Data came from two distinct German multicenter studies on exposure-based CBT for anxiety disorders, the Protect-AD and SpiderVR studies. We separately and independently preprocessed baseline rs-fMRI data from n = 220 patients (Protect-AD) and n = 190 patients (SpiderVR) and extracted a variety of features, including ROI-to-ROI and edge-functional connectivity, sliding-windows, and graph measures. Including these features in sophisticated machine learning pipelines, we found that predictions of individual outcomes never significantly differed from chance level, even when conducting a range of exploratory post-hoc analyses. Moreover, resting state data never provided prediction accuracy beyond the sociodemographic and clinical data. The analyses were independent of each other in terms of selecting methods to process resting state data for prediction input as well as in the used parameters of the machine learning pipelines, corroborating the external validity of the results. These similar findings in two independent studies, analyzed separately, urge caution regarding the interpretation of promising prediction results based on neuroimaging data from small samples and emphasizes that some of the prediction accuracies from previous studies may result from overestimation due to homogeneous data and weak cross-validation schemes. The promise of resting-state neuroimaging data to play an important role in the prediction of CBT treatment outcomes in patients with anxiety disorders remains yet to be delivered.
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Affiliation(s)
- Kevin Hilbert
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychology, HMU Health and Medical University Erfurt, Erfurt, Germany
| | - Joscha Böhnlein
- Institute for Translational Psychiatry, University of Münster, Germany.
| | - Charlotte Meinke
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alice V Chavanne
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany; Université Paris-Saclay, INSERM U1299 "Trajectoires développementales et psychiatrie", CNRS UMR 9010 Centre Borelli, Ecole Normale Supérieure Paris-Saclay, France
| | - Till Langhammer
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lara Stumpe
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Nils Winter
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Ramona Leenings
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Dirk Adolph
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Volker Arolt
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Sophie Bischoff
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jan C Cwik
- Department of Clinical Psychology and Psychotherapy, Faculty of Human Sciences, Universität zu Köln, Germany
| | - Jürgen Deckert
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Fydrich
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Bettina Gathmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Germany
| | - Alfons O Hamm
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - Ingmar Heinig
- Institute of Clinical Psychology & Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Martin J Herrmann
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany
| | - Maike Hollandt
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - Jürgen Hoyer
- Institute of Clinical Psychology & Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Markus Junghöfer
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Katja Koelkebeck
- LVR-University-Hospital Essen, Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Martin Lotze
- Functional Imaging Unit. Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Jennifer L M Mumm
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Peter Neudeck
- Protect-AD Study Site Cologne, Cologne, Germany; Institut für Klinische Psychologie und Psychotherapie, TU Chemnitz, Germany
| | - Paul Pauli
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Andre Pittig
- Translational Psychotherapy, Institute of Psychology, University of Göttingen, Germany
| | - Jens Plag
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Alexianer Krankenhaus Hedwigshoehe, St. Hedwig Kliniken, Berlin, Germany
| | - Jan Richter
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany; Department of Experimental Psychopathology, University of Hildesheim, Hildesheim, Germany
| | | | - Winfried Rief
- Department of Clinical Psychology and Psychotherapy, Faculty of Psychology & Center for Mind, Brain and Behavior - CMBB, Philipps-University of Marburg, Marburg, Germany
| | - Silvia Schneider
- Faculty of Psychology, Clinical Child and Adolescent Psychology, Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Hanna Schwarzmeier
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany
| | - Fabian R Seeger
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany
| | - Niklas Siminski
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Thomas Straube
