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Ysbæk-Nielsen AT. Exploring volumetric abnormalities in subcortical L-HPA axis structures in pediatric generalized anxiety disorder. Nord J Psychiatry 2024; 78:402-410. [PMID: 38573199 DOI: 10.1080/08039488.2024.2335980] [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: 05/15/2023] [Accepted: 03/22/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Pediatric generalized anxiety disorder (GAD) is debilitating and increasingly prevalent, yet its etiology remains unclear. Some believe the disorder to be propagated by chronic dysregulation of the limbic-hypothalamic-pituitary-adrenal (L-HPA) axis, but morphometric studies of implicated subcortical areas have been largely inconclusive. Recognizing that certain subcortical subdivisions are more directly involved in L-HPA axis functioning, this study aims to detect specific abnormalities in these critical areas. METHODS Thirty-eight MRI scans of preschool children with (n = 15) and without (n = 23) GAD underwent segmentation and between-group volumetric comparisons of the basolateral amygdala (BLA), ventral hippocampal subiculum (vSC), and mediodorsal medial magnocellular (MDm) area of the thalamus. RESULTS Children with GAD displayed significantly larger vSC compared to healthy peers, F(1, 31) = 6.50, pFDR = .048. On average, children with GAD presented with larger BLA and MDm, Fs(1, 31) ≥ 4.86, psFDR ≤ .054. Exploratory analyses revealed right-hemispheric lateralization of all measures, most notably the MDm, F(1, 31) = 8.13, pFDR = .024, the size of which scaled with symptom severity, r = .83, pFDR = .033. CONCLUSION The BLA, vSC, and MDm are believed to be involved in the regulation of anxiety and stress, both individually and collectively through the excitation and inhibition of the L-HPA axis. All were found to be enlarged in children with GAD, perhaps reflecting hypertrophy related to hyperexcitability, or early neuronal overgrowth. Longitudinal studies should investigate the relationship between these early morphological differences and the long-term subcortical atrophy previously observed.
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Ou CH, Cheng CS, Lin PL, Lee CL. Grey matter alterations in generalized anxiety disorder: A voxel-wise meta-analysis of voxel-based morphometry studies. Int J Dev Neurosci 2024; 84:281-292. [PMID: 38638086 DOI: 10.1002/jdn.10330] [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: 12/11/2023] [Revised: 03/09/2024] [Accepted: 03/26/2024] [Indexed: 04/20/2024] Open
Abstract
OBJECTIVE Grey matter, a crucial component of the brain, has been found altered in generalized anxiety disorder (GAD) of several voxel-based morphometry studies. The conclusive and consistent grey matter alterations in GAD have not been confirmed. METHOD Eleven voxel-based morphometry studies of GAD patients were included in the current systematic review and meta-analysis. The linear model of anxiety severity scores was applied to explore the relationship of grey matter alterations and anxiety severity. The subgroup analysis of adult GAD and adolescent GAD was also performed. RESULTS Significantly modest grey matter alterations in the left superior temporal gyrus of patients with GAD were found. The anxiety severity score was significantly correlated with grey matter alterations in the right insula, lenticular nucleus, putamen and striatum. The subgroup analysis of adult GAD and adolescent GAD all failed to show significant grey matter alterations. However, in the adult GAD subgroup, anxiety severity score was significantly correlated with grey matter alterations in the right insula. CONCLUSION GAD might have the modest grey matter alterations in the left superior temporal gyrus. Anxiety severity might be related to the grey matter alterations in the limbic regions, such as the right insula, lenticular nucleus, putamen and striatum. This kind of correlation might be related to the effects of adult GAD. Future studies with adequate sample sizes and sophisticated GAD categories will be needed.
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Affiliation(s)
- Chang-Hsien Ou
- Department of Neuroradiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chiu-Shih Cheng
- Department of Neuroradiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Pei-Ling Lin
- Department of Neuroradiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Cheng-Lung Lee
- Department of Neuroradiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
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Liu H, Hao Z, Qiu S, Wang Q, Zhan L, Huang L, Shao Y, Wang Q, Su C, Cao Y, Sun J, Wang C, Lv Y, Li M, Shen W, Li H, Jia X. Grey matter structural alterations in anxiety disorders: a voxel-based meta-analysis. Brain Imaging Behav 2024; 18:456-474. [PMID: 38150133 DOI: 10.1007/s11682-023-00842-x] [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] [Accepted: 12/07/2023] [Indexed: 12/28/2023]
Abstract
Anxiety disorders (ADs) are a group of prevalent and destructive mental illnesses, but the current understanding of their underlying neuropathology is still unclear. Employing voxel-based morphometry (VBM), previous studies have demonstrated several common brain regions showing grey matter volume (GMV) abnormalities. However, contradictory results have been reported among these studies. Considering that different subtypes of ADs exhibit common core symptoms despite different diagnostic criteria, and previous meta-analyses have found common core GMV-altered brain regions in ADs, the present research aimed to combine the results of individual studies to identify common GMV abnormalities in ADs. Therefore, we first performed a systematic search in PubMed, Embase, and Web of Science on studies investigating GMV differences between patients with ADs and healthy controls (HCs). Then, the anisotropic effect-size signed differential mapping (AES-SDM) was applied in this meta-analysis. A total of 24 studies (including 25 data sets) were included in the current study, and 906 patients with ADs and 1003 HCs were included. Compared with the HCs, the patients with ADs showed increased GMV in the left superior parietal gyrus, right angular gyrus, left precentral gyrus, and right lingual gyrus, and decreased GMV in the bilateral insula, bilateral thalamus, left caudate, and right putamen. In conclusion, the current study has identified some abnormal GMV brain regions that are related to the pathological mechanisms of anxiety disorders. These findings could contribute to a better understanding of the underlying neuropathology of ADs.
