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Fitzgerald PJ. Frontal Alpha Asymmetry and Its Modulation by Monoaminergic Neurotransmitters in Depression. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2024; 22:405-415. [PMID: 39069680 PMCID: PMC11289606 DOI: 10.9758/cpn.23.1138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/22/2024] [Accepted: 02/13/2024] [Indexed: 07/30/2024]
Abstract
Frontal alpha asymmetry (FAA) is an electroencephalography (EEG) measure that quantifies trait-like left versus right hemisphere lateralization in alpha power. Increased FAA indicates relatively greater left than right frontal cortex activation and is associated with enhanced reward-related approach behaviors rather than avoidance or withdrawal. Studies dating back several decades have often suggested that having greater FAA supports enhanced positive affect and protection against major depressive disorder (MDD), whereas having greater right frontal activation (i.e., reduced FAA) is associated with negative affect and risk for MDD. While this hypothesis is widely known, a number of other studies instead have found increased FAA in MDD, or evidence that either leftward or rightward bias in FAA is associated with depression. Here we briefly review the literature on leftward or rightward lateralization in FAA in MDD, and find much evidence that MDD is not always characterized by reduced FAA. We also review the limited literature on FAA and monoaminergic neurotransmitter systems, including pharmacologic agents that act on them. Studies of serotonin in particular provide genetic and pharmacologic evidence for modulation of FAA, where some of these data may suggest that serotonin reduces FAA. In a synthesis of the collective literature on FAA and the monoamines, we suggest that serotonin and norepinephrine may differentially affect FAA, with serotonin tending to promote right frontal activation and norepinephrine biased toward left frontal activation. These putative differences in frontal lateralization may influence MDD phenotypes or potential subtypes of the disorder, and suggest pharmacologic treatment strategies.
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Affiliation(s)
- Paul J. Fitzgerald
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
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2
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Yang X, Yang G, Wang R, Wang Y, Zhang S, Wang J, Yu C, Ren Z. Brain glucose metabolism on [18F]-FDG PET/CT: a dynamic biomarker predicting depression and anxiety in cancer patients. Front Oncol 2023; 13:1098943. [PMID: 37305568 PMCID: PMC10248443 DOI: 10.3389/fonc.2023.1098943] [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: 11/20/2022] [Accepted: 05/17/2023] [Indexed: 06/13/2023] Open
Abstract
Objectives To explore the correlation between the incidence rates of depression and anxiety and cerebral glucose metabolism in cancer patients. Methods The experiment subjects consisted of patients with lung cancer, head and neck tumor, stomach cancer, intestinal cancer, breast cancer and healthy individuals. A total of 240 tumor patients and 39 healthy individuals were included. All subjects were evaluated by the Hamilton depression scale (HAMD) and Manifest anxiety scale (MAS), and were examined by whole body Positron Emission Tomography/Computed Tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG). Demographic, baseline clinical characteristics, brain glucose metabolic changes, emotional disorder scores and their relations were statistically analyzed. Results The incidence rates of depression and anxiety in patients with lung cancer were higher than those in patients with other tumors, and Standard uptake values (SUVs) and metabolic volume in bilateral frontal lobe, bilateral temporal lobe, bilateral caudate nucleus, bilateral hippocampus, left cingulate gyrus were lower than those in patients with other tumors. We also found that poor pathological differentiation, and advanced TNM stage independently associated with depression and anxiety risk. SUVs in the bilateral frontal lobe, bilateral temporal lobe, bilateral caudate nucleus, bilateral hippocampus, left cingulate gyrus were negatively correlated with HAMD and MAS scores. Conclusion This study revealed the correlation between brain glucose metabolism and emotional disorders in cancer patients. The changes in brain glucose metabolism were expected to play a major role in emotional disorders in cancer patients as psychobiological markers. These findings indicated that functional imaging can be applied for psychological assessment of cancer patients as an innovative method.
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Affiliation(s)
- Xue Yang
- Department of Neurology, Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, China
| | - Guangxia Yang
- Department of Rheumatology, Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, China
| | - Ruojun Wang
- Department of Neurology, Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, China
| | - Yanjuan Wang
- Department of Nuclear Medicine, Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, China
| | - Shengyi Zhang
- Department of Neurology, Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, China
| | - Jian Wang
- Department of Orthopaedics, The Ninth People’s Hospital of Wuxi, Affiliated to Suzhou University, Wuxi, Jiangsu, China
| | - Chunjing Yu
- Department of Nuclear Medicine, Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, China
| | - Zeqin Ren
- Department of Rehabilitation, The First Affiliated Hospital of Dali University, Dali, Yunnan, China
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3
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Tsai YC, Li CT, Juan CH. A review of critical brain oscillations in depression and the efficacy of transcranial magnetic stimulation treatment. Front Psychiatry 2023; 14:1073984. [PMID: 37260762 PMCID: PMC10228658 DOI: 10.3389/fpsyt.2023.1073984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/11/2023] [Indexed: 06/02/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS) have been proven effective non-invasive treatments for patients with drug-resistant major depressive disorder (MDD). However, some depressed patients do not respond to these treatments. Therefore, the investigation of reliable and valid brain oscillations as potential indices for facilitating the precision of diagnosis and treatment protocols has become a critical issue. The current review focuses on brain oscillations that, mostly based on EEG power analysis and connectivity, distinguish between MDD and controls, responders and non-responders, and potential depression severity indices, prognostic indicators, and potential biomarkers for rTMS or iTBS treatment. The possible roles of each biomarker and the potential reasons for heterogeneous results are discussed, and the directions of future studies are proposed.
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Affiliation(s)
- Yi-Chun Tsai
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan
| | - Cheng-Ta Li
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Chi-Hung Juan
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan
- Cognitive Intelligence and Precision Healthcare Center, National Central University, Taoyuan City, Taiwan
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan
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4
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Gärtner M, de Rover M, Václavů L, Scheidegger M, van Osch MJP, Grimm S. Increase in thalamic cerebral blood flow is associated with antidepressant effects of ketamine in major depressive disorder. World J Biol Psychiatry 2022; 23:643-652. [PMID: 34985394 DOI: 10.1080/15622975.2021.2020900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Ketamine is a promising treatment option for patients with Major Depressive Disorder (MDD) and has become an important research tool to investigate antidepressant mechanisms of action. However, imaging studies attempting to characterise ketamine's mechanism of action using blood oxygen level-dependent signal (BOLD) imaging have yielded inconsistent results- at least partly due to intrinsic properties of the BOLD contrast, which measures a complex signal related to neural activity. To circumvent the limitations associated with the BOLD signal, we used arterial spin labelling (ASL) as an unambiguous marker of neuronal activity-related changes in cerebral blood flow (CBF). We measured CBF in 21 MDD patients at baseline and 24 h after receiving a single intravenous infusion of subanesthetic ketamine and examined relationships with clinical outcomes. Our findings demonstrate that increase in thalamus perfusion 24 h after ketamine administration is associated with greater improvement of depressive symptoms. Furthermore, lower thalamus perfusion at baseline is associated both with larger increases in perfusion 24 h after ketamine administration and with stronger reduction of depressive symptoms. These findings indicate that ASL is not only a useful tool to broaden our understanding of ketamine's mechanism of action but might also have the potential to inform treatment decisions based on CBF-defined regional disruptions.
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Affiliation(s)
- Matti Gärtner
- MSB-Medical School Berlin, Berlin, Germany.,Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Mischa de Rover
- Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands.,Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Lena Václavů
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, Netherlands
| | - Milan Scheidegger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Matthias J P van Osch
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, Netherlands
| | - Simone Grimm
- MSB-Medical School Berlin, Berlin, Germany.,Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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5
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Li H, Song S, Wang D, Zhang D, Tan Z, Lian Z, Wang Y, Zhou X, Pan C, Wu Y. Treatment Response Prediction for Major Depressive Disorder Patients via Multivariate Pattern Analysis of Thalamic Features. Front Comput Neurosci 2022; 16:837093. [PMID: 35720774 PMCID: PMC9199000 DOI: 10.3389/fncom.2022.837093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/19/2022] [Indexed: 11/30/2022] Open
Abstract
Antidepressant treatment, as an important method in clinical practice, is not suitable for all major depressive disorder (MDD) patients. Although magnetic resonance imaging (MRI) studies have found thalamic abnormalities in MDD patients, it is not clear whether the features of the thalamus are suitable to serve as predictive aids for treatment responses at the individual level. Here, we tested the predictive value of gray matter density (GMD), gray matter volume (GMV), amplitude of low-frequency fluctuations (ALFF), and fractional ALFF (fALFF) of the thalamus using multivariate pattern analysis (MVPA). A total of 74 MDD patients and 44 healthy control (HC) subjects were recruited. Thirty-nine MDD patients and 35 HC subjects underwent scanning twice. Between the two scanning sessions, patients in the MDD group received selective serotonin reuptake inhibitor (SSRI) treatment for 3-month, and HC group did not receive any treatment. Gaussian process regression (GPR) was trained to predict the percentage decrease in the Hamilton Depression Scale (HAMD) score after treatment. The percentage decrease in HAMD score after SSRI treatment was predicted by building GPRs trained with baseline thalamic data. The results showed significant correlations between the true percentage of HAMD score decreases and predictions (p < 0.01, r2 = 0.11) in GPRs trained with GMD. We did not find significant correlations between the true percentage of HAMD score decreases and predictions in GMV (p = 0.16, r2 = 0.00), ALFF (p = 0.125, r2 = 0.00), and fALFF (p = 0.485, r2 = 0.10). Our results suggest that GMD of the thalamus has good potential as an aid in individualized treatment response predictions of MDD patients.
