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Merza Mohammad TA, Merza Mohammad TA, Salman DM, Jaafar HM. Pentoxifylline as a Novel Add-on Therapy for Major Depressive Disorder in Adult Patients: A Randomized, Double-Blind, Placebo-Controlled Trial. PHARMACOPSYCHIATRY 2024; 57:205-214. [PMID: 38710206 DOI: 10.1055/a-2291-7204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
BACKGROUND Evidence indicates an association between immune dysregulation and major depressive disorder (MDD). Pentoxifylline (PTX), a phosphodiesterase inhibitor, has been shown to reduce pro-inflammatory activities. The aim of this study was to evaluate changes in depressive symptoms and pro-inflammatory markers after administration of PTX as an adjunctive agent to citalopram in patients with MDD. METHODS One hundred patients were randomly assigned to either citalopram (20 mg/day) plus placebo (twice daily) (n=50) or citalopram (20 mg/day) plus PTX (400 mg) (twice daily) (n=50). The Hamilton Depression Rating Scale-17 (HAM-D-17) scores at baseline, weeks 2, 4, 6, 8, 10, and 12 and serum levels of interleukin1-β (IL-1-β), tumor necrosis factor-α, C-reactive protein, IL-6, serotonin, IL-10, and brain-derived neurotrophic factor (BDNF) at baseline and week 12 were evaluated. RESULTS HAM-D-17 score in the PTX group significantly reduced in comparison to the control group after weeks 4, 6, 8,10, and 12 ((LSMD): - 2.193, p=0.021; - 2.597, p=0.036; - 2.916, p=0.019; - 4.336, p=0.005; and - 4.087, p=0.008, respectively). Patients who received PTX had a better response (83%) and remission rate (79%) compared to the placebo group (49% and 40%, p=0.006 and p=0.01, respectively). Moreover, the reduction in serum concentrations of pro-inflammatory factors and increase in serotonin and BDNF in the PTX group was significantly greater than in the placebo group (p<0.001). CONCLUSION These findings support the safety and efficacy of PTX as an adjunctive antidepressant agent with anti-inflammatory effects in patients with MDD.
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Affiliation(s)
- Talar A Merza Mohammad
- Department of Clinical Pharmacy, College of Pharmacy, Hawler Medical University, Kurdistan Region-Erbil, Iraq
| | - Tavgah A Merza Mohammad
- University of Sulaimani, College of Nursing, Department of Community Health Nursing, Kurdistan Region-Erbil, Iraq
| | - Dyar M Salman
- Department of Clinical Pharmacy, College of Pharmacy, Hawler Medical University, Kurdistan Region-Erbil, Iraq
- Tishk International University, Faculty of Pharmacy, Kurdistan Region-Erbil, Iraq
| | - Halmat M Jaafar
- Department of Clinical Pharmacy, College of Pharmacy, Hawler Medical University, Kurdistan Region-Erbil, Iraq
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Wu Y, Chu Z, Chen X, Zhu Y, Xu X, Shen Z. Functional connectivity between the habenula and posterior default mode network contributes to the response of the duloxetine effect in major depressive disorder. Neuroreport 2024; 35:380-386. [PMID: 38526956 DOI: 10.1097/wnr.0000000000002019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
This study aims to investigate the functional connectivity (FC) changes of the habenula (Hb) among patients with major depressive disorder (MDD) after 12 weeks of duloxetine treatment (MDD12). Patients who were diagnosed with MDD for the first time and were drug-naïve were recruited at baseline as cases. Healthy controls (HCs) matched for sex, age, and education level were also recruited at the same time. At baseline, all participants underwent resting-state functional MRI. FC analyses were performed using the Hb seed region of interest, and three groups including HCs, MDD group and MDD12 group were compared using whole-brain voxel-wise comparisons. Compared to the HCs, the MDD group had decreased FC between the Hb and the right anterior cingulate cortex at baseline. Compared to the HCs, the FC between the Hb and the left medial superior frontal gyrus decreased in the MDD12 group. Additionally, the FC between the left precuneus, bilateral cuneus and Hb increased in the MDD12 group than that in the MDD group. No significant correlation was found between HDRS-17 and the FC between the Hb, bilateral cuneus, and the left precuneus in the MDD12 group. Our study suggests that the FC between the post-default mode network and Hb may be the treatment mechanism of duloxetine and the treatment mechanisms and the pathogenesis of depression may be independent of each other.
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Affiliation(s)
- Yanru Wu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University
| | - Zhaosong Chu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University
| | - Xianyu Chen
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University
| | - Yun Zhu
- Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xiufeng Xu
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University
- Yunnan Clinical Research Center for Mental Disorders
| | - Zonglin Shen
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University
- Yunnan Clinical Research Center for Mental Disorders
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Levy SA, Misiura MB, Grant JG, Adrien TV, Taiwo Z, Armstrong R, Dotson VM. Depression, Vascular Burden, and Dementia Prevalence in Late Middle-Aged and Older Black Adults. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae009. [PMID: 38374692 PMCID: PMC10926943 DOI: 10.1093/geronb/gbae009] [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: 06/20/2023] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES Late-life depression and white matter hyperintensities (WMH) have been linked to increased dementia risk. However, there is a dearth of literature examining these relationships in Black adults. We investigated whether depression or WMH volume are associated with a higher likelihood of dementia diagnosis in a sample of late middle-aged to older Black adults, and whether dementia prevalence is highest in individuals with both depression and higher WMH volume. METHODS Secondary data analysis involved 443 Black participants aged 55+ with brain imaging within 1 year of baseline visit in the National Alzheimer's Coordinating Center Uniform Data Set. Chi-square analyses and logistic regression models controlling for demographic variables examined whether active depression in the past 2 years, WMH volume, or their combination were associated with higher odds of all-cause dementia. RESULTS Depression and higher WMH volume were associated with a higher prevalence of dementia. These associations remained after controlling for demographic factors, as well as vascular disease burden. Dementia risk was highest in the depression/high WMH volume group compared to the depression-only group, high WMH volume-only group, and the no depression/low WMH volume group. Post hoc analyses comparing the Black sample to a demographically matched non-Hispanic White sample showed associations of depression and the combination of depression and higher WMH burden with dementia were greater in Black compared to non-Hispanic White individuals. DISCUSSION Results suggest late-life depression and WMH have independent and joint relationships with dementia and that Black individuals may be particularly at risk due to these factors.
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Affiliation(s)
- Shellie-Anne Levy
- Department of Clinical and Health Psychology, The Center for Cognitive Aging and Memory, University of Florida, Gainesville, Florida, USA
- The Center for Cognitive Aging and Memory, University of Florida, Gainesville, Florida, USA
| | - Maria B Misiura
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Jeremy G Grant
- Department of Clinical and Health Psychology, The Center for Cognitive Aging and Memory, University of Florida, Gainesville, Florida, USA
| | - Tamare V Adrien
- Department of Clinical and Health Psychology, The Center for Cognitive Aging and Memory, University of Florida, Gainesville, Florida, USA
| | - Zinat Taiwo
- Department of Rehabilitation Psychology and Neuropsychology, TIRR Memorial Hermann, Houston, Texas, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Rebecca Armstrong
- Department of Clinical and Health Psychology, The Center for Cognitive Aging and Memory, University of Florida, Gainesville, Florida, USA
| | - Vonetta M Dotson
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
- Gerontology Institute, Georgia State University, Atlanta, Georgia, USA
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Kim OY, Song J. Important roles of linoleic acid and α-linolenic acid in regulating cognitive impairment and neuropsychiatric issues in metabolic-related dementia. Life Sci 2024; 337:122356. [PMID: 38123015 DOI: 10.1016/j.lfs.2023.122356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/02/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
Metabolic syndrome (MetS), which is characterized by insulin resistance, high blood glucose, obesity, and dyslipidemia, is known to increase the risk of dementia accompanied by memory loss and depression. The direct pathways and specific mechanisms in the central nervous system (CNS) for addressing fatty acid imbalances in MetS have not yet been fully elucidated. Among polyunsaturated acids, linoleic acid (LA, n6-PUFA) and α-linolenic acid (ALA, n3-PUFA), which are two essential fatty acids that should be provided by food sources (e.g., vegetable oils and seeds), have been reported to regulate various cellular mechanisms including apoptosis, inflammatory responses, mitochondrial biogenesis, and insulin signaling. Furthermore, inadequate intake of LA and ALA is reported to be involved in neuropathology and neuropsychiatric diseases as well as imbalanced metabolic conditions. Herein, we review the roles of LA and ALA on metabolic-related dementia focusing on insulin resistance, dyslipidemia, synaptic plasticity, cognitive function, and neuropsychiatric issues. This review suggests that LA and ALA are important fatty acids for concurrent treatment of both MetS and neurological problems.
