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Flinkenflügel K, Meinert S, Hirtsiefer C, Grotegerd D, Gruber M, Goltermann J, Winter NR, Stein F, Brosch K, Leehr EJ, Böhnlein J, Dohm K, Bauer J, Redlich R, Hahn T, Repple J, Opel N, Nitsch R, Jamalabadi H, Straube B, Alexander N, Jansen A, Nenadić I, van den Heuvel MP, Kircher T, Dannlowski U. Associations between white matter microstructure and cognitive decline in major depressive disorder versus controls in Germany: a prospective case-control cohort study. Lancet Psychiatry 2024; 11:899-909. [PMID: 39419563 DOI: 10.1016/s2215-0366(24)00291-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 08/18/2024] [Accepted: 09/04/2024] [Indexed: 10/19/2024]
Abstract
BACKGROUND Cognitive deficits are a key source of disability in individuals with major depressive disorder (MDD) and worsen with disease progression. Despite their clinical relevance, the underlying mechanisms of cognitive deficits remain poorly elucidated, hampering effective treatment strategies. Emerging evidence suggests that alterations in white matter microstructure might contribute to cognitive dysfunction in MDD. We aimed to investigate the complex association between changes in white matter integrity, cognitive decline, and disease course in MDD in a comprehensive longitudinal dataset. METHODS In the naturalistic, observational, prospective, case-control Marburg-Münster Affective Disorders Cohort Study, individuals aged 18-65 years and of Caucasian ancestry were recruited from local psychiatric hospitals in Münster and Marburg, Germany, and newspaper advertisements. Individuals diagnosed with MDD and individuals without any history of psychiatric disorder (ie, healthy controls) were included in this subsample analysis. Participants had diffusion-weighted imaging, a battery of neuropsychological tests, and detailed clinical data collected at baseline and at 2 years of follow-up. We used linear mixed-effect models to compare changes in cognitive performance and white matter integrity between participants with MDD and healthy controls. Diffusion-weighted imaging analyses were conducted using tract-based spatial statistics. To correct for multiple comparisons, threshold free cluster enhancement (TFCE) was used to correct α-values at the family-wise error rate (FWE; ptfce-FWE). Effect sizes were estimated by conditional, partial R2 values (sr2) following the Nakagawa and Schielzeth method to quantify explained variance. The association between changes in cognitive performance and changes in white matter integrity was analysed. Finally, we examined whether the depressive disease course between assessments predicted cognitive performance at follow-up and whether white matter integrity mediated this association. People with lived experience were not involved in the research and writing process. FINDINGS 881 participants were selected for our study, of whom 418 (47%) had MDD (mean age 36·8 years [SD 13·4], 274 [66%] were female, and 144 [34%] were male) and 463 (53%) were healthy controls (mean age 35·6 years [13·5], 295 [64%] were female, and 168 [36%] were male). Baseline assessments were done between Sept 11, 2014, and June 3, 2019, and after a mean follow-up of 2·20 years (SD 0·19), follow-up assessments were done between Oct 6, 2016, and May 31, 2021. Participants with MDD had lower cognitive performance than did healthy controls (p<0·0001, sr2=0·056), regardless of timepoint. Analyses of diffusion-weighted imaging indicated a significant diagnosis × time interaction with a steeper decline in white matter integrity of the superior longitudinal fasciculus over time in participants with MDD than in healthy controls (ptfce-FWE=0·026, sr2=0·002). Furthermore, cognitive decline was robustly associated with the decline in white matter integrity over time across both groups (ptfce-FWE<0·0001, sr2=0·004). In participants with MDD, changes in white matter integrity (p=0·0040, β=0·071) and adverse depressive disease course (p=0·0022, β=-0·073) independently predicted lower cognitive performance at follow-up. INTERPRETATION Alterations of white matter integrity occurred over time to a greater extent in participants with MDD than in healthy controls, and decline in white matter integrity was associated with a decline in cognitive performance across groups. Our findings emphasise the crucial role of white matter microstructure and disease progression in depression-related cognitive dysfunction, making both priority targets for future treatment development. FUNDING German Research Foundation (DFG).