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Affiliation(s)
- Hanxiaoran Li
- Institutes of Psychological Sciences, College of Education, Hangzhou Normal University, Hangzhou, China
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Sutao Song
- School of Information Science and Engineering, Shandong Normal University, Jinan, China
- *Correspondence: Sutao Song,
| | - Donglin Wang
- Institutes of Psychological Sciences, College of Education, Hangzhou Normal University, Hangzhou, China
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
- Department of Psychiatry, The Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
- Donglin Wang,
| | - Danning Zhang
- Shandong Mental Health Center, Shandong University, Jinan, Shandong, China
- Danning Zhang,
| | - Zhonglin Tan
- Department of Psychiatry, Hangzhou Seventh People’s Hospital, Hangzhou, China
| | - Zhenzhen Lian
- Institutes of Psychological Sciences, College of Education, Hangzhou Normal University, Hangzhou, China
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Yan Wang
- Institutes of Psychological Sciences, College of Education, Hangzhou Normal University, Hangzhou, China
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
- Department of Psychiatry, The Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
| | - Xin Zhou
- Institutes of Psychological Sciences, College of Education, Hangzhou Normal University, Hangzhou, China
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Chenyuan Pan
- Institutes of Psychological Sciences, College of Education, Hangzhou Normal University, Hangzhou, China
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Yue Wu
- Department of Translational Psychiatry Laboratory, Hangzhou Seventh People’s Hospital, Hangzhou, China
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6
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Oscillatory brain network changes after transcranial magnetic stimulation treatment in patients with major depressive disorder. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2021.100277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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7
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Tsai YC, Li CT, Liang WK, Muggleton NG, Tsai CC, Huang NE, Juan CH. Critical role of rhythms in prefrontal transcranial magnetic stimulation for depression: A randomized sham-controlled study. Hum Brain Mapp 2021; 43:1535-1547. [PMID: 34873781 PMCID: PMC8886663 DOI: 10.1002/hbm.25740] [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: 10/28/2021] [Revised: 11/25/2021] [Accepted: 11/28/2021] [Indexed: 11/21/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is an alternative treatment for depression, but the neural correlates of the treatment are currently inconclusive, which might be a limit of conventional analytical methods. The present study aimed to investigate the neurophysiological evidence and potential biomarkers for rTMS and intermittent theta burst stimulation (iTBS) treatment. A total of 61 treatment‐resistant depression patients were randomly assigned to receive prolonged iTBS (piTBS; N = 19), 10 Hz rTMS (N = 20), or sham stimulation (N = 22). Each participant went through a treatment phase with resting state electroencephalography (EEG) recordings before and after the treatment phase. The aftereffects of stimulation showed that theta‐alpha amplitude modulation frequency (fam) was associated with piTBS_Responder, which involves repetitive bursts delivered in the theta frequency range, whereas alpha carrier frequency (fc) was related to 10 Hz rTMS, which uses alpha rhythmic stimulation. In addition, theta‐alpha amplitude modulation frequency was positively correlated with piTBS antidepressant efficacy, whereas the alpha frequency was not associated with the 10 Hz rTMS clinical outcome. The present study showed that TMS stimulation effects might be lasting, with changes of brain oscillations associated with the delivered frequency. Additionally, theta‐alpha amplitude modulation frequency may be as a function of the degree of recovery in TRD with piTBS treatment and also a potential EEG‐based predictor of antidepressant efficacy of piTBS in the early treatment stage, that is, first 2 weeks.
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Affiliation(s)
- Yi-Chun Tsai
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan
| | - Cheng-Ta Li
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Wei-Kuang Liang
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan.,Cognitive Intelligence and Precision Healthcare Center, National Central University, Taoyuan City, Taiwan
| | - Neil G Muggleton
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan.,Cognitive Intelligence and Precision Healthcare Center, National Central University, Taoyuan City, Taiwan
| | - Chong-Chih Tsai
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan.,Cognitive Intelligence and Precision Healthcare Center, National Central University, Taoyuan City, Taiwan.,Department of Psychiatry, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
| | - Norden E Huang
- Key Laboratory of Data Analysis and Applications, First Institute of Oceanography, State Oceanic Administration, Qingdao, China
| | - Chi-Hung Juan
- Institute of Cognitive Neuroscience, College of Health Sciences and Technology, National Central University, Taoyuan City, Taiwan.,Cognitive Intelligence and Precision Healthcare Center, National Central University, Taoyuan City, Taiwan.,Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan
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8
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Hsu LM, Lane TJ, Wu CW, Lin CY, Yeh CB, Kao HW, Lin CP. Spontaneous thought-related network connectivity predicts sertraline effect on major depressive disorder. Brain Imaging Behav 2021; 15:1705-1717. [PMID: 32710339 DOI: 10.1007/s11682-020-00364-w] [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] [Indexed: 11/25/2022]
Abstract
Sertraline is one of the most commonly prescribed antidepressants. Major depressive disorder (MDD) is characterized by spontaneous thoughts that are laden with negative affect-a "malignant sadness". Prior neuroimaging studies have identified abnormal resting-state functional connectivity (rsFC) in the spontaneous brain networks of MDD patients. But how antidepressant medication acts to relieve the experience of depression as well as adjust its associated spontaneous networks and mood-regulation circuits remains an open question. In this study, we recruited 22 drug-naïve MDD patients along with 35 normal controls and investigated whether the functional integrity of cortical networks associated with spontaneous thoughts is modulated by sertraline treatment. We attempted to predict post-treatment effects based upon what we observed in the pre-treatment rsFC of drug-naïve MDD patients. In the result, we demonstrated that (1) after the sertraline treatment, the medial temporal lobe of default network (DNMTL) and mood regulation pathway-the fronto-parietal control network (FPCN), the thalamus, and the salience network (SN)-were restored to normal connectivity, relative to the pre-treatment condition; however, the altered connections of FPCN-core DN (DNCORE), FPCN-SN, and intra-FPCN among MDD patients remained impaired; (2) thalamo-prefrontal connectivity provides moderate predictive power (r2 = 0.63) for the effectiveness of sertraline treatment. In summary, our findings contribute to a body of evidence that suggests salubrious effects of sertraline treatment primarily involve the FPCN-thalamus-SN pathway. The pre-treatment rsFC in this pathway could serve as a predictor of sertraline treatment outcome.
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Affiliation(s)
- Li-Ming Hsu
- Department of Radiology and Brain Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Timothy Joseph Lane
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
- Brain and Consciousness Research Center, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
| | - Changwei W Wu
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
- Brain and Consciousness Research Center, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
| | | | - Chi-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
| | - Hung-Wen Kao
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Chenggong Road, Neihu District, Taipei City, 114, Taiwan.
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
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9
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Li G, Liu Y, Zheng Y, Wu Y, Li D, Liang X, Chen Y, Cui Y, Yap PT, Qiu S, Zhang H, Shen D. Multiscale neural modeling of resting-state fMRI reveals executive-limbic malfunction as a core mechanism in major depressive disorder. Neuroimage Clin 2021; 31:102758. [PMID: 34284335 PMCID: PMC8313604 DOI: 10.1016/j.nicl.2021.102758] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 06/30/2021] [Accepted: 07/03/2021] [Indexed: 11/15/2022]
Abstract
Major depressive disorder (MDD) represents a grand challenge to human health and society, but the underlying pathophysiological mechanisms remain elusive. Previous neuroimaging studies have suggested that MDD is associated with abnormal interactions and dynamics in two major neural systems including the default mode - salience (DMN-SAL) network and the executive - limbic (EXE-LIM) network, but it is not clear which network plays a central role and which network plays a subordinate role in MDD pathophysiology. To address this question, we refined a newly developed Multiscale Neural Model Inversion (MNMI) framework and applied it to test whether MDD is more affected by impaired circuit interactions in the DMN-SAL network or the EXE-LIM network. The model estimates the directed connection strengths between different neural populations both within and between brain regions based on resting-state fMRI data collected from normal healthy subjects and patients with MDD. Results show that MDD is primarily characterized by abnormal circuit interactions in the EXE-LIM network rather than the DMN-SAL network. Specifically, we observe reduced frontoparietal effective connectivity that potentially contributes to hypoactivity in the dorsolateral prefrontal cortex (dlPFC), and decreased intrinsic inhibition combined with increased excitation from the superior parietal cortex (SPC) that potentially lead to amygdala hyperactivity, together resulting in activation imbalance in the PFC-amygdala circuit that pervades in MDD. Moreover, the model reveals reduced PFC-to-hippocampus excitation but decreased SPC-to-thalamus inhibition in MDD population that potentially lead to hypoactivity in the hippocampus and hyperactivity in the thalamus, consistent with previous experimental data. Overall, our findings provide strong support for the long-standing limbic-cortical dysregulation model in major depression but also offer novel insights into the multiscale pathophysiology of this debilitating disease.
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Affiliation(s)
- Guoshi Li
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Yujie Liu
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC USA; The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China; Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China; Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Yanting Zheng
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC USA; The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China; Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China; Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Ye Wu
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Danian Li
- Cerebropathy Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xinyu Liang
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yaoping Chen
- The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China; Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ying Cui
- Cerebropathy Center, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Pew-Thian Yap
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Shijun Qiu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
| | - Han Zhang
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC USA.
| | - Dinggang Shen
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC USA.