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Affiliation(s)
- Han Liu
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Zeqi Hao
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Shasha Qiu
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Qianqian Wang
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Linlin Zhan
- School of Western Languages, Heilongjiang University, Heilongjiang, China
| | - Lina Huang
- Department of Radiology, Changshu No.2 People's Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu, China
| | - Youbin Shao
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Qing Wang
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
| | - Chang Su
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Yikang Cao
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Jiawei Sun
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Chunjie Wang
- Institute of Brain Science, Department of Psychology, School of Education, Hangzhou Normal University, Hangzhou, China
- Center for Cognition and Brain Disorders, the Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
| | - Yating Lv
- Center for Cognition and Brain Disorders, the Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
| | - Mengting Li
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Wenbin Shen
- Department of Radiology, Changshu No.2 People's Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu, China
| | - Huayun Li
- School of Psychology, Zhejiang Normal University, Jinhua, China.
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China.
| | - Xize Jia
- School of Psychology, Zhejiang Normal University, Jinhua, China.
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China.
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Park SE, Kim YH, Yang JC, Jeong GW. Comparative Functional Connectivity of Core Brain Regions between Implicit and Explicit Memory Tasks Underlying Negative Emotion in General Anxiety Disorder. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2022; 20:279-291. [PMID: 35466099 PMCID: PMC9048018 DOI: 10.9758/cpn.2022.20.2.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/23/2021] [Accepted: 02/27/2021] [Indexed: 11/24/2022]
Abstract
Objective To investigate not only differential patterns of functional connectivity of core brain regions between implicit and explicit verbal memory tasks underlying negatively evoked emotional condition, but also correlations of functional connectivity (FC) strength with clinical symptom severity in patients with generalized anxiety disorder (GAD). Methods Thirteen patients with GAD and 13 healthy controls underwent functional magnetic resonance imaging for memory tasks with negative emotion words. Results Clinical symptom and its severities of GAD were potentially associated with abnormalities of task-based FC with core brain regions and distinct FC patterns between implicit vs. explicit memory processing in GAD were potentially well discriminated. Outstanding FC in implicit memory task includes positive connections of precentral gyus (PrG) to inferior frontal gyrus and inferior parietal gyrus (IPG), respectively, in encoding period; a positive connection of amygdala (Amg) to globus pallidus as well as a negative connection of Amg to cerebellum in retrieval period. Meanwhile, distinct FC in explicit memory included a positive connection of PrG to inferior temporal gyrus (ITG) in encoding period; a positive connection of the anterior cingulate gyrus to superior frontal gyrus in retrieval period. Especially, there were positive correlation between GAD-7 scores and FC of PrG-IPG (r2 = 0.324, p = 0.042) in implicit memory encoding, and FC of PrG-ITG (r2 = 0.378, p = 0.025) in explicit memory encoding. Conclusion This study clarified differential patterns of brain activation and relevant FC between implicit and explicit verbal memory tasks underlying negative emotional feelings in GAD. These findings will be helpful for an understanding of distinct brain functional mechanisms associated with clinical symptom severities in GAD.
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Affiliation(s)
- Shin-Eui Park
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Korea
| | - Yun-Hyeon Kim
- Department of Radiology, Chonnam National University Medical School, Gwangju, Korea
| | - Jong-Chul Yang
- Department of Psychiatry, Jeonuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Gwang-Woo Jeong
- Department of Radiology, Chonnam National University Medical School, Gwangju, Korea
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Broessner G, Ellerbrock I, Menz MM, Frank F, Verius M, Gaser C, May A. Repetitive T1 Imaging Influences Gray Matter Volume Estimations in Structural Brain Imaging. Front Neurol 2021; 12:755749. [PMID: 34777226 PMCID: PMC8581175 DOI: 10.3389/fneur.2021.755749] [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: 08/09/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Voxel-based morphometry (VBM) is a widely used tool for studying structural patterns of brain plasticity, brain development and disease. The source of the T1-signal changes is not understood. Most of these changes are discussed to represent loss or possibly gain of brain gray matter and recent publications speculate also about non-structural changes affecting T1-signal. We investigated the potential of pain stimulation to ultra-short-term alter gray matter signal changes in pain relevant brain regions in healthy volunteers using a longitudinal design. Immediately following regional nociceptive input, we detected significant gray matter volume (GMV) changes in central pain processing areas, i.e. anterior cingulate and insula cortex. However, similar results were observed in a control group using the identical time intervals but without nociceptive painful input. These GMV changes could be reproduced in almost 100 scanning sessions enrolling 72 healthy individuals comprising repetitive magnetization-prepared rapid gradient-echo (MPRAGE) sequences. These data suggest that short-term longitudinal repetitive MPRAGE may produce significant GMV changes without any intervention. Future studies investigating brain plasticity should focus and specifically report a consistent timing at which time-point during the experiment the T1-weighted scan is conducted. There is a necessity of a control group for longitudinal imaging studies.
