Associations Between Daily Mood States and Brain Gray Matter Volume, Resting-State Functional Connectivity and Task-Based Activity in Healthy Adults

The scalp prefrontal-limbic functional connectivity moderates stress-related rumination effects on stress recovery

BACKGROUND

Mood disorders are often associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction, and rumination has been implicated in delayed cortisol recovery. However, research findings on the impact of rumination on cortisol recovery have been inconsistent. The moderating effects of scalp prefrontal-limbic connections on the relationship between rumination and cortisol recovery may explain these discrepancies.

METHOD

Acute stress was induced by a 5-min simulated job interview. Salivary samples and affective ratings were collected at seven pre-determined time points. After the simulated job interview, 35 healthy adult participants were randomly assigned to either the rumination condition (n = 17) or the distraction condition (n = 18).

RESULTS

Inducing stress and rumination led to increased cortisol levels, negative mood, and state rumination. Compared with the distraction group, the rumination group displayed delayed cortisol recovery and decreased scalp prefrontal-limbic connectivities, that is, left ventrolateral prefrontal cortex (LVLPFC) and left temporal area (LTMP) [ps < .05], and right dorsolateral prefrontal cortex (RDLPFC) and anterior cingulate cortex (ACC) [ps < .05]. The relationship between rumination and cortisol recovery was moderated by connectivities between the left dorsolateral prefrontal cortex (LDLPFC) and LTMP, RDLPFC and LTMP, LDLPFC and ACC, and RDLPFC and ACC [B = -0.98 to -0.35, SE = 0.15-0.34, ps < .05]. Higher rumination combined with reduced scalp prefrontal-limbic connectivities to predict delayed cortisol recovery.

CONCLUSION

The current findings suggest that scalp prefrontal-limbic connectivity is a neural underpinning related to emotion regulation for the effects of state rumination on stress recovery. These findings also provide a potential target for non-invasive intervention in HPA axis dysregulation.

Longitudinal changes in resting state fMRI brain self-similarity of asymptomatic high school American football athletes

American football has become the focus of numerous studies highlighting a growing concern that cumulative exposure to repetitive, sports-related head acceleration events (HAEs) may have negative consequences for brain health, even in the absence of a diagnosed concussion. In this longitudinal study, brain functional connectivity was analyzed in a cohort of high school American football athletes over a single play season and compared against participants in non-collision high school sports. Football athletes underwent four resting-state functional magnetic resonance imaging sessions: once before (pre-season), twice during (in-season), and once 34-80 days after the contact activities play season ended (post-season). For each imaging session, functional connectomes (FCs) were computed for each athlete and compared across sessions using a metric reflecting the (self) similarity between two FCs. HAEs were monitored during all practices and games throughout the season using head-mounted sensors. Relative to the pre-season scan session, football athletes exhibited decreased FC self-similarity at the later in-season session, with apparent recovery of self-similarity by the time of the post-season session. In addition, both within and post-season self-similarity was correlated with cumulative exposure to head acceleration events. These results suggest that repetitive exposure to HAEs produces alterations in functional brain connectivity and highlight the necessity of collision-free recovery periods for football athletes.

Histological Study on the Thickness of Gray Matter at the Summit and Bottom of Folium in Different Age Groups of Bangladeshi People

