1
|
Cao P, Chen C, Si Q, Li Y, Ren F, Han C, Zhao J, Wang X, Xu G, Sui Y. Volumes of hippocampal subfields suggest a continuum between schizophrenia, major depressive disorder and bipolar disorder. Front Psychiatry 2023; 14:1191170. [PMID: 37547217 PMCID: PMC10400724 DOI: 10.3389/fpsyt.2023.1191170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Objective There is considerable debate as to whether the continuum of major psychiatric disorders exists and to what extent the boundaries extend. Converging evidence suggests that alterations in hippocampal volume are a common sign in psychiatric disorders; however, there is still no consensus on the nature and extent of hippocampal atrophy in schizophrenia (SZ), major depressive disorder (MDD) and bipolar disorder (BD). The aim of this study was to verify the continuum of SZ - BD - MDD at the level of hippocampal subfield volume and to compare the volume differences in hippocampal subfields in the continuum. Methods A total of 412 participants (204 SZ, 98 MDD, and 110 BD) underwent 3 T MRI scans, structured clinical interviews, and clinical scales. We segmented the hippocampal subfields with FreeSurfer 7.1.1 and compared subfields volumes across the three diagnostic groups by controlling for age, gender, education, and intracranial volumes. Results The results showed a gradual increase in hippocampal subfield volumes from SZ to MDD to BD. Significant volume differences in the total hippocampus and 13 of 26 hippocampal subfields, including CA1, CA3, CA4, GC-ML-DG, molecular layer and the whole hippocampus, bilaterally, and parasubiculum in the right hemisphere, were observed among diagnostic groups. Medication treatment had the most effect on subfields of MDD compared to SZ and BD. Subfield volumes were negatively correlated with illness duration of MDD. Positive correlations were found between subfield volumes and drug dose in SZ and MDD. There was no significant difference in laterality between diagnostic groups. Conclusion The pattern of hippocampal volume reduction in SZ, MDD and BD suggests that there may be a continuum of the three disorders at the hippocampal level. The hippocampus represents a phenotype that is distinct from traditional diagnostic strategies. Combined with illness duration and drug intervention, it may better reflect shared pathophysiology and mechanisms across psychiatric disorders.
Collapse
Affiliation(s)
- Peiyu Cao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Congxin Chen
- Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Qi Si
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
- Huai’an No. 3 People’s Hospital, Huai’an, China
| | - Yuting Li
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Fangfang Ren
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Chongyang Han
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Jingjing Zhao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Xiying Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Guoxin Xu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Yuxiu Sui
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| |
Collapse
|
2
|
Alper J, Feng R, Verma G, Rutter S, Huang KH, Xie L, Yushkevich P, Jacob Y, Brown S, Kautz M, Schneider M, Lin HM, Fleysher L, Delman BN, Hof PR, Murrough JW, Balchandani P. Stress-related reduction of hippocampal subfield volumes in major depressive disorder: A 7-Tesla study. Front Psychiatry 2023; 14:1060770. [PMID: 36816419 PMCID: PMC9932898 DOI: 10.3389/fpsyt.2023.1060770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/10/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a prevalent health problem with complex pathophysiology that is not clearly understood. Prior work has implicated the hippocampus in MDD, but how hippocampal subfields influence or are affected by MDD requires further characterization with high-resolution data. This will help ascertain the accuracy and reproducibility of previous subfield findings in depression as well as correlate subfield volumes with MDD symptom scores. The objective of this study was to assess volumetric differences in hippocampal subfields between MDD patients globally and healthy controls (HC) as well as between a subset of treatment-resistant depression (TRD) patients and HC using automatic segmentation of hippocampal subfields (ASHS) software and ultra-high field MRI. METHODS Thirty-five MDD patients and 28 HC underwent imaging using 7-Tesla MRI. ASHS software was applied to the imaging data to perform automated hippocampal segmentation and provide volumetrics for analysis. An exploratory analysis was also performed on associations between symptom scores for diagnostic testing and hippocampal subfield volumes. RESULTS Compared to HC, MDD and TRD patients showed reduced right-hemisphere CA2/3 subfield volume (p = 0.01, η 2 = 0.31 and p = 0.3, η 2 = 0.44, respectively). Additionally, negative associations were found between subfield volumes and life-stressor checklist scores, including left CA1 (p = 0.041, f 2 = 0.419), left CA4/DG (p = 0.010, f 2 = 0.584), right subiculum total (p = 0.038, f 2 = 0.354), left hippocampus total (p = 0.015, f 2 = 0.134), and right hippocampus total (p = 0.034, f 2 = 0.110). Caution should be exercised in interpreting these results due to the small sample size and low power. CONCLUSION Determining biomarkers for MDD and TRD pathophysiology through segmentation on high-resolution MRI data and understanding the effects of stress on these regions can enable better assessment of biological response to treatment selection and may elucidate the underlying mechanisms of depression.