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10
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Bittar TP, Labonté B. Functional Contribution of the Medial Prefrontal Circuitry in Major Depressive Disorder and Stress-Induced Depressive-Like Behaviors. Front Behav Neurosci 2021; 15:699592. [PMID: 34234655 PMCID: PMC8257081 DOI: 10.3389/fnbeh.2021.699592] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 05/20/2021] [Indexed: 12/13/2022] Open
Abstract
Despite decades of research on the neurobiology of major depressive disorder (MDD), the mechanisms underlying its expression remain unknown. The medial prefrontal cortex (mPFC), a hub region involved in emotional processing and stress response elaboration, is highly impacted in MDD patients and animal models of chronic stress. Recent advances showed alterations in the morphology and activity of mPFC neurons along with profound changes in their transcriptional programs. Studies at the circuitry level highlighted the relevance of deciphering the contributions of the distinct prefrontal circuits in the elaboration of adapted and maladapted behavioral responses in the context of chronic stress. Interestingly, MDD presents a sexual dimorphism, a feature recognized in the molecular field but understudied on the circuit level. This review examines the recent literature and summarizes the contribution of the mPFC circuitry in the expression of MDD in males and females along with the morphological and functional alterations that change the activity of these neuronal circuits in human MDD and animal models of depressive-like behaviors.
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Affiliation(s)
- Thibault P. Bittar
- CERVO Brain Research Centre, Québec, QC, Canada
- Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Benoit Labonté
- CERVO Brain Research Centre, Québec, QC, Canada
- Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Québec, QC, Canada
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11
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Castellanos JP, Woolley C, Bruno KA, Zeidan F, Halberstadt A, Furnish T. Chronic pain and psychedelics: a review and proposed mechanism of action. Reg Anesth Pain Med 2020; 45:486-494. [DOI: 10.1136/rapm-2020-101273] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/01/2020] [Accepted: 04/06/2020] [Indexed: 12/22/2022]
Abstract
The development of chronic pain is a complex mechanism that is still not fully understood. Multiple somatic and visceral afferent pain signals, when experienced over time, cause a strengthening of certain neural circuitry through peripheral and central sensitization, resulting in the physical and emotional perceptual chronic pain experience. The mind-altering qualities of psychedelics have been attributed, through serotonin 2A (5-HT2A) receptor agonism, to ‘reset’ areas of functional connectivity (FC) in the brain that play prominent roles in many central neuropathic states. Psychedelic substances have a generally favorable safety profile, especially when compared with opioid analgesics. Clinical evidence to date for their use for chronic pain is limited; however, several studies and reports over the past 50 years have shown potential analgesic benefit in cancer pain, phantom limb pain and cluster headache. While the mechanisms by which the classic psychedelics may provide analgesia are not clear, several possibilities exist given the similarity between 5-HT2A activation pathways of psychedelics and the nociceptive modulation pathways in humans. Additionally, the alterations in FC seen with psychedelic use suggest a way that these agents could help reverse the changes in neural connections seen in chronic pain states. Given the current state of the opioid epidemic and limited efficacy of non-opioid analgesics, it is time to consider further research on psychedelics as analgesics in order to improve the lives of patients with chronic pain conditions.
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12
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Pardo JV, Sheikh SA, Schwindt G, Lee JT, Adson DE, Rittberg B, Abuzzahab FS. A preliminary study of resting brain metabolism in treatment-resistant depression before and after treatment with olanzapine-fluoxetine combination. PLoS One 2020; 15:e0226486. [PMID: 31931515 PMCID: PMC6957341 DOI: 10.1371/journal.pone.0226486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 11/26/2019] [Indexed: 12/28/2022] Open
Abstract
Treatment-resistant depression (TRD) occurs in many patients and causes high morbidity and mortality. Because TRD subjects are particularly difficult to study especially longitudinally, biological data remain very limited. In a preliminary study to judge feasibility and power, 25 TRD patients were referred from specialty psychiatric practices. All were severely and chronically depressed and mostly had comorbid psychiatric disorders as is typical in TRD. Nine patients were able to complete all required components of the protocol that included diagnostic interview; rating scales; clinical magnetic resonance imaging; medication washout; treatment with maximally tolerated olanzapine-fluoxetine combination for 8 weeks; and pre- and post-treatment fluorodeoxyglucose positron emission tomography. This drug combination is an accepted standard of treatment for TRD. Dropouts arose from worsening depression, insomnia, and anxiety. One patient remitted; three responded. A priori regions of interest included the amygdala and subgenual cingulate cortex (sgACC; Brodmann area BA25). Responders showed decreased metabolism with treatment in the right amygdala that correlated with clinical response; no significant changes in BA25; better response to treatment the higher the baseline BA25 metabolism; and decreased right ventromedial prefrontal metabolism (VMPFC; broader than BA25) with treatment which did not correlate with depression scores. The baseline metabolism of all individuals showed heterogeneous patterns when compared to a normative metabolic database. Although preliminary given the sample size, this study highlights several issues important for future work: marked dropout rate in this study design; need for large sample size for adequate power; baseline metabolic heterogeneity of TRD requiring careful subject characterization for future studies of interventions; relationship of amygdala activity decreases with response; and the relationship between baseline sgACC and VMPFC activity with response. Successful treatment of TRD with olanzapine-fluoxetine combination shows changes in cerebral metabolism like those seen in treatment-responsive major depression.
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Affiliation(s)
- José V. Pardo
- Cognitive Neuroimaging Unit, Mental Health PSL, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States of America
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Sohail A. Sheikh
- Cognitive Neuroimaging Unit, Mental Health PSL, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States of America
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Graeme Schwindt
- Cognitive Neuroimaging Unit, Mental Health PSL, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States of America
| | - Joel T. Lee
- Cognitive Neuroimaging Unit, Mental Health PSL, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States of America
| | - David E. Adson
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Barry Rittberg
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Faruk S. Abuzzahab
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, United States of America
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13
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Biselli T, Lange SS, Sablottny L, Steffen J, Walther A. Optogenetic and chemogenetic insights into the neurocircuitry of depression-like behaviour: A systematic review. Eur J Neurosci 2019; 53:9-38. [PMID: 31633833 DOI: 10.1111/ejn.14603] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 09/13/2019] [Accepted: 10/14/2019] [Indexed: 12/13/2022]
Abstract
Major depressive disorder (MDD) and its treatment are challenges for global health. Optogenetics and chemogenetics are driving MDD research forward by unveiling causal relations between cell-type-specific control of neurons and depressive-like behaviour in rodents. Using a systematic search process, in this review, a set of 43 original studies applying optogenetic or chemogenetic techniques in rodent models of depression was identified. Our aim was to provide an examination of all available studies elucidating central neuronal mechanisms leading to depressive-like behaviour in rodents and thereby unveiling the most promising routes for future research. A complex interacting network of relevant structures, in which central circuitries causally related to depressive-like behaviour are implicated, has been identified. As most relevant structures emerge: medial prefrontal cortex, anterior cingulate cortex, amygdala, nucleus accumbens, ventral tegmental area, hippocampus and raphe nuclei. Further evidence, though examined by only few studies, emerges for structures like the lateral habenula, or medial dorsal thalamus. Most of the identified brain areas have previously been associated with MDD neuropathology, but now evidence can be provided for causal pathological mechanisms within a complex cortico-limbic reward circuitry. However, the studies also show conflicting results concerning the mechanisms underlying the causal involvement of specific circuitries. Comparability of studies is partly limited since even small deviations in methodological approaches lead to different outcomes. Factors influencing study outcomes were identified and need to be considered in future studies (e.g. frequency used for stimulation, time and duration of stimulation, limitations of applied animal models of MDD).
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Affiliation(s)
- Tom Biselli
- Biological Psychology, TU Dresden, Dresden, Germany
| | | | | | | | - Andreas Walther
- Biological Psychology, TU Dresden, Dresden, Germany.,Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
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Ng CH, Kato T, Han C, Wang G, Trivedi M, Ramesh V, Shao D, Gala S, Narayanan S, Tan W, Feng Y, Kasper S. Definition of treatment-resistant depression - Asia Pacific perspectives. J Affect Disord 2019; 245:626-636. [PMID: 30445388 DOI: 10.1016/j.jad.2018.11.038] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/07/2018] [Accepted: 11/03/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND The lack of uniformity in the definition of treatment resistant depression (TRD) within the Asia-Pacific (APAC) region may have implications for patient management. We aimed to characterize the most commonly used TRD definition in selected APAC countries. METHODS A systematic literature review of TRD definitions in APAC countries was conducted in Medline and Embase (2010-2016) and conference proceedings (2014 and 2016). TRD guidelines (APAC, Europe regional, US, or international) were also searched. An expert-panel explored APAC nuances in TRD definitions to achieve consensus for a regional-level definition. RESULTS Ten guidelines and 89 studies qualified for study inclusion. Among the studies, variations were observed in definitions regarding: number of antidepressants failed (range: ≥1 to ≥3), classes of antidepressants (same or different; 59% did not specify class), duration of previous treatments (range: 4-12 weeks), dosage adequacy, and consideration of adherence (yes/no; 88% of studies did not consider adherence). No TRD-specific guidelines were identified. The emerging consensus from the literature review and panel discussion was that TRD is most commonly defined as failure to ≥2 antidepressant therapies given at adequate doses, for 6-8 weeks during a major depressive episode. LIMITATIONS Few studies provided definitions of TRD used in daily clinical practice, and a limited number of countries were represented in the included studies and expert panel. CONCLUSION Attaining consensus on TRD definition may promote accurate, and possibly early detection of patients with TRD to enable appropriate intervention that may impact patient outcomes and quality of life.