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Affiliation(s)
- Oh Yoen Kim
- Department of Food Science and Nutrition, Dong A University, Busan, Republic of Korea; Department of Health Sciences, Graduate School of Dong-A University, Busan, Republic of Korea.
| | - Juhyun Song
- Department of Anatomy, Chonnam National University Medical School, Seoul, Republic of Korea.
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Sadanandan J, Sathyanesan M, Liu Y, Tiwari NK, Newton SS. Carbamoylated Erythropoietin-Induced Cerebral Blood Perfusion and Vascular Gene Regulation. Int J Mol Sci 2023; 24:11507. [PMID: 37511274 PMCID: PMC10380798 DOI: 10.3390/ijms241411507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Cerebral hypoperfusion is associated with enhanced cognitive decline and increased risk of neuropsychiatric disorders. Erythropoietin (EPO) is a neurotrophic factor known to improve cognitive function in preclinical and clinical studies of neurodegenerative and psychiatric disorders. However, the clinical application of EPO is limited due to its erythropoietic activity that can adversely elevate hematocrit in non-anemic populations. Carbamoylated erythropoietin (CEPO), a chemically engineered non-erythropoietic derivative of EPO, does not alter hematocrit and maintains neurotrophic and behavioral effects comparable to EPO. Our study aimed to investigate the role of CEPO in cerebral hemodynamics. Magnetic resonance imaging (MRI) analysis indicated increased blood perfusion in the hippocampal and striatal region without altering tight junction integrity. In vitro and in vivo analyses indicated that hippocampal neurotransmission was unaltered and increased cerebral perfusion was likely due to EDRF, CGRP, and NOS-mediated vasodilation. In vitro analysis using human umbilical vein endothelial cells (HUVEC) and hippocampal vascular gene expression analysis showed CEPO to be a non-angiogenic agent which regulates the MEOX2 gene expression. The results from our study demonstrate a novel role of CEPO in modulating cerebral vasodilation and blood perfusion.
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Affiliation(s)
- Jayanarayanan Sadanandan
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD 57069, USA
| | - Monica Sathyanesan
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD 57069, USA
| | - Yutong Liu
- Radiology Research Division, Department of Radiology, Nebraska Medical Center, Omaha, NE 68198, USA
| | | | - Samuel S Newton
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD 57069, USA
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Xu M, Wang Q, Li B, Qian S, Wang S, Wang Y, Chen C, Liu Z, Ji Y, Liu K, Xin K, Niu Y. Cerebellum and hippocampus abnormalities in patients with insomnia comorbid depression: a study on cerebral blood perfusion and functional connectivity. Front Neurosci 2023; 17:1202514. [PMID: 37397441 PMCID: PMC10311636 DOI: 10.3389/fnins.2023.1202514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 05/29/2023] [Indexed: 07/04/2023] Open
Abstract
Chronic insomnia disorder and major depressive disorder are highly-occurred mental diseases with extensive social harm. The comorbidity of these two diseases is commonly seen in clinical practice, but the mechanism remains unclear. To observe the characteristics of cerebral blood perfusion and functional connectivity in patients, so as to explore the potential pathogenesis and biological imaging markers, thereby improving the understanding of their comorbidity mechanism. 44 patients with chronic insomnia disorder comorbid major depressive disorder and 43 healthy controls were recruited in this study. The severity of insomnia and depression were assessed by questionnaire. The cerebral blood perfusion and functional connectivity values of participants were obtained to, analyze their correlation with questionnaire scores. The cerebral blood flow in cerebellum, vermis, right hippocampus, left parahippocampal gyrus of patients were reduced, which was negatively related to the severity of insomnia or depression. The connectivities of left cerebellum-right putamen and right hippocampus-left inferior frontal gyrus were increased, showing positive correlations with the severity of insomnia and depression. Decreased connectivities of left cerebellum-left fusiform gyrus, left cerebellum-left occipital lobe, right hippocampus-right paracentral lobule, right hippocampus-right precentral gyrus were partially associated with insomnia or depression. The connectivity of right hippocampus-left inferior frontal gyrus may mediate between insomnia and depression. Insomnia and depression can cause changes in cerebral blood flow and brain function. Changes in the cerebellar and hippocampal regions are the result of insomnia and depression. They reflect abnormalities in sleep and emotion regulation. That may be involved in the pathogenesis of comorbidity.
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Affiliation(s)
- Minghe Xu
- Postgraduate Training Base of the 960th Hospital of People's Liberation Army Joint Logistic Support Force, Jinzhou Medical University, Jinan, China
| | - Qian Wang
- Department of Radiology, Qingdao Hospital of Traditional Chinese Medicine (Qingdao Hiser hospital), Qingdao, China
| | - Bo Li
- Department of Radiology, The 960th Hospital of People's Liberation Army Joint Logistic Support Force, Jinan, China
| | - Shaowen Qian
- Department of Radiology, The 960th Hospital of People's Liberation Army Joint Logistic Support Force, Jinan, China
| | - Shuang Wang
- Department of Radiology, The 960th Hospital of People's Liberation Army Joint Logistic Support Force, Jinan, China
| | - Yu Wang
- Department of Radiology, The 960th Hospital of People's Liberation Army Joint Logistic Support Force, Jinan, China
| | - Chunlian Chen
- Department of Radiology, The 960th Hospital of People's Liberation Army Joint Logistic Support Force, Jinan, China
| | - Zhe Liu
- Department of Radiology, The 960th Hospital of People's Liberation Army Joint Logistic Support Force, Jinan, China
| | - Yuqing Ji
- Department of Radiology, The 960th Hospital of People's Liberation Army Joint Logistic Support Force, Jinan, China
| | - Kai Liu
- Department of Radiology, The 960th Hospital of People's Liberation Army Joint Logistic Support Force, Jinan, China
| | - Kuolin Xin
- Sleep Clinic, The 960th Hospital of People's Liberation Army Joint Logistic Support Force, Jinan, China
| | - Yujun Niu
- Department of Radiology, First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
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Batail JM, Corouge I, Combès B, Conan C, Guillery-Sollier M, Vérin M, Sauleau P, Le Jeune F, Gauvrit JY, Robert G, Barillot C, Ferre JC, Drapier D. Apathy in depression: An arterial spin labeling perfusion MRI study. J Psychiatr Res 2023; 157:7-16. [PMID: 36427413 DOI: 10.1016/j.jpsychires.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 07/28/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Apathy, as defined as a deficit in goal-directed behaviors, is a critical clinical dimension in depression associated with chronic impairment. Little is known about its cerebral perfusion specificities in depression. To explore neurovascular mechanisms underpinning apathy in depression by pseudo-continuous arterial spin labeling (pCASL) magnetic resonance imaging (MRI). METHODS Perfusion imaging analysis was performed on 90 depressed patients included in a prospective study between November 2014 and February 2017. Imaging data included anatomical 3D T1-weighted and perfusion pCASL sequences. A multiple regression analysis relating the quantified cerebral blood flow (CBF) in different regions of interest defined from the FreeSurfer atlas, to the Apathy Evaluation Scale (AES) total score was conducted. RESULTS After confound adjustment (demographics, disease and clinical characteristics) and correction for multiple comparisons, we observed a strong negative relationship between the CBF in the left anterior cingulate cortex (ACC) and the AES score (standardized beta = -0.74, corrected p value = 0.0008). CONCLUSION Our results emphasized the left ACC as a key region involved in apathy severity in a population of depressed participants. Perfusion correlates of apathy in depression evidenced in this study may contribute to characterize different phenotypes of depression.