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Affiliation(s)
- Kira Flinkenflügel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Institute for Translational Neuroscience, University of Münster, Münster, Germany.
| | | | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Nils R Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Joscha Böhnlein
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jochen Bauer
- Department of Radiology, University of Münster, Münster, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychology, University of Halle, Halle, Germany; German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany; Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - Robert Nitsch
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Hamidreza Jamalabadi
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Nina Alexander
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany; Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Martijn P van den Heuvel
- Connectome Laboratory, Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands; Department of Child Psychiatry, Amsterdam University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
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Xu Y, Cheng X, Li Y, Shen H, Wan Y, Ping L, Yu H, Cheng Y, Xu X, Cui J, Zhou C. Shared and Distinct White Matter Alterations in Major Depression and Bipolar Disorder: A Systematic Review and Meta-Analysis. J Integr Neurosci 2024; 23:170. [PMID: 39344242 DOI: 10.31083/j.jin2309170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 07/22/2024] [Accepted: 07/31/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Identifying white matter (WM) microstructural similarities and differences between major depressive disorder (MDD) and bipolar disorder (BD) is an important way to understand the potential neuropathological mechanism in emotional disorders. Numerous diffusion tensor imaging (DTI) studies over recent decades have confirmed the presence of WM anomalies in these two affective disorders, but the results were inconsistent. This study aimed to determine the statistical consistency of DTI findings for BD and MDD by using the coordinate-based meta-analysis (CBMA) approach. METHODS We performed a systematic search of tract-based spatial statistics (TBSS) studies comparing MDD or BD with healthy controls (HC) as of June 30, 2024. The seed-based d-mapping (SDM) was applied to investigate fractional anisotropy (FA) changes. Meta-regression was then used to analyze the potential correlations between demographics and neuroimaging alterations. RESULTS Regional FA reductions in the body of the corpus callosum (CC) were identified in both of these two diseases. Besides, MDD patients also exhibited decreased FA in the genu and splenium of the CC, as well as the left anterior thalamic projections (ATP), while BD patients showed FA reduction in the left median network, and cingulum in addition to the CC. CONCLUSIONS The results highlighted that altered integrity in the body of CC served as the shared basis of MDD and BD, and distinct microstructural WM abnormalities also existed, which might induce the various clinical manifestations of these two affective disorders. The study was registered on PROSPERO (http://www.crd.york.ac.uk/PROSPERO), registration number: CRD42022301929.
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Affiliation(s)
- Yinghong Xu
- Department of Psychiatry, Shandong Daizhuang Hospital, 272075 Jining, Shandong, China
- School of Mental Health, Jining Medical University, 272002 Jining, Shandong, China
| | - Xiaodong Cheng
- Department of Psychiatry, Shandong Daizhuang Hospital, 272075 Jining, Shandong, China
| | - Ying Li
- School of Mental Health, Jining Medical University, 272002 Jining, Shandong, China
| | - Hailong Shen
- School of Mental Health, Jining Medical University, 272002 Jining, Shandong, China
| | - Yu Wan
- School of Mental Health, Jining Medical University, 272002 Jining, Shandong, China
| | - Liangliang Ping
- Department of Psychiatry, Xiamen Xianyue Hospital, 361012 Xiamen, Fujian, China
| | - Hao Yu
- School of Mental Health, Jining Medical University, 272002 Jining, Shandong, China
| | - Yuqi Cheng
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China
| | - Jian Cui
- Department of Psychiatry, Shandong Daizhuang Hospital, 272075 Jining, Shandong, China
| | - Cong Zhou
- School of Mental Health, Jining Medical University, 272002 Jining, Shandong, China
- Department of Psychology, Affiliated Hospital of Jining Medical University, 272067 Jining, Shandong, China
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Gruber M, Mauritz M, Meinert S, Grotegerd D, de Lange SC, Grumbach P, Goltermann J, Winter NR, Waltemate L, Lemke H, Thiel K, Winter A, Breuer F, Borgers T, Enneking V, Klug M, Brosch K, Meller T, Pfarr JK, Ringwald KG, Stein F, Opel N, Redlich R, Hahn T, Leehr EJ, Bauer J, Nenadić I, Kircher T, van den Heuvel MP, Dannlowski U, Repple J. Cognitive performance and brain structural connectome alterations in major depressive disorder. Psychol Med 2023; 53:1-12. [PMID: 36752136 PMCID: PMC10600941 DOI: 10.1017/s0033291722004007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 12/02/2022] [Accepted: 12/23/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Cognitive dysfunction and brain structural connectivity alterations have been observed in major depressive disorder (MDD). However, little is known about their interrelation. The present study follows a network approach to evaluate alterations in cognition-related brain structural networks. METHODS Cognitive performance of n = 805 healthy and n = 679 acutely depressed or remitted individuals was assessed using 14 cognitive tests aggregated into cognitive factors. The structural connectome was reconstructed from structural and diffusion-weighted magnetic resonance imaging. Associations between global connectivity strength and cognitive factors were established using linear regressions. Network-based statistics were applied to identify subnetworks of connections underlying these global-level associations. In exploratory analyses, effects of depression were assessed by evaluating remission status-related group differences in subnetwork-specific connectivity. Partial correlations were employed to directly test the complete triad of cognitive factors, depressive symptom severity, and subnetwork-specific connectivity strength. RESULTS All cognitive factors were associated with global connectivity strength. For each cognitive factor, network-based statistics identified a subnetwork of connections, revealing, for example, a subnetwork positively associated with processing speed. Within that subnetwork, acutely depressed patients showed significantly reduced connectivity strength compared to healthy controls. Moreover, connectivity strength in that subnetwork was associated to current depressive symptom severity independent of the previous disease course. CONCLUSIONS Our study is the first to identify cognition-related structural brain networks in MDD patients, thereby revealing associations between cognitive deficits, depressive symptoms, and reduced structural connectivity. This supports the hypothesis that structural connectome alterations may mediate the association of cognitive deficits and depression severity.
