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Mathew J, Adhia DB, Smith ML, De Ridder D, Mani R. Source localized infraslow neurofeedback training in people with chronic painful knee osteoarthritis: A randomized, double-blind, sham-controlled feasibility clinical trial. Front Neurosci 2022; 16:899772. [PMID: 35968375 PMCID: PMC9366917 DOI: 10.3389/fnins.2022.899772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/01/2022] [Indexed: 11/15/2022] Open
Abstract
Persistent pain is a key symptom in people living with knee osteoarthritis (KOA). Infra-slow Neurofeedback (ISF-NF) training is a recent development focusing on modulating cortical slow-wave activity to improve pain outcomes. A parallel, two-armed double-blinded, randomized sham-controlled, feasibility clinical trial aimed to determine the feasibility and safety of a novel electroencephalography-based infraslow fluctuation neurofeedback (EEG ISF-NF) training in people with KOA and determine the variability of clinical outcomes and EEG changes following NF training. Eligible participants attended nine 30-min ISF-NF training sessions involving three cortical regions linked to pain. Feasibility measures were monitored during the trial period. Pain and functional outcomes were measured at baseline, post-intervention, and follow-up after 2 weeks. Resting-state EEG was recorded at baseline and immediate post-intervention. Participants were middle-aged (61.7 ± 7.6 years), New Zealand European (90.5%), and mostly females (62%) with an average knee pain duration of 4 ± 3.4 years. The study achieved a retention rate of 91%, with 20/22 participants completing all the sessions. Participants rated high levels of acceptance and “moderate to high levels of perceived effectiveness of the training.” No serious adverse events were reported during the trial. Mean difference (95% CI) for clinical pain and function measures are as follows for pain severity [active: 0.89 ± 1.7 (−0.27 to 2.0); sham: 0.98 ± 1.1 (0.22–1.7)], pain interference [active: 0.75 ± 2.3 (−0.82 to 2.3); Sham: 0.89 ± 2.1 (−0.60 to 2.4)], pain unpleasantness [active: 2.6 ± 3.7 (0.17–5.1); sham: 2.8 ± 3 (0.62–5.0)] and physical function [active: 6.2 ± 13 (−2.6 to 15); sham: 1.6 ± 12 (−6.8 to 10)]. EEG sources demonstrated frequency-specific neuronal activity, functional connectivity, and ISF ratio changes following NF training. The findings of the study indicated that the ISF-NF training is a feasible, safe, and acceptable intervention for pain management in people with KOA, with high levels of perceived effectiveness. The study also reports the variability in clinical, brain activity, and connectivity changes following training.
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Affiliation(s)
- Jerin Mathew
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- *Correspondence: Jerin Mathew,
| | - Divya Bharatkumar Adhia
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Dirk De Ridder
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Ramakrishnan Mani
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Yang T, Shen B, Wu A, Tang X, Chen W, Zhang Z, Chen B, Guo Z, Liu X. Abnormal Functional Connectivity of the Amygdala in Mild Cognitive Impairment Patients With Depression Symptoms Revealed by Resting-State fMRI. Front Psychiatry 2021; 12:533428. [PMID: 34335316 PMCID: PMC8319717 DOI: 10.3389/fpsyt.2021.533428] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 05/31/2021] [Indexed: 11/28/2022] Open
Abstract
Convergent evidence indicates that individuals with symptoms of depression exhibit altered functional connectivity (FC) of the amygdala, which is a key brain region in processing emotions. At present, the characteristics of amygdala functional circuits in patients with mild cognitive impairment (MCI) with and without depression are not clear. The current study examined the features of amygdala FC in patients with MCI with depression symptoms (D-MCI) using resting-state functional magnetic resonance imaging. We acquired resting-state functional magnetic resonance imaging data from 16 patients with D-MCI, 18 patients with MCI with no depression (nD-MCI), and 20 healthy controls (HCs) using a 3T scanner and compared the strength of amygdala FC between the three groups. Patients with D-MCI exhibited significant FC differences in the amygdala-medial prefrontal cortex and amygdala-sensorimotor networks. These results suggest that the dysfunction of the amygdala-medial prefrontal cortex network and the amygdala-sensorimotor network might be involved in the neural mechanism underlying depression in MCI.