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Affiliation(s)
- C H Ng
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - T Kato
- RIKEN Brain Science Institute, Saitama, Japan
| | - C Han
- Korea University, Seoul, South Korea
| | - G Wang
- Capital Medical University, Anding Hospital, Beijing, China
| | - M Trivedi
- University of Texas Southwestern Medical Center, TX, US
| | - V Ramesh
- Market Access Solutions, LLC, USA
| | - D Shao
- Market Access Solutions, LLC, USA
| | - S Gala
- Market Access Solutions, LLC, USA
| | | | - W Tan
- Janssen Asia Pacific, Singapore
| | - Y Feng
- Janssen Asia Pacific, Singapore
| | - S Kasper
- Medical University of Vienna, Vienna, Austria
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15
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Bailey NW, Hoy KE, Rogasch NC, Thomson RH, McQueen S, Elliot D, Sullivan CM, Fulcher BD, Daskalakis ZJ, Fitzgerald PB. Differentiating responders and non-responders to rTMS treatment for depression after one week using resting EEG connectivity measures. J Affect Disord 2019; 242:68-79. [PMID: 30172227 DOI: 10.1016/j.jad.2018.08.058] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 07/30/2018] [Accepted: 08/12/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Non-response to repetitive transcranial magnetic stimulation (rTMS) treatment for depression is costly for both patients and clinics. Simple and cheap methods to predict response would reduce this burden. Resting EEG measures differentiate responders from non-responders, so may have utility for response prediction. METHODS Fifty patients with treatment resistant depression and 21 controls had resting electroencephalography (EEG) recorded at baseline (BL). Patients underwent 5-8 weeks of rTMS treatment, with EEG recordings repeated at week 1 (W1). Forty-two participants had valid BL and W1 EEG data, and 12 were responders. Responders and non-responders were compared at BL and W1 in measures of theta (4-8 Hz) and alpha (8-13 Hz) power and connectivity, frontal theta cordance and alpha peak frequency. Control group comparisons were made for measures that differed between responders and non-responders. A machine learning algorithm assessed the potential to differentiate responders from non-responders using EEG measures in combination with change in depression scores from BL to W1. RESULTS Responders showed elevated theta connectivity across BL and W1. No other EEG measures differed between groups. Responders could be distinguished from non-responders with a mean sensitivity of 0.84 (p = 0.001) and specificity of 0.89 (p = 0.002) using cross-validated machine learning classification on the combination of all EEG and mood measures. LIMITATIONS The low response rate limited our sample size to only 12 responders. CONCLUSION Resting theta connectivity at BL and W1 differ between responders and non-responders, and show potential for predicting response to rTMS treatment for depression.
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Affiliation(s)
- N W Bailey
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia..
| | - K E Hoy
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - N C Rogasch
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton 3168, Victoria, Australia
| | - R H Thomson
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - S McQueen
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - D Elliot
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - C M Sullivan
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia
| | - B D Fulcher
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton 3168, Victoria, Australia
| | - Z J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - P B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School, Commercial Rd, Melbourne, Victoria, Australia.; Epworth Healthcare, The Epworth Clinic, Camberwell 3004, Victoria, Australia
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Duan X, Yao G, Liu Z, Cui R, Yang W. Mechanisms of Transcranial Magnetic Stimulation Treating on Post-stroke Depression. Front Hum Neurosci 2018; 12:215. [PMID: 29899693 PMCID: PMC5988869 DOI: 10.3389/fnhum.2018.00215] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 05/08/2018] [Indexed: 12/13/2022] Open
Abstract
Post-stroke depression (PSD) is a neuropsychiatric affective disorder that can develop after stroke. Patients with PSD show poorer functional and recovery outcomes than patients with stroke who do not suffer from depression. The risk of suicide is also higher in patients with PSD. PSD appears to be associated with complex pathophysiological mechanisms involving both psychological and psychiatric problems that are associated with functional deficits and neurochemical changes secondary to brain damage. Transcranial magnetic stimulation (TMS) is a non-invasive way to investigate cortical excitability via magnetic stimulation of the brain. TMS is currently a valuable tool that can help us understand the pathophysiology of PSD. Although repetitive TMS (rTMS) is an effective treatment for patients with PSD, its mechanism of action remains unknown. Here, we review the known mechanisms underlying rTMS as a tool for better understanding PSD pathophysiology. It should be helpful when considering using rTMS as a therapeutic strategy for PSD.
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Affiliation(s)
- Xiaoqin Duan
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Gang Yao
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Zhongliang Liu
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Ranji Cui
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
| | - Wei Yang
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetics, The Second Hospital of Jilin University, Changchun, China
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Miller OH, Bruns A, Ben Ammar I, Mueggler T, Hall BJ. Synaptic Regulation of a Thalamocortical Circuit Controls Depression-Related Behavior. Cell Rep 2018; 20:1867-1880. [PMID: 28834750 DOI: 10.1016/j.celrep.2017.08.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 07/08/2017] [Accepted: 07/26/2017] [Indexed: 01/06/2023] Open
Abstract
The NMDA receptor (NMDAR) antagonist ketamine elicits a long-lasting antidepressant response in patients with treatment-resistant depression. Understanding how antagonism of NMDARs alters synapse and circuit function is pivotal to developing circuit-based therapies for depression. Using virally induced gene deletion, ex vivo optogenetic-assisted circuit analysis, and in vivo chemogenetics and fMRI, we assessed the role of NMDARs in the medial prefrontal cortex (mPFC) in controlling depression-related behavior in mice. We demonstrate that post-developmental genetic deletion of the NMDAR subunit GluN2B from pyramidal neurons in the mPFC enhances connectivity between the mPFC and limbic thalamus, but not the ventral hippocampus, and reduces depression-like behavior. Using intersectional chemogenetics, we show that activation of this thalamocortical circuit is sufficient to elicit a decrease in despair-like behavior. Our findings reveal that GluN2B exerts input-specific control of pyramidal neuron innervation and identify a medial dorsal thalamus (MDT)→mPFC circuit that controls depression-like behavior.
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Affiliation(s)
- Oliver H Miller
- Roche Innovation Center Basel, Basel 4070, Switzerland; Tulane Brain Institute, Tulane University, New Orleans, LA 70115, USA
| | - Andreas Bruns
- Roche Innovation Center Basel, Basel 4070, Switzerland
| | - Imen Ben Ammar
- Faculté de Médecine, Université de Strasbourg, Strasbourg 67000, France
| | | | - Benjamin J Hall
- Roche Innovation Center Basel, Basel 4070, Switzerland; Tulane Brain Institute, Tulane University, New Orleans, LA 70115, USA.
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Abstract
OBJECTIVE Several cross-sectional studies have reported a relationship between posttraumatic stress disorder (PTSD) and epilepsy. However, the temporal association between PTSD and epilepsy has rarely been investigated. We hypothesized that the risk of developing epilepsy later in life would be higher in patients with PTSD than in those without PTSD. METHODS Using the Taiwan National Health Insurance Research Database, 6425 individuals with PTSD and 24,980 age-/sex-matched controls were enrolled between 2002 and 2009 in our study and followed up to the end of 2011. Those who developed epilepsy during the follow-up period were identified. RESULTS Individuals with PTSD had a higher incidence of developing epilepsy (2.65 versus 0.33 per 1000 person-years, p < .001), with an earlier onset of epilepsy (37.53 years [15.80 years] versus 48.11 years [23.97 years], p = .002) than did the controls. Individuals with PTSD had an elevated risk of developing epilepsy (hazard ratio [HR] = 3.72, 95% confidence interval [CI] = 2.27-6.11) during the follow-up after adjustment for demographic data and medical and psychiatric comorbidities. Sensitivity analyses after excluding the observation in the first year (HR = 2.53, 95% CI = 1.44-4.47) and the first 3 years (HR = 2.14, 95% CI = 1.15-4.01) revealed consistent results. CONCLUSIONS These results supported a temporal association between PTSD and the development of epilepsy. Further studies are warranted to investigate the underlying pathophysiological pathways that explain the longitudinal association of PTSD with subsequent epilepsy.