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Affiliation(s)
- Marius Gruber
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528 Frankfurt, Germany
| | - Marco Mauritz
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
- Institute of Translational Neuroscience, University of Münster, 48149 Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Siemon C. de Lange
- Connectome Lab, Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV Amsterdam, The Netherlands
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, 1105 BA Amsterdam, The Netherlands
| | - Pascal Grumbach
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Nils Ralf Winter
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Lena Waltemate
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Fabian Breuer
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Tiana Borgers
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Melissa Klug
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, 35032 Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, 35032 Marburg, Germany
| | - Julia-Katharina Pfarr
- Department of Psychiatry and Psychotherapy, University of Marburg, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, 35032 Marburg, Germany
| | - Kai Gustav Ringwald
- Department of Psychiatry and Psychotherapy, University of Marburg, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, 35032 Marburg, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, 35032 Marburg, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
- Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, 07743 Jena, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
- Institute of Psychology, University of Halle, 06108 Halle (Saale), Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Elisabeth J. Leehr
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Jochen Bauer
- Department of Radiology, University of Münster, 48149 Münster, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, 35032 Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, 35032 Marburg, Germany
| | - Martijn P. van den Heuvel
- Connectome Lab, Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV Amsterdam, The Netherlands
- Department of Child Psychiatry, Amsterdam University Medical Center, Amsterdam Neuroscience, 1105 AZ Amsterdam, The Netherlands
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, 60528 Frankfurt, Germany
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Meinert S, Leehr EJ, Grotegerd D, Repple J, Förster K, Winter NR, Enneking V, Fingas SM, Lemke H, Waltemate L, Stein F, Brosch K, Schmitt S, Meller T, Linge A, Krug A, Nenadić I, Jansen A, Hahn T, Redlich R, Opel N, Schubotz RI, Baune BT, Kircher T, Dannlowski U. White matter fiber microstructure is associated with prior hospitalizations rather than acute symptomatology in major depressive disorder. Psychol Med 2022; 52:1166-1174. [PMID: 32921338 DOI: 10.1017/s0033291720002950] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Eighty percent of all patients suffering from major depressive disorder (MDD) relapse at least once in their lifetime. Thus, understanding the neurobiological underpinnings of the course of MDD is of utmost importance. A detrimental course of illness in MDD was most consistently associated with superior longitudinal fasciculus (SLF) fiber integrity. As similar associations were, however, found between SLF fiber integrity and acute symptomatology, this study attempts to disentangle associations attributed to current depression from long-term course of illness. METHODS A total of 531 patients suffering from acute (N = 250) or remitted (N = 281) MDD from the FOR2107-cohort were analyzed in this cross-sectional study using tract-based spatial statistics for diffusion tensor imaging. First, the effects of disease state (acute v. remitted), current symptom severity (BDI-score) and course of illness (number of hospitalizations) on fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity were analyzed separately. Second, disease state and BDI-scores were analyzed in conjunction with the number of hospitalizations to disentangle their effects. RESULTS Disease state (pFWE < 0.042) and number of hospitalizations (pFWE< 0.032) were associated with decreased FA and increased MD and RD in the bilateral SLF. A trend was found for the BDI-score (pFWE > 0.067). When analyzed simultaneously only the effect of course of illness remained significant (pFWE < 0.040) mapping to the right SLF. CONCLUSIONS Decreased FA and increased MD and RD values in the SLF are associated with more hospitalizations when controlling for current psychopathology. SLF fiber integrity could reflect cumulative illness burden at a neurobiological level and should be targeted in future longitudinal analyses.