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Affiliation(s)
- Ting Yang
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Bangli Shen
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Aiqin Wu
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xinglu Tang
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Wei Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Bo Chen
- Tongde Hospital of Zhejiang, Hangzhou, China
| | | | - Xiaozheng Liu
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
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Increased Reactivity of the Mesolimbic Reward System after Ketamine Injection in Patients with Treatment-resistant Major Depressive Disorder. Anesthesiology 2019; 130:923-935. [DOI: 10.1097/aln.0000000000002667] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Abstract
Editor’s Perspective
What We Already Know about This Topic
What This Article Tells Us That Is New
Background
Ketamine rapidly improves maladaptive mood states in major depressive disorder, and some of the neural substrates underlying this therapeutic effect have been identified. This study aimed to identify functional changes within neural networks that may underlie the impact of ketamine on both reward and emotional processing in patients with treatment-resistant major depression.
Methods
Ten adult patients with a Montgomery–Åsberg Depression Rating Scale score above 25 were enrolled to receive a single intravenous administration of ketamine (0.5 mg/kg). Patients’ performance along with related neural network activations were analyzed in a game-like reward task and in an emotional judgment task using functional magnetic resonance imaging 1 day before and 1 and 7 days after ketamine administration.
Results
A significant correlation (R2 = 0.46, P = 0.03) between the improvement of depression scores and the enhanced reaction time for positive items was found in the game-like reward task 1 day after ketamine administration. This enhanced sensitivity for rewarded items was accompanied by increased activity of reward-related brain regions, including the orbitofrontal cortex, ventral striatum, and the ventral tegmental area, an effect that persisted up to 1 week after ketamine injection. In the emotional judgment task, it was found that ketamine rapidly modified local brain activities in response to emotionally negative, positive, or neutral stimuli in the amygdala, insula, anterior cingulate cortex, and in the ventral tegmental area.
Conclusions
Single bolus ketamine administration rapidly triggers lasting changes in mesolimbic neural networks to improve pathologic reward and emotional processing in patients with major depressive disorder.
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Hou Z, Wang Z, Jiang W, Yin Y, Yue Y, Zhang Y, Song X, Yuan Y. Divergent topological architecture of the default mode network as a pretreatment predictor of early antidepressant response in major depressive disorder. Sci Rep 2016; 6:39243. [PMID: 27966645 PMCID: PMC5155246 DOI: 10.1038/srep39243] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/21/2016] [Indexed: 12/04/2022] Open
Abstract
Identifying a robust pretreatment neuroimaging marker would be helpful for the selection of an optimal therapy for major depressive disorder (MDD). We recruited 82 MDD patients [n = 42 treatment-responsive depression (RD) and n = 40 non-responding depression (NRD)] and 50 healthy controls (HC) for this study. Based on the thresholded partial correlation matrices of 58 specific brain regions, a graph theory approach was applied to analyse the topological properties. When compared to HC, both RD and NRD patients exhibited a lower nodal degree (Dnodal) in the left anterior cingulate gyrus; as for RD, the Dnodal of the left superior medial orbitofrontal gyrus was significantly reduced, but the right inferior orbitofrontal gyrus was increased (all P < 0.017, FDR corrected). Moreover, the nodal degree in the right dorsolateral superior frontal cortex (SFGdor) was significantly lower in RD than in NRD. Receiver operating characteristic curve analysis demonstrated that the λ and nodal degree in the right SFGdor exhibited a good ability to distinguish nonresponding patients from responsive patients, which could serve as a specific maker to predict an early response to antidepressants. The disrupted topological configurations in the present study extend the understanding of pretreatment neuroimaging predictors for antidepressant medication.