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Affiliation(s)
- J M Batail
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, F-35703, Rennes, France; Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France; Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France.
| | - I Corouge
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France
| | - B Combès
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France
| | - C Conan
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, F-35703, Rennes, France
| | - M Guillery-Sollier
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, F-35703, Rennes, France; Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France; Univ Rennes, LP3C (Laboratoire de Psychologie: Cognition, Comportement, Communication) - EA 1285, CC5000, Rennes, France
| | - M Vérin
- Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France; CHU Rennes, Department of Neurology, F-35033, Rennes, France
| | - P Sauleau
- Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France; CHU Rennes, Department of Neurophysiology, F-35033, Rennes, France
| | - F Le Jeune
- Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France; Centre Eugène Marquis, Department of Nuclear Medicine, F-35062, Rennes, France
| | - J Y Gauvrit
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France; CHU Rennes, Department of Radiology, F-35033, Rennes, France
| | - G Robert
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, F-35703, Rennes, France; Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France; Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France
| | - C Barillot
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France
| | - J C Ferre
- Univ Rennes, Inria, CNRS, IRISA, INSERM, Empenn U1228 ERL, F-35042, Rennes, France; CHU Rennes, Department of Radiology, F-35033, Rennes, France
| | - D Drapier
- Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie Adulte, F-35703, Rennes, France; Univ Rennes, "Comportement et noyaux gris centraux" Research Unit (EA 4712), F-35000, Rennes, France
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He Y, Shen J, Wang X, Wu Q, Liu J, Ji Y. Preliminary study on brain resting-state networks and cognitive impairments of patients with obstructive sleep apnea-hypopnea syndrome. BMC Neurol 2022; 22:456. [PMID: 36476321 PMCID: PMC9728000 DOI: 10.1186/s12883-022-02991-w] [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: 07/07/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To investigate functional changes in brain resting-state networks (RSNs) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and their correlations with sleep breathing disorders and neurocognitive performance. METHODS In this study, 18 OSAHS patients and 18 matched healthy controls underwent neurocognitive assessment and magnetic resonance imaging (MRI). Group-level independent component analysis (ICA) and statistical analyses were used to explore between-group differences in RSNs and the relationship between functional changes in RSNs, sleep breathing disorders and neurocognitive performance. RESULTS The OSAHS patients performed worse on neuropsychological tests than the healthy controls. Eight RSNs were identified, and between-group analyses showed that OSAHS patients displayed significantly decreased functional connectivity in the bilateral posterior cingulate gyri (PCC) within the default mode network (DMN), the right middle frontal gyrus (MFG) within the dorsal attention network (DAN), and the left superior temporal gyrus (STG) within the ventral attention network (VAN), and increased functional connectivity in the right superior frontal gyrus (SFG) within the salience network (SN). Further correlation analyses revealed that the average ICA z-scores in the bilateral PCC were correlated with sleep breathing disorders. CONCLUSIONS Our findings demonstrate that the DMN, SN, DAN, and VAN are impaired during the resting state and are associated with decreased functionally distinct aspects of cognition in patients with OSAHS. Moreover, the intermittent hypoxia and sleep fragmentation caused by OSAHS are likely to be the main influencing factors.
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Affiliation(s)
- Yaqing He
- Department of Radiology, Suzhou Ninth People’s Hospital, Suzhou, China
| | - Junkang Shen
- grid.452666.50000 0004 1762 8363Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiang Wang
- Department of Respiratory, Suzhou Ninth People’s Hospital, Suzhou, China
| | - Qiaozhen Wu
- Department of Respiratory, Suzhou Ninth People’s Hospital, Suzhou, China
| | - Jiacheng Liu
- grid.452290.80000 0004 1760 6316Department of Radiology, The Affiliated Zhongda Hospital of Southeast University Medical School, Nanjing, China
| | - Yiding Ji
- Department of Radiology, Suzhou Ninth People’s Hospital, Suzhou, China
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Luo Q, Yu H, Chen J, Lin X, Wu Z, Yao J, Li Y, Wu H, Peng H. Altered Variability and Concordance of Dynamic Resting-State Functional Magnetic Resonance Imaging Indices in Patients With Major Depressive Disorder and Childhood Trauma. Front Neurosci 2022; 16:852799. [PMID: 35615286 PMCID: PMC9124829 DOI: 10.3389/fnins.2022.852799] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
Childhood trauma is a non-specific risk factor for major depressive disorder (MDD). resting-state functional magnetic resonance imaging (R-fMRI) studies have demonstrated changes in regional brain activity in patients with MDD who experienced childhood trauma. However, previous studies have mainly focused on static characteristics of regional brain activity. This study aimed to determine the specific brain regions associated with MDD with childhood trauma by performing temporal dynamic analysis of R-fMRI data in three groups of patients: patients with childhood trauma-associated MDD (n = 48), patients without childhood trauma-associated MDD (n = 30), and healthy controls (n = 103). Dynamics and concordance of R-fMRI indices were calculated and analyzed. In patients with childhood trauma-associated MDD, a lower dynamic amplitude of low-frequency fluctuations was found in the left lingual gyrus, whereas a lower dynamic degree of centrality was observed in the right lingual gyrus and right calcarine cortex. Patients with childhood trauma-associated MDD showed a lower voxel-wise concordance in the left middle temporal and bilateral calcarine cortices. Moreover, group differences (depressed or not) significantly moderated the relationship between voxel-wise concordance in the right calcarine cortex and childhood trauma history. Overall, patients with childhood trauma-associated MDD demonstrated aberrant variability and concordance in intrinsic brain activity. These aberrances may be an underlying neurobiological mechanism that explains MDD from the perspective of temporal dynamics.
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Affiliation(s)
- Qianyi Luo
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huiwen Yu
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Juran Chen
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinyi Lin
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhiyao Wu
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiazheng Yao
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuhong Li
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huawang Wu
- Department of Radiology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongjun Peng
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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Luo Q, Chen J, Li Y, Wu Z, Lin X, Yao J, Yu H, Peng H, Wu H. Altered regional brain activity and functional connectivity patterns in major depressive disorder: A function of childhood trauma or diagnosis? J Psychiatr Res 2022; 147:237-247. [PMID: 35066292 DOI: 10.1016/j.jpsychires.2022.01.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 12/26/2022]
Abstract
Childhood trauma (CT) is a non-specific risk factor for major depressive disorder (MDD). However, the neurobiological mechanisms of MDD with CT remain unclear. In the present study, we sought to determine the specific brain regions associated with CT and MDD etiology. Fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) analyses were performed to assess alterations of intrinsic brain activity in MDD with CT, MDD without CT, healthy controls with CT, and healthy controls without CT. Two-by-two factorial analyses were performed to examine the effects of the factors "MDD" and "CT" on fALFF and FC. Moderator analysis was used to explore whether the severity of depression moderated the relationship between CT and aberrant fALFF. We found that the etiological effects of MDD and CT exhibited negative impacts on brain dysfunction including altered fALFF in the left postcentral gyrus, left lingual gyrus, left paracentral lobule (PCL), and left cuneus. Decreased FC was observed in the following regions: (i) the left lingual gyrus seed and the left fusiform gyrus as well as the right calcarine cortex; (ii) the left PCL seed and the left supplementary motor area, left calcarine cortex, left precentral gyrus, and right cuneus; (iii) the left postcentral gyrus seed and left superior parietal lobule, right postcentral gyrus, and left precentral gyrus. Furthermore, the severity of depression acted as a moderator in the relationship between CT and aberrant fALFF in the left PCL. These data indicate that MDD patients with and without trauma exposure are clinically and neurobiologically distinct.
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Affiliation(s)
- Qianyi Luo
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Juran Chen
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Yuhong Li
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Zhiyao Wu
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Xinyi Lin
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Jiazheng Yao
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Huiwen Yu
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Hongjun Peng
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China.
| | - Huawang Wu
- Department of Radiology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China.