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Affiliation(s)
- Gregor Broessner
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Isabel Ellerbrock
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mareike M Menz
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Frank
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Verius
- Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria
| | - Christian Gaser
- Departments of Neurology and Psychiatry, Jena University Hospital, Jena, Germany
| | - Arne May
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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6
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Balzekas I, Sladky V, Nejedly P, Brinkmann BH, Crepeau D, Mivalt F, Gregg NM, Pal Attia T, Marks VS, Wheeler L, Riccelli TE, Staab JP, Lundstrom BN, Miller KJ, Van Gompel J, Kremen V, Croarkin PE, Worrell GA. Invasive Electrophysiology for Circuit Discovery and Study of Comorbid Psychiatric Disorders in Patients With Epilepsy: Challenges, Opportunities, and Novel Technologies. Front Hum Neurosci 2021; 15:702605. [PMID: 34381344 PMCID: PMC8349989 DOI: 10.3389/fnhum.2021.702605] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/29/2021] [Indexed: 01/10/2023] Open
Abstract
Intracranial electroencephalographic (iEEG) recordings from patients with epilepsy provide distinct opportunities and novel data for the study of co-occurring psychiatric disorders. Comorbid psychiatric disorders are very common in drug-resistant epilepsy and their added complexity warrants careful consideration. In this review, we first discuss psychiatric comorbidities and symptoms in patients with epilepsy. We describe how epilepsy can potentially impact patient presentation and how these factors can be addressed in the experimental designs of studies focused on the electrophysiologic correlates of mood. Second, we review emerging technologies to integrate long-term iEEG recording with dense behavioral tracking in naturalistic environments. Third, we explore questions on how best to address the intersection between epilepsy and psychiatric comorbidities. Advances in ambulatory iEEG and long-term behavioral monitoring technologies will be instrumental in studying the intersection of seizures, epilepsy, psychiatric comorbidities, and their underlying circuitry.
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Affiliation(s)
- Irena Balzekas
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Biomedical Engineering and Physiology Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, United States
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States
- Mayo Clinic Medical Scientist Training Program, Rochester, MN, United States
| | - Vladimir Sladky
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czechia
| | - Petr Nejedly
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- The Czech Academy of Sciences, Institute of Scientific Instruments, Brno, Czechia
| | - Benjamin H. Brinkmann
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Daniel Crepeau
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Filip Mivalt
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Faculty of Electrical Engineering and Communication, Department of Biomedical Engineering, Brno University of Technology, Brno, Czechia
| | - Nicholas M. Gregg
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Tal Pal Attia
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Victoria S. Marks
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Biomedical Engineering and Physiology Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, United States
| | - Lydia Wheeler
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Biomedical Engineering and Physiology Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, United States
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States
| | - Tori E. Riccelli
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States
| | - Jeffrey P. Staab
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Brian Nils Lundstrom
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Kai J. Miller
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, United States
| | - Jamie Van Gompel
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Neurosurgery, Mayo Clinic, Rochester, MN, United States
| | - Vaclav Kremen
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Czech Institute of Informatics, Robotics and Cybernetics, Czech Technical University in Prague, Prague, Czechia
| | - Paul E. Croarkin
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Gregory A. Worrell
- Bioelectronics, Neurophysiology, and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
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Park SE, Kim BC, Yang JC, Jeong GW. MRI-Based Multimodal Approach to the Assessment of Clinical Symptom Severity of Obsessive-Compulsive Disorder. Psychiatry Investig 2020; 17:777-785. [PMID: 32777920 PMCID: PMC7449838 DOI: 10.30773/pi.2020.0124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/31/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE This study assessed the associations of the abnormal brain activation and functional connectivity (FC) during memory processing and brain volume alteration in conjunction with psychiatric symptom severity in patients with obsessive-compulsive disorder (OCD). METHODS Twenty-OCD patients and 20-healthy controls (HC) underwent T1-weighted and functional imaging underlying explicit memory task. RESULTS In memory encoding, OCD patients showed higher activities in right/left (Rt./Lt.) inferior temporal gyrus (ITG), medial prefrontal cortex (MPFC), dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC), compared with HC. In task-based FC, caudate (Cd) was positively connected with DLPFC and ITG in OCD, while HC showed different connectivities of Cd-ACC and Rt.-Lt. ITG. In memory retrieval, only Cd was activated in OCD patients. Cd was positively connected with DLPFC and vmPFC in OCD, but negatively connected between same brain areas in HC. OCD patients showed increased gray matter (GM) volumes of cerebellum, DLPFC, orbitofrontal cortex (OFC), hippocampus, Cd and ITG, and concurrently, increased white matter volumes of DLPFC. In OCD patients, GM volumes of Cd and OFC were positively correlated with HAMA and Y-BOCS. Functional activity changes of Cd in OCD were positively correlated with Y-BOCS. CONCLUSION Our findings support to accessing clinical symptom and its severity linked by brain structural deformation and functional abnormality in OCD patients.