Context The cerebellum is a part of the hindbrain and consists of cortical gray matter (GM) at the surface and a medullary core of white matter (WM). The GM contains a cell body of neurons that helps process and transmit any command type through nerve fibers found in the WM. The main functions of GM in the central nervous system empower persons to control motor activity, recollection, and passion. So, this research aims to assess the thickness of GM at the summit and bottom of folia by histologically studying the cerebellum cortex. Methods The collection of data was a descriptive type of cross-sectional study. The method was the purposive type. This study was conducted from August 2016 to March 2017, and the research was carried out at Mymensingh Medical College's Department of Anatomy, Bangladesh. Specimens containing cerebellum were preserved from Bangladeshi cadavers according to sexes and ages ranging in years. We chose fresh specimens from people who died within the last 12 hours and preserved them in 10% formol saline. The size of the tissue that was collected for the histological study was not more than 2 cm² and not more than 4-5 mm thick. Then the tissue was placed in 10% formol saline. This fluid was used for quick fixation and partial dehydration of the tissue. After dehydration, each tissue segment is processed for infiltration and embedding separately. Every section was stained with hematoxylin and eosin stain (H&E) before being coated with dibutyl phthalate polystyrene xylene (DPX) coverslips on slides. Result The mean (±SD) thickness of GM at the summit of folium was 886.2±29.7µm in Group A, 925.2±25.9µm in Group B, 912.7±22.3µm in Group C, and 839.9±40.7µm in Group D. Mean (±SD) GM thickness at the bottom of the fissure was 395.6±12.2 µm, 403.9±26.0µm, 380.4±23.4 µm, and 375.8±28.8 µm in Groups A, B, C, and D respectively. Conclusion The thickness of the cortex is an essential factor in the normal development process, and it was similar in the current study. Normal aging, Alzheimer's disease, and other dementias cause reduced GM which makes the cortical sheet thin. Huntington's disease, corticobasal degeneration, amyotrophic lateral sclerosis, and schizophrenia are all examples of neurological disorders. Cortical thinning is typically locally localized, and the progression of atrophy can thus disclose much about a disease's history and causal variables. The present study correspondingly found that GM was reduced after the age of 50 years onward. Furthermore, longitudinal investigations of cortical atrophy have the potential to be extremely useful in measuring the efficacy of a wide range of treatments.

Triple network model of brain connectivity changes related to adverse mood effects in an oral contraceptive placebo-controlled trial

Combined oral contraceptives (COC) are among the most commonly used contraceptive methods worldwide, and mood side effects are the major reason for discontinuation of treatment. We here investigate the directed connectivity patterns associated with the mood side effects of an androgenic COC in a double-blind randomized, placebo-controlled trial in women with a history of affective COC side effects (n = 34). We used spectral dynamic causal modeling on a triple network model consisting of the default mode network (DMN), salience network (SN) and executive control network (ECN). Within this framework, we assessed the treatment-related changes in directed connectivity associated with adverse mood side effects. Overall, during COC use, we found a pattern of enhanced connectivity within the DMN and decreased connectivity within the ECN. The dorsal anterior cingulate cortex (SN) mediates an increased recruitment of the DMN by the ECN during treatment. Mood lability was the most prominent COC-induced symptom and also arose as the side effect most consistently related to connectivity changes. Connections that were related to increased mood lability showed increased connectivity during COC treatment, while connections that were related to decreased mood lability showed decreased connectivity during COC treatment. Among these, the connections with the highest effect size could also predict the participants' treatment group above chance.

Neural underpinnings of expecting alcohol: Placebo alcohol administration alters nucleus accumbens resting state functional connectivity

BACKGROUND

Using balanced placebo designs, seminal alcohol administration research has shown individuals' beliefs about whether they have consumed alcohol, irrespective of the actual presence of alcohol, can determine level of alcohol consumption and impact social behavior. Despite the known effect of expecting alcohol on drinking behavior, few studies have used the placebo manipulation to directly investigate the neural underpinnings of the expectancy-related effects that occur following perceived alcohol consumption in humans. The present paper examined placebo responses in the laboratory to better understand the neural basis for the psychological phenomenon of expectancies.

METHODS

As part of a larger within-subjects study design, healthy young adults (N = 22, agemean+SD=23 +1) completed resting state fMRI scans and measures of subjective response before and after consuming placebo beverages. Effect of placebo beverage consumption (pre- versus post-beverage consumption) on functional connectivity within prefrontal cortical networks was examined using the CONN Toolbox. Relations between perceived subjective response to alcohol with functional connectivity response following placebo beverage consumption were examined.

RESULTS

Compared to pre-beverage scan, placebo beverage consumption was associated with increased positive functional connectivity between right nucleus accumbens - ventromedial prefrontal cortex and subcallosal cingulate cortex (pFDR<0.05). Subjective ratings of intoxication (i.e., feeling 'drunk') positively correlated with placebo beverage-related increases in nucleus accumbens - subcallosal cingulate cortex functional connectivity.

CONCLUSION

Results suggest placebo response to alcohol is associated with increased functional connectivity within a key reward network (nucleus accumbens - ventromedial prefrontal cortex and subcallosal cingulate cortex) and put forth a mechanism by which alcohol expectancies may contribute to the subjective experience of intoxication.