Collapse
Affiliation(s)
- Judy Alper
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Department of Biomedical Engineering, City College of New York, New York, NY, United States
| | - Rui Feng
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Gaurav Verma
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Sarah Rutter
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kuang-Han Huang
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Long Xie
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Paul Yushkevich
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Yael Jacob
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Stephanie Brown
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Marin Kautz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Molly Schneider
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Hung-Mo Lin
- Population Health Science and Policy Department, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Lazar Fleysher
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Bradley N Delman
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Patrick R Hof
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - James W Murrough
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Priti Balchandani
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| |
Collapse
|
3
|
Chibaatar E, Watanabe K, Okamoto N, Orkhonselenge N, Natsuyama T, Hayakawa G, Ikenouchi A, Kakeda S, Yoshimura R. Volumetric assessment of individual thalamic nuclei in patients with drug-naïve, first-episode major depressive disorder. Front Psychiatry 2023; 14:1151551. [PMID: 37032922 PMCID: PMC10073419 DOI: 10.3389/fpsyt.2023.1151551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Despite the previous inconsistent findings of structural and functional abnormalities of the thalamus in patients with major depressive disorder (MDD), the disruption of the thalamic nuclei in the pathophysiology of this disorder has not yet been adequately studied. Therefore, we investigated the volumetric changes of thalamic subregions and their nuclei in drug-naïve, first-episode MDD patients. We also investigated the association between HAM-D scores, a clinical scale frequently used to evaluate the severity of depression and thalamic nuclei volumes in MDD patients. Methods This study included 76 drug-naïve MDD patients and an equal number of healthy subjects. Magnetic resonance imaging (MRI) data were obtained using a 3T MR system and thalamic nuclei volumes were evaluated using FreeSurfer ver.7.11. The volumetric differences were compared by one-way analysis of covariance (ANCOVA) and to ensure that effects were not accounted for by other factors, age, sex, and ETICV variables were included as covariates. Results We observed significant volume reductions of the left whole thalamus (p < 0.003) and several thalamic nuclei mostly on the left side in the MDD group compared with healthy controls (HCs). Furthermore, we have revealed weak negative correlations between several thalamic nuclei volumes and HAM-D total and subscale scores. Discussion This is the first research study to investigate alterations of the various thalamic nuclei volumes in MDD patients compared with HCs. Moreover, we first analyzed the association between individual thalamic nuclei volumes and HAM-D subscale scores. Though our study may be restricted at certain levels, especially by the demographic difference between the two groups, they possibly contribute at a preliminary level to understanding the thalamic structural changes at its subregions in patients with drug-naïve, first-episode MDD.