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11
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Investigating the association between depression and cerebral haemodynamics-A systematic review and meta-analysis. J Affect Disord 2022; 299:144-158. [PMID: 34800572 DOI: 10.1016/j.jad.2021.11.037] [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] [Received: 06/25/2021] [Revised: 10/25/2021] [Accepted: 11/14/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Vascular mechanisms may play a role in depression. The aim of this review is to summarise the evidence on alterations in cerebral haemodynamics in depression. METHODS MEDLINE (1946- present), Embase (1947-present), Web of Science (1970-present), PsycINFO (1984-present), CINAHL (1976-present) and CENTRAL were searched using a predefined search strategy. A meta-analysis was conducted in four groups: 1) global cerebral blood flow (CBF) in ml/min/100 g, 2) CBF velocity (CBFv) in cm/s (maximum flow of left middle cerebral artery, 3) combined CBF and CBFv, 4) Ratio of uptake of Tc 99 m HMPAO (region of interest compared to whole brain). Data are presented as mean difference or standardised mean difference and 95% confidence interval (95% CI). A narrative synthesis of the remaining studies was performed. RESULTS 87 studies were included. CBF was significantly reduced in depressed patients compared to HC [15 studies, 538 patients, 416 HC, MD: -2.24 (95% CI -4.12, -0.36), p = 0.02, I2 = 64%]. There were no statistically significant differences in other parameters. The narrative synthesis revealed variable changes in CBF in depressed patients, particularly affecting the anterior cingulate and prefrontal cortices. LIMITATIONS There were various sources of heterogeneity including the severity of depression, use of antidepressant medication, imaging modality used and reporting of outcomes. All of these factors made direct comparisons between studies difficult. CONCLUSIONS The reduction in CBF in depressed patients compared to HCs may indicate a role for assessment and CBF altering interventions in high-risk groups. However, results were inconsistent across studies, warranting further work to investigate specific subgroups.
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12
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Takizawa Y, Murray J, Bambling M, Matsumoto Y, Ishimoto Y, Yamane T, Edirippulige S. Integrating neuroscientific knowledge into psychotherapy amongst Japanese psychotherapists: presence, benefits, needs and cultural barriers. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2022. [DOI: 10.1080/21507686.2022.2035783] [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]
Affiliation(s)
- Yu Takizawa
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Judith Murray
- School of Psychology/School of Nursing Midwifery and Social Work, University of Queensland, Brisbane, Australia
| | - Matthew Bambling
- School of Clinical Medicine, University of Queensland, Brisbane, Australia
| | - Yuki Matsumoto
- School of Human Life Sciences, Tokushima Bunri University, Tokushima, Japan
| | - Yuma Ishimoto
- Teacher Education Center, Tottori University, Tottori, Japan
| | - Takahiro Yamane
- Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Sisira Edirippulige
- Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
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13
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Xu YL, Wang XY, Chen J, Kang M, Wang YX, Zhang LJ, Shu HY, Liao XL, Zou J, Wei H, Ling Q, Shao Y. Altered Spontaneous Brain Activity Patterns of Meibomian Gland Dysfunction in Severely Obese Population Measured Using the Fractional Amplitude of Low-Frequency Fluctuations. Front Psychiatry 2022; 13:914039. [PMID: 35633781 PMCID: PMC9130486 DOI: 10.3389/fpsyt.2022.914039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/14/2022] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Utilizing the fractional amplitude of low-frequency fluctuations (fALFF) technique, this study sought to correlate spontaneous cerebral abnormalities with the clinical manifestations of meibomian gland dysfunction (MGD) in severely obese (SO) population. SUBJECTS AND METHODS Twelve MGD patients in SO population (PATs) (4 males and 8 females) and twelve healthy controls (HCs) (6 males and 6 females) matched by gender and age were enrolled. Every participant underwent resting-state functional magnetic resonance imaging (rs-MRI) scanning. Spontaneous cerebral activity alterations were examined using the fALFF method. Receiver operating characteristic (ROC) curves were utilized to classify the medial fALFF values of the PATs and HCs. PATs were also asked to complete anxiety and depression score forms, permitting a correlation analysis. RESULTS In contrast with HCs, PATs had prominently increased fALFF values in the left lingual gyrus, the right globus pallidus, the right anterior cingulate and paracingulate gyri and the left middle occipital lobe (P < 0.05), and decreased fALFF values in the right cerebellum, the left fusiform gyrus, the right medial orbitofrontal gyrus, the left triangle inferior frontal gyrus and the left inferior parietal gyrus (P < 0.05). The results of the ROC curve indicated that changes in regional fALFF values might help diagnose MGD in SO population. Moreover, fALFF values in the right cerebellum of PATs were positively correlated with hospital anxiety and depression scores (HADS) (r = 0.723, P = 0.008). The fALFF values in the left triangle inferior frontal gyrus of PAT were negatively correlated with HADS (r = -0.651, P = 0.022). CONCLUSIONS Aberrant spontaneous activity was observed in multiple regions of the cerebrum, offering helpful information about the pathology of MGD in SO population. Aberrant fALFF values in these regions likely relates to the latent pathologic mechanisms of anomalous cerebral activities in PATs.
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Affiliation(s)
- Yu-Ling Xu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiao-Yu Wang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jun Chen
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Min Kang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yi-Xin Wang
- Department of Ophthalmology and Visual Sciences, Cardiff University, Cardiff, United Kingdom
| | - Li-Juan Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hui-Ye Shu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xu-Lin Liao
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jie Zou
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hong Wei
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qian Ling
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
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14
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Empana JP, Boutouyrie P, Lemogne C, Jouven X, van Sloten TT. Microvascular Contribution to Late-Onset Depression: Mechanisms, Current Evidence, Association With Other Brain Diseases, and Therapeutic Perspectives. Biol Psychiatry 2021; 90:214-225. [PMID: 34325805 DOI: 10.1016/j.biopsych.2021.04.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/16/2022]
Abstract
Depression is common in older individuals and is associated with high disability and mortality. A major problem is treatment resistance: >50% of older patients do not respond to current antidepressants. Therefore, new effective interventions for prevention and treatment of depression in older individuals need to be developed, which requires a better understanding of the mechanisms underlying depression. The pathophysiology of depression is multifactorial and complex. Microvascular dysfunction may be an early and targetable mechanism in the development of depression, notably depression that initiates in late life (late-onset depression). Late-onset depression commonly co-occurs with other diseases or syndromes that may share a microvascular origin, including apathy, cognitive impairment, dementia, and stroke. Together, these disabilities may all be part of one large phenotype resulting from global cerebral microvascular dysfunction. In this review, we discuss the pathophysiology of microvascular dysfunction-related late-onset depression, summarize recent epidemiological evidence on the association between cerebral microvascular dysfunction and depression, and indicate potential drivers of cerebral microvascular dysfunction. We also propose the hypothesis that depression may be a manifestation of a larger phenotype of cerebral microvascular dysfunction, highlight potential therapeutic targets and interventions, and give directions for future research.
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Affiliation(s)
- Jean-Philippe Empana
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France
| | - Pierre Boutouyrie
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France
| | - Cédric Lemogne
- Université de Paris, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Paris, France
| | - Xavier Jouven
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France
| | - Thomas T van Sloten
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France; School for Cardiovascular Diseases Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.
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15
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Ha M, Han K, Jung Y, Kim D, Paik JS, Na KS. Is retinal vein occlusion associated with depression symptoms?: A nationwide cohort study. Medicine (Baltimore) 2021; 100:e26937. [PMID: 34397943 PMCID: PMC8360422 DOI: 10.1097/md.0000000000026937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 07/27/2021] [Indexed: 01/04/2023] Open
Abstract
Retinal vessels share similar anatomical and physiological characteristics with the cerebral microvasculature, and abnormal cerebral blood flow is reportedly associated with depressive disorder. However, there is limited evidence regarding the relationship between depression and the risk of retinal vein occlusion (RVO). This study aimed to investigate the association between depression and the prospective risk of RVO using nationally representative longitudinal data. This retrospective, nationwide, population-based cohort study included 9,178,222 people aged 20 years or older who underwent the Korean National Health Screening Program examination in 2009. The depression group consisted of subjects whose initial diagnoses were made between 2009 and 2010 (n = 128,700). The predictive value for RVO was analyzed using multivariate Cox proportional hazard regression models.From the Kaplan-Meier curves, the depression group showed significantly higher RVO incidence probability, relative to the comparison group (P < .0001). After all confounding variables were adjusted, the hazard ratio of RVO in the depression group with or without recurrence was 1.2 (95% confidence interval [CI]: 1.076-1.338) and 1.087 (95% CI: 1.012-1.167), respectively, relative to the comparison group. This is the first nationwide, population-based, epidemiologic study that evaluated the association between depression and the risk of RVO development. The presence of depression was significantly associated with increased risks of RVO, and the recurrence of depression showed a higher RVO incidence probability.