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Affiliation(s)
- Susanne Meinert
- Department of Psychiatry, University of Münster, Münster, Germany
| | | | | | - Jonathan Repple
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Katharina Förster
- Department of Psychiatry, University of Münster, Münster, Germany
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Nils R Winter
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Verena Enneking
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Stella M Fingas
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Lena Waltemate
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Anna Linge
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Core-Unit Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Tim Hahn
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Ronny Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Nils Opel
- Department of Psychiatry, University of Münster, Münster, Germany
- Interdisciplinary Centre for Clinical Research (IZKF) Münster, University of Münster, Münster, Germany
| | | | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
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Association Between Genetic Risk for Type 2 Diabetes and Structural Brain Connectivity in Major Depressive Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 7:333-340. [PMID: 33684623 DOI: 10.1016/j.bpsc.2021.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/20/2021] [Accepted: 02/18/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) and type 2 diabetes mellitus (T2D) are known to share clinical comorbidity and to have genetic overlap. Besides their shared genetics, both diseases seem to be associated with alterations in brain structural connectivity and impaired cognitive performance, but little is known about the mechanisms by which genetic risk of T2D might affect brain structure and function and if they do, how these effects could contribute to the disease course of MDD. METHODS This study explores the association of polygenic risk for T2D with structural brain connectome topology and cognitive performance in 434 nondiabetic patients with MDD and 539 healthy control subjects. RESULTS Polygenic risk score for T2D across MDD patients and healthy control subjects was found to be associated with reduced global fractional anisotropy, a marker of white matter microstructure, an effect found to be predominantly present in MDD-related fronto-temporo-parietal connections. A mediation analysis further suggests that this fractional anisotropy variation may mediate the association between polygenic risk score and cognitive performance. CONCLUSIONS Our findings provide preliminary evidence of a polygenic risk for T2D to be linked to brain structural connectivity and cognition in patients with MDD and healthy control subjects, even in the absence of a direct T2D diagnosis. This suggests an effect of T2D genetic risk on white matter integrity, which may mediate an association of genetic risk for diabetes and cognitive impairments.
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Grumbach P, Opel N, Martin S, Meinert S, Leehr EJ, Redlich R, Enneking V, Goltermann J, Baune BT, Dannlowski U, Repple J. Sleep duration is associated with white matter microstructure and cognitive performance in healthy adults. Hum Brain Mapp 2020; 41:4397-4405. [PMID: 32648625 PMCID: PMC7502839 DOI: 10.1002/hbm.25132] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 01/01/2023] Open
Abstract
Reduced sleep duration and sleep deprivation have been associated with cognitive impairment as well as decreased white matter integrity as reported by experimental studies. However, it is largely unknown whether differences in sleep duration and sleep quality might affect microstructural white matter and cognition. Therefore, the present study aims to examine the cross-sectional relationship between sleep duration, sleep quality, and cognitive performance in a naturalistic study design, by focusing on the association with white matter integrity in a large sample of healthy, young adults. To address this, 1,065 participants, taken from the publicly available sample of the Human Connectome Project, underwent diffusion tensor imaging. Moreover, broad cognitive performance measures (NIH Cognition Toolbox) and sleep duration and quality (Pittsburgh Sleep Quality Index) were assessed. The results revealed a significant positive association between sleep duration and overall cognitive performance. Shorter sleep duration significantly correlated with fractional anisotropy (FA) reductions in the left superior longitudinal fasciculus (SLF). In turn, FA in this tract was related to measures of cognitive performance and was shown to significantly mediate the association of sleep duration and cognition. For cognition only, associations shift to a negative association of sleep duration and cognition for participants sleeping more than 8 hr a day. Investigations into subjective sleep quality showed no such associations. The present study showed that real-world differences in sleep duration, but not subjective sleep quality are related to cognitive performance measures and white matter integrity in the SLF in healthy, young adults.