The brain at rest: Exploratory Neurophysiological Findings Among Men With Histories of Childhood Sexual Abuse

Purpose

There is a lack of research on childhood sexual abuse (CSA) experienced by men, with even less research examining long term neurophysiological repercussions. This study explored the neurophysiology of the brain at rest to examine the influence of CSA on resting state functional connectivity (RSFC) into adulthood.

Methods

RSFC was examined with functional magnetic resonance imaging (fMRI) within the default mode, salience and limbic networks in men with CSA histories, with and without post-traumatic stress disorder (PTSD; CSA + PTSD n = 7, CSA-PTSD n = 9), and men without a CSA history nor PTSD (n = 13).

Results

CSA + PTSD participants had increased functional connectivity (FC) in the medial prefrontal cortex (mPFC) from the default mode network seed compared to participants with CSA-PTSD. Both CSA groups showed significantly less FC in the striatal-thalamic circuits of the salience network than the control group. Similarly, the robust FC between the bilateral amygdalae and the mPFC that was notable in control participants, was not exhibited in participants who experienced CSA with or without PTSD histories.

Conclusions

These findings demonstrate that intrinsic neurophysiological differences in limbic, salience and default mode network connectivity are apparent even during a resting state between the groups of participants. This is preliminary evidence of long-term neurophysiological effects of CSA in men with PTSD, and even in those without. Importantly, these findings can validate the lived experiences of males with CSA histories and guide researchers and clinicians to potential avenues to support their well-being.

Coping drinking motives, neural functional coupling during emotion processing, and alcohol use in young adults with bipolar disorder

BACKGROUND

Rates of alcohol use disorders in individuals with bipolar disorder are 3 to 5 times greater than in the general population and exceed rates of alcohol use disorders reported in other affective and anxiety disorders. Despite this high rate of comorbidity, our understanding of the psychosocial and neural mechanisms that underlie the initiation of alcohol misuse in young adults with bipolar disorder remains limited. Prior work suggests that individuals with bipolar disorder may misuse alcohol as a coping mechanism, yet the neural correlates of coping drinking motives and associated alcohol use have not been previously investigated in this population.

METHODS

Forty-eight young adults (22 bipolar disorder type I, 26 typically developing; 71% women; average age ± standard deviation = 22 ± 2 years) completed the Drinking Motives and Daily Drinking Questionnaires, and a Continuous Performance Functional magnetic resonance imaging (fMRI) Task with Emotional and Neutral Distracters. We calculated the relative difference in anterior cingulate cortex (ACC) functional coupling with the anterior insula and amygdala in response to emotional distracters compared with neutral stimuli and investigated the relations with coping drinking motives and alcohol use.

RESULTS

Across all participants, coping drinking motives were associated with greater quantity of recent alcohol use. In individuals with bipolar disorder, greater ACC-anterior insula functional coupling was associated with greater coping drinking motives, and greater quantity and frequency of recent alcohol use. The relative difference in ACC-anterior insula functional coupling was not associated with coping drinking motives or alcohol use in the typically developing group. Greater ACC-anterior insula functional coupling in individuals with bipolar disorder was also associated with greater anxiety symptoms and recent perceived psychological stress. Exploratory analyses suggest that the relations between ACC-anterior insula functional coupling and coping drinking motives may be confounded by anticonvulsant use.

CONCLUSION

Results suggest that a difference in ACC-anterior insula functional coupling during emotion processing may underlie alcohol use as a maladaptive coping mechanism in young adults with bipolar disorder.

Neural functional connectivity changes to psychosocial stress in young adults with bipolar disorder and preliminary associations with clinical trajectories

BACKGROUND

Stress-related mechanisms are implicated in the pathophysiology of bipolar disorder and may contribute to heterogeneity in illness course. Yet, there is a lack of study investigating the neural mechanisms underlying the stress response in this condition. This study investigated changes in amygdala activation and functional connectivity in response to acute psychosocial stress in young adults with bipolar disorder and explored relations with clinical phenotype and prospective mood symptoms.

METHODS

42 young adults [19 with bipolar disorder, age_mean  ± SD =21.4 ± 2.2 years] completed a modified version of the Montreal Imaging Stress Task. Amygdala activation and functional connectivity with prefrontal cortex (PFC) regions of interest was calculated for control and stress conditions. Main effects of group, condition, and group by condition interaction on amygdala activation and connectivity were modeled. A subset of bipolar participants completed 1-year follow-up assessments. Relations between neural responses to stress with concurrent substance use and prospective mood symptoms were explored.