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Affiliation(s)
- Minji Ha
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Younhea Jung
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Daran Kim
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji-Sun Paik
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Sun Na
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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16
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Siragusa MA, Rufin T, Courtois R, Belzung C, Andersson F, Brizard B, Dujardin PA, Cottier JP, Patat F, Réméniéras JP, Gissot V, El-Hage W, Camus V, Desmidt T. Left amygdala volume and brain tissue pulsatility are associated with neuroticism: an MRI and ultrasound study. Brain Imaging Behav 2021; 15:1499-1507. [PMID: 32761564 DOI: 10.1007/s11682-020-00348-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
Brain changes associated with the personality trait of neuroticism have been partly elucidated. While subcortical brain volume changes, especially a larger amygdala, appear consistent in high neuroticism, functional changes, such as cerebral blood flow (CBF) differences, have shown conflicting results, possibly because of the limitations in methods of CBF measurement. In our study, we investigated changes in amygdala volume and CBF-related function associated with neuroticism in healthy and depressed subjects using both conventional magnetic resonance imaging (MRI) measures of brain volume and the innovative technique of ultrasound Tissue Pulsatility Imaging (TPI), which has a high level of detection in measuring brain tissue pulsatility (BTP). Middle-aged females with depression (n = 25) and without depression (n = 25) underwent clinical examination, magnetic resonance imaging (MRI) and ultrasound assessment (TPI). Neuroticism was positively associated with left amygdala volume and mean BTP in individuals without depression, in both simple and multiple regressions that included potential confounding factors such as age and body mass index. No association was found in the depressed group. We confirmed the role of the left amygdala in the brain physiology of neuroticism in nondepressed individuals. Moreover, we identified a novel mechanism associated with high neuroticism, namely BTP, that may reflect greater CBF and account for the increased risk of cerebrovascular disease in individuals with high neuroticism. Because neuroticism is considered a risk factor for depression, our paper provides potential objective biomarkers for the identification of subjects at risk for depression.
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Affiliation(s)
| | | | - Robert Courtois
- CRIAVS Centre-Val de Loire, CHRU de Tours, Tours, France
- Département de Psychologie, EE 1901 'Qualipsy' (Qualité de vie et Santé psychologique), Université François Rabelais de Tours, Tours, France
| | | | | | - Bruno Brizard
- UMR 1253, iBrain, Inserm, Université de Tours, Tours, France
| | | | - Jean-Philippe Cottier
- UMR 1253, iBrain, Inserm, Université de Tours, Tours, France
- CHRU de Tours, Tours, France
| | - Frédéric Patat
- UMR 1253, iBrain, Inserm, Université de Tours, Tours, France
- CHRU de Tours, Tours, France
- CIC 1415, CHU de Tours, Inserm, Tours, France
| | | | | | - Wissam El-Hage
- UMR 1253, iBrain, Inserm, Université de Tours, Tours, France
- CHRU de Tours, Tours, France
- CIC 1415, CHU de Tours, Inserm, Tours, France
| | - Vincent Camus
- UMR 1253, iBrain, Inserm, Université de Tours, Tours, France
- CHRU de Tours, Tours, France
| | - Thomas Desmidt
- UMR 1253, iBrain, Inserm, Université de Tours, Tours, France.
- CHRU de Tours, Tours, France.
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17
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Alexopoulos GS. Mechanisms and Treatment of Late-Life Depression. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2021; 19:340-354. [PMID: 34690604 DOI: 10.1176/appi.focus.19304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
(Appeared originally in Translational Psychiatry 2019; 9:188).
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Affiliation(s)
- George S Alexopoulos
- Weill Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Road, White Plains, NY 10605, USA
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18
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Wang Z, Yuan Y, Jiang Y, You J, Zhang Z. Identification of specific neural circuit underlying the key cognitive deficit of remitted late-onset depression: A multi-modal MRI and machine learning study. Prog Neuropsychopharmacol Biol Psychiatry 2021; 108:110192. [PMID: 33285264 DOI: 10.1016/j.pnpbp.2020.110192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/23/2020] [Accepted: 11/30/2020] [Indexed: 01/21/2023]
Abstract
Neuropsychological impairment is a key feature of late-onset depression (LOD), with deficits observed across multiple cognitive domains. And this neuropsychological impairment can persist even after the remission of depressive symptoms. However, none of previous studies have explored the pattern of cognitive deficit in remitted LOD (rLOD), and investigated the specific neural circuit underlying the key cognitive deficit of LOD. 40 rLOD patients and 36 controls underwent comprehensive neuropsychological assessments and magnetic resonance imaging (MRI) scans. The influence of executive function or information processing speed deficit on other cognitive domains was first investigated. We then applied a multivariate machine learning technique known as relevance vector regression to evaluate the potential of multiple-modal MRI (i.e., integrating whole-brain grey-matter [GM] volume and white-matter [WM] tract features) for making accurate predictions about the key cognitive deficit for individual rLOD patient. We revealed that the information processing speed appears to represent a key cognitive deficit in rLOD. Further the machine learning model identified a wide range of GM regions and WM tracts that significantly contributed to the prediction of individual performance on information processing speed (r = 0.50, P < 0.001). The GM regions mainly located in the frontal-subcortical and limbic systems; and the WM tracts mainly located in the frontal-limbic pathway, including the anterior corona radiata, fornix, posterior cingulate bundle, and uncinate fasciculus. This present study provide strongly evidence supporting the concept of rLOD that the core aspect of the cognitive deficits (i.e., information processing speed) is associated with disruption of the frontal-subcortical-limbic pathway.
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Affiliation(s)
- Zan Wang
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China.
| | - Yonggui Yuan
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China
| | - Ying Jiang
- Department of Neurology, the 962nd Hospital of the PLA Joint Logistic Support Force, Harbin 150080, China
| | - Jiayong You
- Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Zhijun Zhang
- School of Medicine, Southeast University, Nanjing 210009, China; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing 210009, China.
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19
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Zhang S, Gong Q, Wu D, Tian Y, Shen L, Lu J, Xu L, Gu H, Xu J, Liu W. Genetic and Pathological Characteristic Patterns of a Family With Neuronal Intranuclear Inclusion Disease. J Neuropathol Exp Neurol 2021; 79:1293-1302. [PMID: 33271601 DOI: 10.1093/jnen/nlaa142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Neuronal intranuclear inclusion disease (NIID) is a rare, progressive neurodegenerative disorder. This study aimed to investigate clinical, imaging, genetic, and dermatopathological characteristics of a family with adult-onset NIID. The proband was a 62-year-old woman with 3 brothers and 2 sisters. Of these, 4 had symptoms of paroxysmal visual field defect, extrapyramidal symptoms, dysautonomia, emotional changes, and cognitive dysfunction. Genetic examination revealed no abnormality related to cerebrovascular diseases. More than 200 CGG repeats of FMR1 gene cause fragile X-associated tremor/ataxia syndrome (FXTAS) whereas repeats of the proband were found 29 times, which excluded FXTAS. Quantitative reverse transcription polymerase chain reaction (PCR) and GC-rich-PCR identified an expanded GGC repeat (with ∼100 repeats) in the 5' region of NOTCH2NLC in the patient and her 2 younger brothers. Pathological examination found eosinophilic intranuclear inclusions inside adipocytes, fibrocytes, and sweat gland cells. Immunohistochemistry and immunofluorescence staining revealed positive staining for ubiquitin and p62. The detailed pathological and genetic features of this NIID family provide a valuable contribution to the existing knowledge base of this rare disorder.