- Institute of Psychology, Unit of Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Osnabrueck, Osnabruck, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Adrian Wroblewski
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Yunbo Yang
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Kati Roesmann
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany; Institute of Psychology, Unit of Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Osnabrueck, Osnabruck, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany; German Center for Mental Health (DZPG), partner site Berlin/Potsdam, Germany
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Tanik F, Ozer Kaya D. Relationships Between Function, Pain Severity and Psychological and Cognitive Levels in People With Chronic Neck Pain: Cross-Sectional Study. Pain Manag Nurs 2024:S1524-9042(24)00195-4. [PMID: 39003128 DOI: 10.1016/j.pmn.2024.06.008] [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: 10/20/2023] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE This study aimed to investigate the relationship between pain and functional levels with pain catastrophizing, rumination, decision-making, and critical thinking in people with chronic neck pain. METHODS The study included 62 patients with chronic neck pain who had presented to a physiotherapy center with pain complaints for at least 3 months. The visual analog scale for pain severity, the Neck Disability Index for functional level, the Pain Catastrophizing Scale, the Ruminative Thinking Scale, the Melbourne Decision-Making Scale I-II, and the Marmara Critical Thinking Inventory were used for assessments. RESULTS Activity pain, night pain, and disability were positively correlated with rumination (rho: 0.368, p = .003; rho: 0.423, p = <.001; rho = 0.334, p = .008). There was a positive correlation between night pain, disability, and pain catastrophizing (rho = 0.298, p = .019; rho = .434 p < .001). A negative correlation was observed between patients' pain severity and disability with critical thinking scores (rho = -0.393, p = .002; rho = -0.377 p = .003, rho = -0.428 p < .001, rho = -0.441 p < .001). CONCLUSIONS The study suggested that there were positive correlations between pain severity and disability with rumination and pain catastrophizing. Additionally, chronic neck pain was found to have negative correlations with critical thinking scores, indicating potential impacts on cognitive processes. These findings may provide insights into the complex interplay between chronic pain and psychological factors, which can inform the development of interventions to enhance chronic pain management.
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Affiliation(s)
- Faruk Tanik
- Department of Physiotherapy and Rehabilitation, Health Sciences Institute, Izmir Katip Celebi University, Izmir, Turkey; Physiotherapy and Rehabilitation Application and Research Center, Izmir Katip Celebi University, Izmir, Turkey.
| | - Derya Ozer Kaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey; Physiotherapy and Rehabilitation Application and Research Center, Izmir Katip Celebi University, Izmir, Turkey
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Chaudhary S, Zhang S, Chen Y, Dominguez JC, Chao HH, Li CSR. Age-related reduction in anxiety and neural encoding of negative emotional memory. Front Aging Neurosci 2024; 16:1375435. [PMID: 39021704 PMCID: PMC11252031 DOI: 10.3389/fnagi.2024.1375435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/24/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Older adults experience less anxiety. We examined how memory of negative emotional images varied with age and may reflect age-related differences in anxiety. Methods Fifty-one adults, age 22-80 years, underwent imaging with a memory task where negative and neutral images were displayed pseudo-randomly. They were queried post-scan about the images inter-mixed with an equal number of images never displayed. Sensitivity (d') and reporting bias (Z-score of false alarm rate; Z[FAR]) were quantified with signal detection theory. Results Age was negatively correlated with both Spielberg State Trait Anxiety Inventory (STAI) state score and d' (negative - neutral) and positively with Z[FAR] (negative - neutral). However, STAI score and d' or Z[FAR] (negative - neutral) were not significantly correlated. In whole-brain regression, STAI score was correlated with higher activity of the right middle/superior temporal gyri/temporal parietal junction (MTG/STG/TPJ) for "negative correct - incorrect" - "neutral correct - incorrect" trials. Further, the MTG/STG/TPJ activity (β) was also negatively correlated with age. Mediation analyses supported a complete mediation model of age → less anxiety → less MTG/STG/TPJ β. Discussion Together, the findings demonstrated age-related changes in negative emotional memory and how age-related reduction in anxiety is reflected in diminished temporoparietal cortical activities during encoding of negative emotional memory.