Collapse
Affiliation(s)
- Enkhmurun Chibaatar
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Keita Watanabe
- Open Innovation Institute, Kyoto University, Kyoto, Japan
| | - Naomichi Okamoto
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Nasanbadrakh Orkhonselenge
- Department of Second Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tomoya Natsuyama
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Gaku Hayakawa
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Atsuko Ikenouchi
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shingo Kakeda
- Department of Radiology, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
- *Correspondence: Reiji Yoshimura,
| |
Collapse
|
4
|
Wei ZZ, Qiu B, Song X, Liu Y. Editorial: Current Status and the Need for Acute and Chronic Modulation of Brain Circuits as Interventions in Neurological and Psychiatric Disorders. Front Hum Neurosci 2022; 16:927382. [PMID: 35832874 PMCID: PMC9271917 DOI: 10.3389/fnhum.2022.927382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Zheng Z. Wei
- Department of Neurology, Beijing Friendship Hospital Center for Neurological Disorders, Beijing, China
- *Correspondence: Zheng Z. Wei
| | - Bin Qiu
- Department of Pharmacology, Yale School of Medicine, New Haven, CT, United States
| | - Xiaopeng Song
- McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, MA, United States
| | - Yuxuan Liu
- Department of Pediatrics, Stanford University, Stanford, CA, United States
- Yuxuan Liu
| |
Collapse
|
5
|
Okamoto N, Watanabe K, Tesen H, Ikenouchi A, Igata R, Konishi Y, Natsuyama T, Fujii R, Kakeda S, Kishi T, Iwata N, Yoshimura R. Volume of Amygdala Subregions and Plasma Levels of Brain-Derived Neurotrophic Factor and Cortisol in Patients with s/s Genotype of Serotonin Transporter Gene Polymorphism of First-Episode and Drug-Naive Major Depressive Disorder: An Exploratory Study. Neurol Int 2022; 14:378-390. [PMID: 35466212 PMCID: PMC9036263 DOI: 10.3390/neurolint14020031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 02/05/2023] Open
Abstract
The amygdala is a prominent region of the brain that plays a critical role in the pathophysiology of major depressive disorder (MDD). The amygdala is formed from a collection of interconnected substructures (nuclei) that relay signals from multiple brain areas, which suggests that the amygdala has different functions depending on its subregion. There are two main alleles of serotonin transporter gene polymorphism (5-HTTLPR): a 44-bp insertion (l-allele) or deletion (s-allele). The transcriptional activity of the l-allele of the gene is twice that of the s-allele. The present study aimed to investigate the association between the volume of the whole amygdala and subregions of the amygdala in 25 first-episode and drug-naive patients with MDD and 46 healthy controls (HCs) with the s/s genotype of 5-HTTLPR and plasma levels of brain-derived neurotrophic factor (BDNF) or cortisol. No significant difference was observed in the amygdala total and subregion volumes between the HC and MDD groups. No significant difference was found in the plasma levels of BDNF and cortisol between the two groups. In addition, no correlations were found between the total and subregion amygdala volume and plasma levels of cortisol or BDNF.
Collapse
Affiliation(s)
- Naomichi Okamoto
- Department of Psychiatry, Hospital of University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; (N.O.); (H.T.); (A.I.); (R.I.); (Y.K.); (T.N.); (R.F.)
- Medical Center for Dementia, Hospital of University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - Keita Watanabe
- Open Innovation Institute, Kyoto University, Kyoto 606-8501, Japan;
| | - Hirofumi Tesen
- Department of Psychiatry, Hospital of University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; (N.O.); (H.T.); (A.I.); (R.I.); (Y.K.); (T.N.); (R.F.)
| | - Atsuko Ikenouchi
- Department of Psychiatry, Hospital of University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; (N.O.); (H.T.); (A.I.); (R.I.); (Y.K.); (T.N.); (R.F.)