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Affiliation(s)
- Shugang Zhang
- From the Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University
| | - Qixing Gong
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University
| | - Di Wu
- Department of Neurology, Affiliated ZhongDa Hospital, Neuropsychiatric Institute, School of Medicine, Southeast University, Nanjing, Jiangsu
| | - Yun Tian
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lu Shen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Lu
- From the Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University
| | - Ligang Xu
- From the Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University
| | - Hao Gu
- From the Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University
| | - Jianxia Xu
- From the Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University
| | - Weiguo Liu
- From the Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University
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20
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Siegel AN, Rodrigues N, Nasri F, Wilkialis L, Lipsitz O, Lee Y, Gill H, Subramaniapillai M, Phan L, Majeed A, Lui LMW, Rashidian H, Ho R, Toma S, Goldstein BI, Mansur RB, McIntyre RS, Rosenblat JD. Novel therapeutic targets in mood disorders: Pentoxifylline (PTX) as a candidate treatment. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110032. [PMID: 32634540 DOI: 10.1016/j.pnpbp.2020.110032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/24/2020] [Accepted: 06/28/2020] [Indexed: 01/22/2023]
Abstract
Numerous pharmacological treatments for mood disorders are currently available; however, rates of treatment resistance, relapse and recurrence remain high. Therefore, novel treatments acting outside of the conventionally targeted monoamine system are urgently needed to improve patient outcomes. Emerging and converging evidence suggests that immune dysfunction, oxidative stress, impaired cerebral blood flow (CBF) and decreased neurotrophic factors all contribute to mood disorder pathophysiology and are therefore treatment targets of interest. Pentoxifylline (PTX) is a phosphodiesterase inhibitor with potent anti-inflammatory and antioxidant effects, with additional pleiotropic effects that lead to improved CBF and increases in brain derived neurotrophic factor (BDNF) levels. The direct effect of non-specific phosphodiesterase inhibition may also improve alertness and cognitive function through enhancing second messenger systems. Replicated preclinical studies have demonstrated antidepressant-like effects in animal models. Small preliminary clinical trials have demonstrated promising results for antidepressant and procognitive effects, however, have yet to be replicated in larger mood disorder samples. Only one randomized clinical trial (RCT) specifically assessed the effects of adjunctive PTX in major depressive disorder (MDD), showing clinically and statistically significant antidepressant effects compared to placebo. No studies have assessed PTX in bipolar disorder (BD), where inflammation and altered CBF have also been strongly implicated. Taken together, PTX presents as a promising pleiotropic agent with several potential novel mechanisms of action meriting further evaluation in clinical trials to evaluate target engagement, antidepressant, procognitive and mood stabilizing effects.
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Affiliation(s)
- Ashley N Siegel
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Nelson Rodrigues
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Flora Nasri
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Linas Wilkialis
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Orly Lipsitz
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Hartej Gill
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | | | - Lee Phan
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Amna Majeed
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Leanna M W Lui
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Houman Rashidian
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Institute for Health Innovation and Technology (iHealthtech) National University of Singapore, Singapore
| | - Simina Toma
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Benjamin I Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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21
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Kihira S, Koo C, Nael K, Belani P. Regional Parieto-occipital Hypoperfusion on Arterial Spin Labeling Associates with Major Depressive Disorder. Open Neuroimag J 2020. [DOI: 10.2174/1874440002013010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Reduced cerebral blood flow in parieto-occipital regions has been reported in neurodegenerative disorders using ASL. We aimed to investigate neuropsychiatric and neurodegenerative comorbidities that may associate with parieto-occipital region hypoperfusion.
Methods:
This was a retrospective single-center study. Between March 2017 to May 2018, adult patients who underwent brain MRI with the inclusion of ASL perfusion and who had bilateral reductions of CBF in the parieto-occipital regions were included. ASL was performed using a pseudo-continuous arterial spin labeling (pCASL) technique on 1.5T MR system. Age and gender-matched patients with no perfusion defect were concurrently collected. Comorbidity data was collected from EMR, including major depressive disorder, Alzheimer’s disease, Parkinson’s disease, Schizophrenia, anxiety disorder, hypertension, diabetes mellitus type II, coronary artery disease, and chronic kidney disease. A Pearson’s Chi-Square test was performed to assess for comorbidities associated with hypoperfusion of the parieto-occipital lobes.
Results:
Our patient cohort consisted of 93 patients with bilateral hypoperfusion in the parieto-occipital lobes and 93 age and gender-matched patients without corresponding perfusion defects based on ASL-CBF. Among the comorbidities assessed, there was a statistically significant association between hypoperfusion of the parieto-occipital lobes and major depressive disorder (p=0.004) and Parkinson’s disease (p=0.044). There was no statistically significant association for Alzheimer’s disease, generalized anxiety disorder, diabetes mellitus type II, hypertension, coronary artery disease, or chronic kidney disease.
Conclusion:
Major depressive disorder may be linked to regional parieto-occipital hypoperfusion on ASL.
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Belani P, Kihira S, Pacheco F, Pawha P, Cruciata G, Nael K. Addition of arterial spin-labelled MR perfusion to conventional brain MRI: clinical experience in a retrospective cohort study. BMJ Open 2020; 10:e036785. [PMID: 32532776 PMCID: PMC7295400 DOI: 10.1136/bmjopen-2020-036785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE The usage of arterial spin labelling (ASL) perfusion has exponentially increased due to improved and faster acquisition time and ease of postprocessing. We aimed to report potential additional findings obtained by adding ASL to routine unenhanced brain MRI for patients being scanned in a hospital setting for various neurological indications. DESIGN Retrospective. SETTING Large tertiary hospital. PARTICIPANTS 676 patients. PRIMARY OUTCOME Additional findings from ASL sequence compared with conventional MRI. RESULTS Our patient cohorts consisted of 676 patients with 257 with acute infarcts and 419 without an infarct. Additional findings from ASL were observed in 13.9% (94/676) of patients. In the non-infarct group, additional findings from ASL were observed in 7.4% (31/419) of patients, whereas in patients with an acute infarct, supplemental information was obtained in 24.5% (63/257) of patients. CONCLUSION The addition of an ASL sequence to routine brain MRI in a hospital setting provides additional findings compared with conventional brain MRI in about 7.4% of patients with additional supplementary information in 24.5% of patients with acute infarct.
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Affiliation(s)
- Puneet Belani
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Shingo Kihira
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Felipe Pacheco
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Puneet Pawha
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Giuseppe Cruciata
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kambiz Nael
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
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23
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Shinohara Y, Umezaki Y, Minami I, Watanabe M, Miura A, Mikutsuki L, Kawasaki K, Sugawara S, Trang TTH, Suga T, Watanabe T, Yoshikawa T, Takenoshita M, Motomura H, Toyofuku A. Comorbid depressive disorders and left-side dominant occlusal discomfort in patients with phantom bite syndrome. J Oral Rehabil 2019; 47:36-41. [PMID: 31398263 PMCID: PMC6916626 DOI: 10.1111/joor.12872] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/11/2018] [Accepted: 08/05/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Phantom bite syndrome (PBS) is characterised by occlusal discomfort without corresponding dental abnormalities. Despite repeated, failed dental treatments, patients with PBS persist in seeking bite correction. PBS has been regarded as a mental disorder. However, we have reported that PBS patients with a dental trigger tend to have less psychiatric history than those without. Hence, the symptoms of PBS cannot be explained by a mental disorder alone, and it is unclear if mental disorders affect occlusal sensation. OBJECTIVE To elucidate the pathophysiology of PBS, we analysed the dental history, PBS symptom laterality and psychiatric history of patients. METHODS In this retrospective study, we reviewed outpatients with PBS who presented at our clinic between April 2012 and March 2017. Their medical records were reviewed for demographic data, medical history and laterality of occlusal discomfort. RESULTS Approximately half of the 199 enrolled patients had bilateral occlusal discomfort. In the others, the side with occlusal discomfort generally tended to be the one that had received dental treatment. There was no significant relationship between the side chiefly affected by occlusal discomfort and whether dental treatment had been received; however, the affected side differed depending on whether the patient had comorbid psychiatric disorders (P = .041). CONCLUSIONS The distributions of the side with symptoms of PBS were different between those with and without comorbid psychiatric disorders, suggesting that psychiatric disorders might affect occlusal sensation due to a subtle dysfunction in brain areas central to sensory integration. Central dysfunction might play an important role in PBS.