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19
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Chen MH, Li CT, Lin WC, Hong CJ, Tu PC, Bai YM, Cheng CM, Su TP. Persistent antidepressant effect of low-dose ketamine and activation in the supplementary motor area and anterior cingulate cortex in treatment-resistant depression: A randomized control study. J Affect Disord 2018; 225:709-714. [PMID: 28922734 DOI: 10.1016/j.jad.2017.09.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 09/07/2017] [Accepted: 09/07/2017] [Indexed: 12/16/2022]
Abstract
A single low-dose ketamine infusion exhibited a rapid antidepressant effect within 1h. Despite its short biological half-life (approximately 3h), the antidepressant effect of ketamine has been demonstrated to persist for several days. However, changes in brain function responsible for the persistent antidepressant effect of a single low-dose ketamine infusion remain unclear METHODS: Twenty-four patients with treatment-resistant depression (TRD) were randomized into three groups according to the treatment received: 0.5mg/kg ketamine, 0.2mg/kg ketamine, and normal saline infusion. Standardized uptake values (SUVs) of glucose metabolism measured through 18F-FDG positron-emission-tomography before infusion and 1day after a 40-min ketamine or normal saline infusion were used for subsequent whole-brain voxel-wise analysis and were correlated with depressive symptoms, as defined using the Hamilton Depression Rating Scale-17 (HDRS-17) score RESULTS: The voxel-wise analysis revealed that patients with TRD receiving the 0.5mg/kg ketamine infusion had significantly higher SUVs (corrected for family-wise errors, P = 0.014) in the supplementary motor area (SMA) and dorsal anterior cingulate cortex (dACC) than did those receiving the 0.2mg/kg ketamine infusion. The increase in the SUV in the dACC was negatively correlated with depressive symptoms at 1day after ketamine infusion DISCUSSION: The persistent antidepressant effect of a 0.5mg/kg ketamine infusion may be mediated by increased activation in the SMA and dACC. The higher increase in dACC activation was related to the reduction in depressive symptoms after ketamine infusion. A 0.5mg/kg ketamine infusion facilitated the glutamatergic neurotransmission in the SMA and dACC, which may be responsible for the persistent antidepressant effect of ketamine much beyond its half-life.
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Affiliation(s)
- Mu-Hong Chen
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Ta Li
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Chen-Jee Hong
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Chi Tu
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ya-Mei Bai
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tung-Ping Su
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan.
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Chen MH, Hsu JW, Huang KL, Bai YM, Ko NY, Su TP, Li CT, Lin WC, Tsai SJ, Pan TL, Chang WH, Chen TJ. Sexually Transmitted Infection Among Adolescents and Young Adults With Attention-Deficit/Hyperactivity Disorder: A Nationwide Longitudinal Study. J Am Acad Child Adolesc Psychiatry 2018; 57:48-53. [PMID: 29301669 DOI: 10.1016/j.jaac.2017.09.438] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 09/03/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Previous studies have suggested that attention-deficit/hyperactivity disorder (ADHD) is related to risky sexual behaviors, which have been regarded as a major risk factor of sexually transmitted infection (STI). However, the association between ADHD and subsequent STIs remains unknown. METHOD Using the Taiwan National Health Insurance Research Database, 17,898 adolescents and young adults who were diagnosed with ADHD by psychiatrists and 71,592 age- and sex-matched comparisons without ADHD were enrolled from 2001 through 2009 and followed to the end of 2011. Participants who developed any STI during the follow-up period were identified. Cox regression analysis was performed to examine the risk of STIs between patients with ADHD and those without ADHD. RESULTS Patients with ADHD were prone to developing any STI (hazard ratio [HR] 3.36, 95% CI 2.69∼4.21) after adjusting for demographic data, psychiatric comorbidities, and ADHD medications compared with the comparison group. Substance use disorders (HR 1.94, 95% CI 1.27∼2.98) also were associated with STI risk. Short-term use (HR 0.70, 95% CI 0.53∼0.94) and long-term use (HR 0.59, 95% CI 0.37∼0.93) of ADHD medications were related to a lower risk of subsequent STIs. However, an association between substance use disorders and STIs was observed only in women. By contrast, the effect of ADHD medications on the decrease of STI risk was observed only in men. CONCLUSION Adolescents and young adults with ADHD had an increased risk of developing any STI later in life compared with the non-ADHD comparisons. Patients with ADHD who also had substance use disorders were at the highest risk of subsequent STIs. Treatment with ADHD medications was associated with a lower risk of subsequent STIs.
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Affiliation(s)
- Mu-Hong Chen
- Taipei Veterans General Hospital, Taipei, Taiwan and the College of Medicine, National Yang-Ming University, Taipei
| | - Ju-Wei Hsu
- Taipei Veterans General Hospital, Taipei, Taiwan and the College of Medicine, National Yang-Ming University, Taipei.
| | - Kai-Lin Huang
- Taipei Veterans General Hospital, Taipei, Taiwan and the College of Medicine, National Yang-Ming University, Taipei
| | - Ya-Mei Bai
- Taipei Veterans General Hospital, Taipei, Taiwan and the College of Medicine, National Yang-Ming University, Taipei
| | - Nai-Ying Ko
- College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
| | - Tung-Ping Su
- Taipei Veterans General Hospital, Taipei, Taiwan and the College of Medicine, National Yang-Ming University, Taipei; General Cheng Hsin Hospital, Taipei
| | - Cheng-Ta Li
- Taipei Veterans General Hospital, Taipei, Taiwan and the College of Medicine, National Yang-Ming University, Taipei
| | - Wei-Chen Lin
- Taipei Veterans General Hospital, Taipei, Taiwan and the College of Medicine, National Yang-Ming University, Taipei
| | - Shih-Jen Tsai
- Taipei Veterans General Hospital, Taipei, Taiwan and the College of Medicine, National Yang-Ming University, Taipei
| | - Tai-Long Pan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan; the Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology, Taoyuan; and the Liver Research Center, Division of Hepatology, Chang Gung Memorial Hospital, Taoyuan
| | | | - Tzeng-Ji Chen
- Taipei Veterans General Hospital and the Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei
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Li Y, Jing B, Liu H, Li Y, Gao X, Li Y, Mu B, Yu H, Cheng J, Barker PB, Wang H, Han Y. Frequency-Dependent Changes in the Amplitude of Low-Frequency Fluctuations in Mild Cognitive Impairment with Mild Depression. J Alzheimers Dis 2017; 58:1175-1187. [PMID: 28550250 DOI: 10.3233/jad-161282] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Yuxia Li
- Department of Neurology, Xuan Wu Hospital of Capital Medical University, Beijing, China
- Department of Neurology, Tangshan Gongren Hospital, Tangshan, Hebei Province, China
| | - Bin Jing
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Han Liu
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Yifan Li
- XiangYa School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Xuan Gao
- Department of Neurology, Tangshan Gongren Hospital, Tangshan, Hebei Province, China
| | - Yongqiu Li
- Department of Neurology, Tangshan Gongren Hospital, Tangshan, Hebei Province, China
| | - Bin Mu
- Department of Neurology, Xuan Wu Hospital of Capital Medical University, Beijing, China
| | - Haikuo Yu
- Department of Rehabilitation, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Jinbo Cheng
- The State Key Laboratory of Brain and Cognitive Sciences, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Peter B. Barker
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Hongxing Wang
- Department of Neurology, Xuan Wu Hospital of Capital Medical University, Beijing, China
| | - Ying Han
- Department of Neurology, Xuan Wu Hospital of Capital Medical University, Beijing, China
- Center of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China
- National Clinical Research Center for Geriatric Disorders, Beijing, China
- PKU Care Rehabilitation Hospital, Beijing, China
- Beijing Institute of Geriatrics, Beijing, China
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Mohamed RE, Aboelsafa AA. Multivoxel proton magnetic resonance spectroscopy detects thalamic neurochemical metabolic changes in patients with major depressive disorder. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2017. [DOI: 10.1016/j.ejrnm.2017.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Chau DT, Fogelman P, Nordanskog P, Drevets WC, Hamilton JP. Distinct Neural-Functional Effects of Treatments With Selective Serotonin Reuptake Inhibitors, Electroconvulsive Therapy, and Transcranial Magnetic Stimulation and Their Relations to Regional Brain Function in Major Depression: A Meta-analysis. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:318-326. [PMID: 29560920 DOI: 10.1016/j.bpsc.2017.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/19/2017] [Accepted: 01/19/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Functional neuroimaging studies have examined the neural substrates of treatments for major depressive disorder (MDD). Low sample size and methodological heterogeneity, however, undermine the generalizability of findings from individual studies. We conducted a meta-analysis to identify reliable neural changes resulting from different modes of treatment for MDD and compared them with each other and with reliable neural functional abnormalities observed in depressed versus control samples. METHODS We conducted a meta-analysis of studies reporting changes in brain activity (e.g., as indexed by positron emission tomography) following treatments with selective serotonin reuptake inhibitors (SSRIs), electroconvulsive therapy (ECT), or transcranial magnetic stimulation. Additionally, we examined the statistical reliability of overlap among thresholded meta-analytic SSRI, ECT, and transcranial magnetic stimulation maps as well as a map of abnormal neural function in MDD. RESULTS Our meta-analysis revealed that 1) SSRIs decrease activity in the anterior insula, 2) ECT decreases activity in central nodes of the default mode network, 3) transcranial magnetic stimulation does not result in reliable neural changes, and 4) regional effects of these modes of treatment do not significantly overlap with each other or with regions showing reliable functional abnormality in MDD. CONCLUSIONS SSRIs and ECT produce neurally distinct effects relative to each other and to the functional abnormalities implicated in depression. These treatments therefore may exert antidepressant effects by diminishing neural functions not implicated in depression but that nonetheless impact mood. We discuss how the distinct neural changes resulting from SSRIs and ECT can account for both treatment effects and side effects from these therapies as well as how to individualize these treatments.