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Affiliation(s)
- Zhenghua Hou
- Department of Psychosomatics &Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China.,Department of Psychiatry, Affiliated Wuhu NO.4 Hospital of Shanghai Jiaotong University BIO-X center, Wuhu 241001, China
| | - Zan Wang
- Department of Neurology, Institute of Neuropsychology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Wenhao Jiang
- Department of Psychosomatics &Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Yingying Yin
- Department of Psychosomatics &Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Yingying Yue
- Department of Psychosomatics &Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Yuqun Zhang
- Department of Psychosomatics &Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Xiaopeng Song
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Yonggui Yuan
- Department of Psychosomatics &Psychiatry, Institute of Psychosomatics, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
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Aversive stimuli exacerbate defensive motor behaviour in motor conversion disorder. Neuropsychologia 2016; 93:229-241. [PMID: 27842291 DOI: 10.1016/j.neuropsychologia.2016.11.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/06/2016] [Accepted: 11/04/2016] [Indexed: 11/22/2022]
Abstract
Conversion disorder or functional neurological symptom disorder (FND) can affect the voluntary motor system, without an organic cause. Functional symptoms are thought to be generated unconsciously, arising from underlying psychological stressors. However, attempts to demonstrate a direct relationship between the limbic system and disrupted motor function in FND are lacking. We tested whether negative affect would exacerbate alterations of motor control and corresponding brain activations in individuals with FND. Ten patients and ten healthy controls produced an isometric precision-grip contraction at 10% of maximum force while either viewing visual feedback of their force output, or unpleasant or pleasant emotional images (without feedback). Force magnitude was continuously recorded together with change in brain activity using fMRI. For controls, force output decayed from the target level while viewing pleasant and unpleasant images. Patients however, maintained force at the target level without decay while viewing unpleasant images, indicating a pronounced effect of negative affect on force output in FND. This emotional modulation of force control was associated with different brain activation patterns between groups. Contrasting the unpleasant with the pleasant condition, controls showed increased activity in the inferior frontal cortex and pre-supplementary motor area, whereas patients had greater activity in the cerebellum (vermis), posterior cingulate cortex, and hippocampus. Engagement of a cerebellar-limbic network in patients is consistent with heightened processing of emotional salience, and supports the role of the cerebellum in freezing responses in the presence of aversive events. These data highlight a possible neural circuit through which psychological stressors elicit defensive behaviour and modulate motor function in FND.
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Padilla-Coreano N, Bolkan SS, Pierce GM, Blackman DR, Hardin WD, Garcia-Garcia AL, Spellman TJ, Gordon JA. Direct Ventral Hippocampal-Prefrontal Input Is Required for Anxiety-Related Neural Activity and Behavior. Neuron 2016; 89:857-66. [PMID: 26853301 DOI: 10.1016/j.neuron.2016.01.011] [Citation(s) in RCA: 300] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/31/2015] [Accepted: 12/24/2015] [Indexed: 12/22/2022]
Abstract
The ventral hippocampus (vHPC), medial prefrontal cortex (mPFC), and basolateral amygdala (BLA) are each required for the expression of anxiety-like behavior. Yet the role of each individual element of the circuit is unclear. The projection from the vHPC to the mPFC has been implicated in anxiety-related neural synchrony and spatial representations of aversion. The role of this projection was examined using multi-site neural recordings combined with optogenetic terminal inhibition. Inhibition of vHPC input to the mPFC disrupted anxiety and mPFC representations of aversion, and reduced theta synchrony in a pathway-, frequency- and task-specific manner. Moreover, bilateral, but not unilateral, inhibition altered physiological correlates of anxiety in the BLA, mimicking a safety-like state. These results reveal a specific role for the vHPC-mPFC projection in anxiety-related behavior and the spatial representation of aversive information within the mPFC.
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Affiliation(s)
- Nancy Padilla-Coreano
- Department of Neuroscience, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA
| | - Scott S Bolkan
- Department of Neuroscience, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA
| | - Georgia M Pierce
- Department of Neuroscience, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA
| | - Dakota R Blackman
- Department of Neuroscience, Barnard College, 3009 Broadway, New York, NY 10027, USA
| | - William D Hardin
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA
| | - Alvaro L Garcia-Garcia
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA
| | - Timothy J Spellman
- Department of Physiology and Cellular Biophysics, Columbia University, 622 West 168(th) Street, New York, NY 10032, USA
| | - Joshua A Gordon
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA; Division of Integrative Neuroscience, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032 USA.
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