RESULTS

There were no between-group differences in amygdala activation or functional connectivity during the control condition. Increased right amygdala-right rostral PFC (rPFC) functional connectivity to stress was observed in bipolar disorder, compared to typically developing controls. In bipolar disorder, greater increase in right amygdala-right rPFC functional connectivity to stress was associated with less frequent cannabis use, and prospectively with shorter duration and lower severity of depression symptoms over follow-up.

CONCLUSION

Results from this preliminary study suggest differences in frontolimbic functional connectivity responses to stress in young adults with bipolar disorder and associations with cannabis use and prospective mood symptoms.

Shared genetic effects of emotion and subcortical volumes in healthy adults

Ample studies have reported a strong association between emotion and subcortical volumes; still, the underlying mechanism regarding this relation remains unclear. Using a twin design, the current study aimed to explore the intrinsic association between emotion and subcortical volumes by examining their phenotypic, genetic, and environmental correlations. We used a group dataset of 960 individuals from the Human Connectome Project (234 monozygotic twins, 145 dizygotic twins, 581 not twins, males = 454, age = 22-37 years). We found that both emotion and subcortical volumes were heritable. Of the 17 emotional traits, 13 were significantly phenotypically correlated with the volumes of multiple subcortical regions. There was no environmental correlation between emotion and subcortical volumes; however, we found a genetic overlap between overall emotional traits and caudate volume. Taken together, our results showed that emotion and subcortical volumes were heritable and closely related. Although the caudate has been often studied with execution of movement, given that the caudate volume is genetically associated with diverse emotional domains, such as negative affect, psychological well-being, and social relationships, it may suggest that the caudate volume might also be an important factor when studying the brain basis of emotion.

Stronger functional network connectivity and social support buffer against negative affect during the COVID-19 outbreak and after the pandemic peak

Health and financial uncertainties, as well as enforced social distancing, during the COVID-19 pandemic have adversely affected the mental health of people. These impacts are expected to continue even after the pandemic, particularly for those who lack support from family and friends. The salience network (SN), default mode network (DMN), and frontoparietal network (FPN) function in an interconnected manner to support information processing and emotional regulation processes in stressful contexts. In this study, we examined whether functional connectivity of the SN, DMN, and FPN, measured using resting-state functional magnetic resonance imaging before the pandemic, is a neurobiological marker of negative affect (NA) during the COVID-19 pandemic and after its peak in a large sample (N = 496, 360 females); the moderating role of social support in the brain-NA association was also investigated. We found that participants reported an increase in NA during the pandemic compared to before the pandemic, and the NA did not decrease, even after the peak period. People with higher connectivity within the SN and between the SN and the other two networks reported less NA during and after the COVID-19 outbreak peak, and the buffer effect was stronger if their social support was greater. These findings suggest that the functional networks that are responsible for affective processing and executive functioning, as well as the social support from family and friends, play an important role in protecting against NA under stressful and uncontrollable situations.

The neuroanatomical correlates of repetitive negative thinking: A systematic review

Repetitive negative thinking (RNT) is a cognitive process characterised by intrusive, repetitive, and difficult-to-disengage-from negative thoughts. Heightened RNT levels are prevalent across clinical disorders and have been associated with ill-health (e.g. cardiovascular disease), even at lower, non-clinical levels. Identifying the neuroanatomical correlates of RNT could help characterise structural alterations that transcend diagnostic boundaries and further understanding of the pathogenesis of clinical disorders. We therefore conducted a systematic review to investigate associations between RNT and brain morphology. Following title/abstract and full-text screening, 24 studies were included. We found evidence that RNT severity is associated with grey and white matter volumes/microstructure, particularly in the dorsolateral prefrontal cortex, anterior cingulate cortex and superior longitudinal fasciculus, regions heavily implicated in cognitive control, and emotional processing and regulation. However, inconsistent associations, potentially due to the heterogeneity of included studies (e.g. methodological differences, type of RNT assessed), preclude specific conclusions being reached regarding any one region's association with RNT. Further, given the defuse nature of thoughts, it may be that RNT is associated with distributed brain regions operating within large-scale networks, rather than with a single structure. High quality longitudinal studies, investigating structural networks, are required to confirm the neuroanatomical basis of RNT and elucidate the direction of relationships.