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Affiliation(s)
- Shin-Eui Park
- Center for Research Equipment, Korea Basic Science Institute, Cheongju, Republic of Korea
| | - Byeong-Chae Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jong-Chul Yang
- Department of Psychiatry, Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Republic of Korea
| | - Gwang-Woo Jeong
- Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea
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Cui H, Zhang B, Li W, Li H, Pang J, Hu Q, Zhang L, Tang Y, Yang Z, Wang J, Li C, Northoff G. Insula shows abnormal task-evoked and resting-state activity in first-episode drug-naïve generalized anxiety disorder. Depress Anxiety 2020; 37:632-644. [PMID: 32196828 DOI: 10.1002/da.23009] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 02/27/2020] [Accepted: 03/10/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Interoception is associated with neural activity in the insula of healthy humans. On the basis of the somatic symptoms in generalized anxiety disorder (GAD), especially abnormal heartbeat perception, we hypothesized that abnormal activity in the insula was associated with interoceptive awareness in patients with GAD. METHODS We investigated the psychological correlates of interoceptive awareness in a sample of 34 patients with first-onset, drug-naïve GAD and 30 healthy controls (HCs). Furthermore, we compared blood oxygenation level-dependent responses between the two groups during a heartbeat perception task to assess task-evoked activity and its relationship with psychological measures. We also examined between-group differences in insular subregions resting-state functional connectivity (rsFC), and its relationship with anxiety severity. RESULTS Patients with GAD had significantly higher body perception scores than HCs. They also exhibited greater task-evoked activity in the left anterior insula, left posterior insula, and right anterior insula during interoceptive awareness than HCs. Left anterior insula activity was positively correlated with body awareness in patients with GAD, and rsFC between the left anterior insula and left medial prefrontal gyrus was negatively correlated with somatic anxiety severity. CONCLUSIONS Investigating a sample of first-episode, drug-naïve patients, our study demonstrated abnormal interoceptive awareness in patients with GAD and that this was related to abnormal anterior insular activity during both rest and task. These results shed new light on the psychological and neural substrates of somatic symptoms in GAD, and they may serve to establish abnormal interoceptive awareness as a neural and psychological marker of GAD.
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Affiliation(s)
- Huiru Cui
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Wei Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaoyan Pang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhi Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China.,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China.,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada.,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.,Mental Health Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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9
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Lind A, Salomäki S, Parkkola R, Haataja L, Rautava P, Junttila N, Koikkalainen J, Lötjönen J, Saunavaara V, Korja R. Brain volumes in relation to loneliness and social competence in preadolescents born very preterm. Brain Behav 2020; 10:e01640. [PMID: 32333525 PMCID: PMC7303371 DOI: 10.1002/brb3.1640] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/02/2020] [Accepted: 03/28/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The aim of the present study was to assess how regional brain volumes associate with self-experienced social and emotional loneliness and social competence in very preterm and term-born preadolescents. MATERIALS AND METHODS Thirty-four very preterm subjects (birthweight ≤1,500 g and/or gestational age <32 weeks) without neurodevelopmental impairments and/or major brain pathologies and 31 term-born subjects underwent magnetic resonance imaging at 12 years of age. Regional brain volumes were measured using an automated image quantification tool. At 11 years of age, social and emotional loneliness were assessed with the Peer Network and Dyadic Loneliness Scale-self-report questionnaire and cooperating skills, empathy, impulsivity, and disruptiveness with the Multisource Assessment of Children's Social Competence Scale-self-report questionnaire. RESULTS In the very preterm group, a number of significant associations were found between smaller regional brain volumes and self-experienced emotional loneliness, more impulsivity and more disruptiveness. In the control group, brain volumes and loneliness were not associated, and brain volumes and social competence were associated with a lesser degree than in the very preterm group. CONCLUSION Experiences of emotional loneliness and poorer social competence appear to be more related to brain volumes in very preterm preadolescents than in those born full-term. It also appears that in very preterm preadolescents, emotional loneliness may be more reflected in brain development than social loneliness.