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Affiliation(s)
- Shefali Chaudhary
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Yu Chen
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | | | - Herta H. Chao
- VA Connecticut Healthcare System, West Haven, CT, United States
- Department of Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States
- Wu Tsai Institute, Yale University, New Haven, CT, United States
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Borchers LR, Gifuni AJ, Ho TC, Kirshenbaum JS, Gotlib IH. Threat- and reward-related brain circuitry, perceived stress, and anxiety in adolescents during the COVID-19 pandemic: a longitudinal investigation. Soc Cogn Affect Neurosci 2024; 19:nsae040. [PMID: 38874967 PMCID: PMC11219304 DOI: 10.1093/scan/nsae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 04/29/2024] [Accepted: 06/13/2024] [Indexed: 06/15/2024] Open
Abstract
The Coronavirus disease (COVID-19) pandemic led to heightened anxiety in adolescents. The basolateral amygdala (BLA) and the nucleus accumbens (NAcc) are implicated in response to stress and may contribute to anxiety. The role of threat- and reward-related circuitry in adolescent anxiety during the COVID-19 pandemic, however, is not clear. Ninety-nine adolescents underwent resting-state fMRI ∼1 year before the pandemic. Following shelter-in-place orders, adolescents reported their perceived stress and, 1 month later, their anxiety. Generalized multivariate analyses identified BLA and NAcc seed-based whole-brain functional connectivity maps with perceived stress. In the resulting significant clusters, we examined the association between seed-based connectivityand subsequent anxiety. Perceived stress was associated with bilateral BLA and NAcc connectivity across distributed clusters that included prefrontal, limbic, temporal, and cerebellar regions. Several NAcc connectivity clusters located in ventromedial prefrontal, parahippocampal, and temporal cortices were positively associated with anxiety; NAcc connectivity with the inferior frontal gyrus was negatively associated. BLA connectivity was not associated with anxiety. These results underscore the integrative role of the NAcc in responding to acute stressors and its relation to anxiety in adolescents. Elucidating the involvement of subcortical-cortical circuitry in adolescents' capacity to respond adaptively to environmental challenges can inform treatment for anxiety-related disorders.
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Affiliation(s)
- Lauren R Borchers
- Department of Psychology, Stanford University, Stanford, CA 94305, United States
| | - Anthony J Gifuni
- Department of Psychology, Stanford University, Stanford, CA 94305, United States
- Psychiatry Department and Douglas Mental Health University Institute, McGill University, Montréal, Québec H4H 1R3, Canada
| | - Tiffany C Ho
- Department of Psychology, University of California, Los Angeles, CA 90095, United States
| | - Jaclyn S Kirshenbaum
- Department of Psychiatry, Columbia University, New York, NY 10027, United States
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA 94305, United States
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Di Passa AM, Prokop-Millar S, Yaya H, Dabir M, McIntyre-Wood C, Fein A, MacKillop E, MacKillop J, Duarte D. Clinical efficacy of deep transcranial magnetic stimulation (dTMS) in psychiatric and cognitive disorders: A systematic review. J Psychiatr Res 2024; 175:287-315. [PMID: 38759496 DOI: 10.1016/j.jpsychires.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 05/19/2024]
Abstract
Deep transcranial magnetic stimulation (dTMS) has gained attention as an enhanced form of traditional TMS, targeting broader and deeper regions of the brain. However, a fulsome synthesis of dTMS efficacy across psychiatric and cognitive disorders using sham-controlled trials is lacking. We systematically reviewed 28 clinical trials comparing active dTMS to a sham/controlled condition to characterize dTMS efficacy across diverse psychiatric and cognitive disorders. A comprehensive search of APA PsycINFO, Cochrane, Embase, Medline, and PubMed databases was conducted. Predominant evidence supports dTMS efficacy in patients with obsessive-compulsive disorder (OCD; n = 2), substance use disorders (SUDs; n = 8), and in those experiencing depressive episodes with major depressive disorder (MDD) or bipolar disorder (BD; n = 6). However, the clinical efficacy of dTMS in psychiatric disorders characterized by hyperactivity or hyperarousal (i.e., attention-deficit/hyperactivity disorder, posttraumatic stress disorder, and schizophrenia) was heterogeneous. Common side effects included headaches and pain/discomfort, with rare but serious adverse events such as seizures and suicidal ideation/attempts. Risk of bias ratings indicated a collectively low risk according to the Grading of Recommendations, Assessment, Development, and Evaluations checklist (Meader et al., 2014). Literature suggests promise for dTMS as a beneficial alternative or add-on treatment for patients who do not respond well to traditional treatment, particularly for depressive episodes, OCD, and SUDs. Mixed evidence and limited clinical trials for other psychiatric and cognitive disorders suggest more extensive research is warranted. Future research should examine the durability of dTMS interventions and identify moderators of clinical efficacy.
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Affiliation(s)
- Anne-Marie Di Passa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Shelby Prokop-Millar
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Horodjei Yaya
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Melissa Dabir
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Carly McIntyre-Wood
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, ON, Canada
| | - Allan Fein
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, ON, Canada
| | - Emily MacKillop
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - James MacKillop
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, ON, Canada
| | - Dante Duarte
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Seniors Mental Health Program, Department of Psychiatry and Neurosciences, McMaster University, Hamilton, ON, Canada.