Variation in rostral anterior cingulate functional connectivity with amygdala and caudate during first manic episode distinguish bipolar young adults who do not remit following treatment

OBJECTIVES

Altered activity in the ventrolateral prefrontal and anterior cingulate cortices, as well as subcortical and amygdala projection sites, was previously reported during a first manic episode in youth with bipolar disorder and observed to be associated with treatment response. To extend these findings, we investigated functional connectivity among these regions in first-episode manic participants who remitted after 8 weeks of treatment compared to those who did not.

METHODS

Forty-two participants with bipolar disorder (60% female) during their first manic episode were recruited and received 8 weeks of treatment. Twenty-one remitted following treatment. Participants completed fMRI scans, at baseline and following 8 weeks of treatment, while performing a continuous performance task with emotional and neutral distractors. A healthy comparison group (n = 41) received fMRI evaluations at the same intervals. Differences in functional connectivity of the amygdala and caudate with the rostral anterior cingulate and ventrolateral prefrontal cortices at baseline (and changes in functional connectivity following treatment) were modeled between groups.

RESULTS

At baseline, non-remitters showed an increase in positive connectivity between right anterior cingulate and caudate and a loss of negative connectivity between right anterior cingulate and amygdala, compared to healthy participants. Individuals who remitted following treatment showed an increase in negative connectivity between amygdala and left anterior cingulate 8 weeks following treatment.

CONCLUSIONS

Results provide evidence of alterations in anterior cingulate amygdala and caudate functional connectivity in bipolar disorder non-remitters during a first manic episode and changes in anterior cingulate functional connectivity associated with remission suggesting targets to predict treatment response. Registered at ClinicalTrials.Gov; Functional and Neurochemical Brain Changes in First-episode Bipolar Mania. NCT00609193. URL: https://clinicaltrials.gov/ct2/show/NCT00609193?term=strakowskirank=1.

Brain Anatomical Mediators of GRIN2B Gene Association with Attention/Hyperactivity Problems: An Integrated Genetic-Neuroimaging Study

This study aims to investigate the genetic and neural determinants of attention and hyperactivity problems. Using a proof-of-concept imaging genetics mediation design, we explore the relationship between the glutamatergic GRIN2B gene variants and inattention/hyperactivity with neuroanatomical measures as intermediates. Fifty-eight children and adolescents were evaluated for behavioral problems at three time points over approximately 7 years. The final assessment included blood drawing for genetic analyses and 3T magnetic resonance imaging. Attention/hyperactivity problems based on the Child Behavior Checklist/6-18, six GRIN2B polymorphisms and regional cortical thickness, and surface area and volume were estimated. Using general linear model (GLM) and mediation analyses, we tested whether GRIN2B exerted an influence on stable inattention/hyperactivity over development, and to what extent this effect was mediated by brain morphology. GLM results enlightened the relation between GRIN2B rs5796555-/A, volume in the left cingulate isthmus and inferior parietal cortices and inattention/hyperactivity. The mediation results showed that rs5796555-/A effect on inattention/hyperactivity was partially mediated by volume in the left isthmus of the cingulate cortex, suggesting a key role of this region in translating glutamatergic GRIN2B variations to attention/hyperactivity problems. This evidence can have important implications in the management of neurodevelopmental and psychiatric disorders.

Reliability modelling of resting-state functional connectivity

Resting-state functional magnetic resonance imaging (rs-fMRI) has an inherently low signal-to-noise ratio largely due to thermal and physiological noise that attenuates the functional connectivity (FC) estimates. Such attenuation limits the reliability of FC and may bias its association with other traits. Low reliability also limits heritability estimates. Classical test theory can be used to obtain a true correlation estimate free of random measurement error from parallel tests, such as split-half sessions of a rs-fMRI scan. We applied a measurement model to split-half FC estimates from the resting-state fMRI data of 1003 participants from the Human Connectome Project (HCP) to examine the benefit of reliability modelling of FC in association with traits from various domains. We evaluated the efficiency of the measurement model on extracting a stable and reliable component of FC and its association with several traits for various sample sizes and scan durations. In addition, we aimed to replicate our previous findings of increased heritability estimates when using a measurement model in a longitudinal adolescent twin cohort. The split-half measurement model improved test-retest reliability of FC on average with +0.33 points (from +0.49 to +0.82), improved strength of associations between FC and various traits on average 1.2-fold (range 1.09-1.35), and increased heritability estimates on average with +20% points (from 39% to 59%) for the full HCP dataset. On average, about half of the variance in split-session FC estimates was attributed to the stable and reliable component of FC. Shorter scan durations showed greater benefit of reliability modelling (up to 1.6-fold improvement), with an additional gain for smaller sample sizes (up to 1.8-fold improvement). Reliability modelling of FC based on a split-half using a measurement model can benefit genetic and behavioral studies by extracting a stable and reliable component of FC that is free from random measurement error and improves genetic and behavioral associations.