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Affiliation(s)
- Annika Lind
- Department of Psychology, University of Turku, Turku, Finland.,Turku Institute for Advanced Studies (TIAS), University of Turku, Turku, Finland
| | | | - Riitta Parkkola
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Leena Haataja
- Children's Hospital and Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Päivi Rautava
- Public Health, University of Turku and Clinical Research Centre of Turku University Hospital, Turku, Finland
| | - Niina Junttila
- Department of Teacher Education, University of Turku, Turku, Finland.,Finnish National Agency for Education, Helsinki, Finland
| | | | | | - Virva Saunavaara
- Division of Medical Imaging, Department of Medical Physics, Turku University Hospital, Turku, Finland.,Turku PET Center, University of Turku and Turku University Hospital, Turku, Finland
| | - Riikka Korja
- Department of Psychology, University of Turku, Turku, Finland
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10
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Mithani K, Davison B, Meng Y, Lipsman N. The anterior limb of the internal capsule: Anatomy, function, and dysfunction. Behav Brain Res 2020; 387:112588. [PMID: 32179062 DOI: 10.1016/j.bbr.2020.112588] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 12/22/2019] [Accepted: 02/28/2020] [Indexed: 12/22/2022]
Abstract
The last two decades have seen a re-emergence of neurosurgery for severe, refractory psychiatric diseases, largely due to the advent of more precise and safe operative techniques. Nevertheless, the optimal targets for these surgeries remain a matter of debate, and are often grandfathered from experiences in the late 20th century. To better explore the rationale for one target in particular - the anterior limb of the internal capsule (ALIC) - we comprehensively reviewed all available literature on its role in the pathophysiology and treatment of mental illness. We first provide an overview of its functional anatomy, followed by a discussion on its role in several prevalent psychiatric diseases. Given its structural integration into the limbic system and involvement in a number of cognitive and emotional processes, the ALIC is a robust target for surgical treatment of refractory psychiatric diseases. The advent of novel neuroimaging techniques, coupled with image-guided therapeutics and neuromodulatory treatments, will continue to enable study on the ALIC in mental illness.
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Affiliation(s)
- Karim Mithani
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | | | - Ying Meng
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Nir Lipsman
- Sunnybrook Research Institute, Toronto, Ontario, Canada.
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11
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Personalized Clinical Approaches to Anxiety Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:489-521. [DOI: 10.1007/978-981-32-9705-0_25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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12
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Kolesar TA, Bilevicius E, Wilson AD, Kornelsen J. Systematic review and meta-analyses of neural structural and functional differences in generalized anxiety disorder and healthy controls using magnetic resonance imaging. NEUROIMAGE-CLINICAL 2019; 24:102016. [PMID: 31835287 PMCID: PMC6879983 DOI: 10.1016/j.nicl.2019.102016] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/22/2019] [Accepted: 09/27/2019] [Indexed: 12/18/2022]
Abstract
PFC-amygdala FC is altered in GAD, indicating top-down processing deficits. GAD had reduced activity for emotion regulation and working memory in the culmen. Salience, default, and central executive nodes have altered structure and function.
Objective To compare structure, functional connectivity (FC) and task-based neural differences in subjects with generalized anxiety disorder (GAD) compared to healthy controls (HC). Methods The Embase, Ovid Medline, PsycINFO, Scopus, and Web of Science databases were searched from inception until March 12, 2018. Two reviewers independently screened titles, abstracts, and full-text articles. Data were extracted from records directly contrasting GAD and HC that included structure (connectivity and local indices such as volume, etc.), FC, or task-based magnetic resonance imaging data. Meta-analyses were conducted, as applicable, using AES-SDM software. Results The literature search produced 4,645 total records, of which 85 met the inclusion criteria for the systematic review. Records included structural (n = 35), FC (n = 33), and task-based (n = 42) findings. Meta-analyses were conducted on voxel-based morphometry and task-based results. Discussion The systematic review confirms and extends findings from previous reviews. Although few whole-brain resting state studies were conducted, key nodes of resting state networks have altered physiology: the hippocampus (default network), ACC and amygdala (salience network), have reduced volume, and the dlPFC (central executive network) and ACC have reduced FC with the amygdala in GAD. Nodes in the sensorimotor network are also altered with greater pre- and postcentral volume, reduced supplementary motor area volume, and reduced FC in anterior and increased FC in posterior cerebellum. Conclusions Despite limitations due to sample size, the meta-analyses highly agree with the systematic review and provide evidence of widely distributed neural differences in subjects with GAD, compared to HC. Further research optimized for meta-analyses would greatly improve large-scale comparisons.
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Affiliation(s)
- Tiffany A Kolesar
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada
| | - Elena Bilevicius
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Alyssia D Wilson
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jennifer Kornelsen
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada; Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada; Department of Radiology, University of Manitoba, Winnipeg, MB, Canada.
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13
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Tønnesen S, Kaufmann T, Doan NT, Alnæs D, Córdova-Palomera A, Meer DVD, Rokicki J, Moberget T, Gurholt TP, Haukvik UK, Ueland T, Lagerberg TV, Agartz I, Andreassen OA, Westlye LT. White matter aberrations and age-related trajectories in patients with schizophrenia and bipolar disorder revealed by diffusion tensor imaging. Sci Rep 2018; 8:14129. [PMID: 30237410 PMCID: PMC6147807 DOI: 10.1038/s41598-018-32355-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 09/06/2018] [Indexed: 12/18/2022] Open
Abstract
Supported by histological and genetic evidence implicating myelin, neuroinflammation and oligodendrocyte dysfunction in schizophrenia spectrum disorders (SZ), diffusion tensor imaging (DTI) studies have consistently shown white matter (WM) abnormalities when compared to healthy controls (HC). The diagnostic specificity remains unclear, with bipolar disorders (BD) frequently conceptualized as a less severe clinical manifestation along a psychotic spectrum. Further, the age-related dynamics and possible sex differences of WM abnormalities in SZ and BD are currently understudied. Using tract-based spatial statistics (TBSS) we compared DTI-based microstructural indices between SZ (n = 128), BD (n = 61), and HC (n = 293). We tested for age-by-group and sex-by-group interactions, computed effect sizes within different age-bins and within genders. TBSS revealed global reductions in fractional anisotropy (FA) and increases in radial (RD) diffusivity in SZ compared to HC, with strongest effects in the body and splenium of the corpus callosum, and lower FA in SZ compared to BD in right inferior longitudinal fasciculus and right inferior fronto-occipital fasciculus, and no significant differences between BD and HC. The results were not strongly dependent on age or sex. Despite lack of significant group-by-age interactions, a sliding-window approach supported widespread WM involvement in SZ with most profound differences in FA from the late 20 s.