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Rosenbaum D, Int-Veen I, Laicher H, Woloszyn L, Wiegand A, Ladegast S, Eßer U, Kroczek A, Sippel D, Menkor S, Lawyer G, Albasini F, Frischholz C, Mössner R, Nieratschker V, Leehr EJ, Rubel J, Fallgatter AJ, Ehlis AC. Neural correlates of stress-reactive rumination in depression - The role of childhood trauma and social anxiety. Neurobiol Stress 2024; 31:100640. [PMID: 38800538 PMCID: PMC11127161 DOI: 10.1016/j.ynstr.2024.100640] [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: 12/30/2023] [Revised: 04/29/2024] [Accepted: 05/05/2024] [Indexed: 05/29/2024] Open
Abstract
Recent work showed an association of prefrontal dysfunctions in patients with Major Depressive Disorder (MDD) and social stress induced rumination. However, up to date it is unclear which etiological features of MDD might cause prefrontal dysfunctions. In the study at hand, we aimed to replicate recent findings, that showed prefrontal activation alterations during the Trier Social Stress Test (TSST) and subsequently increased stress-reactive rumination in MDD compared to healthy controls. Moreover, we aimed to explore the role of adverse childhood experiences and other clinical variables in this relationship. N = 55 patients currently suffering from MDD and n = 42 healthy controls (HC) underwent the TSST, while cortical activity in areas of the Cognitive Control Network (CCN) was measured via functional near-infrared spectroscopy (fNIRS). The TSST successfully induced a stress reaction (physiologically, as well as indicated by subjective stress ratings) and state rumination in all subjects with moderate to large effect sizes. In comparison to HC, MDD patients showed elevated levels of state rumination with large effect sizes, as well as a typical pattern of reduced cortical oxygenation during stress in the CCN with moderate effect sizes. Self-reported emotional abuse and social anxiety were moderately positively associated with increased stress-reactive rumination. Within the MDD sample, emotional abuse was negatively and social anxiety positively associated with cortical oxygenation within the CCN with moderate to large effect sizes. In conclusion, our results replicate previous findings on MDD-associated prefrontal hypoactivity during stress and extends the research toward specific subtypes of depression.
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Affiliation(s)
- David Rosenbaum
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Isabell Int-Veen
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Hendrik Laicher
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Leonie Woloszyn
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Ariane Wiegand
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Sandra Ladegast
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Ute Eßer
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Agnes Kroczek
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Daniel Sippel
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Sebastian Menkor
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | | | - Francesco Albasini
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
- Central Institute of Mental Health (CIMH), Mannheim, Germany
- Dept. of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Christian Frischholz
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Rainald Mössner
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
| | - Vanessa Nieratschker
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
- German Center for Mental Health (DZPG), Germany
| | | | - Julian Rubel
- Psychotherapy Research Lab, Psychology and Sport Sciences, Justus-Liebig-University Giessen, Giessen, Germany
| | - Andreas J. Fallgatter
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
- German Center for Mental Health (DZPG), Germany
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital of Tuebingen, Tuebingen, Germany
- German Center for Mental Health (DZPG), Germany
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Koek RJ, Avecillas-Chasin J, Krahl SE, Chen JW, Sultzer DL, Kulick AD, Mandelkern MA, Malpetti M, Gordon HL, Landry HN, Einstein EH, Langevin JP. Deep brain stimulation of the amygdala for treatment-resistant combat post-traumatic stress disorder: Long-term results. J Psychiatr Res 2024; 175:131-139. [PMID: 38733927 PMCID: PMC11419692 DOI: 10.1016/j.jpsychires.2024.05.008] [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: 03/03/2024] [Revised: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024]
Abstract
Deep brain stimulation (DBS) holds promise for neuropsychiatric conditions where imbalance in network activity contributes to symptoms. Treatment-resistant Combat post-traumatic stress disorder (TR-PTSD) is a highly morbid condition and 50% of PTSD sufferers fail to recover despite psychotherapy or pharmacotherapy. Reminder-triggered symptoms may arise from inadequate top-down ventromedial prefrontal cortex (vmPFC) control of amygdala reactivity. Here, we report long-term data on two TR-PTSD participants from an investigation utilizing high-frequency amygdala DBS. The two combat veterans were implanted bilaterally with quadripolar electrodes targeting the basolateral amygdala. Following a randomized staggered onset, patients received stimulation with adjustments based on PTSD symptom severity for four years while psychiatric and neuropsychiatric symptoms, neuropsychological performance, and electroencephalography were systematically monitored. Evaluation of vmPFC-Amygdala network engagement was assessed with 18FDG positron emission tomography (PET). CAPS-IV scores varied over time, but improved 55% from 119 at baseline to 53 at 4-year study endpoint in participant 1; and 44%, from 68 to 38 in participant 2. Thereafter, during 5 and 1.5 years of subsequent clinical care respectively, long-term bilateral amygdala DBS was associated with additional, clinically significant symptomatic and functional improvement. There were no serious stimulation-related adverse psychiatric, neuropsychiatric, neuropsychological, neurological, or neurosurgical effects. In one subject, symptomatic improvement was associated with an intensity-dependent reduction in amygdala theta frequency power. In our two participants, FDG-PET findings were inconclusive regarding the hypothesized mechanism of suppression of amygdala hyperactivity. Our findings encourage further research to confirm and extend our preliminary observations.