Birth weight is associated with adolescent brain development: A multimodal imaging study in monozygotic twins

Previous research has shown that the prenatal environment, commonly indexed by birth weight (BW), is a predictor of morphological brain development. We previously showed in monozygotic (MZ) twins associations between BW and brain morphology that were independent of genetics. In the present study, we employed a longitudinal MZ twin design to investigate whether variations in prenatal environment (as indexed by discordance in BW) are associated with resting‐state functional connectivity (rs‐FC) and with structural connectivity. We focused on the limbic and default mode networks (DMNs), which are key regions for emotion regulation and internally generated thoughts, respectively. One hundred and six healthy adolescent MZ twins (53 pairs; 42% male pairs) followed longitudinally from birth underwent a magnetic resonance imaging session at age 15. Graph theoretical analysis was applied to rs‐FC measures. TrackVis was used to determine track count as an indicator of structural connectivity strength. Lower BW twins had less efficient limbic network connectivity as compared to their higher BW co‐twin, driven by differences in the efficiency of the right hippocampus and right amygdala. Lower BW male twins had fewer tracks connecting the right hippocampus and right amygdala as compared to their higher BW male co‐twin. There were no associations between BW and the DMN. These findings highlight the possible role of unique prenatal environmental influences in the later development of efficient spontaneous limbic network connections within healthy individuals, irrespective of DNA sequence or shared environment.

Transient effects of multi-infusion ketamine augmentation on treatment-resistant depressive symptoms in patients with treatment-resistant bipolar depression - An open-label three-week pilot study

INTRODUCTION

While the psychiatric benefits of ketamine have been verified through clinical trials, there is limited information about ketamine augmentation in patients with treatment-resistant bipolar depression (TRBPD). Hence, in the present study, we investigate the therapeutic efficacy and functional brain alterations associated with multi-infusion ketamine augmentation in patients with TRBPD.

METHODS

The present three-week study included 38 patients with TRBPD, all of whom received a series of nine ketamine injections over the study period. The Hamilton Depression Rating Scale (HAMD) was used to assess the effects of multi-infusion ketamine combined with mood stabilizers. Brain function was evaluated by global functional connectivity density (gFCD).

RESULTS

Adjunctive treatment with multiple infusions of ketamine, when combined with a mood stabilizer, could effectively alleviate depressive symptoms for one week, yet the symptoms began to relapse during the second week. Functional brain alterations were detected via gFCD. Specifically, gFCD reductions were mainly found in the bilateral insula, right caudate nucleus, and bilateral inferior frontal gyrus, while increased gFCD was mainly located in the bilateral postcentral gyrus, subgenual anterior cingulate cortex, bilateral thalamus, and cerebellum. Although gFCD alterations were sustained for up to three weeks after the first ketamine infusion, the antidepressant effects of ketamine augmentation sharply declined from the end of the second week of treatment.

CONCLUSIONS

Multi-infusion ketamine augmentation can rapidly alleviate depressive symptoms in patients with TRBPD. The clinical effects were primarily visible in the first week after treatment and partially sustained for two weeks; however, the therapeutic effects and related functional brain alterations sharply decreased from the end of the second week. Based on these findings, we demonstrated that the clinical efficacy and functional brain alterations induced by ketamine augmentation are transient.

DNA methylation differences in stress-related genes, functional connectivity and gray matter volume in depressed and healthy adolescents

BACKGROUND

Studies in adult depressed patients have indicated that altered DNA methylation patterns at genes related to serotonin and HPA axis functioning (e.g., SLC6A4, FKBP5) are associated with changes in frontolimbic functional connectivity and structure. Here, we examined whether these associations can be generalized to adolescents.