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Affiliation(s)
- Siren Tønnesen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Tobias Kaufmann
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nhat Trung Doan
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dag Alnæs
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Aldo Córdova-Palomera
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Dennis van der Meer
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jaroslav Rokicki
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Torgeir Moberget
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Tiril P Gurholt
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Unn K Haukvik
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torill Ueland
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
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14
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Moon CM, Jeong GW. Associations of neurofunctional, morphometric and metabolic abnormalities with clinical symptom severity and recognition deficit in obsessive-compulsive disorder. J Affect Disord 2018; 227:603-612. [PMID: 29172053 DOI: 10.1016/j.jad.2017.11.059] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/29/2017] [Accepted: 11/12/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) causes neural dysfunction associated with cognitive deficit and emotional dysregulation. This study assessed the associations of the neurofunctional changes, gray matter (GM) and white matter (WM) volume alterations in conjunction with in vivo metabolic changes on the working memory tasks in patients with OCD. METHODS Eighteen patients with OCD and 18 healthy controls matched for age, sex, and educational levels underwent high-resolution T1-weighted magnetic resonance imaging (MRI), event-related functional MRI (fMRI), and proton magnetic resonance spectroscopy (1H-MRS) at 3T. RESULTS In fMRI, patients with OCD showed lower activities in the cerebellum, inferior temporal gyrus, orbitofrontal gyrus, dorsolateral prefrontal cortex and calcarine gyrus compared to the controls. In VBM, the patients showed significantly reduced GM volumes, especially in the cerebellum, hippocampus, and superior temporal gyrus, together with significantly reduced WM volumes in the retrolenticular part of the internal capsule, dorsolateral prefrontal cortex (DLPFC) and orbitofrontal gyrus. In 1H-MRS, the ratios of N-acetylaspartate/creatine and choline/creatine were significantly lower in the DLPFC of the patients than in the controls, whereas the ratio of β∙γ-glutamine-glutamate/creatine was significantly higher in the patients than in the controls. LIMITATIONS This study examined small numbers of subjects in each one of the groups. CONCLUSIONS The findings will be helpful to aid us in understanding of neurocognitive impairment in OCD, and thus, enhancing the diagnostic accuracy for OCD by additional information on the associated brain functional deficit, cerebral volume change and metabolic abnormality.
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Affiliation(s)
- Chung-Man Moon
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Republic of Korea
| | - Gwang-Woo Jeong
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Republic of Korea; Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
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15
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Abstract
Generalized anxiety disorder (GAD) is a prevalent and highly disabling mental health condition; however, there is still much to learn with regard to pertinent biomarkers, as well as diagnosis, made more difficult by the marked and common overlap of GAD with affective and anxiety disorders. Recently, intensive research efforts have focused on GAD, applying neuroimaging, genetic, and blood-based approaches toward discovery of pathogenetic and treatment-related biomarkers. In this paper, we review the large amount of available data, and we focus in particular on evidence from neuroimaging, genetic, and neurochemical measurements in GAD in order to better understand potential biomarkers involved in its etiology and treatment. Overall, the majority of these studies have produced results that are solitary findings, sometimes inconsistent and not clearly replicable. For these reasons, they have not yet been translated into clinical practice. Therefore, further research efforts are needed to distinguish GAD from other mental disorders and to provide new biological insights into its pathogenesis and treatment.
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Affiliation(s)
- Eduard Maron
- Faculty of Medicine, Department of Medicine, Center for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK ; Department of Psychiatry, University of Tartu, Tartu, Estonia ; North Estonia Medical Center, Department of Psychiatry, Tallinn, Estonia
| | - David Nutt
- Faculty of Medicine, Department of Medicine, Center for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
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16
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Maron E, Lan CC, Nutt D. Imaging and Genetic Approaches to Inform Biomarkers for Anxiety Disorders, Obsessive-Compulsive Disorders, and PSTD. Curr Top Behav Neurosci 2018; 40:219-292. [PMID: 29796838 DOI: 10.1007/7854_2018_49] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Anxiety disorders are the most common mental health problem in the world and also claim the highest health care cost among various neuropsychiatric disorders. Anxiety disorders have a chronic and recurrent course and cause significantly negative impacts on patients' social, personal, and occupational functioning as well as quality of life. Despite their high prevalence rates, anxiety disorders have often been under-diagnosed or misdiagnosed, and consequently under-treated. Even with the correct diagnosis, anxiety disorders are known to be difficult to treat successfully. In order to implement better strategies in diagnosis, prognosis, treatment decision, and early prevention for anxiety disorders, tremendous efforts have been put into studies using genetic and neuroimaging techniques to advance our understandings of the underlying biological mechanisms. In addition to anxiety disorders including panic disorder, generalised anxiety disorder (GAD), specific phobias, social anxiety disorders (SAD), due to overlapping symptom dimensions, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) (which were removed from the anxiety disorder category in DSM-5 to become separate categories) are also included for review of relevant genetic and neuroimaging findings. Although the number of genetic or neuroimaging studies focusing on anxiety disorders is relatively small compare to other psychiatric disorders such as psychotic disorders or mood disorders, various structural abnormalities in the grey or white matter, functional alterations of activity during resting-state or task conditions, molecular changes of neurotransmitter receptors or transporters, and genetic associations have all been reported. With continuing effort, further genetic and neuroimaging research may potentially lead to clinically useful biomarkers for the prevention, diagnosis, and management of these disorders.