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Affiliation(s)
- Ralph J Koek
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, 760 Westwood Blvd., Room 58-229, Los Angeles, CA, USA, 90095-1759; Psychiatry Service, Mental Health and Behavioral Sciences, Sepulveda Ambulatory Care Center, VAGLAHS, 16111 Plummer St. (116A-11), North Hills, CA, USA, 91343.
| | - Josue Avecillas-Chasin
- Department of Neurosurgery University of Nebraska Medical Center College of Medicine, 42nd and Emile, Omaha, Nebraska USA, 68198.
| | - Scott E Krahl
- Department of Neurosurgery, University of California at Los Angeles (UCLA), 300 Stein Plaza Driveway Suite 420, Los Angeles, CA, 90095, USA; Research Service, VAGLAHS (Clinical Neurophysiology), 16111 Plummer St., Building 1, North Hills, CA, USA, 91343.
| | - James Wy Chen
- Department of Neurology, UCLA, 710 Westwood Plaza, Los Angeles, CA, 90095, USA; Neurology Service (Epilepsy Center of Excellence), VAGLAHS, 11301 Wilshire Blvd, Los Angeles, CA, USA, 90073.
| | - David L Sultzer
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, 760 Westwood Blvd., Room 58-229, Los Angeles, CA, USA, 90095-1759; Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine Institute for Memory Impairments and Neurological Disorders, 3214 Biological Sciences III, Irvine, CA, USA, 92697-4545.
| | - Alexis D Kulick
- Psychology Service (Neuropsychology), Mental Health and Behavioral Sciences, VAGLAHS, 16111 Plummer St. (116A-11) North Hills, CA, USA, 91343.
| | - Mark A Mandelkern
- Imaging Department, VAGLAHS, 11301 Wilshire Blvd, Los Angeles, CA, USA, 90073.
| | - Maura Malpetti
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK.
| | - Hailey L Gordon
- STEM Pathways at Boston University, 610 Commonwealth Avenue, Room 402, Boston, MA, 02215, USA.
| | | | - Evan H Einstein
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, 760 Westwood Blvd., Room 58-229, Los Angeles, CA, USA, 90095-1759
| | - Jean-Philippe Langevin
- Department of Neurosurgery, UCLA, 300 Stein Plaza Driveway Suite 420, Los Angeles, CA, 90095, USA; Southwest VA Epilepsy Center of Excellence, 11301 Wilshire Blvd, Bldg 500 (10H2), Los Angeles, CA, USA, 90073.