METHODS

25 adolescents with depression (Mean age = 15.72 ± 0.94 SD; 20 girls) and 20 healthy controls (Mean age = 16.05 ± 1.5 SD; 16 girls) underwent a functional and structural magnetic resonance imaging protocol, which included a resting-state assessment and measures of brain morphometry. DNA was obtained from saliva. Levels of SLC6A4 and FKBP5 methylation were determined using pyrosequencing.

RESULTS

SLC6A4 methylation was linked to amygdala-frontal operculum resting-state functional connectivity (rs-FC), regardless of diagnosis, and was differentially associated with inferior orbitofrontal gyrus (IFOG) gray matter (GM) volume in adolescents with depression and controls. Replicating and extending previous findings in adults, FKBP5 methylation was associated with IFOG GM volume in depressed and healthy adolescents, as well as orbitofrontal cortex (OFC)-rostral prefrontal cortex (RPFC) connectivity in healthy adolescents only.

LIMITATIONS

Effects of medication use or genotype cannot be ruled out. Further, the relatively small sample size and predominately female sample may limit generalizability.

CONCLUSIONS

These findings suggest that previously observed associations between SLC6A4 and FKBP5 methylation and frontolimbic processes in adult depressed patients can be in part generalized to adolescent patients. Further, findings suggest that measuring peripheral methylation at these genes deserves further attention as potential markers of typical and atypical development.

Adjunct ketamine treatment of depression in treatment-resistant schizophrenia patients is unsatisfactory in pilot and secondary follow-up studies

OBJECTIVE

To investigate the effects of adjunct ketamine treatment on chronic treatment-resistant schizophrenia patients with treatment-resistant depressive symptoms (CTRS-TRD patients), including alterations in brain function.

METHODS

Intravenous ketamine (0.5 mg/kg body weight) was administered to CTRS-TRD patients over a 1-hr period on days 1, 4, 7, 10, 13, 16, 19, 22, and 25 of our initial pilot study. This treatment method was subsequently repeated 58 days after the start of the pilot study for a secondary follow-up study. Calgary Depression Scale for Schizophrenia (CDSS), Positive and Negative Syndrome Scale (PANSS), and regional homogeneity (ReHo) results were used to assess treatment effects and alterations in brain function throughout the entire duration of our studies.

RESULTS

Between day 7 and day 14 of the first treatment, CDSS scores were reduced by 63.8% and PANSS scores were reduced by 30.04%. In addition, ReHo values increased in the frontal, temporal, and parietal lobes. However, by day 21, depressive symptoms relapsed. During the second treatment period, CDSS and PANSS scores exhibited no significant differences compared to baseline between day 58 and day 86. On day 65, ReHo values were higher in the temporal, frontal, and parietal lobes. However, on day 79, the increase in ReHo values completely disappeared.

CONCLUSIONS

Depressive symptoms in CTRS-TRD patients were alleviated with adjunct ketamine treatment for only 1 week during the first treatment period. Moreover, after 1 month, the antidepressant effects of ketamine on CTRS-TRD patients completely disappeared. Correspondingly, ReHo alterations induced by ketamine in the CTRS-TRD patients were not maintained for more than 3 weeks. These pilot findings indicate that adjunct ketamine treatment is not satisfactory for CTRS-TRD patients.

Anterior hippocampal volume predicts affect-focused psychotherapy outcome

BACKGROUND

The hippocampus plays an important role in psychopathology and treatment outcome. While posterior hippocampus (PH) may be crucial for the learning process that exposure-based treatments require, affect-focused treatments might preferentially engage anterior hippocampus (AH). Previous studies have distinguished the different functions of these hippocampal sub-regions in memory, learning, and emotional processes, but not in treatment outcome. Examining two independent clinical trials, we hypothesized that anterior hippocampal volume would predict outcome of affect-focused treatment outcome [Interpersonal Psychotherapy (IPT); Panic-Focused Psychodynamic Psychotherapy (PFPP)], whereas posterior hippocampal volume would predict exposure-based treatment outcome [Prolonged Exposure (PE); Cognitive Behavioral Therapy (CBT); Applied Relaxation Training (ART)].

METHODS

Thirty-five patients with posttraumatic stress disorder (PTSD) and 24 with panic disorder (PD) underwent structural magnetic resonance imaging (MRI) before randomization to affect-focused (IPT for PTSD; PFPP for PD) or exposure-based treatments (PE for PTSD; CBT or ART for PD). AH and PH volume were regressed with clinical outcome changes.