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Affiliation(s)
- Eduard Maron
- Neuropsychopharmacology Unit, Centre for Academic Psychiatry, Division of Brain Sciences, Imperial College London, London, UK.
- Department of Psychiatry, University of Tartu, Tartu, Estonia.
- Department of Psychiatry, North Estonia Medical Centre, Tallinn, Estonia.
| | - Chen-Chia Lan
- Neuropsychopharmacology Unit, Centre for Academic Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - David Nutt
- Neuropsychopharmacology Unit, Centre for Academic Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
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17
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Wang X, Cheng B, Luo Q, Qiu L, Wang S. Gray Matter Structural Alterations in Social Anxiety Disorder: A Voxel-Based Meta-Analysis. Front Psychiatry 2018; 9:449. [PMID: 30298028 PMCID: PMC6160565 DOI: 10.3389/fpsyt.2018.00449] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 08/30/2018] [Indexed: 02/05/2023] Open
Abstract
The current insight into the neurobiological pathogenesis underlying social anxiety disorder (SAD) is still rather limited. We implemented a meta-analysis to explore the neuroanatomical basis of SAD. We undertook a systematic search of studies comparing gray matter volume (GMV) differences between SAD patients and healthy controls (HC) using a whole-brain voxel-based morphometry (VBM) approach. The anisotropic effect size version of seed-based d mapping (AES-SDM) meta-analysis was conducted to explore the GMV differences of SAD patients compared with HC. We included eleven studies with 470 SAD patients and 522 HC in the current meta-analysis. In the main meta-analysis, relative to HC, SAD patients showed larger GMVs in the left precuneus, right middle occipital gyrus (MOG) and supplementary motor area (SMA), as well as smaller GMV in the left putamen. In the subgroup analyses, compared with controls, adult patients (age ≥ 18 years) with SAD exhibited larger GMVs in the left precuneus, right superior frontal gyrus (SFG), angular gyrus, middle temporal gyrus (MTG), MOG and SMA, as well as a smaller GMV in the left thalamus; SAD patients without comorbid depressive disorder exhibited larger GMVs in the left superior parietal gyrus and precuneus, right inferior temporal gyrus, fusiform gyrus, MTG and superior temporal gyrus (STG), as well as a smaller GMV in the bilateral thalami; and currently drug-free patients with SAD exhibited a smaller GMV in the left thalamus compared with HC while no larger GMVs were found. For SAD patients with different clinical features, our study revealed directionally consistent larger cortical GMVs and smaller subcortical GMVs, including locationally consistent larger precuneus and thalamic deficits in the left brain. Age, comorbid depressive disorder and concomitant medication use of the patients might be potential confounders of SAD at the neuroanatomical level.
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Affiliation(s)
- Xiuli Wang
- Department of Clinical Psychology, the Fourth People's Hospital of Chengdu, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Qiang Luo
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Lihua Qiu
- Department of Radiology, the Second People's Hospital of Yibin, Yibin, China
| | - Song Wang
- Department of Clinical Psychology, the Fourth People's Hospital of Chengdu, Chengdu, China.,Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China
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18
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Qiao J, Li A, Cao C, Wang Z, Sun J, Xu G. Aberrant Functional Network Connectivity as a Biomarker of Generalized Anxiety Disorder. Front Hum Neurosci 2017; 11:626. [PMID: 29375339 PMCID: PMC5770732 DOI: 10.3389/fnhum.2017.00626] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 12/08/2017] [Indexed: 12/14/2022] Open
Abstract
Neural disruptions during emotion regulation are common of generalized anxiety disorder (GAD). Identifying distinct functional and effective connectivity patterns in GAD may provide biomarkers for their diagnoses. This study aims to investigate the differences of features of brain network connectivity between GAD patients and healthy controls (HC), and to assess whether those differences can serve as biomarkers to distinguish GAD from controls. Independent component analysis (ICA) with hierarchical partner matching (HPM-ICA) was conducted on resting-state functional magnetic resonance imaging data collected from 20 GAD patients with medicine-free and 20 matched HC, identifying nine highly reproducible and significantly different functional brain connectivity patterns across diagnostic groups. We then utilized Granger causality (GC) to study the effective connectivity between the regions that identified by HPM-ICA. The linear discriminant analysis was finally used to distinguish GAD from controls with these measures of neural connectivity. The GAD patients showed stronger functional connectivity in amygdala, insula, putamen, thalamus, and posterior cingulate cortex, but weaker in frontal and temporal cortex compared with controls. Besides, the effective connectivity in GAD was decreased from the cortex to amygdala and basal ganglia. Applying the ICA and GC features to the classifier led to a classification accuracy of 87.5%, with a sensitivity of 90.0% and a specificity of 85.0%. These findings suggest that the presence of emotion dysregulation circuits may contribute to the pathophysiology of GAD, and these aberrant brain features may serve as robust brain biomarkers for GAD.