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49
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Sharon O, Ben Simon E, Shah VD, Desel T, Walker MP. The new science of sleep: From cells to large-scale societies. PLoS Biol 2024; 22:e3002684. [PMID: 38976664 PMCID: PMC11230563 DOI: 10.1371/journal.pbio.3002684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024] Open
Abstract
In the past 20 years, more remarkable revelations about sleep and its varied functions have arguably been made than in the previous 200. Building on this swell of recent findings, this essay provides a broad sampling of selected research highlights across genetic, molecular, cellular, and physiological systems within the body, networks within the brain, and large-scale social dynamics. Based on this raft of exciting new discoveries, we have come to realize that sleep, in this moment of its evolution, is very much polyfunctional (rather than monofunctional), yet polyfunctional for reasons we had never previously considered. Moreover, these new polyfunctional insights powerfully reaffirm sleep as a critical biological, and thus health-sustaining, requisite. Indeed, perhaps the only thing more impressive than the unanticipated nature of these newly emerging sleep functions is their striking divergence, from operations of molecular mechanisms inside cells to entire group societal dynamics.
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Affiliation(s)
- Omer Sharon
- Department of Psychology, University of California, Berkeley, California, United States of America
- Helen Wills Neuroscience Institute, University of California, Berkeley, California, United States of America
| | - Eti Ben Simon
- Department of Psychology, University of California, Berkeley, California, United States of America
- Helen Wills Neuroscience Institute, University of California, Berkeley, California, United States of America
| | - Vyoma D. Shah
- Department of Psychology, University of California, Berkeley, California, United States of America
- Helen Wills Neuroscience Institute, University of California, Berkeley, California, United States of America
| | - Tenzin Desel
- Department of Psychology, University of California, Berkeley, California, United States of America
- Helen Wills Neuroscience Institute, University of California, Berkeley, California, United States of America
| | - Matthew P. Walker
- Department of Psychology, University of California, Berkeley, California, United States of America
- Helen Wills Neuroscience Institute, University of California, Berkeley, California, United States of America
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50
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Pasculli G, Busan P, Jackson ES, Alm PA, De Gregorio D, Maguire GA, Goodwin GM, Gobbi G, Erritzoe D, Carhart-Harris RL. Psychedelics in developmental stuttering to modulate brain functioning: a new therapeutic perspective? Front Hum Neurosci 2024; 18:1402549. [PMID: 38962146 PMCID: PMC11221540 DOI: 10.3389/fnhum.2024.1402549] [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: 03/17/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Developmental stuttering (DS) is a neurodevelopmental speech-motor disorder characterized by symptoms such as blocks, repetitions, and prolongations. Persistent DS often has a significant negative impact on quality of life, and interventions for it have limited efficacy. Herein, we briefly review existing research on the neurophysiological underpinnings of DS -specifically, brain metabolic and default mode/social-cognitive networks (DMN/SCN) anomalies- arguing that psychedelic compounds might be considered and investigated (e.g., in randomized clinical trials) for treatment of DS. The neural background of DS is likely to be heterogeneous, and some contribution from genetically determinants of metabolic deficiencies in the basal ganglia and speech-motor cortical regions are thought to play a role in appearance of DS symptoms, which possibly results in a cascade of events contributing to impairments in speech-motor execution. In persistent DS, the difficulties of speech are often linked to a series of associated aspects such as social anxiety and social avoidance. In this context, the SCN and DMN (also influencing a series of fronto-parietal, somato-motor, and attentional networks) may have a role in worsening dysfluencies. Interestingly, brain metabolism and SCN/DMN connectivity can be modified by psychedelics, which have been shown to improve clinical evidence of some psychiatric conditions (e.g., depression, post-traumatic stress disorder, etc.) associated with psychological constructs such as rumination and social anxiety, which also tend to be present in persistent DS. To date, while there have been no controlled trials on the effects of psychedelics in DS, anecdotal evidence suggests that these agents may have beneficial effects on stuttering and its associated characteristics. We suggest that psychedelics warrant investigation in DS.
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Affiliation(s)
- Giuseppe Pasculli
- Department of Computer, Control, and Management Engineering (DIAG), La Sapienza University, Rome, Italy
- Italian Society of Psychedelic Medicine (Società Italiana di Medicina Psichedelica–SIMePsi), Bari, Italy
| | | | - Eric S. Jackson
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
| | - Per A. Alm
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Danilo De Gregorio
- IRCCS, San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Gerald A. Maguire
- School of Medicine, American University of Health Sciences, Signal Hill, CA, United States
- CenExel CIT Research, Riverside, CA, United States
| | - Guy M. Goodwin
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - David Erritzoe
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Robin L. Carhart-Harris
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
- Psychedelics Division, Neuroscape, University of California, San Francisco, CA, United States
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