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Affiliation(s)
- David T Chau
- Laureate Institute for Brain Research, Tulsa, Oklahoma
| | | | - Pia Nordanskog
- Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Wayne C Drevets
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Janssen Research & Development, Janssen Pharmaceuticals of Johnson & Johnson, Titusville, New Jersey
| | - J Paul Hamilton
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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Alamian G, Hincapié AS, Combrisson E, Thiery T, Martel V, Althukov D, Jerbi K. Alterations of Intrinsic Brain Connectivity Patterns in Depression and Bipolar Disorders: A Critical Assessment of Magnetoencephalography-Based Evidence. Front Psychiatry 2017; 8:41. [PMID: 28367127 PMCID: PMC5355450 DOI: 10.3389/fpsyt.2017.00041] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/28/2017] [Indexed: 12/21/2022] Open
Abstract
Despite being the object of a thriving field of clinical research, the investigation of intrinsic brain network alterations in psychiatric illnesses is still in its early days. Because the pathological alterations are predominantly probed using functional magnetic resonance imaging (fMRI), many questions about the electrophysiological bases of resting-state alterations in psychiatric disorders, particularly among mood disorder patients, remain unanswered. Alongside important research using electroencephalography (EEG), the specific recent contributions and future promise of magnetoencephalography (MEG) in this field are not fully recognized and valued. Here, we provide a critical review of recent findings from MEG resting-state connectivity within major depressive disorder (MDD) and bipolar disorder (BD). The clinical MEG resting-state results are compared with those previously reported with fMRI and EEG. Taken together, MEG appears to be a promising but still critically underexploited technique to unravel the neurophysiological mechanisms that mediate abnormal (both hyper- and hypo-) connectivity patterns involved in MDD and BD. In particular, a major strength of MEG is its ability to provide source-space estimations of neuromagnetic long-range rhythmic synchronization at various frequencies (i.e., oscillatory coupling). The reviewed literature highlights the relevance of probing local and interregional rhythmic synchronization to explore the pathophysiological underpinnings of each disorder. However, before we can fully take advantage of MEG connectivity analyses in psychiatry, several limitations inherent to MEG connectivity analyses need to be understood and taken into account. Thus, we also discuss current methodological challenges and outline paths for future research. MEG resting-state studies provide an important window onto perturbed spontaneous oscillatory brain networks and hence supply an important complement to fMRI-based resting-state measurements in psychiatric populations.
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Affiliation(s)
- Golnoush Alamian
- Department of Psychology, University of Montreal , Montreal, QC , Canada
| | - Ana-Sofía Hincapié
- Department of Psychology, University of Montreal, Montreal, QC, Canada; Department of Computer Science, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile; Interdisciplinary Center for Neurosciences, School of Psychology, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - Etienne Combrisson
- Department of Psychology, University of Montreal, Montreal, QC, Canada; Center of Research and Innovation in Sport, Mental Processes and Motor Performance, University Claude Bernard Lyon I, University of Lyon, Villeurbanne, France; Brain Dynamics and Cognition, Lyon Neuroscience Research Center, INSERM U1028, UMR 5292, University of Lyon, Villeurbanne, France
| | - Thomas Thiery
- Department of Psychology, University of Montreal , Montreal, QC , Canada
| | - Véronique Martel
- Department of Psychology, University of Montreal , Montreal, QC , Canada
| | - Dmitrii Althukov
- Department of Psychology, University of Montreal, Montreal, QC, Canada; Department of Computer Sciences, National Research Institution Higher School of Economics, Moscow, Russia; MEG Center, Moscow State University of Pedagogics and Education, Moscow, Russia
| | - Karim Jerbi
- Department of Psychology, University of Montreal, Montreal, QC, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
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25
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Nichols DE, Johnson MW, Nichols CD. Psychedelics as Medicines: An Emerging New Paradigm. Clin Pharmacol Ther 2016; 101:209-219. [PMID: 28019026 DOI: 10.1002/cpt.557] [Citation(s) in RCA: 170] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/19/2016] [Accepted: 10/20/2016] [Indexed: 12/28/2022]
Abstract
Scientific interest in serotonergic psychedelics (e.g., psilocybin and LSD; 5-HT2A receptor agonists) has dramatically increased within the last decade. Clinical studies administering psychedelics with psychotherapy have shown preliminary evidence of robust efficacy in treating anxiety and depression, as well as addiction to tobacco and alcohol. Moreover, recent research has suggested that these compounds have potential efficacy against inflammatory diseases through novel mechanisms, with potential advantages over existing antiinflammatory agents. We propose that psychedelics exert therapeutic effects for psychiatric disorders by acutely destabilizing local brain network hubs and global network connectivity via amplification of neuronal avalanches, providing the occasion for brain network "resetting" after the acute effects have resolved. Antiinflammatory effects may hold promise for efficacy in treatment of inflammation-related nonpsychiatric as well as potentially for psychiatric disorders. Serotonergic psychedelics operate through unique mechanisms that show promising effects for a variety of intractable, debilitating, and lethal disorders, and should be rigorously researched.
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Affiliation(s)
- D E Nichols
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA
| | - M W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - C D Nichols
- Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
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26
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Fang L, Yao Z, An J, Chen X, Xie Y, Zhao H, Mao J, Liang W, Ma X. Topological Organization of Metabolic Brain Networks in Pre-Chemotherapy Cancer with Depression: A Resting-State PET Study. PLoS One 2016; 11:e0166049. [PMID: 27832148 PMCID: PMC5104370 DOI: 10.1371/journal.pone.0166049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 10/21/2016] [Indexed: 12/14/2022] Open
Abstract
This study aimed to investigate the metabolic brain network and its relationship with depression symptoms using 18F-fluorodeoxyglucose positron emission tomography data in 78 pre-chemotherapy cancer patients with depression and 80 matched healthy subjects. Functional and structural imbalance or disruption of brain networks frequently occur following chemotherapy in cancer patients. However, few studies have focused on the topological organization of the metabolic brain network in cancer with depression, especially those without chemotherapy. The nodal and global parameters of the metabolic brain network were computed for cancer patients and healthy subjects. Significant decreases in metabolism were found in the frontal and temporal gyri in cancer patients compared with healthy subjects. Negative correlations between depression and metabolism were found predominantly in the inferior frontal and cuneus regions, whereas positive correlations were observed in several regions, primarily including the insula, hippocampus, amygdala, and middle temporal gyri. Furthermore, a higher clustering efficiency, longer path length, and fewer hubs were found in cancer patients compared with healthy subjects. The topological organization of the whole-brain metabolic networks may be disrupted in cancer. Finally, the present findings may provide a new avenue for exploring the neurobiological mechanism, which plays a key role in lessening the depression effects in pre-chemotherapy cancer patients.
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Affiliation(s)
- Lei Fang
- Department of radiology, Qilu Hospital, First Affiliated Hospital of Shandong University, 107 Cultural West Road, Jinan, 250012, Shandong Province, P.R.China
- PET/CT Center, Affiliated Lanzhou General Hospital of Lanzhou Military Area Command, 333 South Binhe Road, Lanzhou, 730050, Gansu Province, P.R.China
| | - Zhijun Yao
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, 730000, P.R.China
| | - Jianping An
- Nuclear Medicine Department, Affiliated Lanzhou General Hospital of Lanzhou Military Area Command, 333 South Binhe Road, Lanzhou, 730050, Gansu Province, P.R.China
| | - Xuejiao Chen
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, 730000, P.R.China
| | - Yuanwei Xie
- School of Information Science and Engineering, Lanzhou University, Lanzhou, Gansu Province, 730000, P.R.China
| | - Hui Zhao
- Nuclear Medicine Department, Affiliated Lanzhou General Hospital of Lanzhou Military Area Command, 333 South Binhe Road, Lanzhou, 730050, Gansu Province, P.R.China
| | - Junfeng Mao
- PET/CT Center, Affiliated Lanzhou General Hospital of Lanzhou Military Area Command, 333 South Binhe Road, Lanzhou, 730050, Gansu Province, P.R.China
| | - Wangsheng Liang
- PET/CT Center, Affiliated Lanzhou General Hospital of Lanzhou Military Area Command, 333 South Binhe Road, Lanzhou, 730050, Gansu Province, P.R.China
| | - Xiangxing Ma
- Department of radiology, Qilu Hospital, First Affiliated Hospital of Shandong University, 107 Cultural West Road, Jinan, 250012, Shandong Province, P.R.China
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Maron E, Nutt D. Biological predictors of pharmacological therapy in anxiety disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2016. [PMID: 26487811 PMCID: PMC4610615 DOI: 10.31887/dcns.2015.17.3/emaron] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
At least one third of patients with anxiety disorders do not adequately respond to available pharmacological treatment. The reason that some patients with anxiety disorders respond well, but others not, to the same classes of medication is not yet fully understood. It is suggested that several biological factors may influence treatment mechanisms in anxiety and therefore could be identified as possible biomarkers predicting treatment response. In this review, we look at current evidence exploring different types of treatment predictors, including neuroimaging, genetic factors, and blood-related measures, which could open up novel perspectives in clinical management of patients with anxiety disorders.