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Affiliation(s)
- Yukiko Shinohara
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yojiro Umezaki
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Ichiro Minami
- Department of Removable Partial Prosthodontics, Masticatory Function Rehabilitation, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motoko Watanabe
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, Tokyo, Japan
| | - Anna Miura
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Lou Mikutsuki
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kaoru Kawasaki
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shiori Sugawara
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tu Thi Hyen Trang
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayuki Suga
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Watanabe
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tatsuya Yoshikawa
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Miho Takenoshita
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Haruhiko Motomura
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akira Toyofuku
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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24
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Alexopoulos GS. Mechanisms and treatment of late-life depression. Transl Psychiatry 2019; 9:188. [PMID: 31383842 PMCID: PMC6683149 DOI: 10.1038/s41398-019-0514-6] [Citation(s) in RCA: 267] [Impact Index Per Article: 53.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/26/2018] [Accepted: 01/01/2019] [Indexed: 01/25/2023] Open
Abstract
Depression predisposes to medical illnesses and advances biological aging indicated by shorter telomere length, accelerated brain aging and advanced epigenetic aging. Medical illnesses also increase the risk of late-life depression. The reciprocal relationships of depression with aging-related and disease-related processes have generated pathogenetic hypotheses and provided treatment targets. Targeting risk factors of vascular disease in mid-life is a logical approach in prevention of vascular depression. The depression-executive dysfunction and the vascular depression syndromes have clinical presentations and neuroimaging findings consistent with frontostriatal abnormalities. Dopamine D2/3 agonists are effective in depression of Parkinson's disease and their efficacy needs to be assessed in these two syndromes. Computerized cognitive remediation targeting functions of the cognitive control network may improve both executive functions and depressive symptoms of late-life major depression. Significant progress has been made in neurostimulation treatments in depressed younger adults. TMS targeting deep structures responsible for mood regulation is well tolerated by older adults and its efficacy in syndromes of late-life depression needs to be studied. Efficacious psychotherapies for late-life depression exist, but are underutilized in part because of their complexity. Streamlined, stepped psychotherapies targeting behaviors assumed to result from dysfunction of brain networks implicated in late-life depression can be easy to learn and have potential for dissemination. However, their effectiveness needs further investigation. Depression increases the risk of dementing disorders. Antidepressants are rather ineffective in treating depression of demented patients, but long-term use of antidepressants may reduce the risk of dementia. However, confirmation studies are needed.
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Affiliation(s)
- George S. Alexopoulos
- 000000041936877Xgrid.5386.8Weill Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Road, White Plains, NY 10605 USA
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25
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Salo KI, Scharfen J, Wilden ID, Schubotz RI, Holling H. Confining the Concept of Vascular Depression to Late-Onset Depression: A Meta-Analysis of MRI-Defined Hyperintensity Burden in Major Depressive Disorder and Bipolar Disorder. Front Psychol 2019; 10:1241. [PMID: 31214072 PMCID: PMC6555192 DOI: 10.3389/fpsyg.2019.01241] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 05/10/2019] [Indexed: 12/14/2022] Open
Abstract
Background: The vascular depression hypothesis emphasizes the significance of vascular lesions in late-life depression. At present, no meta-analytic model has investigated whether a difference in hyperintensity burden compared to controls between late-life and late-onset depression is evident. By including a substantial number of studies, focusing on a meaningful outcome measure, and considering several moderating and control variables, the present meta-analysis investigates the severity of hyperintensity burden in major depressive disorder (MDD) and bipolar disorder (BD). A major focus of the present meta-analysis refers to the role of age at illness onset. It is analyzed whether late-onset rather than late-life depression characterizes vascular depression. Method: In total, 68 studies were included in the meta-analysis and a multilevel random effects model was calculated using Hedges' g as the effect size measure. Results: The severity of hyperintensity burden was significantly greater in the patient group compared to the control group. This effect was evident regarding the whole patient group (g = 0.229) as well as both depression subgroups, with a significantly greater effect in BD (g = 0.374) compared to MDD (g = 0.189). Hyperintensity burden was more pronounced in late-onset depression than in early-onset depression or late-life depression. A considerable heterogeneity between the included studies was observed, which is reflected by the large variability in effects sizes. Conclusion: In conclusion, the present meta-analysis underscores the association of hyperintensities with MDD and BD. Especially late-onset depression is associated with an increased hyperintensity burden, which is in line with the vascular depression hypothesis. The results suggest that it might be more feasible to confine the concept of vascular depression specifically to late-onset depression as opposed to late-life depression. Further research is needed to understand the causal mechanisms that might underlie the relation between hyperintensity burden and depression.
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Affiliation(s)
- Katharina I. Salo
- Department of Psychology and Sports Sciences, Institute of Psychology, Westfälische Wilhelms-Universität, Münster, Germany
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26
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Wang Z, Yuan Y, You J, Zhang Z. Disrupted structural brain connectome underlying the cognitive deficits in remitted late-onset depression. Brain Imaging Behav 2019; 14:1600-1611. [DOI: 10.1007/s11682-019-00091-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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27
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Luo MY, Guo ZN, Qu Y, Zhang P, Wang Z, Jin H, Ma HY, Lv S, Sun X, Yang Y. Compromised Dynamic Cerebral Autoregulation in Patients With Depression. Front Psychiatry 2019; 10:373. [PMID: 31258489 PMCID: PMC6587060 DOI: 10.3389/fpsyt.2019.00373] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 05/13/2019] [Indexed: 01/18/2023] Open
Abstract
Background: Patients with depression tend to have various comorbid neurological symptoms, but the mechanisms remain unclear. The purpose of this study was to analyze the characteristics of dynamic cerebral autoregulation in depressed patients. Methods: Patients (aged ≥ 18 years) who were diagnosed with depression [17-item Hamilton Depression Rating Scale (HAMD) > 17] or suspected of depression (HAMD > 7) were enrolled in this study. Medically healthy volunteers were recruited as controls. The subjects also received the 7-item HAMD. We simultaneously recorded noninvasive continuous arterial blood pressure and bilateral middle cerebral artery blood flow velocity from each subject. Cerebral autoregulation was assessed by analyzing the phase difference using transfer function analysis. Results: This study enrolled 54 patients with suspected depression, 45 patients with depression, and 48 healthy volunteers. The mean phase difference values were significantly lower in the patients with depression (F = 9.071, P < 0.001). In the multiple regression analysis, depression was negatively correlated with the phase difference values. Conclusions: Dynamic cerebral autoregulation was compromised in patients with depression and negatively correlated with the depression score. Improving dynamic cerebral autoregulation may be a potential therapeutic method for treating the neurological symptoms of depression.