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Affiliation(s)
- Jianping Qiao
- School of Physics and Electronics, Shandong Normal University, Jinan, China.,Shandong Province Key Laboratory of Medical Physics and Image Processing Technology, Shandong Normal University, Jinan, China.,Institute of Data Science and Technology, Shandong Normal University, Jinan, China
| | - Anning Li
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Chongfeng Cao
- Department of Emergency, Jinan Central Hospital Affiliated to Shandong University, Jinan, China
| | - Zhishun Wang
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Jiande Sun
- Institute of Data Science and Technology, Shandong Normal University, Jinan, China.,School of Information Science and Engineering, Shandong Normal University, Jinan, China
| | - Guangrun Xu
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
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19
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Zhao Y, Chen L, Zhang W, Xiao Y, Shah C, Zhu H, Yuan M, Sun H, Yue Q, Jia Z, Zhang W, Kuang W, Gong Q, Lui S. Gray Matter Abnormalities in Non-comorbid Medication-naive Patients with Major Depressive Disorder or Social Anxiety Disorder. EBioMedicine 2017. [PMID: 28633986 PMCID: PMC5514428 DOI: 10.1016/j.ebiom.2017.06.013] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background An overlap of clinical symptoms between major depressive disorder (MDD) and social anxiety disorder (SAD) suggests that the two disorders exhibit similar brain mechanisms. However, few studies have directly compared the brain structures of the two disorders. The aim of this study was to assess the gray matter volume (GMV) and cortical thickness alterations between non-comorbid medication-naive MDD patients and SAD patients. Methods High-resolution T1-weighted images were acquired from 37 non-comorbid MDD patients, 24 non-comorbid SAD patients and 41 healthy controls (HCs). Voxel-based morphometry analysis of the GMV (corrected with a false discovery rate of p < 0.001) and vertex-based analysis of cortical thickness (corrected with a clusterwise probability of p < 0.001) were performed, and group differences were compared by ANOVA followed by post hoc tests. Outcomes Relative to the HCs, both the MDD patients and SAD patients showed the following results: GMV reductions in the bilateral orbital frontal cortex (OFC), putamen, and thalamus; cortical thickening in the bilateral medial prefrontal cortex, posterior dorsolateral prefrontal cortex, insular cortex, left temporal pole, and right superior parietal cortex; and cortical thinning in the left lateral OFC and bilateral rostral middle frontal cortex. In addition, MDD patients specifically showed a greater thickness in the left fusiform gyrus and right lateral occipital cortex and a thinner thickness in the bilateral lingual and left cuneus. SAD patients specifically showed a thinner cortical thickness in the right precentral cortex. Interpretation Our results indicate that MDD and SAD share common patterns of gray matter abnormalities in the orbitofrontal-striatal-thalamic circuit, salience network and dorsal attention network. These consistent structural differences in the two patient groups may contribute to the broad spectrum of emotional, cognitive and behavioral disturbances observed in MDD patients and SAD patients. In addition, we found disorder-specific involvement of the visual processing regions in MDD and the precentral cortex in SAD. These findings provide new evidence regarding the shared and specific neuropathological mechanisms that underlie MDD and SAD. MDD and SAD share common gray matter abnormalities in the orbitofrontal-striatal-thalamic circuit, salience and dorsal attention network. MDD patients show disorder-specific involvement of the visual processing regions. SAD patients show disorder-specific involvement of the precentral cortex.
An overlap of clinical symptoms between major depressive disorder (MDD) and social anxiety disorder (SAD) suggests similar brain mechanisms for the two disorders. However, few studies have directly compared the brain structures of the two disorders. The aim of this study was to assess gray matter volume and cortical thickness alterations between non-comorbid medication-naive MDD patients and SAD patients. We found that MDD and SAD shared a common pattern of gray matter abnormalities in the orbitofrontal-striatal-thalamic circuit, salience network and dorsal attention network. MDD patients showed disorder-specific involvement of the visual processing regions. SAD patients showed disorder-specific involvement of the precentral cortex.
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Affiliation(s)
- Youjin Zhao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Lizhou Chen
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Wenjing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Yuan Xiao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Chandan Shah
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Hongru Zhu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, PR China
| | - Minlan Yuan
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, PR China
| | - Huaiqiang Sun
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Qiang Yue
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Zhiyun Jia
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China
| | - Wei Zhang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, PR China
| | - Weihong Kuang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, PR China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China.
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China.
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