RESULTS

Baseline whole hippocampal volume did not predict post-treatment clinical severity scores in any treatment. For affect-focused treatments, but not exposure-based treatments, anterior hippocampal volume predicted clinical improvement. Smaller AH correlated with greater affect-focused treatment improvement. Posterior hippocampal volume did not predict treatment outcome.

CONCLUSIONS

This is the first study to explore associations between hippocampal volume sub-regions and treatment outcome in PTSD and PD. Convergent results suggest that affect-focused treatment may influence the clinical outcome through the 'limbic' AH, whereas exposure-based treatments do not. These preliminary, theory-congruent, therapeutic findings require replication in a larger clinical trial.

Using ambulatory assessment to measure dynamic risk processes in affective disorders

BACKGROUND

Rapid advances in the capability and affordability of digital technology have begun to allow for the intensive monitoring of psychological and physiological processes associated with affective disorders in daily life. This technology may enable researchers to overcome some limitations of traditional methods for studying risk in affective disorders, which often (implicitly) assume that risk factors are distal and static - that they do not change over time. In contrast, ambulatory assessment (AA) is particularly suited to measure dynamic "real-world" processes and to detect fluctuations in proximal risk for outcomes of interest.

METHOD

We highlight key questions about proximal and distal risk for affective disorders that AA methods (with multilevel modeling, or fully-idiographic methods) allow researchers to evaluate.

RESULTS

Key questions include between-subject questions to understand who is at risk (e.g., are people with more affective instability at greater risk than others?) and within-subject questions to understand when risk is most acute among those who are at risk (e.g., does suicidal ideation increase when people show more sympathetic activation than usual?). We discuss practical study design and analytic strategy considerations for evaluating questions of risk in context, and the benefits and limitations of self-reported vs. passively-collected AA.

LIMITATIONS

Measurements may only be as accurate as the observation period is representative of individuals' usual life contexts. Active measurement techniques are limited by the ability and willingness to self-report.

CONCLUSIONS

We conclude by discussing how monitoring proximal risk with AA may be leveraged for translation into personalized, real-time interventions to reduce risk.

Empirical examination of the replicability of associations between brain structure and psychological variables

Linking interindividual differences in psychological phenotype to variations in brain structure is an old dream for psychology and a crucial question for cognitive neurosciences. Yet, replicability of the previously-reported 'structural brain behavior' (SBB)-associations has been questioned, recently. Here, we conducted an empirical investigation, assessing replicability of SBB among heathy adults. For a wide range of psychological measures, the replicability of associations with gray matter volume was assessed. Our results revealed that among healthy individuals 1) finding an association between performance at standard psychological tests and brain morphology is relatively unlikely 2) significant associations, found using an exploratory approach, have overestimated effect sizes and 3) can hardly be replicated in an independent sample. After considering factors such as sample size and comparing our findings with more replicable SBB-associations in a clinical cohort and replicable associations between brain structure and non-psychological phenotype, we discuss the potential causes and consequences of these findings.

Self-Awareness of Psychopathology and Brain Volume in Patients With First Episode Psychosis

Memory impairment, excessive rumination, and increased interpersonal sensitivity are major characteristics of high psychosis risk or first episode psychosis (FEP). Herein, we investigated the relationship between brain volume and self-awareness of psychopathology in patients with FEP. All participants (FEP: 34 and HCs: 34) completed clinical assessments and the following self-reported psychopathology evaluations: prospective and retrospective memory questionnaire (PRMQ), ruminative response scale (RRS), and interpersonal sensitivity measure (IPSM). Structural magnetic resonance imaging was then conducted. The PRMQ, RRS, and IPSM scores were significantly higher in the FEP group than in the healthy controls (HCs). The volumes of the amygdala, hippocampus, and superior temporal gyrus (STG) were significantly lower in the FEP group than in the HCs. There was a significant group-dependent moderation effect between self-awareness of psychopathology (PRMQ, RRS, and IPSM scores) and right STG (rSTG) volume. In the FEP group, self-awareness of psychopathology was positively associated with rSTG volume, while in the HCs, this correlation was negative. Our results indicate that self-awareness of psychopathology impacts rSTG volume in the opposite direction between patients with FEP and HCs. In patients with FEP, awareness of impairment may induce increases in rSTG brain volume. However, HCs showed decreased rSTG volume when they were aware of impairment.