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Affiliation(s)
- Ming-Ya Luo
- Department of Neurology, First Hospital of Jilin University, Chang Chun, China
| | - Zhen-Ni Guo
- Clinical Trial and Research Center for Stroke, Department of Neurology, First Hospital of Jilin University, Chang Chun, China
| | - Yang Qu
- Department of Neurology, First Hospital of Jilin University, Chang Chun, China
| | - Peng Zhang
- Department of Neurology, First Hospital of Jilin University, Chang Chun, China
| | - Zan Wang
- Clinical Trial and Research Center for Stroke, Department of Neurology, First Hospital of Jilin University, Chang Chun, China
| | - Hang Jin
- Department of Neurology, First Hospital of Jilin University, Chang Chun, China
| | - Hong-Yin Ma
- Department of Neurology, First Hospital of Jilin University, Chang Chun, China
| | - Shan Lv
- Department of Neurology, First Hospital of Jilin University, Chang Chun, China
| | - Xin Sun
- Department of Neurology, First Hospital of Jilin University, Chang Chun, China
| | - Yi Yang
- Department of Neurology, First Hospital of Jilin University, Chang Chun, China
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28
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Wei W, Karim HT, Lin C, Mizuno A, Andreescu C, Karp JF, Reynolds CF, Aizenstein HJ. Trajectories in Cerebral Blood Flow Following Antidepressant Treatment in Late-Life Depression: Support for the Vascular Depression Hypothesis. J Clin Psychiatry 2018; 79:18m12106. [PMID: 30358242 PMCID: PMC6419103 DOI: 10.4088/jcp.18m12106] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/28/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Studies have identified longitudinally that there exists an association between depression, cerebral blood flow (CBF), and white matter hyperintensities that are thought to be due to vascular pathologies in the brain. However, the changes in CBF, a measure that reflects cerebrovascular integrity, following pharmacotherapy are not well understood. In this study, we investigated the dynamic CBF changes over the course of antidepressant treatment and the association of these changes with depressive symptoms. METHODS We used pseudocontinuous arterial spin labeling to investigate CBF changes in a sample of older patients (≥ 50 years of age; N = 46; 29 female) with a DSM-IV diagnosis of major depressive disorder. Participants had 5 magnetic resonance imaging scans (at baseline, the day after receiving a placebo, the day after receiving a first dose of venlafaxine, a week after starting venlafaxine treatment, and at the end of trial [12 weeks]). Montgomery-Asberg Depression Rating Scale (MADRS) was used to evaluate depression severity and treatment outcome. We investigated the association between changes in depression severity with changes in voxel-wise CBF while adjusting for potential confounding factors. RESULTS Increased CBF in the middle and posterior cingulate between baseline and end of treatment was significantly associated with percent decrease in MADRS score, independent of sex and Mini-Mental State Examination score (5,000 permutations, cluster forming threshold P < .005, family-wise error P < .05). No significant effects were detected between baseline and other scans (ie, placebo, acute [single dose], or subacute [after a week]). CONCLUSIONS Regional CBF increases were associated with decreases in depressive symptoms. This observation is consistent with the vascular depression hypothesis in late-life depression. TRIAL REGISTRATION ClinicalTrials.gov identifiers: NCT00892047 and NCT01124188.
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Affiliation(s)
- Wenjing Wei
- The Third Xiangya Hospital of Central South University, Changsha, Hunan, China,University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Helmet T. Karim
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Chemin Lin
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Akiko Mizuno
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jordan F. Karp
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Charles F. Reynolds
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Howard J. Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America,Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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29
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Liu X, Jiang W, Yuan Y. Aberrant Default Mode Network Underlying the Cognitive Deficits in the Patients With Late-Onset Depression. Front Aging Neurosci 2018; 10:310. [PMID: 30337869 PMCID: PMC6178980 DOI: 10.3389/fnagi.2018.00310] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 09/14/2018] [Indexed: 12/15/2022] Open
Abstract
Late-onset depression (LOD) is regarded as a risk factor or a prodrome of Alzheimer’s disease (AD). Moreover, LOD patients with cognitive deficits have the higher risk of subsequent AD. Thus, it is necessary to understand the neural underpinnings of cognitive deficits and its pathological implications in LOD. Consistent findings show that the default mode network (DMN) is an important and potentially useful brain network for the cognitive deficits in LOD patients. In recent years, genetics has been actively researched as a possible risk factor in the pathogenesis of LOD. So, in this review, we discuss the current research progress on the cognitive deficits and DMN in LOD through a combined view of brain network and genetics. We find that different structural and functional impairments of the DMN might be involved in the etiological mechanisms of different cognitive impairments in LOD patients.
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Affiliation(s)
- Xiaoyun Liu
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, Institute of Psychosomatics, Medical School, Southeast University, Nanjing, China
| | - Wenhao Jiang
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, Institute of Psychosomatics, Medical School, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, Institute of Psychosomatics, Medical School, Southeast University, Nanjing, China
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30
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Oliveira ÍAF, Guimarães TM, Souza RM, Dos Santos AC, Machado-de-Sousa JP, Hallak JEC, Leoni RF. Brain functional and perfusional alterations in schizophrenia: an arterial spin labeling study. Psychiatry Res Neuroimaging 2018; 272:71-78. [PMID: 29229240 DOI: 10.1016/j.pscychresns.2017.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/30/2017] [Accepted: 12/01/2017] [Indexed: 01/10/2023]
Abstract
Schizophrenia is a severe mental disorder that affects the anatomy and function of the brain, with an impact on one's thoughts, feelings, and behavior. The purpose of the study was to investigate cerebral blood flow (CBF) and brain connectivity in a group of patients with schizophrenia. Pseudo-continuous arterial spin labeling (pCASL) images were acquired from 28 patients in treatment and 28 age-matched healthy controls. Mean CBF and connectivity patterns were assessed. Schizophrenia patients had decreased CBF in the bilateral frontal pole and superior frontal gyrus, right medial frontal gyrus, triangular and opercular parts of the inferior frontal gyrus, posterior division of the left supramarginal gyrus, superior and inferior divisions of the left lateral occipital cortex, and bilateral occipital pole. Moreover, through different methods to assess connectivity, our results showed abnormal connectivity patterns in regions involved in motor, sensorial, and cognitive functions. Using pCASL, a non-invasive technique, we found CBF deficits and altered functional organization of the brain in schizophrenia patients that are associated with the symptoms and characteristics of the disorder.
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Affiliation(s)
- Ícaro A F Oliveira
- Inbrain Lab, Department of Physics, FFCLRP, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Tiago M Guimarães
- Department of Neuroscience and Behavior, FMRP, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Roberto M Souza
- Department of Neuroscience and Behavior, FMRP, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Antônio C Dos Santos
- Department of Medical Clinic, FMRP, University of Sao Paulo, Ribeirao Preto, Brazil
| | - João Paulo Machado-de-Sousa
- Department of Neuroscience and Behavior, FMRP, University of Sao Paulo, Ribeirao Preto, Brazil; National Institute of Science and Technology - Translational Medicine (INCT-TM), CNPq, Brazil
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, FMRP, University of Sao Paulo, Ribeirao Preto, Brazil; National Institute of Science and Technology - Translational Medicine (INCT-TM), CNPq, Brazil
| | - Renata F Leoni
- Inbrain Lab, Department of Physics, FFCLRP, University of Sao Paulo, Ribeirao Preto, Brazil.
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31
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Zhang Y, Yang Y, Wang Z, Bian R, Jiang W, Yin Y, Yue Y, Hou Z, Yuan Y. Altered Regional Cerebral Blood Flow of Right Cerebellum Posterior Lobe in Asthmatic Patients With or Without Depressive Symptoms. Front Psychiatry 2018; 9:225. [PMID: 29892237 PMCID: PMC5985698 DOI: 10.3389/fpsyt.2018.00225] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 05/08/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Asthma is a chronic disease appeared to be associated with depression. But the underpinnings of depression in asthma remain unknown. In order to understand the neural mechanisms of depression in asthma, we used cerebral blood flow (CBF) to probe the difference between depressed asthmatic (DA) and non-depressed asthmatic (NDA) patients. Methods: Eighteen DA patients, 24 NDA patients and 57 healthy controls (HC) received pulsed arterial spin labeling (pASL) scan for measuring CBF, resting-state functional magnetic resonance imaging (rs-fMRI) scan, severity of depression and asthma control assessment, respectively. Results: Compared to NDA, DA patients showed increased regional CBF (rCBF) in the right cerebellum posterior lobe. Compared to HC, DA, and NDA patients all showed significantly decreased rCBF in the right cerebellum posterior lobe. Conclusions: We showed the first evidence of altered rCBF in the right cerebellum posterior lobe in asthma using pASL, which appeared to be involved in the neuropathology in asthma. Clinical Trial Registration: An investigation of therapeutic mechanism in asthmatic patients: based on the results of Group Cognitive Behavioral Therapy (Registration number: ChiCTR-COC-15007442) (http://www.chictr.org.cn/usercenter.aspx).
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Affiliation(s)
- Yuqun Zhang
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
| | - Yuan Yang
- Department of Respiration, ZhongDa Hospital, Southeast University, Nanjing, China
| | - Ze Wang
- Center for Cognition and Brain Disorders and the Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
| | - Rongrong Bian
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
| | - Wenhao Jiang
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
| | - Yingying Yin
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
| | - Yingying Yue
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
| | - Zhenghua Hou
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.,Institute of Psychosomatics, School of Medicine, Southeast University, Nanjing, China
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