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Affiliation(s)
- Eduard Maron
- Department of Psychiatry, North Estonia Medical Centre, Tallinn, Estonia; Department of Psychiatry, University of Tartu, Tartu, Estonia ; Faculty of Medicine, Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| | - David Nutt
- Faculty of Medicine, Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
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28
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Nagalski A, Puelles L, Dabrowski M, Wegierski T, Kuznicki J, Wisniewska MB. Molecular anatomy of the thalamic complex and the underlying transcription factors. Brain Struct Funct 2016; 221:2493-510. [PMID: 25963709 PMCID: PMC4884203 DOI: 10.1007/s00429-015-1052-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 04/27/2015] [Indexed: 01/19/2023]
Abstract
Thalamocortical loops have been implicated in the control of higher-order cognitive functions, but advances in our understanding of the molecular underpinnings of neocortical organization have not been accompanied by similar analyses in the thalamus. Using expression-based correlation maps and the manual mapping of mouse and human datasets available in the Allen Brain Atlas, we identified a few individual regions and several sets of molecularly related nuclei that partially overlap with the classic grouping that is based on topographical localization and thalamocortical connections. These new molecular divisions of the adult thalamic complex are defined by the combinatorial expression of Tcf7l2, Lef1, Gbx2, Prox1, Pou4f1, Esrrg, and Six3 transcription factor genes. Further in silico and experimental analyses provided the evidence that TCF7L2 might be a pan-thalamic specifier. These results provide substantial insights into the "molecular logic" that underlies organization of the thalamic complex.
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Affiliation(s)
- Andrzej Nagalski
- Laboratory of Neurodegeneration, International Institute of Molecular and Cell Biology, Warsaw, 02-109, Poland
- Laboratory of Molecular Neurobiology, Centre of New Technologies, University of Warsaw, Warsaw, 00-927, Poland
| | - Luis Puelles
- Department of Human Anatomy, University of Murcia and IMIB, Murcia, 30071, Spain
| | - Michal Dabrowski
- Laboratory of Bioinformatics, Center of Neurobiology, Nencki Institute of Experimental Biology, Warsaw, 02-093, Poland
| | - Tomasz Wegierski
- Laboratory of Neurodegeneration, International Institute of Molecular and Cell Biology, Warsaw, 02-109, Poland
| | - Jacek Kuznicki
- Laboratory of Neurodegeneration, International Institute of Molecular and Cell Biology, Warsaw, 02-109, Poland
| | - Marta B Wisniewska
- Laboratory of Neurodegeneration, International Institute of Molecular and Cell Biology, Warsaw, 02-109, Poland.
- Laboratory of Molecular Neurobiology, Centre of New Technologies, University of Warsaw, Warsaw, 00-927, Poland.
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Wang L, Kong Q, Li K, Su Y, Zeng Y, Zhang Q, Dai W, Xia M, Wang G, Jin Z, Yu X, Si T. Frequency-dependent changes in amplitude of low-frequency oscillations in depression: A resting-state fMRI study. Neurosci Lett 2016; 614:105-11. [PMID: 26797652 DOI: 10.1016/j.neulet.2016.01.012] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 12/27/2015] [Accepted: 01/08/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE We conducted this fMRI study to examine whether the alterations in amplitudes of low-frequency oscillation (LFO) of major depressive disorder (MDD) patients were frequency dependent. MATERIALS AND METHODS The LFO amplitudes (as indexed by amplitude of low-frequency fluctuation [ALFF] and fractional ALFF [fALFF]) within 4 narrowly-defined frequency bands (slow-5: 0.01-0.027Hz, slow-4: 0.027-0.073Hz, slow-3: 0.073-0.198Hz, and slow-2: 0.198-0.25Hz) were computed using resting-state fMRI data of 35 MDD patients and 32 healthy subjects. Repeated-measures analysis of variance (ANOVA) was performed on ALFF and fALFF both within the low frequency bands of slow-4 and slow-5 and within all of the four bands. RESULTS We observed significant main effects of group and frequency on ALFF and fALFF in widely distributed brain regions. Importantly, significant group and frequency interaction effects were observed in the ventromedial prefrontal cortex, inferior frontal gyrus, precentral gyrus, in a left-sided fashion, the bilateral posterior cingulate and precuneus, during ANOVA both within slow-4 and slow-5 bands and within all the frequency bands. CONCLUSIONS The results suggest that the alterations of LFO amplitudes in specific brain regions in MDD patients could be more sensitively detected in the slow-5 rather than the slow-4 bands. The findings may provide guidance for the frequency choice of future resting-state fMRI studies of MDD.
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Affiliation(s)
- Li Wang
- Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Bejing, China
| | - Qingmei Kong
- Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Bejing, China
| | - Ke Li
- Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China
| | - Yunai Su
- Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Bejing, China
| | - Yawei Zeng
- Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China
| | - Qinge Zhang
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Wenji Dai
- Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Bejing, China
| | - Mingrui Xia
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China.
| | - Gang Wang
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Zhen Jin
- Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China
| | - Xin Yu
- Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Bejing, China
| | - Tianmei Si
- Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Bejing, China.
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30
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Modulation of intrinsic brain activity by electroconvulsive therapy in major depression. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:77-86. [PMID: 26878070 DOI: 10.1016/j.bpsc.2015.09.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION One of the most effective interventions for intractable major depressive episodes is electroconvulsive therapy (ECT). Because ECT is also relatively fast-acting, longitudinal study of its neurobiological effects offers critical insight into the mechanisms underlying depression and antidepressant response. Here we assessed modulation of intrinsic brain activity in corticolimbic networks associated with ECT and clinical response. METHODS We measured resting-state functional connectivity (RSFC) in patients with treatment-resistant depression (n=30), using functional magnetic resonance imaging (fMRI) acquired before and after completing a treatment series with right-unilateral ECT. Using independent component analysis, we assessed changes in RSFC with 1) symptom improvement and 2) ECT regardless of treatment outcome in patients, with reference to healthy controls (n=33, also scanned twice). RESULTS After ECT, consistent changes in RSFC within targeted depression-relevant functional networks were observed in the dorsal anterior cingulate (ACC), mediodorsal thalamus (mdTh), hippocampus, and right anterior temporal, medial parietal, and posterior cingulate cortex in all patients. In a separate analysis, changes in depressive symptoms were associated with RSFC changes in the dorsal ACC, mdTh, putamen, medial prefrontal, and lateral parietal cortex. RSFC of these regions did not change in healthy controls. CONCLUSIONS Neuroplasticity underlying clinical change was in part separable from changes associated with the effects of ECT observed in all patients. However, both ECT and clinical change were associated with RSFC modulation in dorsal ACC, mdTh and hippocampus, which may indicate that these regions underlie the mechanisms of clinical outcome in ECT and may be effective targets for future neurostimulation therapies.
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Silverstein WK, Noda Y, Barr MS, Vila-Rodriguez F, Rajji TK, Fitzgerald PB, Downar J, Mulsant BH, Vigod S, Daskalakis ZJ, Blumberger DM. NEUROBIOLOGICAL PREDICTORS OF RESPONSE TO DORSOLATERAL PREFRONTAL CORTEX REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION IN DEPRESSION: A SYSTEMATIC REVIEW. Depress Anxiety 2015; 32:871-91. [PMID: 26382227 DOI: 10.1002/da.22424] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/19/2015] [Accepted: 08/24/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A significant proportion of patients with depression fail to respond to psychotherapy and standard pharmacotherapy, leading to treatment-resistant depression (TRD). Due to the significant prevalence of TRD, alternative therapies for depression have emerged as viable treatments in the armamentarium for this disorder. Repetitive transcranial magnetic stimulation (rTMS) is now being offered in clinical practice in broader numbers. Many studies have investigated various different neurobiological predictors of response of rTMS. However, a synthesis of this literature and an understanding of what biological targets predict response is lacking. This review aims to systematically synthesize the literature on the neurobiological predictors of rTMS in patients with depression. METHODS Medline (1996-2014), Embase (1980-2014), and PsycINFO (1806-2014) were searched under set terms. Two authors reviewed each article and came to consensus on the inclusion and exclusion criteria. All eligible studies were reviewed, duplicates were removed, and data were extracted individually. RESULTS The search identified 1,673 articles, 41 of which met both inclusion and exclusion criteria. Various biological factors at baseline appear to predict response to rTMS, including levels of certain molecular factors, blood flow in brain regions implicated in depression, electrophysiological findings, and specific genetic polymorphisms. CONCLUSIONS Significant methodological variability in rTMS treatment protocols limits the ability to generalize conclusions. However, response to treatment may be predicted by baseline frontal lobe blood flow, and presence of polymorphisms of the 5-hydroxytryptamine (5-HT) -1a gene, the LL genotype of the serotonin transporter linked polymorphic region (5-HTTLPR) gene, and Val/Val homozygotes of the brain-derived neurotrophic factor (BDNF) gene.