- Medical Center for Dementia, Hospital of University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
| | - Ryohei Igata
- Department of Psychiatry, Hospital of University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; (N.O.); (H.T.); (A.I.); (R.I.); (Y.K.); (T.N.); (R.F.)
| | - Yuki Konishi
- Department of Psychiatry, Hospital of University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; (N.O.); (H.T.); (A.I.); (R.I.); (Y.K.); (T.N.); (R.F.)
| | - Tomoya Natsuyama
- Department of Psychiatry, Hospital of University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; (N.O.); (H.T.); (A.I.); (R.I.); (Y.K.); (T.N.); (R.F.)
| | - Rintaro Fujii
- Department of Psychiatry, Hospital of University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; (N.O.); (H.T.); (A.I.); (R.I.); (Y.K.); (T.N.); (R.F.)
| | - Shingo Kakeda
- Department of Radiology, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8560, Japan;
| | - Taro Kishi
- Department of Psychiatry, Fujita Health University, Toyoake 470-1192, Japan; (T.K.); (N.I.)
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University, Toyoake 470-1192, Japan; (T.K.); (N.I.)
| | - Reiji Yoshimura
- Department of Psychiatry, Hospital of University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan; (N.O.); (H.T.); (A.I.); (R.I.); (Y.K.); (T.N.); (R.F.)
- Correspondence: ; Tel.: +81-93-691-7253
| |
Collapse
|
6
|
Natsuyama T, Okamoto N, Watanabe K, Chibaatar E, Tesen H, Hayasaki G, Ikenouchi A, Kakeda S, Yoshimura R. Gyrification patterns in first-episode, drug-naïve major depression: Associations with plasma levels of brain-derived neurotrophic factor and psychiatric symptoms. Front Psychiatry 2022; 13:1031386. [PMID: 36684011 PMCID: PMC9852994 DOI: 10.3389/fpsyt.2022.1031386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/06/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Cortical structural changes in major depressive disorder (MDD) are usually studied using a voxel-based morphometry approach to delineate the cortical gray matter volume. Among cortical structures, gyrification patterns are considered a relatively stable indicator. In this study, we investigated differences in gyrification patterns between MDD patients and healthy controls (HCs) and explored the association of gyrification patterns with plasma brain-derived neurotrophic factor (BDNF) levels and depressive symptoms in MDD patients. METHODS We evaluated 79 MDD patients and 94 HCs and assessed depression severity in the patients using the 17-item Hamilton Depression Rating Scale (HAM-D). Blood samples of both groups were collected to measure plasma BDNF levels. Magnetic resonance imaging (MRI) data were obtained using three-dimensional fast-spoiled gradient-recalled acquisition. Differences in plasma BDNF levels between groups were examined using the Mann-Whitney U test. Principal component analysis and orthogonal partial least squares discriminant analysis (OPLS-DA) were conducted to investigate the gyrification patterns which were significantly different between the groups, i.e., those with variable importance in projection (VIP) scores of >1.5 and p-value < 0.05 in multiple regression analyses adjusted for age and sex. Finally, multiple regression analysis was performed on the selected gyrification patterns to examine their association with BDNF levels in the two groups and HAM-D in the patients. RESULTS There were no significant differences in plasma BDNF levels between the groups. We found that 108 (71.0%) of 152 total local gyrification indices were MDD < HC. We identified 10 disease-differentiating factors based on critical gyrification features (VIP > 1.5 and p-value adjusted for age and sex < 0.05). However, we found no significant correlations between the 10 gyrification patterns and plasma BDNF levels and no interaction with group. Moreover, no significant correlations were observed between the local gyrification indices and HAM-D total scores. CONCLUSION These results suggest that abnormal early cortical neurodevelopment may mediate vulnerability to MDD, independent of plasma BDNF levels and depressive symptoms.
Collapse
Affiliation(s)
- Tomoya Natsuyama
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Naomichi Okamoto
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Keita Watanabe
- Open Innovation Institute, Kyoto University, Kyoto, Japan
| | - Enkhmurun Chibaatar
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hirofumi Tesen
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Gaku Hayasaki
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Atsuko Ikenouchi
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan.,Medical Center for Dementia, Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shingo Kakeda
- Department of Radiology, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
| |
Collapse
|