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Affiliation(s)
| | - Nils Opel
- Department of PsychiatryUniversity of MünsterMünsterGermany
| | - Stella Martin
- Department of EconomicsUniversity of MünsterMünsterGermany
| | | | | | - Ronny Redlich
- Department of PsychiatryUniversity of MünsterMünsterGermany
| | | | | | - Bernhard T. Baune
- Department of PsychiatryUniversity of MünsterMünsterGermany
- Department of PsychiatryMelbourne Medical School, The University of MelbourneMelbourneVictoriaAustralia
- The Florey Institute of Neuroscience and Mental HealthThe University of MelbourneParkvilleVictoriaAustralia
| | - Udo Dannlowski
- Department of PsychiatryUniversity of MünsterMünsterGermany
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Severity of current depression and remission status are associated with structural connectome alterations in major depressive disorder. Mol Psychiatry 2020; 25:1550-1558. [PMID: 31758093 DOI: 10.1038/s41380-019-0603-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/25/2019] [Accepted: 11/11/2019] [Indexed: 11/08/2022]
Abstract
Major depressive disorder (MDD) is associated to affected brain wiring. Little is known whether these changes are stable over time and hence might represent a biological predisposition, or whether these are state markers of current disease severity and recovery after a depressive episode. Human white matter network ("connectome") analysis via network science is a suitable tool to investigate the association between affected brain connectivity and MDD. This study examines structural connectome topology in 464 MDD patients (mean age: 36.6 years) and 432 healthy controls (35.6 years). MDD patients were stratified categorially by current disease status (acute vs. partial remission vs. full remission) based on DSM-IV criteria. Current symptom severity was assessed continuously via the Hamilton Depression Rating Scale (HAMD). Connectome matrices were created via a combination of T1-weighted magnetic resonance imaging (MRI) and tractography methods based on diffusion-weighted imaging. Global tract-based metrics were not found to show significant differences between disease status groups, suggesting conserved global brain connectivity in MDD. In contrast, reduced global fractional anisotropy (FA) was observed specifically in acute depressed patients compared to fully remitted patients and healthy controls. Within the MDD patients, FA in a subnetwork including frontal, temporal, insular, and parietal nodes was negatively associated with HAMD, an effect remaining when correcting for lifetime disease severity. Therefore, our findings provide new evidence of MDD to be associated with structural, yet dynamic, state-dependent connectome alterations, which covary with current disease severity and remission status after a depressive episode.
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Dong Q, Liu J, Zeng L, Fan Y, Lu X, Sun J, Zhang L, Wang M, Guo H, Zhao F, Yan D, Li H, Guo W, Zhang Y, Liu B, Hu D, Li L. State-Independent Microstructural White Matter Abnormalities in Major Depressive Disorder. Front Psychiatry 2020; 11:431. [PMID: 32477196 PMCID: PMC7240278 DOI: 10.3389/fpsyt.2020.00431] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/28/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Even with continuous antidepressant treatment, residual symptoms and the risk of relapse can persist in remitted major depressive disorder (MDD) patients. Hence, having a clear recognition of the persistent abnormalities of the underlying neural substrate in MDD through a longitudinal investigation is of great importance. METHODS A total of 127 adult medication-free MDD patients with an acute depressive episode and 118 matched healthy controls (HCs) underwent diffusion tensor imaging. Over a 6-month treatment course, 62 remitted patients underwent a second scan. Remission was defined as a 24-item Hamilton Depression Rating Scale (HAMD24) score ≤7 for at least two weeks. Diffusion tensor imaging was performed with a 3.0 T scanner. Differences in whole-brain fractional anisotropy (FA) between MDD patients and HCs were assessed by an independent t-test using gender, age, and education as covariates. RESULTS Significant FA reductions in the left insula, left middle occipital gyrus, right thalamus, left pallidum and left precuneus were observed in current MDD (cMDD) patients compared with HCs. Moreover, significant FA reductions in the left insula were observed in remitted (rMDD) patients compared to HCs. However, no significant differences in FA values were found when comparing cMDD and rMDD patients. CONCLUSIONS The abnormalities in the insula showed state-independent characteristics, while the abnormalities in the middle occipital gyrus, thalamus, pallidum and precuneus seemed to be state-dependent impairments in MDD patients.
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Affiliation(s)
- Qiangli Dong
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Jin Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Lingli Zeng
- College of Intelligence Science and Technology, National University of Defense Technology, Changsha, China
| | - Yiming Fan
- College of Intelligence Science and Technology, National University of Defense Technology, Changsha, China
| | - Xiaowen Lu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Jinrong Sun
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Liang Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Mi Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Hua Guo
- Department of Psychiatry, Zhumadian Psychiatric Hospital, Zhumadian, China
| | - Futao Zhao
- Department of Psychiatry, Zhumadian Psychiatric Hospital, Zhumadian, China
| | - Danfeng Yan
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Haolun Li
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Weilong Guo
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Yan Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Bangshan Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Dewen Hu
- College of Intelligence Science and Technology, National University of Defense Technology, Changsha, China
| | - Lingjiang Li
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
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