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Affiliation(s)
- William K Silverstein
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Yoshihiro Noda
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Mera S Barr
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Fidel Vila-Rodriguez
- Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tarek K Rajji
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne, Victoria, Australia
| | - Jonathan Downar
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,MRI-Guided rTMS Clinic, Department of Psychiatry, University Health Network, Toronto, Ontario, Canada
| | - Benoit H Mulsant
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Simone Vigod
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Reproductive Life Stages Program, Women's Mental Health Program, Women's College Hospital, Toronto, Ontario, Canada
| | - Zafiris J Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Daniel M Blumberger
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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32
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Arns M, Bruder G, Hegerl U, Spooner C, Palmer DM, Etkin A, Fallahpour K, Gatt JM, Hirshberg L, Gordon E. EEG alpha asymmetry as a gender-specific predictor of outcome to acute treatment with different antidepressant medications in the randomized iSPOT-D study. Clin Neurophysiol 2015; 127:509-519. [PMID: 26189209 DOI: 10.1016/j.clinph.2015.05.032] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/28/2015] [Accepted: 05/12/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine whether EEG occipital alpha and frontal alpha asymmetry (FAA) distinguishes outpatients with major depression (MDD) from controls, predicts antidepressant treatment outcome, and to explore the role of gender. METHODS In the international Study to Predict Optimized Treatment in Depression (iSPOT-D), a multi-center, randomized, prospective open-label trial, 1008 MDD participants were randomized to escitalopram, sertraline or venlafaxine-extended release. The study also recruited 336 healthy controls. Treatment response was established after eight weeks and resting EEG was measured at baseline (two minutes eyes open and eyes closed). RESULTS No differences in EEG alpha for occipital and frontal cortex, or for FAA, were found in MDD participants compared to controls. Alpha in the occipital and frontal cortex was not associated with treatment outcome. However, a gender and drug-class interaction effect was found for FAA. Relatively greater right frontal alpha (less cortical activity) in women only was associated with a favorable response to the Selective Serotonin Reuptake Inhibitors escitalopram and sertraline. No such effect was found for venlafaxine-extended release. CONCLUSIONS FAA does not differentiate between MDD and controls, but is associated with antidepressant treatment response and remission in a gender and drug-class specific manner. SIGNIFICANCE Future studies investigating EEG alpha measures in depression should a-priori stratify by gender.
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Affiliation(s)
- Martijn Arns
- Dept. of Experimental Psychology, Utrecht University, Utrecht, The Netherlands; Research Institute Brainclinics, Nijmegen, The Netherlands.
| | - Gerard Bruder
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Ulrich Hegerl
- Dept. of Psychiatry and Psychotherapy, University of Leipzig, Germany
| | - Chris Spooner
- Brain Resource Ltd, Sydney, NSW, Australia; Brain Resource Ltd, San Francisco, CA, USA
| | - Donna M Palmer
- Brain Resource Ltd, Sydney, NSW, Australia; Brain Resource Ltd, San Francisco, CA, USA; Brain Dynamics Center, Sydney Medical School, The University of Sydney, Sydney, NSW and Westmead Millenium Institute, Westmead, NSW, Australia
| | - Amit Etkin
- Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Kamran Fallahpour
- Department of Psychiatry, Columbia University, New York, NY, USA; Brain Resource Center, New York, USA
| | - Justine M Gatt
- Brain Dynamics Center, Sydney Medical School, The University of Sydney, Sydney, NSW and Westmead Millenium Institute, Westmead, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia; School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Laurence Hirshberg
- Alpert Medical School, Brown University, The Neuro Development Center, Inc, Providence, RI, USA
| | - Evian Gordon
- Brain Resource Ltd, Sydney, NSW, Australia; Brain Resource Ltd, San Francisco, CA, USA
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Smart OL, Tiruvadi VR, Mayberg HS. Multimodal approaches to define network oscillations in depression. Biol Psychiatry 2015; 77:1061-70. [PMID: 25681871 PMCID: PMC5826645 DOI: 10.1016/j.biopsych.2015.01.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/18/2014] [Accepted: 01/12/2015] [Indexed: 01/26/2023]
Abstract
The renaissance in the use of encephalography-based research methods to probe the pathophysiology of neuropsychiatric disorders is well afoot and continues to advance. Building on the platform of neuroimaging evidence on brain circuit models, magnetoencephalography, scalp electroencephalography, and even invasive electroencephalography are now being used to characterize brain network dysfunctions that underlie major depressive disorder using brain oscillation measurements and associated treatment responses. Such multiple encephalography modalities provide avenues to study pathologic network dynamics with high temporal resolution and over long time courses, opportunities to complement neuroimaging methods and findings, and new approaches to identify quantitative biomarkers that indicate critical targets for brain therapy. Such goals have been facilitated by the ongoing testing of novel invasive neuromodulation therapies, notably, deep brain stimulation, where clinically relevant treatment effects can be monitored at multiple brain sites in a time-locked causal manner. We review key brain rhythms identified in major depressive disorder as foundation for development of putative biomarkers for objectively evaluating neuromodulation success and for guiding deep brain stimulation or other target-based neuromodulation strategies for treatment-resistant depression patients.
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Affiliation(s)
- Otis Lkuwamy Smart
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia
| | - Vineet Ravi Tiruvadi
- Department of Biomedical Engineering, Georgia Institute of Technology, Emory University School of Medicine, Atlanta, Georgia
| | - Helen S Mayberg
- Departments of Psychiatry, Neurology, and Radiology, Emory University School of Medicine, Atlanta, Georgia..
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Korgaonkar MS, Fornito A, Williams LM, Grieve SM. Abnormal structural networks characterize major depressive disorder: a connectome analysis. Biol Psychiatry 2014; 76:567-74. [PMID: 24690111 DOI: 10.1016/j.biopsych.2014.02.018] [Citation(s) in RCA: 249] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 02/12/2014] [Accepted: 02/13/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) has been shown to be associated with a disrupted topological organization of functional brain networks. However, little is known regarding whether these changes have a structural basis. Diffusion tensor imaging (DTI) enables comprehensive whole-brain mapping of the white matter tracts that link regions distributed throughout the entire brain, the so-called human connectome. METHODS We examined whole-brain structural networks in a cohort of 95 MDD outpatients and 102 matched control subjects. Structural networks were represented by an 84 × 84 connectivity matrix representing probabilistic white matter connections between 84 parcellated cortical and subcortical regions using DTI tractography. Network-based statistics were used to assess differences in the interregional connectivity matrix between the two groups, and graph theory was used to examine overall topological organization. RESULTS Our network-based statistics analysis demonstrates lowered structural connectivity within two distinct brain networks that are present in depression: the first primarily involves the regions of the default mode network and the second comprises the frontal cortex, thalamus, and caudate regions that are central in emotional and cognitive processing. These two altered networks were observed in the context of an overall preservation of topology as reflected as no significant group differences for the graph-theory measures. CONCLUSIONS This is the first report to use DTI to show the structural connectomic alterations present in MDD. Our findings highlight that altered structural connectivity between nodes of the default mode network and the frontal-thalamo-caudate regions are core neurobiological features associated with MDD.
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Affiliation(s)
- Mayuresh S Korgaonkar
- The Brain Dynamics Centre, Sydney Medical School-Westmead and Westmead Millennium Institute for Medical Research, Sydney; Discipline of Psychiatry, University of Sydney Medical School: Western, Westmead Hospital, Sydney
| | - Alex Fornito
- Monash Clinical and Imaging Neuroscience, School of Psychology and Psychiatry & Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Leanne M Williams
- The Brain Dynamics Centre, Sydney Medical School-Westmead and Westmead Millennium Institute for Medical Research, Sydney; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Stuart M Grieve
- The Brain Dynamics Centre, Sydney Medical School-Westmead and Westmead Millennium Institute for Medical Research, Sydney; Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Australia; Department of Radiology, Royal Prince Alfred Hospital, Australia; Charles Perkins Centre, University of Sydney, Camperdown, Australia.
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Why are cortical GABA neurons relevant to internal focus in depression? A cross-level model linking cellular, biochemical and neural network findings. Mol Psychiatry 2014; 19:966-977. [PMID: 25048001 PMCID: PMC4169738 DOI: 10.1038/mp.2014.68] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 04/16/2014] [Accepted: 05/19/2014] [Indexed: 12/15/2022]
Abstract
Major depression is a complex and severe psychiatric disorder whose symptomatology encompasses a critical shift in awareness, especially in the balance from external to internal mental focus. This is reflected by unspecific somatic symptoms and the predominance of the own cognitions manifested in increased self-focus and rumination. We posit here that sufficient empirical data has accumulated to build a coherent biologic model that links these psychologic concepts and symptom dimensions to observed biochemical, cellular, regional and neural network deficits. Specifically, deficits in inhibitory γ-aminobutyric acid regulating excitatory cell input/output and local cell circuit processing of information in key brain regions may underlie the shift that is observed in depressed subjects in resting-state activities between the perigenual anterior cingulate cortex and the dorsolateral prefrontal cortex. This regional dysbalance translates at the network level in a dysbalance between default-mode and executive networks, which psychopathologically surfaces as a shift in focus from external to internal mental content and associated symptoms. We focus here on primary evidence at each of those levels and on putative mechanistic links between those levels. Apart from its implications for neuropsychiatric disorders, our model provides for the first time a set of hypotheses for cross-level mechanisms of how internal and external mental contents may be constituted and balanced in healthy subjects, and thus also contributes to the neuroscientific debate on the neural correlates of consciousness.
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Li CT, Hsieh JC, Huang HH, Chen MH, Juan CH, Tu PC, Lee YC, Wang SJ, Cheng CM, Su TP. Cognition-Modulated Frontal Activity in Prediction and Augmentation of Antidepressant Efficacy: A Randomized Controlled Pilot Study. Cereb Cortex 2014; 26:202-10. [DOI: 10.1093/cercor/bhu191] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Li CT, Chen MH, Juan CH, Huang HH, Chen LF, Hsieh JC, Tu PC, Bai YM, Tsai SJ, Lee YC, Su TP. Efficacy of prefrontal theta-burst stimulation in refractory depression: a randomized sham-controlled study. Brain 2014; 137:2088-98. [DOI: 10.1093/brain/awu109] [Citation(s) in RCA: 168] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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